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Breast cancer cell population. Its usage for setting of optimal therapeutical regimen. Predictive model.
Kolařík, Dušan ; Halaška, Michael (advisor) ; Kofránek, Jiří (referee) ; Dundr, Pavel (referee)
1 ABSTRACT Background Breast cancer cell population characteristics are used in common clinical practice for estimation of prognosis of the malignant disease (prognostic factors) and for prediction of reactivity of the tumor to certain therapeutic modality (predictive factors). Also axillary lymph node status is an independent prognostic factor in women with early breast cancer. Therefore, surgical excision and following histopathological examination of the nodes is the obligatory part of primary breast cancer surgery. The extension of axillary surgery varies widely, although sentinel lymph node biopsy is considered to be the standard procedure. However, it must be admitted that this type of procedure need not be optimal for all the breast cancer patients. Aims of the study The aim of this study is the verify the hypothesis whether or not the axillary lymph node metastatic affection can be effectively estimated using non-surgical methods - i.e. by evaluation of the combination of prognostic and predictive factors of the primary breast tumor. Statistical model composed on the basis of data of early breast cancer patients is the basic tool for this prediction. Application of this model In everyday practice can enable to adjust the extent of axillary surgery for each individual patient. Patients and methods A...
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Určení frekvence mutací genu pro fumaráthydratázu u pacientek s děložními myomy
Kubínová, Kristýna ; Mára, Michal (advisor) ; Halaška, Michael (referee) ; Baxová, Alice (referee)
Introduction: Uterine fibroids are the most common benign tumours of female genital tract with the peak incidence in the 4th and 5th decennium. The aetiology of uterine fibroids still remains poorly understood. Genetic factors play undisputed role in the onset of uterine fibroids. Up to date numerous gene mutations were identified in certain percentage of patients with uterine fibroids. One of the candidate genes is Fumarate hydratase gene (FH). Heterozygous germiline mutations of FH cause two hereditary syndromes: Multiple smooth muscle tumours of the skin and uterus (MCUL1)/ Hereditary leiomyomatosis and renal cell cancer syndrome (HLRCC) characterised by leiomyomata of the skin, early onset uterine fibroids between 20-30 years of age and renal papillary carcinoma. The aim of our thesis was to identify the frequency of FH mutations in patients with early onset sporadic uterine fibroids. Methods: Patients with the diagnosis of uterine fibroids up to the age of 30 years were enrolled in the study. Control group consisted of patients with absence of uterine fibroids. Activities of Fumarate hydratase and control protein Citrate synthase were measured in lymphocytes and compared to the results obtained from the healthy controls. Mutation analysis of FH gene was performed. Activity of Fumarate...
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Evaluation of postoperative lymphoedema after differently radical surgery for vulvar and cervical carcinoma
Nováčková, Marta ; Halaška, Michael (advisor) ; Špaček, Jiří (referee) ; Mlynček, Miloš (referee) ; Kučera, Eduard (referee)
The aim of this study was a prospective detection of postoperative lymphedema of the lower limbs in patients after the surgery for cervical and vulvar cancer using different methods of examination and their comparison and monitoring of postoperative complications and quality of life. Totally 78 women were followed after the surgery for cervical cancer and 36 for carcinoma of the vulva. Due to the radicality of the surgery the patients were divided into the conservative and radical groups. Lower limbs lymphedema were evaluated preoperatively and 3, 6 and 12 months after the surgery by the measurement of the lower limbs circumference, multifrequency bioelectrical impedance analysis (MFBIA) and subjective feeling. Quality of life using the European Organisation for Research and Treatment of Cancer (EORTC) questionnaires was evaluated before and 6 and 12 month after the surgery. 12 months after the cervical cancer surgery 35.9 % of patients reported subjective lymphedema, 37.18 % lymphedema were objectively diagnosed by the measurement of lower limb circuits and in 52.56 % of cases the increase of amount of extracellular fluid was detected by the MFBIA Ri/R0 method. The prevalence of lymphedema after the surgery for vulvar cancer reached 19.44% by the subjective assessment, 38.89 % by the measurement of...
