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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...
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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.
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Gene expression analysis in patients with myelodysplastic syndrome
Vašíková, Alžběta ; Votavová, Hana (advisor) ; Neuwirtová, Radana (referee) ; Jarošová, Marie (referee)
Myelodysplastic syndrome (MDS) is a clonal disorder affecting maturation and differentiation of hematopoietic stem cells. MDS is characterized by ineffective hematopoiesis resulting in peripheral blood cytopenia in at least one lineage, and increased risk of development of acute myeloid leukemia (AML). This disorder mostly affects the elderly, with the incidence of 10-50/100000 people per year. Heterogeneity of MDS is further underlined by the presence of both idiopathic primary and secondary therapy-related forms, which arise from accumulation of mutational events induced by cytotoxic therapy (exposure to alkylating agents or after therapy with topoisomerase II inhibitors). In this thesis, we focused on determination of differential gene expression between MDS patients and control subjects using different microarray platforms. Using nylon membranes, we detected 4 genes (ERCC1, FLT1, NME4, PCNA) with increasing expression pattern in advanced MDS stages, which correlated with disease progression. Their strong up- regulation was also observed in patients with de novo AML, suggesting their involvement in the leukemic transformation of MDS. Comparison of gene expression profiles of early and advanced MDS obtained by Agilent microarrays resulted in the set of differentially expressed genes, which might...
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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.
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Measuring efficiency of hospitals in the Czech Republic
Procházková, Jana ; Chalupka, Radovan (referee) ; Gregor, Martin (advisor)
This thesis estimates cost efficiency of 99 general hospitals in the Czech Republic during 2001-2008 using Data Envelopment Analysis and Stochastic Frontier Analysis. It tests comparability of their results finding out a certain qualitative similarity. Next, determinants were added into SFA and efficiency of Czech hospitals examined. The presence of inefficiency is group specific even having accounted for various determinants. The effects of determinants were tested. Inefficiency increases with teaching status, more than 20,000 treated patients a year, not-for-profit status, larger share of the elderly in the municipality and average salary in the district. Inefficiency decreases with less than 10,000 patients treated a year, larger population, higher unemployment rate and more hospitals in the region.
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Smell of faraway, smell of flowers. Graphic casuistic of a client with psychotic diagnosis
SMETANOVÁ, Tereza
This bachelor paper talks about disease called schizophrenia. The theoretical part is focused on basic terminology, it's also touching slightly the dopamin theory and Wienbergers hypothesis. One chapter is dedicated to lexical semiotics in the graphical production of psychotic patients and other people connected with this problematics. There is also mentioned the art brut and patient art. The practical part is dedicated to a casuistry of a client, which is diagnosed with paranoid schizophrenia. The paper is using information from daily contact and work with the patient. There are mentioned arteterapeutical accesses and posibilities of work with schizophrenic clientele. The paper is going to try to analyse the process and developement of graphical output of the client based on her production. The secondary goal is to prove, that for the schizophrenic patient is really important to have the possibility of graphical utterance and good therapeutic relation with the therapist.
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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...
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Nutritional support for cancer patients
Petrovová, Hana ; Těšínský, Pavel (advisor)
According to the report of the Institute of Health Information and Statistics , published in 2007 which processes the results of 2005 , the incidence of malignant neoplasms in the Czech Republic in the long term increasing incidence . The most common Malignant tumors are basal cell carcinoma , although mostly for its specificity from other classifications set aside . Of the more serious diagnoses are among the most frequent malignancy colorectal neoplasm , trachea and lung cancer in women and in men the prostate. In 2005 in the Czech Republic reported over seventy thousand malignant neoplasms and neoplasms in situ (1) . Weight loss may be as the first sign of malignant disease and may occur later in the course . frequency weighting loss and malnutrition occurs in 31-78 % of oncology patients Depending on the location, type and stage of the disease . The most commonly occurs in gastrointestinal cancer and lung cancer ( 2 ) . For some patients as a result cancer develops cachexia. Causes of weight loss in cancer patients are numerous and Currently , it is clear that far yet know all . Generally causes divided into three major groups : physiological disorders caused by abnormalities interactions tumor - host ( changes in metabolism , anorexia) and finally consequences anticancer treatments ( both chemo - Radio...
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Nonparametric estimations in survival analysis
Svoboda, Martin ; Malá, Ivana (advisor) ; Tomášek, Ladislav (referee)
This work introduces nonparametric models which are used in time to event data analysis. It is focused on applying these methods in medicine where it is called survival analysis. The basic techniques and problems, which can appear in survival analysis, are presented and explained here. The Kaplan -- Meier estimator of survival function is discussed in the main part. This is the most frequented method used for estimating the survival function in patients who have undergone a specific treatment. The Kaplan -- Meier estimator is also a common device in the statistical packets. In addition to estimation of survival function, the estimation of hazard function and cumulative hazard function is presented. The hazard function shows the intensity of an individual experiencing the particular event in a short time period. Special problems occur when analyzing time to event data. A distinctive feature, often present in such data, is known as censoring. That is the situation when the individual does not experience the event of interest at the time of study. The thesis covers also an empiric part, where the results of an analysis of patients with the larynx carcinoma diagnosis are shown. These patients were treated in a hospital located in České Budějovice. This analysis is based on a theory presented in the previous chapters.
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