The authors present a case of a 38‐year‐old patient with progressive Brown‐Séquard neu‐ rodeficit. Idiopathic spinal cord herniation at the spine level Th5 was identified as the main cause. Surgical reposition of the spinal cord and closure of the dural defect led to gradual clinical improvement. Improvement was observed in clinical as well as electrophysiological picture. Autoři deklarují, že v souvislosti s předmětem studie nemají žádné komerční zájmy. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. Redakční rada potvrzuje, že rukopis práce splnil ICMJE kritéria pro publikace zasílané do biomedicínských časopisů. The Editorial Board declares that the manu‐ script met the ICMJE “uniform requirements” for biomedical papers. K. Saur1, S. Ostrý1, P. Vaněk1, T. Belšán2, V. Beneš1 ÚVN – Vojenská fakultní nemocnice Praha: 1 Neurochirurgická klinika 1. LF UK, IPVZ 2 Radiologické oddělení * MUDr. Karel Saur Neurochirurgická klinika 1. LF UK, IPVZ ÚVN – Vojenská fakultní nemocnice Praha U Vojenské nemocnice 1200 169 02 Praha 6 e-mail: karel.saur@uvn.cz Přijato k recenzi: 1. 3. 2013 Přijato do tisku: 21. 5. 2013

AIMS:Mycoplasma hominis and Ureaplasma urealyticum are potentially pathogenic bacterial species that are frequently isolated from the urogenital tract of women. These pathogens could be responsible for various genitourinary diseases and have been associated with adverse pregnancy outcomes and female fertility problems. The aim of this study was to analyse the presence of M. hominis and U. urealyticum in the cervical canal of uterus of women with and without fertility problems.METHODS:Endocervical swabs obtained from women with reproductive problems and fertile women were tested by both cultivation and polymerase chain reaction. The antimicrobial susceptibility to the azithromycin, ciprofloxacin, doxycycline and erythromycine of the isolated strains of M. hominis and U. urealyticum was also tested by the microdilution broth method.RESULTS:A total of 111 women with fertile problems were examined. U. urealyticum was detected in samples from 44 (39.6%) women. M. hominis was detected in significantly fewer samples, i.e. only from 9 (8.1%) samples. From these, 6 (5.4%) women were positive for both microorganisms. The fertile group consisted from 23 women. The presence of U. urealyticum was detected in 8 (34.7%) of them. M. hominis was detected only in the mixture with U. urealyticum in 3 (13.0%) cases. The most effective antibiotic against both species in our study was doxycycline.CONCLUSION:The results show slightly higher incidence of M. hominis and U. urealyticum in the genitourinary tract of women with fertility problems compare with control group. The potential negative effect of these species on the reproduction ability of women was not observed.

Infekce plodu a novorozence ovlivňuji jak perinatalni mortalitu, tak morbiditu. Mohou vyvolavat předcasne porody, jsou přicinou cele řady vrozených vývojových vad, stejně jako organových postiženi různeho stupně. Nasledujici text diskutuje problematiku perinatalnich infekci způsobenou lidskými herpetickými viry.

Clanek se zabýva kožnimi změnami asociovanými s diabetes mellitus, podava přehled o mykotických onemocněnich kůže a sliznic u diabetiků a jednotce necrobiosis lipoidica

Perinatalni a neonatalni pece jsou velmi důležitou zaležitosti zejmena pro ohrožena a patologicka těhotenstvi a perinatalně ohroženeho novorozence. Perinatologie zahrnuje peci o těhotnou ženu, plod a novorozence v obdobi viability plodu, přes obdobi porodu a sestineděli, resp. do casneho a pozdniho neonatalniho obdobi, tj. 28 dnů po narozeni ditěte. Obecně lze řici, že infekcni onemocněni se v souvislosti s těhotenstvim přenaseji třemi možnými cestami: transplacentarně, tj. v těhotenstvi přes placentu, perinatalně, tj. při porodu buď aspiraci plodove vody nebo inokulaci infekcniho agens do kůže nebo sliznice ditěte během porodu, a nebo mateřským mlekem.

Varicella-zoster virus (VZV), herpes simplex virus one (HSV-1) and herpes simplex virus two (HSV-2) represent three out of the eight known human herpesviruses and belong to the subfamily of α-herpesviruses. These viruses are present worldwide and humans are their sole host and reservoir. After the primary infection, these viruses persist in the body throughout life. The period of latency may be interrupted by reactivation of infection due to various factors. Each virus can induce a wide spectrum of diseases. The primary infection is typical for children and otherwise healthy individuals are often asymptomatic. It is mainly immunocompromised patients who are at risk of developing severe disease or complications when infected by these viruses. However, even in otherwise healthy individuals an infection by a-herpesviruses can run a severe course and lead to death.

