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Monitoring of Pleural Effusion Parameters During the Treatment of Chest Empyema
Matuchová, Inka ; Krejsek, Jan (advisor) ; Bobek, Vladimír (referee) ; Vodička, Josef (referee)
Monitoring of pleural effusion parameters during the treatment of chest empyema Chest empyema is a severe complication with collection of pus in the pleural cavity. The mortality rate of chest empyema is up to 40 %. Generally, treatment involves a drain insertion into the inflammatory focus and pleural space irrigation with local application of medication. These processes are usually lengthy with high risk of relapse. Our aim is to shorten the period of treatment using cytological-energy analysis of pleural effusions. This approach is based on simultaneous cytological and metabolic investigation of the pleural effusions. Results allow us to determine the type and intensity of local immune response in the pleural cavity. Repetitive investigations of pleural effusions in time give us information aiming the development of local immunity response in the pleural cavity and can follow the effect of therapy. Our goal is to define the theoretical framework for application of cytological-energy analysis of pleural effusions in patients with chest empyemas. The determination of the catalytic activities of aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) in pleural effusions as parameters of tissue damage is introduced by us. We established that cytological-energy analysis of pleural effusion...
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Differential diagnosis of selected rare benign tumors of the lung and pleura
Mukenšnabl, Petr ; Fakan, František (advisor) ; Vodička, Josef (referee) ; Šteiner, Ivo (referee)
Selected rare benign tumors of the lung and pleura were studied with special reference to immunohistochemical findings and their differential diagnosis. The major objective is to better characterize unusual rare pulmonary tumors, which are unknown to most pathologists not specialized in pulmonary pathology. Moreover the clinicians, in particular, radiologists, pneumologists, surgeons, and oncologists are not familiar with these rare tumors as well. Therefore, these rare entities may cause a considerable problems in differential diagnostics and therapeutic management of the patients. The study of rare benign pulmonary and pleural tumors includes the following entities: papillary adenoma, alveolar adenoma, mucous gland adenoma of the bronchus, granular cell tumor, lymphangioleiomyomatosis of the lungs, desmoid fibromatosis of the pleura, sclerosing hemangioma associated with carcinoid tumorlet tumor, sclerosing hemangioma with with regional lymph node metastases. A special emphasis is given to previously unrecognized rare entities we have characterized in the world literature, such as multiple recurrent glomangioma of the lung, epithelial plasma cell granuloma-like tumor of the lungs, glandular papilloma of bronchus arising in sclerosing hemangioma and chondroid hamartoma of the lung associated with...
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Relationship of protein SIVA and signaling pathways Hedgehog/GLI and mTOR to the origin and progression of non-small cell lung cancer.
Vachtenheim, Jiří ; Lischke, Robert (advisor) ; Zemanová, Milada (referee) ; Vodička, Josef (referee)
Non-small cell lung cancer belongs to most frequent malignant tumours at all worldwide. Despite significant progress in knowledge about etiopathogenesis and targeted anticancer therapy, basic scientific research in this particular field and development of more effective treatment remains challenging. In case of its inadequate activation, the Hedgehog signaling pathway is involved in non-small cell cancer development. P53 is well known tumour suppressor gene, that serves as anticancer barrier. Its activity is mostly determined by the transcriptional activation of many pro-apoptotic genes, one of which is SIVA-1. Recently, it has been surprisingly shown, that SIVA-1 has also pro-oncogenic properties in a mouse model of non-small cell lung cancer. The aim of this study was to clarify the importance of Hedgehog signaling pathway and protein SIVA-1 and their potential relationship in development and progression of human non-small cell lung cancer. In selected cell lines of human non-small cell lung cancer, expression of each single component of Hedgehog signalign pathway was detected. In the tissue samples of tumour obtained from 39 patients that underwent surgery for non-small cell lung cancer and selected cell lines of the same tumour, expression of SIVA-1 protein was revealed. These findings indicate...
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Tumor infiltrating lymphocytes as prognostic factor in colorectal cancer prognosis after radical surgical treatment
Novák, Petr ; Vodička, Josef (advisor) ; Šiller, Jiří (referee) ; Gürlich, Robert (referee)
Novák P.: Tumor infiltrating lymphocytes as prognostic factor of colorectal cancer after radical surgical treatment Background: Colorectal cancer (CRC) belongs among the most frequent malignant diseases and represents worldwide problem. Czech Republic has one of the highest incidence of CRC. The fight against this disease is kept in many lines as preventive, surgical and oncological treatment and very important part is also the estimation of prognosis and suggestion of individual treatment. Aim: The aim of this study was to analyze the relation of contemporary clinical and histopathological factors and tumor infiltrating lymphocytes, dendritic and natural killer cells. The next aim was to differentiate the patients with high risk of shortened overal survival and tendency to early recurrence of CRC after radical surgical treatment. Methods: We analyzed the group of 150 patients (93 men, 57 women) that were operated on at the Department of Surgery of Teaching Hospital in Pilsen between 2004 and 2007. The important condition for inclusion into the study was radical operation. We excluded patients with any disease that could influence immunological reactivity. We examined endovascular, endolymphatic, perineural infiltration by tumor cells (0 - none, 1 positive). Infiltrations of tumor by lymphatic cells...
