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The principles of neurosurgical and intensive care liquorology
Kelbich, Petr ; Krejsek, Jan (advisor) ; Krahulík, David (referee) ; Jílek, Petr (referee)
The principles of neurosurgical and neurointensive care liquorology We observed the development of the cerebrospinal fluid (CSF) patterns in 120 patients after bleeding in the CNS (central nervous system). We used our original cytological- energetic principle to investigate 1453 samples of the CSF from these patients. The principal aim of our investigation is the detection of immunocompetitive cells in the CSF and the specification of their activation via the coefficient of energy balance (KEB). Furthermore we evaluated the numbers of erythrocytes and leucocytes in the CSF and also the catalytic activities of the aspartate aminotranspherase (AST) in the CSF as biomarkers of structural disorder of the CNS. Our goal was to evaluate a three week long development of the CSF patterns to gain more accurate information for a more effective therapy and for a better prediction of further clinical development of these patients. We confirmed that following biomarkers were unfavourable for the development of the CSF compartment and probably the CNS as a whole: higher extent of bleeding in the CNS; higher frequency of the neutrophile granulocytes in the CSF compartment; higher extent of anaerobic metabolism in the CSF compartment; higher level of the catalytic activity of the AST in the CSF; higher age...
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The effect of hypothermia on outcome and neurologic injury after prolonged cardiac arrest treated by emergency preservation and delayed resuscitation
Drábek, Tomáš ; Jech, Robert (advisor) ; Hess, Ladislav (referee) ; Mareš, Jan (referee)
5 Summary: Currently, the outcomes from traumatic exsanguination cardiac arrest (CA) show that over 50% of deaths due to trauma occur at the scene, where medical care is limited. Less than 10% of patients who become pulseless from trauma survive. However, in an appropriate setting, some of those traumatic injuries could be surgically repairable. Emergency preservation and resuscitation (EPR) is a novel approach for resuscitation of exsanguination CA victims. EPR uses deep hypothermic preservation for prolonged CA to buy time for transport, damage control surgery, and delayed resuscitation with cardiopulmonary bypass (CPB). Initially, we used a dog model to maximize clinical relevance. We showed that the efficacy of EPR is related to the depth of hypothermia and duration of CA. Pharmacologic adjuncts tested to augment hypothermia generally failed. Extended hemorrhagic shock did not prevent the success of EPR vs. conventional resuscitation if extended post-resuscitative hypothermia was provided. Oxygenation of the flush allowed extending of survivable duration of deep hypothermic CA. Because of the lack of molecular tools available for use in dogs, we developed a rat EPR model to study the cellular and molecular mechanisms underlying deep hypothermic neuroprotection to allow us to define specific targets for...
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The role of angiotensin receptors in neuropathic pain
Kalynovska, Nataliia ; Paleček, Jiří (advisor) ; Krůšek, Jan (referee)
Neuropathic pain is one of the most debilitating disorders. Currently available treatments for neuropathic pain are still unsatisfactory as they have only limited treatment effect and patients may suffer from unwanted side effects. Mechanism-based approaches to neuropathic pain treatment are considered to be more effective. Therefore multiple studies are dedicated to study the pathophysiological mechanisms of neuropathic pain. One of the possible underlying mechanism that causes neuropathic pain is neuroinflammation. Recent studies suggested that angiotensin II ( main effector molecule of the renin-angiotensin system) via its receptors in the central nervous system may be involved in the neuroinflammatory processes. The aim of this study was to investigate the role of angiotensin receptor type 1 in the developement and maintenance of neuropathic pain induced in animal model. Spinal nerve ligation (L5) was used as a model of peripheral neuropathy. Our results showed that treatment with AT1R blocker losartan markedly reduced thermal hyperalgesia and reduced increased sensitivity to mechanical stimuli in the SNL-operated rats.This indicates a possibly significant role of AT1 receptors in the development of neuropathic pain, probably due to reduction of neuroinflammation in the nervous system. These findings...
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