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Phenotypic assessment of patients with severe chronic obstructive pulmonary disease by HRCT of the lung (Prospective analysis of patients in National Database of COPD)
Kočová, Eva ; Eliáš, Pavel (advisor) ; Heřman, Miroslav (referee) ; Marel, Miloslav (referee)
Phenotypic assessment of patients with severe chronic obstructive pulmonary disease with using HRCT of the lung Aim Chronic obstructive pulmonary disease (COPD) is very important societal and economic problem worldwide. The main risk factor form COPD is tabacco smoke. CODP patients are very heterogenic group with different clinical symptoms. Due to different dominant clinic symptoms it is important to sort out patients to different groups - phenotypes. However differentiation into phenotype groups is not unified. Also using computed tomography (CT) in COPD diagnosis is not routine. The aim of this study is to assess if CT should be one of the basal paraclinic method used in diagnosis of all COPD patient. Materials and methos Patients from Czech multicentre research database of severe COPD which is registered on www.clinicaltrials.gov with number NCT01923051were analysed. The analysis of CT scans with clinical symptoms and lung functional tests was performed. Results From May 2013 were 784 patients included to the database. Completelly 359 patients had CT examination and lung functional tests. More than two thirds of patients (69,4 %) were dyspnoeic even during walk on level ground. Most of the patients were i GOLD group C and D. We have found bronchiectasis on CT in 120 (37,4 %), lung emphysema in...
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Options computed tomography with high resolution in the diagnosis pulmonary complications in haematological malignancies
Mírka, Hynek ; Kreuzberg, Boris (advisor) ; Neuwirth, Jiří (referee) ; Heřman, Miroslav (referee)
Value of HRCT in the diagnostics of pulmonary complications of malignant haematologic diseases. Early diagnosis is one of the essential conditions for successful therapy of heamatologic malignancies and their complications. Imaging methods play an important role in their detection and patient's management. HRCT is the most contributing method in the diagnostics of pulmonary involvement, which is very common in this group of patients. The aim of this thesis was to find out the potential of this method in the diagnostics of pulmonary complications in patients with haematologic malignancy. For this purpose were assessed 4 objectives: 1) comparison between HRCT and chest X-ray; 2) determination of capability of HRCT to make a specific diagnose; 3) definition of indication criteria for HRCT and 4) assignment of the suitable examination technique. In the time period from January 2000 until December 2005 were performed 214 HRCT examinations of the lungs in the group of 162 patients with haematological malignancy and pulmonary symptomatology. 176 examinations were compared with chest X-ray, which was performed 48 hours or less before HRCT. Pulmonary lesion was discovered in 180 cases (84,1%). 123 findings were confirmed by another method (response to a specific therapy, cultivation, serology, BAL or...
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Multimodality MR Imaging of Pathological Changes in Schizophrenia
Slezák, Ondřej ; Ryška, Pavel (advisor) ; Mechl, Marek (referee) ; Heřman, Miroslav (referee)
Multimodality MR imaging of pathological changes in schizophrenia Aim: To prove structural changes of the neocortex and white matter of the brain indicating connectivity disorder in early phases of schizophrenia. Material and methods: A prospective monocentric study comparing a cohort of patients after the first episode of schizophrenia (on average 15.6 days after the initial hospitalization) with a control group of healthy persons. Probands were examined using a complex MRI protocol. Twenty-six patients and twenty-four healthy persons were examined in total. Three dimensional T1 and T2 data and DWI data were analyzed using TBSS FA, FBA a surface- based morphometry. Results: Large areas of dispersively decreased FA were found in patients compared to control group using TBSS. Several fixels of decreased FD metric were found using FBA in the anterior commissure of patients and one sporadic fixel of decreased FDC metric was found in frontal white matter of the brain. No statistically significant areas of cortical surface area and cortical thickness differences were found using SBM. Conclusions: Large areas of decreased microstructural integrity of the white matter of the brain were found. However, it was not possible to specify the nature of its corruption using FBA. Our findings indicate the crucial role of...
