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Prevalence of neurodegenerative disorders in patients with esophageal achalasia
Jerie, Martin ; Vojtěch, Zdeněk (advisor) ; Šonka, Karel (referee) ; Bronský, Jiří (referee)
Introduction: Achalasia is a primary motility disorder of the esophagus due to degeneration neurons in myenteric plexus. Although the exact pathogenesis is unknown, autoimmune and neurodegenerative processes seem to be involved. We thus hypothesized that the prevalence of neurodegenerative and/or neuroinflammatory disorders (NDD) with autoimmune component could be higher among patients with achalasia and vice versa as the background pathogenetic mechanisms might be similar. Methods: This was a prospective, observational, comparative questionnaire-based study. Patients with achalasia from a gastroenterology center and patients with NDD from neurology centers in the Czech Republic were enrolled. Patients from achalasia group were then examined by neurologist and neurological patients by gastroenterologist, including further testing to confirm or rule out either NDD and achalasia, respectively. We assessed the prevalence of both achalasia and NDD and compared them with prevalences in general population. Results: A total of 150 patients with achalasia and 112 patients with NDD were enrolled. We observed an increased prevalence of NDD among patients with achalasia (6.0 % (9/150) as compared to the estimated 2.0 % prevalence of NDD in general population, p=0.003). In the NDD group, 32 out of 112 patients...
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Optimizing of epilepsy surgery in paediatric patients
Bělohlávková, Anežka ; Kršek, Pavel (advisor) ; Doležalová, Irena (referee) ; Vojtěch, Zdeněk (referee)
Optimizing of Epilepsy Surgery in Paediatric Patients Abstract Epilepsy surgery represents an effective treatment of intractable focal epilepsy. The presented work aims to describe the state of the art and enhance diagnostic and therapeutic algorithm in paediatric patients. The ultimate goal is to improve the outcome of surgeries. The work depicts the evolution of the paediatric epilepsy surgery program in Motol Epilepsy Center over the course of years 2000-2017. Complexity of patients (younger age, epileptogenic zone in proximity of eloquent cortex, multifocal MRI findings) and surgeries (hemispherotomy) alike increased over time. However, the outcomes in terms of postoperative seizure-freedom and complications remained stable. Cognitive abilities of patients improved by 9.1 IQ/DQ points one year after surgery. Patients with preexisting intellectual deficit reached the most significant increase. We developed a novel paradigm of intraoperative cortical electrical stimulation mapping. Furthermore, we introduced a technique employing visual detection of SEEG electrodes during the surgery. These procedures aim to achieve a complete resection while avoiding complications. We developed and standardized Czech versions of questionnaires IPES a QOLIE-AD-48 assessing quality of life in children with epilepsy. We...
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Alternative methods in the surgical treatment of mesial temporal lobe epilepsy
Vojtěch, Zdeněk ; Nevšímalová, Soňa (advisor) ; Šonka, Karel (referee) ; Komárek, Vladimír (referee)
Purpose: The aim of the study was to evaluate effectiveness and complications of alternative methods of stereotactic treatment (gamma knife radiosurgery and radiofrequency amygdalohippocampectomy) in mesial temporal lobe epilepsy due to mesial temporal sclerosis. Methods: Both patient groups underwent a standard preoperative epilepsy evaluation. Both procedures were planned according to the individual anatomy of each patient. Between November 1995 and May 1999, 14 patients underwent Leksell Gamma Knife radiosurgical amygdalohippocampectomy with a marginal dose of 18, 20, or 25 Gy to the 50% isodose following. Between April 2004 and October 2009 a group of 51 patients was treated using stereotactic thermo-lesion of the same mesiotemporal structures. Lesions were performed using a string electrode inserted through the occipital approach with a single trajectory. Results: In the radiosurgical group, one patient was classified as Engel Class Ib, three were Engel Class IIc, four were Engel Class IIIa, five were Engel Class IVb and one was Engel class IVc 39 months after treatment. One patient was classified as Engel Class Ib, three were Engel Class IIc, one was Engel Class IIIa, and two were Engel Class IVb in a subgroup of seven patients who were unoperated 2 years prior to the last visit and at least 8...
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Analysis of Pension Reform in the Czech Republic in 2010-2016 in the Context of Demographic Development
Vojtěch, Zdeněk ; Krebs, Vojtěch (advisor) ; Brabec, Petr (referee)
The pension system is an important part of social policy and public budget. Negative demographic development put pressure on the financial sustainability of the pension system therefore political establishment are forced to implement reform measures. The aim of the thesis will be to analyze the pension system of the Czech Republic between 2010 and 2016 and on the basis of this analysis to propose measures for its improvements. In the theoretical part the thesis will examine the social policy and issues of pension systems. At the same time it will pay attention to the international institutions and their proposals. In the practical part the thesis will be focused on demographic development which is a fundamental factor of the long-term stability of the pension system. It will analyze the changes in the pension system in the period under review. The conclusion of the thesis will show the possible ways to improve the stability of the pension system.
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Alternative methods in the surgical treatment of mesial temporal lobe epilepsy
Vojtěch, Zdeněk ; Nevšímalová, Soňa (advisor) ; Šonka, Karel (referee) ; Komárek, Vladimír (referee)
Purpose: The aim of the study was to evaluate effectiveness and complications of alternative methods of stereotactic treatment (gamma knife radiosurgery and radiofrequency amygdalohippocampectomy) in mesial temporal lobe epilepsy due to mesial temporal sclerosis. Methods: Both patient groups underwent a standard preoperative epilepsy evaluation. Both procedures were planned according to the individual anatomy of each patient. Between November 1995 and May 1999, 14 patients underwent Leksell Gamma Knife radiosurgical amygdalohippocampectomy with a marginal dose of 18, 20, or 25 Gy to the 50% isodose following. Between April 2004 and October 2009 a group of 51 patients was treated using stereotactic thermo-lesion of the same mesiotemporal structures. Lesions were performed using a string electrode inserted through the occipital approach with a single trajectory. Results: In the radiosurgical group, one patient was classified as Engel Class Ib, three were Engel Class IIc, four were Engel Class IIIa, five were Engel Class IVb and one was Engel class IVc 39 months after treatment. One patient was classified as Engel Class Ib, three were Engel Class IIc, one was Engel Class IIIa, and two were Engel Class IVb in a subgroup of seven patients who were unoperated 2 years prior to the last visit and at least 8...
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Employment policy in Nazi Germany during 1933-1939
Vojtěch, Zdeněk ; Fabianková, Klára (advisor) ; Johnson, Zdenka (referee)
This thesis deals with employment policy in Nazi Germany from 1933 to 1939. The focus is mainly on public programs and the construction of highways. The Great Depression hit Germany hard. When the Nazi government came to power, unemployment amounted to six milion which corresponded to a third of the workforce. The subject of discussion until today is how the Nazi regime was able to resolve unprecedented unemployment. The work is based on the hypothesis that public programs accounted for half the reduction of unemployment. First, I examine macro-economic analysis of the first and second four-year plan and labor market policies. Then I analyze public programs and the construction of highways. After that I compare the findings with the development in the labor market and the general economic situation. I conclude that public programs only partially contributed to the reduction of unemployment.
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