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The fluid therapy during burn shock guided by hemodynamic parameters
Tokarik, Monika ; Vaněk, Tomáš (advisor) ; Cvachovec, Karel (referee) ; Kofránek, Jiří (referee)
ABSTRACT Keywords Burn shock; fluid therapy; arterial pulse contour analysis; dynamic preload parameters; hourly urine output. Introduction: Our hypothesis is based on the assumption that the volume therapy in the acute phase of burn shock corrected by a combination of dynamic preload parameters and hourly diuresis is reduced compared to fluid therapy which is corrected only by hourly diuresis. The dynamic preload parameters seem to be the most reliable predictors of response to fluid challenge. Materials and Methods: A group of 21 burned patients meeting preliminary criteria (age range 18 - 75 years with 2nd - 3rd - degree burns and TBSA ≥10 - 75 %) was randomized during 2009 - 2011 as follows. Hemodynamic monitoring through lithium dilution cardiac output was used in 10 randomized patients (LiDCO group) while those without LiDCO monitoring were defined as a control group. The modified Brooke formula as a starting resuscitative formula, ...
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Breast cancer cell population. Its usage for setting of optimal therapeutical regimen. Predictive model.
Kolařík, Dušan ; Halaška, Michael (advisor) ; Kofránek, Jiří (referee) ; Dundr, Pavel (referee)
1 ABSTRACT Background Breast cancer cell population characteristics are used in common clinical practice for estimation of prognosis of the malignant disease (prognostic factors) and for prediction of reactivity of the tumor to certain therapeutic modality (predictive factors). Also axillary lymph node status is an independent prognostic factor in women with early breast cancer. Therefore, surgical excision and following histopathological examination of the nodes is the obligatory part of primary breast cancer surgery. The extension of axillary surgery varies widely, although sentinel lymph node biopsy is considered to be the standard procedure. However, it must be admitted that this type of procedure need not be optimal for all the breast cancer patients. Aims of the study The aim of this study is the verify the hypothesis whether or not the axillary lymph node metastatic affection can be effectively estimated using non-surgical methods - i.e. by evaluation of the combination of prognostic and predictive factors of the primary breast tumor. Statistical model composed on the basis of data of early breast cancer patients is the basic tool for this prediction. Application of this model In everyday practice can enable to adjust the extent of axillary surgery for each individual patient. Patients and methods A...
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Formalization of Integrative Physiology
Mateják, Marek ; Kofránek, Jiří (advisor) ; Kasal, Pavel (referee) ; Otáhal, Jakub (referee)
New information technologies bring with them new possibilities for defining and simulating complex physical systems. A huge amount of progress was made in this field with the Modelica language standard, developed by the worldwide nonprofit Modelica Association. Using the Modelica language specification, new chemical, hydraulic, thermal and population components for human physiology were designed for the implementation of the physiological principles in this thesis. The presented free Modelica libraries was named PHYSIOLIBRARY and CHEMICAL. Similarly to the electrical circuits already implemented in the Modelica Standard Library, it is also possible to connect the components of these libraries to the diagrams and, in this way, define more complex components of physiological systems. Using this kind of implementation, this thesis presents an extension and improvement of the HumMod version 1.6 model, developed at the University of Mississippi Medical Center (Jackson, MS), which has more than 5,000 variables. As a result of the use of graphical diagrams, our implementation is more expandable and more modifiable at each point. The precise rules of connections lead to fewer implementation errors. In addition, the visual verification of the model is achieved, because the physiological connections of...
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Modelica in physiological modelling. Models with spatially distributed parameters, Authorin educational simulators.
Šilar, Jan ; Kofránek, Jiří (advisor) ; Maršálek, Petr (referee) ; Roubík, Karel (referee)
Mathematical models in physiology are useful to formulate and verify hypotheses, to make predictions, to estimate hidden parameters and in education. This thesis deals with modelling in physiology using the Modelica language. New methods for model implementation and simulator production were developed. Modelica is an open standard equation-based object-oriented language for modelling complex systems. It is highly convenient in physiology modelling due to its ability to describe extensive models in a lucid hierarchical way. The models are described by algebraic, ordinary differential and discrete equations. Partial differential equations are not supported by the Modelica standard yet. The thesis focuses on two main topics: 1) modelling of systems described by partial differential equations in Modelica 2) production of web-based e-learning simulators driven by models implemented in Modelica. A Modelica language extension called PDEModelica1 for 1-dimensional partial differential equations was designed (based on a previous extension). The OpenModelica modelling tool was extended to support PDEModelica1 using the method of lines. A model of countercurrent heat exchange between the artery and vein in a leg of a bird standing in water was implemented using PDEModelica1 to prove its usability. The...
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Breast cancer cell population. Its usage for setting of optimal therapeutical regimen. Predictive model.
Kolařík, Dušan ; Halaška, Michael (advisor) ; Kofránek, Jiří (referee) ; Dundr, Pavel (referee)
1 ABSTRACT Background Breast cancer cell population characteristics are used in common clinical practice for estimation of prognosis of the malignant disease (prognostic factors) and for prediction of reactivity of the tumor to certain therapeutic modality (predictive factors). Also axillary lymph node status is an independent prognostic factor in women with early breast cancer. Therefore, surgical excision and following histopathological examination of the nodes is the obligatory part of primary breast cancer surgery. The extension of axillary surgery varies widely, although sentinel lymph node biopsy is considered to be the standard procedure. However, it must be admitted that this type of procedure need not be optimal for all the breast cancer patients. Aims of the study The aim of this study is the verify the hypothesis whether or not the axillary lymph node metastatic affection can be effectively estimated using non-surgical methods - i.e. by evaluation of the combination of prognostic and predictive factors of the primary breast tumor. Statistical model composed on the basis of data of early breast cancer patients is the basic tool for this prediction. Application of this model In everyday practice can enable to adjust the extent of axillary surgery for each individual patient. Patients and methods A...