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Monitoring and Comparison of the Therapeutic Effect of the Three Miniinvasive Low Back Pain Treatment Methods (Pulsed Radiofrequency Modulation, Oxygen-ozone Therapy and Periradicular Therapy) in Patients with Algic Radicular Syndrome L5 or S1 over a Period of One Year after Procedure
Jandura, Jiří ; Ryška, Pavel (advisor) ; Gabrhelík, Tomáš (referee) ; Heřman, Miroslav (referee)
Aim: To compare the therapeutic efficacy of the three minimally invasive methods (PRF, KOT, PRT) in patients with chronic (more than 3 months lasting) unilateral radicular syndrome L5 or S1. The hypothesis: PRF and KOT are more effective than PRT in the treatment of chronic radicular pain. Material and methods: Prospective, randomized, unilaterally blinded, monocentric study. All patients underwent one of the procedures, navigated by CT. Two questionnaires: PainDETECT and Oswestry disability questionnaire were used to measure of the outcome - before treatment, immediately after and at the of 3th, 6th and 12th month after. Evaluated parameters: quantity of pain (VAS), neuropathic component of pain (NB), disability (ODI), character of pain (CHB), analgesic consumption (an), physiotherapy (re). Results: Group of 178 patients (115 women, 63 men, median age 56, BMI 27,5). (PRF 57, KOT 69, PRT 52). VAS was immediately reduced after procedures, mainly in PRT group with statistic significance in comparison - KOT to PRT (p = 0,0152). By the end of 3rd and 6th month after, the VAS values in all methods were similar, still lower than before treatment. PRT showed the best analgesic effect on NB, with statistical significance between PRT and PRF after 3rd and 6th month (p = 0,0457 and 0,0108, respectively)....
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Phenotypic assessment of patients with severe chronic obstructive pulmonary disease by HRCT of the lung (Prospective analysis of patients in National Database of COPD)
Kočová, Eva ; Eliáš, Pavel (advisor) ; Heřman, Miroslav (referee) ; Marel, Miloslav (referee)
Phenotypic assessment of patients with severe chronic obstructive pulmonary disease with using HRCT of the lung Aim Chronic obstructive pulmonary disease (COPD) is very important societal and economic problem worldwide. The main risk factor form COPD is tabacco smoke. CODP patients are very heterogenic group with different clinical symptoms. Due to different dominant clinic symptoms it is important to sort out patients to different groups - phenotypes. However differentiation into phenotype groups is not unified. Also using computed tomography (CT) in COPD diagnosis is not routine. The aim of this study is to assess if CT should be one of the basal paraclinic method used in diagnosis of all COPD patient. Materials and methos Patients from Czech multicentre research database of severe COPD which is registered on www.clinicaltrials.gov with number NCT01923051were analysed. The analysis of CT scans with clinical symptoms and lung functional tests was performed. Results From May 2013 were 784 patients included to the database. Completelly 359 patients had CT examination and lung functional tests. More than two thirds of patients (69,4 %) were dyspnoeic even during walk on level ground. Most of the patients were i GOLD group C and D. We have found bronchiectasis on CT in 120 (37,4 %), lung emphysema in...
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Management and imaging of bronchopulmonary malformations in children
Kynčl, Martin ; Roček, Miloslav (advisor) ; Eliáš, Pavel (referee) ; Heřman, Miroslav (referee)
Background Bronchopulmonary malformations (BPMs) consists of a broad spectrum of developmental abnormalities, ranging from abnormal lung with normal vasculature to abnormal vasculature with normal lungs and lesions with both parenchymal and vascular abnormalities. Terminology remains a problem, the use of descriptive approach is strongly supported in practice. The aim of our study was to assess the accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in classifying the different types of BPMs and to correlate this imaging with pathologic finding. Materials and methods We identified 24 patients reffered to our institution between years 2010 and 2015 with prenatal ultrasound (US) diagnosis of BPM, who had undergone surgical resection. Postnatal chest CT scans and fetal MRI of these patients formed the basis of our retrospective study. Two radiologists blinded to the histopathological results rewieved all CT and fetal MRI scans. Detected lesions were classified by predetermined criteria. These data were correlated with histopathological results. Results The significant diagnosis overlap of 71% (17 cases out of 24) between the CT and histology was observed. The significant diagnosis overlap between MRI and histology was observed of 80 % (8 cases out of 10). The diagnosis overlap of...
