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The role of IL-17 in kidney transplantation
Menšíková, Markéta ; Krulová, Magdaléna (referee) ; Stříž, Ilja (advisor)
The role of IL-17 in kidney transplantation - abstract Naive CD4+ T-lymphocytes (Thp) can develop into Th17 line in the presence of TGF- and IL-6. Th17 cells are characterized by expression of Ror- t and by production of interleukin-17 (IL-17). It is secreted as a glycoprotein homodimer. Binding to IL-17 receptor (IL-17R), which is present in all cell types, stimulates the production of proinflammatory cytokines and chemokines. The ratio of Th17: Treg in the graft showing signs of rejection is higher than in the graft without rejection. The presence of IL-17 in a culture of proximal tubular epithelial cells (PTEC) stimulates the production of IL-6, IL-8, MCP-1 and C3 complement component. Simultaneous action of IL-17 and CD40L synergistically increases the production of IL-6, IL-8 and RANTES. Signaling from the receptor on the surface of PTEC associated with its increased expression is effected via the src kinase and MAP kinase, and probably leads to the transcription factor NF- B. In rat models of transplantation, the IL-17 appears in allografts on the second day after surgery, the level rises until the fifth day, then decreases and disappears before the death of the animal. IL-17 is not detectable in isografts and negative controls. It appears before the IFN- , which had been considered a trigger of...
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Immunomodulatory properties of mesenchymal stem cells - use in therapy
Pavlíková, Michaela ; Stříž, Ilja (referee) ; Krulová, Magdaléna (advisor)
Mesenchymal stem cells (MSC) are extensively studied mainly due to their feasible clinical application. Therapeutic potential of MSC consists not only of the ability to differentiate into mesenchymal cells, ectodermal and endodermal cell lines, but primarily in their immunomodulatory functions. Due to their effect on immune cells, MSC promote the shift of the inflammatory immune response to antiinflammatory. The ability to suppress inflammation, together with their differentiation potential and antiapoptotic potential on the surrounding cells makes MSC a promising tool for treating serious diseases. This work discusses the effect of MSC on the individual cells of the immune system. It focuses on the description of the effect of MSC in four model cases. These are an experimental autoimmune encephalomyelitis, myocardial infarction, diabetes mellitus and skin graft transplantation. The knowledge of the mechanisms of the interactions between MSC and the cells of the immune system, together with the understanding the effect of specific conditions on MSC is essential for their use in clinical therapy. Keywords: mesenchymal stem cells, immunomodulation, autoimmune diseases, transplantation
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Medical Specialist Awareness and Attitude about Organ Donation
Hajšlová, Petra ; Hošťálková, Monika (advisor) ; Vaňková, Milena (referee)
Bachelor thesis is focused on finding the awareness and attitudes of nurses towards organ donation. The work is divided into two parts ̶ theoretical and empirical. In the theoretical part summarizes available data on the history and development in this field, applicable legislation is mentioned, care for organ donors and overview of the current situation of organ donation, along with current trends. Empirical part took the form of quantitative research, which was conducted by anonymous questionnaires. The aim was to determine nurses' awareness about organ donation organization, determine their orientation in the field of diagnosis of brain death, to map the contemporary practice in the care of a dead donor organs and detect personal attitude on the issue of donation. Respondents were nurses that during their practice on the wards encounter this issue. Questionnaires were distributed on anesthesiology and resuscitation department of Central Military Hospital ̶ Military University Hospital in Prague, then to the operating room and intensive inpatient department of intensive and resuscitation care at the Institute for Clinical and Experimental Medicine. Investigation was attended by 96 nurses. In results, we found that the principle of presumed consent to organ donation in the Czech Republic is...
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Opinions of the students of the South Bohemia university about selected ethical problems of the health care
RAZIMOVÁ, Pavlína
This Bachelor thesis is focused on ethical issues in medicine, namely in communication between physician and patient, further on euthanasia, interruption and transplantation. This work is divided into two parts. The theoretical part introduces the theme of the thesis. It provides the basic information about ethics, about the relationship between physician and patient and their communication, about patient´s rights, about euthanasia, interruption and transplantation, too. The practical part reflects opinions of the students of the South Bohemia university in České Budějovice of these ethical matters. The analysis is based on quantitative research, which was performed by anonymous questionnaire in electronic form. The obtained data are processed in tabular and graphic forms.
