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The Problems of Craniocerebrals Injury in Intensive Care
Jašek, Kamil ; Bartůněk, Petr (advisor) ; Kozler, Petr (referee)
The topic of this Thesis is the intensive care of patiens suffering from a craniocerebral Injury, such injuries contributing to high mortality and morbidity in patiens with trumas. The theoretical part of this Thesis gives a brief outline of the anatomy and physiology of the head and goes into a greater detail into the kinds of injuries, their symptoms, diagnostics, and treatment. The empiricical part hereof is produced in the form of case study and focuses on the intensive care of patients so injured. The chosen patient in the case was a jung man after a traffic accident who had suffered from a very serious craniocerabral injury. Monitored is his hospitalization from his reception to his release from the AR ward. The tenth day hospitalization is dealt with in detail.
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Consequences of early ischemic hippocampal lesion in rats
Mátéffyová, Adela ; Kubová, Hana (advisor) ; Mareš, Jan (referee) ; Brázdil, Milan (referee) ; Kozler, Petr (referee)
Stroke is an important cause of neurological morbidity in infants and children, with an incidence of approximately 8 cases per 100000 per year (Giroud et af. 1995). In chi ldren, stroke is often under-recognized/unrecognized because of variation in the presentation, evaluation, and diagnosis. In many cases, asyrnmetry of reaching and grasping, failure to reach developmental milestones, or post-neonatal seizures that appear some months after the acute event are the only mark of previous stroke. Powered by TCPDF (www.tcpdf.org)
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název v anglickém jazyce není uveden
Benešová, Petra ; Langmeier, Miloš (advisor) ; Hach, Petr (referee) ; Kozler, Petr (referee)
Using hislochemical analysis (NADPH-diaphorase) we have been investigating the influence of intraperitoneal administration of kainic acid, hypoxia and combination of both these factors on neurons of the hippocampus and on the primary auditory cortex in male rats of the Wistar strain. Kainic acid was administered to 12-day-old and I8-day-old animals, which were exposed to long-lasting repeated hypoxia from the 2nd till the 17th day of age in a hypobaric chamber (for 8 hours a day). At the age of 22, 90 and 365 days, the animals were transcardially perfused with 4% paraformaldehyde under deep thiopental anesthesia. Cryostate sections were stained to identify NADPH-d positive neurons that were then quantified in CA1 and CA3 areas of the hippocampus, in the hilus, dorsal and ventral blade of the dentate gyrus and in the primary auditory cortex. In 22-day-old animals with kainic acid administered 18th day of life both hypoxia and kainic acid increased the number of NADPH-d positive neurons in the hilus, CA1 and CA3 areas of the hippocampus and in the primary auditory cortex. On the contrary, kainic acid given to the hypoxic animals lowered the number of NADPH-d positive neurons in the dentate gyrus. In 90-day-old animals with kainic acid administered 18th day of life hypoxia and kainic acid given to both,...
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Functional assessment of motor activities of patients after brain damage before and after intensive rehabilitation intervention (with the goal to obtain restoration of upper arm physiological functions)
Sládková, Petra ; Švestková, Olga (advisor) ; Jeřábek, Jaroslav (referee) ; Kozler, Petr (referee)
6 Abstract The rehabilitation of patients with brain damage is an interprofessional, complex, intensive, long-lasting and individually oriented process. One frequent consequence of brain damage is hemiparesis, which also causes a disorder of the upper extremity movement pattern. The movement ability of the upper extremity is essential for an individual's self-sufficiency, the performance of common daily activities, and thus for an independent life in a family setting. Special therapeutic rehabilitation approaches should involve the training of new activities, including the motor learning mechanism that activates brain plasticity. A functional reorganization of the motor cortex occurs along with the activation of reserve neurons and the replacement of damaged synapses. One of the aims of this work was to demonstrate, using objective function methods, the possibility of influencing the movement patterns of a paretic upper extremity by means of intensive interprofessional rehabilitation even several years after the brain damage. The second aim was to demonstrate that the monitoring of motor functions in patients after brain damage leads to improved motivation, thereby improving motor functions. A study was conducted among 55 selected patients after brain damage with central hemiparesis who participated in the...