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Non invasive assessment of pulmonary hypertension on chest radiograph and non contrast CT
Brožík, Jan ; Eliáš, Pavel (advisor) ; Ferda, Jiří (referee) ; Heřman, Miroslav (referee)
Non invasive assessment of pulmonary hypertension on chest radiograph and non contrast CT Objective: To evaluate relationship between selected qualitative and quantitative parameters and mean pulmonary artery pressure (mPAP) in patients with chronic pulmonary disease. To assess, whether a radiologist with use of a set of measurements in combination with positivity of qualitative findings is able reliably predict presence of pulmonary hypertension (PH) on chest radiographs (CXR) and High-resolution CT (HRCT) of lungs. To examine reproducibility of the used method by assessment of interobserver agreement between radiologists in diagnosing pulmonary hypertsension. Materials and Methods:53 individuals with chronic lung disease underwent right heart cathetrisation, CXR and HRCT. 30 patients had PH confirmed. CXRs and HRCTs were reviewed independetly by three radiologist who besides evaluation of findings stated whether PH is present. Relation between relevant parameters and mPAP, agreement between radiologists and real presence of PH were assessed. Results: The strongest correlation on CXR was found between mPAP and ratio of right descending pulmonary artery width and the left main bronchus (r = 0,256650, p = 0,023362) and right descending pulmonary artery width (r = 0,188897, p = 0,002048). The...
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Options computed tomography with high resolution in the diagnosis pulmonary complications in haematological malignancies
Mírka, Hynek ; Kreuzberg, Boris (advisor) ; Neuwirth, Jiří (referee) ; Heřman, Miroslav (referee)
Value of HRCT in the diagnostics of pulmonary complications of malignant haematologic diseases. Early diagnosis is one of the essential conditions for successful therapy of heamatologic malignancies and their complications. Imaging methods play an important role in their detection and patient's management. HRCT is the most contributing method in the diagnostics of pulmonary involvement, which is very common in this group of patients. The aim of this thesis was to find out the potential of this method in the diagnostics of pulmonary complications in patients with haematologic malignancy. For this purpose were assessed 4 objectives: 1) comparison between HRCT and chest X-ray; 2) determination of capability of HRCT to make a specific diagnose; 3) definition of indication criteria for HRCT and 4) assignment of the suitable examination technique. In the time period from January 2000 until December 2005 were performed 214 HRCT examinations of the lungs in the group of 162 patients with haematological malignancy and pulmonary symptomatology. 176 examinations were compared with chest X-ray, which was performed 48 hours or less before HRCT. Pulmonary lesion was discovered in 180 cases (84,1%). 123 findings were confirmed by another method (response to a specific therapy, cultivation, serology, BAL or...
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The rebuilding plan sewer network Sříbro City
Heřman, Miroslav ; Synáčková, Marcela (advisor) ; Zdeněk, Zdeněk (referee)
The present work provides a general description of the development of sewerage system in the world and in the Czech Republic. This is supplemented with the most commonly used materials and legislative links. The main objective of this thesis is to conduct a detailed description of a construction-technical survey of the sewer network city Stříbro. It contains documentation of the status quo, construction problems and defects in the sewer network in the next section, then the data obtained with the use of CCTV survey, evaluate and suggest restoring the city sewer system city Stříbro. The reason for the development is to create a recovery plan for the purpose of efficient operation of the sewer.
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