Epidemiological data on sexually transmitted infections in the Czech Republic has been carefully reported for many years. Here we present an analysis of regional data on syphilis spanning more than 30 years in eastern Bohemia. The epidemiological data were derived from the mandatory reporting of sexually transmitted diseases covering the period 1981-2011. The data showed a minimal incidence of cases in 1990 and an increasing trend thereafter. Two peaks in the incidence are apparent - within years 1995-1999 and 2003-2007. Interestingly, while before 1990 the numbers of positive men always exceeded those of women, their numbers equalized or even reversed within the two peaks. The results may also reflect trends in social change in the country after 1989. The analysis showed that the regional prevalence of syphilis in eastern Bohemia still remains low compared to some other regions of the Czech Republic.

UNLABELLED:Pathogenic species of the Legionella genus can cause respiratory diseases ranging in severity from benign Pontiac fever to life-threatening Legionnaires disease often characterized by severe pneumonia, high fever, and multiple organ involvement. Predisposing underlying conditions, such as immunosuppression, chronic lung disease, and malignancies and other variables such as smoking and higher age constitute high-risk factors. Legionalla has been isolated from natural aquatic habitats (freshwater streams and lakes, water reservoirs, etc.), artificial sources, and also from humid soil. These pathogens are distributed worldwide. Besides water reservoirs (surface and underground water, fresh and salt water), they occur in a wide range of technical devices and systems - water distribution systems, showers, pools, spa systems, perlators, foggy makers, irrigation systems with sprinklers, cooling towers, etc. About 20% of detected Legionella infections in Europe have been associated with travel history. Travel-associated cases present a particular difficulty in terms of identifying the source of infection and implementing remedial measures.KEYWORDS:Legionella pneumophila - Legionnaires disease - Pontiac fever - nosocomial infections.

The epidemiology of selected sexually transmitted diseases in the Czech Republic has been carefully evaluated for many years. Data from 1981-2011 for eastern Bohemia shows a sharp decrease in the incidence of gonorrhea in 1993-1994 and a very low incidence thereafter with a slightly higher prevalence in males. However, syphilis and genitourinary infections with Chlamydia trachomatis show entirely opposite trends. Also, for the similar number of diagnostic tests performed, Chlamydia had a 10 fold higher rate of positive results. This underscores the changing epidemiology of sexually transmitted infections (STI) and necessity for adapting the reporting algorithms accordingly.

V soucasne době zname osm lidských herpetických virů – herpes simplex virus 1, herpes simplex virus 2, varicella zoster virus, cytomegalovirus, virus Epstein-Barrove, HHV-6 (typ HHV-6A a HHV-6B), HHV-7 a HHV-8. Tyto viry jsou rozsiřeny celosvětově a jejich jediným hostitelem a zaroveň rezervoarem je clověk. Po primoinfekci perzistuji tyto viry v lidskem organizmu celoživotně. Obdobi latence může být v důsledku působeni různých faktorů přeruseno reaktivaci infekce. Jednotlive viry vyvolavaji siroke spektrum onemocněni. Primoinfekce jsou povětsinou typicke pro dětský věk a maji casto asymptomatický průběh. V připadě, že dojde k nakaze novorozence nebo imunokompromitovaneho pacienta, může mit onemocněni těžký až smrtelný průběh. Nicmeně nejsou zcela vzacna ani komplikovana onemocněni pacientů, kteři nepatři do rizikových skupin.

Streptococcus suis is regarded to be a significant pathogen in swine with global prevalence and possible transmission of infection to humans. Sporadic cases of infection have been reported worldwide including Europe. Such infection in humans leads to development of various serious conditions, including, most frequently, meningitis and sepsis. The presented case report describes extensive clinical presentation of the infection, ranging from sepsis, spondylodiscitis and abscess formation in paravertebral muscles to osteomyelitis and hearing impairment. In our case, the disease led to several months of hospitalization and severe disability.

Dengue is an acute viral infection transmitted by Aedes mosquitoes. The disease is endemic in tropical and subtropical countries and, until recently, was considered to be exclusively an imported infection in Europe. However, this picture is changing, as there have been cases of autochtonous dengue reported in France and Croatia in 2010 and on Madeira in 2012. In addition, neurological complications are seen more frequently and in an increasing number of forms. Although this disease affects both sexes and people from all age groups, neurological complications are the most frequently diagnosed in children. Correct diagnosis can pose a problem in our geographical area due to a lack of experience with the disease on one hand and atypical disease symptomatology in our patients compared to those observed in patients from the original endemic areas on the other. Dengue can become a serious problem in our region, mainly due to gradual spread of the vector from the original areas northwards; rapid and correct diagnosis of such cases is of great importance.

