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Malignant Melanoma - New Scientific Knowledge
Woznica, Vlastimil ; Třešková, Inka (advisor) ; Hauer, Lukáš (referee) ; Měšťák, Ondřej (referee)
Introduction Malignant melanoma is one of the most aggressive skin tumors with unfavorable prognosis and high mortality, especially in the connection with advanced stages. Regarding the incidence growth, it has recorded an increase of 50 % in the last 10 years. The most important for prognosis of the patient with this malignant disease is early diagnosis and radical surgery without delay. In recent years, the benefit of targeted treatment and immunotherapy has been demonstrated in the patients with locally advanced melanoma after resection of primary tumor and nodal metastases. Aims The main goal of our study is to identify patients with a high risk of relapse using biomarkers from fluid biopsy (sections of free DNA circulating in blood) who went through a curative surgical treatment and for whom costly adjuvant therapy would be beneficial. Another goal is to use the above-mentioned biomarkers to detect early recurrence itself and residual disease after excision of the primary tumor site. Methods Whole blood samples were collected at regular time intervals from patients with early-stage malignant melanoma undergoing curative surgery. Plasma was first separated from the collected whole blood samples by two-phase centrifugation. Cell-free DNA (cfDNA) was isolated at the MD Anderson Cancer...
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Controversies in Assessment of Surgical Safety Margins in Oral Squamous Cell Carcinoma
Pošta, Petr ; Hauer, Lukáš (advisor) ; Mottl, Radovan (referee) ; Pink, Richard (referee)
Oral squamous cell carcinoma (OSCC) is a serious and relatively common disease of the oral cavity. Radical surgical removal of the tumor currently remains the treatment of choice. Leaving residual tumor cells in the patient's body has a clearly negative prognostic effect. The key to the success of this treatment modality is the accurate determination of the extent of the tumor and the determination of the safe surgical margin of tumor resection. For this purpose, additional investigative techniques are used, further researched and newly developed to identify the extent of the presence of tumor-altered cells. The benefit of pre- and intraoperative use of natural autofluorescence was investigated in the presented research. The essence of our research is the hypothesis that the use of natural autofluorescence, specifically the VELscope (Visually Enhanced Lesion Scope) system, will lead to an increase in the success of surgical therapy in terms of achieving a tumor cell-free resection margin. The total number of 122 patients with a diagnosis of OSCC included in our study were divided after meeting the inclusion criteria by simple randomization into study and control groups. Before surgery, each patient from the study group was examined with a VELscope device together with marking the extent of...
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Preclinical research of degradation of metallic osteosynthetic alloys in vivo on animal biomodels
Machoň Levorová, Jitka ; Foltán, René (advisor) ; Hauer, Lukáš (referee) ; Hirjak, Dušan (referee)
The dissertation is dealing with the option of using biodegradable metal alloys such as osteosynthetic material in maxillofacial surgery, The hypothesis presupposes that Zn-1,6Mg and WE43 alloys are from the viewpoint of the degradation period and biological interactions suitable for fixation of facial skeleton. The theoretical part of the work evaluates current trends in the use of biodegradable metal alloys. It monitors the development of material for osteosynthesis in maxillofacial surgery emphasizing the biological reactions of material and undesirable qualities including their clinical impact. The experiment part of the work is divided in two successive stages. The first stage used the rat biomodel to implant Zn-1,6Mg and WE43 alloys. The aim was to compare the duration of degradation and to receive the reaction of the ambient tissue. The animals were euthanized in regular intervals. They were scanned ex vivo by means of cone-beam tomography to find the degradation period of each alloy. Histopathological examination was performed to receive the reaction of the ambient bone tissue. The conclusion evaluates WE43 alloy is more suitable for osteosynthesis in the facial skeleton according to the results of the first stage. The second stage used the rabbit biomodel for implantation of WE43 and titanium as a...
