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Modern therapy of chondral defects
Neckař, Pavel ; Havlas, Vojtěch (advisor) ; Zeman, Petr (referee) ; Tuček, Michal (referee)
The thesis describes the application of cultured bone marrow stem cells in the therapy of focal chondral defect of the knee joint. In the experimental part of the work, the goal was to quantitatively and qualitatively compare two sampling sites of bone marrow monocytic aspirates, the iliac crest bone and the proximal tibia, in order to determine a suitable cell source for advanced cell therapy. The sample analysis showed that the amount of monocytic cells and the yield of stem cells from the aspirate obtained were significantly higher in the bone marrow from the iliac crest. We did not find significant qualitative differences between the two sources of stem cells. In the clinical part of the work, I present a description of the surgical procedure and the results of a 1-year follow-up of patients after the implantation of cultured stem cells from the bone marrow, under the name BiCure® orthoMSCp (Bioinova, Prague, Czech Republic), fixed on a commercially available 3D scaffold Chondrotissue® (BioTissue AG, Geneva, Switzerland) using coagulated autologous platelet-rich plasma. The primary objective of the clinical study included the evaluation of the short-term and long-term safety of the applied medical product. The secondary objective of the work included the assessment of the effectiveness of the...
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Mesenchymal stromal cells and biological scaffolds for neural tissue regeneration
Kočí, Zuzana ; Kubinová, Šárka (advisor) ; Filová, Eva (referee) ; Zach, Petr (referee)
Despite tremendous progress in medicine, injuries of the adult central neural system remain without satisfactory solution. Regenerative medicine employs tissue engineering, cellular therapies, medical devices, gene therapy, or growth factors with the aim to bridge the lesion, re-establish lost connections and enhance endogenous repair in order to restore neural function. The aim of my thesis was to evaluate therapeutic potential of two approaches, transplantation of human mesenchymal stromal cells (hMSCs) and biological scaffolds derived from extracellular matrix (ECM) for neural regeneration, particularly in models of spinal cord injury (SCI). First, hMSCs from various sources - bone marrow (BM), adipose tissue (AT) and Wharton's jelly (WJ) - were isolated and characterized in vitro. All cell types met the minimal criteria for MSC phenotype and displayed similar properties in terms of their surface marker expression, differentiation potential, migratory capacity, and secretion of cytokines and growth factors. On the other hand, the cell yield from WJ and AT was significantly higher, and MSCs isolated from these tissues proliferated better than from BM. Therapeutic effect of intrathecal application of hWJ-MSCs was then evaluated in SCI compression model in rats. The effect of low (0.5 million) and...
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The development of swine B cells and the role of gama delta T lymphocytes in immunization of naive immune system.
Štěpánová, Kateřina
Thesis summary The process of B cell lymphogenesis in swine remains uncertain. Some reports indicate that pigs belong to a group of animal that use ileal Peyers's patches (IPP) for the generation of B cells while others point to the possibility that the bone marrow is functional throughout life. The functional subpopulations of B cells in swine are also unknown. Together with other ruminants, and also birds, γδ T cells in swine may account for >70% of all T cells which is in apparent contrast with humans and mice. The purpose of this thesis was to address these discrepancies and unresolved issues. The results disprove the existing paradigm that the IPP is primary lymphoid tissue and that B cells develop in IPP in an antigen-independent manner. On the other hand, it shows that bone marrow is fully capable of B cell lymphogenesis and remains active at least for the same period of time as it had been speculated for the IPP. This thesis also identified functionally different subsets of porcine peripheral B cells, and shows that CD21 molecules can be expressed in differential forms. Finally, this thesis identifies two lineages of γδ T cells that differ in many functional and phenotype features. This finding may explain why γδ T cells constitute of minority of lymphocytes in circulation of humans and mice.
