Prezentace aplikace PowerPoint

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‹záhlaví›

‹datum a čas›=

‹zápatí›

‹#› ------=_NextPart_01C5E9D6.0FBAA310 Content-Location: file:///C:/1EC54594/file4884_soubory/pres.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C5E9D6.0FBAA310 Content-Location: file:///C:/1EC54594/file4884_soubory/slide0240.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Prezentace aplikace PowerPoint

Prognostický a prediktivní vý= znam thymidinkinázy u malignit

Votava T., Topolčan O., Holube= c L.jr., Kausitz J., Svobodová S., Černá Z. and Finek J .

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Cíl studie

•Ověřit význam thymidinkinázy (TK) při sledování pacientů s nádorovým onemocněním

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Thymidinkináza (TK)
Charakteristika I

•<= /span>1951 - Reichard, Eastborn

•TK hraje významnou roli v nitrobuněčném metabolismu thymidinu.

<= span style=3D'mso-special-format:bullet;position:absolute;left:-3.98%'>•<= /span>Enzym „záchranné“ cesty syntézy= DNA.

•<= /span>Sérová hladina TK - parametr buněčné proliferace

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<= /span>

DNA

dUMP

= ; &n= bsp; = ; &n= bsp; = ; B12

= ; Thymidilátsyntetáza

= ; &n= bsp; = ; &n= bsp;

= ; &n= bsp;

= ; &n= bsp; THFA-C1

FH2

= ; &n= bsp; ADP&= #13;

= ; ATP&= #13;

= ; &n= bsp; = ; &n= bsp; = ; Thymidinkináza = (d TK-F ) &nb= sp;

= ; &n= bsp; = ; „salvage“ enzym

Thy= midine

dTMP

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Thymidinkináza (TK) Charakteristi= ka II

–<= /span><= /span>

–<= /span> = 3 izoenzymy TK - fetální mitochondriáln&iacu= te;, cytosolová,

–<= /span> větší význ= am monitoraceTK - u „systémových“ malignit (leukémie, lymfomy)

– malobuněčné karci= nomy plic

•

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Thymidinkináza (TK) Charakteristi= ka III

=

–<= /span> <= /span>

–<= /span> = Ovlivnění sérové hladiny: virové infekce (VZV,CMV,HIV), deficit vit= B12 , hepatopatie

–<= /span> <= /span>

– Cytostatická terapi= e: 5-fluorouracil,(Mtx)
–<= /span>

•

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Charakteristika souboru

=

–<= /span> <= /span>

– 38 dětí <= /span>

– 27 chlapců, 11 dívek

– věk při diagnóze 1 rok - 15 l= et

– 04/94 - 04/05 <= /span>

– fen= otyp - B-ALL(29),T-ALL(5), AML (4)

•

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Cíle sledování

=

–<= /span> <= /span>

– Má sérová hla= dina TK při diagnose klinický význam (prognosa, riziko relapsu)?

–<= /span> = Je sledování hladiny TK v remisi onemocnění dobrým uk= azatelem pro vč= ;asný záchyt relapsu?

= 211;

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=
= TK(IU/L) akutní leukémie &= #8211;
dět= i - výsledky celkem

•Min- Max

•Median

•

•328

•22

•34

•360

•13 - 800 =

•12 -90 =

•15 -145 =

•300-800 =

•Relaps
• n=3D6 =

•Remise
• n =3D38

•Po terapii

•n=3D 38 =

•Před terapií

•n =3D38 =

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TK(IU/L) akutní leukémie - děti - relapsy =

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TK(IU/L)
akutní leukémie –
děti= - relapsy

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TK(IU/L)
akutní leukémie - děti - relapsy

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TK(IU/L)
akutní leukémie - děti - relapsy

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Hladina T= K - = pacient 1

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Hladina = TK - = pacient 2

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Hladin= a TK - pacient 3

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Hladina = TK - pacient 4

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Hladina = TK - pacient 5

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Kolorektální karcinom (n = =3D28)- TK, <= /span>= hladiny 9, 6, 3, 0 před progresí onemocnění

