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Th1/Th2 cytokine gene polymorphisms in patients with urine fibroid
Sosna, Ondřej ; Kužel, David (advisor) ; Živný, Jan (referee) ; Novotný, Zdeněk (referee)
Background: Uterine fibriod (UF) or leiomyoma is the most frequent benign tumour upon lower genital tract and represents the most frequent indication for hysterectomy. The aetiology remains still unknown. The genetic factors contributing for the development of UF are being intensively investigated. The aim of our study was to look for possible genetic markers which could be used as prognostic tools for evaluation of an increased risk for development of UF. Methods: The study group enrolled 102 patients diagnosed with UF and 145 healthy controls. Ultrasonographic examination of the pelvis was performed and a single blood sample was taken in all women. Histological verification followed the surgery in the patient group. The principal of the cytokine gene polymorphisms detection is based on PCR reaction with sequence-specific primers. Results: A large spectrum of Th1/Th2 cytokine gene polymorphisms in patients with uterine fibroid was compared with control group. The frequencies of the majority of tested cytokine gene SNP in the patient cohort were not statistically different from the cytokine SNP in the control group. However, an intriguing association between polymorphisms of the IL-4 gene promotor at positions -590 C/T and -33 C/T, and the risk of leiomyoma was observed. The CC genotype of IL-4 at position...
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The role of human papillomavirus in the etiology and prognosis of squamous cell carcinoma of the oropharynx
Rotnáglová, Eliška ; Klozar, Jan (advisor) ; Šlapák, Ivo (referee) ; Zámečník, Josef (referee)
Tonsillar cancer (TC) presents an important part of head and neck cancers and its incidence is rising in the Czech Republic. Cigarette smoking and alcohol abuse are risk factors responsible for approximately two thirds of all head and neck cancers. Furthermore, a role of human papillomavirus (HPV) as an independent risk factor has been demonstrated recently. The aims of the present study were to find demographical differences between the group of HPV-positive and negative patients, to determine the prevalence of HPV in TC of Czech patients and also to find out whether the virus in HPV DNA positive tumors is transcriptionally active. Another aim was to test different markers of HPV infection for a precise selection of patients with HPV associated disease and to determine the prognostic role of these markers. A set of 109 patients with primary TC was examined for HPV DNA presence in tumor tissue and for the presence of HPV specific antibodies in serum. Data regarding risk factors were obtained by questionnaires. Forty-five samples were available for E6 and E2 mRNA analysis and for immunohistochemical analysis of p16 and p53 expression. The overall prevalence of HPV DNA in TC was 65%. In 93% of HPV16 DNA positive samples the virus was transcriptionally active. The E2 expression status has shown that in...
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Role of diagnostic imaging in hydronephrosis
VOSMÍKOVÁ, Anna
I have chosen the topic of my thesis ?The task of displaying methods for a hydronephrosis ground diagnostic? thanks to the many possibilities of diagnostic and laboratory screening methods. Hydronephrosis and its matters is often discussed topic within a medical staff - how to examine it and which method is the most effective. This is the main goal of my work as well. The main goal of my work is to compare the most effective and the most informative screening methods of the outcome urinary system. Furthermore, I would like to introduce a proposal of an applicable method of the outcome urinary system visualization. I set up the hypothesis, that an outcome urography which used to be the main radiologic method of diagnostic of hydronephrosis, is nowadays successfully replaced by the complex of the modern displaying methods. I have done a quantitative research in two Prague´s hospitals with an accreditation. I focused on 30 patients with a hydronephrosis (also derived from the secondary source) in each hospital. I compared a number of the screenings to which the patients were indicated and also the screenings the clearly displayed the ground of the hydronephrosis. I have also registered the ground of hydronephrosis, which primary was not the goal of my work. It is used to apply an ultrasonography as the first choice of diagnostic in cases where there is the suspection of hydronephrosis in FNM and ÚVN. Ultrasongraphy is a method without ionising radiation and with the fast kidney structure evaluation. It was not always shown clearly by ultrasound by patients with hydronephrosis, and that is why the other methods like RTG, CT, IVU and MR were used. The scintigraphy was done as well, but only for TNM staging tumours. The first objective of my work is a comparison between diagnostic methods. This target was met in the research results, added by charts. The second objective, to present a plan for an appropriate method to display outcome urinary system, is not possible to fulfill. The same procedure cannot be used for each patient ? considering the different ground of the hydronefrosis, we need to use individual attitude. I also present an extensive chapter on causes of hydronefrosis in my work. According to the results I confirm a hypothesis, that an outcome urography is nowadays mainly replaced by modern diagnostic methods, mostly by the computer tomography. In the end, I would like to mention, that the work of the radiologic assistant has changed nowadays, especially thanks to the development of radiodiagnostic and of the digitalization. Radiologic assistant has become very important part of the medical team. His/her work also includes a communication with a patient, his/her monitoring during the screening, and a professional communication with the medical team. The knowledge of the new work methods, its principles and the work with the new Pc programs (e.g. PACs) is also indispensable.
