|
Therapeutic vasculogenesis in patients with critical leg ischemia
Skalická, Lenka ; Linhart, Aleš (advisor) ; Neužil, Petr (referee) ; Roztočil, Karel (referee)
PhD Aims: The aim of our study was to evaluate an efficacy and safety of intra-arterial injection of bone marrow mononuclear cells (BMMCs) in patients with chronic critical limb ischemia (CLI) Methods.In average 400ml bone marrow blood was harvested from posterior iliac crests in 24 CLI patients. BMMCs were obtained from the blood by standard procedure used for bone marrow transplantation. After digital subtraction angiography was performed in each patient, BMMCs were injected into arteries of 28 limbs. Primary outcome was the efficacy of BMMCs injection measured as a successfull healing of limb defects, a change of Fontain ischemia grade and a rate of high limb amputations. Secondary outcomes were a safety of the BMMCs injections, changes in angiographic findings after BMMCs injections and changes in quality of life (questionnaire SF-36). Results: After one year follow-up all patients were alive and 2 patients have undergone high limb amputation. Out of 14 limb defects, eleven have been healed completely and the average Fontain ischemia grade has changed from baseline value of 3.5 to 2.0 after one year (P<0.0001). Angiographic findings have improved in all examined segments of limb vessels. One year after the procedure patients have reported significant improvement. Conclusion: The intra-arterial...
|
|
Experimental Small Bowel Transplantation
Kudla, Michal ; Adamec, Miloš (advisor) ; Kohout, Pavel (referee) ; Hejnal, Jiří (referee)
The small bowel transplantation (SBT) represents reasonable alternative to ultimate total parenteral nutrition of the patient suffering from terminal stage of chronic bowel failure. To date, the small bowel transplantation was not carried out in the Czech Republic. The initial experimental research and gaining experience with transplantations on animal models are inevitable before successful commencement of small bowel transplantation programme. In my dissertation thesis I am in full details describing the surgical technique of small bowel transplantation in rat. In comparison with the published data I have succeed to reach rather similar results of operating time and survival of the experimental animals. In the second part of my experiment I tried to influence the acute rejection of the small bowel graft occurrence by administration of cytostatic agent gemcitabin. The chosen dosage of the remedy did not suppress the rejection. In the third part I am describing the surgical technique of lymphatic vessels reconstruction in SBT rat model, which might lead to improvement of the SBT outcome. The last part of my dissertation thesis is preclinical. I am describing the initial experience with surgical technique of small bowel graft harvesting from cadaverous donor.
|
|
Phosphates containing food and their implications for osteoporosis
Šobáň, Jan ; Rambousková, Jolana (advisor) ; Černá, Milena (referee)
Phosphates containing food and their implications for osteoporosis Phosphates are salts of phosphoric acid resulting from the secession of three acidic hydrogen from it. Phosphates are found in natural foods such as nuts, legumes, cereals, meat and offal. Phosphorus is also being added to foods industrially for its' various chemical properties. From more than 1 500 "E's" I found 16 that contain phosphates and thus significantly increase the supply of phosphorus in the body. Usual daily intake of phosphorus is about 1 g. Increased intake of phosphorus forms an acidic environment in the kidney and calcium phosphate complexes, and thus leads to calcium removing from the body and bone demineralization. "E's" containing phosphates are frequently found in meat products, processed cheese, confectionery, bakery products, cola beverages, frozen and instant foods. Most commonly used additive is E-338 phosphoric acid. Osteoporosis is a systemic skeletal disease characterized by a small amount of bone mass and de- terioration of bone micro-architecture resulting in increased fragility and fracture risk. The Czech Republic declares to have 600 000 patients treated for osteoporosis.