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Bone marrow transplantation, its historical development and current trends
CIMBÁLNÍKOVÁ, Eva
The transplantation of bone marrow - more generally said of hematopoietic cells - is in the present time one of the modern therapeutical methods used in cases of malfunction of haematogenesis inside of the bone. The ususal reason for going through with transplantation is leukemia, lymphomas, also anemia, congenital metabolic disorders, autoimmune disorders or some of the solid tumors. Thanks to the transplantation of hematopoietic cells, it is possible to highten the chance of restoration in more than 50 % of patients suffering from oncological disease. The submitted thesis is processed in theoretical form, it is goal is to present the important points leading to progress of this presently very much used treatment and also thorough descripton of present trends in the area of transplantation of hematopoietic cells, that are almost identical in local transplatation centers as they are in the world. Another goal is to describe the role of a general nurse during providing of the care for a patient before and after transplantation of hematopoietic cells. The thesis is focused on the key areas of the issues of transplatation of hematopoietic cells and it is divided into several parts. The first part deals with the general description of the topic, it presents short introduction into the transplantation of hematopoietic cells, the basic division, historical and current indications and short preamble into todays trends. It describes closely the area of the registry of the bone marrow donors, which is the basics for the choosing of the suitable unrelated donor. The second part of the thesis deals with the desciption of historical progress since the very beginnings, through the progress during postwar period, the development of 70s and 80s of the previous century and also the 90s of the 20th century up until the present day. The third part is focused on current methods of collection of hematopoietic cells and following transplatation, it also describes closely the ways of donating hematopoietic cells, the preparation of the patient for transplantation, the course of transplantation and what should the patient prepare for during the early posttransplantation period. The fourth part is focused on nursing, it states thoroughly the role of a nurse in the nursing care before and after transplantation of hematopoietic cells, the principles a nurse has to abide by, and it also closely describes the role of a nurse during transplant application. It also describes dietary and important regimen measures the patient is set to follow after transplantation. The last part is focused especially on complications that are possible after hemopoetic cells transplantation. The necessary data have been obtained through thorough study of professional Czech and foreign monoghraphs and scientific periodicals. The acquisition of the data was significantly contributed to by the attended internsip in Internal hematological and oncological clinic of the Faculty hospital Brno Bohunice. The findings regarding nursing were obtained especially by the study of nursing standards. This thesis points out the important role of transplatation of hemopoetic cells as a method of treatment predominantly of hemooncological illnesses in current medicine and the most important roles of a nurse during the nursing of transplantation patients. The thesis provides a comperehensive overview on the issue of transplants of the hematopoietic cells and describes key areas that are considered as important. It focuses on the historical progress and the desciption of present trends thanks to which the transplantology can be considered as a highly professional and top field. It also highlights the main roles of a nurse during nursing that must be proffesional, qualified, meticulous, considerate and individualized. The results of the survey are supposed to provide the professional and amateur public enough information about the issue of transplantation of the hematopoietic cells.
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Involvement of donors of blood plasma to the donor's registry bone marrow
Míková, Iveta ; Kordulová, Pavla (advisor) ; Chvojková, Kateřina (referee)
The Bachelor thesis is focusing on the possibility to exploit the potential of regular blood plasma donors for inclusion into the register of bone marrow donors. Based on the assumption, that this is the almost identical population and that the criteria for blood plasma donating are similar to the criteria for bone marrow donation, plasma donors are tested periodically on the infectious diseases transmitted through blood, they have experience with the intravenous collection and plasma donors are largely complying with the age limit needed for bone marrow register. The theoretical part describes anatomy and physiology of blood plasma and bone marrow and current knowledge on the issue for donating of blood plasma and bone marrow. Describes types and indications of bone marrow transplantation, registers of blood plasma and bone marrow donors, the motivation for donating, reliefs and remunerations for donors. I have used for the making of this thesis processed research from Bibliographia medica tschechoslovacia in the National medical library, personal source of reference literature, professional consultation, own experiences and another Bachelor thesis. Methods: The Thesis was prepared based on quantitative research in the form of none standard anonymous questionnaire. The target group were the donors...
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The issue of collection and bone marrow transplantation in pediatric and adult patients
KONEČNÁ, Martina
This thesis aims to provide a closer look at the issue and presentation of a clear summary of information on the issue of bone marrow transplantation via the Review Method and Information Synthesis. The thesis contains a theoretical description of nurse intervention before and after extracting bone marrow from a voluntary donor, as well as a description of nurse´s interventions before and after transplantingextracted hematopoietic cells from a patient suffering from the indicating blood illness. Treating hemato-oncological diseases is a lengthy and very demanding process. It relies in transplanting hematopoietic cells, and it means a great hope to cure the ill person. The transplantation itself is preceded by a long row of examinations, medical and administrative procedures needed to ensure the highest hope of curing the ill patient possible. In the Czech Republic, there are two donor registers cooperating together, based on the principle of all-register international cooperation. Since the moment of graft conversion, the transplanted patient is in a highly risky state. The patient´s living days start to be counted again. Taking care of hematopoietic cell recipients, the patient´s maximal well-being, safety, psychological well-being and most importantly, avoiding possible complications which may significantly slow down or even destroy medical staff´s and the voluntary donor´s efforts to save another person´s life completely, are all necessary focal points of the process. The thesis describes specific procedures of care for patients suffering from different kinds of complications, with regard to the nurses´ work. Because there is a difference in caring and communicating with adult and child patients, one of the subchapters is devoted especially to caring for child oncological patients, and the options of adjusting the communication to their needs and their parents´ needs. To return the patient back to their best life quality possible, it is necessary to follow principles of a healthy lifestyle and correct nutrition principles.
