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Nursing proces of patient after reconstructive breast surgery with method of free TRAM flap
Kneiflová, Jana ; Hakenová, Renata (advisor) ; Kulhavá, Miluše (referee)
(Aj) The topic of presented diploma thesis is nursing care of patients undergoing breast reconstruction surgery using TRAM (Transverse Rectus Abdominis Musculocutaneous) flap. The thesis is divided into theoretical and empirical part. Theoretical part deals with history of plastic surgery, breast anatomy, and physiology. In her thesis author focuses on breast cancer, its increasing incidence shifting to the younger and younger age groups, surgical therapy by total mastectomy as part of multidisciplinary treatment, postmastectomy reconstructive procedures using TRAM flap, and possible intraoperative, and postoperative complications. In empirical part author published case report of a patient after total mastectomy followed by TRAM flap breast reconstruction and dealt with nursing care during the immediate postoperative period in the intensive care unit and latter on in plastic surgery department's postoperative ward. The aim of author's thesis is to point out specific issues pertinent to nursing care both in the intensive care unit and standard postoperative ward in patients undergoing above mentioned surgical procedure as well as to highlight the need for more intensive supervision during postoperative period in such a cases compared to classic breast reconstruction with silicon implant. This...
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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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Study of population specific alterations of breast cancer predisposition genes in Czech Republic.
Judasová, Kristýna ; Ševčík, Jan (advisor) ; Holá, Dana (referee)
Breast cancer is the most frequent malignant disease in the female population worldvide. About 10 % of all cases are of hereditary origin. The inactivation of tumor suppressor gene BRCA1 is the main genetic predisposing factor in breast cancer in the Czech Republic. Primarily, BRCA1 participates in DNA double strand break repair. Depending on cell cycle phase, the damage is repaired by homologous recombination or non-homologous end joining. Alternative splicing variants of BRCA1 are frequently detected during the genetic screening of high risk patients. The clinical significance of these variants is unknown. Understanding of the nature of breast cancer genetics is the critical factor for early diagnosis. Based on earlier studies from the Institute of Biochemistry and Experimental Oncology 1st Faculty of Medicine Charles University, two alternative splicing variants which were repeatedly detected in patients, were chosen for functional analysis. The aim of this work is to investigate the impact of alternative splicing variants BRCA1Δ5 and BRCA1Δ10 on DNA double strand breaks repair. Particular variants were over- expressed in the cells of model system. Activity of homologous recombination (HR) and non-homologous end joining (NHEJ) was scored by in vitro DNA repair assay. The cellular localization of...
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Psychological and social aspects of coping with oncological gynecological illnesses (focused on breast cancer)
Šreibrová, Lenka ; Niederlová, Markéta (advisor) ; Šivicová, Gabriela (referee)
The thesis "Psychological and social aspects of coping with oncological gynecokogical illnesses (focused on breast cancer)" studies the demands and difficulties which women diagnosed with breast cancer are delaing with. In the theoretical part, attention is given to breast tumor and to the stages of the illness. It shows the needs and problems the women face and the possibilities of psychological help. This part of my thesis also describes different types of cure and its specifics and the changes it brings to the women's life. It is followed by coping strategies and defence mechanisms. In conclusion, the effects of the illness on personal relationships are outlined. In the empirical part, we map supporting psychological and other factors which helped with the treatment and with coping with it. The empirical part comprises 11 individual interviews with women who had breast cancer. The research methodology is supplemented with The Life Satisfaction Inventory. In the interviews we also focused on the factors of health care which were helping and the ones that could be improved. The results of the mapping qualitative study indicated two most important factors which helped the women to cope with this serious illness. It was social support and active coping strategies. In the sphere of health care, the...
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Detection of minimal residual disease in bone marrow an peripheral blood in patients with breast cancer.
Čabiňaková, Michaela ; Tesařová, Petra (advisor) ; Konopásek, Bohuslav (referee) ; Macek, Milan (referee)
Introduction: Simultaneous detection of disseminated tumor cells (DTCs) and circulating tumor cells (CTCs) was shown to be associated with an especially poor prognosis and increased incidence of disease-related deaths in non-metastatic breast cancer patients. We analyzed the occurance of DTCs in bone marrow and CTCs in peripheral blood in patients with primary breast cancer, we evaluated the correlation of their presence with other prognostic markers and we investigated the changes in DTCs/CTCs number at different time points during treatment. Materials and methods: Blood of 50 patients with primary breast cancer were used for immunomagnetic separation and detection of circulating tumor cells using the commercial available system the AdnaTest Breast Cancer™ (AdnaGen GmbH, Langenhagen, Germany). Bone marrow aspirates from 50 patients were analyzed for DTCs by immunocytochemistry using the pancytokeratin antibody conjugated with FITC (Monoclonal Anti-Cytokeratin antibody F3418, Sigma Aldrich, USA). Results: DTCs were identified in 30% (15/50) and CTCs in 22% (11/50) of patients. We found that DTC positivity could point to a significantly high risk of larger primary tumor size (p- value 0.011) and significantly higher risk of lymph node involvement (p- value 0.002). For CTC positivity, no such...
