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The importance of tumor markers and markers of angiogenesis for colorectal cancer prognosis
Levý, Miroslav ; Lipská, Ludmila (advisor) ; Třeška, Vladislav (referee) ; Šafarčík, Kristian (referee) ; Keil, Radan (referee)
Despite extensive progress in understanding of the molecular pattern of the tumor, growing possibilities of chemotherapy and surgical treatment, colorectal cancer remains the significant cause of death worldwide. Surgical treatment alone has already reached in oncologic radicality its limits, and therefore the surgeons turned to the molecular base of tumor growth in an effort to find markers that allow to operate patients at lower stages of the disease and thus improve the results and prognosis of the disease. And also to find markers, which, after currative operation will find a possible relapse in early stage to enable the surgeon to perform second curative intervention. Tumor markers are substances that often arise in connection with the changed metabolism transformed tumor cells, and therefore their levels increased in the presence of malignancy. Serum tumor markers are important parameters that may facilitate the prediction of the disease, its progression or regression (remission). Tumor markers are clinically used for screening, primary diagnosis, staging, prognosis, but particularly for predicting recurrence of disease, monitoring therapy. This work aims to summarize the current knowledge about the colorectal cancer markers, outline the possible development and present results of relationship...
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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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Cytomegalovirus infection after kidney transplantation
Reischig, Tomáš ; Třeška, Vladislav (advisor) ; Viklický, Ondřej (referee) ; Zadražil, Josef (referee) ; Pazdiora, Petr (referee)
1 SUMMARY Cytomegalovirus (CMV) disease is a common infectious complication in patients after solid organ transplantation. The last decade witnessed major advances in CMV disease prevention. Use of universal prophylaxis or preemptive therapy resulted in a decrease in the incidence of CMV disease from 20-60% to 5-20%. However, the efficacy of preventive approaches in terms of indirect effects of CMV occurrence is problematic. Association with allograft rejection belongs to well documented and clinically extremely important indirect effects of CMV with a prolonged adverse impact on graft survival. Potential mechanisms include overexpression of major histocompatibility complex molecules, growth factors and cytokines, and upregulation of adhesion molecules. A number of questions remain to be answered in evaluating CMV as a risk factor for acute rejection. While CMV disease is associated with an increased incidence of acute rejection, data regarding the role of asymptomatic CMV viremia are controversial. In our research we evaluated the role of CMV in pathogenesis of allograft rejection in the era of modern immunosuppression and CMV prophylaxis as well as optimal preventive strategy to minimize impact of CMV. In the first trial, renal transplant (RTx) recipients were followed prospectively for 12 months to...
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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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New Possibilities of Prevention and Monitoring of Breast Cancer
Hosnedlová, Andrea ; Třeška, Vladislav (advisor) ; Jandík, Pavel (referee) ; Gaťek, Jiří (referee)
Introduction: Breast cancer is one of the most common cancer in women, whose incidence rate is significantly increasing worldwide. Mortality has been reduced over the past few years, thanks to constantly improving diagnostic methods, full-scale mammography screening as well as comprehensive treatment. The success rate of treatment is known to depend on the earliness of diagnosis of breast cancer. Therefore, the scientists endeavour to find and optimize laboratory diagnosis of tumors using serum or tissue tumor markers. However, thus far, there is no biomarker suitable for screening or diagnosis of the early stage of breast cancer. Aim of the study: Our main goal was to study classic tumor markers and many other molecules associated with the process of carcinogenesis, namely markers of angiogenesis and lymphangiogenesis, growth factors, multifunctional proteins and proteases to assess their benefit of evaluation of tumor aggressiveness, extent of surgery, choice of the subsequent therapy and recurrence detection. A partial objective was to compare preoperative levels of these biomarkers (CEA, CA 15-3, CYFRA 21-1, TPA, TK, MonoTotal, VEGF, EGF, IGF-1, IGF-BP3, Osteopontin, Osteoprotegerin, Matrix Metalloproteinases MMP-2 and MMP-9) between a group of patients with malignant and benign breast disease....