|
|
The influence od educational to maintenance of secondary prevention rules of myocardial infarction
ŠÍMOVÁ, Martina
This bachelor thesis deals with the effects of educational plans on the compliance with the principles of the secondary prevention of myocardial infarction. The theoretical background covers atherosclerosis, acute myocardial infarction, the secondary prevention of myocardial infarction and the educational process in nursing. Prior to elaborating the practical part of the thesis we had established two objectives. Objective 1: To find out whether the patients educated without an educational plan are as knowledgeable as the patients educated through an educational plan. Objective 2: To compare whether the patients educated without an educational plan comply with the principles of the secondary prevention of myocardial infarction in the same way as the patients with an educational plan. A qualitative form of research had been chosen for this thesis, semi-standardized interview in particular. The analysis of the data gained was subsequently carried out. Two objectives had been established in the thesis. Objective 1: To find out whether the patients educated without an educational plan are as knowledgeable as the patients educated through an educational plan. Through the analysis of the obtained data we found out that the patients educated without an educational plan are as knowledgeable as the patients educated through an educational plan. Objective 2: To compare whether the patients educated without an educational plan comply with the principles of the secondary prevention of myocardial infarction in the same way as the patients with an educational plan. Having compared the results we found out that the patients with an educational plan comply with the principles of the secondary prevention more consistently than the patients educated without an educational plan. The objectives of the thesis were met.
|
|
Impairment of nasal mucociliary clearance in former smokers with stable chronic obstructive pulmonary disease relates to the presence of a chronic bronchitis phenotype
Koblížek, Vladimír ; Salajka, František (advisor) ; Skřičková, Jana (referee) ; Marel, Miloslav (referee)
AJ Impairment of nasal mucociliary clearance in former smokers with stable chronic obstructive pulmonary disease relates to presence of a chronic bronchitis phenotype Background: Associations between nasal and bronchial impairment have been repeatedly described in chronic obstructive pulmonary disease (COPD) whereas nasal mucociliary clearance (MCC) in COPD patients is not yet fully understood. We studied nasal MCC parameters in COPD patients and compared them with healthy adults (HA) and with cystic fibrosis (CF) patients with compromised MCC. Methodology: Pilot study of seventeen COPD patients without exacerbation; all of them were examined to investigate and compare nasal and bronchial ciliary beat frequency (CBF) and ciliary beat pattern. Main observational study of 98 COPD ex-smokers and subjects from control groups (15 CF and 39 HA) evaluated for nasal MCC time (NMCCt) and by digital video microscopy of nasal mucosa recording ciliary beat frequency (CBF) and ciliary beat pattern (index of ciliary dyskinesia). Results: It was found no difference in mean ciliary beat frequencies between nasal (6.0 Hz ± 1.3) and bronchial (5.9 ± 1.3) mucosa (p = 0.427). We found medium association in degree of ciliary dyskinesia (κ = 0.733). In the main observational study: the NMCCt was decreased in HA (575...
|
|
Gene Therapy of CML: Experimental Vaccines against Bcr-abl-transformed Cells
Lučanský, Vincent ; Vonka, Vladimír (advisor) ; Roubalová, Kateřina (referee) ; Reiniš, Milan (referee)
Chronic myeloid leukemia is malignant disease characterized by myeloproliferative clonal expansion of hematopoietic stem cell. It is causally associated with the formation of the so called Philadelphia chromosome and production of its specific product, the chimeric BCR-ABL protein. The amino acid sequence of the fusion region is unique, implying that the BCR-ABL protein carries tumor specific antigen. Currently imatinib mesylate dominates the treatment of CML. It is well tolerated and when compared to the other drugs used, it prolongs the life expectancy significantly. Unfortunately, it is not capable to cure the disease. The only potentially curative approach nowadays is the bone marrow transplantation; however, it is connected with a relatively high morbidity and mortality. Moreover, it is available only to a minority of the patients. Under these circumstances the need for the development of a relatively safe and generally available treatment is understandable. Immunotherapy could be such a treatment. Several experimental vaccines based on BCR-ABL sequence were developed and tested in mice in our institute. The DNA vaccines used were carrying sequences coding for the whole BCR-ABL protein, or for 25 amino acids long junction region (these DNA sequences were fused with adjuvant genes such as...
