[Acute uterine inversion after delivery]. / Akutní inverze delohy po porodu.

OBJECTIVE: A case of acute inversion of the uterus after childbirth, in which we successfully perform a manual vaginal reposition of the uterus. DESIGN: Case report. SETTING: Department of Obstetrics and Gynaecology, Krajská nemocnice Liberec, a.s.; Department of Obstetrics and Gynaecology, Palacky University Hospital, Olomouc. OBSERVATION: Our case report describes acute post-partum uterine inversion of the second degree, which developed after delivery in a 36-year-old primigravida. The placenta was not delivered despite uterotonics administration, use of the Credé manoeuvre and controlled umbilical cord traction. We decided for manual removal of the placenta in general anaesthesia. After successful removal of the placenta, uterine inversion was diagnosed. Therefore, we immediately started with vaginal reposition and the manual reposition of the uterus successful. Total blood loss amounted to approx. 2500 ml and the patient fell into the shock state. Severe coagulopathy was diagnosed using rotational thrombelastography. We were able to stabilise the condition of the patient and on the eigth day after delivery she was discharged home. CONCLUSION: Uterine inversion is a rare complication of the third labour stage. Some obstetricians do not encounter this condition in their entire practice, but it can be cause of maternal mortality. Therefore, it is necessary that every obstetrician considers this possibility, knowing the risk factors and the therapeutic options in this critical situation.

Signal transduction pathways participating in homeostasis and malignant transformation of the intestinal tissue.

Intestinal homeostasis is a complex and tightly regulated process governed by a variety of signalling pathways that balance cell proliferation and differentiation. As revealed by extensive use of defined mouse models, perturbations within the signalling circuitry trigger initial expansion of premalignant cells. In this review, we attempt to summarise recent advances in the knowledge of the cellular signalling mechanisms that drive tumorigenesis in the human and mouse intestine.

Isolation of DNA-dependent RNA polymerase from the thermophilic actinomycete Thermomonospora curvata.

DNA-Dependent RNA polymerase (EC 2.7.7.6) was isolated from Thermomonospora curvata. The purification steps included precipitation with Polymin P, elution of the precipitate with 0.3 mol/L KCl, precipitation with ammonium sulfate, affinity chromatography on heparin-agarose and molecular filtration on Biogel A 1.5 m.

Electron microscopy and the polymerase chain reaction of spirochetes from the blood of patients with Lyme disease.

Results of studies using direct antigen detection suggest that seronegative Lyme borreliosis is not rare and support the hypothesis that Borrelia antigens can persist in humans. We report three successful cultures from blood out of 30 attempts from 96 Lyme disease patients. The proof of borreliaemia in early or late phases of Lyme disease by immuno-capture electron microscopy has practical importance for subsequent cultivation. The polymerase chain reaction with oligonucleotide sequences directed against 16S rRNA identified two of our blood isolates as Borrelia burgdorferi genospecies III., VS 461 group, and one as Borrelia garinii sp. nov. All of the three isolates were reactive with monoclonal antibody H9724 against flagellin and with antibody against main extracellular protein at 83 kDa. Borrelia garinii had a single predominant protein OspA at 33.5 kDa and reacted with monoclonal antibody H5332 in contrast to two isolates of the VS 461 group with two major proteins OspA and OspB at 32.5 and 35 kDa. We conclude that isolation of spirochetes from the blood might prove successful in clinically selected cases of Lyme borreliosis. Immuno-capture electron microscopy has proved to be a sensitive assay for monitoring and studying Lyme borreliosis.

[Evaluation of permanent sequelae of eye injuries in relation to the duration of work disability and degree of invalidism]. / Hodnocení trvalých následku ocních úrazu vzhledem k délce pracovní neschopnosti a stupni invalidity.

The authors evaluated the sequelae of 200 eye injuries based on forensic attests during the investigation period from 1983-1997. The group comprised 166 men and 34 women, mean age 37.5 years, incl. 25 children under 18 years. They classified the injuries in-to groups with regard to their origin and mechanism. Attention was paid to evaluation of visual acuity at distance, the number of operations of the eyes and the authors classified the group with regard to ophthalmological diagnosis and complications. The mean period of hospitalization was 32.8 days, the mean period of work incapacity 117.7 days. In the whole group there were 75 monoculi, 6 bilaterally blind subjects, one quarter had 6/6 vision on both eyes. Almost half the injured subjects had a reduced work capacity, there were 66 partial invalids, 22 full invalids, 13 subjects had an altered work capacity. The discussion is focused on better collaboration of the ophthalmologist and physician assessing the work capacity in evaluation of permanent sequelae of eye injuries.