Towards an understanding of the genus Glutinoglossum with emphasis on the Glutinoglossum glutinosum species complex (Geoglossaceae, Ascomycota).

Glutinoglossum is one of the earth tongue genera with viscid or glutinous ascocarps. Based on morphology and ITS1-5.8S-ITS2, nrLSU and tef1 sequence data, seven new species are described: G. circinatum, G. lumbricale, G. orientale, G. peregrinans, G. proliferatum, G. pseudoglutinosum, and G. triseptatum. The lectotypes for Geoglossum glutinosum var. lubricum and for Geoglossum glabrum var. majus as well as the epitype for Glutinoglossum glutinosum are designated. The comprehensive morphological study of G. heptaseptatum resulted in the discovery of ascospores germinating by conidia inside the asci, which is first noted for Glutinoglossum species. The status of Cibalocoryne is discussed.

Practical application of bicultural stocking and its effects on fish growth, blood biochemistry, and solid waste elimination in recirculating aquaculture system.

Traditional monoculture systems often face challenges related to solid waste production and nutrient use. This study addresses these concerns by investigating the impact of bicultural farming of burbot (Lota lota) and rainbow trout (Oncorhynchus mykiss) in a recirculating aquaculture system (RAS) and the subsequent alteration of production of solid waste, growth and physiological status. The rationale behind incorporating burbot lies in its potential as a supplementary species to improve overall system efficiency and sustainability. The experimental groups in triplicate represented the different ratios of rainbow trout (T) and burbot (B) in the stock: T70/B30, T85/B15 and T100/B0. Burbot, although not assessed in monoculture due to its limited commercial significance, was incorporated into the study as a supplementary species, expected to enhance the nutrient utilisation through its bottom-feeding behaviour and anticipated consumption of solid waste produced by trout. After 77 days of culture, the survival rates of trout remained consistent across experimental groups, averaging over 99%, while burbot exhibited comparable survival rates despite lower cumulative survival, averaging 88%. Feed conversion ratios showed no significant differences between the groups, indicating consistent feed utilisation. A significantly higher specific growth rate (SGR) in trout was observed in group T70/B30. The SGR values of burbot were marginally low and without significant differences between groups. Among biochemical markers of blood plasma, phosphorus concentrations were significantly higher in group T70/B30 for both trout and burbot, suggesting better access to the feed for both species. Elevated antioxidant activity and evidence of oxidative stress were found for both species in intestinal tissue. The presence of burbot in stock significantly affected the production of suspended solids per gram of applied feed. Therefore, group T100/B0 demonstrated the highest solid production at multiple time points, suggesting a relationship between burbot presence and the production of suspended solids. Starting at the 9-week, the trout monoculture group exhibited significantly higher phosphorus levels in sediments compared to group T70/B30, emphasising the role of burbot in shaping sediment nutrient dynamics in RAS, such as supplementary cleaning fish. After 11 weeks, group T100/B0 displayed significantly higher values of produced suspended solids and their composition: DM, organic DM, and phosphorus content per gram of feed applied. These results provide evidence of the influence of burbot on suspended solids production and characteristics. In conclusion, this study indicates the positive effects of burbot presence on solid production and sediment nutrient composition.

Nitrogen balance, 3-methylhistidine excretion, and plasma amino acid profile in infants after cardiac operations for congenital heart defects: the effect of early nutritional support.

OBJECTIVE: The objective of this study was to evaluate the effect of nutritional support on proteolysis and plasma amino acid profile in infants early after cardiac operations for congenital heart defects. METHODS: Thirty-seven patients, 2 to 12 months old, were randomized on postoperative day 1 for 24-hour isocaloric metabolic study. Group STANDARD (18 patients) received glucose as the maintenance fluid, and group PN (19 patients) received glucose and crystalloid amino acid solution at a dosage of 0.8 +/- 0.1 gm/kg per day. The nonprotein caloric intake in the two groups was 25 +/- 15 and 33 +/- 9 kcal/kg, respectively (p = not significant). RESULTS: The nitrogen balance was markedly less negative in group PN than in group STANDARD (-114 +/- 81 vs -244 +/- 86 mg/kg, respectively, p = 0.001). There was a highly significant inverse correlation between the nitrogen balance and urinary 3-methylhistidine excretion in both groups, but the muscle proteolysis was blunted more effectively in patients receiving amino acids. Concentrations of the plasmatic branched-chain amino acids, alanine, glycine, and proline, decreased significantly in group STANDARD but not in group PN on postoperative day 2. Glutamine and threonine levels declined significantly on postoperative day 2 in both groups. Low levels of arginine were observed in our patients before operation and in the early postoperative period. The amino acid concentrations normalized on postoperative day 7 in all patients. CONCLUSION: Significant proteolysis and hypoaminoacidemia were observed in infants early after cardiac operations. This hypercatabolic response was blunted by parenteral nutritional support.