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Sexual dysfunctions in w omen with urinary incontinence
Pastor, Zlatko ; Weiss, Petr (advisor) ; Halaška, Michael (referee) ; Raboch, Jiří (referee)
Aim: This study was designed to examine the influence of female urinary incontinence on development of sexual dysfunctions. By means of the questionnaire investigation we inquired how often and how the sexual behaviour and response were modified. Our goal was to determine the prevalence of coital incontinence, describe the most common sexual disorders and to find out how women deal with the urinary incontinence in a partner relationship and how such situations are resolved. Attention was given to the interests of health care professionals in this area, the quality of their communication with patients, effect and satisfaction with therapy. Research sample: The study included 106 women with urinary incontinence (aged 30-44 years and 44-59 years). Characteristics of their sexual behaviour were compared between the two age groups and in relation to assessed diagnosis. Changes in sexual behaviour were evaluated both in relation to the population group who were a part of representative research study of Czech women in 2008 and control group of 112 healthy women of comparable age. Material and methods: To describe and analyze sexual dysfunction in incontinent women, we used a modified version of sexological questionnaire from the research study of Weiss and Zverina and two international validated...
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The influence of reduced radicality of oncosurgical treatment on urogenital tract morbidity
Chmel, Roman ; Rob, Lukáš (advisor) ; Halaška, Michael (referee) ; Mlynček, Miloš (referee) ; Roztočil, Aleš (referee)
Cervical cancer is the fourth most common gynecological malignancy in Czech Republic. The incidence of cervical cancer in 2008 was 19.2/100000 (1021 women) and mortality reached 6/100000. Both radiotherapy and surgery have comparable results in the treatment of cervical cancer but surgical treatment is still the favoured modality especially in young female. Very succesful curability of early stages of this disease (88-97 %) based on individualized therapy currently leads to emphasize the quality of life increasing of treated women. Morbidity related to the treatment is connected with radicality of surgery. The dominant objective of the submitted study was prospective detection of preoperative and postoperative control over the micturition and urinary continence in 142 evaluated women who underwent nerve-sparing radical abdominal hysterectomy type C1, less radical surgery - laparoscopic pelvic lymphadenectomy and laparoscopic assisted vaginal hysterectomy type A or less radical fertility sparing surgery - laparoscopic pelvic lymphadenectomy and simple trachelectomy. Postoperative morbidity is connected with both pelvic lymphadenectomy and resection of the paracervix and proximal part of vagina with hypogastric nerve and inferior hypogastric plexus injury. The lower urinary tract function before and after the...
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Vascularity of Female Urethra in Correlation to Urinary Incontinence : Diagnostic Algorithms and Its Clinical Implications
Švabík, Kamil ; Martan, Alois (advisor) ; Halaška, Michael (referee) ; Adamík, Zdeněk (referee)
Introduction: Intrinsic and extrinsic urethral factors play a significant role in urinary continence mechanism in women. Urethral wall structure including inervation, perfusion of submucosal layer etc. is not clinically assessed despite its important role in urethral closure function. The association of incontinence and pelvic floor reconstructive surgery is well known. Every postoperative healing process is associated with factors of ischemia and neovascularisation. According those facts we would expect that the healing and scaring should involve intrinsic urethral mechanism. After reconstructive surgery Implants further increase scaring process. Methods: In our study we included patients with anterior compartment defect. We randomized patients into three interventional arms according the surgical approach and use of implants. Before and 3-5 month after the surgery we performed urodynamic studies and pelvic floor ultrasound examination, including Doppler for urethral perfusion assessment. Another early ultrasound scan was added forth day after surgery. We correlated ultrasound and urodynamic parameters. Results: We randomized 87 patients. We couldn't find any correlation between the morphologic changes and severity of incontinence. Methods for urethral perfusion assessment showed high inaccuracy...
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Diagnostic options for detection of postoperative lymphoedema in patients with breast cancer
Halaška, Michael ; Marešová, Dana (advisor) ; Bunc, Václav (referee) ; Stárka, Luboslav (referee)
Lymphoedema is a severe postoperative complication after treatment of many malignancies. It is a pathological accumulation of extracellular water (ECW). Early diagnostic tool is needed. Multifrequency bioimpedance analysis (MFBIA) is a method for detection of changes in ECW. We would like to establish the methodology for detection of lymphoedema of limb in patients undergoing breast cancer surgery. We measured a control group of 60 women, 5 women with pronounced lymphoedema and a group of 37 patients undergoing a breast cancer surgery during 9 month after the surgery by MFBIA and circumferency. Characteristics of the patients were recorded. Different linear extrapolations from 1, 5, 50, 100, 200 kHz were determined to find resistance at 0 Hz for each women; ratio of R0 nondominant/ dominant and non-operated/operated limb was evaluated; Pearson correlation coefficient was used to compare correlation of the results and characteristics of the patient. Extrapolation with the lowest standard deviation was found to be 5, 50, 100 kHz. On the group of women with pronounced lymphoedema higher sensitivity was found by MFBIA compared to circumferency measurements. Stronger correlation between the volumes calculated from circumferences with weight and BMI compared to MFBIA was found. We found statistically significant...
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