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The role of ATP-MgCl2 in ischemia-reperfusion and sepsis
Nalos, Marek ; Kasal, Eduard (advisor) ; Matějovič, Martin (referee) ; Šrámek, Vladimír (referee)
The previously reported multiple beneficial effects of ATP-MgCl2 were tested in two clinically relevant large animal models. We observed mainly cardiovascular effects of ATP-MgCl2 likely related to purinergic receptors stimulation. Adding ATP and its metabolite adenosine to ex vivo LPS stimulated whole human blood cultures and measuring cytokine secretion we have further tested whether modulation of inflammation might be responsible for some of the ATP-MgCl2 effects. The results are summarized as follows: 1. Infusing ATP-MgCl2 intravenously in a porcine I-R injury model of thoracic aortic cross clamping provides better cardiovascular stability compared to currently used standard agent sodium nitroprusside. Although ATP-MgCl2 led to reduced gut lactate release we could not demonstrate any beneficial effects on numerous markers of reperfusion injury. Moreover the combination of sodium nitroprusside with esmolol provided hemodynamic control superior to ATP-MgCl2. 2. In long term hyperdynamic porcine model of sepsis ATP-MgCl2 increased portal venous blood flow, reduced ileal mucosal-arterial pCO2 gap and preserved hepatic arterial buffer response as well as metabolic coupling between lactate release from the gut and its utilization by the liver. Despite the beneficial effects of ATP-MgCl2 on hepatosplanchnic...
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Optimization of Hemodynamics of Trauma Patients in Intensive Care Using Transesophageal Doppler Monitoring
Pradl, Richard ; Chytra, Ivan (advisor) ; Málek, Jiří (referee) ; Šrámek, Vladimír (referee)
Esophageal Doppler was confirmed as a useful non-invasive tool for management of fluid replacement in elective surgery. The aim of this study was to assess the effect of early optimization of intravascular volume using esophageal Doppler on blood lactate levels and organ dysfunction development in comparison with standard hemodynamic management in multiple-trauma patients. This was a randomized controlled trial. Multiple-trauma patients with blood loss of more than 2,000 ml admitted to the intensive care unit (1CU) were randomly assigned to the protocol group with esophageal Doppler monitoring and to the control group. Fluid resuscitation in the Doppler group was guided for the first 12 hours of ICU stay according to the protocol based on data obtained by esophageal Doppler, whereas control patients were managed conventionally. Blood lactate levels and organ dysfunction during ICU stay were evaluated. Eighty patients were randomly assigned to Doppler and 82 patients to control treatment. The Doppler group received more intravenous colloid during the first 12 hours of ICU stay (1,667±426 ml versus 682±322 ml; p < 0,0001), and blood lactate levels in the Doppler group were lower after 12 and 24 hours of treatment than in the control group (2,92±0,54 mmol/1 versus 3,23±0,54 mmol/1 [p = 0,0003] and 1,99±0,44...
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Hemo elimination method in the treatment of sepsis and early multi-organ dysfunction
Sýkora, Roman ; Matějovič, Martin (advisor) ; Chytra, Ivan (referee) ; Maňák, Jan (referee) ; Šrámek, Vladimír (referee)
The most common cause of death in patients with sepsis/septic shock is deterioration of the function of multiple organs, termed multiple organ dysfunction syndrome. Although our understanding of mechanisms involved in the pathophysiology of sepsis-induced tissue damage has improved substantially, therapy of these syndromes still remains largely supportive. The hallmark of sepsis is an overwhelming systemic production of both pro- and anti-inflammatory mediators leading to generalized endothelial and epithelial damage, microcirculatory-mitochondrial distress, altered endocrine and coagulation homeostasis and cellular immune hyporesponsiveness. Therefore, the hypothesis that modulation of this excessive immunological and biological response to infection might improve patient outcome appears reasonable. Hemoelimination techniques represent biologically plausible way to provide non-specific removal of soluble pro- and anti-inflammatory mediators, although the concept of blood purification in sepsis remains a matter of considerable debate. The aim of this thesis was to elucidate effects of 1) high volume hemofiltration (HVHF) and 2) coupled plasma filtration adsorption (CPFA) in a long-term, hyperdynamic porcine septic shock model, which fulfils the criteria for human sepsis. We hypothesized that both HVHF and...
