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Evaluation of tooth preparation using Er: YAG laser in comparison with other preparation methods
Bučková, Michaela ; Dostálová, Taťjana (advisor) ; Racek, Jaroslav (referee) ; Mazánek, Jiří (referee) ; Smrčka, Pavel (referee)
Er: YAG laser is a new method of preparation that promises gentler and more accurate dental treatment. Its specific characteristics is large absorption of the beam in the water and a small absorption in the tissue without the thermal effect. Therefore the treatment is safer and effectiver. The research has the aim in its theoretical - cognitive part to assess its advantages in comparison with treaditional treatment method - drill. As an essential element will be evaluation of caries lesion in vitro and in vivo. The size of the cavity will be judged on, the shape of developing a smear layer and retention surface in relation to the filling and the . The extracted teeth will be scanned in electronic microscope to assess the formation of contact and non-contact preparation, focusing on the shape and size of the prepared lesion in relation to modern filling materials - low viscosity composites. Extensive research supported by the Ministry of Health (IGA : 9991-4 and 13351-4) that focuses on the the use of various therapeutic methods in the treatment of special needs patients. Dental treatment of a special needs patients is expensive and time-consuming than conventional dental treatment. Therefore, clinical application of theoretical cognitive part will create a electronical support system for the...
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Monoclonal gammopathies in patients after solid organ transplantation. Relationship between posttransplantation immunosuppression and lymphoproliferative disease.
Sečník, Peter ; Franeková, Janka (advisor) ; Racek, Jaroslav (referee) ; Slavík, Luděk (referee)
Introduction: Solid organ transplant (TX) patients have a high risk of post-transplant lymphoproliferative disease (PTLD). One of the candidate methods for identifying an increased risk of developing PTLD are laboratory tests for detection of abnormal synthesis of immunoglobulins - gammopathy (GP). Aims: Main objectives were to determine the frequency of posttransplant GP and PTLD, analyse the impact of GP and PTLD on posttransplant morbidity and mortality, verify the association between GP and PTLD, identify and analyse laboratory markers of early stage PTLD, and use the data to design an effective PTLD diagnostic strategy. Methods: The default cohort consisted of 8034 patients after TX performed at the Institute of Clinical and Experimental Medicine in Prague in the years 1966-2018. For each of the 3 studies performed, a specific subcohort was derived (study 1: 5667 patients, study 2: 96 patients, study 3: 7828 patients). For data evaluation, we used standard epidemiological indicators (incidence risk, incidence rate), Cox regression analysis, Fine and Grey competing risks analysis, and Kaplan-Meier survival analysis. Results: The observed incidence of PTLD was 1.86 (95% CI 1.64-2.08) cases per 1000 person- years with a maximum incidence in the first and fourth-sixth year after TX....
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Metabolic Effects of L-Carnitine Supplementation in Hemodialyzed Patients
Cibulka, Roman ; Racek, Jaroslav (advisor) ; Zima, Tomáš (referee) ; Eiselt, Jaromír (referee)
Chronic kidney failure is associated with many kinds of metabolic disorders caused by the kidney disease and also attributable to dialysis treatment. Phenomena such as accumulation or deficit of various substances and dysregulation of metabolic pathways participate in the pathogenesis of these changes. One of these disorders, which we studied in more detail, is a deficit of carnitine. Carnitine is a substance which plays an essential role in beta-oxidation of fatty acids by catalyzing their transport into the mitochondrial matrix. It enables obtaining of energy, namely in muscle cells including myocardium. Patients with chronic kidney failure treated by hemodialysis are known to have decreased carnitine concentration in plasma and tissues due to its impaired synthesis in kidneys and the great loss across the hemodialysis membrane during dialysis sessions. A single hemodialysis session reduces plasma free-carnitine concentrations to about one-third of their predialysis values because of small molecule of free-carnitine. On the other hand, renal elimination of acylcarnitine, which is physiologically ineffective, may be impaired in chronic kidney failure, leading to increased blood concentrations of acylcarnitine. Considerable evidence suggests that carnitine deficiency and abnormalities of carnitine...
