The compression therapy is often being underestimated not only by medical staff and doctors, but also by patients. Therefore, it is often perceived as a simple task frequently handed over to hospital attendants. At the nursing schools the time devoted to the issue of compression therapy is minimal. That is probably why there are nurses with a very limited information at their disposal regarding this issue. The compression therapy is nevertheless an essential part of prevention and treatment of the venous and lymphatic diseases. When the compressive bandaging is carried out efficiently, it can improve the quality of life of a patient with a venous or lymphatic disease. Moreover, it can help in preventing thromboembolic diseases during surgical interventions. However, in order for the compressive bandage to be effective, several conditions must be met. First, it has to be carried out by a properly trained medical staff. Second, it is highly important that the patient undergoes a thorough education concerning compressive bandaging, so that he or she is able to keep the bandage effective when released home. Based on evidence, the aim of this thesis is to find out how effective is the practice of compressive bandaging within nursing care. The thesis consists of two parts. The first is theoretical and it contains the findings of various researches and publications related to the issue of venous diseases, aplication of the compressive bandage, differences between elastic stockings and elastic roller bandage and the findings concerning the education of a patient. The second part is practical. It consists of a quantitative research with a participation of 192 respondents who work as nurses in medical facilities and who are therefore closest to the patient undergoing compressive therapy. The thesis is interested in the amount of knowledge nurses have in relation to the compressive bandage, in the way they apply the bandage and in the process of the education of the patient. The research shows that the choice of a type of a compressive therapy is conditioned by the supply of the ward. Furthermore, the research reveals that there is no connection between the length of the professional experience of a nurse and her or his method of applying the compressive bandage. The recommendation for practice is an educational seminar for nurses aimed at completing their theoretical knowledge. This would also serve as an opportunity to practice not only the application of the bandage, but also the use of a measuring instrument Picopress.

The thesis evaluates the results of experimental protocol involving the fertility sparing treatment procedure in early stage cervical carcinoma (LAP I protocol). Sentinel lymph node detection and experimental extirpation of afferent channels using laparoscopy and its technical aspects were analysed in prospective group of 85 women. The oncologic results and early/late morbidity show that established surgical procedures can be considered safe with minimal morbidity, provided that the indication criteria are met. The second part analyses the results of 148 women with no further pregnancy plans suffering from cervical tumors less than 2 cm in size with invasion less than half of the stroma (LAP II protocol). The oncological results in our defined group are very good and comparable to 'standard' procedure of modified radical hysterectomy type B or C with lower morbidity. In the separate section the thesis analyses the possibilities of laparoscopy in endometrial cancer treatment including the potentials of use of sentinel lymph node detection and technical aspects of laparoscopy in obese women. Currently the biggest controversy is the use of laparoscopy in malignant ovarian tumors. Our oncogynaecological study group at FN Motol prefers the laparotomic approach and we chose to include the set of advanced...

The innate and adaptive immune processes are modulated by hormones including glucocorticoids and by microbiota. The exact mechanisms underlying the microbial and hormonal contributions to this control are not completely clear. Present study is therefore focused to crosstalk between microbiota and de novo biogenesis or local regeneration of glucocorticoids. In particular, the study analysed the effect of commensal microbiota on expression of genes encoding steroidogenic enzymes (Star, Cyp11a1, Hsd3b1, Cyp21a1, Cyp11b1) and regeneration of glucocorticoids (Hsd11b1) in adrenal glands, colon, spleen and mesenteric lymph nodes using conventional and germ-free mice. The expression of all 5 components of steroidogenesis was identified only in the adrenal gland and colon, whereas the lymphoid organs expressed predominantly Star, Cyp11a1 and Hsd3b1 indicating the ability to produce only progesterone but not corticosterone. Microbiota decreased the expression of Star in all studied tissues but the expression of other genes was insensitive to microbiota or did not respond homogenously depending on the tissue and gene. Hsd11b1 expression was upregulated by microbiota in the spleen but not in other tissues. Similarly, the in vitro treatment of immune cells isolated from mesenteric lymph nodes by microbial...

The thesis evaluates the results of experimental protocol involving the fertility sparing treatment procedure in early stage cervical carcinoma (LAP I protocol). Sentinel lymph node detection and experimental extirpation of afferent channels using laparoscopy and its technical aspects were analysed in prospective group of 85 women. The oncologic results and early/late morbidity show that established surgical procedures can be considered safe with minimal morbidity, provided that the indication criteria are met. The second part analyses the results of 148 women with no further pregnancy plans suffering from cervical tumors less than 2 cm in size with invasion less than half of the stroma (LAP II protocol). The oncological results in our defined group are very good and comparable to 'standard' procedure of modified radical hysterectomy type B or C with lower morbidity. In the separate section the thesis analyses the possibilities of laparoscopy in endometrial cancer treatment including the potentials of use of sentinel lymph node detection and technical aspects of laparoscopy in obese women. Currently the biggest controversy is the use of laparoscopy in malignant ovarian tumors. Our oncogynaecological study group at FN Motol prefers the laparotomic approach and we chose to include the set of advanced...

The sentinel lymph node biopsy is part of recommended surgical staging guidelines in patients with early stages of cervical cancer. High success rates of bilateral detection of SLN are achieved in sites with adequate experience with this procedure. The sentinel lymph node biopsy without systematic pelvic lymph node dissection is currently considered inadequate procedure for stages IB to IIA of the disease. One of the benefits of sentinel lymph node detection is extensive histopathological examination using the ultrastaging protocol enabling detection of small metastases (i.e. micrometastases). At the moment, there is lack of evidence about oncological safety of sentinel lymph node biopsy which might replace systematic lymph node dissection in the future. Prognostic significance of micrometastases is also controversial due to the lack of data about their potential presence in non-sentinel lymph nodes in cases with negative sentinel lymph nodes. This dissertation deals with the concept of sentinel lymph node biopsy in the cervical cancer and focuses on several topics. We have shown that the presence of micrometastasis is associated with significant negative impact on patients' prognosis on the largest retrospective cohort of patients ever published. Only 67% of patients with micrometastasis have...