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Contribution of New Immunosuppressants after Heart Transplantation
Skalická, Blanka ; Málek, Ivan (advisor) ; Horký, Karel (referee) ; Lischke, Robert (referee)
Background: Acute cellular rejection and graft vascular disease are major factors limiting the survival after orthotopic heart transplantation (OHTx). Tacrolimus could be more potent than cyclosporin A in therapy of recurrent acute rejection episodes in OHTx patients. Dyslipidemia is one of the risk factors involved in the development of graft vascular disease. Statins are common part of standard drug regimen after OHTx. On the other hand, they are potentially dangerous as they could interact with cyclosporin A. Study in healthy volunteers showed that tacrolimus should have no interactions with statins. Aim: In the first study we retrospectively assessed the effect of switching patients after OHTx with recurrent cellular rejection episodes from cyclosporin A to tacrolimus. In the second (prospective) study we evaluated the efficacy and safety of combined therapy with tacrolimus and atorvastatin in patients after OHTx with dyslipidemia. (...) Conclusions: Tacrolimus has a beneficial effect not only on recurrent acute rejection episodes in heart transplant recipients but it also decreases the incidence of future rejection episodes. In patients after OHTx with dyslipidemia switching to tacrolimus and atorvastatin could be a suitable therapeutic option, because this combination is safe and effective in...
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Design of flywheel of jaw crusher
Horký, Karel ; Kala, Pavel (referee) ; Škopán, Miroslav (advisor)
Diploma thesis deals with design of a flywheel and a belt pulley of single toggle jaw crusher DCJ 900x600. The first part is dedicated to overview of the methods for calculation of a size of flywheels for working machines. The second part is focused on calculation of a size of the flywheel. The third part treats the constructional design of the flywheel. In the last two parts there is elaborated analysis of a changing size of the flywheel depended on increasing the working rotation speed and change of coefficient .
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Aldosterone synthase in arterial hypertension and possible influence of its genenetic polymorphism on left ventricular hypertrophy
Heller, Samuel ; Horký, Karel (advisor) ; Málková, Jana (referee) ; Widimský, Jiří (referee)
Part I. The aldosterone synthase gene (CYP11B2) polymorphism T-344C in blood pressure and left ventricular hypertrophy. BACKGROUND: Aldosterone is a key cardovascular hormone, it significantly influences volume, pressure and electrolyte balance. Aldosterone plays an important role in development of left ventricular (LV) hypertrophy and myocardial fibrosis. The aldosterone synthase gene (CYP11B2) is an important candidate gene region in essential hypertension. DESIGN AND METHODS: We assessed the influence of the T-344C polymorphism of aldosterone synthase - the rate-limiting enzyme in aldosterone biosynthesis - on the structure of the left ventricle in young normotensive men. The population included 113 normotensive mid-European Caucasian men aged 18-40 years (mean 27 +/- 5 years). We also studied the association of -344T/C polymorphism of the CYP11B2 gene with the presence and severity of hypertension in 369 individuals, of whom 213 were hypertensive patients (139 controlled hypertensive, 74 resistant hypertensive) and 156 were healthy normotensive subjects. The genotype was assessed using polymerase chain reaction with subsequent cleavage with restriction enzyme HAEIII (restriction fragment length polymorphism method) and visualization with ethidium bromide. Plasma renin activity (PRA) and plasma...
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Additional working equipment and tools for machines for excavators
Horký, Karel ; Pokorný, Přemysl (referee) ; Škopán, Miroslav (advisor)
This bachelor thesis is focused on research of hydraulic demolition hammers and hydraulic demolition shares that are manufactured and used to demolish the buildings nowadays. There is written down a research of types of equipment for an application on different types of excavators in both cases. In this thesis there is a comparison of this equipment also included. Comparison is written down to the tables and drawn to the graphs. Moreover there is included a survey of additional equipment for crushing and separating a structural rubble.
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Comparison of QT dispersion and heart rate turbulence
Havránek, Štěpán ; Kittnar, Otomar (advisor) ; Horký, Karel (referee) ; Slavíková, Jana (referee)
Introduction: Both QT dispersion (QTD) and heart rate turbulence (HRT) were studied and tested like potential noninvasive markers for risk stratification. Aims: Compare QTD between different groups of patients with expected different mechanism of developing changes in QTD. Investigate if HRT is present following ventricular train drives and depends on left ventricular dysfunction. Test the hypothesis that QTD and HRT parameters assessed during programmed ventricular stimulation correlated to each other and there is association with iducibility of ventricular arrhythmia. Methods: We analysed body surface potential mapping (BSPM) recordings and vectorcardiographic T-loop parameters (T-loop width - Tw and T-loop amplitude - Ta) in 37 healthy women (20 - 36 yrs) in the 36th to 40th week of physiological pregnancy and 2 to 6 days after delivery. Control group contained 18 healthy women. Then we analysed BSPM recordings from 27 psychiatric outpatients treated with prophylactic doses of dosulepin (20 women, 44 ± 13 yrs) and compared to those obtained from 37 healthy volunteers. From these recordings the QTD was evaluated. This parameter was estimated using both BSPM recordings and 12 lead standard ECG. Acquired data were statistically correlated with Tw or Ta and dosulepin plasma levels, respectively. Distribution...