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Ischemia-reperfusion injury in lungs after transplantation and the role of radical oxygen species
Mrázková, Hana ; Lischke, Robert (advisor) ; Třeška, Vladislav (referee) ; Kittnar, Otomar (referee)
Keywords: Lung Tx, EVLP, NHBD, IR injury, ROS, hypercapnia, gender differences This dissertation thesis deals with a very topical issue of the lack of donor organs for lung transplants. As with other organs, the number of patients on waiting lists in terminal stages of their diseases is also constantly rising but there is not an adequate increase in donor organs. We focused our experimental work on the development of research concerning the solution which is most successful in a long-term perspective, i.e. organ transplants from non- heart-beating donors (NHBDs), in an ex vivo lung transplant protocol (EVLP) on an animal model (Wistar rats). This is a method which is clinically established worldwide (in the Czech Republic only experimentally) and is constantly subject to further research. Based on earlier studies, we focused the first experimental part of this work on the potential protective effect of hypercapnic ventilation on ischemia-reperfusion (IR) lung injury in EVLP. The study proved that the hypercapnic ventilation has a protective effect on the generation of reactive oxygen species (ROS) in IR lung injury, but only when used in the period of reperfusion. In the second experimental study, we followed up a very topical issue of the effect of gender on IR lung injury in EVLP in...
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Implantation of cryopreserved mitral allograft into tricuspidal position in an experiment with sheep: Technical aspects of implantation and immediate results evaluated with the aid of epicardial echocardiography
Vojáček, Jan ; Špatenka, Jaroslav (advisor) ; Dominik, Jan (referee) ; Třeška, Vladislav (referee) ; Černý, Štěpán (referee)
Aortic, mitral and pulmonary valve replacement is routinely performed with reasonable clinical results. But the optimal substitute for the tricuspid valve remains controversial. Contemporary prostheses either mechanical or bioprosthetic are associated with a high risk of thrombosis and/or structural failure. Mitral allografts could have advantages over existing prostheses, especially in patients with infectious endocarditis. We describe our first experience with cryopreserved mitral allograft processing and implantation into the tricuspid position in a sheep experimental model. Material and Methods: We subjected 20 sheep (age 1 year, weight 23 - 36 kilograms) to general anesthesia and a left thoracotomy. An epicardial echocardiographic study was performed and the mitral valve was harvested. Donor animals were put to death by intravenous anesthetics injection. Allografts were immersed into cultivation medium E 199 with an antibiotic cocktail. After 24 hours storage at the temperature of 37.0oC the valves were kept at + 5 to + 7 oC over a period of 3-5 days. Then they were transferred into the cryoprotective solution (E 199 with 10% dimethylsulfoxide) and sealed into plastic bags using a double-layer technique. Finally, they were programmed cooled and stored in the liquid stage of liquid nitrogen (- 196 oC)...
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Biological activity of breast cancer
Zedníková, Ilona ; Třeška, Vladislav (advisor) ; Gaťek, Jiří (referee) ; Jandík, Pavel (referee)
Structured abstract Introduction: Breast cancer is the most common malignant disease in women and represents a worldwide problem. By using up-to-date diagnostics methods, mammography screening as well as complex treatment, mortality was substantially reduced. However, the incidence of disease is constantly growing in a moderate way. The struggle against this disease has several levels, such as prevention, primary tumor therapy as well as solution of recurrent disease or generalization of this. Therefore, it is very significant to evaluate prognosis on the basis of biological characteristics of tumor and to determine the right individual therapy in each patient. Aim of the study: Our aim was to determine a group of patients with malignant breast disease on the basis of biological characteristics of the tumor axillary exenteration might be omitted in if there is the presence of sentinel lymph node metastasis, which can reduce morbidity connected with this surgery without worsening prognosis. Group and methodology: The research project lasted from June 2012 to June 2015. It was an introspective randomized study where the main investigated group was made up of women with primarily surgically treated mammary cancer who underwent sentinel lymph node biopsy (SNB) within surgery. These were divided into three...
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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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