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The relationship between selected inflammation markers and markers of the endothelial dysfunction to preterm labor and fetal inflammatory response
Koucký, Michal ; Hájek, Zdeněk (advisor) ; Krofta, Ladislav (referee) ; Živný, Jan (referee)
The doctoral dissertacion is focused on the role of inflammation in the pathogenesis of preterm labor. In the first part, we describe the current view on pathophysiology of preterm labor. In the second part, we evaluated the relationship of specific markers of inflammation and endothelial dysfunction to preterm birth and fetal inflammatory response. The most important findings of our study was that we found decreased levels of MMP-2 and decreased levels of sRAGE in women with preterm labor in comparison with the control group of pregnant women. Similarly, we found decreased levels of MMP-2 in women with subsequent diagnosed fetal inflammatory response. sRAGE is currently ranked among patttern recognition receptors. In the case of sRAGE we followed the results of our pilot project, it can be assumed that the its low level are connected with tissue damage. We confirmed that it can play an important role in the pathogenesis of preterm labor. We assume abnormal regulatory mechanisms of the production of MMP-2. In both cases, however, further studies are required to elucidate the functional significance of our results.
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Modern technologies in the assessment and treatment of pelvic organ prolapse - experimental and clinical studies
Urbánková, Iva ; Krofta, Ladislav (advisor) ; Mašata, Jaromír (referee) ; Kachlík, David (referee)
This project has shown that pelvic organ prolapse is linked with maternal age and delivery-related injuries. Up to every eight women may have a symptomatic prolapse already one year after their first delivery. Moreover, those with muscle injury have a higher short-term risk of pelvic organ prolapse development. To improve our knowledge we further explored the potential of an ovine model for prolapse and vaginal surgery. We showed that many anatomical and morphological features and vaginal wall changes induced by specific lifespan factors (first delivery, artificial menopause, and hormonal replacement) are similar to what is observed in women. We further used this model for testing novel implants and mesh visualization techniques. We believe that the ovine model can be used in future research on pelvic organ prolapse pathophysiology and novel treatment modalities.t
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Variation of abnormalities of foramen obturatum and retropubic space and its relation to complications of tape surgery
Hubka, Petr ; Mašata, Jaromír (advisor) ; Smetana, Karel (referee) ; Krofta, Ladislav (referee)
Introduction: The knowledge of anatomy is crucial for introduction of new surgical methods. It is also of especial use while dealing with surgical complications during surgeries with limited surgical field, where the way of approach limits the management of complications. It was assumed that common anatomical variations would influence different efficacy of surgeries and would explain potential complications. Methods: During anatomical dissections fifty female cadavers were dissected and tension-free vaginal tapes TVT-S H, TVT-S U, TVT Abbrevo and Ajust were studied. A novel descriptive system for localisation of the tape was created. During the dissection the tape was located and its localisation and fixation was described. Results: Common anatomical variation in the sample was corona mortis with frequency of 72 %. Preperitoneal fatty plug, which is recognized by some authors as the first stage of obturator hernia, was found in 40 % in obturator canal. The proper fixation of TVT-S H was achieved in 53.6 %. In 10.5 % urinary bladder was injured. In case of TVT-S U the proper fixation occurred in 63.8 %. In two cases the inserter was nearby corona mortis. Within the group of TVTO Abbrevo the tape was fixated properly into the obturator complex (consists of the obturator membrane and obturator muscles) in...
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The relationship between selected inflammation markers and markers of the endothelial dysfunction to preterm labor and fetal inflammatory response
Koucký, Michal ; Hájek, Zdeněk (advisor) ; Krofta, Ladislav (referee) ; Živný, Jan (referee)
The doctoral dissertacion is focused on the role of inflammation in the pathogenesis of preterm labor. In the first part, we describe the current view on pathophysiology of preterm labor. In the second part, we evaluated the relationship of specific markers of inflammation and endothelial dysfunction to preterm birth and fetal inflammatory response. The most important findings of our study was that we found decreased levels of MMP-2 and decreased levels of sRAGE in women with preterm labor in comparison with the control group of pregnant women. Similarly, we found decreased levels of MMP-2 in women with subsequent diagnosed fetal inflammatory response. sRAGE is currently ranked among patttern recognition receptors. In the case of sRAGE we followed the results of our pilot project, it can be assumed that the its low level are connected with tissue damage. We confirmed that it can play an important role in the pathogenesis of preterm labor. We assume abnormal regulatory mechanisms of the production of MMP-2. In both cases, however, further studies are required to elucidate the functional significance of our results.