Minimisation of priming volume and blood saving in paediatric cardiac surgery.

We started a programme of donor blood reduction for open heart surgery in children in 1983. At first, only meticulous surgical and perfusion techniques were used. Later, increased haemodilution was added. Miniaturisation of the perfusion circuit and introduction of blood taken prior from the patient further decreased donor blood requirements. In 1989, we used 0.89 l per patient compared to 3.2 l per patient in 1983. Miniaturisation of the circuit was tested in a pilot study on 30 children undergoing the Senning operation in 1988. Priming volume was reduced from 661 +/- 72 ml to 421 +/- 62 ml. In 1989, 167 out of 194 children (86%) received a clear prime. Ninety-seven of 100 children whose weight was over 15 kg received a clear prime: 55 did not require subsequent transfusion. Prime miniaturisation and autotransfusion can considerably reduce blood requirements for open heart surgery.

A role of autoimmunity in the etiopathogenesis of Landau-Kleffner syndrome?

Four children, 3 boys and 1 girl, with the syndrome of acquired aphasia Landau-Kleffner were followed up during the last 10 years. In 3 children an episodic form of the disease with a good response to corticosteroid treatment and with a favourable prognosis was observed. In the other 1 no improvement of speech function was observed and also epileptic fits were reduced only with difficulty. A positive autoimmune reaction to central (MOZAN) and peripheral (LISAN) myelin was observed repeatedly during the attacks of clinical worsening. On the contrary, during the periods of improvement of language disturbances during the treatment with corticosteroids this hypersensitivity to central as well as peripheral myelin disappeared. Possible changes in myelinization and the role of autoimmune reactions in the etiopathogenesis of the disease are discussed.

Erdheim-Chester disease.

A new case of Erdheim-Chester lipoid granulomatosis is described in a 40-year-old man. In this lipid storage disease, characteristic symmetrical osteosclerotic areas are observed mainly in metadiaphyses of long tubular bones. Bone biopsy is mandatory for definite diagnosis, although characteristic radiographic pictures often provide an important clue to the correct diagnosis.

The role of the neonatal intensive care nurse in the delivery room.

The experienced Neonatal Intensive Care Unit (NICU) nurse is a crucial member of the delivery room resuscitation team. In a survey of tertiary centers, the neonatal nurse was the most consistent member of the team in attendance at high risk deliveries. This nursing role, including rationale, preparation for, and future potential, is explored in this article.

Primary repair of interrupted aortic arch and associated heart lesions in newborns.

Primary repair of interrupted aortic arch and associated heart lesions was performed in 13 patients aged from 1 to 85 days. The surgery was performed through the midline sternotomy approach in extracorporeal circulation and deep hypothermia. Hypothermic circulatory arrest at 14 to 19 degrees C was used for reconstruction of the aortic arch. In all patients it was possible to perform a direct anastomosis between the ascendent and descendent aorta. At the same time closure of the ventricular septal defect was performed in 11 patients, closure of the atrial septal defect in 4, correction of persistent truncus arteriosus in 3, resection of subaortic stenosis in 2, arterial switch repair of transposition of the great arteries in 1, correction of double outlet right ventricle in 1 and patch closure of aortico-pulmonary window in 1 patient. Three (23.1%) newborns died in the early postoperative period: two from sepsis and one from multiple organ failure. Ten patients (76.9%) were followed up for 1 to 29 months postoperatively. All of them are in very good condition with a nonrestrictive aortic anastomosis. Primary one-stage repair of interrupted aortic arch and associated heart lesions is preferred to the two-stage repair in all newborns with this critical congenital heart disease.

[Is lithium a teratogen?]. / Je lithium teratogenem?