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Detection of minimal residual disease in patients with early breast cancer
Janků, Filip ; Matouš, Bohuslav (advisor) ; Brdička, Radim (referee) ; Melichar, Bohuslav (referee)
Breast cancer is one of the most serious health problems in our society. In the Czech Republic there are nearly 6000 women newly diagnosed annually. Despite the increasing incidence the mortality is leveling off or even decreasing in many countries (152,153). It is probably attributed to earlier diagnosis and the introduction of screening mammograms in many developed countries (154), and new findings in molecular biology of tumors. Several molecular factors are already routinely used in routine clinical practice as prognostic (estrogen and progesterone receptors, HER-2/neu, p53, Ki-67, vascular endothelial growth factor-VEGF), and predictive factors (estrogen and progesterone receptors, HER-2/neu) or therapeutic targets of anticancer treatment (estrogen and progesterone receptors, EGFR, HER- 2/neu, HER3, HER4, VEGF, mTOR) (7,45,155-157). The detection of minimal residual disease in early breast cancer is another attempt to implement modern diagnostic technologies in order to improve treatment outcomes. The aim of the study was to investigate diagnosis and prognostic implications of minimal residual disease in axillary lymph nodes, and bone marrow of patients with early breast cancer. The most promising material was bone marrow. From the clinical point of view it is necessary to validate both...
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Psychosocial aspect of pediatric onkology. Child and Family.
LEMERMANOVÁ, Stanislava
The work, which is focused on learning about families living with a school-age child suffering from a cancer disease, has brought a number of findings and experience. Its goal was to map general climate of a family living with a child suffering from cancer and an effort to record some of its typical or specific differences. Interviews of ill children, their siblings and parents brought the most important finding regarding functioning these families. Interviews of children imply that they have enough information about treatment and examinations, however, not enough information about the disease. Communication of parents and children about the diseases turned out to be problematic. Some children want to know more about the disease but their parents are unable to meet their needs. Interruption of school attendance, and thus, interruption of the contact with schoolmates is the most depressive change for children. In the interviews parents say that the worst period was the one when it was already obvious that the disease was serious but the diagnosis had not been set. Child{\crq}s disease entirely changed everyday life of the families; everything was governed by the fact whether the child is in hospital and how he or she feels. One of parents had to stay with the child and thus the family split. Healthy siblings found themselves in the shade of the ill child, the older ones tried to understand the situation and help their brother/sister and the parents as much as possible. Deepening of the relationship between the parents, psychic maturing of the ill child and his/her older siblings, and change in the value attitudes of parents may be ranked among the positive changes. The situation brought a clear and factual result that all family members are extraordinary close to each other and the families are adaptable. Serious disease of the child results in a fact that the families function in a stress situation and more intensive solidarity and adaptability are a necessity for them. On the basis of the research we may say in the conclusion that relevant attention and care should be paid not only to ill children and their parents but also to their healthy siblings. Tumour disease and risk to the child{\crq}s life represent an extreme stress for a family. The structure of the family changes and its everyday life turns upside down completely. The families I met during the research were managing the situation well. Even though the situation was exhausting for them and some faced communication problems, they could all function and take care of their ill child.
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The effects of zinc ions on breast tissue cancerogenesis
Kratochvílová, Monika ; Stiborová, Marie (referee)
The concept of breast cancer describes a wide range of serious diseases. It is one of the most common cancer diseases among women worldwide. The most difficult and problematic subtype is the triple negative breast cancer. This subtype is characteristic by the loss of expression of hormon receptors and HER-2, which makes it unresponsive to available targeted therapy. The breast cancer, as well as other malignancies, has a relationship withzinc ions. Zinc is an essencial element and it is involved in many of important cellular processes and thus it is able to directlyor indirectly affect the cancerogenesis. Increased levels of zinc ions in malignant breast cancer tissue compared to healthy tissue were well described. However, zinc has documented anticancer properties. The aim of this study was to determine if excessive suplementation with zinc ions has an effect on breast cancer development in vivo. The cell line 4T1 was chosen as a model of the triple negative subtype in mus musculus. The mouse strain BALB/c was used as an animal model. A total dose of zinc sulphate per one gram of mouse weight used in the experiment was 0.15 mg. We determined not only the growth of primary tumour, but also an expression levels of selected genes and antioxidant capacity of the whole organism. The volume of primary...
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The Specifics of Nursing Care in Patients with Organic Psychosyndrome due to Craniocelebral Injury, Disorder.
