[Comparison of hysterectomy techniques in a group of patient operated for the diagnosis female to male transsexualism]. / Porovnání technik hysterektomie v souboru jedincu operovaných z indikace transsexualismu femaleto male.

OBJECTIVE: Comparison of duration of surgery, blood loss, complications, lenght of post-operative hospitalisation and post-operative morbidity in a group of patient operated for the diagnosis FtM transsexualism. DESIGN: Retrospective clinical study. MATERIAL: In our set of patients were 163 FtM transsexuals with caryotype 46 XX and normal gynecological finding (81 virgins). They were operated on from 1998-2012 at Department of Obstetrics and Gynecology The First Faculty of Medicine Charles University in Prague and Hospital Na Bulovce after at least of 12 months of hormonal preparation. METHODS: We used following types of hysterectomy and bilateral adnexectomy: total abdominal hysterectomy from infraumbilical median laparotomy (AHL) or from suprapubic transverse incision - Pfannenstiel (AH), laparoscopically assisted vaginal hysterectomy (LAVH), total laparoscopic hysterectomy (TLH). In two patients TLH and colpectomy was performed in one setting. RESULTS: In the 23 AHL group the duration of the surgery was 54 minute, blood loss was 226 ml and the length of post-operative hospitalisation was 6.7 days. In the 22 individualy of AH group the duration of the surgery was 60 minute, blood loss was 240 ml and the length of post-operative hospitalisation was 6.1 days. In 4 patients of LAVH group the duration of the surgery was 73 minute, blood loss 200 ml and the length of post-operative hospitalisation was 5 days. In the TLH group (112 pts) the duration of the surgery was 91 minutes, blood loss was 121 ml and the length of post-operative hospitalisation was 4.4 days. In the 2 TLH with colpectomy group the duration of the surgery was 152 minute, blood loss was 250 ml and the length of post-operative hospitalisation was 5.5 days. In one case a peroperative lesion of urinary bladder occured and once a conversion TLH to AH for a strong vaginal bleeding was necessary. Among postoperative complication in one case subileus in AH group was diagnosed, once vaginal bleeding, once haematoma in the suture and one case of secondary healing. Postoperative complication after TLH included 4 times bleeding from vaginal suture, once haematoma in Douglas pouch, once seroma in the place of trocar insertion, once subileus. Once ureter was injured and treated by the ureteral stent insertion. Complication after AHL and LAVH were not recognised. CONCLUSION: Total laparoscopic hysterectomy is the method of choice in the group of FtM transsexuals. This technique could be used also in nuliparous women with long and narrow vagina. Compared with laparotomic approach lower blood loss and shorter hospital stay was proved. Earlier restitution of full activity is another advantage. Musculus rectus abdominis flap can be used for phallus construction. The only significant disadvantage is a longer duration of surgery.

Predicting axillary sentinel node status in patients with primary breast cancer.

The aim of this study is to determine the combination of characteristics in early breast cancer that could estimate the risk of occurrence of metastatic cells in axillary sentinel lymph node(s). If we were able to reliably predict the presence or absence of axillary sentinel involvement, we could spare a considerable proportion of patients from axillary surgery without compromising therapeutic outcomes of their disease. The study is based on retrospective analysis of medical records of 170 patients diagnosed with primary breast cancer. These women underwent primary surgery of the breast and axilla in which at least one sentinel lymph node was obtained. Logistic regression has been employed to construct a model predicting axillary sentinel lymph node involvement using preoperative and postoperative tumor characteristics. Postoperative model uses tumor features obtained from definitive histology samples. Its predictive capability expressed by receiver operating characteristic curve is good, area under curve (AUC) equals to 0.78. The comparison between preoperative and postoperative results showed the only significant differences in values of histopathological grading; we have considered grading not reliably stated before surgery. In preoperative model only the characteristics available and reliably stated at the time of diagnoses were used. The predictive capability of this model is only fair when using the data available at the time of diagnosis (AUC = 0.66). We conclude, that predictive models based on postoperative values enable to reliably estimate the likelihood of occurrence of axillary sentinel node(s) metastases. This can be used in clinical practice in case surgical procedure is divided into two steps, breast surgery first and axillary surgery thereafter. Even if preoperative values were not significantly different from postoperative ones (except for grading), the preoperative model predictive capability is lower compared to postoperative values. The reason for this worse prediction was identified in imperfect preoperative diagnostic.