Beginning with the seventies literature has brought a series of publications drawing attention to possible effects of lithium on the origin of congenital malformations. The discussion on the teratogenic effects of lithium in world literature has not come to final conclusion yet. The paper reviews some knowledge from home and foreign literature, dealing with the problems of lithium teratogenicity. A series of information has been provided on the basis of metaanalysis of data having been published until 1994 in the review systems MEDLINE, TOXLINE and Lithium Information Center database. The aim of the contribution has been to review the published data on this question. The available literature has shown that teratogenicity of lithium has not been proved univocally. Last studies rather suggest that lithium is not a strong teratogen. In view of the fact that teratogenicity of lithium cannot be safely excluded, the paper recommends that this kind of risk should be taken into account, if lithium administration is considered to be applied in pregnant women, especially during the first three months of pregnancy.

[Immunologic study of Lyme borreliosis]. / Imunologická studie lymeské borreliózy.

In 84 patients in the second or third stage of serologically proved Lyme borreliosis suffering from different forms of central and/or peripheral nervous system involvement the participation of autoimmunological mechanisms was investigated. The cellular hypersensitivity to encephalitogenic basic protein and to antigens from peripheral myelin was evaluated on the cytopherometer Opton according to the influence of macrophage slowing factor--liberated during the short-term incubation of the sensibilized lymphocytes with specific antigen--on the mobility of tanned sheep red blood cells in the electrical field. The frequency of positive findings in comparison with the results in other types of neuroinfections, examined previously, put the Lyme borreliosis on the first place. The explanation of this fact may be seen in the immunoregulatory disturbances, even though the changes of the total and active T lymphocytes were not significant. The knowledge of immunological changes is very important for the indication of immunomodulating procedures suitably complementing the treatment by antibiotics.

[Radical anatomic correction of transposition of great arteries in neonates. A new program of treatment of critical congenital heart defects]. / Radikální anatomická korekce transpozice velkých arterií u novorozencu. Nový program lécby kritické vrozené srdecní vady.

METHODS AND RESULTS: From the group of 110 neonates born with transposition of the great arteries during 1991-1994 that were referred for the treatment to Kardiocentrum, University Hospital Prague-Motol, 46 neonates with simple transposition were operated on according to the criteria for anatomical correction (arterial switch) at the mean age of 9 days (4-20 days). Fourteen infants with transposition and large ventricular septal defect were corrected with arterial switch at the mean age of 2.5 months (5 weeks-9 months). Fifty neonates that did not meet criteria for arterial switch procedure were indicated for correction at the atrial level (Senning procedure) that has been performed at the mean age of 5 months (1-10 months). Out of 46 operated neonates 10 died following the operation and one child died 2 months later after surgery. There were 2 death out of last 20 neonates (10%). Thirty five children surviving 1-4 years after anatomical arterial correction of transposition are without complaints in excellent condition, NYHA class I. CONCLUSIONS: The procedure of the anatomical correction at the level of the great arteries (arterial switch) according to Jatene, that has been successfully introduced at Kardiocentrum, University Hospital Prague-Motol, has been reproducible and became the method of choice for operations of transposition of the great arteries in neonates with the suitable anatomy.

[The effect of heart surgery during extracorporeal circulation and deep hypothermia on glucose metabolism in infants and young children]. / Vliv operace srdce v mimotelním obehu a v hluboké hypotermii na metabolismus glukózy u kojencu a malých detí.

Authors examined levels of glucose, insulin, and C-peptide in the plasma of 6 infants and small children with the isolated transposition of the great arteries (3 pts) and ventricular septal defect (3 pts) in the course of open-heart surgery in deep hypothermia. The mean age of the patients was 7.2 months (6 to 15) and weight 5.6 kg (5.2-7.5). Exogenous intake of glucose during the operation was excluded. Methods of anaesthesia, operation technique, and conduction of extracorporeal circulation (ECC) were constant in all patients. Fresh ACD blood diluted with Hartman solution approximately 1:1 was used for the prime of ECC circuit (content 800 ml) to get the hematocrit 0.27 +/- 0.2 after mixing the prime with the patient's blood volume. Glycemia was determined by Beckman ERA 2001 analyzor, and levels of insulin and C-peptide by radioimmunoassay kits MJ-96 (Poland) and Novo (Denmark). Significant hyperglycemia was found in all patients during the period of hypothermia, and was overlasting to the rewarming period until the end of the operation and 1 hour postoperatively. Then level of glycemia was decreasing to the normal values which were found in the last sample (17 hours post-op). The raise of glycemia was not a stimulus to the proportional increase of insulin and C-peptide levels in plasma. It proved transitional suppress of insulin secretion in the beta cells of the pancreas in the cooling period. Levels of insulin and C-peptide significantly and concordantly increased after 20 min. of rewarming (r = 0.83). However, hyperglycemia overlasted during the course of rewarming, too.(ABSTRACT TRUNCATED AT 250 WORDS)