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Změny hladiny TK během chemoterapie

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Změny hladiny TK během chemoterapie

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Změny hladiny TK během chemoterapie

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Závěr I

=

=

•Hladina TK při diagnose akutní leukémie v dětském věku nemá význam z hlediska stanovení prognosy nebo vývoje onemocnění <= /b>

•
•U kolorektálního karcinomu lze monitorac&iac= ute; hladin TK při chemoterapii odhadnout vývoj choroby

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Závěr II

=

=

•Monitorov&= aacute;ní TK u dětských <= span style=3D'position:absolute;top:37.5%;left:10.29%;width:85.2%;height:8.5%'>= akutních leukémií může na= pomoci časné diagnostice relapsu onemnocnění !!!

•

•Senzitivita 83%

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Závěr III

=

=

•

•Cena

•

•Nezatěžuje pacienta

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Děkuji za poz= ornost

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‹záhlaví›

‹datum a čas›=

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Druhá úroveň =

Třetí úroveň

Čtvrtá úroveň <= /span>

Pátá úroveň

‹zápatí›

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window.gPPTHTML=3DSupportsPPTHTML() var gMainDoc=3Dnew Array(new hrefList("slide0240.htm",1,-1,1),new hrefList(= "slide0052.htm",1,-1,1),new hrefList("slide0219.htm",1,-1,1),new hrefList("= slide0203.htm",1,-1,1),new hrefList("slide0021.htm",1,-1,1),new hrefList("s= lide0243.htm",1,-1,1),new hrefList("slide0244.htm",1,-1,1),new hrefList("sl= ide0245.htm",1,-1,1),new hrefList("slide0247.htm",1,-1,1),new hrefList("sli= de0248.htm",1,-1,1),new hrefList("slide0249.htm",1,-1,1),new hrefList("slid= e0250.htm",1,-1,1),new hrefList("slide0251.htm",1,-1,1),new hrefList("slide= 0256.htm",1,-1,1),new hrefList("slide0257.htm",1,-1,1),new hrefList("slide0= 258.htm",1,-1,1),new hrefList("slide0259.htm",1,-1,1),new hrefList("slide02= 60.htm",1,-1,1),new hrefList("slide0224.htm",1,-1,1),new hrefList("slide025= 2.htm",1,-1,1),new hrefList("slide0226.htm",1,-1,1),new hrefList("slide0225= .htm",1,-1,1),new hrefList("slide0236.htm",1,-1,1),new hrefList("slide0253.= htm",1,-1,1),new hrefList("slide0254.htm",1,-1,1),new hrefList("slide0255.h= tm",1,-1,1)); function FullScrInit() { g_allowAdvOnClick =3D GetCurSld().mAdvOnClk document.body.style.backgroundColor=3D"black" document.oncontextmenu=3Dparent._CM; document.onkeydown =3D _KDH; document.ondragstart=3DCancel document.onselectstart=3DCancel self.focus() } function Redirect( frmId ) { var str=3Ddocument.location.hash,idx=3Dstr.indexOf('#'), sId=3DGetSldId() if(idx>=3D0) str=3Dstr.substr(1); if( window.name !=3D frmId && ( sId !=3D str) ) { obj =3D GetObj("Main-File") window.location.href=3Dobj.href+"#"+sId return 1 } return 0 } var MHTMLPrefix =3D CalculateMHTMLPrefix(); function CalculateMHTMLPrefix() { if ( document.location.protocol =3D=3D 'mhtml:') { href=3Dnew String(document.location.href) Start=3Dhref.indexOf('!')+1 End=3Dhref.lastIndexOf('/')+1 if (End < Start) return href.substring(0, Start) else return href.substring(0, End) } return ''; } function GetTags(base,tag) { if(g_supportsPPTHTML) return base.all.tags(tag); else return base.getElementsByTagName(tag); } function UpdNtsPane(){ if(frames["PPTNts"]) PPTNts.location.replace( MHTMLP= refix+GetHrefObj( gCurSld ).mNtsHref ) } function UpdNavPane( sldIndex ){ if(gNavLoaded) PPTNav.UpdNav() } function UpdOtNavPane(){ if(gOtlNavLoaded) PPTOtlNav.UpdOtlNav() } function UpdOtlPane(){ if(gOtlLoaded) PPTOtl.UpdOtl() } function SetHasNts( fVal ) { if( gHasNts !=3D fVal ) { gHasNts=3DfVal UpdNavPane() } } function ToggleOtlText() { gOtlTxtExp=3D!gOtlTxtExp UpdOtlPane() } function ToggleOtlPane() { frmset=3Ddocument.all("PPTHorizAdjust") frm=3Ddocument.all("PPTOtl") if( gOtlOpen ) frmset.cols=3D"*,100%" else frmset.cols=3D"25%,*" gOtlOpen=3D!gOtlOpen frm.noResize=3D!frm.noResize UpdOtNavPane() } function ToggleNtsPane() { frmset=3Ddocument.all("PPTVertAdjust") frm=3Ddocument.all("PPTNts") if( gNtsOpen ) frmset.rows=3D"100%,*" else frmset.rows=3D"*,20%" gNtsOpen=3D!gNtsOpen UpdNtsPane() } function ClearMedia() { if (PPTSld.pptSound) 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Poznámky

