Spontaneous spleen rupture rarely occurs, and is primarily present in patients with splenomegaly. This is a life-threatening condition that, without adequate surgical treatment, always ends lethally. The very etiology of spontaneous atriumatic spleen rupture is not known, but it can often be associated with neoplastic diseases, liver cirrhosis, and some infectious diseases. Diagnosis is made by non-invasive methods (findings of red blood cell elements, ultrasonography, computerized tomography of abdominal CT, magnetic resonance NMR). The therapy consists of laparotomy, evacuation of the haemorrhagic content and removal of the spleen. Surgical treatment is successful, and as a postoperative complication, bleeding may occur as a result of inadequate care of the laryngeal artery and vein, and short gastric blood vessels. Here we presented a 58- year- old male patient who, due to a marked abdominal pain, low blood pressure, and low blood cell counts, was taken to hospital and successfully surgically treated at the Clinic for General and Abdominal Surgery.

Rare diseases ('orphan diseases') (RDs) count for 5000-8000 diseases with low prevalence and most commonly of genetic origin. Although most of rare diseases are manifested in early childhood, many are diagnosed in adults, even in elderly. Common characteristics, such as severity, debilitating and life-threatening features, with the lack of a specific drugs, make the treatment of RD a significant public-health problem. Even though randomized controlled trials (RCTs) are the most ideal design for evaluating new drugs, the aim of this review was to present the aggravating circumstances that development of so-called orphan drugs faces in context of RD. We searched the PubMed/Medline for publications on studies and ethics in RDs and applying of 'omics' technologies in analysing tissue samples at biobanks published between 2010 and 2017. In this review, we presented the most significant obstacles in conducting clinical trials in RD as well as main alternative clinical trial designs aiming to decrease the number of patients recruited with increased access to innovative medicines as many as possible. Furthermore, we have presented the possibility of accessing innovative drugs outside of clinical trials as well as ethics violations by the involvement of the subject in clinical trial. Modern technologies in molecular biology will enable the development of 'precision medicine' aimed at identifying the best therapeutic goal, depending on the genetic and epigenetic factors in the affected person. That is why RD biobanks have great significance in the preservation and distribution of tissue samples, in the research of diagnostic biomarkers and the drug development.

This study showed that chimney sweeps and creosote workers had lower DNA methylation of F2RL3 and AHRR, which is a risk factor for lung cancer. PAH exposure from soot and creosote oil likely play a role in this epigenetic modification.