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Bioartificial liver in the treatment of experimental acute hepatic failure in a large laboratory animal
Pantoflíček, Tomáš ; Šmejkal, Karel (advisor) ; Král, Vladimír (referee) ; Třeška, Vladislav (referee)
Bioartificial liver in the treatment of experimental acute hepatic failure in a large laboratory animal Aim: To evaluate bioartificial liver (BAL) in the treatment of acute liver failure in the experiment. Methods: 10 minipigs weight 25 - 30 kilograms with experimental acute liver failure (ALF) by surgical devascularization with portocaval by-pass were treated by BAL. The biochemical and hemodynamical parameters of ALF including intracranial pressure (ICP) were measured. The results were compared to control group without BAL treatment. Results: To compare plasma bilirubin there was statistically significant difference between experimental and control groups in 6th and 9th hours to favourite BAL group of minipigs (20,86 vs. 10,60, 22.29 vs. 11,75) and in the 12th hour (37,4 vs. 12,88). The value of ICP in both groups was not significant. Conclusion: The functionality of BAL on our own surgical model of ALF was proven. Initial 85 % viability of fresh isolated porcine hepatocytes and their survival in the time of BAL treatment was reached. Bilirubin plasma concentration has significantly changed in comparison in both groups. ICP values were not changed significantly. Key words: acute liver failure - minipig - bioartificial liver - BAL - Bioreactor - hepatocytes - intracranial pressure
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Perioperative prognostic factors in breast cancer
Černá, Monika ; Třeška, Vladislav (advisor) ; Gaťek, Jiří (referee) ; Šiller, Jiří (referee) ; Jandík, Pavel (referee)
Introduction: Breast cancer still remains the most common malignancy in women and its incidence is slowly increasing. A marked reduction of mortality has been achieved in the last 10 years thanks to modern diagnostic methods, mammary screening, and comprehensive and targeted cancer therapy. Modern diagnostic capabilities not only allow early diagnosis of a primary tumor lesion and precise determination of its biological nature before commencing treatment, but they also enable early diagnosis of local and regional recidives, including diagnosis of metastases in distant organs. In addition to clinical examination, conventional and complementary imaging examinations and tumor markers our objective was to determine the importance and use of growth factors in relation to the overall prognosis. The growth factors physiologically act already during the ontogenetic period when they control cell growth, proliferation, differentiation and apoptotic processes. It is known that they take part in the tumor growth processes which are characterized by autonomous behavior, increased proliferative activity, distinct differentiation activity and reduced apoptosis. Growth factors work as autoregulation factors in the neoplastic process as well as through their paracrine effects mediated by more or less specific receptors....
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Analysis of the cytosol of thyroid gland and its contribution in the differential diagnosis of nodular lesions
Pikner, Richard ; Topolčan, Ondřej (advisor) ; Fínek, Jindřich (referee) ; Třeška, Vladislav (referee)
Thyroid nodules represent the most frequent endocrine lession in our population and it is neccessary to differentiate malignant lessions from them. The aim of the study was to validate determination of selected angiogenic, proliferative, and appptotic markers in cytosol tissue extracts. We analysed 166 tissue samples (85 goitres, benign adenomas and 10 malignat tumours in which VEGF, bFGF, Endostatin, Thymidinkinase ans TPS were determined. Main limitation of cytosolic analysis is tissue sample volume, that must be about 1cm3 and interindividual variability caused by tissue sample heterogeneity. Best way is to compare normal with pathological tissue samples from one patient. We fund significant differences amog histological groups in VEGF, bFGF, Endostatin and maily Tymidinkinase and TPS. These differences are not sufficiently huge to distinguish goitres and benign lessions . We also did not find any correlation between cytosolic markers and iminuhistochemistry markers . Cytosol analysis is not able to measure local expression and its differences in anylysed tissue, but it is able to quantitatively determine mean levels of selected markers.
