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Mechanical properties of mitral allografts
Hlubocký, Jaroslav ; Špatenka, Jaroslav (advisor) ; Dominik, Jan (referee) ; Rosenberg, Josef (referee)
Mitral allograft has never been as widely used as the aortic one for the treatment of infective endocarditis in clinical practice. Results of mitral valve replacements with mitral allograft were poor. Development of better techniques of mitral valve repair and improving quality of valve prostheses led surgeons to abandon use of mitral allografts in mitral position. On the other hand that technique could be helpful for treatment of tricuspid valve pathology, mainly of infectious endocarditis. We were evaluating the possibility of inserting a cryopreserved mitral allograft into the tricuspid position in a sheep experimental model. Within the framework of this experimental project the mechanical properties of the cryopreserved mitral allograft were tested. A novel methodology of graft tissue mechanical properties testing was developed. It reflexes the surgical technique of mitral allograft transplantation as it investigates whole functional unit composed of mitral annulus, leaflet, chordae tendinaea, and papillary muscle together. A five-parameter Maxwell model was applied to characterize the viscoelastic behavior of sheep mitral valves. A control group of 39 fresh mitral specimens and a test group of 13 cryopreserved mitral allografts processed according to the tissue bank standards were tested. The testing...
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Periradicular therapy in the Hospital Český Krumlov a.s.
KUTIŠOVÁ, Magdalena
This bachelor thesis focuses on the issue of backache and its treatment. Backache is one of the most common diagnosis. The most affected are usually people in their productive age and therefore the economic and social consequences are very significant. There are many techniques used in diagnosis of backache, easier and cheaper techniques are used in the first place. The diagnosis consists of examination of the patient, medical history and clinical examination. The treatment depends on type and progress of the illness. The basic division is acute (4 to 6 weeks) and chronic case (more than 3 months). Another division is common backache, nervous radicular pain and serious illness of spine. I will mainly focus on nervous radicular pain. The basis of the therapy should be active treatment accompanied by physiotherapy. In addition to this therapy, pharmacological treatment is also used. The pharmacological treatment consists of application of nonsteroidal anti-inflammatory drugs, analgesic and also antidepressants. If the conservative therapy is not effective, it is possible to use the least invasive techniques. The most popular one is the periradicular therapy under CT guidance, which is also the subject of this thesis. During the periradicular therapy under CT guidance the needle is being inserted to intervertebral foramen in the area of radicular affected nerve where lytic mixture is then being applied. The lytic mixture is sometimes replaced by ozone with the same effect. When the PRT was first used, it was mainly applied in the area of lumbar spine. Nowadays, it is usually used in treatment of lesion in the area of cervical spine. The objective of this thesis is to describe anatomy of the examined area, physiological and pathological state, the main indications for the periradicular therapy and methods of implementation including the used tools and pharmaceutical. Following part is focused on development of application of this method in the Hospital of Český Krumlov, a.s. the radiodiagnostics department, and to analyse the effectiveness of the treatment. I have conducted analysis and processed data of performed periradicular therapies in the Hospital of Český Krumlov, a.s. from 2010, when the method was introduced, up to 2015. I have made a questionnaire survey of 40 people selected by chance and then I processed the data in order to create a general overview of obtained results. The result of the thesis is that the number of performed periradicular therapies is steadily increasing. One-third increase was recorded from 2010 to 2015. The number of women patients prevails, 53% of patients in the given period were women. The most common age category is 50 to 59 years, this category constitutes 37% of all patients. It was found out that most of the patients were treated just for one or two times. Only 7% of the patients were treated for more than two times. When processing the data from my survey, I have found out that most of the patients are satisfied with the effectiveness of the therapy, which corresponds with the results quoted in the bibliography.
