[Woman´s subarachnoid hemmorage in pregnancy]. / Subarachnoidální krvácení u matky v gravidite.

OBJECTIVE: Diagnostics and solution to a case of subarachnoid hemorrhagie in a pregnant woman. Description of a subarachnoid hemmorage case in week 13 of pregnancy and pointing out to the insidiousness anamnestic examination. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, Uherskohradistská nemocnice a.s. CASE REPORT: The patient history describes a case of a 31-year-old hypertensive woman in week 38 of pregnancy, who experienced a complication during her pregnancy. Itinially the problem seemed to be gastroenteritis, which her son suffered from as well. Subsequently, the patient was diagnosed with subarachnoid hemorrhage, and a caesarean section and a neurosurgical operation was performed. CONCLUSION: Subarachnoid hemorrhage is weighty complication during pregnancy. It imminently threatens the woman´s life, as well as the life of the fetus. An anamnestic and physical examination as its result may lead to a quick diagnosis and a solution to this acute disease and subsequently may rescue the life of both the mother and the fetus.

[Hemangioblastoma cerebellum during pregnancy]. / Hemangioblastom mozecku v tehotenství.

OBJECTIVE: Authors describe a case of woman in the age of 27 years, 36th+0 week of pregnancy, who was hospitalized for headache and vomittin. Magnestic resonance showed the cystic expansion in the left hemisphere of cerebellum with the overpressure in the IV. ventricle and wiht the beginning obstructive hydrocephalus. STUDY TYPE: Case report. SETTING: Hospital of Uherské Hradiste, Inc., Gynecology and Maternity Department. METHOD: Own observation.

[Effect of GnRH analogues pre-treatment on myomectomy outcomes in reproductive age women]. / Vliv aplikace GnRH analog na peroperacní a postoperacní výsledky myomektomie u zen v reprodukcním veku.

OBJECTIVE: To evaluate the role of three-monthly pre-treatment with gonadothropin releasing hormone (GnRH) analogues prior to myomectomy for women in comparison with control group of patients with no application. Analysis is focused on peroperative and postoperative results of surgery treatment for women with clinically symptomatic uterine fibroids in reproductive age with interest in getting pregnant. DESIGN: Prospective clinical study. SETTING: Gynecological and Obstetric Clinic of Medical Faculty of Masaryk University and the University Hospital Brno. MAIN MEASURES: The group of 212 patients with symptomatic uterine fibroids detected by ultrasound. 90 patients (42.5%) underwent laparoscopic myomectomy (LM) and 122 patients (57.5%) underwent open laparotomic myomectomy (OM). In the selected group we were observing the common number of exstirpated uterine fibroids, their size, anatomical localisation, depth of invasion of dominant exstirpated uterine fibroid in relation to uterine wall. METHODS: Both groups of patients were randomised into two parts. The group LM with GnRH pretreatment contained 42 patients (19,8 %) and control group with no pre-treatment 48 patients (22.7%). Laparotomic part of study was divided into two groups with preoperative application of GnRH analogues 44 patients (36,7 %) and control group OM with no application 44 patients (20.8%). The main outcome measures were peroperative blood loss, duration of surgery, the length of hospital stay, evidence of per- and postoperative complications and the final results by second look laparoscopy (SLL). RESULTS: In the observed group LM with pre-treatment of GnRh analogues there was significantly higher volume of blood loss (p = 0.0003), significantly longer duration of surgery (p = 0.0063) and significantly higher lenght of hospital stay (p = 0.0025) compared with control group. We have not found a significant difference in the incidence of peroperational converse to laparotomy, final result of neoformation of uterus wall and occurrence of postoperative adhesions by SLL in observed LM group compared with control group. In the observed OM group with pre-treatment of GnRH analogues there was no significant difference in: peroperative blood loss (p = 0.5324), duration of surgery (p = 0.3927) neither average length of hospital stay compared with control group. In the OM group, there was significantly lower incidence of recidives of uterine fibroids observed by SLL (p = 0.0025) and no significant difference of occurrence of postoperative adhesions compared with control group. We have not found significant difference in the incidence of peroperative complications, early and late postoperative complications in group of LM and OM in comparison with control groups. CONCLUSION: Application of GnRH analogues in observed group of patients before LM and OM have not lead to improvement of peroperative results in comparison with control group. Pre-treatment of GnRh analogues before OM have lead to significant drop in recidives of uterine fibroids observed by SLL (p = 0.0025) compared with control group.