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Formalization of Integrative Physiology
Mateják, Marek ; Kofránek, Jiří (advisor) ; Kasal, Pavel (referee) ; Otáhal, Jakub (referee)
New information technologies bring with them new possibilities for defining and simulating complex physical systems. A huge amount of progress was made in this field with the Modelica language standard, developed by the worldwide nonprofit Modelica Association. Using the Modelica language specification, new chemical, hydraulic, thermal and population components for human physiology were designed for the implementation of the physiological principles in this thesis. The presented free Modelica libraries was named PHYSIOLIBRARY and CHEMICAL. Similarly to the electrical circuits already implemented in the Modelica Standard Library, it is also possible to connect the components of these libraries to the diagrams and, in this way, define more complex components of physiological systems. Using this kind of implementation, this thesis presents an extension and improvement of the HumMod version 1.6 model, developed at the University of Mississippi Medical Center (Jackson, MS), which has more than 5,000 variables. As a result of the use of graphical diagrams, our implementation is more expandable and more modifiable at each point. The precise rules of connections lead to fewer implementation errors. In addition, the visual verification of the model is achieved, because the physiological connections of...
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Information support in the area of software simulators in medical education
Jirásková, Klára ; Kofránek, Jiří (advisor) ; Jarolímková, Adéla (referee)
(english) The subject of this thesis is the analysis of the development and use of medical simulators in terms of information support, basic description and introduction to the issue of medical training simulators themselves. The introduction describes the simulators since the beginning of the historical development to the current use. Subsequently, the work deals with manikin for patient simulators, the essential components, required for proper functioning, which are mathematical models on the background of the simulators. The chapter on repositories, describes the problems of model documentation and archiving of articles which describes the models. There are described reference managers for managing the literature and made a basic comparison of their features. The thesis focuses on a selected reference manager - Docear, which is described and used in the practical part. It deals with the organization of the scientific literature of Biomedical simulators in the Department of Biocybernetics and Computer Aided Teaching at the 1st Medical Faculty of Charles University. Key words (english) - medical simulators, information support, education, information base, repository, reference manager, mind maps
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Reunified description of acid-base physiology and chemistry of blood plasma
Matoušek, Stanislav ; Kofránek, Jiří (advisor) ; Wooten, Wrenn (referee) ; Kittnar, Otomar (referee)
This thesis addresses an important problem of biomedical acid-base theory, where there are two apparently contradictory ways of describing the acid-base status of blood plasma, while the underlying physiology and chemistry obviously has to be only one. The two descriptions are called the traditional approach, based mainly on the work of Ole Siggaard-Andersen and the modern approach, based on the work of Peter Stewart and his followers. This work has three starting points. First are generally accepted basic concepts of acid-base chemistry and physiology. Second is an elegant formalism to the description of acid-base phenomena in complex solutions developed by Guenther. First part of this thesis builds on these two starting points, which serve as a basis for a detailed analysis augmented by the use of simple computer modelling. This results in formal description of several more advanced concepts, including the titration curves of proteins, behaviour of bicarbonate and protein buffers in single solution, relationship between strong ion charge and protein buffer charge and fuzzy division between strong ions and buffer ions in physiology. The modeling work then proceeds to comparing various models of albumin, principal protein buffer of blood plasma. Theoretical concepts of this work, such as pH-pKA...
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Measurement of the membrane potential using ion-selective electrode sensitive to tetraphenylphosphonium
Lábajová, Anna ; Kofránek, Jiří (advisor) ; Sigler, Karel (referee) ; Plášek, Jaromír (referee)
103 ABSTRACT The computerized device for membrane potential measurement using the tetraphenylphosphonium-selective electrode was constructed. Signal acquisition, processing and data storage were realized by MATLAB/Simulink software. The selective membrane was optimized incorporating TPP+ TPB- precipitate into the membrane. The electrode had a Nernstian response from 3.10-6 M TPP+ . The TPP+ TPB- precipitate was later replaced by sodium tetrakis[3,5-bis(1,1,1,3,3,3-hexafluoro-2- methoxy-2-propyl)phenyl]borate (NaHFPB). The electrode with incorporated NaHFPB had a Nernstian response from 1.10-6 M TPP+ and had better sensitivity than commercially available electrodes. The values of selectivity coefficients for K+ , Na+ , Ca2+ and Mg2+ were calculated. The device was used for mitochondrial membrane potential measurement of isolated mitochondria and for evaluating the respiratory chain function of digitonin- permeabilized cells (hepatocytes, HeLa G, BSC-40 and control transmitochondrial cybrids). This method was used also for monitoring the mitochondrial permeability transition pore (MPTP) function of isolated mitochondria and permeabilized hepatocytes. MPTP opening was induced by high calcium concentration and the action of calcium was enhanced by pro-oxidant tert-butyl hydroperoxide (t-BHP). This...
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