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Experimental Treatment of the Spinal Cord Injury and Clinical Treatment of Thoraco-Lumbar Vertebral Fractures
Krůpa, Petr ; Řehák, Svatopluk (advisor) ; Hejčl, Aleš (referee) ; Hrabálek, Lumír (referee)
Vertebral body fractures together with the spinal cord injury (SCI) remain a challenging medical condition. While management of the thoracic-lumbar (Th-L) vertebral fractures belongs to basic neurosurgical procedures with a usually excellent outcome, treatment of the severe spinal cord injury has mostly unsatisfactory results and thus novel approaches are highly in demand. In this study, experimental treatment of the SCI in a rat model using human mesenchymal stem cells derived from Wharton's jelly (WJ-MSCs) and a novel highly water soluble, nano-formulated curcumin is evaluated. Furthermore, a novel method of mini- invasive percutaneous posterior stabilisation (MIS) of Th-L vertebral fractures is retrospectively compared with classical open posterior (OPEN) procedure. To assess the effectivity of hWJ-MSCs treatment in the ischemic-compression model of SCI in rats, different dosages (0.5 or 1.5 million cells) and repeated applications were compared. Cells or saline were applied intrathecally by lumbar puncture once, or in three consecutive weeks after injury. Nanocurcumin and a vehicle nanocarrier as a control were delivered both locally, immediately after the spinal cord injury, and subcutaneously during the four consecutive weeks after SCI. Rats were assessed for locomotor skills (BBB, flat beam,...
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Early Volumetry of Brain Metastases Treated with CyberKnife
Reguli, Štefan ; Řehák, Svatopluk (advisor) ; Jančálek, Radim (referee) ; Kalita, Ondřej (referee)
The CyberKnife is a device for frameless whole-body radiosurgery using image guided robotic technology and linear accelerator as a photon source. It was introduced in USA in 2001. First CyberKnife device in eastern ad middle Europe was installed in Faculty hospital Ostrava in 2010. So we were given a chance do use the most recent technology in treating oncological patients. Brain metastases are an important and frequently treated indication in modern radiosurgery. This non-invasive method offers good local control with minimum toxicity and repeability of the treatment. Biological aspect and dose delivery is equivalent to devices using framed stereotaxis and cobalt as radiation source (Gamma Knife). The difference is in technological performance. The ability of fraccionated therapy with CyberKnife enables radiotherapy of larger tumours. Patients treated with CyberKnife for metastatic brain disease are checked with repeated magnetic resonance imaging (MRI) to to figure out the growth of treated tumours and/or apperance of new lesions. In our prospective study we measure the volume of brain metastases on MRI with use of computer -assisted volumetry. We evaluate the predictive value of volumetric changes on MRI exams 6 weeks and 12 weeks post radiosurgery respectively. The aim was to identify high-risk...
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Early Diagnosis of the Failure of Endoscopic Third Ventriculostomy
Krejčí, Tomáš ; Řehák, Svatopluk (advisor) ; Krahulík, David (referee) ; Brichtová, Eva (referee)
Early diagnosis of the failure of endoscopic third ventricolostomy Aim of the study: The aim of the study is to determine the risk of ETV failure based on the presence or absence of radiological indications of third chamber deformation (bowing of the third chamber) on preoperative MR brain scans in patients with obstructive hydrocephalus. Additionally evaluating extend of the bowing, patients age, regression of bowing following successful ETV, etiology, degree of prematurity of newborns, persistence and character of clinical symptoms and other factors. Type of the study: Prospective clinical study. The data set and methodology: Data set comprised 157 patients with obstructive hydrocephalus operated on Neurosurgical clinic of University Hospital Ostrava between January 2008 and December 2016. The follow up duration was at least 3 months. From this cohort we were able to determine effect of bowing on ETV outcome in 135 patients. Of these patients, 70 were adults, 27 were children between 7 months and 16 years of age and 38 were infants under 6 months. From 38 infants under 6 months were 22 severe premature newborns, 9 moderately premature newborns and 7 mildly premature newborns. The extend of the bowing was determine in the range 3 - 14 mm. Results: ETV was noted as successful in 84 cases (62%). Statistical...
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Patients' quality of life after subarachnoid hemorrhage
Škrášková, Petra ; Štefančíková, Mariana (advisor) ; Řehák, Svatopluk (referee) ; Oborníková, Martina (referee)
Author: Petra Škrášková Institution: Institute of social medicine, Charles University - Faculty of Medicine in Hradec Kralové Department of nursing Thesis title: Patients' quality of life after subarachnoid hemorrhage Supervisor: PhDr. Mariana Bažantová Number of pages: 134 Number of attachment: 13 Year: 2010 Keywords: quality of life, cognitive impairment, aneurysm, subarachnoid hemmorhage, nursing care Bachelor's thesis is focused on patients' quality of life 1 to 1,5 years after subarachnoid hemorrhage. The primary emphasis is set on the impact of this disease on psychological, social and emotional patients' life. The thesis is divided into theoretical and empirical part. Patients' quality of life has been studied since the second half of the last century in various medical disciplines. Definition and ways how to investigate patients' quality of life are discussed in the theoretical part of thesis. The impact of subarachnoid hemorrhage on quality of life are reviewed and discussed. The second chapter is dealing with cognitive changes and function of brain cortex. This topic is very important since impairment of these functions significantly decrease quality of life after subarachnoid hemorrhage. The third chapter is focused on general data about subarachnoid hemorrhage and intracranial...
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