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Histology of the lungs with a focus on bronchogenic carcinoma
KAPOUNOVÁ, Pavla
The aim of this bachelor thesis is to explain the anatomic and microscopic lung structure as well as basic features of selected pulmonary disorders, especially of bronchogenic carcinoma. The thesis deals with types, causes, pathogenesis, symptoms, diagnosis, and treatment of bronchogenic carcinoma. The thesis is comprised of two parts. The theoretical part introduces lung development, anatomic and microscopic structure of the lower respiratory tract, lung structure and function, vascular supply, and lymphatic drainage. The most frequent nonneoplastic and neoplastic pulmonary diseases are described here. The practical part of the thesis is focused on tissue processing. This complex process starts with the removal of a tissue specimen from a patient's body (biopsy) and it is finished when microscopic slide is handed to a physician (pathologist). All steps are important; there is an imperative to prevent any specimen damage as it could hamper the diagnosis. All tissue specimens must be stored in a fixative and delivered to a histopathologic laboratory, together with a clinical request for a pathological examination. Following steps are carried out in the histopathology laboratory: macroscopic examination and cut-up, processing in a tissue automate, embedding, cutting, and staining. The basic staining method is performed by hematoxylin-eosin. Finally, slides are covered and given to a pathologist who establishes a diagnosis on a particular slide, or asks for additional examinations. These may be additional histochemical stains or auxiliary studies such as immunohistochemistry or genetics. All these methods may contribute to a final diagnosis of the biopsy. The chapter Frequency of diagnoses summarises lung biopsies examined at our department (Šikl Department of Pathology, University Hospital, Plzen, the Czech Republic) in 2015. In the discussion, the frequency of bronchogenic carcinoma types is evaluated with a regard to the sex and age. Several graphs are added. Research: CD133 as a prognostic marker for non-small cell lung cancers.
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Transport and Deposition of Aerosol in Human Respiratory Tract
Elcner, Jakub ; Kratochvíl, Zdeněk (referee) ; Volavý, Jaroslav (referee) ; Jícha, Miroslav (advisor)
One of approaches in treatment of respiratory system diseases is the use of drug particles suspended in air in the form of aerosol. It is a fast and non-invasive method for the delivery of medicine into tracheobronchial tree or bloodstream. Although the method of the medication dosage by means of inhalers or nebulizers is well known, the effectiveness of that approach is still an actual issue. A significant amount of drugs delivered with the use of the medication dosage never reaches its primary destination and the drugs deposit in antecendent areas of respiratory tract where their presence is not required. This thesis deals with a problem of the passage of monodisperse homogenous aerosol with micron-size particles through the upper parts of the respiratory tract. This work was created with the use of numerical simulations carried out by means of the finite volume method in the commercial code based on computational fluid dynamics. Turbulence was modelled using the Reynolds averaged Navier–Stokes equations with the two-equation eddy viscosity k-omega SST model. The main output of the thesis is the analysis of airflow in two respiratory regimes. Stationary and cyclic cases of the flow behaviour were considered and the validation of simulated results with experiments performed on similar geometries was carried out. Furthermore, the review of simplified lung models and their geometries was made and the acquired results were used for the calculation of air distribution in the respiratory tract. The last part of the thesis deals with the calculation of particle deposition and with the analysis of the results.
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Segmentation of Airways in CT Data
Votoupal, P.
This paper deals with the segmentation of lung parenchyma and extraction of airways tree from three dimensional CT scans. The external mask of the lungs is created and subsequently used to ease the process of airway segmentation. A method, based on grayscale reconstruction, is used for segmentation proces.
