National Repository of Grey Literature 18 records found  1 - 10next  jump to record: Search took 0.00 seconds. 
New biomarkers for prognostication after cardiac arrest
Vondráková, Dagmar ; Málek, Filip (advisor) ; Vízek, Martin (referee) ; Rokyta, Richard (referee)
Cardiac arrest is an extremely serious condition characterized by global ischemia followed by reperfusion after successful resuscitation and restoration of spontaneous circulation. Despite all advances in current medicine, the prognosis of cardiac arrest survivors remains very poor. One of the major problems in these patients is, therefore, the early and reliable determination of the prognosis that is necessary for choosing the most appropriate diagnostic and therapeutic approach. However, the current possibilities for early prognostication in cardiac arrest survivors remain very limited. The aims of our work were: (i) to study the possibilities of influencing oxidative stress as one of the key pathogenic factors involved in the development of so-called post-cardiac arrest syndrome; and (ii) to determine the prognostic value of copeptin, neuron-specific enolase (NSE) and markers of oxidative stress in cardiac arrest survivors. In the experimental part of the work we used porcine model of cardiac arrest for the comparison of the effects of hypothermia, ischemic postconditioning (IPC) and administration of nitric oxide (NO) on oxidative stress burden and organ damage; we found that neither NO nor IPC did have a superior protective effect over hypothermia. In the clinical part we have in several...
The role of protein kinase C and its targets in cardioprotection
Holzerová, Kristýna ; Hlaváčková, Markéta (advisor) ; Alán, Lukáš (referee) ; Vízek, Martin (referee)
The mortality of cardiovascular diseases remains high and it likely tends to increase in the future. Although many ways how to increase the resistance against myocardial ischemia- reperfusion damage have been described, few of them were transferred into clinical practice. Cardioprotective effect of chronic hypoxia has been described during 60s of the last century. Its detailed mechanism has not been elucidated, but a number of components has been identified. One of these components presents protein kinase C (PKC). The role of PKC was described in detail in the mechanism of ischemic preconditioning, but its involvement in the mechanism of cardioprotection induced by chronic hypoxia remains unclear. One reason is the amount of PKC isoforms, which have often contradictory effects, and the diversity of hypoxic models used. The most frequently mentioned isoforms in connection with cardioprotection are PKCδ and PKCε. The aim of my thesis was to analyze changes in these PKC isoforms at two different cardioprotective models of hypoxia - intermittent hypobaric (IHH) and continuous normobaric hypoxia (CNH). We also examined the target proteins of PKCδ and PKCε after the adaptation to IHH, which could be involved in the mechanism of cardioprotection. These included proteins associated with apoptosis and...
Mild therapeutical hypothermia and oxidative stress after cardiac arrest
Krüger, Andreas ; Ošťádal, Petr (advisor) ; Vízek, Martin (referee) ; Rokyta, Richard (referee)
Successfull cardiopulmonary resuscitation is an essential life-saving tool; nevertheless, general ischemia during cardiac arrest may trigger different pathways that could turn even into a fatal damage; this condition is called post-cardiac arrest syndrome. It has been repeatedly shown that oxidative stress (OS) plays one of the key roles in the development of ischemia-reperfusion injury. However, current evidence on the possible participation of OS in the pathogenesis of post-cardiac arrest syndrome is insufficient. We tested following hypotheses: (i) ischaemia-reperfusion injury after cardiac arrest is accompanied by OS and (ii) mild therapeutical hypothermia decreases OS cardiac arrest. In the experimental part of our work we studied the effects of hypothermia and normothermia on hemodynamic parameters, markers of organ damage and on the OS burden in porcine model of cardiac arrest. Furthermore, we compared the effects of hypothermia with ischaemic postconditioning and nitric oxide administration in the porcine model of extracorporeal cardiopulmonary resuscitation. We found protective effects of hypothermia on all major endpoints including OS in comparison with normothermia; moreover, hypothermia improved also selected variables compared to ischemic postconditioning and nitric oxide. In the...
