No abstract

Human cytomegalovirus infection is common in the general population but generally remains silent; the risk of disease is greatest in fetuses and the newborn and in immunocompromised subjects. In Of the 30 samples of DNA from mononuclear cells tested, 25 were positive for cytomegalovirus by the polymerase chain reaction. When the antibody data were decoded we found that all of the samples negative by the polymerase chain reaction were negative for antibody but that five of the 25 samples positive by the polymerase chain reaction were negative for antibody. Three of the five subjects positive by the polymerase chain reaction but negative for antibody were retested after six months. The total antibody test (Abbott) used initially was repeated on the new samples, and another total antibody test (Compenz, Northumbria Biologicals) and an IgG detection test (Medac) were performed; all three tests gave negative results. Serum from these three subjects was also analysed by western blotting with antigens derived from cytomegalovirus AD 169, and two of the samples were designated weakly positive. In all three subjects DNA from mononuclear cells remained positive by the polymerase chain reaction. CommentSeveral subjects considered not to be carriers of cytomegalovirus on the basis of their antibody state were found to be harbouring the virus in mononuclear cells in peripheral blood. Careful handling of the samples and rigorous controls ruled out contamina-M 1 2 3 4 5 6 7 8 9 10 HBVHHV CC BL 171 T M

No abstract

This report describes a case of a 55-year old woman presenting with evisceration of small bowel through the vagina, five years after a Total abdominal hysterectomy and bilateral salpingoopherectomy for irregular bleeding and a benign ovarian cyst. Examination under anesthesia revealed a 70 cm loop of bowel prolapsing through a 5 cm defect in the vaginal vault. She underwent an exploratory laparotomy and repair of vaginal vault defect. Small bowel prolapse through vaginal vault defect is a rare complication after abdominal hysterectomy. Appropriate management includes prompt recognition, thorough assessment of the herniated viscus and surgical repair of the vaginal defect. Combining abdominal and vaginal approaches as in our case may facilitate repair and avoid further morbidity.

No abstract