[COMPLICATIONS OF DIAGNOSTIC AND OPERATIVE HYSTEROSCOPY--REVIEW].

Hysteroscopy is a diagnostic or surgical mini-Invasive gynecologic operating procedure. The complications of this standard procedure are relatively rare. According to retrospective studies they are 0.95-13.6%. They occur more often by an operative rather than a diagnostic hysteroscopy. These complications could be divided into two groups of an approximately equal occurrence--due to a dilation and passing through the cervix uteri (cervical laceration, creative a false cervix uteri, perforation, bleeding, impossibility to pass through the inner orifice of the cervical canal, insufficiency of the cervix uteri) and due to the operative technique itself (uterine perforation, fluid overload, thermal or mechanical trauma of the inner urinaiy and gastrointestinal tract, infection, rupture of the uterus during a subsequent pregnancy). The most occurring complication is namely the uterine perforation--1-9%, the most severe could indeed be the fluid overload--0.01-11%. The gynecologist performing the hysteroscopy should be well grounded in the typical complications. Unveiling and performing a quick intervention of the latter could prevent unwanted consequences for the patient and the legal issues that could follow occur.

[Maternal biochemical screening -- an approach for genetic prevention. part 1. first and second trimester screening].

UNLABELLED: The aim is to perform our eight-year experience on prenatal (matemal) screening for Down syndrome (DS). METHODS: Pregnant women underwent screening in second trimester (ST2) - 14(+4)-19(+3) gestational week using serum AFP and free beta-hCG biochemical markers. A more sensitive first trimester test has been implemented in 11(+0)-13(+6) gestational weeks since the end of 2009. This combined screening test (CST1) was based on US measurements of NT (nuchal translucency) and NB (nasal bones) supplemented by biochemical markers of serum free beta-hCG and PAPP-A. Uniform methodology, web-based software and system for laboratory quality control had been used. False positive ratios for DS were estimated at cut-offs 1/250 for Down syndrome and 1/100 for Edwards syndrome. RESULTS: The test was performed on 17 468 pregnant women: 13 016 by biochemical screening 2 test (BHS2) and 4452 by first trimester test CST1. High risk for a chromosome disorder by BHS2 test was found in 1097 (8,4%) cases (5,96% < 35 years and 21,13% > 35 years). 7 fetuses were diagnosed with chromosome disease (5 fetuses with trisomy 21,1 - trisomy 18 and 1 - triploid); false positive were 1090 (8,4%). High risk for a chromosome disorder by CST1 test was found in 102 (2,3%) cases. 4 affected fetuses were diagnosed (3 with trisomy 21 and 1 with trisomy 13). Verified diagnosis for DS by first and second trimester tests were 43% (3 out of 7 cases) with 57% false negative results and 45,5% (6 out of 11 cases) with 54,5% false negative results respectively. Description of biochemical values/MoMs and US measurements are applied. CONCLUSIONS: We comment on the importance of US measurements in CST1 test and correct analysis of biochemical and US markers in counseling of every individual patient, beyond final risk number.

[A clinico-morphological study of cancer of the gastric stump following an operation for benign disease]. / Klinikomorfologichnoto prouchvane na raka na stomashniia ostatuk sled operatsiia po povod na dobrokachestveno zaboliavane.

The study covers 108 patients with stomach resection (Billroth II), performed over a period of six years (1988-1993). Endoscopic and biopsy findings are described. Carcinoma of the gastric stump is established in 16 cases (14.8 per cent), high degree epithelial dysplasia-in six (5.5 per cent), and signs of acute or chronic anastomositis, superficial of atrophic gastritis, intestinal metaplasia, lipid islands and single hyperplastic polypoid lesions are present in all cases. Dysplasia III degree and carcinoma in the gastrojejunal junction are observed in the older age group with 10-15 years postoperative follow-up study. Patients with stomach resection should undergo check-ups and multiple biopsies at 3-5 years intervals, especially those with high-degree epithelial dysplasia.

[Mesangial IgA glomerulonephritis with atypical clinical manifestations and course]. / Mezangialen IgA-glomerulonefrit s netipichni klinichni proiavi i protichane.

The authors describe three female-patients with mesangial IgA-glomerulonephritis with non-typical clinical manifestations and course. Manifest nephrotic syndrome was established in one of them, favourably influenced by glucocorticosteroid treatment, and advanced renal insufficiency--in the other two.