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Biomaterials and stem cells in spinal cord injury
Tukmachev, Dmitry ; Syková, Eva (advisor) ; Dubový, Petr (referee) ; Sameš, Martin (referee)
Spinal Cord Injury is a very serious trauma which can't be effectively cured at present time. The use of ECM hydrogels as supportive and stimulatory milieu and transplantation of stem cells represent promising approaches for SCI therapy. However, current treatments are limited by inefficient delivery of stem cells into the lesion site. Therefore, the aim of this study was the development of SCI treatment using ECM hydrogels and effective stem cell delivery system. The non-invasive magnetic system was designed and used to accumulate SPION-labelled stem cells at a specific site of a SCI lesion. Decellularized porcine SC and UB tissues, synthetic P(HEMA-AEMA) hydrogel with oriented porosity and modified hyaluronic acid HA-PH-RGD were transplanted into a spinal cord lesion of rats with or without stem cells, followed by histological analysis and gene expression analysis. All types of hydrogels integrated into the lesion and stimulated neovascularization and axonal ingrowth into the lesion. There was no significant difference in the tissue infiltration between the plain hydrogels and those seeded with stem cells. However, a subacute injection HA-PH- RGD/Fibrinogen combined with Wharton's jelly-derived human mesenchymal stem cells enhanced axonal ingrowth into the lesion. Significant down-regulation of...
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Perineural spread of pelvic tumors: mechanism and diagnosis
Čapek, Štěpán ; Sameš, Martin (advisor) ; Haninec, Pavel (referee) ; Hořínek, Daniel (referee)
Perineural spread of pelvic tumors mechanism and diagnosis Abstract Neoplastic lumbosacral plexopathies are infrequent affections of the lumbosacral plexus. Cases with minimal or non-specific finding on imaging can be particularly puzzling to diagnose. We describe a series of patients with perineural spread from the site of the primary tumor along the visceral autonomous nerves to the lumbosacral plexus and further proximally to the spinal nerves and even intradurally and also distally to the sciatic nerve. On series of 17 patients diagnosed with perineural spread of pelvic malignancy we describe characteristic clinical presentation and imaging finding. In many of these cases a tissue biopsy is necessary to finalize the diagnosis. We describe operative technique of targeted fascicular biopsy of the sciatic nerve and our experience with this procedure. On series of 117 patients, we report the outcome and complication: diagnostic yield was 84.8% and complication rate was 2.7 %. If a tissue sample is needed to conclude the diagnosis, targeted fascicular biopsy does increase the yield at an acceptable complication rate. Perineural spread of pelvic cancer is a new clinical-pathological entity with an unknown natural history or ideal treatment strategy. Based on the imaging finding in this group we present a...
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Modelling of changes of the intracranial pressure (ICP) during physiological and pathological processes
Vaněk, Petr ; Otáhal, Jakub (advisor) ; Suchomel, Petr (referee) ; Sameš, Martin (referee)
The more we know about the circulation of CSF through ventricle system, brain parenchyma, subarachnoideal space and the development of intracranial pressure (ICP), the more we understand different pathologies and pathological processes of the central cervous system. The knowledge about the basic hydrodynamic charecteristics of craniospinal system is a key factor for understanding a wide range of pathological situations affecting CNS, these are for example intracranial hypertension, normal pressure hydrocephalus and syringomyelia. In the presented paper, we are presenting a newly developed measuring system Visionbrain that enables us to gain the biological data and consequently to analyse them. At the same time, the results of such measurements were used to specify the compertmental model of CSF circulation. The model devides craniospinal system into five divisions - two intracranial and three spinal. Such model is the third generation of this model and, compared to the older version, it includes two intracranial veins. Thanks to this stucture, the model enables us simultaneous modeling of heart and respiratory pulsations of CSF. Compared to the other published models, it also includes defined structure of spinal part. The model is derived using laws of conservation and it encompasses pressure...
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Predictive value of clinical, imaging and cerebrospinal fluid dynamics examinations in the diagnostic algorithm of the normal pressure hydrocephalus.
Radovnický, Tomáš ; Sameš, Martin (advisor) ; Haninec, Pavel (referee) ; Bartoš, Aleš (referee)
8.SUMMARY By evaluating the effect of treatment of patients with idiopathic normal pressure hydrocephalus (iNPH) indicated for surgery based on positive supplementary tests, we determined their positive predictive value. Both the lumbar infusion test and the tap test have a high positive predictive value for the clinical response to shunt surgery. A patient with a typical symptomatology, a radiological examination finding, and a positive supplementary test will most likely benefit from surgery. Supplementary tests are a valid part of the diagnostic algorithm regardless their invasiveness. Using diffusion tensor imaging on the MRI performed in patients with iNPH prior to surgery, one year after surgery and in healthy controls, we found changes in diffusion parameters in the periventricular white matter. Patients had a higher MD in ALIC, PLIC and CC compared to healthy controls, reflecting a higher degree of axonal degeneration in patients with iNPH. Patients in comparison with healthy controls had higher FA only in a PLIC. This area is affected by compression in patients with iNPH more severe. After the shunt surgery, we recorded a significant decrease in PLIC, which corresponds to the decompression after derivation of the CSF. However, the drop in value was not to the value of healthy controls. In patients...