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Nursing care for patient after lung surgery
PECHOVÁ, Lenka
The operation of the lungs is being performed on the base of a variety causes, among which the most common causes are cancer, inflammatory diseases, accidents and a variety of complications of diagnostic and therapeutic procedures. After the surgery, patients are taken to the intensive care unit (ICU). The nurse must meet the patient´s biological, psychological, but also laboratory and medication needs. The attainment on this thesis which is titled as "Nursing care for patients after lung surgery" was to determine the method of nursing care for patients after lung surgery. Three research questions were also asked to achieve this. The necessary information were obtained through qualitative research, semi-structured interviews with nurses from the Department of Surgical Intensive Care Unit, Hospital Czech Budejovice a.s. The research was conducted during March 2015. Three categories were generated from an analysis of data: Specific care for patients after lung surgery, Education, Rehabilitation. This research suggests that nurses meet frequently with this specific care for patients after lung surgery that means several times a month. Further information from this research is that the patient after surgery gets parenteral nutrition first, on the second day starts with a liquid diet and the nurses are following the care with most commond diets as diet no 0, 1, 3, and diet no 9 if the patient is a diabetic. After the surgery, the oxygen is being provided to a patient. The results showed that the nurses must always check to see if the airways are clean, that the patient does not have any mucus in the lungs and that he's able to cough without problems. Nurses are checking the blood gas values by using a Pulse Oximeter. Emphasis is placed on the post-surgery rehabilitation to allow patient to be fully ventilated. For a different lenght of times the indwelling urinary catheter (hereinafter PAK) is fed to patients with respect to the operating performance. It depends on the patient's health condition. The nurses must check the functions of the thoracic drains which are often inserted after surgery. First, the patient has an active suction or active mobile suction, then Bülauov drainage. Frequency of change of the surgical wound dressings is mainly set by the doctor. Postoperative pain is monitored in a verbal way. Prescribed medication is administered also by using the epidural line. Subsequently, the patient receives painkillers IM inj. According to the nurses the post-surgery complications are breathing problems, bleeding from wounds, pain, risk of infection, high waste of chest tubes, the inability of the lungs to maintain a vacuum and subsequent collapse of the lung. The education of the nurses is very multidirectional and each one applies different methods to enrich their knowledge. Physical Therapists are responsible for the rehabilitation of patients after lung surgery. Nurses have a very good knowledge in a nursing care which is applied in their practice. However in some ways the information obtained from the nurses disagree with the procedures set forth in the literature. The conclusion of this work should be aimed to the improvement of nursing care for patients after lung surgery and to correct the shortcomings in the providing of nursing care. This work can be used as educational material for nurses starting job at the Department of Surgical Intensive Care Unit, Hospital Czech Budejovice a.s.
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Radiotherapy of small cell lung cancer
KORDÍKOVÁ, Jitka
Of all lung cancers, small cell lung cancer ( SCLS ) occurs with frequency of 25 - 30%. Patient with small cell lung cancer treated with chemotherapy with or without chest irradiation. Without treatment, small cell carcinoma of the lung has the most aggressive clinical course of any type of pulmonary tumor, with median survival from diagnosis of only 2 to 4 months. Small cell carcinoma has a greater tendency to be widely disseminated by the time of diagnosis but is much more responsive to chemotherapy and irradiation. The aim of this work was to assess irradiation of the chest for small cell lung cancer among patients treatment in years 1990 {--}1995 and patients treatment in years 2000-2005 in the hospital České Budějovice a.s. I´m processed the data about average age, sex, disease range, treatment type, irradiation mode, medical answer and median of survival. Small cell lung cancer is most frequent disease in the men, but also this disease increases in the women. The age rang is 37 {--} 79 years. The average age is 60,7 years. The stage third and fourth is most frequent disease rang. The irradiation techniques are mostly used - 11x3Gy, 20x2Gy, 25x1,8Gy. The median of survival was 8 months. The patients treated only with irradiation was the median of survival 4 months. The patients treated with combination irradiation and chemotherapy was median of survival 10 months. It is advisable to use chemotherapy. Radiotherapy plays an extremely important role in palliation of symptoms of the primary tumor and of metastatic disease, particularly brain and bone metastazes.
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