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Puppets and Music
Solce, Matija ; ŠRÁMEK, Vratislav (advisor) ; MALÍKOVÁ, Nina (referee)
Based on my practical experiences, I connected different aspects of illusion and defined alternative version of puppet theatre, which I named ?theatre of illusive points?. On other side I took the musical way of my understanding of illusion and connected them in few examples of my own productions and events.
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The Analysis of Motives and Rhythm in the West Side Story
Jankulárová, Michaela ; FRANZ, Vladimír (advisor) ; ŠRÁMEK, Vratislav (referee)
In first section this thesis is trying to explain the definition of "musical" and to sum up the brief history of American musical with accentuation of some important and interesting musical productions. Further it is trying to highlight some theatrical, musical-theatrical and pure musical genres from which the musical as we know it today draws. In the second section there is an attempt to define motives and rhythm of musical West Side Story based on analysis of the songs used in it. The main focus is on the songs "America" and "Cool". The songs are analyzed chronologically, with no intention to divide them by themes. The thesis is trying to find out the fundamental elements which are characteristic for each song or which are somehow important for the musical as a whole. 
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Zjišťování účinnosti opatření na omezení znečišťování ovzduší na základě snížení negativních účinků polutantů na složky ŽP a lidské zdraví
Český ekologický ústav, Praha ; Česká geologická služba, Praha ; Ekotoxa Opava, s.r.o., Opava ; Chroust, Petr ; Šrámek, Vít ; Fabiánek, Petr ; Sáňka, Milan ; Čupr, Pavel ; Holoubek, Ivan ; Trumpešová, Zlata ; Kazmarová, Helena ; Fara, Milan ; Fottová, Dana ; Skořepová, Irena ; Zapletal, Miloš
Zhodnocení přístupů, metod a metodik (MŽP, EU, EHK OSN) včetně rešerše literatury, které budou použity pro řešení projektu v letech 2003 až 2005, a to zejména metod a metodik, které jsou zaměřeny na vyhodnocení účinků vybraných látek znečišťujících ovzduší na ekosystémy, půdy, vody, materiály respektive lidské zdraví s využitím emisních limitů, imisních limitů, kritických zátěží a kritických prahů s vymezením oblastí s očekávaným nárůstem rizik v predikovaných časových horizontech. Popis a diskuse metod a metodik pro: hodnocení vývoje emisní situace sloučenin síry, dusíku a těžkých kovů, hodnocení imisních koncentrací látek znečišťujících ovzduší, odvození suché a mokré depozice sloučenin síry, dusíku, těžkých kovů s ohledem na kritické zátěže, výpočet kritických zátěží a modelování procesu acidifikace, hodnocení negativních vlivů imisí a atmosférické depozice rizikových prvků na půdu, vymezení parametrů ovlivňujících vývoj defoliace lesních porostů v síti ICP Forests na území České republiky, monitorování zdravotního stavu lesních porostů pomocí metod dálkového průzkumu Země, mapování zátěže vybraného materiálu, hodnocení zdravotního stavu obyvatelstva a jeho ukazatelů, stanovení expozice populace a jejich skupin znečišťujícím látkám z ovzduší, zjišťování expozice, modelování dávky v hodnocení expozice a role expozičních scénářů v odhadu expozice, prostorového vymezení oblastí s očekávaným zlepšením stavu složek životního prostředí a s očekávaným nárůstem rizik, ekonomického bilancování a odhady nákladů na technická opatření ke snížení zátěží z ovzduší.
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