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Thoracic aorta wall pathology: diagnosis, stentgraft placement, indications, strategy and procedure technique, clinical results
Novotný, Jiří ; Krajina, Antonín (advisor) ; Chochola, Miroslav (referee) ; Roček, Miloslav (referee)
Thoracic aorta wall pathology: diagnosis, stentgraft placement, indications, strategy and procedure technique, clinical results Aim. Our single-center study was designed to assess management of thoracic aorta using a stent graft in individual types of pathology. While focused on the technical success rates and efficacy of management, the study also sought to document the incidence of intra- procedural complications and to assess the rate of sac growth and endoleak incidence. Method. A total of 86 patients with thoracic aorta disease were treated using a stent graft over a period of 12 years. They were 24 women and 62 men with a mean age 58.5 years. Late CT follow-up was performed in 75 patients, 31 (36%) were lost to follow-up, most (25) patients died. The most frequent reason (50%) for treatment included size of the aneurysmal sac, with progressive sac growth accounting for 19%. Results. Complications were rare, with most serious ones including 6 cases (7%) of hemorrhage, 3 fatal cases, with the other cases (peripheral bleeding) managed by a surgeon. Primarily intractable endoleak documented by DSA was observed in 9 treated patients (10%). The most frequent CT-documented endoleak was Type I endoleak diagnosed in 18 treated patients (20%). Spontaneous endoleak regression was demonstrated in 6...
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Vascular access for hemodialysis and hemodynamics
Válek, Martin ; Lopot, František (advisor) ; Malík, Jan (referee) ; Roček, Miloslav (referee)
The study is based on the program of monitoring of the state of surgically created vascular accesses by measuring the vascular access blood flow (QVA). Besides the comprehensive analysis of factors influencing the value of QVA it discussed in detail hemodynamic changes caused by the presence of non-physiological arteriovenous anastomosis. The study is based on data acquired in the course of more than 10 years during which this program has been routinely used and is based on data from 506 patients with a total of 4,296 measurements of QVA. In patients, QVA is significantly inter- and intraindividually variable. QVA is significantly influenced by multiple factors and corresponds also to the overall health of the patient. No simple factor has been proven to predominantly influence QVA. The study points out the significant long-term physiological variability of QVA (23%) as a parameter that was not taken into account despite its importance in deciding on the correct indication of radiological interventions. The study also analyzes the strong correlation between QVA and cardiac output. It brings a new method of evaluation of the influence of vascular access on myocardium through a calculation of the load of left ventricle and shows that there is a strong non-linear dependency between the flow and the...
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Dental care of patients after surgical therapy of inborn oro-facial clefts 3D technologies in diagnostics and therapy of cleft patients
Kašparová, Magdaléna ; Dostálová, Taťjana (advisor) ; Mazánek, Jiří (referee) ; Roček, Miloslav (referee)
Patients with orofacial defects, inborn or acquired, isolated or in combination with other handicaps in syndroms, suffer from various problems including psychological problems. Morphological changes within these handicaps burden not only the patients themselves, but also their families. Among the main problems are difficulties with feeding, speech or breathing. Anomalies in number or position of deciduous and permanent teeth, development of jaws and dental arches are often present. Multidisciplinary aproach is necessary when solving all of the tasks and the multidiciplinary team consits of experts from field of plastic surgery, foniatry, speach therapist, dentist and oral surgeons. Surgical therapy involves early primary reconstruction of cleft lip and causes necessity of very detailed therapy planing and evaluation. It is very important to create systematic aproach to dental care including valuace diagnostic methods. In the work presented there will be variol methods of diagnosis and evaluation of the treatment introduced with the aim of evaluating modern methods including 3D printing and digital technologies and a valid alternative to traditional methods (plaster casts). Key words: 3D printing, cleft lip and palate, dentistry
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Translumbar Central Venous Hemodialysis Catheters
Jonszta, Tomáš ; Krajina, Antonín (advisor) ; Roček, Miloslav (referee) ; Michálek, Pavel (referee)
Translumbar Central Venous Hemodialysis Catheters Aim: Hemodialysis catheter translumbal placement enables high quality venous access in patients with exhausted usual venous routes. The aim of this study is to evaluate technical success of catheter insertion and long-term patency of translumbar hemodialysis catheters (TLC) and to compare the results with standard tunnelized hemodialysis catheters inserted via internal jugular vein (SC). Material and methods: Between 2010 and 2018 translumbar dialysis catheter (TLC) was inserted in 37 patients in whom occlusion of internal jugular and brachiocephalic veins precluded standard implantation route. 17 (45,9 %) men and 20 (54,1 %) women were treated with age median 64,0 years, range 41-89 years. The TLC patients were compared with standard tunnelized heamodialysis internal jugular catheter patients (SC), in whom procedures were performed in the same time period. SC was placed in 196 patients, 113 (57,7 %) men and 83 (42,3 %) women, with age median 68,5 years, range 16-91 years. Results: The total time of follow up for the TLC patients was 1-2097 days with median 673 days, while the follow up for the SC pacients was 1-2915 days with median 310 days. Technical success rate for the insertion was 97,4 % in the TLC group and 98,6 % in the SC group. Periprocedural...