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Minimally-invasive approaches for the hip replacements
Kubeš, Radovan ; Koudela, Karel (advisor) ; Poul, Jan (referee) ; Landor, Ivan (referee)
Contemporary world and medicine are marked by very rapid development of miniaturization, which surprisingly not missed also endoprothetics and arised thankfully to the strong medial attention gigantic wave of public interest about possibility of mini - invasive operative. In public media was this method presented like revolutionary and almost like a nonstrum, first medical publications (especially from pioneers those techniques) were also generally positive, but also since the begginnig had this method also its non-supporters. Own idea of mini- invasive operative is without any doubt correct step into the future, theoretical benefits are indisputable and logical. In wiew of this facts, that it was for me "no man's land" , I decided as a first step to study all published facts and later than I began practical testing of mini-invasive approaches on cadavers studies and than finally after very carefully evaluation of all facts I started to perform mini-invasive approaches. In an effort to deprese maximally the learnig curve, I started my mini-invasive implantation with femoral component only - so cervicocapital endoprosthesis, only after estimation of this group and with newly acquired experiences I came up to perform MIS- THR .. Our statistically prooved final results tell us, that implantation THR...
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Implantation of cryopreserved mitral allograft into tricuspidal position in an experiment with sheep: Technical aspects of implantation and immediate results evaluated with the aid of epicardial echocardiography
Vojáček, Jan ; Špatenka, Jaroslav (advisor) ; Dominik, Jan (referee) ; Třeška, Vladislav (referee) ; Černý, Štěpán (referee)
Aortic, mitral and pulmonary valve replacement is routinely performed with reasonable clinical results. But the optimal substitute for the tricuspid valve remains controversial. Contemporary prostheses either mechanical or bioprosthetic are associated with a high risk of thrombosis and/or structural failure. Mitral allografts could have advantages over existing prostheses, especially in patients with infectious endocarditis. We describe our first experience with cryopreserved mitral allograft processing and implantation into the tricuspid position in a sheep experimental model. Material and Methods: We subjected 20 sheep (age 1 year, weight 23 - 36 kilograms) to general anesthesia and a left thoracotomy. An epicardial echocardiographic study was performed and the mitral valve was harvested. Donor animals were put to death by intravenous anesthetics injection. Allografts were immersed into cultivation medium E 199 with an antibiotic cocktail. After 24 hours storage at the temperature of 37.0oC the valves were kept at + 5 to + 7 oC over a period of 3-5 days. Then they were transferred into the cryoprotective solution (E 199 with 10% dimethylsulfoxide) and sealed into plastic bags using a double-layer technique. Finally, they were programmed cooled and stored in the liquid stage of liquid nitrogen (- 196 oC)...
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Physiotherapy of scar in prevention and treatment of functional disorders
HRDÝ, Tomáš
The topic of the thesis is "Scar physiotherapy in the prevention and treatment of functional disorders." A scar is an inferior connective tissue resulting by the healing process, in various depths of soft tissues of various etiologies. A scar can never reach the original rheological properties of the given tissue, it is a regeneration product, replacing the original damaged tissue. A scar is physiologically healed into a thin, pale hair line, which does not affect local shunt and protraction abilities of soft tissues moving in accordance with the osteoarticular apparatus. If the healing process does not happen physiologically, a pathological scar is created, that scar can often become active, having a negative impact not only on its immediate vicinity, but also reflexively on the whole postural-locomotor system of the individual. The thesis is a comprehensive view on the scar as another "organ ", the activity of which can manifest itself in postural and movement patterns of the person. In the study the connection of a scar and its neurophysiological chaining are discussed, where an active scar may cause local changes in the muscle tone, skin sensitivity, it can lead to dysfunctions of internal organs and a limited mobility of the locomotive segment with the afferent link to the central level of motor control. Overlooking a scar as a possible provoking segment of a pathogenetic chain can lead to the failure of therapy and the relapse of symptoms. The method of this study was qualitative research based on a deliberate (purpose) data collection. The data were obtained by the method of observation, interview, document analysis and kinesiologic examination. The research group consisted of 4 probands, in which an activity of a scar at different levels of soft tissues linked to postural-locomotor system was found by examination. On the basis of continuous and a final examinations of the probands, the research questions were answered. The results show that appropriately selected techniques of physiotherapy had a positive effect on the health condition of a given patient. Using continuous and meaningful therapy including manual medicine techniques, physical therapy, balneology and pharmacology, the activity of the scar tissue with all its consequences was mitigated or completely stopped. The outcomes of the study can be used by physiotherapists as well as other members of the medical staff, and may also serve to physicians in differential-diagnostic considerations.
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