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Opinions of the adult population of the South Bohemia region about selected ethical problems of the health care
BICANOVÁ, Anna
The theme of this thesis are opinions of adult population of the South Bohemia region about selected ethical problems. These problems involve doctor's relationship with patient, opinions of euthanasia, abortion and transplantation organs and tissues. In the theoretical part are explained and escribed the basic concepts related to this thesis. Furthermore, the theoretical part deals with the views from professional literature on these selected topics. The aim of the thesis is to determine the views of the adult population of South Bohemia on selected ethical issues in health care. The main objectives are the views on the relationships of the doctors with the patients, the introduction of euthanasia in the Czech Republic, a positive or negative view of abortion and opinion on supposed consent to postmorten donating organs. In the practical part the thesis deals with the quantitative research and evaluation of the research questionnaire.
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Mikromanipulace a kryopreservace zárodečných buněk ryb
LINHARTOVÁ, Zuzana
The induction of germ-line chimerism is an expanding focus of fisheries research. This technique is having a potential to enhance the production of gametes of species that are commercially valuable, endangered, species with problematic reproduction, using a more common or easily available species or species adapted to artificial reproduction as a surrogate host. The main goal of this technology is to establish a small-bodied surrogate broodstock producing functional donor gametes based on germ cell transplantation. Extent preliminary experiments, including documentation of donor/host embryonic and larval development, characterization of germ cells enriched by documentation of their migratory activities, sterilization of the host, isolation and cryopreservation of donor germ cells, are key factors for launching this biotechnology. All these crucial points were the main objective of the present work. The whole thesis provided the focus on two different fish species. First, our commercially valuable fish, the tench, where we would like to apply our current knowledge to create a germ-line chimera within cyprinids by transplantation of tench germ cells to smaller and faster-reproducing fish species as white cloud mountain minnow. Secondly we focused on the endangered species (listed in IUCN Red List) of large body size with long reproductive cycle, the sturgeons. In this case, we have chosen sterlet as a host, providing an advantage of shorter generation interval and smaller body size, to produce gametes of donor, a critically endangered species of large body size with long reproductive cycle, such as beluga. This innovative technology could result in collection of sperm and eggs in shorter time from small-bodied host. In tench we firstly focused on embryonic and larval development documentation together with description of origin and migration pathways of primordial germ cells (PGCs). PGCs represent a powerful tool for creation a germ-line chimera within fish species because they transmit genetic information to the next generation (Linhartova et al., 2014a). Secondly, we reported a practical technique for isolation and cryopreservation of early stages of germ cells (GC), including spermatogonia (SG) and spermatocytes (Linhartova et al., 2014b). In case of sturgeons, Saito et al. (2014) firstly described the origin and migration patterns of sturgeon PGCs deposited at the vegetal pole of the egg similar to that in anurans. Secondly, Psenicka et al. (2015) reported isolation and cryopreservation of female and male GC, SG from testes and OG and pre-vitellogenic oocytes from ovary, of 2-4-year old Siberian sturgeon. Moreover the isolated GC were transplanted into host (sterlet) and process of transplantation resulted in successful colonization of sterlet genital ridge. The potential host for germ-cell tranplantation, sterlet, was sterilized by knock-down of germ cell specific gene, the dead end gene, by the morpholino antisense oligonucleotide (MO) agent (dnd-MO). These results reported the first known and functional method of sturgeon sterilization (Linhartova et al., manuscript). We provided important information on morphology and ultrastructure of beluga spermatozoa structure by scanning and transmission electron microscopy to increase knowledge of evolutionary and taxonomic relationships among sturgeons (Linhartova et al., 2013). Finally, this thesis presents several studies with differing focus of research but with one target goal to induce germ-line chimerism in fish. All these results are prerequisite of future application and development of surrogate production in these species.