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Detection of fetal abnormalities in the I. trimester of pregnancy
Pošarová, Alena ; Krofta, Ladislav (advisor)
The topic of his thesis detection of fetuses with congenital abnormalities in I. trimester of gestation , I chose based on their interest in this issue. 5 As the name suggests, the work itself , try the following pages briefly summarize methods of prenatal diagnostics with a focus on the first trimester . It medical discipline , which in recent decades has undergone dynamic development , related to the development of technical background , in particular ultrasonic techniques and laboratory methods. Birth of a child victim severe mental retardation significantly affect the future the whole family. 's why I consider it necessary to possible future parents should all available information , and hence to make responsible decisions about their future life and the life of his child . Contribution of early diagnosis of congenital defects is therefore invaluable especially for expectant parents and their chances of a healthy baby. It is also about move diagnosis of chromosomal aberrations and eventual termination pregnancy in the earliest possible stages due to mental and health impact of a pregnant woman . When drafting diplomky I , among others, drew from the grant MD . Ladislav Krofta from the years 1999-2002, and 2005 - 2007 , which are listed in literature.
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Present view of Down syndrome screening
Hollá, Lucia ; Krofta, Ladislav (advisor)
he topic of his thesis current view on screening Down Syndrome I chose because of his interest in pediatrics, neonatology and Gynecology. Antenatal screening for trisomy 21 began to be implemented in practice beginning of the 70th years. Since then underwent rapid development when the invented many new methods for detection of Down syndrome with constantly increasing efficiency of the test and moving to earlier detection time period of gestation. The task of my thesis is to summarize all available methods prenatal screening for Down syndrome, combinations thereof, and the advantages disadvantages efficiency and their preferences by pregnant women.
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Relationship between screening marker PAPP-A and pathological pregnancy
Stádníková, Lucie ; Krofta, Ladislav (advisor)
Biochemical screening biochemical testing verified indicators of increased risk of failure of gestation and fetal pregnancy has become an important part of prevention of certain těžkých congenital defects (congenital anomalies) in the population scale. the following interact with the ultrasound screening THAT increases diagnostic efficiency, but also by the positive results are becoming indications for in-depth, targeted and repeated ultrasound examinations throughout the pregnancy. Pathological findings of these two expand the range of diagnostic tests prenatal effective prevention těžkých anomalies. There are indications for invasive methods of prenatal genetic diagnostics, but also to increased clinical care of these risk of pregnancy. a The nejpoužívanější biochemical markers that can indicate a higher risk of embryonic or fetal postižení těžkými chromosome anomalies and other contingent závažnými disorders prenatal development are: AFP (alpha-fetoprotein), hCG (human chorionic gonadotropin, human chorionic gonadotropin), uE3 (unconjugated estriol) and PAPP-A (preganancy-associated plasma A protein, plasma protein-A associated with pregnancy).
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Detection of fetal abnormalities in the I. trimester of pregnancy
Finkeová, Kristýna ; Krofta, Ladislav (advisor)
The presented thesis "Detection of fetal abnormalities in the 1st trimester of pregnancy" includes a list of methods used for the detection of fetal abnormalities in the first trimester. At the beginning it briefly summarizes the abnormalities, which can be detected. The second chapter is devoted to various detection methods, in particular, ultrasound examination, invasive methods and biochemical screening. It deals with the various indicators which are assessed during ultrasound examination and the biochemical markers, which can be detected. It describes the combination of detection methods used in practice. The final chapter presents the typical factors that are evaluated when calculating the risk of fetal abnormalities, and the methods used for this calculation.
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The role of 3D and 4D ultrasound diagnosis and screening in first trimester
Hillenbrand, Nicola Birgit ; Krofta, Ladislav (advisor)
Early spontaneous abortions occur in 6-20% of all pregnancies; however, the exact mechanisms involved in these losses remain unclear. In this context, several 2D ultrasonographic parameters have been tested as predictors of early gestational losses including the shape and diameter of the yolk sac, and embryonic heart rate. The mean gestational sac diameter has also been correlated with gestational age and fetal growth. There have been first trimester studies on the volumetric examination of the gestational sac, amniotic fluid, placenta and yolk sac. This dissertation will focus on early pregnancy loss and the investigation of its etiology. Conventional ultrasonographic methods will be reviewed and compared with novel, more sophisticated methods in order to evaluate if scientific research as come closer to the etiology and early diagnosis of miscarriage. Special focus will be put on the predictive value of gestational sac shape and volume.
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Ultrasound diagnosis of congenital malformations (biochemical marker PAPP-A)
Bieberová, Lucie ; Krofta, Ladislav (advisor)
Since the early 90th of the last century there is a worldwide effort to find the method or the group of prenatal diagnostic methods, which wouldn't be invasive for the fetus and wouldn't handle information about fetus already in the earlest stage. For this reason there was a search for both the ultrasound markers and biochemical markers. It was very important to find the method that would be able to disclose any pathology as soon as possible, it means in the first trimester of pregnancy. Appropriate options' combination of ultrasound screening and advantage of setting the biochemical markers offer increased likelihood of prenatal detection capability while maintaining a low rat of false positivity. In I. trimester PAPP-A is used as one of the markers in combined screening of aneuploidies. According to available resources the serum concentration of PAPP-A is significantly reduced between 8 - 14. week below 0,5 MoM in fetuses with Down syndrome. In this monitored set of women (without monitoring of other ultrasound and biochemical markers) 92% of isolated PAPP-A value below 0.5 MoM was associated with birth of healthy fetus.
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