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Syndesmotic lesion in fracture-dislocations of the ankle - Maisonneuve fracture
Fojtík, Petr ; Naňka, Ondřej (advisor) ; Hromádka, Rastislav (referee) ; Skála-Rosenbaum, Jiří (referee)
A Maisonneuve fracture (MF) is a fracture dislocation of the ankle caused by external rotational force. In the traditional concept it includes a subcapital fracture of the fibula, an injury to the tibiofibular syndesmosis and to the interosseous membrane, and it is considered as an unstable injury. The experimental (anatomical) goal of the dissertation work was a detailed study of the incisura fibularis tibiae (IFT), its maximum depth and its localization relative to the articular surface of the ankle. The second experimental goal was a detailed description of the lateral surface of the distal fibula, where there is a prominent but still nameless edge that gives the distal fibula its typical triangular shape on a transverse section (workingly we called it lateral malleolar crest, LMC). Both of these structures are extremely important in the diagnosis and treatment of ankle fractures. The clinical part of the work included an overview of all the literature devoted to MF and further analysis of our group of patients with MF with a focus on the posterior malleolus (PM) fracture. Anatomical studies were performed on 352 dry bone specimens of adult tibiae and fibulae. The clinical study was conducted on a group of 100 patients with MF in adult patients treated at The Department of Orthopedics, 1st...
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Effect of temperature on arrhythmogenesis during heart development
Vostárek, František ; Sedmera, David (advisor) ; Tomek, Viktor (referee) ; Naňka, Ondřej (referee)
5 Abstract: Aims: The main objective of this work was to analyze in detail the effects of acute temperature changes on the function of isolated chick embryonic heart in vitro in comparison with natural conditions in ovo. Methods: The effects of temperature change (34 řC, 37 řC and 40 řC - hypo-, normo- and hyperthermia, respectively) on calcium dynamics in four days old isolated chick hearts in vitro were investigated by high-speed calcium optical imaging. For comparison and validation of in vitro measurements, experiments were also performed in ovo using videomicroscopy. Artificial electrical stimulation experiments were performed in vitro and in ovo to uncover conduction limits of different heart segments. Results: We observed almost linear dependence of sinus frequency on temperature in our temperature range. Sinus frequency during hypothermia and hyperthermia in vitro and in ovo changed about 20% in comparison with normothermia. We observed no significant changes in amplitude of calcium transients during temperature change to hypothermia but hyperthermia caused a significant decrease in amplitude of calcium transients (atria 35%, ventricles 38%). We observed a wide spectrum of arrhythmias, which occurred spontaneously even during normothermia in vitro. Occurrence of arrhythmias in vitro significantly...
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Preoperative planning of the reconstructive surgery of the forefoot
Klouda, Jan ; Hromádka, Rastislav (advisor) ; Naňka, Ondřej (referee) ; Teyssler, Petr (referee)
Univerzita Karlova v Praze 1. lékařská fakulta Postgraduální doktorský program v biomedicíně Studijní obor: Experimentální chirurgie Disertační práce MUDr. Jan Klouda: Preoperative planning of the reconstructive surgery of the forefoot Abstract The presented thesis describes a study aimed at the change of articular surface position in the region of first metatarsophalangeal joint after operative reconstruction due to hallux valgus deformity, done by performing Lapidus arthrodesis. The study evaluates a cohort of patients, who underwent surgery in Department of Orthopaedics, First Faculty of Medicine, Charles University in Prague at Motol University Hospital from 2010 to 2015. The results and clinical implications of the aforementioned retrospective study were published in 2018. The observers evaluated several defined angles on preoperative and postoperative radiographs of the forefoot. The angles were thoroughly selected with regard to the exact representation of first metatarsophalangeal joint articular surface position in relation to the axes of first metatarsal and the whole forefoot. The executed measurements allowed us to assess the overall effectivity of the performed surgery in deformity correction, as well as to describe possible pitfalls and disadvantages resulting from the change of structural...
