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Assesment of vitality of the vascularized fibular graft in intercalary defect reconstructions using Capanna technique
Lesenský, Jan ; Matějovský, Zdeněk (advisor) ; Trč, Tomáš (referee) ; Tomáš, Tomáš (referee)
INTRODUCTION: The reconstruction of the femoral diaphysis following bone tumor resection is challenging. While massive bone allografts are traditional, they carry risks due to avitality, leading to issues like infection and structural failure. Combining these with a vascularized fibula was proposed to solve these issues. However multiple complications including fibular graft necrosis exist. Currently, there's no reliable early postoperative technique to assess viability of the fibula, which is essential in management of complications. Also the superiority of this complex method compared to others is uncertain. STUDY OBJECTIVE: This study aims to introduce a noninvasive technique to determine fibula viability based on CT densitometry. Correlation of clinical outcomes with imaging studies is used to define predictive factors of fibular vitality. Results of combined grafts is tested against other reconstruction methods. MATERIAL AND METHODS: We prospectively collected data from 41 patients over ten years, all undergoing femoral diaphysis reconstruction post-tumor resection. Ten patients received a combined graft and underwent regular CT scans, which were then analyzed densitometrically to find objective signs of fibula vitality related to clinical outcomes. RESULTS: Our analysis confirmed that...
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The role of IL-17 in kidney transplantation
Menšíková, Markéta ; Stříž, Ilja (advisor) ; Krulová, Magdaléna (referee)
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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Case Study of Physiotherapy Treatment of a Patient with the Diagnosis of Anterior Cruciate Reconstruction
Bramham, Michael Edwin ; Vomáčková, Helena (advisor) ; Nováková, Tereza (referee)
Title: Case Study of Physiotherapy Treatment of a Patient with the Diagnosis of Anterior Cruciate Ligament Reconstruction. Thesis aim: The thesis is split into two parts; 1) Theoretical part. 2) Practical part (Case Study). The theoretical part will show an overview of the anatomy, kinesiology and biomechanics of the knee joint, aswell as how an anterior cruciate ligament injury is commonly obtained, the reconstruction surgery procedure, and the therapy used by the therapist in the rehabilitation process. In the practical part, I shall apply this theoretical knowledge, aswell as the knowledge of examinations and therapies that I have learned during my degree on to a patient with the diagnosis of anterior cruciate reconstruction, analysing the results. Clinical findings: The patient was a 24 year old female, with a diagnoss of anterior cruciate reconstruction of the left knee, performed by an allograft 6 weeks prior. The main clinical findings were a range of motion deficit in the operated knee in both flexion and extension, aswell as general weakening and atrophy of the muscles in this side. Procedures: The procedures used were based on those taught by Charles University in Prague, Faculty of Physical Education and Sport. These included but were not limited to; post isometric relaxation, joint...
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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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