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The impact and comparison of imaging methods in prenatal diagnosis of congenital defects
Frisová, Veronika ; Roček, Miloslav (advisor) ; Eliáš, Pavel (referee) ; Vaněčková, Manuela (referee)
Traditional two-dimensional (2D) ultrasound has been and remains the mainstay of prenatal screening and diagnosis of congenital structural abnormalities. However, real clinical impact of the newer innovative methods (3D/4D ultrasound and MRI) remains to be unclear. The aim of this study is to evaluate the impact of combined examination by ultrasound and fetal magnetic resonance on prenatal diagnosis of congenital defects and optimization of perinatal management. Both imaging methods were in our department performed on the same day by a single operator specialized in fetal medicine. Therefore, another aim of this study was to compare the importance of 2D and 3D/4D ultrasound and magnetic resonance for exactness of the prenatal diagnosis of congenital defects. 212 pregnancies were examined. 89% of patients were referred for abnormal or suspicious finding at local ultrasound examination and 11% for an increased risk of congenital defects due to an abnormal family history or an abnormal result of previous laboratory testing. Detailed postnatal diagnosis was successfully retrieved in 113 (53%) of referred pregnancies. Only this group of pregnancies with known detailed postnatal diagnosis was used for the evaluation of the impact of combined imaging by ultrasound and magnetic resonance on prenatal diagnosis of...
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Translumbar Central Venous Hemodialysis Catheters
Jonszta, Tomáš ; Krajina, Antonín (advisor) ; Roček, Miloslav (referee) ; Michálek, Pavel (referee)
Translumbar Central Venous Hemodialysis Catheters Aim: Hemodialysis catheter translumbal placement enables high quality venous access in patients with exhausted usual venous routes. The aim of this study is to evaluate technical success of catheter insertion and long-term patency of translumbar hemodialysis catheters (TLC) and to compare the results with standard tunnelized hemodialysis catheters inserted via internal jugular vein (SC). Material and methods: Between 2010 and 2018 translumbar dialysis catheter (TLC) was inserted in 37 patients in whom occlusion of internal jugular and brachiocephalic veins precluded standard implantation route. 17 (45,9 %) men and 20 (54,1 %) women were treated with age median 64,0 years, range 41-89 years. The TLC patients were compared with standard tunnelized heamodialysis internal jugular catheter patients (SC), in whom procedures were performed in the same time period. SC was placed in 196 patients, 113 (57,7 %) men and 83 (42,3 %) women, with age median 68,5 years, range 16-91 years. Results: The total time of follow up for the TLC patients was 1-2097 days with median 673 days, while the follow up for the SC pacients was 1-2915 days with median 310 days. Technical success rate for the insertion was 97,4 % in the TLC group and 98,6 % in the SC group. Periprocedural...
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Management and imaging of bronchopulmonary malformations in children
Kynčl, Martin ; Roček, Miloslav (advisor) ; Eliáš, Pavel (referee) ; Heřman, Miroslav (referee)
Background Bronchopulmonary malformations (BPMs) consists of a broad spectrum of developmental abnormalities, ranging from abnormal lung with normal vasculature to abnormal vasculature with normal lungs and lesions with both parenchymal and vascular abnormalities. Terminology remains a problem, the use of descriptive approach is strongly supported in practice. The aim of our study was to assess the accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in classifying the different types of BPMs and to correlate this imaging with pathologic finding. Materials and methods We identified 24 patients reffered to our institution between years 2010 and 2015 with prenatal ultrasound (US) diagnosis of BPM, who had undergone surgical resection. Postnatal chest CT scans and fetal MRI of these patients formed the basis of our retrospective study. Two radiologists blinded to the histopathological results rewieved all CT and fetal MRI scans. Detected lesions were classified by predetermined criteria. These data were correlated with histopathological results. Results The significant diagnosis overlap of 71% (17 cases out of 24) between the CT and histology was observed. The significant diagnosis overlap between MRI and histology was observed of 80 % (8 cases out of 10). The diagnosis overlap of...
