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THE SURGICAL TREATMENT OF UNSTABLE FRACTURES OF STERNUM AND RIBS
Šimánek, Václav ; Šebor, Jindřich (advisor) ; Čapov, Ivan (referee) ; Vyhnánek, František (referee)
The injury of chest belongs to most frequented injuries. As far as 70 per cent of injuries of thorax is connected with injury of other organs. The relevance of injury of chest increases with age. The prognosis of polytraumatized patients with injury of thorax is aggravated in combination with craniocerebral injury. 50 per cent of death caused by injuries is connected with trauma of chest. The trauma of thorax are most frequently blunt. The open injuries are heavier. The main reason of blunt injuries of chest are road traffic accidents. 80 per cent of open injuries are created by shooting weapons or by stabbing. The fractures of ribs belong to most frequent types of fractures and simultaneously to the most types of injuries of thorax. The multiple fractures of ribs are serious. From 10 to 20 per cent of fractures of ribs have the manifestation of paradox breathing. The unstable fractures of ribs are classified after Pate and Eschapasse-Gailard. The conservative and operative types of treatment are used for stabilization of chest wall. The opinion on usage of this treatment are not unified. The artificial lung ventilation with low PEEP is used during conservative treatment. Operative treatment utilizes the external or internal fixation of unstable fragments of chest wall. At the Department of Surgery,...
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USE OF TUMOR MARKERS IN POSTOPERATIVE PROGNOSIS OF NON-SMALL-CELL LUNG CANCER
Šafránek, Jarmil ; Klečka, Jiří (advisor) ; Schützner, Jan (referee) ; Haruštiak, Svetozár (referee) ; Čapov, Ivan (referee)
USE OF TUMOR MARKERS IN POSTOPERATIVE PROGNOSIS OF NON-SMALL- CELL LUNG CANCER Introduction: The most frequently used prognostic parameters in clinical practice of NSCLC are disease stadium and affection of hilar or mediastinal lymph nodes. These phactors are not sufficient and therefore new prognostic parameters - tumor markers - are being searched for. Tumor markers regarding NSCLC have mainly been used so far to monitore effects of medical treatment or detection of carcinoma recurrency. The study concentrates on assessment of tumor markers significance for NSCLC. Methods: The total group includes 125 patients operated on for NSCLC in the years 2004-2007. Single groups of patients were assessed successively. Serum markers CYFRA 21-1, CEA, TK, TPS, and NSE were assessed in an immunoanalytical way in 34 patients: Serum parameters of angiogenesis through Luminex® xMAP® technology were assessed in 27 patients. Serum values of cytokeratins were assessed in an immunoanalytical way with 125 patients. Expressions of metalloproteinases (MMP-7, MMP-9) and their inhibitors (TIMP-1, TIMP-2) were assessed in NSCLC tissue with 91 patients and in lung tissue with 12 patients with benign pulmonary disease. Finally, OS and DFI were assessed in accordance with tissue expression of metalloproteinases and their...
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Detection of Micrometastases in the Hilar and Mediastinal Lymph Nodes at the Primary and Secondary Lung Tumors Using OSNA and Immunohistochemistry Metods.
Vejvodová, Šárka ; Vodička, Josef (advisor) ; Čapov, Ivan (referee) ; Schützner, Jan (referee)
Introduction: Current guidelines for treatment of lung cancer and lung metastases are based on morphology of the tumor and clinical stage of the disease. Correct determination of disease stage allows us to choose the optimal treatment therefore it is mandatory to determine the TNM classification as accurately as possible. State of lymphatic nodes together with the size of the primary tumor and the number of the metastases determine the adjuvant oncological therapy. According to guidelines, standard oncological treatment of pulmonary cancer, consist in radical removal of tumor tissue and in systematic nodal dissection, or more precisely in the specific lobar lymphadenectomy in indicated cases. The removed nodes are subjected to standard histopathological evaluation, which is able to reliably identify macrometastases, although micrometastases may not always be detected. There may be a situation, when lymph nodes are not found to be affected by cancer dissemination during the common histopathological evaluation, but may still contain micrometastases. Since carcinomas are tumors of epithelial origin, their essential proteins of intermediate cytoskeleton are the cytokeratins (CK). This fact can be used to detect micrometastases in regional lymph nodes. Since unaffected lymph nodes are formed by...
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THE SURGICAL TREATMENT OF UNSTABLE FRACTURES OF STERNUM AND RIBS
Šimánek, Václav ; Šebor, Jindřich (advisor) ; Čapov, Ivan (referee) ; Vyhnánek, František (referee)
The injury of chest belongs to most frequented injuries. As far as 70 per cent of injuries of thorax is connected with injury of other organs. The relevance of injury of chest increases with age. The prognosis of polytraumatized patients with injury of thorax is aggravated in combination with craniocerebral injury. 50 per cent of death caused by injuries is connected with trauma of chest. The trauma of thorax are most frequently blunt. The open injuries are heavier. The main reason of blunt injuries of chest are road traffic accidents. 80 per cent of open injuries are created by shooting weapons or by stabbing. The fractures of ribs belong to most frequent types of fractures and simultaneously to the most types of injuries of thorax. The multiple fractures of ribs are serious. From 10 to 20 per cent of fractures of ribs have the manifestation of paradox breathing. The unstable fractures of ribs are classified after Pate and Eschapasse-Gailard. The conservative and operative types of treatment are used for stabilization of chest wall. The opinion on usage of this treatment are not unified. The artificial lung ventilation with low PEEP is used during conservative treatment. Operative treatment utilizes the external or internal fixation of unstable fragments of chest wall. At the Department of Surgery,...
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USE OF TUMOR MARKERS IN POSTOPERATIVE PROGNOSIS OF NON-SMALL-CELL LUNG CANCER
Šafránek, Jarmil ; Klečka, Jiří (advisor) ; Schützner, Jan (referee) ; Haruštiak, Svetozár (referee) ; Čapov, Ivan (referee)
USE OF TUMOR MARKERS IN POSTOPERATIVE PROGNOSIS OF NON-SMALL- CELL LUNG CANCER Introduction: The most frequently used prognostic parameters in clinical practice of NSCLC are disease stadium and affection of hilar or mediastinal lymph nodes. These phactors are not sufficient and therefore new prognostic parameters - tumor markers - are being searched for. Tumor markers regarding NSCLC have mainly been used so far to monitore effects of medical treatment or detection of carcinoma recurrency. The study concentrates on assessment of tumor markers significance for NSCLC. Methods: The total group includes 125 patients operated on for NSCLC in the years 2004-2007. Single groups of patients were assessed successively. Serum markers CYFRA 21-1, CEA, TK, TPS, and NSE were assessed in an immunoanalytical way in 34 patients: Serum parameters of angiogenesis through Luminex® xMAP® technology were assessed in 27 patients. Serum values of cytokeratins were assessed in an immunoanalytical way with 125 patients. Expressions of metalloproteinases (MMP-7, MMP-9) and their inhibitors (TIMP-1, TIMP-2) were assessed in NSCLC tissue with 91 patients and in lung tissue with 12 patients with benign pulmonary disease. Finally, OS and DFI were assessed in accordance with tissue expression of metalloproteinases and their...
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