Prezentac= e

Osnova

1

Prognostick&yacu= te; a prediktivní význam thymidinkinázy u malignit

Votava T., Topolčan O., Holubec L.jr., Kausitz J., Svobodov&aac= ute; S., Černá Z. and Finek J .

FN Plzeň, LF UK Plzeň, 1. LF UK Praha

2

Cíl studi= e

Ověřit význam thymidinkinázy (TK) při sledování pacientů s nádorovým onemocněním

3

Thymidinkin&aacu= te;za (TK)
Charakteristika I

1951 - Reichard, Eastborn

TK hraje význam= nou roli v nitrobuněčném metabolismu thymidinu.

Enzym „záchranné“ cesty syntézy DNA= .

Sérová hladina TK - parametr buněčné proliferace

4

5

Thymidinkin&aacu= te;za (TK) Charakteristika II

3 izoenzymy TK - fet&= aacute;lní mitochondriální, cytosolová,

větší význam monitoraceTK - u „systémovýchR= 20; malignit (leukémie, lymfomy)

malobuněčné karcinomy plic

6

Thymidinkin&aacu= te;za (TK) Charakteristika III

Ovlivnění sérové hladiny: virové infekce (VZV,CMV,HIV), deficit vit B₁₂, hepatopatie

Cytostatická terapie: 5-fluorouracil,(Mtx)

7

Charakteristika = souboru

38 dětí
27 chlapců, 11 dívek

věk při diagnóze 1 rok= - 15 let

04/94 - 04/05

fenotyp - B-ALL(29),T-ALL(5), AML (4)

8

Cíle sledování

Má sérová hladina TK při diagnose klinický význam (prognosa, riziko relapsu)?

Je sledován&ia= cute; hladiny TK v remisi onemocnění dobrým ukazatelem= pro včasný záchyt relapsu?

9

TK(IU/L) akutn&i= acute; leukémie –
děti - výsledky celkem

10

TK(IU/L) akutn&= iacute; leukémie - děti - relapsy

11

TK(IU/L)
akutní leukémie –
děti - relapsy

12

TK(IU/L)
akutní leukémie - děti - relapsy

13

TK(IU/L)
akutní leukémie - děti - relapsy

14

Hladina TK - pa= cient 1

15

Hladina TK - pa= cient 2

16

Hladina TK - pa= cient 3

17

Hladina TK - pa= cient 4

18

Hladina TK - pa= cient 5

19

Kolorektá= ;lní karcinom (n =3D28)- TK, hladiny 9, 6, 3, 0 před progresí onemocnění