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Topographical anatomy of the retroperitoneum and its blood vessels and lymphatics
Turyna, Radovan ; Kachlík, David (advisor) ; Bouda, Jiří (referee) ; Naňka, Ondřej (referee)
The purpose of this study was to describe the distribution and structure
of ventral tributaries leading into the inferior vena cava where right-sided paraaortic lymphadenectomy is performed. The study examined
21 retroperitoneal specimens by graphic reconstruction, statistical evaluation, and histological examination of ventral tributaries (VTs). Seventy VTs were identified. The average number per specimen was 3.33. There were 20, 40, and 40% of VTs found in Levels I, II, and III, respectively. During the preparation, we observed an unusual arrangement of the IVC wall, into which VTs were led through a preformed sleeve-like channel and anchored near the lumen. This finding is a key mechanism that explains the ease with which VTs are extracted during surgery. Due to the lack of uniformity concerning the moniker for VTs in the literature, and due to the typical anatomical position and distribution of VTs within retroperitoneum, we propose that these veins should be called venae retroperitoneales anteriores. The second aim of the study was to gain a thorough knowledge of the topography and distribution of until now officially unnamed minute direct branches from abdominal aorta, stemming from its ventral and lateral aspects, supplying surrounding tissue, and to comprise it to the existing studies. Due to the...
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Quality of life after urogynecologic surgery Comparation of change of quality of life after urogynecologic surgery in relation to anatomy of the pelvis foor
Drahorádová, Petra ; Mašata, Jaromír (advisor) ; Zachoval, Roman (referee) ; Naňka, Ondřej (referee)
Introduction: Stress urinary incontinence is a common problem which affects a high percentage of women. Anti-incontinent surgery has played an important role in the treatment of stress urinary incontinence. Burch colposuspension was considered a gold standard in anti-incontinence surgery, with good long-term results. However, over the past decade this procedure has been largely replaced by the application of various types of TVTs (tensionfree vaginal tapes). In our study we have focused on comparing developments in the quality of life and the occurrence of complications in a long-term follow-up after TVT, TVT O and colposuspension. For subjective assessment of urinary incontinence we have chosen a validated specialized Incontinence Quality of Life questionnaire (I-QoL). The aim of our study was to monitor the trends with quality of life after TVT, TVT O and colposuspension procedures and to establish whether the occurrence of complications affects the quality of life (QoL) and compare of the quality of life among anti-incontinence procedures and longterm subjective and objective outcome. Methods: The study included 215 women who underwent a TVT, TVT O or Burch procedure between 1.6.2002 - 31.5.2005. Women were completely urogynecologic examined and urodynamic stress incontinence was documented....
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Preclinical use and critical evaluation of micro-CT from the perspective of oral and maxillofacial surgery.
Bartoš, Martin ; Foltán, René (advisor) ; Naňka, Ondřej (referee) ; Bulik, Oliver (referee)
The preclinical imaging method micro-CT (microtomography) allows the visualization and quantification of the structure of samples at a resolution of micrometers. Its' importance is increasing globally. In addition to several advantages (non-destructive, the possibility of direct 3D analysis, time efficiency, etc.), micro-CT also has some significant limitations (problematic validation of results, image artifacts, significant influence of image modifications, etc.). This thesis focuses on the application of micro-CT in the field of research and development of metallic and non-metallic materials promoting bone healing with their possible clinical applications. The first part addresses the limitations of micro-CT through several studies. A comparison of pore sizes in biomaterials utilizing scanning electron microscopy (SEM) and micro-CT was performed, and the complications of pore size evaluation were presented. SEM image analysis leads to significantly higher values than micro-CT (approximately three times), which allows for comparison of the studies using only one of these methods. Validation of micro-CT 3D analysis results based on calibration phantoms with complex structure, to date, is not possible. We therefore developed software generating phantom datasets of 3D objects with well-defined...