[Anatomic correction of a double outlet right ventricle using the Taussig-Bing arterial switch]. / Anatomická korekce dvojvýtokové pravé komory typu Taussig-Bing arteriální switch.

Four children with double outlet right ventricle type Taussig-Bing were operated in 1988-1990 by anatomical correction-arterial switch. Primary correction of the defect was performed in one infant at the age of three months. Three children had a previous palliative operation (banding of the pulmonary artery, resection of coarctation of the aorta and ductus arteriosus). Anatomical correction of the defect was performed in a second stage at the age of 14, 15 and 19 months. One child died from Gram-negative septicaemia on the 8th day after operation. Three children are completely free from complaints and develop normally. The authors discuss some technical aspects of the arterial switch operation in infants with double outlet right ventricle.

[Tactics and technique of primary correction of aortic arch interruption using a median sternotomy]. / Taktika a technika primární korekce interrupce aortálního oblouku ze strední sternotomie.

Primary correction of an interrupted aortic arch was performed in seven neonates aged 2 to 26 days. The operation was performed from median sternotomy with extracorporeal circulation using hypothermic arrest of the circulation for reconstruction of the aortic arch. In all neonates it proved possible to make a direct anastomosis of the ascendent and descendent aorta. At the same time in six children a defect of the ventricular septum was closed, in two the common arterial trunk was corrected, in one resection of subaortic stenosis was performed and in another child correction of the aortopulmonary window. After the operation three neonates died from sepsis and multiorgan failure. At present four patients are alive who, 10 to 20 months after operation, are in a good condition. All have a non-restrictive anastomosis of the aorta. Primary correction of an interrupted aortic arch and associated defects is preferred by the authors to two-stage surgery.

[Miniaturized extracorporeal circulation for infants]. / Miniaturizovaný mimotelní obeh pro kojence.

By using the smallest commercially available oxygenator and our own modification of an apparatus for extracorporeal circulation we achieved minimal filling. By placing the apparatus close to the operating table the set can be miniaturized and the length of the tubes can be maximally reduced, while a satisfactory overview is ensured. The authors compared a group of 10 children operated by using this miniature apparatus with a control group of 20 children where the standard set up was used. The filling of the apparatus incl. added solutions was significantly smaller in the group with the mini-apparatus--on average 420 ml, as compared with the control group (671 ml). Despite the substantially larger amount of transfused blood in the control group with the greater volume (500 ml/patient), the resulting packed cell volume was the same in both groups. The other common postoperative parameters did not differ significantly in the two groups. The minimal filling of the apparatus for extracorporeal circulation in the described set up makes possible in the majority of children and infants with an elevated packed cell volume perfusion without the use of donor blood which is consistent with contemporary trends.

[Possible use of the autotransfusion technic in pediatric heart surgery]. / Moznosti vyuzití techniky autotransfúze v podmínkách detské kardiochirurgie.

Consequential miniaturization of the apparatus for extracorporeal circulation and its simple connection, by introduction of haemodilution into perfusion technique along with careful surgical technique and the introduction of the principle of autotransfusion made it possible to reduce the consumption of donor blood in our department during the last six years to 25%. Autotransfusion proved to be in children weighing more than 15 kg a safe method. In the first half of 1989 we made 194 operations of the open heart. 167 patients (i.e. 86%) of this number did not require preserved blood in the primary filling of the apparatus for extracorporeal circulation. In a group of 100 patients weighing more than 15 kg in 65% the method of autotransfusion was applied; 55% of the patients did not need donor blood in the course of hospitalization.

[Correction of double-outlet right ventricle using the Kawashima intraventricular tunnel procedure]. / Korekce dvojvýtokové pravé komory intraventrikulárním tunelem podle Kawashimy.