GONDÁŠOVÁ, Jitka
Formerly used as a separate term, organic psychosyndrome has been currently included, according to the International Classification of Diseases, in the group of mental disorders arranged on the basis of the conclusive aetiology in the events of brain injuries, brain diseases and other brain damage leading to brain dysfunction. Organic psychosyndrome is a state of changed brain functioning resulting from an injury, cerebral apoplexy or brain tumour or from other causes. At that time the brain activity is changed, the cognitive functions are reduced, and the manner of experiencing along with the personality manifestations is changed with various intensities. Patients show overall restlessness and sometimes perception disorders. Organic psychosyndrome has a varied course and abates at various speeds. It never means a definite change of brain functioning. After the organic psychosyndrome abates, a cognitive deficit or a personality change caused by the brain injury may continue. Nursing care is very demanding for nurses both in physical and mental terms. The purpose of the quantitative research is to ascertain preparedness of nurses to communicate with patients with the organic psychosyndrome and to find out whether higher education influences provision of nursing care, whether nurses cooperate with the patients{\crq} families, and how nurses educate the families. The quantitative research was conducted in the form of questionnaires in selected wards of Nemocnice České Budějovice a.s. Pursued in March 2010, the research was aimed at respondents from the wards of traumatology, neurosurgery, neurology and psychiatry. 82 questionnaires were processed. Hypothesis 1 {--} Nurses do not have information concerning the specific communication with patients with organic psychosyndrome {--} has been disproved. The other hypotheses have been confirmed. A nurse with a higher education has more information about the form of nursing care of a patient with the psychosyndrome, educates the patient{\crq}s family continuously in the course of his/her hospitalization, involves the family members in the patient{\crq}s self-sufficiency training, educates the family mostly in the form of a dialog and has no printed education material at her disposal.
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Barriers in communication between nurse and terminally ill peadiatric patient
IMRAMOVSKÁ, Simona
Nursing care for paediatric terminally ill patients in the Czech Republic is continuously evolving and developing. It is important for the nurses to learn to use suitable communication. Theoretical part of this work includes information on terminal stages of illnesses in children and the corresponding care that should be provided. It further focuses on communication with the child and his/her parents. The theoretical background for this work is the conceptual Callista Roy Adaptation model for nursing applied on a paediatric terminally ill patient. The main aim of this work was to focus on revealing features in nurse communication with a child patient with regard to his/her medical diagnosis. We have focused on mapping medical diagnosis for paediatric patients in terminal stage of their illness that evoke communication barriers in nurses involved with the patients. Further step of this research was obtaining the information about the type of barriers the nurses evolve. Another aim was to create educational material for nurses based on information obtained from the research that would lead to improved communication between the nurse and the terminally ill child. A personal aim was also set in this work to gain necessary information and experience for the starting carrier as a paediatric nurse. Five research questions were posed to reach the aims of this work aimed at identifying communication barriers with regard to medical diagnosis child patient in the terminal stage of the disease, barriers in communication with a child patient in the terminal stage of the disease, evaluation of the quality of nurse communication with terminally ill child patients, use of communication aids in nursing care for these patients and we also wanted to know what changes in the communication with the terminally ill children the nurses experienced since the beginning of their working practice. The practical part is divided into two qualitative research investigations. In the first phase of this research eleven nurses working at paediatric oncology wards and eight nurses from hospice care aimed at child patients participated. Half-structured interview technique was used for the research. Based on the practical aim, second phase of the research consisted of evaluation of the impact educational material created as a result of the first phase of the research had on the nurses. The first phase of the research showed that the communication barriers are evoked in nurses by the following diagnoses: bone tumours, brain tumours and multiple sclerosis. Further barriers found in nurses regarding communication with terminally ill patients included: children above 12 years of age, lack of knowledge about suitable communication and about the patient, unsolved issues with own mortality, fear and embarrassment of possible mistakes and the patient personality. Nurses use many means of communication. Nurses noticed changes in communication that happened during their carrier; they mentioned more reassurance, more knowledge, better assessment of the children and suitable timing. They also feel better during the time of mourning, understanding the role of the parents; they feel more humble and respectful towards life itself. Nurses evaluate their level of communication with child patients very positively and have a will to educate themselves further. The nurses showed signs of psychological load. It was also revealed that a psychologist is not functional or altogether missing in their place of work. The second phase of the research showed that nurses welcomed and appreciated the educational material created for them, they found it useful in their nursing practice, they evaluated it as useful for beginner nurses. Based on this material a children book was purchased for the ward. The recommendation for practice is the use of the Callista Roy Adaptation model for nursing. I have personally gained both wide theoretical knowledge and experience from the interviewed nurses.
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