20

Změny hlad= iny TK během chemoterapie

21

Změny hlad= iny TK během chemoterapie

22

Změny hlad= iny TK během chemoterapie

23

Závěr I

Hladina TK při diagnose akutní leukémie v dětském věku nemá význam z hlediska stanovení prognosy nebo vývoje onemocnění<= /li>

U kolorektálního karcinomu lze monitorací hladi= n TK při chemoterapii odhadnout vývoj choroby

24

Závěr II

Monitorování TK u dětských akutních leukémií může napomoci časné diagnostice relapsu onemnocnění !!!

Senzitivita 83%

25

Závěr III<= /div>

Cena

Nezatěžuje pacienta

26

Děkuji za pozornost

= = = = = = = = = = = = =
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1	Prognostick&yacu= te; a prediktivní význam thymidinkinázy u malignit Votava T., Topolčan O., Holubec L.jr., Kausitz J., Svobodov&aac= ute; S., Černá Z. and Finek J . FN Plzeň, LF UK Plzeň, 1. LF UK Praha
2	Cíl studi= e Ověřit význam thymidinkinázy (TK) při sledování pacientů s nádorovým onemocněním
3	Thymidinkin&aacu= te;za (TK) Charakteristika I 1951 - Reichard, Eastborn TK hraje význam= nou roli v nitrobuněčném metabolismu thymidinu. Enzym „záchranné“ cesty syntézy DNA= . Sérová hladina TK - parametr buněčné proliferace
4
5	Thymidinkin&aacu= te;za (TK) Charakteristika II 3 izoenzymy TK - fet&= aacute;lní mitochondriální, cytosolová, větší význam monitoraceTK - u „systémovýchR= 20; malignit (leukémie, lymfomy) malobuněčné karcinomy plic
6	Thymidinkin&aacu= te;za (TK) Charakteristika III Ovlivnění sérové hladiny: virové infekce (VZV,CMV,HIV), deficit vit B₁₂, hepatopatie Cytostatická terapie: 5-fluorouracil,(Mtx)
7	Charakteristika = souboru 38 dětí 27 chlapců, 11 dívek věk při diagnóze 1 rok= - 15 let 04/94 - 04/05 fenotyp - B-ALL(29),T-ALL(5), AML (4)
8	Cíle sledování Má sérová hladina TK při diagnose klinický význam (prognosa, riziko relapsu)? Je sledován&ia= cute; hladiny TK v remisi onemocnění dobrým ukazatelem= pro včasný záchyt relapsu?
9	TK(IU/L) akutn&i= acute; leukémie – děti - výsledky celkem
10	TK(IU/L) akutn&= iacute; leukémie - děti - relapsy
11	TK(IU/L) akutní leukémie – děti - relapsy
12	TK(IU/L) akutní leukémie - děti - relapsy
13	TK(IU/L) akutní leukémie - děti - relapsy
14	Hladina TK - pa= cient 1
15	Hladina TK - pa= cient 2
16	Hladina TK - pa= cient 3
17	Hladina TK - pa= cient 4
18	Hladina TK - pa= cient 5
19	Kolorektá= ;lní karcinom (n =3D28)- TK, hladiny 9, 6, 3, 0 před progresí onemocnění
20	Změny hlad= iny TK během chemoterapie
21	Změny hlad= iny TK během chemoterapie
22	Změny hlad= iny TK během chemoterapie
23	Závěr I Hladina TK při diagnose akutní leukémie v dětském věku nemá význam z hlediska stanovení prognosy nebo vývoje onemocnění<= /li> U kolorektálního karcinomu lze monitorací hladi= n TK při chemoterapii odhadnout vývoj choroby
24	Závěr II Monitorování TK u dětských akutních leukémií může napomoci časné diagnostice relapsu onemnocnění !!! Senzitivita 83%
25	Závěr III<= /div> Cena Nezatěžuje pacienta
26	Děkuji za pozornost