Anatomical correction with an intraventricular tunnel, as suggested by Kawashima, was performed in 14 children with a double-outlet right ventricle and a subpulmonary (4) or non-committed (10) defect of the ventricular septum with one early and one late death. Nine children had previous palliative operations. Complications after radical surgery were residual ventricular defects (4), infectious endocarditis (2) and impaired rhythm (one sudden death). Twelve patients are after medium- term or long-term follow-up free from subjective complaints, ten children report good performance, in two the performance is slightly reduced. Anatomical intraventricular correction of double-outlet right ventricle restores the mitral valve and left ventricle to the systemic circulation. The prognosis of children with double-outlet right ventricle and subpulmonary or remote ventricular defect improves substantially.

[Combined methods for economic blood utilization in cardiac reoperations in children]. / Kombinované metody pro setrení spotreby krve pri reoperacích srdce u detí.

During 47 re-operations on the open heart the authors used the method of autotransfusion, predeposition of the patient's blood and intravenous administration of aprotinin to reduce postoperative haemorrhage and blood consumption. The patients were classified according to the methods or their combinations used into three groups and the authors compared, using statistical methods the blood losses, blood consumption, haemolysis, renal function and the effect of the methods used on the morbidity. The results were compared with a control group where the mentioned methods of economizing on blood were not used. The authors recorded significantly higher haematocrit values in all three groups where economic methods were used at the end of the extracorporeal circulation (EC), as compared with the control group. The volume of the administered blood transfusion was significantly lower in group 1 where an autotransfusion apparatus Cell saver was used. The volume of the administered blood transfusion in the other groups did not differ when evaluated by statistical methods. The filling of the apparatus for extracorporeal circulation was blood free in 90% in group 1, in 75% in group 2, in 92.2% in group 3 and in 75% in the control group. Blood losses via thoracic drains did not differ significantly in different groups though there was a wide range of recorded values. In both groups 2 and 3 where patients were given aprotinin haemoglobinuria was more frequent, as confirmed by laboratory tests. The authors observed also a greater diuresis, without laboratory evidence of impairment of renal function.(ABSTRACT TRUNCATED AT 250 WORDS)

[Heart surgery in neonates (experience with surgery in 420 neonates)]. / Kardiochirurgie novorozencu (zkusenosti s operacemi u 420 novorozencu).

In the child cardiocentre in Prague 5-Motol in 1977-1993 a total of 420 neonates with critical inborn heart disease were operated. Obstructive defects of the left heart were found in 178 children, obstructive defects of the right heart in 87, defects with a left-right shunt with pulmonary hypertension in 75, conotruncal malformations in 73 and various operations were made in 7 children. Complete repair of the defect was achieved in 281 neonates, incl. 104 where extracorporeal circulation was used. Palliative operations were made in 139 children. Early mortality during the entire period was 26%, whereby a decrease from 40% to 16% was recorded during the last three years. At present it is possible to repair permanently critical inborn heart disease in the majority of neonates. This is made possible in particular by early non-invasive diagnosis, treatment with prostaglandins E in duct-dependent critical heart disease, optimal time for and selection of most suitable surgery, microsurgical technique, miniaturization of extracorporeal circulation and the method of deep hypothermia.

[Aortic reconstruction in neonates with hypoplastic left heart syndrome] . / Rekonstrukce aorty u novorozencu se syndromem hypoplastického levého srdce.

The surgical technique and tactics of the Norwood operation in neonates with hypoplastic left heart syndrome represent a surgical challenge. The Norwood operation was performed from the midline sternotomy approach, in extracorporeal circulation and deep hypothermic circulatory arrest was used for reconstruction of the hypoplastic aorta. Operation consisted of reconstruction of the "neoaorta" and the aortic arch from the original hypoplastic ascendent aorta, pulmonary trunk and a patch cut from a pulmonary homograft or pericardium, excision of the atrial septum and an arterial shunt from a Goretex vascular graft 3.5 or 4 mm in diameter. In patients with well developed aortic arch it was possible to reconstruct the aorta using Damus-Kaye-Stansel operation without circulatory arrest. Out of 12 operated patients with this defect, two (16.7%) died during the early postoperative period, one patient died late. The postoperative course was often complicated. In 6 (50.0%) patients the second step of Norwood operation, the bidirectional cavopulmonary anastomosis, was performed without mortality. According to our experience, it was necessary to prepare patients adequately before the first surgery. Perfect reconstruction of the aorta and a well functioning shunt had the crucial significance.