Experimental pulmonary embolism - pathophysiological aspects
Mizera, Roman ; Herget, Jan (advisor) ; Lischke, Robert (referee) ; Vízek, Martin (referee)
- Experimental pulmonary embolism, pathophysiological aspects MUDr. Roman Mizera Theoretical part of the thesis deals with mechanisms of pulmonary hypertension after pulmonary embolism (PE) and summarizes the knowledge of literary sources in this issue. Peripherally deals with the mechanical obstruction of pulmonary vessels, particularly discusses vasoconstriction after the PE. In the experimental part are described three separate experiments. The first experiment tested effect of reactive oxygen species (ROS) and preventive administration their scavenger - superoxide dismutase inhibitor tempol on basal perfusion pressure, vasoconstriction, NO synthase activity and the production of NOx after acute PE. Results show that after PE grows NO synthase activity and the production of NOx, the administration of tempol reduces basal perfusion pressure and vasoconstriction after PE. In the second experiment, we measured basal perfusion pressure and vasoconstriction after PE in lungs exposed to 5 day chronic hypoxia. We tested influence of PDE-5 inhibitor sildenafil on the pulmonary vessels tone. Sildenafil decreased basal pressure after PE in chronic hypoxia, its administration does not affect the pulmonary vasoconstriction of pulmonary vessels, but increases their compliance. The last project tested effect...
Aspects of identification of patients with primary ciliary dyskinesia
Djakow, Jana ; Cinek, Ondřej (advisor) ; Vízek, Martin (referee) ; Panczak, Aleš (referee)
Primary ciliary dyskinesia (PCD) is a rare but underdiagnosed genetic disease. This innate disorder of motile cilia causes a non-functional mucociliary clearance which is the main reason for a clinical picture of recurrent or chronic upper and lower respiratory tract infections. Fertility disorders or abnormal organ situs can also be found in some patients. The diagnosis of PCD is extremely complicated and complex. A combination of several diagnostic procedures as well as skilled personnel and special technical equipment are usually needed for the PCD diagnostics. Although significant progress has been made in understanding the PCD etiopathogenesis and the advanced diagnostics has become available, therapeutic possibilities are rather limited and the treatment efficiency still remains to be confirmed by the evidence base medicine. The dissertation thesis assembles several publications in which different aspects of primary ciliary dyskinesia were addressed. The most extensive part of our research addressed rapidly evolving possibilities of PCD genetic diagnostics. We studied possibility of priority sequencing of several segments of the genes DNAH5 and DNAI1 which were known to be the most frequently mutated genes in the PCD patients at the time of the study. We proved this method being able to...
Pes equinovarus:New Treatment Strategies and Pathogenetic Mechanisms
Ošťádal, Martin ; Herget, Jan (advisor) ; Vízek, Martin (referee) ; Poul, Jan (referee)
Idiopathic pes equinovarus (also referred to as clubfoot) is a congenital deformity of the foot and lower leg; it has five components: equinus, varus, adductus, cavus and supination of the foot. At present two principle methods are mostly used for the treatment of clubfoot: physiotherapy and continuous motion without immobilization and the Ponseti method (serial manipulation, cast application, Achilles tenotomy and transposition of m. tibilalis ant.). This method has been reported to have short-term success rates approaching 100%, and the long-term results have been equally impressive. We believe, however, that the data on the success rate may be significantly influenced by the duration of the period after termination of the treatment. The purpose of the first part of our study was, therefore, to compare the short-term (up to three years) and long-term (three to seven years) results of treatment of idiopathic clubfeet with the Ponseti method and to determine the factors for recurrence. We have tested the hypothesis whether is it possible to cure all clubfeet with the Ponseti method only. We have found significant difference between the evaluation of the short- term and long-term results: the number of relapses during the first three years of treatment, indicated for surgical intervention, was...
název v anglickém jazyce není uveden
Klusáčková, Pavlína ; Pelclová, Daniela (advisor) ; Hajduková, Zdeňka (referee) ; Vízek, Martin (referee)
Early diagnosis of occupational asthma is important especially for the prognosis of this disease. The confirmation of the diagnosis of occupational asthma is sometimes difficult using diagnostic methods available nowadays. That is why searching new methods is very important. Analysis of exhaled breath condensate (EBC) by liquid chromatography combined with mass spectrometry enables the separate detection of cysteinyl leukotrienes (LT) - LTC4, LTD4, LTE4; LTB4 and 8-isoprostane. If patients with occupational asthma and controls were compared, only LTC4 was significantly higher among all EBC parameters studied in asthmatics (despite corticosteroid treatment). This marker could be used in the future diagnostics. Monitoring of 24-hours variability of EBC parameters in patients, in whom occupational asthma is suspected, showed relatively high intraindividual and interindividual variation. It is evident therefore, that if only one daily measurement in asthmatics would be possible (which is common in articles of several authors), it should be collected in the same period of day in all persons. In negative bronchoprovocation tests significant changes of EBC parameters were not found. The evaluation of positive bronchoprovocation tests was limited by small number of patients, however in five persons from six, the...