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Allograft coronary artery disease
Kocík, Miroslav ; Málek, Ivan (advisor) ; Horký, Karel (referee) ; Hejnal, Jaroslav (referee)
We have proved high incidence of early detected TxCAD in OHTx recipients' population. Neither any of immunologic nor nonimmunologic factors tested in our study was found to represent a risk factor for early detected TxCAD development except of donor age and recipient's BMI. Despite proving survival to be worse in recipients suffering from early detected TxCAD in compare to the rest of OHTx recipients, we have failed to demonstrate, that early detected TxCAD is an independent risk factor for OHTx recipients negative clinical outcome. Similarly despite demonstration, that serious cardiac events are more frequent in subgroup of patients with early detected TxCAD, we have failed to prove early detected TxCAD to represent an independent risk factor for its occurrence.
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Effectiveness of treatment of chronic forms of atrial fibrillation by radiofrequency catheter ablation, application of preventive stimulation modes and hybrid therapies
Šedivá, Lucie ; Aschermann, Michael (advisor) ; Heinc, Petr (referee) ; Horký, Karel (referee)
Výsledky naší studie nám umožňují odpovědět na hlavní cíl studie: Pomocí paměťových záznamů z kardiostimulátoru jsme prokázali největší efektivitu na potlačení FS kombinovanou terapií, tedy radiofrekvenční katetrizační ablací a aktivovanými preventivními funkcemi kardiostimulátoru. Hodnocení celkové zátěže FS, které jsme měli umožněné díky paměťovým funkcím KS prokázalo výrazně lepší výsledky u skupiny C, 63% vyléčených ( FS=0), proti skupině B, která měla úspěšnost léčby 45% ( FS=0) a skupina A pouze 30% ( FS=0). Ad 1 Do naší studie byli zařazeni nemocní s chronickými typy FS, ze 150 nemocných bylo 39 nemocných ( 26%) ve stadiu permanentní FS, 111 nemocných (74%) mělo persistující FS, vyžadující pro výrazné potíže a hemodynamický dopad opakované kardioverze. Ve všech skupinách jsme prokazovali významné zlepšení ( ve skupině A mělo v závěru studie devět nemocných permanentní FS. Ve skupině B to byl jeden nemocný a ve skupině v C měli čtyři nemocní permanentní. Ve skupině C bylo nejvíce nemocných s nulovou zátěží FS ( celkem 24 nemocných). Ad 2 Posouzení kvality života-srovnání dotazníků před randomizací a po dvanácti měsících ukazuje nejlepší výsledek u skupiny C, i když u celého souboru došlo vlivem léčby ke zlepšení kvality života. Ad 3 V celém průběhu studie od aktivace preventivních algoritmů po...
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The effect of biventricular pacing as compared to single - side left - ventricular pacing and bifocal pacing of the right ventricle in patients with chronic heart failure
Riedlbauchová, Lucie ; Kautzner, Josef (advisor) ; Horký, Karel (referee) ; Táborský, Miloš (referee)
Cardiac resynchronization therapy (CRT) represents an accepted treatment modality in patients with advance chronic heart failure, acute and long-term benefit of which was confirmed in several clinical trials. Recently, reduced mortality and rate of hospitalization for heart failure were also demonstrated. However, response to CRT is interindividually highly variable with a substantial proportion of CRT recipients who do not respond to this therapy. Although the identification of suitable candidates is probably the most important factor in the reduction of the rate of non-responders, some other determinants, peri- and post-implant, may substantially affect the final effect of CRT. The present PhD focused on some of these variables: 1/ First of them is a selection of the appropriate pacing mode. This PhD evaluated effect of 3 pacing modalities that have been proposed as alternatives of CRT - biventricular pacing (BiV), single-site left-ventricular pacing (LVP) and rightventricular bifocal pacing (Bif). It was clearly shown that the first two pacing strategies, BiV (it is simultaneous pacing of both ventricles) and LVP, cause comparable acute hemodynamic improvement at rest. Study No.2 of this PhD confirms that the comparable effect of BiV and LVP is preserved also during the exercise. In addition, study No.1...
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