[Attempt to use the genetically engineered growth hormone SAIZEN in children with somatotropic insufficiency: results of clinical trials in Russia]. / Opyt ispol'zovaniia genno-inzhenernogo gormona rosta SAIZEN dlia lecheniia detei s somatotropnoi nedostatochnost'iu: rezul'taty klinicheskoi aprobatsii v Rossii.

The efficacy and safety of SAISEN, a recombinant human growth hormone obtained from mammalian cells, was tested in children with hypophyseal nanism. The treatment duration was 1 year. The results indicate that SAISEN (ARES-SERONO) is a highly effective and safe preparation of growth hormone, noticeably stimulating the growth rate both in previously untreated children with somatotropic insufficiency, and in those previously treated with STH preparations. Therapy with SAISEN was not associated with any side effects, as shown by both clinical and laboratory data.

[Effect of high doses of tocopherol on the processes of lipid peroxidation and insulin secretion in patients with non-insulin-dependent diabetes mellitus]. / Vliianie bol'nykh doz tokoferola na protsessy perekisnogo okisleniia lipidov i sekretsiiu insulina u bol'nykh insulinnezavisimym sakharnym diabetom.

Forty-one patients with type II diabetes mellitus were examined, divided into four groups administered various types of treatment: (1) diets, (2) predian, (3) glibenclamide, and (4) sugar-reducing drugs and insulin. All the patients were prescribed vitamin E in daily doses 600 and 1200 mg. The results indicate that vitamin E in high doses stimulates pancreatic insulin-producing function and is conducive to normalization of lipid peroxidation no matter what kind of therapy is administered.

[The hypothalamo-hypophyseal system in patients with multinodular colloid euthyroid goiter]. / Sostoianie gipotalamo-gipofizarnoi sistemy u bol'nykh s mnogouzlovym kolloidnym éutireoidnym zobom.

Eighty patients with multinodular colloidal euthyroid goiter were examined. Thyrotropin-releasing hormone (TRH) test was carried out in 22 patients and 7 healthy women. The results of the test indicate a clear-cut tendency to reduction of hypophyseal TTH reserve in patients with multinodular euthyroid goiter with enlarged thyroid. In other words, clinical diagnosis of an euthyroid condition in the examinees appears to be groundless, particularly in patients with stage IV multinodular euthyroid goiter who may be referred to latent hyperthyrosis group on the basis of TRH test results. Three types of STH reaction were revealed by TRH test in these patients. The authors put forward a hypothesis on STH contribution as a growth factor to the pathogenesis of multinodular colloid euthyroid goiter.

[Cloning of the recA gene of the propionic acid bacterium Propionibacterium shermanii in Escherichia coli cells]. / Klonirovanie recA-gena propionovokislykh bakterii Propionibacterium shermanii v kletkakh Escherichia coli.

Propionibacterium are producers of vitamin B-12 and organic acids and are of importance in national economy. Genetics of this organism was studied insufficiently. We constructed the genomic library of Propionibacterium shermanii in cells of Escherichia coli using the plasmid vector pVZ361 and identified recA gene. The vector gives a chance for direct selection of Str-resistant clones containing an insert in BamHI site. The recombinant plasmid carrying the recA gene of P. shermanii was isolated from the genomic library using complementation in E. coli. Strains E. coli C600 and HB101 were transformed by hybrid plasmids, and UV-light-resistant clones were identified. The clones were purified and subjected to treatment with 4-NQO and MMS. Diagrams reflecting survival dependence of the bacteria carrying recombinant plasmids and lacking them on the mutagen concentration and UV-light dose clearly confirmed functioning of P. shermanii recA gene in E. coli cells. The insert with recA gene underwent restriction analysis. The 1.7 kb fragment with recA gene was then transferred to pBI101 plasmid and the resultant recombinant plasmid was used in the SOS test. The mutagens (MMS, 4-NHQ) and UV-light induced the SOS response in E. coli HB101 (recA) carrying the recombinant plasmid.

