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Perioperative nutritional care in patients undergoing radical cystectomy for bladder cancer
Slanařová, Barbora ; Staník, Michal (advisor) ; Furdek, Michal (referee)
Perioperative nutritional care is an integral part of the management and accelerated recovery program after radical cystectomy. Currently, there is limited literature dealing about perioperative nutritional care in patients undergoing radical cystectomy for bladder cancer. The purpose of the practical part was to determine the effect of preoperative immunomodulating nutrition of ONS type on the postoperative complications and the length of stay in hospital in 25 patients undergoing radical cystectomy for bladder cancer at the Masaryk Memorial Cancer Institute in 2022, compared to 32 patients without preoperative immunomodulating nutrition who underwent radical cystectomy in 2021. The second efficacy point of the practical part was to investigate the process of specialised perioperative nutritional care held according to a specialised protocol involving patients undergoing radical cystectomy for bladder cancer and to propose a modification of the process in order to improve the quality of nutritional care provided in perioperative period. In our research, preoperative immunomodulating nutrition of ONS type did not significantly affect postoperative complications and length of stay in hospital compared to the retrospective control group without preoperative immunomodulating preparation. Further...
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Experimental verification of in silico predicted protein binder to FOXO4 transcription factor and transcriptome analysis of bladder cancer
Tauš, Petr ; Drbal, Karel (advisor) ; Převorovský, Martin (referee)
This diploma thesis includes an experimental and a bioinformatic part. The two parts are linked together through the subject of transcription factors of 'forkhead box O' (FOXO) family. FOXO transcription factors have a key role in many cellular processes including cell cycle regulation, apoptosis and metabolism. For a long time, they have been considered strictly as the tumor-suppressors yet a growing number of evidence is pointing out to their pro-tumorigenic role. In consequence FOXO transcription factors are studied intensively as potential therapeutic targets in cancer. In the past decade, in silico prediction of protein-protein interactions has become popular in basic research as well as in drug development. Nonetheless, the predicted structures are still far from fitting to the expected behavior of the respective biomolecules. In the experimental part of this thesis, I verified the interaction of four in silico predicted protein binders based on naturally occurring PDZ domain with FOXO4 using microscale thermophoresis. Non-invasive bladder tumors represent a heterogeneous disease where reliable prediction of tumor aggressiveness is still lacking despite an intensive research. In the bioinformatic part of this thesis, I described the cellular composition of the tumor microenvironment and demonstrated...
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The Role of Cellular Metabolism in Carcinogenesis. Molecular Pathophysiology of Bladder Cancer Chemoresistance
Kripnerová, Michaela ; Kuncová, Jitka (advisor) ; Nevoral, Jan (referee) ; Chovanec, Miroslav (referee)
Therapeutic resistance of tumours represents an important clinical issue. We can classify the therapeutic tumour resistance in two ways. According to the clinical course, tumours can behave either as primary resistant, i.e. from the very beginning not responsive, or they can display a secondary (also called acquired) resistance, whereby an initial clinical response is lost and the tumour develops into chemo-, radio- or immunoresistant disease. An alternative classification distinguishes cell autonomous resistance mechanisms from resistance that relies on complex interactions within the context of tumour microenvironment. From the research perspective, modelling therapeutic resistance frequently involves experimental treatment of sensitive cancer cells and selection of daughter resistant cell lines. The Ph.D. thesis includes derivation of two unique models of urothelial bladder carcinoma therapeutic resistance. The first model involves newly established urothelial carcinoma cell lines BC44 and BC44DoxoR, which resulted from a prolonged doxorubicin exposure of the mother cell line. The daughter chemoresistant cell line exhibits multidrug resistant phenotype, which extends beyond the selecting drug - doxorubicin - to four additional chemotherapeutic drugs (cisplatin, methotrexate, vinblastine, and...