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Orbital Floor Fractures
Mottl, Radovan ; Šimůnek, Antonín (advisor) ; Hauer, Lukáš (referee) ; Pink, Richard (referee)
Summary: Orbital floor fractures This work aimed to assess the impact of the implant material, the size of the defect, and the type of fracture on postoperative complications of surgically treated base orbit fractures. The monitored complications were enophthalmos, diplopia, innervation disorders of the infraorbital nerve. A total of 67 patients with "pure" and "impure" orbital fractures were enrolled in this study. The patients were examined, indicated for surgery, and operated at the Dentistry Clinic of the University Hospital in Hradec Kralove at the Department of Oral, Maxillofacial and Facial Surgery between 2009 and 2020. The group of patients included 41 men and 26 women. In the study, we compared several types of implant materials, i.e., 0.5 mm thick poly-p- dioxanone PDS foil (Ethicon, Johnson & Johnson, Germany), 0.4 mm thick titanium mesh (Synthes GmbH, Oberdorf, Switzerland), 1.5 mm thick Medpor (Porex Surgical Products Group, Newnan, USA), an individually made Toman column, and a Foley catheter balloon filled with saline. This study showed that the use of titanium mesh for the reconstruction of the orbit base led to a higher incidence of innervation disorders in the infraorbital nerve area (p=0.0245), compared to the use of other implant materials. Furthermore, a difference in the incidence of...
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Molecular genetic characteristics of salivary gland tumors in differential diagnosis and prognosis prediction
Hauer, Lukáš ; Skálová, Alena (advisor) ; Laco, Jan (referee) ; Mazánek, Jiří (referee)
Molecular genetic characteristics of salivary gland tumors in differential diagnosis and prognosis prediction Abstract: In the presented manuscript the author summarizes the current knowledge on molecular biomarkers of salivary gland cancer, focusing on tumor-type specific fusion oncogenes and their use as diagnostic, prognostic and therapeutic biomarkers. In detail, the author deals with adenoid cystic carcinoma (AdCC), the second most common salivary gland cancer. New facts of its biological behavior as well as new fusion oncogenes probably responsible for its carcinogenesis were described in the last few years. A retrospective case series evaluating 27 patients suffering from AdCC, who were treated at the University Hospital in Pilsen in the last 30 years (1986- 2016), is presented in this study. The following characteristics were observed: age, gender, tumor location, clinical stage at diagnosis, presence of regional and distant metastases, tumor grade, duration of follow-up, treatment and outcomes. Detection of the 1p36 deletion and the t(6;9)(q22-23;p23-24) chromosomal translocation resulting in the MYB-NFIB gene fusion were performed. The incidence of AdCC in minor salivary glands, submandibular gland, parotid gland and sublingual gland was 41 %, 26 %, 22 % and 11% respectively. The following staging...
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Molecular genetic characteristics of salivary gland tumors in differential diagnosis and prognosis prediction
Hauer, Lukáš ; Skálová, Alena (advisor) ; Laco, Jan (referee) ; Mazánek, Jiří (referee)
Molecular genetic characteristics of salivary gland tumors in differential diagnosis and prognosis prediction Abstract: In the presented manuscript the author summarizes the current knowledge on molecular biomarkers of salivary gland cancer, focusing on tumor-type specific fusion oncogenes and their use as diagnostic, prognostic and therapeutic biomarkers. In detail, the author deals with adenoid cystic carcinoma (AdCC), the second most common salivary gland cancer. New facts of its biological behavior as well as new fusion oncogenes probably responsible for its carcinogenesis were described in the last few years. A retrospective case series evaluating 27 patients suffering from AdCC, who were treated at the University Hospital in Pilsen in the last 30 years (1986- 2016), is presented in this study. The following characteristics were observed: age, gender, tumor location, clinical stage at diagnosis, presence of regional and distant metastases, tumor grade, duration of follow-up, treatment and outcomes. Detection of the 1p36 deletion and the t(6;9)(q22-23;p23-24) chromosomal translocation resulting in the MYB-NFIB gene fusion were performed. The incidence of AdCC in minor salivary glands, submandibular gland, parotid gland and sublingual gland was 41 %, 26 %, 22 % and 11% respectively. The following staging...
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