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Use of a visual biofeedback in the movement patterns recovery by patients with the central paresis
Gueye, Tereza ; Angerová, Yvona (advisor) ; Smrčka, Václav (referee) ; Kozler, Petr (referee)
We evaluated the effectiveness of two virtual reality therapies (VRT) with visual biofeedback, Armeo Spring® upper limb exoskeleton (Armeo) and Homebalance® interactive system (Homebalance), in early post-stroke rehabilitation. Using a randomized controlled study design, participants within 30 days after stroke with arm paresis (Armeo study) or with balance problem (Homebalance study) were assigned either to the respective intervention group (Armeo IG n=25; mean age 66.5 years, and Homebalance IG n=25; mean age 69.6 years) performing VRT instead of conventional physiotherapy or to the control group (Armeo CG, n=25, mean age 68.1 years, and Homebalance CG, n=25, mean age 65.9 years) having conventional physiotherapy only. Montreal Cognitive Assessment (MoCA), Functional Independence Measure (FIM), Fugl Mayer Assessment-Upper Extremity Scale (FMA-UE), Modified Rivermead Mobility Index (m-RIM) and Berg Balance Scale (BBS) were performed before and after the 3-week therapy with 12 therapies. Results of participants <65 and ≥65 years old were compared. Acceptance of both VRTs was evaluated by self-rated questionnaire. In the Armeo study, paretic upper arm function improved significantly in both IG and CG groups, the improvement in FMA-UE was significantly higher in Armeo IG as compared to CG (p=0.02)...
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Neurorehabilitation after brain injury. Therapeutic possibilities.
Angerová, Yvona ; Lippertová-Grünerová, Marcela (advisor) ; Jeřábek, Jaroslav (referee) ; Kozler, Petr (referee)
Neurorehabilitation is a multidisciplinary rehabilitation process used in patients with neurological diseases. These patients have not only movement disorders but also cognitive and neurobehavioral problems as well as aphasias. Their rehabilitation is a long term process and the results are often unsatisfactory. Neuroplasticity - physiological basis for neurorehabilitation induces functional restitution or recovery after secondary brain damage. Various neuroprotective substances (e.g. erythropoietin - EPO) are tested to empower mechanisms of plasticity after brain injury. Preclinical studies testing efficacy of those substances in animal brain damage models are essential to prepare clinical trials. The aim of the study was to reveal the influence of EPO combined with rehabilitation on functional outcomes after global cerebral hypoxia. FIM (Functional independence measure) test was used for functional evaluation and Meilli test for visual memory of the patients who attended special program for rehabilitation in clinical part. Patients who came earlier had better prognosis than patients who came later. In experimental part three-months old male Wistar albino rats were exposed to hypobaric hypoxia for 60 minutes in an experimental chamber, simulating an altitude of 8000 m. Half of the animals received...
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Functional assessment of motor activities of patients after brain damage before and after intensive rehabilitation intervention (with the goal to obtain restoration of upper arm physiological functions)
Sládková, Petra ; Švestková, Olga (advisor) ; Jeřábek, Jaroslav (referee) ; Kozler, Petr (referee)
6 Abstract The rehabilitation of patients with brain damage is an interprofessional, complex, intensive, long-lasting and individually oriented process. One frequent consequence of brain damage is hemiparesis, which also causes a disorder of the upper extremity movement pattern. The movement ability of the upper extremity is essential for an individual's self-sufficiency, the performance of common daily activities, and thus for an independent life in a family setting. Special therapeutic rehabilitation approaches should involve the training of new activities, including the motor learning mechanism that activates brain plasticity. A functional reorganization of the motor cortex occurs along with the activation of reserve neurons and the replacement of damaged synapses. One of the aims of this work was to demonstrate, using objective function methods, the possibility of influencing the movement patterns of a paretic upper extremity by means of intensive interprofessional rehabilitation even several years after the brain damage. The second aim was to demonstrate that the monitoring of motor functions in patients after brain damage leads to improved motivation, thereby improving motor functions. A study was conducted among 55 selected patients after brain damage with central hemiparesis who participated in the...