[Molecular cloning of threonine biosynthesis genes from Propionibacterium shermanii in Escherichia coli cells]. / Molekuliarnoe klonirovanie genov biosinteza treonina Propionibacterium shermanii v kletkakh Escherichia coli.

Cloning the genes for threonine biosynthesis from Propionibacterium shermanii was performed in Escherichia coli cells using the plasmid vector pVZ361. The cloned genes were identified via complementation of thrB, thrC, thrA1 and thrA2 mutations of E. coli. The gene complementing thrB of E. coli was located within a 5.1 kb fragment of P. shermanii chromosomal DNA. The cloned DNA fragment hybridized with a chromosomal fragment of P. shermanii of the same size. The plasmid pSPt4 (with the thrB gene) was digested with Sau3A and ligated with the BamHI-restricted pUC19 vector. The 1.8 kb DNA fragment of P. shermanii was shown to complement the thrB gene function in E. coli cells.

[The drug arginine aspartate (pargin) in the therapy of hyposomal states]. / Preparat arginina aspartat (parzhin) v terapii giposomal'nykh sostoianii.

Arginine aspartate (Pargine), a stimulator of endogenous STH, was given to 13 adolescents with retarded growth resulting from a relative deficiency of STH for 6 mos. Two patients discontinued treatment after 3 mos., two others are still on therapy. In 3 adolescents the rate of growth against a background of therapy was insufficient (1.3 cm over 6 mos.). Six patients demonstrated a positive effect: the rate of growth over 6 mos. was 4.13 +/- 0.39 cm, the basal level of STH increased by 6.3 +/- 2.46 ng/ml. The drug use did not accelerate skeletal differentiation in either of the patients. A conclusion is that the drug can be used to influence growth processes in patients with hyposomal conditions.

[The interaction of growth hormone secretion and gonadal function in adolescents with delayed physical development]. / Vzaimosviaz' sekretsii gormona rosta i funktsii polovykh zhelez u podrostkov s zaderzhkoi fizicheskogo razvitiia.

The studies conducted in adolescents with physical underdevelopment allowed a conclusion on reduced anabolic processes particularly growth process at the expense of both STH and sex steroids: T and E2. Studies of sex steroid and gonadotrophic hormone concentrations in blood serum revealed dysfunction of the hypothalamo-hypophyseal-gonadal system in this group of patients. Evaluation of androgen receptor level in protein cytosol fraction from the pubic skin of undersized youths with delayed sexual development demonstrated its significant reduction against the control group that may be explained by incomplete ability for androgen receptor synthesis due to relatively low T-level and its biologically active free fraction and low sensitivity of target tissues to androgens as a result of dissociation between functional activity of STH and T.

[The sexual function of men with acromegaly]. / Sostoianie polovoi funktsii u muzhchin, bol'nykh akromegaliei.

Some acromegalic male patients (50%) have weakened sexual function accompanied by a decrease in the levels of LH, FSH and testosterone. Hyperprolactinemia of various degrees was observed in 11 of 13 patients (84%). The summary index SFM (the male sexual formula) and a PRL level showed negative correlation. There was no significant difference in LH response to LH-RH administration between patients with normal and disturbed sexual function. Radiation therapy, in particular proton-beam therapy, produced no negative influence on male sexual function in a long-term period after therapy.

[The possible sources of hyperandrogenism in hirsutism in girls]. / Vozmozhnye istochniki giperandrogenii pri girsutizme u devochek.

The purpose of the investigation is to elucidate the role of adrenal androgens in the development of the syndrome of polycystic ovaries in girls of pubertal age. Clinical manifestations of disease and hormonal indices, the levels of testosterone, 17-oxyprogesterone and cortisol with ACTH and dexamethasone tolerance tests were investigated. A significant rise of the level of testosterone and 17-oxyprogesterone was revealed in response to ACTH administration in 30% of the examinees indicating the adrenal genesis of hyperandrogenism. A characteristic feature of the development of disease in this group of patients is early development of hirsutism followed by disturbed menstrual function.

[The efficacy of proton irradiation of the hypophysis in children with Itsenko-Cushing disease]. / Effektivnost' protonnogo oblucheniia gipofiza u detei s bolezn'iu Itsenko-Kushinga.