Background: VZV is unique among the herpesviruses in its transmission by inhalation of aerosolized virus particles. Infection via the respiratory route increases the opportunity for rapid spread of the virus through susceptible populations and exposure of those already latently infected. Methods: A total of 438 clinical samples were obtained from patients exhibiting symptoms of varicella zoster virus infection manifested as chickenpox or herpes zoster treated in the Faculty Hospital of Charles University, Medical School in Hradec Kralove, Czech Republic. Characterization of individual VZV strains was performed utilizing restriction fragment length polymorphisms (RFLPs), PCR and sequencing. Single nucleotide polymorphisms (SNP) in the open reading frames (ORF) 21, 22 and 50 were used to identify individual VZV strains. Results: Sequencing analysis showed that 127 isolates were of the European E1 genotype, 309 were of the European E2 genotype and 2 were identified as Mosaic M1 strain. In addition, two unusual genotypes were identified, both representing a combination of E1 and M2 strain specific SNPs. Conclusion: The genotyping of VZV helps to better understand differences in properties of individual wild type and/or vaccine VZV strains; inform about pathogenic potential of individual VZV strains and help to detect mutations in functionally important gene and analyze their effects on phenotype.

Herpes zoster (HZ) is not a rare disease the average annual incidence in Czech Republic only was 6,306 cases (61,3 per 100 thousand inhabitants) during the period 1990-2008. The peak incidence age group is between 60-70 years, however the risk for the disease increases steadily after 50 years of age and so does the likelihood for the development of complications.The most common complications reported in Czech Republic during the year 2008 were those affecting central nervous system (CNS), such as meningitis, encephalitis and other diseases of CNS (30, 21 and 20 cases, respectively), followed by ocular involvement (94 cases) and generalized herpes zoster (13 cases). Immunosuppression increases the risk of the development of disease, the severity of attack and the likelihood of complications. Here we present a case report of herpes zoster in a patient with several co-morbidities, who developed neurological complications.The case report contains a review of basic epidemiological and clinical characteristics of HZ, as well as common complications of this disease, and a summary of the epidemiological situation in Czech Republic.

Varicella zoster virus has highly conserved genome 125,000 base pairs. The different molecular genetic methods of analyzing VZV genome are discussed, as well as their results with regards to the virus phylogenesis, geographic distributions, possible recombination and virulence of different VZV strains.

Herpes zoster (shingles) is a viral infection of the skin that manifests itself as painful, unilateral vesicular rash. The causative agent is varicella-zoster virus (VZV). Primary infection with VZV causes chickenpox, a common childhood infection, and then the virus lies dormant in the sensory neural ganglia, reactivating to cause shingles. The most important complications are neurological disorders (in particular postherpetic neuralgia) and eye disorders. First-line therapy are antiviral agents. A single vaccine has been registered to date. Herpes zoster occurs sporadically in the Czech Republic and its incidence is long-term stable. In 1990-2008 the average annual incidence was 6306 cases (61.3 cases/100,000 population), with the lowest number of 5511 cases (53.5/100,000) reported in 1991 and the highest number of 6,894 cases (67.6/100,000) reported in 2002. The incidence rate in females (69.9/100,000) was 1.4 times as high as in males (49.5/100,000). From the age perspective, the elderly are at a considerably higher risk of developing shingles. In 2008, the incidence rate was the highest in the age group 70 years (155.0/100,000). Nevertheless, the beginning of the upward trend is seen in the age group 45-49 years. Herpes zoster does not show any seasonal trend.

Prace shrnuje a popisuje pigmentove melanocytarni afekce kožni, uvadi klasifikaci, klinicke charakteristiky a histologický obraz jednotlivých typů pigmentových melanocytarnich nevů a shrnuje poznatky o nahledech na vývoj a progresi melanocytarnich tumorů z tzv. atypických (dysplastických) nevů.

Authors described the results of immunohistological investigation in 13 patients--12 with clinical diagnosis of bullous pemphigoid and 1 patient with clinical diagnosis of epidermolysis bullosa acquisita. 1 M NaCl solution was used to split normal human skin, used as substrates for immunohistological testing of the antilamina lucida and anti-sublamina densa antibodies.