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Anti-inflammatory compounds and stem cells in treatment of spinal cord injury
Kárová, Kristýna ; Jendelová, Pavla (advisor) ; Sameš, Martin (referee) ; Chvátal, Alexandr (referee)
Despite intense scientific efforts, spinal cord injury (SCI) remains to be a severe neurological condition that has no treatment. Currently, therapy is based on alleviating pressure by surgical spinal cord decompression, administration of methylprednisolone and physical therapy. In this study, therapeutic effects of anti-inflammatory compounds and of three types of stem cells were tested in a balloon compression model of spinal cord injury in rats. Natural compounds epigallocatechin-3-gallate (EGCG) or curcumin were administered in situ and then intraperitoneally every day for up to 28 days. Human bone marrow mesenchymal stem cells (MSCs), human spinal neural precursors (SPC-01) and neural precursors derived from human induced pluripotent stem cells (iPS-NPs) were transplanted intrathecally (MSCs) or via spinal injection into immunosuppressed rats 7 days after induction of SCI. To determine effects of therapies, changes in motor function was tested by open field test BBB, flat beam test and score, Plantar test and rotarod. Morphometric analysis was used to assess gray/matter sparing and cavity size. Immunohistochemistry was used to determine survival and differentiation of transplanted cells, activation of classical pathway of NFκB (p65 nuclear translocation), astroglial activation (GFAP) and...
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Modelling of changes of the intracranial pressure (ICP) during physiological and pathological processes
Vaněk, Petr ; Otáhal, Jakub (advisor) ; Suchomel, Petr (referee) ; Sameš, Martin (referee)
The more we know about the circulation of CSF through ventricle system, brain parenchyma, subarachnoideal space and the development of intracranial pressure (ICP), the more we understand different pathologies and pathological processes of the central cervous system. The knowledge about the basic hydrodynamic charecteristics of craniospinal system is a key factor for understanding a wide range of pathological situations affecting CNS, these are for example intracranial hypertension, normal pressure hydrocephalus and syringomyelia. In the presented paper, we are presenting a newly developed measuring system Visionbrain that enables us to gain the biological data and consequently to analyse them. At the same time, the results of such measurements were used to specify the compertmental model of CSF circulation. The model devides craniospinal system into five divisions - two intracranial and three spinal. Such model is the third generation of this model and, compared to the older version, it includes two intracranial veins. Thanks to this stucture, the model enables us simultaneous modeling of heart and respiratory pulsations of CSF. Compared to the other published models, it also includes defined structure of spinal part. The model is derived using laws of conservation and it encompasses pressure...
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Stem cells and modified biomaterials in the for the treatment of spinal cord injury
Růžička, Jiří ; Jendelová, Pavla (advisor) ; Sameš, Martin (referee) ; Zvěřina, Eduard (referee)
Progress in experimental treatments of spinal cord injury (SCI) utilizing growth factors, stem cells and biomaterials has revealed the pathological mechanizms of the secondary processes and demonstrated the potential of combined therapy for future clinical treatment. The mobilization of bone marrow by the combined application of Flt3 ligand and G-CSF diminishes astrogliosis and increases axonal sprouting and thus leads to more pronounce spinal tissue sparing and neurological improvement when compared with single treatments. All types of stem cells used in this study significantly decreased the locomotor deficit after SCI. The most noticeable impact was observed in the NP-iPS treated group, especially due to their long term survival, interaction with host tissue, their impact on glial scarring and modulation of the immune response. MSCs, despite their short lifetime, decrease the immune response after SCI and modulate glial scar formation. The lowest effectivity on locomotor recovery after SCI was demonstrated by fetal spinal progenitors, which were not capable of sufficient integration into the host tissue, even though they showed long-term survival and differentiation. The methods used to prepare methacrylate based hydrogels have a significant impact on the adhesion, growth and survival of MSC...
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Stenting of carotid stenoses with distal protection device and intravascular ultrasound
Lacman, Jiří ; Krajina, Antonín (advisor) ; Kalvach, Pavel (referee) ; Sameš, Martin (referee)
Stenting of carotid stenoses with distal protection device and intravascular ultrasound Carotid artery stenting is generally accepted and less invasive alternative to surgical endarterectomy for indicated patients. The goal of the treatment is to prevent strokes and subsequent neurological problems. This paper introduces the current state of this method of intervention, its indications and specifically addresses the issue of possible uses and benefits of intravascular ultrasound ( IVUS) and virtual histologization (VH ) in the diagnosis of carotid stenosis and atherosclerotic plaque and treatment of carotid artery stenosis. The author performed 119 IVUS examinations on 110 patients, 33 of these examinations were made virtual histologization of plaque. Periprocedural complications were observed during IVUS examination and stenting. Using the virtual histologization, atherosclerotic carotid plaques were classified into types according to their composition (risk vs . risk-free plaques) and correlated with the length of stenosis and percentage of stenosis. In the IVUS group there were 80 men and 30 women, the average age was 72 years, symptomatic carotid artery was examined in 69 cases (58 %), asymptomatic in 50 cases (42 %). To the IVUS -VH group were counted 33 patients who underwent 35 examinations....
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