Feeding artery of vascular accesses for hemodialysis: model of arterial adaptation to high blood flow
Tuka, Vladimír ; Malík, Jan (advisor) ; Vízek, Martin (referee) ; Zicha, Josef (referee)
Background: Arteries adapt their diameter to changing haemodynamic conditions to maintain constant wall shear stress, the force generated by flowing blood on endothelial cells. The feeding artery of haemodialysis vascular accesses is a human model of arterial adaptation to chronically high blood flow and thus to high wall shear stress. The process of arterial adaptation is endothelium dependent. Endothelial dysfunction related to End-Stage Renal Failure, diabetes mellitus, dyslipidemia may impair also the dilatation of the feeding artery of vascular accesses. First the review of the literature presents in three parts different aspects of arterial adaptation: 1) arterial adaptation with focusing on the role of haemodynamic factors, 2) the influence of end-stage renal disease on arterial adaptation, 3) feeding artery of vascular accesses as a model of arterial response to chronic increase in blood flow. Methods: We examined the feeding artery of radial and brachial polytetrafluoroethylene grafts shortly after and one and two years after access creation. We used duplex ultrasonography to obtain internal diameter and blood velocity in the feeding arteries. We calculated wall shear rate as 4 x blood velocity / internal diameter and used it as approximation of wall shear stress. Results: In the first study we...
Resistance of immature heart muscle to insufficient oxygen
Charvátová, Zuzana ; Ošťádal, Bohuslav (advisor) ; Vízek, Martin (referee) ; Kuneš, Jaroslav (referee) ; Škovránek, Jan (referee)
Dle údajů Světové zdravotnické organizace jsou v zemích střední a východní Evropy nejčastější příčinou úmrtí choroby srdce a cév. Více než polovinu z tohoto množství zaujímá jediné onemocnění, jímž je akutní a chronická ischemická choroba srdeční (ICHS). Cílem klinických i experimentálních kardiologů, kteří se výzkumem prevence a terapie ICHS zabývají, je proto tuto nepříznivou situaci zlepšit. ICHS vzniká jako důsledek nerovnováhy mezi množstvím kyslíku (a substrátů) dodávaného srdeční buňce a množstvím kyslíku, které buňka aktuálně potřebuje ke splnění metabolických nároků. Při ischemii (na rozdíl od hypoxie) je navíc kromě dodávky živin narušen i odvod produktů a nežádoucích zplodin buněčného metabolizmu. Výsledkem je pak přechod srdečního svalu na anaerobní metabolizmus, hromadění metabolitů a porucha energetické a iontové homeostázy; to vede k poruchám kontraktility a konečným důsledkem omezení perfuze myokardu může být zánik srdeční buňky a vznik infarktu myokardu. V tom, zda poškození bude reverzibilní či ireverzibilní, hraje rozhodující roli délka trvání ischemie. Jedinou možností, jak zabránit či alespoň zmírnit nevratné poškození srdečního svalu, je včasné obnovení průtoku krve koronárním řečištěm v postižené oblasti. Rozsah ischemického poškození srdečního svalu nezávisí pouze na intenzitě a...
Some aspects of the pathophysiology of macrovascular complications of type 2 diabetic patients and of their assertion in practice
Adamíková, Alena ; Svačina, Štěpán (advisor) ; Anděl, Michal (referee) ; Vízek, Martin (referee)
Pacienti s diabetem 2. typu a dalšími rizikovými faktory (dyslipidémie, mikroalbuminurie) mají vysoké riziko asymptomatického kardiovaskulárního onemocnění. Pozitivní mikroalbuminurie ve skupině asymptomatických diabetiků 2. typu byla prokázána u 11,6% pacientů a u všech se vyskytla různě závažná forma kardiovaskulárních onemocnění. Dysfunkce endotelu, aktivní zánětlivý proces v cévní stěně, poruchy lipidového spektra, porucha reverzního transportu cholesterolu se podílejí na akceleraci aterosklerotického procesu u diabetiků 2. typu. Vysoká hladina zánětlivého markeru hs-CRP 3,053±2,668 mg/l přetrvávající ve studovaném souboru i přes zavedenou terapii poukazuje na nutnost systematického a trvalého aktivního terapeutického přístupu k diabetikům 2. typu s rizikovými faktory. Statisticky významný vztah dlouhodobé kompenzace diabetu dle HbA1c a parametrů transientní ischemické dilatace levé komory (TID) u těchto pacientů dokumentuje riziko hyperglykémie pro pseudodilataci levé komory srdeční způsobenou difuzní subendokardiální ischemií (p=0,035). Aktivní přístup k těmto rizikovým pacientům jak po stránce diagnostiky (zátěžové EKG, zátěžový SPECT myokardu), tak po stránce terapie, může podstatně ovlivnit jejich další kvalitu života a životní prognózu.

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