[Micturition, sexual and defecation disorders in middle-aged women after pelvic fractures. A comparative study]. / Mikcní, sexuální a defekacní problémy u zen v aktivním veku po zlomenine pánve: srovnávací studie.

PURPOSE OF THE STUDY: To present the results of a three-year study on micturition, defecation, gynecological and sexual disorders in middle-aged women who sustained pelvic fractures. MATERIAL AND METHODS: A group of 33 female patients who were treated for unstable pelvic fractures (AO types B or C) in the 2004-2009 period were evaluated (treated group) and compared with 31 women who had given vaginal birth at least once and went to see a urologist because of urinary problems in the period from 2009 to 2010 (control group). The questionnaires used in the study included ICIQ, UIQ, UDI and PISQ12 instruments. Urodynamic tests included flow cystometry, urethral pressure profile at rest and under stress and uroflowmetry. For a comparison of continuous variables of normal distribution, the t-test for independent samples was used. In the questionnaire study when responses were classified as nominal-ordinal variables, the Mann-Whitney U-test was used. Differences between the two patient groups in qualitative variables were tested by Pearson s 2 test. When the expected number of answers in contingency table was lower than 5, Fisher s exact test was used; when the number of answers was 0, Haldane s correction was employed. The results in all tests were considered significant when the level of significance was lower than 5%, i.e. p-value < 0.05. RESULTS: The age of patients in the treated group ranged from 17 to 55 years (average, 32 years), the age in the control group was between 30 and 78 years (average, 58 years). The difference was significant (p<0.001). The control group patients had significantly more serious urination disorders than the treated group patients. Some micturition problems were reported by 25 patients (75%) of the treated group and by all patients of the control group (p<0.001). Intestinal disorders were more frequent in the treated group, in which 19 (61%) patients reported problems as against seven (21%) in the control group. Gynaecological problems involving feelings of genital prolapse had 13 (39%) control patients (p = 0.041). Sexual disorders were markedly worse in the treated group, with 16 (52%) of the patients having problems in comparison with only seven (21%) in the control group. DISCUSSION: A comparison of patient groups composed using the method described here is disputable. The first difficulty lay with a low compliance of the treated patients, of whom only 33 underwent examination out of 52 originally enrolled. The other problem was the necessity of having an exactly defined control group of patients willing to undergo urological and gynaecological examination including urodynamic testing. The groups composed by our method were comparable only in the micturition disorder characteristic. A significantly higher age of the control group affected the comparison of defecation, gynaecological and sexual problems. CONCLUSIONS: The results of this study showed a high occurrence of micturition, defecation and sexual disorders in middle-aged women after pelvic injury. However, the problems are usually not serious enough to make the patients seek help of a specialist. The authors recommend that these problems should be looked for by disorder-directed inquiry in the final period of pelvic fracture treatment and help of a specialist in urology, gynaecology, sexuology or proctology should be offered to the patients in whom disorders have been identified. Key words: urinary incontinence, voiding dysfunction, stool incontinence, obstipation, unstable pelvic fracture.

[Low grade renal trauma (Part II): diagnostic validity of ultrasonography]. / Poranení ledvin nizsích stupnu (2. cást): Validita ultrasonografie v diagnostice.

PURPOSE OF THE STUDY: The aim of the study was to verify whether ultrasonography can be considered a reliable method for the diagnosis of low-grade renal trauma. MATERIAL AND METHODS: The group investigated included patients with grade I or grade II blunt renal trauma, as classified by the AAST grading system, in whom ultrasonography alone or in conjunction with computed tomography was used as a primary diagnostic method. B-mode ultrasound with a transabdominal probe working at frequencies of 2.5 to 5.0 MHz was used. Every finding of post-traumatic changes in the renal tissues, i.e., post-contusion hypotonic infiltration of the renal parenchyma or subcapsular haematoma, was included. The results were statistically evaluated by the Chi-square test with the level of significance set at 5%, using Epi Info Version 6 CZ software. RESULTS: The group comprised 112 patients (43 women, 69 men) aged between 17 and 82 years (average, 38 years). It was possible to diagnose grade I or grade II renal injury by ultrasonography in only 60 (54%) of them. The statistical significance of ultrasonography as the only imaging method for the diagnosis of low-grade renal injury was not confirmed (p=0.543) DISCUSSION: Low-grade renal trauma is a problem from the diagnostic point of view. It usually does not require revision surgery and, if found during repeat surgery for more serious injury of another organ, it usually does not receive attention. Therefore, the macroscopic presentation of grade I and grade II renal injury is poorly understood, nor are their microscopic findings known, because during revision surgery these the traumatised kidneys are not usually removed and their injuries at autopsy on the patients who died of multiple trauma are not recorded either. CONCLUSIONS: The results of this study demonstrated that the validity of ultrasonography for the diagnosis of low-grade renal injury is not significant, because this examination can reveal only some of the renal injuries such as perirenal haematoma. An injury to the renal parenchyma is also indicated by hypoechogenic areas of varying sizes in the renal cortex. A negative ultrasonographic finding is no proof of the absence of renal trauma. As low-grade renal injury is difficult to detect by mere clinical examination or by a single imaging method, the authors regard as necessary to actively look for them, taking into consideration the mechanism of injury, haematuria findings and evaluation of ultrasonographic and CT scans.

