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Treatment for Brain Arteriovenous Malformations
Bradáč, Ondřej ; Beneš, Vladimír (advisor) ; Haninec, Pavel (referee) ; Vaverka, Miroslav (referee)
Introduction: The surgical and endovascular results of the treatment of pial AVM provided at our Neurosurgical centre are presented. These results are supported by neuropsychological outcomes of subgroup of treated patients. Going by these results and by an overview of literary data on the efficacy and complications of each therapeutic modality, the optimal algorithm of indications is presented Cohort of patients: The main series comprises 222 patients aged 9 to 87 years treated in the years 1998 - 2013. The surgical group consists of 85 patients, 55 patients received solely endovascular treatment. Thirty-four patients were consulted and referred directly to the Radiosurgical unit. The remaining 48 were recommended to abide by the strategy of "watch and wait". A subgroup of 66 patients, who underwent treatment of AVM was neuro-psychologically tested at least two years after treatment using a battery of tests constructed specifically for this study. A control group consisted of 10 subjects without any neurological disease. Results: In the surgical group, serious complications were 3.5% at a 96.5% therapeutic efficacy. As for AVM treated with purely endovascular methods, serious procedural complications were seen in 5.5% of patients, with efficacy totalling 36.4%. One observed patient suffered...
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Single cell gene expression profiling and quality control
Švec, David ; Kubista, Mikael (advisor) ; Beneš, Vladimír (referee) ; Vopálenský, Václav (referee)
Single cell gene expression profiling and quality control David Švec Institute of Biotechnology AS CR, Laboratory of Gene Expression, Prague, Czech Republic TATAA Biocenter, Research & Development, Gothenburg, Sweden Abstract: Gene expression profiling has become an exceedingly important tool for describing occurence of mRNA in tissue samples and even single cells. Most often we use it for characterization of cell types, degree of differentiation and pathology on a molecular level. In our newly established laboratory, we developed high resolution qPCR tomography to show distribution of tens of maternal mRNAs within a single oocyte. We demonstrated that distribution of mRNAs has an important role in further development of the organism. For high resolution qPCR tomography, where one oocyte is divided in tens of samples and about fifty genes are studied in each sample, we optimized dye based protocol for microfluidic high-throughput platform BioMark. Next step was complementing the molecular profile of tens most important genes with information about histology of each selected tissue section using laser microdissection. As a model we used embryonic development of mouse molar. Our goal was to describe interaction of up to one hundred genes in different stages of development and on the single cell level. This...
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Single cells gene expression profiling and analysis
Novosadová, Vendula ; Kubista, Mikael (advisor) ; Beneš, Vladimír (referee) ; Vopálenský, Václav (referee)
Cells are the basic units of life. Studying complex tissues and whole organs requires an understanding of cell heterogeneity and responses to stimuli at the single-cell level. Even the cells, which belong to the same cell type, behave differently at a specific moment and contain different amount of mRNA. Quantitative polymerase chain reaction (qPCR) is one the most sensitive methods for the detection of mRNA, however, gene expression profiling in single cells leads to a large amount of missing data due to the fact that the transcript is missing, or is below the level of detection. Therefore, it is necessary to establish a new statistical approach for analysis of single cells. In this thesis the potential of single-cell gene expression profiling using the high throughput instrument Biomark, focusing on data analysis and biological interpretation, is discussed. Data normalization and handling of missing data are two important steps in data analysis that are performed differently at the single-cell level. Single cells are not normalized by reference genes but the number of cells as a normalizer is applied. Missing data are replaced by value, which is equaled one quarter of transcript amount in the cell. Furthermore it is shown how single-cell gene expression data can be viewed and how subpopulations...
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The Carotid Stump Syndrome
Hrbáč, Tomáš ; Beneš, Vladimír (advisor) ; Přibáň, Vladimír (referee) ; Haninec, Pavel (referee)
Introduction: Internal Carotid Stump Syndrome may be one of the possible causes of ischemic stroke (iCMP), as well as retinal infarction (RI). Syndrome of the occluded internal carotid (ACI) (stump syndrome) is a nosological unit, which is characterized by an onset of ipsilateral iCMP or RI of thromboembolic ethiology in patients with occlusion of ACI via the externa carotid or arteria ophthalmica. In my thesis, I have concentrated upon the specification of the stump syndrome, its diagnostics and treatment; furthermore I have assessed the appropriateness of surgical approach in comparison with conservative approach. Material and methods: A total of 621 patients with occlusion were treated in two centres in the course of five years. In a group of 40 patients, the ACI occlusion was detected sonographically, the length of the occluded ACI being >5 mm, with normal vasoreactivity based upon SPECT CO2 and excluded cardiogenic cause of iCMP. The patients were divided in two groups - surgical and conservative. Patients were monitored in 6-month intervals for the total period of four years. Results: No RI or iCMP were detected in the surgical group; one patient died six months after surgery. We observed one case of amaurosis fugax in the conservative group. Conclusion: Ultrasound examination is a fully sufficient...