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Changes in the iron metabolism and its regulation in patients with end-stage renal disease treated by hemodialysis and kidney transplantion
Turková Sedláčková, Terezie ; Racek, Jaroslav (advisor) ; Zima, Tomáš (referee) ; Teplan, Vladimír (referee)
Iron is a very important biogenous trace element, which is involved in many of cell processes in organism. For its character iron can be also involved in Fenton reaction, where a toxic hydroxyl radical is produced. The iron metabolism is very carefully regulated in order to avoid formation of hydroxyl radical. Iron Responsive Proteins-Iron Responsive Elements (IRPs-IREs) system is involved in the regulation of iron metabolism on cell level, small peptide hormon hepcidin is involved in the regulation on systemic level. Hepcidin was discovered in 2000 as a peptide with antimicrobial properties. It is a key regulator of iron metabolism, as was discovered later. The target of hepcidin is ferroportin-the only known iron cell exporter. The expression of hepcidin is downregulated by hypoxia and anemia and upregulated by iron overload and inflammation. Hemodialyzed patients suffer from anemia very often. This anemia is caused by many factors, e.g. inadequate production of erythropoietin, chronic inflammation, chronic oxidative stress, blood loss during hemodialysis process or lower lifetime of red blood cells. We realized three studies on the patients with end-stage renal disease in our laboratories. Our aim was to find a relationship of hepcidin and other parameters of iron metabolism, inflammation and...
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Asymmetric Dimethylarginine and Its Relation to Atherogenesis
Široká, Romana ; Racek, Jaroslav (advisor) ; Teplan, Vladimír (referee) ; Hyánek, Josef (referee)
ASYMMETRIC DIMETHYLARGININE - COMPARSION OF CHROMATOGRAPHY AND IMMUNOMETRIC METHODS Objective:Asymmetric dimethylarginine (ADMA) is often discussed in connection with hyperhomocysteinemia and its toxic effect on vessel wall. ADMA concentration is usually measured by HPLC (High Performance Liquid Chromatography) after previous derivatisation. Recently, ELISA (Enzym Linked Immuno Assay) methods for ADMA determination were introduced and ELISA kits are commercially available. Method and Result:The aim of the study was to compare HPLC and ELISA methods for ADMA determination. For HPLC determination we used equipments from Thermo separation product (Florida, USA). After solid-phase extraction on polymer cation-exchange column and the following derivatisation with o-phthaldialdehyde the samples were separated using C18 column (mobile phase 8.7% acetonitril, 50 mmol/l phosphate buffer, pH 6.5) and a fluorescence detector. NG-monomethyl-L-arginine was used as an internal standard. ADMA® ELISA kit, based on a competitive principle, was obtained from DLD Diagnostika, Hamburg, Germany. ADMA was measured in EDTA plasma of 40 healthy blood donors and 40 hemodialysis patients with hyperhomocysteinemia. Conclusion: In spite of different principles both methods showed a very good correlation (r = 0.944, p<0.0001). ELISA...
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Development of the palate morphology and dental arch form in cleft patients
Urbanová, Wanda ; Koťová, Magdalena (advisor) ; Kamínek, Milan (referee) ; Racek, Jaroslav (referee)
Development of the palate morphology and shape of the dental arch in patients with cleft Objective: The aim of this study was to compare the differences in development of the palate morphology and in the relationship and shape of the dental arches in two groups of individuals with different types of orofacial cleft defects. Introduction: Orofacial clefts are the cause of the insufficient growth of the face. Range of the resulting deformation depends on the type of cleft, individual growth disposition of the patient and comprehensive interdisciplinary treatment of the cleft. Material and Methods: The sample consisted of 18 patients with unilateral cleft lip and palate and 18 patients with isolated cleft palate. Measurements were performed on study casts of patients aged 9 and 13 years in average. Following measurements were performed: the frontal and distal width of the upper and lower dental arch, the length of both halves of the upper dental arches, the frontal length and depth of the upper dental arch and the overjet. According to the sagittal relationship of the dental arches, patients were classified into one of five categories of the GOSLON yardstick score. The results were compared between groups and between both age periods using one- or two-sample Wilcoxon test and Fisher test for the GOSLON...