Accuracy of intraoperative frozen section during laparoscopic management of early endometrial cancer.

OBJECTIVE: The aim of our retrospective study was to correlate the intraoperative frozen section (FS) and permanent section (PS) diagnosis among patients with early-stage endometrial cancer (FIGO Stage I). METHODS: Retrospective analysis of clinical data. A set of 63 women were operated by the technique of laparoscopic assisted vaginal hysterectomy with bilateral salpingo-oophorectomy (LAVH with BSO). All probands had intraoperative FS biopsy performed with grading and myometrial invasion assessment. These data were then compared with PS diagnosis. Statistical evaluation was used to detect diagnostic accuracy of FS (sensitivity, specificity and positive vs negative predictive value, and accuracy rate). RESULTS: The average age was 61 years, BMI 32.4 kg/m2 and operation time including lymphadenectomy (LAE) was 108.7 minutes. Sensitivity of FS was 77.8%, specificity 98.1%, positive predictive value (PPV) 87.5%, negative predictive value (NPV) 96.4% and accuracy rate 95.2%. Suboptimal surgical management due to underevaluation of FS biopsy compared to PS diagnosis occurred in 2 patients (3.2%). CONCLUSION: Combination of LAVH with BSO and use of intraoperative FS enables the surgeon to individualize surgical treatment for every patient to the extent of either performing complete operation together with LAE or not.

[Laparoscopic correction of posttraumatic uterovaginal descent with rectal prolapse]. / Laparoskopická korekce posttraumatického uterovaginálního sestupu s prolapsem rekta.

A case review of laparoscopic management of the uterovaginal descent and rectal prolaps in one step in a young female following her complicated pelvic fracture.

[Pelvic ring injury]. / Poranení pánevního kruhu.

The authors compare their experience with the treatment of pelvic ring injuries with the literature data concerning the etiology, diagnosis and classification of this trauma, co-existing pathologies, primary therapeutic procedures, timing of the definitive treatment, surgical approaches, osteosynthesis of the posterior and anterior segments, complications and lasting sequelae. The authors regard the issue of surgical treatment as an independent discipline in the field of musculoskeletal system traumatology. They see the reason for it in the variability and complexity of primary therapeutic procedures and the necessity of following up and attending to the patients in whom treatment of complications and lasting sequelae requires multi-disciplinary co-operation.

[Hydrogen expandable implants in the treatment of stress incontinence in women--a pilot study]. / Pouzití hydrogelových bobtnavých implantátu v lécbe stresové inkontinence moci u zen--pilotní studie.

OBJECTIVE: The aim of the study was to evaluate the use of new-type implants for the treatment of female urinary stress incontinence. The patients with intrinsic sphincter deficiency were also included, the other were after previous surgery for GSI. DESIGN: Original article. SETTING: Departments of Obstetrics and Gynaecology, Faculty Hospital Na Bulovce and General Faculty Hospital, 1. Faculty of Medicine, Charles University, Prague, Institute of Macromolecular Chemistry, Czech Academy of Science, Prague. METHODS: We operated 9 patients, two of them with type III (McGuire) urinary stress incontinence the rest after operations for GSI in general anesthesia. Six to nine hydrogel swelling implants were introduced into the submucosa of proximal urethra under the transrectal ultrasound guidance. We evaluated the effect 6 to 9 months after the operation. RESULTS: Two patient were dry (negative stress-test and pad-weight test), one patient had substantial improvement, 4 had mild improvement and 2 did not notice any change. We found de novo urge symptoms in four patients, two of them were of the motor type. CONCLUSION: The new type of implants reached the success rate of other currently used materials. The improvement of stress incontinence was on the cost of de novo urge symptoms in some patients. The urgency was successfully managed with spasmolytic drugs.