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Kidney market
Mroviecová, Lenka ; Dušek, Libor (advisor) ; Šlajs, Jan (referee)
This diploma thesis deals with the possible solution of the kidney shortage problem. Especially analyses effect of legislation system of registration to organ donation on count of kidney transplants and waiting time. The effect of the legislation system is analyzed with panel data of OECD countries. Using random effects method, the estimated result suggest that the countries using informed consent produce on average 7,49 kidney transplants per million population fewer and on average 1,95 years longer waiting time, than countries using presumed consent. Although model predicted positive impact of presumed consent system, empirical data from Chile didn't confirm this assumption. Based on the analysis, I suggest better solution of kidney shortage problem, than change of the registration system. Introduce of compensatory payments to living kidney donors.
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Citizens´ opinions on transplantation of tissues and organs
ŠIMKOVÁ, Soňa
This graduation theses is focused on attitudes of people to tissues and organs transplantations. It is composed of two parts, the first one is theoretical, the other practical. The theoretical part is engaged in the topic of transplantation. It shortly and concisely describes the transplantation from the medical standpoint, then further the general history of transplantations. It mainly focuses on the transplantations from the standpoint of our actual legislation, especially of the Transplantation Act. It also concisely introduces the transplantation legislative in selected countries as well as the transplantations from the standpoint of ethics. In the practical part I used the method of the quantitative research, performed with the help of questionnaires. The data were collected through an anonymous questionnaire. The aim of my work was to show the public awareness of the transplantations and attitudes of people towards the given topic. My research encompasses a description of methodology, an examined sample, outcomes and a discussion about the outcomes. The questionnaire was determined to the Czech citizens of various ages and types of education. Only the lower limit was cut down to the age of eighteen years. Respondents were partly enlisted by the direct questioning, according to their will to cooperate and some of them were enlisted for a consideration of their individual interest through the server vyplnto.cz. The final research sample was made by 526 respondents. There was a preliminary research made with 10 respondents before the actual research to find out if the questions were intelligible. There were two hypotheses set in terms of the research. The first hypotheses claims that the citizens agree to donation of their tissues and organs for their relatives. If I took into account only one particular question investigating the possible agreement to donating tissues or organs for a relative to save her/his life, I couldn´t reject this hypotheses, because the majority of respondents claimed they would donate a tissue or an organ, but this hypotheses was statistically tested through the test of good consensus. This test considers more questions related to a hypotheses. After this test I came to a conclusion that this hypotheses could be rejected, so it is not true that people agree to their donation of tissues and organs to their close persons. The other hypotheses claims that people do not know the principle of presumption of agreement or supposed agreement related to the post-mortem organs and tissues removals. The results of this work show the incomplete knowledge of the Czech citizens related to the topic of transplantations. It is mainly illustrated by the fact that more than one half of respondents never heard about our Transplantation Act and almost 80 % of people think that the public is not well informed. Almost one half of respondents never heard about the principle of supposed agreement, nevertheless the most of them agree to the fact that their organs and tissues should be used for transplantations in case of their sudden death. The results of my graduation hypotheses show the need of better education related to the transplantations. The education should come in various ways. As the most effective I consider the education through the media, furthermore the education in form of leaflets, information brochures and advertisement spots. There should be paper brochures available in medical institutions and seminars and trainings organized for general public. If the age should be taken into account, it would be the best to start the education in the secondary schools.