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Unruptured intracranial aneurysms : Does the risk of endovascular treatment outweigh natural history?
Beneš, Vladimír ; Stejskal, Lubor (advisor) ; Haninec, Pavel (referee) ; Janoušková, Ladislava (referee)
Summary: Background: The management of unruptured intracranial aneurysms (UIAs) remains controversial. The international study of UIAs (ISUIA) found low rates of rupture and appreciable treatment risks, which can be interpreted that many UIAs should not be treated. Results of endovascular coiling of 131 patients with UIAs are presented along with a risk-benefit analysis based on patient and aneurysm characteristics. Patients and methods: From December 1996 to September 2005, 131 patients (93 women and 38 men, mean age 51 years) with 151 UIAs were treated using detachable coil embolisation. Data on procedural complications, patient and aneurysm characteristics, clinical and radiological follow-up were entered into a prospectively collected database. A risk-benefit analysis was performed. Results: Endovascular treatment was successful in 145 (96%) aneurysms. One aneurysm ruptured intraoperatively with a fatal outcome. Ten thromboembolic events occurred, leaving one patient moderately disabled. The combined morbidity and mortality rate at 6 months per patient is 1,5% (95% confidence interval: 0,07 - 5,7%). Risk-benefit analysis comparing these data with published natural history suggests that treatment with low complication rates can be offered to most patients with UIAs. Conclusion: UIAs can be coiled with...
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Gene expression in early development of Xenopus laevis
Šindelka, Radek ; Jonák, Jiří (advisor) ; Beneš, Vladimír (referee) ; Svoboda, Petr (referee)
Everyhigherorganismconsistsof severalhundredsof differentcell types.The cell differentiationis a processwhich requireshighlypreciseregulationof mRNA productionand subsequentlyproteinsynthesis.Duringdevelopmentof an organism eachcellgainsa uniquepaletteof mRNAand proteinmolecules,whichreflectsthe cell'sfate.To understandthe basicfunction and regulationof genesthat are importantduringdevelopment,mRNA expressionprofilingis an irreplaceabletool. However, most techniquesto determine the mRNA content, such as Northern blot, microarraysand in situ hybridizationhave some limitationsin their specificity,dynamicrangeand/or sensitivity.Quantitativereal-timePCR analysis(qPCR)for nucleicacids quantificationwas introduced in the last decade and it has overcome the above mentioned drawbacks.qPCR has rapidly becomethe goldenstandardin basicresearchas well as in manyaspectsof appliedresearchsuchas moleculardiagnostic,food pathogendetectionand geneticallymodifiedorganism(GMO)analysis. We decidedto applyqPCRin studieswhere it helpsus to understandbasicbiologicalprocessesthattake placein the developingorganism.One of the focusareasof the Laboratoryof gene expressionat IMG AS CR,where Idid my PhDthesis,was the role of Src tyrosine kinasesin the early developmentof vertebratesstudied on the African clawed frog Xenopus...
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Anaestheologic Nursing Care of Patient during Carotid Endarterectomy
Šrámková, Jitka ; Vaňková, Milena (advisor) ; Beneš, Vladimír (referee)
Cílem práce je zpracování problematiky ošetřovatelské péče o nemocného se stenózou vnitřní karotidy z pohledu anesteziologické sestry na neurochirurgickém operačním sále během karotické endarterectomie. V této případové studii se věnuji 57-letému pacientovi, kterému byl při prohlídce v zaměstnání náhodně zjištěn šelest nad pravou karotidou. Praktickým lékařem byl odeslán na ultrazvuk, kde byla zjištěna stenóza vnitřní karotidy (asymptomatická). Po vyšetření neurologem bylo doplněno CTAg karotid a pacient odeslán k hospitalizaci na neurochirurgické oddělení Krajské nemocnice Liberec k operačnímu řešení tohoto problému. V klinické části popisuji anatomii a patofyziologii mozku, etiologii, rozdělení, léčbu a prevenci mozkových ischémií. Podrobněji je pak popsána technika samotné operace a regionální anestezie použitá při výkonu. Zmíněn je i průběh karotické endarterectomie tak, jak probíhal u pacienta. Ošetřovatelská část zahrnuje stručnou charakteristiku ošetřovatelského procesu a ošetřovatelského modelu Virginie Hendersonové. Podle tohoto modelu je rozpracována ošetřovatelská anamnéza pacienta. Na základě ošetřovatelské anamnézy jsou pak stanoveny ošetřovatelské diagnózy ke druhému dni hospitalizace, pobytu na operačním sále od přijetí ze standardního oddělení po přeložení na JIP. Diagnózy jsou rozpracovány...
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