Ultrasound imaging of paravaginal defects in women with stress incontinence before and after paravaginal defect repair.

OBJECTIVE: The aim of our study was to analyze whether transabdominal and introital sonography can identify paravaginal defects and to determine changes that occur following paravaginal defect repair and Burch colposuspension. METHODS: Twenty women with genuine stress incontinence took part in this prospective study. The mobility of the bladder neck was assessed transperineally with a curved array probe following instillation of 300 mL saline. The same probe was used transabdominally to determine the presence of paravaginal defects. Introital examination using a transvaginal probe was then performed to determine the presence of paravaginal defects. The same measurements were performed following Burch colposuspension and paravaginal defect repair. RESULTS: There were significant differences in bladder neck position and mobility before and after surgical intervention. In 18 women before surgery, transabdominal ultrasound identified unilateral or bilateral paravaginal defects. Eight unilateral defects were found on the right side but only two were found on the left side. In eight women, the defect was bilateral. The introital approach obtained similar results apart from in two patients with a bilateral defect in whom it indicated a unilateral right defect. Between the first and second weeks following the operation transabdominal ultrasound found no paravaginal defects in 16 women and introital ultrasound found no paravaginal defects in 18 women. We were unable to visualize the region of the paravaginal defect in two women using transabdominal ultrasound because the abdominal wall was edematous after surgery. Five to 6 weeks after the operation, our results were confirmed by abdominal and introital ultrasound in all cases. No paravaginal defects were found in any of the patients after paravaginal defect repair. CONCLUSION: Our clinical study suggests that ultrasound scanning should be performed to confirm the presence of paravaginal defects and that paravaginal defect repair may be added to Burch colposuspension for the treatment of genuine stress incontinence, as an operation to correct cystourethrocele and the posterior urethrovesical angle.

[Photodynamic therapy of benign viral vulvar lesions]. / Fotodynamická terapie benigních virových lézí vulvy.

OBJECTIVE: The aim of the study was to evaluate the use of the photodynamic effect in the treatment of genital warts in women. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynecology, Hospital Na Bulovce, 1st Faculty of Medicine, Charles University, Prague. METHODS: Twenty-five women with genital warts (HPV infection), which were verified by biopsy, were involved into the study. The affected area was treated by ten milligrams of the 5-aminolevulinic acid in three milliliters of gel for 8 hours. Red light with the 630 nanometers wavelength was applied for 15 minutes, with calculated energy intake 30 J/cm2. RESULTS: All women were free of symptoms and had negative colposcopy in the followed period of 3 to 12 months. On average 3.8 sessions were necessary to reach the remission. It was possible to repeat the session after two weeks time. During the application of light, 17 (68%) of the patients felt either no or slight burning sensation, 6 (24%) had unpleasant but bearable sensation and 2 patients had to be treated in short intravenous anesthesia. CONCLUSION: Photodynamic therapy (PDT) is a promising modality in the treatment of HPV vulvar lesions and can be considered to be a method of choice.

Case report. Disseminated infection of Blastoschizomyces capitatus in a patient with acute myelocytic leukaemia.

Blastoschizomyces capitatus infection in a 48-year-old man with acute myelocytic leukaemia is reported. A multiorgan involvement and fulminant course of the fungal infection resulted in the patient's death despite fluconazole prophylaxis, therapy with amphotericin B and administration of granulocyte colony-stimulating factor. Predisposing factors to the infection, clinical relevance of surveillance strains and in vitro antifungal susceptibility testing are discussed.

[Ultrasonic evaluation of paravaginal defects before and after surgical treatment in women with urinary stress incontinence]. / Ultrazvukové hodnocení paravaginálního defektu pred a po operacní lécbe u zen se stresovým typem inkontinence moci.