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Effect of temperature on arrhythmogenesis during heart development
Vostárek, František ; Sedmera, David (advisor) ; Tomek, Viktor (referee) ; Naňka, Ondřej (referee)
5 Abstract: Aims: The main objective of this work was to analyze in detail the effects of acute temperature changes on the function of isolated chick embryonic heart in vitro in comparison with natural conditions in ovo. Methods: The effects of temperature change (34 řC, 37 řC and 40 řC - hypo-, normo- and hyperthermia, respectively) on calcium dynamics in four days old isolated chick hearts in vitro were investigated by high-speed calcium optical imaging. For comparison and validation of in vitro measurements, experiments were also performed in ovo using videomicroscopy. Artificial electrical stimulation experiments were performed in vitro and in ovo to uncover conduction limits of different heart segments. Results: We observed almost linear dependence of sinus frequency on temperature in our temperature range. Sinus frequency during hypothermia and hyperthermia in vitro and in ovo changed about 20% in comparison with normothermia. We observed no significant changes in amplitude of calcium transients during temperature change to hypothermia but hyperthermia caused a significant decrease in amplitude of calcium transients (atria 35%, ventricles 38%). We observed a wide spectrum of arrhythmias, which occurred spontaneously even during normothermia in vitro. Occurrence of arrhythmias in vitro significantly...
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Topographical anatomy of the retroperitoneum and its blood vessels and lymphatics
Turyna, Radovan ; Kachlík, David (advisor) ; Bouda, Jiří (referee) ; Naňka, Ondřej (referee)
The purpose of this study was to describe the distribution and structure
of ventral tributaries leading into the inferior vena cava where right-sided paraaortic lymphadenectomy is performed. The study examined
21 retroperitoneal specimens by graphic reconstruction, statistical evaluation, and histological examination of ventral tributaries (VTs). Seventy VTs were identified. The average number per specimen was 3.33. There were 20, 40, and 40% of VTs found in Levels I, II, and III, respectively. During the preparation, we observed an unusual arrangement of the IVC wall, into which VTs were led through a preformed sleeve-like channel and anchored near the lumen. This finding is a key mechanism that explains the ease with which VTs are extracted during surgery. Due to the lack of uniformity concerning the moniker for VTs in the literature, and due to the typical anatomical position and distribution of VTs within retroperitoneum, we propose that these veins should be called venae retroperitoneales anteriores. The second aim of the study was to gain a thorough knowledge of the topography and distribution of until now officially unnamed minute direct branches from abdominal aorta, stemming from its ventral and lateral aspects, supplying surrounding tissue, and to comprise it to the existing studies. Due to the...
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Quality of life after urogynecologic surgery Comparation of change of quality of life after urogynecologic surgery in relation to anatomy of the pelvis foor
Drahorádová, Petra ; Mašata, Jaromír (advisor) ; Zachoval, Roman (referee) ; Naňka, Ondřej (referee)
Introduction: Stress urinary incontinence is a common problem which affects a high percentage of women. Anti-incontinent surgery has played an important role in the treatment of stress urinary incontinence. Burch colposuspension was considered a gold standard in anti-incontinence surgery, with good long-term results. However, over the past decade this procedure has been largely replaced by the application of various types of TVTs (tensionfree vaginal tapes). In our study we have focused on comparing developments in the quality of life and the occurrence of complications in a long-term follow-up after TVT, TVT O and colposuspension. For subjective assessment of urinary incontinence we have chosen a validated specialized Incontinence Quality of Life questionnaire (I-QoL). The aim of our study was to monitor the trends with quality of life after TVT, TVT O and colposuspension procedures and to establish whether the occurrence of complications affects the quality of life (QoL) and compare of the quality of life among anti-incontinence procedures and longterm subjective and objective outcome. Methods: The study included 215 women who underwent a TVT, TVT O or Burch procedure between 1.6.2002 - 31.5.2005. Women were completely urogynecologic examined and urodynamic stress incontinence was documented....
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