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Clinical findings and diagnosis of vestibular lesions in patiens with vestibular schwannomem
Kalitová, Petra ; Langmeier, Miloš (advisor) ; Šlapák, Ivo (referee) ; Kozler, Petr (referee)
Summary: The aim of our study was diagnosis and rehabilitation of vestibular loss in patients with vestibular schwannoma. In the first part we focused on analysis of a group of patients before resection of vestibular schwannoma, mainly on evaluation of gain of posturography and on optimalisation of diagnostic algorithm of vestibular pathology. Throughout the second experiment, we studied if rehabilitation of postural gait with visual biofeedback will speed up vestibular compensation in patients after resection of vestibular schwannoma. The group consisted of 44 patients, who underwent surgical removal of vestibular schwannoma. Before surgery each patient underwent clinical vestibular examination, electronystagmographic recordings and posturography. In the second part of the study 17 patients from previous group were chosen. These patients underwent rehabilitation and rehabilitation with biofeedback. For evaluation was used independent samples T-test and cross-tabulation. A great number of variables were reduced by factor analysis. For statistical analysis of the group with rehabilitation was used nonparametric Wilcoxon signed rank test. Statistical analysis revealed that the most typical parameter for vestibular pathology is the time of the step quick turn test, which is a part of posturography. We proved...
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Neurorehabilitation after brain injury. Therapeutic possibilities.
Angerová, Yvona ; Lippertová-Grünerová, Marcela (advisor) ; Jeřábek, Jaroslav (referee) ; Kozler, Petr (referee)
Neurorehabilitation is a multidisciplinary rehabilitation process used in patients with neurological diseases. These patients have not only movement disorders but also cognitive and neurobehavioral problems as well as aphasias. Their rehabilitation is a long term process and the results are often unsatisfactory. Neuroplasticity - physiological basis for neurorehabilitation induces functional restitution or recovery after secondary brain damage. Various neuroprotective substances (e.g. erythropoietin - EPO) are tested to empower mechanisms of plasticity after brain injury. Preclinical studies testing efficacy of those substances in animal brain damage models are essential to prepare clinical trials. The aim of the study was to reveal the influence of EPO combined with rehabilitation on functional outcomes after global cerebral hypoxia. FIM (Functional independence measure) test was used for functional evaluation and Meilli test for visual memory of the patients who attended special program for rehabilitation in clinical part. Patients who came earlier had better prognosis than patients who came later. In experimental part three-months old male Wistar albino rats were exposed to hypobaric hypoxia for 60 minutes in an experimental chamber, simulating an altitude of 8000 m. Half of the animals received...
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název v anglickém jazyce není uveden
Milotová, Martina ; Langmeier, Miloš (advisor) ; Kozler, Petr (referee) ; Stárka, Luboslav (referee)
The long-term consumption of ethanol by pregnant or nursing rat mothers results in extensive damage of the hippocampal area in their offspring. The histochemical methods combining bis-benzimide 33342 (Hoechst) and Fluoro-Jade B staining were used to detect ethanol effects on the structure of the rat hippocampus and gyrus dentatus during development and adult age (18, 35, 90 and 360 days old offspring). In all experimental groups, in all analyzed areas, degenerative changes were observed, loss of pyramidal and granular cells and neural cells with segmented nuclei. In animals, whose mothers drunk 20% ethanol, structural changes were more intensive when compared with the group consuming 10% ethanol. The highest density of the degenerating (FJ/B positive) cells was found in 18-days-old animals whose mothers were exposed to 20% ethanol. In the age of 90 and 360 days no degenerating cells were identified in the monitored areas. With respect to the properties of the ethanol and mechanism of its effect we suppose that exposure to ethanol during the perinatal period induced the neural cell loss by apoptotic mechanism. From the results of the work can be concluded: 1. The perinatal exposure to ethanol results in degeneration of neural cells in the hippocampus and gyrus dentatus (working hypothesis I was confirmed)....
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