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Perineural spread of pelvic tumors: mechanism and diagnosis
Čapek, Štěpán ; Sameš, Martin (advisor) ; Haninec, Pavel (referee) ; Hořínek, Daniel (referee)
Perineural spread of pelvic tumors mechanism and diagnosis Abstract Neoplastic lumbosacral plexopathies are infrequent affections of the lumbosacral plexus. Cases with minimal or non-specific finding on imaging can be particularly puzzling to diagnose. We describe a series of patients with perineural spread from the site of the primary tumor along the visceral autonomous nerves to the lumbosacral plexus and further proximally to the spinal nerves and even intradurally and also distally to the sciatic nerve. On series of 17 patients diagnosed with perineural spread of pelvic malignancy we describe characteristic clinical presentation and imaging finding. In many of these cases a tissue biopsy is necessary to finalize the diagnosis. We describe operative technique of targeted fascicular biopsy of the sciatic nerve and our experience with this procedure. On series of 117 patients, we report the outcome and complication: diagnostic yield was 84.8% and complication rate was 2.7 %. If a tissue sample is needed to conclude the diagnosis, targeted fascicular biopsy does increase the yield at an acceptable complication rate. Perineural spread of pelvic cancer is a new clinical-pathological entity with an unknown natural history or ideal treatment strategy. Based on the imaging finding in this group we present a...
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The Role of Cellular Metabolism in Carcinogenesis. Molecular Pathophysiology of Bladder Cancer Chemoresistance
Kripnerová, Michaela ; Kuncová, Jitka (advisor) ; Nevoral, Jan (referee) ; Chovanec, Miroslav (referee)
Therapeutic resistance of tumours represents an important clinical issue. We can classify the therapeutic tumour resistance in two ways. According to the clinical course, tumours can behave either as primary resistant, i.e. from the very beginning not responsive, or they can display a secondary (also called acquired) resistance, whereby an initial clinical response is lost and the tumour develops into chemo-, radio- or immunoresistant disease. An alternative classification distinguishes cell autonomous resistance mechanisms from resistance that relies on complex interactions within the context of tumour microenvironment. From the research perspective, modelling therapeutic resistance frequently involves experimental treatment of sensitive cancer cells and selection of daughter resistant cell lines. The Ph.D. thesis includes derivation of two unique models of urothelial bladder carcinoma therapeutic resistance. The first model involves newly established urothelial carcinoma cell lines BC44 and BC44DoxoR, which resulted from a prolonged doxorubicin exposure of the mother cell line. The daughter chemoresistant cell line exhibits multidrug resistant phenotype, which extends beyond the selecting drug - doxorubicin - to four additional chemotherapeutic drugs (cisplatin, methotrexate, vinblastine, and...
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Analysis of cell-free nucleic acids in urine of urological patients.
Šantorová, Šárka ; Korabečná, Marie (advisor) ; Brdička, Radim (referee) ; Drábek, Jiří (referee)
The two studies follow free nucleic acids in urine in search for biomarkers to distinguish urinary bladder cancer patients from controls. Bladder cancer forms 4 % of newly diagnosed oncological diseases in the Czech Republic. Nowadays, there is no accredited non-invasive method for its diagnosis, which is sufficiently accurate. Urine supernatant, which is washing the bladder mucosa and which does not contain cell debris, seems to be an appropriate source of biomarkers for non-invasive diagnosis. miRNAs, as a non-invasive biomarker of urinary bladder cancer, were studied in one of the studies. miRNAs are short noncoding RNA, which block the process of translation. miRNAs occur in all body fluids and are relatively stable. A study with three phases was assessed to find a suitable miRNA marker. 109 individuals were examined in total (36 controls and 73 bladder cancer patients). The analysis of miRNAs was based on RT-PCR (Reverse Transcription Polymerase Chain Reaction). In the first phase, the urine of 59 individuals was analyzed on TaqMan array card with 381 miRNAs. In the second phase, the results of the first phase were confirmed on the same cohort by a single miRNA assay. In the third phase, a new cohort was used (23 controls and 27 bladder cancer patients), analyzed by a single miRNA assay again....