OBJECTIVE: The aim of our study was to analyze whether transabdominal and introital ultrasonography can accurately identify paravaginal defect associated with GSI (Genuine stress urinary incontinence) and to determine the changes after paravaginal defect repair. DESIGN: Prospective randomised clinical study. SETTING: Department of Obstetrics and Gynecology, Charles University, Prague, Czech Republic. METHODS: Sixteen women with GSI, who had previously not undergone anti-incontinence surgery were involved. Their average age was 52 years, average weight 71 kg and average parity 2.0. Within vaginal examination our attention was focussed on the diminution of sulsus superioris vaginae during Valsalva maneuver. The bladder of a patient in supine position was filled with 300 ml of sterile saline. Than a 5 MHz curved array probe was used to assess the bladder neck mobility from the perineal approach, and the same probe was used from the abdominal approach to determine paravaginal defect and subsequently a vaginal probe from introital approach was used for the rest of the examination. After Burch colposuspension and paravaginal defect repair US scanning was performed 6 till 8 days and 5 or 6 weeks after operation. RESULTS: We found significant differences in bladder neck position and mobility before and after the operation. In women with symptoms of GSI we found from abdominal approach unilateral or bilateral paravaginal defect in fifteen women. Unilateral defect was found on the right side six times and on the left side only once. In eight women the defect was bilateral. The introital approach obtained similar results, only in two patients with bilateral defect the examination concluded unilateral right defect. After the operation we did not find PVD in patients after paravaginal defect repair. We obtained worse results from vaginal examination, where preoperatively PVD was correctly determined (sensitivity) only in 82.6%. CONCLUSION: From our preliminary results we can suggest performing US scanning to conform paravaginal defect before anti-incontinence surgery and possibly adding to the Burch colposuspension paravaginal defect repair to correct cystourethrocele.

[Suspension of the lower third of the urethra in ambulatory practice--minimally invasive treatment of urinary stress incontinence--technique and initial experience]. / Záves dolní tretiny uretry ambulantne--minimálne invazivní lécba stresové inkontinence moci--technika a první zkusenosti.

OBJECTIVE: The aim of the article is the presentation of a new, mini-invasive method for the treatment of urethral incompetence in women--TVT (tension-free vaginal tape). DESIGN AND SETTING: The design was a prospective comparison of the first 10 patients at the Department of Obstetrics and Gynaecology of the 1st Medical Faculty and General Faculty Hospital in Prague where urethral incompetence = genuine stress incontinence regardless of their history was diagnosed consecutively. METHODS: We present the technique of the operation, examination procedure including the application of dynamic magnetic resonance before and after operation at rest and under Valsalva, the subjective and objective outcome in the analyzed group. We compare also the parameters of urethrovesical junction mobility in the MR image and discuss their importance for the new continence mechanism in the TVT method. RESULTS: All patients are 10-18 months after the operation continent. The functional morphology of the lower urinary tract and of the pelvic floor on the MR image after TVT did not reveal any relevant changes in bladder neck dynamic mobility. CONCLUSION: The experience of other authors concerning possible complications, postoperative care and results are evaluated; they are without exception positive.

[Candida myocarditis and polymyositis in acute lymphoblastic leukemia]. / Kandidová myocarditis a polymyositis pri akutní lymfoblastické leukémii.

Candida sepsis in 18-year-old man with acute lymphoblastic leukemia was associated with multisystem alteration accentuated in cardiac and skeletal muscles. Candida tropicalis identified in the post-mortem blood culture was resistant to azole-chemotherapeutics and semi-sensitive to polyene-antibiotics. Unusual myocardial involvement and a role of Candida spp. during opportune infections in immunosuppressed patients are discussed.

[Diagnostic bronchoscopy--mycologic and bacteriologic findings]. / Diagnostische Bronchoskopie--Mykologische und bakteriologische Befunde.

The authors studied the findings of mycotic and bacterial agents in the lower air passages of 122 patients with lung disease examined by bronchoscopy. The series represents a current profile of patients investigated at the Department of tuberculosis and respiratory diseases, Pardubice hospital within 17 months of the years 1982-1983. Bronchial swabs were compared with the findings in the swabs of the throat taken immediately before the endoscopic examination. Yeast organisms were isolated from the bronchi of 12 patients, and from the throats of 50 subjects examined. Amongst the agents isolated, Candida albicans showed the highest frequency of occurrence (68.0%). Isolation of Aspergillus fumigatus from the bronchi revealed pulmonary mycetoma in one case. Pathogenic and potentially pathogenic bacterial flora was isolated from the bronchial swabs in 40 subjects examined. A total of 47.5% findings belonged to patients suffering from inflammatory disease of the lower air passages. Isolations of Mycobacterium tuberculosis from the bronchial swabs of three subjects examined, where other cultivation examinations gave negative results, are considered by the authors as a contribution to the differential diagnosis in infiltrative disease of the lung. The value of examination of directed swabs at bronchoscopy by culture, the problems of contamination and the reliability of the results obtained are discussed.

