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Functions of open MHC class I molecule conformations
Vaníčková, Marie ; Poláková, Ingrid (advisor) ; Vaníková, Šárka (referee)
The major role of MHC class I molecules in adaptive system is to present antigen peptides derived from intracellular environment on the cell surface. These peptides are recognized by CD8+ T-lymphocytes and they can also interact with NK cells via trans-interaction. MHC class I molecules are composed of a heavy chain, β2-microglobulin (β2m, light chain) and peptide, forming a closed conformation. The heavy chain is non-covalently associated with the light chain and is folded into extracellular domain (α1, α2, α3 subunits), transmembrane domain and cytoplasmic domain (with conserved motifs). Upon active metabolism, the β2m and peptide may dissociate from the MHC I heavy chain what leads to the formation of open conformations of MHC I. This conformational change causes the subunit to unfold and allow its interaction with various receptors and molecules. Open conformers of MHC I may form cis-interactions with themselves creating homodimers involved in immunological functions or they can associate with different receptors on the cell surface creating heterodimers responsible for non-immunological functions. Soluble forms of free heavy chains also exist outside of the cell surface. Cis-associations are very important as they influence signaling pathways of the cell, inhibition or activation of...
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Questions of the midwife´s care of the women with a dead fetus
VANÍČKOVÁ, Marie
The care of women with a dead fetus is always very difficult for both midwives and the women. This is a hard situation in which parents need support, sufficient information, intimacy and appropriate nursing care. Midwives care can falicitate parents to overcome this tragic event. A quantitative research methods have been used in the work. A questionnaire was considered to be a source of lots of information in quite a short time. The findings of the questionnaires have been compared to the information available in professional literature. The questionnaires contained thirty-five questions. The research work was realised from November 2008 to January 2009. One hundred and ten questionnaires were given to midwives in České Budějovice, Český Krumlov, Domažlice, Jindřichův Hradec, Praha, Prachatice, Strakonice and Ústí nad Labem. Sixty-six respondents answered the questions (100%). The midwives care in ll hospitals was compared and then only those of České Budějovice, Český Krumlov and Jindřichův Hradec were used as a random sample. Seven aims and seven hypotheses were stated at the beginning. All of them have been fulfilled and proved. Midwives provide mothers with all necessary information on common nursing care in details. However, a small number of midwives inform mothers about burial or religious ceremonies and psychologic consultations. They are mostly not able to deal with problems of death in general so it becomes very difficult for them to discuss it with the mothers. Senior midwives can handle the situation much better than the junior ones. In some ways it is based on personal experience. Most midwives did not know that there is no burial duty in the Czech Republic while most of them knew the possibility of giving name to the dead born child. One of the research findings is very optimistic: all midwives are willing to help the mothers and their partners in such a hard situation. The fact that they assist in a dead fetus delivery represents a form of support and midwives should be prepared to it. So they need all information available for situations like these and should become familiar with all aspects of grieving in order to relieve parents. If midwives can assist parents in coping with their situation about dead born baby, they gain new experience and, especially, the certitude they have done everything they could for her clients.
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