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Analysis of cell-free nucleic acids and its potential clinical application.
Pazourková, Eva ; Korabečná, Marie (advisor) ; Drábek, Jiří (referee) ; Vodička, Radek (referee)
This work presents the results ofour research of cell-free nucleic acids (cfNA). The first part shows changes in methylation patterns of immune response genes promoters that are detectable in plasma during the hemodialysis sessions and also differences in methylation between patients and healthy subjects. Alterations include genes that play their role in the regulation of hematopoiesis and these changes are in close relation with the need of anemia therapy. In the other plasma cfNA study we detected miRNA signatures in patients with acute myeloid leukemia at diagnosis (6 highly abundant miRNAs found) and in remission achieved after standard chemotherapy (trend to n01malization, lower levels ofthese miRNAs). Another part of work presents data from the study of potential non-invasive biomarker of bladder cancer. The amounts of cfDNA in urine are higher in patients than in healthy subjects and there were found 5 down-regulated miRNAs. Simultaneously it was established set of 30 miRNAs that are constantly present in urine supematants independently on sex, age and healthy status of subjects. The last part presents analysis ofcell-free fetal DNA. We analyzed differences between a new quantification method - droplet digital PCR and real-time PCR which is used routinely nowadays. Slightly more precise was...
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Experimental verification of in silico predicted protein binder to FOXO4 transcription factor and transcriptome analysis of bladder cancer
Tauš, Petr ; Drbal, Karel (advisor) ; Převorovský, Martin (referee)
This diploma thesis includes an experimental and a bioinformatic part. The two parts are linked together through the subject of transcription factors of 'forkhead box O' (FOXO) family. FOXO transcription factors have a key role in many cellular processes including cell cycle regulation, apoptosis and metabolism. For a long time, they have been considered strictly as the tumor-suppressors yet a growing number of evidence is pointing out to their pro-tumorigenic role. In consequence FOXO transcription factors are studied intensively as potential therapeutic targets in cancer. In the past decade, in silico prediction of protein-protein interactions has become popular in basic research as well as in drug development. Nonetheless, the predicted structures are still far from fitting to the expected behavior of the respective biomolecules. In the experimental part of this thesis, I verified the interaction of four in silico predicted protein binders based on naturally occurring PDZ domain with FOXO4 using microscale thermophoresis. Non-invasive bladder tumors represent a heterogeneous disease where reliable prediction of tumor aggressiveness is still lacking despite an intensive research. In the bioinformatic part of this thesis, I described the cellular composition of the tumor microenvironment and demonstrated...
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Immunochemical determination of active and inactive form of cathepsin B in patients with bladder cancer
Urban, Tomáš ; Bosáková, Zuzana (advisor) ; Klapková, Eva (referee)
This thesis is focused on immunochemical determination of concentration of active and inactive form of cathepsin B in patients with bladder cancer in order to compare diagnostic efficiency of methods for their possible use for routine diagnosis. Cathepsin B and procathepsin B were measured in serum and urine in 82 patients with bladder cancer (47 men and 35 women), with the average age of 66.5 year. The control group contain of 72 healthy subjects (31 men and 41 women), with the average age of 58.5 year. The concentration of cathepsin B and procathepsin B in the urine were corrected to creatinine, which was determined by the enzymatic creatinase method. The concentrations of cathepsin B in urine were singnificantly elevated in patients than in control group (median = 3.5 µg/l vs. 0.9 µg/l, P = 0.01), similarly the results of the cathepsin B/creatinine ratio were elevated (median = 0.4 µg/mmol vs. 0.1 µg/mmol, P = 0.01). There were no significant difference in concentration in serum between patients and control group (median = 4.8 µg/l vs. 4.2 µg/l, P = 0.8). The concentration values of procathepsin B were significantly higher in patients compare to control group both in urine (median = 3.9 µg/l vs. 1.4 µg/l, P < 0.0001), in serum (median = 73.3 µg/l vs. 58.7 µg/l, P = 0.0005) and similarly in...
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