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Mesenchymal stromal cells and biological scaffolds for neural tissue regeneration
Kočí, Zuzana ; Kubinová, Šárka (advisor) ; Filová, Eva (referee) ; Zach, Petr (referee)
Despite tremendous progress in medicine, injuries of the adult central neural system remain without satisfactory solution. Regenerative medicine employs tissue engineering, cellular therapies, medical devices, gene therapy, or growth factors with the aim to bridge the lesion, re-establish lost connections and enhance endogenous repair in order to restore neural function. The aim of my thesis was to evaluate therapeutic potential of two approaches, transplantation of human mesenchymal stromal cells (hMSCs) and biological scaffolds derived from extracellular matrix (ECM) for neural regeneration, particularly in models of spinal cord injury (SCI). First, hMSCs from various sources - bone marrow (BM), adipose tissue (AT) and Wharton's jelly (WJ) - were isolated and characterized in vitro. All cell types met the minimal criteria for MSC phenotype and displayed similar properties in terms of their surface marker expression, differentiation potential, migratory capacity, and secretion of cytokines and growth factors. On the other hand, the cell yield from WJ and AT was significantly higher, and MSCs isolated from these tissues proliferated better than from BM. Therapeutic effect of intrathecal application of hWJ-MSCs was then evaluated in SCI compression model in rats. The effect of low (0.5 million) and...
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The significance of morphology in differential diagnosis of lymphoproliferative disorders.
Kaválková, Adriana ; Fátorová, Ilona (advisor) ; Pešková, Eliška (referee)
This work deals with lymphoproliferative diseases in which morphology can contribute to diagnosis and speed up the diagnostic process. The cytomorphological examination is performed whenever any hematopathology is suspected. Cell morphology is assessed from both peripheral blood and bone marrow aspirates. We evaluate many parameters during microscopic examination of the cells: size, shape and deposition of the nucleus, chromatin structure, presence of nuclei, cytoplasm volume and colour, the presence of granules, vacuole, etc. The most common finding in peripheral blood is reactive lymphocytosis and often the presence of cellular atypia: e.g. visible nucleus, a distinct fine structure of chromatin, heterogeneity of the nucleus. Lymphoproliferation can be manifested by non-specific clinical and laboratory findings, which are sometimes difficult to properly evaluate. Therefore should be the results of other laboratory tests and clinical picture taken into account too. Morphology continues to play an important role in the process of recognizing leukaemias and lymphomas. In today's classification responds morphology seldom to the question what disease we looking at. However, the examination is still far more accessible and usually faster than follow-up laboratory methods and has its place in the chain...
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Characterization of hematopoietic cells in patients with mature B-cell malignancies
Maswabi, Bokang Calvin ; Živný, Jan (advisor) ; Otáhal, Pavel (referee) ; Alberich Jorda, Meritxell (referee)
(English) Using flow cytometry we analyzed absolute and relative proportions of hematopoietic stem and progenitors cells (HSPC) populations including hematopoietic stem cells (HSC), multipotent progenitors (MPP), multilymphoid progenitors (MLP) and pro B cells from bone marrow of patients with mature B cell malignancies and in healthy controls. We found lower absolute and relative numbers of MLP and higher relative numbers of HSC were observed in patients when compared to age-matched controls irrespective of bone marrow (BM) involvement. On the other hand significantly decreased absolute numbers of MPP were observed only in patients who had their BM infiltrated by disease. We also confirmed published data showing increasing absolute and relative percentages of MLP with increasing age, decreasing relative percentages of HSC with increasing age, and decreasing absolute and relative pro B cell frequencies with increasing age in healthy subjects. While decreased absolute and relative pro B cell numbers were also found in patient samples as age increased, no significant correlations were detected in patients HSC, MPP or MLP populations. Age-related sub-analysis of PTs samples demonstrated that most of the disease associated changes in HSPC frequencies were observable more prominently in the elderly (>45...
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Prognostic significance of atypical leukemic cell morphology in chronic lymphocytic leukemia.
Fučíková, Nikola ; Smolej, Lukáš (advisor) ; Vrbacký, Filip (referee)
CHARLES UNIVERSITY IN PRAGUE Faculty of Pharmacy in Hradec Králové Department of Biological and Medical Sciences Study program: Health Care Bioanalytics Candidate: Bc. Nikola Fučíková Supervisor: doc. MUDr. Lukáš Smolej, Ph.D. Title of diploma thesis: Prognostic significance of atypical leukemic cell morphology in chronic lymphocytic leukemia The aim of this thesis is to evaluate the prognostic significance of atypical cell morphology and smudge cells in patients with untreated chronic lymphocytic leukemia. We performed differential leukocytes count and classified lymphocytes as typical and atypical in a cohort of 101 patients (median age, 66 years; males, 69%, Rai III/IV stages, 18%). For atypical CLL, we used the 15% threshold and 59% of patients were classified as atypical CLL (aCLL). For smudge cells, we chose the 30% threshold and 33% of patients were classified as smudge cells positive. Patients in early clinical Rai stage (0) had significantly higher number of smudge cells (p=0.04). We didn't find a significant association between aCLL / smudge cells with modern prognostic indicators. We didn't find a relationship between aCLL and the time to first-line therapy (p=0.394). However, patients with aCLL had a significantly shorter overall survival (p=0.0397). There was a trend toward shorter...
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