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There is no standard limit value for somatic cell count (SCC) of raw goat milk in the EU despite that excellent hygienic quality milk is needed for the manufacture of fermented milk products or cheese varieties. Mastitis often results such high SCC - besides the potential risk for humans - that the clotting of milk will not be perfect, resulting slack curd with higher whey releasing; furthermore, wrong structure, ripening, bad sensory properties of cheese can also be its consequences. In this paper, we report the SCC of milk samples from five different goat breeds bred in Hungary, measured with two fast methods compared with the results from the reference method. Furthermore, we investigated the applicability and the accuracy of the MT-02 (Agro Legato Ltd., Hungary) instrument. We determined that the White Side test and the instrument MT were suitable for the estimation of possible risks and consequences in the case of the use of high SCC milk before production. The general summarized average milk SCC was 6.64 × 105 ml−1. The highest difference between the results from MT-02 and the fluorometric (reference) method was 5 × 105 ml−1, but it was a singular, extreme value. The r2 of the calculated linear calibration equation was 0.7819; consequently, this method seems to be applicable in the measurement of SCC with MT-02 instrument. Furthermore, the SCC of samples did not differ significantly by genotypes and by seasons (spring: 5.85 × 105 ml−1, autumn: 6.22 × 105 ml−1).

Introduction: Implantation of a ventriculoperitoneal shunt is a standard procedure in the treatment of hydrocephalus. Shunt malfunction can be due to various causes, such as failure of the peritoneal (distal) part of the shunt with a frequency of 5% to 47%., Objective: The aim of this study was to compare laparoscopic and laparotomic techniques for implantation of a ventriculoperitoneal shunt., Material and Methods: We considered a cohort of 304 patients with hydrocephalus, acquired during a 10-year period, who underwent surgical intervention at the Neurosurgical and Surgical Clinics of the University Hospital Brno., Results: The 304 patients underwent a total of 392 operations, of which 67 (17.1%) were performed using a laparoscopic approach and 325 (82.9%) using a laparotomic approach. In the laparotomy group, 59 (18.2%) interventions were repeated due to complications of the peritoneal part of the shunt, while in the laparoscopy group revisions accounted for only 3 cases (4.5%)., Conclusions: The laparoscopic technique significantly reduces the risk of complications of the peritoneal part of the shunt, and thus the overall complications associated with the implantation of the ventriculoperitoneal shunt. Laparoscopy is indicated in the case of migration of the peritoneal catheters into the abdominal cavity and is also very helpful in revisions in the case of malfunction of the peritoneal part of the shunt or in the case of previous abdominal surgery. It can explain the anatomical conditions in the abdominal cavity and it is able to treat any incidental pathology.

Introduction: Laparoscopic adrenalectomy has become a standard surgical procedure for the most of adrenal gland disorders. Hormonal active adenomas, feochromocytomas even some malignant tumors are the most frequent indications. The number of operations for accidentally diagnosed foci has grown rapidly. It has been suggested to revise recommendations specifying criteria, based on which incidentaloma is indicated for adrenalectomy. The aim of this work is to compare the results of adrenalectomies for hormonal active lesions and incidentalomas., Material and Methods: An analysis of 65 patients who underwent adrenalectomy in the Department of Surgery University Hospital Brno Bohunice from 2005 to 2010. Correlation between preoperative examination outcomes and postoperative histology findings was performed. Furthermore, findings in patients indicated for surgery for hormonally active versus for hormonally inactive suprarenal tumors were compared., Results: Thirty-eight patients underwent laparoscopic surgery for hormonally active adrenal tumors, one for bilateral metastasses of bronchogenic carcinoma. In 26 cases adrenalectomy was indicated for incidentaloma. Adrenal hyperplasia was the commonest histological finding in the group with hormonally inactive tumors. No carcinoma was detected in this group. In 5 of 19 patients operated for suspective feochromocytoma, the procedure did not result in blood pressure adjustment and feochromocytoma was histologically confirmed in 11 out of the 19 subjects. The size of the tumors was significantly higher in incidentalomas, compared to hormonally active pathologies. No incidentaloma and hypertension subjects experienced alteration in their clinical condition after the procedure., Conclusion: Laparoscopic adrenalectomy is a standard procedure in the majority of hormonally active focal suprarenal conditions. Patients with accidentally detected suprarenal tumors should be carefully indicated, taking into consideration internal comorbidities and any surgical procedures in a patient's history. The benefit of adrenalectomy for the clinical condition alteration is arguable in incidentalomas. The National Institutes of Health U.S.A. (NIH) consensus guidlines should be strictly followed during the decision making proces. Indication for adrenalectomy in tumors of less than 6 cm and with benign appearance on CT or MRI is not considered rational.

In the Czech Republic, mycobacteriosis is relatively rare. The low incidence probably reflects high BCG coverage rates in the Czech population. Globally, the importance of BCG vaccine has been increasing, as a result of acquired immunodeficiencies, particularly HIV infection. The presented case report describes the course of disseminated mycobacteriosis in a Vietnamese asylum seeker with newly diagnosed advanced HIV infection. In HIV patients, disseminated mycobacteriosis, most frequently caused by members of Mycobacterium avium complex (MAC), is mostly manifested in the last stage, AIDS, with extremely severe immunodeficiency, or in immune reconstitution inflammatory syndrome (IRIS), shortly after initiation of antiretroviral therapy. From the beginning, the patient's condition was complicated by multiple simultaneous severe opportunistic infections which, together with gradually progressing atypical mycobacteriosis, resulted in overall exhaustion of the organism. The adverse prognosis of these infections is significantly influenced by prolonged diagnosis based on culture detection of slow-growing mycobacteria. In the above patient, the lethal course was contributed to by resistance to commonly used antitubercular drugs which was only detected post mortem due to time-consuming susceptibility tests.

Kaposi's sarcoma (KS) is an unusual form of tumor which in the era of HIV/AIDS pandemic is increasingly observed outside the original endemic areas. It was shown that the development of KS is in directly related to infection with human herpes virus 8 (HHV-8). The pathophysiology of KS is complex and is influenced by HIV co-infection and by global cytokine interactions. Skin, gastrointestinal tract and respiratory organs are typically involved. A good therapeutic effect of combined antiretroviral therapy (cART) was documented. We provode a review of the current knowledge of the pathophysiology of and therapeutic options for KS and one clinical case.

Bouveret's syndrome is gastric outlet obstruction caused by impaction of large gallstone in the duodenal bulb which penetrated through a cholecystoduodenal fistula. A 56-years-old lady suffered from right upper abdominal pain and vomiting. Investigations, including abdominal radiograph, ultrasonography and computed tomography, revealed pneumobilia and a large stone impacted in the duodenal bulb. She underwent upper GIT endoscopy, where was found a large stone in the duodenal bulb and cholecystoduodenal fistula on frontal wall of pars descendens duodeni. A stone was too large for endoscopic treatment. She underwent laparotomy with cholecystectomy, the stone was removed and the cholecystoduodenal fistula was closed with omentoplastic.