[Mass occurrence of mycotic tracheitis in chickens]. / Hromadný výskyt mykotické tracheitidy kurat.

An enzootic of chick mycosis, caused by the spores of the fungus Aspergillus fumigatus, is described. The mycotic infection affected the respiratory tract of the birds; pathological changes were located mainly in the region of the trachea. The changes had the nature of diphtheroid necrotic inflammation destroying the mucous membrane and causing almost an obstruction of the trachea. Deposits of granulomatous inflammation, containing fungus elements, were detected in the peritracheal tissue, and in individual birds also in the lungs. Litter contaminated with Aspergillus was the source of infection.

[Mycotic esophagitis - a contribution to its etiology]. / Mykotická esofagitida - príspevek k etiologii.

Six cases of mycotic pseudomembrane inflammation of the esophagus formed 0.6% of all the necropsies within observed period. The basic disease was malignant tumour in 5 patients, non-tumorous blood disease in one. Culturally, yeast-like organisms of the genus Candida were proved in all cases. In three cases necrotizing and pseudomembrane inflammation of the larynx developed simultaneously. In the control group cultivation examination of the esophagus and larynx was made in 50 "at risk" patients (children, diabetics and oncologic patients) without any overt mycotic disease. A positive mycologic findings was from the esophagus in 60% from the larynx in 38%. In both localities the most frequent was Candida albicans, in isolated cases also conditionally pathogenic fungi of the genera, Saccharomyces and Torulopsis were detected. All these organisms apparently may spread from the digestive tract to the upper respiratory passages.

[Adiaspiromycosis--a little known lung disease]. / Ubersichtsarbeit.

Adiaspiromycosis produced by the fungus Emmonsia crescens is a pulmonary disease afflicting primarily small wild mammals. Man, too, may become an accidental link of the saproparatrophic circulation of the agent. Humans are infected--similarly to other mammals--by inhaling the elements of the saprophytic stage of the fungus living for long time periods in the soil substrates. After the infecting cells, aleuriospores, have invaded the host lungs, they are converted into the elements of the parasitic stage--adiaspores. These are surrounded by granulomatous tissue and reach up to 700 microns in diameter. In the circulation of the agent, the infected wild mammals play a role of reservoir hosts harbouring the parasitic stage of the fungus in nature for a relatively long time. In some cases these animals also enable spread of adiaspiromycosis from exoanthropic foci into human habitations. Clinical and experimental studies show that the result of an infection may be--in addition to its liquidation--an asymptomatic form of disease or a disseminated pulmonary process. In addition to as yet insufficiently proved proper action of fungus cells, a reduction in the functional pulmonary parenchyma plays a role in the pathogenesis of the pulmonary forms. An existence of extrapulmonary forms of adiaspiromycosis is not excluded. Serological methods have not been routinely used for diagnosis as yet: immune reaction of the organism has a character of antibody response and delayed hypersensitivity. Cell mediated immunity has not been studied as yet. Treatment of human disease is primarily a surgical one. The fungistatic drugs pimaricin or amphotericin B may be employed, corticosteroids may be indicated in individual cases. The efficacy of modern antifungal substances has not been established as yet.

[Maduromycotic mycetoma in a horse]. / Maduromykotický mycetom kone.

A case of maduromycotic mycetoma (eumycetoma) in seven years old draught horse is described. The disease was localized in anal region and healed after surgical treatment. Attention is drawn to the necessity of distinguishing three types of mycosis in horses, characterized by the origin of tumor lesions - mycetomas, hyphomycosis and entomophthoromycosis - and information was gathered on their etiology and geographical occurrence. On the basis of the morphology of fungal elements traced in inflammated changed tissues and with regard to the existing findings on the origin of eumycetoma in animals, it was concluded that the disease described was probably caused by fungus Allescheria boydii Shear. Exact definition of the causative agent was impossible without mycological cultivation.