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Thoracic aorta wall pathology: diagnosis, stentgraft placement, indications, strategy and procedure technique, clinical results
Novotný, Jiří ; Krajina, Antonín (advisor) ; Chochola, Miroslav (referee) ; Roček, Miloslav (referee)
Thoracic aorta wall pathology: diagnosis, stentgraft placement, indications, strategy and procedure technique, clinical results Aim. Our single-center study was designed to assess management of thoracic aorta using a stent graft in individual types of pathology. While focused on the technical success rates and efficacy of management, the study also sought to document the incidence of intra- procedural complications and to assess the rate of sac growth and endoleak incidence. Method. A total of 86 patients with thoracic aorta disease were treated using a stent graft over a period of 12 years. They were 24 women and 62 men with a mean age 58.5 years. Late CT follow-up was performed in 75 patients, 31 (36%) were lost to follow-up, most (25) patients died. The most frequent reason (50%) for treatment included size of the aneurysmal sac, with progressive sac growth accounting for 19%. Results. Complications were rare, with most serious ones including 6 cases (7%) of hemorrhage, 3 fatal cases, with the other cases (peripheral bleeding) managed by a surgeon. Primarily intractable endoleak documented by DSA was observed in 9 treated patients (10%). The most frequent CT-documented endoleak was Type I endoleak diagnosed in 18 treated patients (20%). Spontaneous endoleak regression was demonstrated in 6...
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Dental care of patients after surgical therapy of inborn oro-facial clefts 3D technologies in diagnostics and therapy of cleft patients
Kašparová, Magdaléna ; Dostálová, Taťjana (advisor) ; Mazánek, Jiří (referee) ; Roček, Miloslav (referee)
Patients with orofacial defects, inborn or acquired, isolated or in combination with other handicaps in syndroms, suffer from various problems including psychological problems. Morphological changes within these handicaps burden not only the patients themselves, but also their families. Among the main problems are difficulties with feeding, speech or breathing. Anomalies in number or position of deciduous and permanent teeth, development of jaws and dental arches are often present. Multidisciplinary aproach is necessary when solving all of the tasks and the multidiciplinary team consits of experts from field of plastic surgery, foniatry, speach therapist, dentist and oral surgeons. Surgical therapy involves early primary reconstruction of cleft lip and causes necessity of very detailed therapy planing and evaluation. It is very important to create systematic aproach to dental care including valuace diagnostic methods. In the work presented there will be variol methods of diagnosis and evaluation of the treatment introduced with the aim of evaluating modern methods including 3D printing and digital technologies and a valid alternative to traditional methods (plaster casts). Key words: 3D printing, cleft lip and palate, dentistry
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The impact and comparison of imaging methods in prenatal diagnosis of congenital defects
Frisová, Veronika ; Roček, Miloslav (advisor) ; Eliáš, Pavel (referee) ; Vaněčková, Manuela (referee)
Traditional two-dimensional (2D) ultrasound has been and remains the mainstay of prenatal screening and diagnosis of congenital structural abnormalities. However, real clinical impact of the newer innovative methods (3D/4D ultrasound and MRI) remains to be unclear. The aim of this study is to evaluate the impact of combined examination by ultrasound and fetal magnetic resonance on prenatal diagnosis of congenital defects and optimization of perinatal management. Both imaging methods were in our department performed on the same day by a single operator specialized in fetal medicine. Therefore, another aim of this study was to compare the importance of 2D and 3D/4D ultrasound and magnetic resonance for exactness of the prenatal diagnosis of congenital defects. 212 pregnancies were examined. 89% of patients were referred for abnormal or suspicious finding at local ultrasound examination and 11% for an increased risk of congenital defects due to an abnormal family history or an abnormal result of previous laboratory testing. Detailed postnatal diagnosis was successfully retrieved in 113 (53%) of referred pregnancies. Only this group of pregnancies with known detailed postnatal diagnosis was used for the evaluation of the impact of combined imaging by ultrasound and magnetic resonance on prenatal diagnosis of...
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