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The Importance of Measuring Intraabdominal Pressure in Cases of Severe Acute Pancreatitis
Kural, Tomáš ; Třeška, Vladislav (advisor) ; Chytra, Ivan (referee) ; Kala, Zdeněk (referee) ; Leffler, Jan (referee)
Treatment of severe acute pancreatitis is considered to be conservative. The only generally accepted indication for surgery in severe acute pancreatitis patients is an established infection of the necrotic tissue and persisting or progressing symptoms of multiorgan failure despite the maximal intensive treatment. For surgical treatment are also indicated patients with complications of severe acute pancreatitis (erosive hemorrhage, perforation of GIT etc.). In the proposed work, attention is drawn to those cases, where the general condition of the patient deteriorates combined with a progression of ACS and where a decompressive laparotomy can improve the prognosis of the disease. In our group of 214 patients with severe acute pancreatitis, who were treated over the last six years, 70 patients were indicated for surgery. Out of this count, in 17 cases the indication for decompressive laparotomy was a raise of intraabdominal pressure up to the values of ACS together with the symptoms of organ dysfunction, 6 patients died and 11 younger patients survived.
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Pathogenesis of the Lymphocele following the Kidney Transplantation
Pacovský, Jaroslav ; Navrátil, Pavel (advisor) ; Třeška, Vladislav (referee) ; Adamec, Miloš (referee)
The lymphocele is a surgical transplant complication resulting from lymphatic vessels injury. This injury is background of the lymphocele pathogenesis, no lymphocele cannot become into existence without this step. On the other hand, the all organ procurement and transplantation procedures are associated with any rate of this injury at all time. Our results present proteins as a very important factor influencing interstitial fluids transport. The colloid osmotic pressure of the proteins controls interstitial fluids flow even across the vessel walls. Lymph fluid flow is also under the osmotic pressure control. The proteins play serious role in the second phase post-transplant lymphocele pathogenesis. At first, proteins control return of the leaked lymph back into the lymphatic vessels. Finally, inflammatory proteins participate on development of the fibrous lymphocele capsule. Postoperative care for protein metabolism seems to be very important in the protection against the post-transplant lymphocele formation. Carefully metabolic care for patient after renal transplantation should help to decline risk of lymphocele. The knowledge of the pre-transplant protein level and its fractions is very useful for relevant estimation of the risk of the post-transplant lymphocele formation. Calculation of the...
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Cryopreserved semilunar heart allografts: Leaflet surfase damage in scanning electron microscopy
Burkert, Jan ; Špatenka, Jaroslav (advisor) ; Černý, Štěpán (referee) ; Černý, Jan (referee) ; Třeška, Vladislav (referee)
7. Anglický souhrn: Cryopreserved semilunar heart valve allografts: leaflet surface damage in scanning elect.-on microscopy. Objective: Allograft heart va1ves (AHV), biologica1 va1ves ofhuman origin, offer potential advantages over conventiona1 xenografts in terms of superior hemodynamics and, perhaps, better durability. The most important factors for long-term AHV c1inical peďormance are the processing and cryopreservation methods. The aim ofthis study was to eva1uate the impact of current processing protocol on va1ve tissue morphology, maínly to address the effect of successive processing steps on the leaflet suďace structure. For the detection offine changes in endothelia1 covering and underlying layers, our own modification ofthe scanning electron microscopy (SEM) technique was utilized. Material and methods: The study was based on an investigation of20 AHV (40 specimens). Fourteen valves came from heart-beating donors (multiorgan harvesting) when the heart could not be transplanted for any reason (donor criteria, availability of recipient and/or logistics). Six were obtained at the time of routine postmortems - non heart-beating donors (NHBD). AU specimens were initially flxed in Bakeťs solution. Tissue samples were dissected, dried with hexamethyldisilazane (HMDS), gold-coated, studied and...
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Gemcitabine in anti-rejection treatment in experimental liver transplantation
Mergental, Hynek ; Ryska, Miroslav (advisor) ; Bělina, František (referee) ; Třeška, Vladislav (referee)
The first part of thesis is focused on the technical aspects of experimental model of liver transplantation on rats. The second part describes the research project that tested a novel immunosuppressive drug gemcitabine compared to low dose of cyclosporine A on the acute liver rejection model. To use a cytostatic drug in a low dose with a minimal toxicity as an immunosuppressant would be attractive for clinical use. Particularly because liver transplantation for hepatocellular carcinoma represent a frequent indication nowadays and also due to risk of development of a new post transplant malignancies as an side effect of standard immunosuppressant. Our results showed lower nephrotoxicity compared to cyclosporine, however, did not confirm the previous optimistic reports in terms of rejection treatment as it only mildly decreased the rejection severity. Our data suggests that gemcitabine cannot be used as a main immunosuppressant alone.
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