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Lymphotherapy as part of physiotherapy in patients after the ablation of breast in outpatient care
Jarotková, Eva ; Horká, Bohumila (advisor) ; Vondráková, Ivana (referee)
Author: Eva Jarotková Institution: Department of Rehabilitation Medicine, Faculty of Medicine in Hradec Králové Title of the thesis: Lymphotherapy as part of physiotherapy in patients after the ablation of breast in outpatient care Supervisor: Mgr. Bohumila Horká Number of pages: 97 Year: 2014 Key words: lymphatic system, secondary lymphedema, breast cancer, Complex Decongestive Therapy, quality of life This bachelor's thesis deals with lymphotherapy - Complex Decongestive Therapy, which makes an important part of physiotherapy in patients after the treatment of breast cancer. Information about anatomy, physiology and pathophysiology of the lymphatic system is covered within the theoretical part. It also brings forward the whole issue of breast cancer with its diagnosis, prevention and treatment and mainly focuses on its complication, secondary lymphedema of the upper extremity. The end of the theoretical part describes the basis of Complex Decongestive Therapy. The empirical part shows how Complex Decongestive Therapy is used in two patients after the ablation of breast, diagnosed with the secondary lymphedema of the upper extremity. The goal of this part is to prove how significantly Complex Decongestive Therapy contributes to cure lymphedema and how greatly it affects the quality of patient's...
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Clinical and genetic aspects of familial breast cancerFrequency of recurrent mutations in BRCA1 and BRCA2 genes in Czech republic and the role of NBN gene
Matějů, Martin ; Novotný, Jan (advisor) ; Konopásek, Bohuslav (referee) ; Vaňásek, Jaroslav (referee)
Summary: Background: An increased risk for development of hereditary breast cancer is associated with germline mutations in BRCA1/2 and the influence of NBN mutations is also supposed. The aim of this study is to specify the frequency of recurrent mutations in BRCA1/2 in unselected breast cancer patients and the frequency of most common pathogenic mutations in NBN in Czech republic, to assess current criteria for genetic testing and to consider the addition of NBN to the tested genes. Methods: Screening for recurrent mutations 5382insC and 300T>G in BRCA1 was performed by RFLP, screening for mutations in exon 11 of BRCA1 was performed by PTT, screening for mutations in a selected region of exon 11 of BRCA2 by DHPLC, and screening for mutations in exon 6 of NBN by HRMA. All the mutations were confirmed by direct sequencing. Results: In 679 unselected breast cancer patients 7 carriers of 5382insC, 3 of 300T>G, and 4 of other mutations in BRCA1 were identified. 2 locally prevalent mutations were found in BRCA2. In 730 controls only one 5382insC BRCA1 mutation was identified. Out of 5 NBN mutations found in 600 high-risk patients two were 657del5 and one R215W. A total of 8 NBN mutation carriers were identified among 703 breast cancer patients, 2 of them 657del5 carriers and three R215W carriers. In 915...
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The molecular causes of human diseases and teaching of this topic on high school
Jirkovská, Magdaléna ; Janštová, Vanda (advisor) ; Mourek, Jan (referee)
This bachelor's thesis is a literature research that deals with The molecular causes of human diseases and teaching of this topic on high schools. The first part is focused on an explanation of the molecular causes of selected human diseases mentioned in textbooks for high schools. It also touches another possibilities of teaching these topics at secondary schools. Human diseases mentioned in this part of the bachelor's thesis were chosen by researche of textbooks. The second part of the thesis deals with the evaluation of textbooks. Textbooks were evaluated only in terms of the content of information related to the topic of my thesis. The evaluation criteria were stated upfront and they were identical for all textbooks.
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Gene expression study of oxysterol signal pathway in breast cancer patients
Kloudová, Alžběta ; Souček, Pavel (advisor) ; Vopálenský, Václav (referee)
Hormonal therapy is a common part of breast carcinoma treatment in patients whose tumors express estrogen and progesterone receptors. The aim of hormonal therapy is to prevent proliferative effect of hormones througt their receptor proteins in order to inhibit tumor growth. However, certain number of tumors is resistant to hormonal therapy despite expression of hormonal receptors. Presently, the reasons of this resistance are not fully understood. Oxysterols are hydroxylated cholesterol derivates, which may play some role in development of the resistance. They may interfere with hormonal therapy effect and influence some signal pathways leading to cancer progression. This study comes with results of gene expression of proteins influenced by oxysterol action, metabolic and transport proteins, transcription factors and members of signaling pathways that may be related to oxysterol effect. This thesis identifies some candidate genes for future analysis on the basis of comparison of gene expression between estrogen receptor positive and negative tumors and correlation with clinopathological data. The final goal should lead to discovery of new diagnostic markers for breast cancer therapy. Powered by TCPDF (www.tcpdf.org)
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