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The rescue of critically endangered fish species through manipulation with spermatogonia and oogonia
DOBROVOLNÝ, Petr
The transplant experiments described in this work may help to shorten the generation interval for long maturing endangered fish species and their more effective reproduction. Further, it is possible to preserve the separated spermatogonia and oogonia using a cryopreservation in liquid nitrogen. We conserve both paternal and maternal DNA and the gene pool of endangered fish species will not be depleted of maternal part. It's because we can freeze only sperm in the preservation of mature gametes. Fish eggs and embryos would not survive freezing. The described methods will be applied in the future to more effective rescue of critically endangered sturgeons by the transplantation of their germ cells into a Sterlet (Acipenser ruthenus). These methods can be suitable for application on other species of endangered fish in case of finding an appropriate recipient. As an example of our fish species is a European eel (Anguilla Anguilla). The Siberian sturgeon (Acipenser baeri) and the Sterlet (Acipenser ruthenus) were used as model organisms. For Siberian sturgeon the enzymatic dissociation technique, sorting of germ cells using Percoll gradient concentration and transplantation of sturgeon spermatogonia and oogonia were used. The results showed that the use of 0.3% of trypsin in PBS is optimal for dissociation of spermatogonia and oogonia, because this medium was dissociating the highest number of cells without reducing their viability. The separation of the early stages of germ cells has been successfully achieved by segregation in 10 to 30% of Percoll gradient with the help of centrifugation. After transplantation it was proved in spermatogonia as well in oogonia that they colonized the genital ridges of the host. The recipient became a chimera of a germ line, which can produce donor gametes throughout his life.
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Nursing of organ donors at the Department of the Anesthesiology and Resuscitation.
KLIVANOVÁ, Zuzana
This bachelor thesis deals with nursing of organ donors at the Department of Anesthesiology and Resuscitation and mainly the work nurses perform. There are situations, when transplantation is the only way how to save one's life and the nursing of such patients is vital. Hygiene, bandaging and brain-death diagnosis are not only very important, but also time demanding. The most demanding thing is the psyche of the nurse herself, she has to be aware of the fact, that the patient she nurses is going to die, but one or more lives are saved in the process. The whole process of transplantation is very long and complicated and requires a lot of medical interventions from numerous doctors and nurses, who deserve a great deal of credit. The nurse has full responsibility for the patient, she works on her own and without supervision and she alone is responsible for the nursing quality. Nursing requires good knowledge of every aspect of the process. The nurse is a full member of the whole transplantation medical team, because it is her, who spends the most time with the patient and it is her who takes notice of every single problem which she consults with the doctor. The theoretical part deals with the process of taking off the organs from brain-dead patients. It also deals with the history of transplantation and the law and morale aspect of organ transplantation. Then the thesis deals with the process of brain-death diagnosis and the medical equipment used in this process. The last chapter is about organ donors monitoring at the department of intense care, nursing of the organ donors and nursing of deceased patients. The aim of this research was to find out how the nursing process works at the Department of Anesthesiology and Resuscitation. There were two main pre-set questions for this research. The first question was. How are the organ donors nursed at the Department of Anesthesiology and Resuscitation? The second was. What mistakes do the nurses make while nursing organ donors? The practical part of this work contains the outcomes of my qualitative research from the Department of Anesthesiology and Resuscitation at the hospital in Ceske Budejovice. A semi-structured dialogue method was used. There were sixteen questions prepared according to professional literature. The research I made was acknowledged by the head nurse and I spoke with eight previously chosen Department of Anesthesiology and Resuscitation nurses. During the dialogues I took notes which I then processed via the paper-pencil technique. After a precise analysis of the data collected I established three main categories. First one is basic nursing, second one is nursing of brain-dead patients and the last one is nursing of organ donors. Each category consists itself from various sub-categories, which are shown in a diagram. Some questions mentioned in the dialogues can't be categorised, so they are mentioned in the diagrams. The last question was of a morale nature, which is crucial in this field of nursing. The findings of this bachelor thesis show, how organ donors are nursed. The research has shown that the hygiene, bandaging and organ donor vital functions monitoring is no different from nursing of other acute patients. The nursing quality in the hospital is according to all the standards, which nurses follow precisely. Dead bodies are handled exclusively by nurses as it is a natural part of the whole process. Nurses were fully able to specify the methods of determining a brain-dead patient. They knew what tissue samples are essential and what kind of medical equipment is used for brain-death diagnosis. The communication between the hospital and the Centre of coordination for organ donors is done according to the law n. 285/2002 Sb. It is the duty of medical staff to inform the centre about every single patient. This process is the responsibility of the doctor and the nurse does as she is told.
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