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Ischemia of free flaps
Richtr, Patrik ; Vodička, Josef (advisor) ; Sukop, Andrej (referee) ; Veselý, Jiří (referee)
Background: Free muscle flap transfers, frequently used in plastic and reconstructive surgery, are associated with alternating episodes of ischemia and reperfusion. This phenomenon could be a cause of damage in the transferred flap. Major detrimental effect is usually attributed to the oxidative stress. Aim: The aim of this study was therefore 1) to develop a clinically relevant experimental model of free muscle flap for musculus latissimus dorsi (MLD), 2) to elaborate a technique allowing, by means of routine laboratory methods, the detection of changes occurring with oxidative stress, and 3) to evaluate the impact of ischemia and subsequent reperfusion on free flap muscle tissue (in terms of oxidative stress). Methods: In 18 domestic pigs, MLD was prepared on both sides (experimental and control), leaving just the thoracodorsal branch for nutrition. The vascular stalk for the experimental MLD was clamped temporarily (60 min) to mimic ischemia during flap transfer. After the clamp release (corresponds to reperfusion following anastomosis), both arterial, venous blood, and tissue samples were obtained from the ischemic as well as control flaps at timepoints 1, 30, 45, and 60 min. For baseline characteristics, tissue, arterial, and venous blood were sampled prior to clamping. In all samples, lactate,...
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Prognostic Markers of Surgical Treatment of Malignant Lung Tumours
Skála, Martin ; Vodička, Josef (advisor) ; Kučera, Radek (referee) ; Neoral, Čestmír (referee)
Prognostic markers of surgical treatment of malignant lung tumours Summary: Introduction: Lung cancer is the most common malignancy in adults in western countries. The ideal strategy of treatment depends on early diagnosis because the clinical stage strongly impacts the prognosis. Among conventional diagnostic methods, we can analyse immunochemical markers to make the diagnosis more precise. Aim: None of the biomarkers has been evaluated sufficiently specific for one type of tumour. In our work, we tried to find a panel of immunochemical markers, which could be useful as well for the assessment of prognosis as for diagnosis. Especially in situations when taking a biopsy is impossible. The next aim of our study was to evaluate the context between clinical-pathological factors and the level of immunochemical markers and their influence on prognosis. Methods: In our study, we classified 109 patients with lung carcinoma. In the control group were also 109 persons. All 109 patients with NSCLC underwent lung resection at the Department of Surgery of University hospital in Pilsen between 17th April 2018 and 26th August 2020. Blood samples were realized on the day of operation, one week after the operation and then on day 90 and day 365. Serum level of CEA, NSE, CYFRA 21-1, MonoTotal, IGF-1, proGRP and TPS were...
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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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Ischemia of free flaps
Richtr, Patrik ; Vodička, Josef (advisor) ; Sukop, Andrej (referee) ; Veselý, Jiří (referee)
Background: Free muscle flap transfers, frequently used in plastic and reconstructive surgery, are associated with alternating episodes of ischemia and reperfusion. This phenomenon could be a cause of damage in the transferred flap. Major detrimental effect is usually attributed to the oxidative stress. Aim: The aim of this study was therefore 1) to develop a clinically relevant experimental model of free muscle flap for musculus latissimus dorsi (MLD), 2) to elaborate a technique allowing, by means of routine laboratory methods, the detection of changes occurring with oxidative stress, and 3) to evaluate the impact of ischemia and subsequent reperfusion on free flap muscle tissue (in terms of oxidative stress). Methods: In 18 domestic pigs, MLD was prepared on both sides (experimental and control), leaving just the thoracodorsal branch for nutrition. The vascular stalk for the experimental MLD was clamped temporarily (60 min) to mimic ischemia during flap transfer. After the clamp release (corresponds to reperfusion following anastomosis), both arterial, venous blood, and tissue samples were obtained from the ischemic as well as control flaps at timepoints 1, 30, 45, and 60 min. For baseline characteristics, tissue, arterial, and venous blood were sampled prior to clamping. In all samples, lactate,...
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Tumor infiltrating lymphocytes as prognostic factor in colorectal cancer prognosis after radical surgical treatment
Novák, Petr ; Vodička, Josef (advisor) ; Šiller, Jiří (referee) ; Gürlich, Robert (referee)
Novák P.: Tumor infiltrating lymphocytes as prognostic factor of colorectal cancer after radical surgical treatment Background: Colorectal cancer (CRC) belongs among the most frequent malignant diseases and represents worldwide problem. Czech Republic has one of the highest incidence of CRC. The fight against this disease is kept in many lines as preventive, surgical and oncological treatment and very important part is also the estimation of prognosis and suggestion of individual treatment. Aim: The aim of this study was to analyze the relation of contemporary clinical and histopathological factors and tumor infiltrating lymphocytes, dendritic and natural killer cells. The next aim was to differentiate the patients with high risk of shortened overal survival and tendency to early recurrence of CRC after radical surgical treatment. Methods: We analyzed the group of 150 patients (93 men, 57 women) that were operated on at the Department of Surgery of Teaching Hospital in Pilsen between 2004 and 2007. The important condition for inclusion into the study was radical operation. We excluded patients with any disease that could influence immunological reactivity. We examined endovascular, endolymphatic, perineural infiltration by tumor cells (0 - none, 1 positive). Infiltrations of tumor by lymphatic cells...
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