The authors represent the results of the treatment of 20 children with Itsenko-Cushing disease (ICD) by proton-beam irradiation of the pituitary body. The use of the medical proton beam of the Institute of Theoretical and Experimental Physics was found to be effective for the treatment of children with mild and average forms of ICD. Irradiation of the pituitary gland at a dose of 70-100 Gy is accompanied by general and local radiation reactions which are not dangerous for children. The time of development of remission after irradiation depends on a degree of severity and features of a course of disease.

[Characteristics of the course of periodontitis in kidney pathology]. / Nekotorye osobennosti techeniia parodontita pri patologii pochek.

A total of 104 subject were investigated and divided into 3 groups: 1. virtually healthy, without any clinical sign of periodontal inflammation; 2. periodontitis patients without internal organs affliction; 3. patients with renal pathology in which periodontitis was a concomitant disease. Biochemical investigation of the blood, oral and gingival fluids was performed. The peculiarities of periodontal involvement into renal pathology were established with lactate dehydrogenase and acid phosphatase both considerably activated in the oral and gingival fluids in groups 2 and 3. These enzymes were also activated in patients with chronic renal diseases.

[Experience in the use of biostator in the treatment of diabetes mellitus in children of the pubertal age]. / Opyt primeneniia "Biostatora" pri lechenii sakharnogo diabeta u detei pubertatnogo vozrasta.

The authors discuss the possibilities of the use of the apparatus "artificial pancreas biostator" in multiple modality treatment of patients suffering from type I diabetes. The own research data are provided. They are based on the use of the apparatus "biostator" in 62 children aged 9-15 years with diabetes mellitus in order to improve insulin therapy. After treatment sessions with the aid of the apparatus all the patients noted improvement of the well-being and abatement of the signs of diabetes mellitus lability. In some cases, the treatment using the apparatus promoted a more rapid attainment of disease compensation as compared to the application of conventional treatment methods. It has been shown that high insulin requirement of pubertal children with diabetes decompensation is determined in many respects by activation of the hypothalamus-pituitary-adrenal system.

[Methodical approaches to the determination of steroid hormone levels in different biological fluids in children with congenital dysfunction of the adrenal cortex]. / Metodicheskie podkhody k opredeleniu urovnei steroidnykh gormonov v razlichnykh biologicheskikh zhidkostiakh pri vrozhdennoi disfunktsii kory nadpochechnikov u detei.

The paper treats of the data on the use of radioimmunoassays for the measurement of steroid hormone content (17-hydroxyprogesterone, testosterone) in blood serum and saliva of children with congenital adrenocortical dysfunction. It is confirmed that these hormones can be detected in saliva only with the aid of highly sensitive and highly specific RIA systems. A positive correlation has been established between hormonal levels in both biological fluids.

[Mechanisms of disturbance of the secretion of prolactin in patients with acromegaly]. / Mekhanizmy narusheniia sekretsii prolaktina u bol'nykh akromegaliei.

Metoclopramide (DA-antagonist, M) tests were performed in 21 patients with acromegaly and in controls; the levels of adrenohypophyseal hormones were determined before and after drug administration. Irrespective of the basal level of prolactin (P) all the patients demonstrated a decrease in stimulated P secretion which was more noticeable in patients with hyperprolactinemia. The hyperergic response of TSH to M administration was observed in some of the patients with acromegaly. Such a response indicated an elevated tone of the dopaminergic (DA) system. The results obtained were suggestive of dysfunction of DA regulation of P secretion in all the patients with acromegaly.

[Use of divascan in the treatment of diabetic retinopathy]. / Primenenie divakana v lechenii diabeticheskoi retinopatii.

Divascan (iprasochrome), a drug designed by GDR pharmacologists, brings about a positive effect in the management of diabetic microangiopathies, particularly at early stages. Altogether 22 patients with diabetes mellitus, types I and II, were on divascan therapy. Before and after treatment the patients were subjected to clinical and ophthalmoscopic studies including the determination of microcirculation in the conjunctiva, renal function, the level of serotonin, its precursors and the main metabolite. The optimal dose of divascan is 7.5-10 mg/day, the period of therapy not less than 3 months followed by the use of maintenance doses. The drug produces no side effects.