|
|
New biological markers in lymphoproliferative diseases
Špaček, Martin ; Mandys, Václav (advisor) ; Smolej, Lukáš (referee) ; Lysák, Daniel (referee)
New biological markers in lymphoproliferative diseases Summary The prognosis of patients with lymphoid neoplasms is extremely variable. Reliable prognostic markers could allow the identification of patient subsets that may benefit from alternate approaches. Epstein-Barr virus (EBV) is associated with approximately one third of Hodgkin lymphoma (HL) cases. EBV-DNA is often present in the plasma and whole blood of EBV-associated HL patients. However, the significance of EBV-DNA monitoring is debated. In a cohort of 165 adult HL patients EBV-DNA viral load was prospectively monitored. Our results suggest that assessment of plasma EBV-DNA viral load might be of value for estimation of prognosis and follow-up of patients with EBV-positive HL. The role of the TP53 gene's R72P polymorphism in NHL has been analyzed in several studies but it has not been studied in HL. We have evaluated the role of R72P in 340 NHL and 298 HL patients. Our results support the evidence that R72P is not a prognostic factor in Caucasian NHL patients, and they indicate its irrelevance for HL development or prognosis. In a study of 73 patients with chronic lymphocytic leukemia we have assessed IgVH mutational status, presence of mutation in TP53 gene and expression of CD38 and ZAP-70. Overall concordance between ZAP-70 expression and IgVH...
|
|
BK-polyomavirus infection in patients after simultaneous pancreas and kidney transplantation
Mindlová, Martina ; Saudek, František (advisor) ; Forstová, Jitka (referee) ; Reischig, Tomáš (referee)
Introduction. The aim of the study was to introduce a new BKV PCR protocol in our centre and to verify its accuracy as well as to assess the prevalence, risk factors of BK virus replication, course of BKV infection and therapeutic approaches in simultaneous pancreas and kidney (SPK) recipients in order to design a screening protocol. Methods. The results analysed by both Affigene® and Transplantation Virology, Basel PCR protocols were compared. Thereafter 183 SPK patients were examined to assess the prevalence of BK viremia, viruria and BKVN and to identify the risk factors of BKV replication. The cases of retransplantation after a graft loss due to BKVN were retrospectively described. Results. 100 of results were analysed according to the Affigene ® and Transplantation Virology, Basel PCR protocols with the accordance of 95%, Rho = 0,946, 95% CI: 0.920 - 0.963, P<0,0001, Bland-Altman plot analyses: bias Basel PCR protocol/Affigene® BKV trender: -0,1 (mean) *±1.96 SD: -1,6 - 1,3] for both methods. Point-prevalence was assessed in 183 patients; Viruria found in 17,3 %, viremia in 3.8% of patients. High-level viruria >107 copies/mL detected in 3,7% of patiets, high-level virémia >104 in 1,6% of patients simultaneously with high-level viruria. BKVN was found in 0,5% of patients. Diabetes duration...
|
|
Renal Biopsy in Diabetes, Comparison of Morphology and Clinical Symptoms
Kruntorád, Vít ; Rychlík, Ivan (advisor)
Diploma student work can bring many beneficial skills and useful knowledge. It mainly on him, how much is ready to put time, energy and creative potential. I managed to find the unique theme of work, I have also become a big challenge. The main motivation was Considering that the work has clear clinical meaning and perhaps even impact. Diabetes mellitus (DM) is a serious disease significantly changing the current life of the patient. Good control and treatment disease requires patient discipline in lifestyle and respect of medical schemes. However, even with goodcompensation diabetes may progress and reduce the quality of life affected. This is mainly on chronic complications specific for this disease - that is affected eye, kidney and polyneuropatické. The theme of this work is just one the most serious chronic komlikací diabetes and diabetic nephropathy. We tried to map the situation of kidney damage in diabetics, its dependence on selected clinical parameters and some prognostic parameters. The information that we have collected will be further used in the project of the Czech Society of Nephrology (CNS) within the Czech registry of renal biopsy (CRRB) - Renal biopsy in diabetic patients, survey results in 1999-2003, which isfinancially fully backed by the CNS. Is the exclusive property of CRRB CNS, the...
|
| |
guest ::