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Oxidative and carbonyl stress,microinflammation and cardiovascular risk in patiens with chronic kidney disease
Peiskerová, Martina ; Kalousová, Marta (advisor) ; Teplan, Vladimír (referee) ; Racek, Jaroslav (referee)
Short summary: Background: High cardiovascular risk in patients with chronic kidney disease is partly due to mineral dysbalance, microinflammation and oxidative stress. CKD patients accumulate traditional and non-traditional CV risk factors. FGF23, MMPs and PlGF belong among these non-traditional biomarkers of CV risk. FGF23 is a phosphaturic hormone and inhibitor of calcitriol synthesis. It is associated with vascular calcifications. Matrix-metalloproteinases (e.g. MMP-2, MMP-9) are proteolytic, proinflammatory enzymes, contributing to myocardial remodelation. Placental growth factor (PlGF) is a proangiogenic cytokine that is associated with LV hypertrophy in animal model. Plasmatic FGF23, MMPs and PlGF are elevated in CKD. Aim: We aimed to describe dynamic changes between several novel biomarkers of CV risk (FGF23, MMP-2, MMP-9 and PlGF) in CKD stages 1-5, to describe their mutual correlations and possible association with traditional CV risk markers. We studied possible association of laboratory and echocardiographic parameters in patients with CKD stages 2-4. Methods: In a cross-sectional study we evaluated 80 patiens with CKD 1-5 and 44 healthy controls. In a prospective study we evaluated echocardiographic and laboratory parameters in 62 patients with CKD 2-4 for an average study period of 36±10...
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Dental status in handicapped patients
Chleborád, Karel ; Dostálová, Taťjana (advisor) ; Racek, Jaroslav (referee) ; Hanzlíček, Petr (referee)
The information in the medical records serve many purposes: they can be used for diagnosis and therapy, medical documentation contains information that can be the basis for financial authorities for treatment or for pumping reimbursement from health insurance. The data can be used in statistics and other scientific purposes. The aim of study is to verify the simplicity of data process implementation and time of data storing for modification of classical paper WHO dental card, lifetime dental EHR controlled by keyboard and lifetime dental EHR controlled by voice. All three methods were applied on 126 patients. At first the patients were inspected by a standard technique (communication between dentist and nurse) and the data recorded into the paper WHO dental card. The same person recorded all data to lifetime dental EHR using keyboard and using voice. Then we compared the time, which was needed for recording the data using these three methods. Using Friedman test we found very significant differences in time of recording among three methods (p<0.001). We can see that the paper WHO dental card was recorded quickly, but its rise due to missing electronic form is difficult. Times for recording data using keyboard or voice in lifetime dental EHR were not significantly different. The clinical practice...
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Voice controled electronic health record in dentistry
Hippmann, Radek ; Dostálová, Taťjana (advisor) ; Hanzlíček, Petr (referee) ; Racek, Jaroslav (referee)
Title: Voice controlled electronic health record in dentistry Author: MUDr. Radek Hippmann Department: Department of paediatric stomatology, Faculty hospital Motol Supervisor: Prof. MUDr. Taťjana Dostalová, DrSc., MBA Supervisor's e-mail: Tatjana.Dostalova@fnmotol.cz This PhD thesis is concerning with development of the complex electronic health record (EHR) for the field of dentistry. This system is also enhanced with voice control based on the Automatic speech recognition (ASR) system and module for speech synthesis Text-to- speech (TTS). In the first part of the thesis is described the whole issue and are defined particular areas, whose combination is essential for EHR system creation in this field. It is mainly basic delimiting of terms and areas in the dentistry. In the next step we are engaged in temporomandibular joint (TMJ) problematic, which is often ignored and trends in EHR and voice technologies are also described. In the methodological part are described delineated technologies used during the EHR system creation, voice recognition and TMJ disease classification. Following part incorporates results description, which are corresponding with the knowledge base in dentistry and TMJ. From this knowledge base originates the graphic user interface DentCross, which is serving for dental data...
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