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The correlation of intracranial pressure and next investigative parameters at the cerebral contusion
Škúci, Ivan ; Choc, Milan (advisor) ; Novák, Zdeněk (referee) ; Smrčka, Martin (referee)
Patients with a brain injury must overcome a central neurological insult and a systematic metabolic response. The systematic response includes hypermetabolism, hypercatabolism, altered vascular permeability, increased hormone and cytokine release, altered gastric emptying, altered mineral metabolism and altered immune status. This response may initiate mechanisms which lead to secondary brain injury and may adversely affect the function of other organs. Last two decades have improved our knowledge of pathophysiology in patients with primary and secondary brain injury including traumatic contusions. In a moment of injury, primary brain injury which is traumatic contusion can not be therapeutically prevented it can only have a preventive effect. Secondary brain injury can be therapeutically affected although both types of injuries have common pathophysiological signs of disturbed metabolism on cells and subcellular level. Research methods based on molecular biology opens a new zone of research reaction of central neurological system for trauma or ischemia with effort to get involved immediately at the beginning of developing adverse pathophysiological cascade leading to a death of neurotic cell. The brain contusion is a primary centre of brain injury with anatomic changes which can be graphically proved. In...
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Biological properties of non-functioning pituitary adenomas.
Česák, Tomáš ; Náhlovský, Jiří (advisor) ; Smrčka, Martin (referee) ; Paleček, Tomáš (referee)
Introduction: Non-functioning pituitary adenomas (NFPAs) are regarded as benign, slowly growing tumours of the sella turcica region. Their growth is generally constantly exponential; however, rapid and aggressive proliferation is not the exception, especially in young patients. Treatment involves surgical removal. In literature, the role of postoperative irradiation of the residual tumour is controversial. Aim: The aim of this study was to investigate the natural growth patterns of NFPAs and attempt to identify the factors affecting their growth potential. As part of the study, nuclear marker Ki-67 was tested as a possible reliable indicator of adenoma proliferation, as well as it's role as a potential marker of postoperative remnant's growth potential. This would enable the identification of serious rapid growth in cases of tumour recurrence. Material: Our study is based on 105 patients operated for NFPAs between years 2000-2007. The fixed inclusion criteria of the study (a postoperative residue detected by 2 graphic examinations, absence of adjuvant therapy and the imunohistochemical determination of the proliferation marker) were fulfilled by 29 patients (22 men, 3 women). The average age of the patient group was 62.9 years. By large, the tumours were afunctional macroadenomas with gonadotrophin...
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Endoscopic treatment for posthemorrhagic hydrocefalus in premature newborns
Lipina, Radim ; Náhlovský, Jiří (advisor) ; Smrčka, Martin (referee) ; Smrek, Martin (referee)
Endoscopic treatment for posthemorrhagic hydrocefalus in premature newborns Abstract Introduction: Up to date the pathophysiology of posthemorrhagic hydrocephalus (PHH) in premature newborns is explained as a consequence of cytokine TGF β1 release into cerebrospinal fluid (CSF) during initial bleeding, followed by induction of "inflamatory proteins" in subarachnoideal spaces. Method of choice in treatment of PHH is ventriculo-peritoneal drainage. The role of endoscopic third ventriculostomy (ETV) in these patients is unclear, through obstruction is proved in some patients with PHH. The aim of our study was to monitor the success rate of ETV in the group of premature newborns with obstructive PHH and to ascertain the relation between TGF β1 levels and developement of hyporesorptive hydrocefalus and thus ETV succes rate, which has not been reported yet. Materials and methods: We followed 38 premature newborns with PHH since January 2004 to November 2007. 34 patients was treated by Ommaya reservoir implantation and repeated taps. In 29 patients TGF β 1 level was examinated. In case of persisting hydrocephalus MRI of brain was performed. In 25 patients with proved obstruction on MRI ETV was indicated. We evaluated ETV succes rate and those relation to TGF β 1 CSF levels. Results: In 73,5% patiens in our series...
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