How Much Evidence do we have on the Central Effects of Botulinum Toxin in Spasticity and Dystonia?

The brain is continually reorganizing (plasticity). Plastic changes within the sensorimotor system are not only beneficial (adaptive plasticity) but may even worsen function (maladaptive plasticity). Conditions such as dystonia and poststroke spasticity (PSS) that interfere with motor performance could be attributed to maladaptive plasticity. Botulinum toxin (BoNT) has been proven to be safe and effective in treating various hyperfunctional cholinergic states. Beside the well-known neuromuscular junction site of action, BoNT also exerts effects through supraspinal mechanisms and can even affect cortical reorganization. The hypothesis of central reorganization following BoNT treatment has been supported by studies using neurophysiological and imaging methods in patients with focal dystonia and PSS. The growing evidence of BoNT-related central (remote) effects make BoNT injections a promising tool to favorably affect maladaptive changes even at the cortical level

Intravenous Thrombolysis in Posterior Circulation Stroke

Background: Intravenous thrombolysis (IVT) is a standard treatment for both anterior circulation ischemic stroke (ACIS) and posterior circulation ischemic stroke (PCIS). PCIS is a clinical syndrome associated with ischemia-related changes in the territory of the posterior circulation arteries. Embolism is the most common stroke mechanism in posterior circulation. PCIS represents 12–19% of all IVT-treated strokes.Methods and Results: We searched the PubMed database for assessments of intracerebral hemorrhage (ICH) and clinical outcome in PCIS patients treated with IVT. ICH occurs in 0–6.9% of posterior ischemic stroke depending on the definition of symptomatic ICH, and any ICH in 17–23.4% of posterior ischemic stroke. For patients with PCIS, 38–49% have a favorable outcome (mRS 0–1) after IVT. Better clinical outcomes occur more often in patients with PCIS than in those with ACIS. The mortality rate among PCIS patients treated with IVT ranges from 9 to 19%; it does not differ significantly between PCIS and ACIS.Conclusions: Up to date, no data about PCIS and IVT are available from RTCs. Based on limited results from retrospective clinical studies and case series, IVT is safer for use in PCIS than in ACIS. Patients with brainstem ischemia, vertebral artery occlusion, and absence of basilar or posterior cerebral artery occlusion could be considered for treatment with IVT even in borderline cases. Time to IVT in PCIS seems to be a less crucial factor than in ACIS. IVT for PCIS may be beneficial even after 4.5 h from symptom onset

Contrast-induced acute kidney injury and its contemporary prevention

The complexity and application range of interventional and diagnostic procedures using contrast media (CM) have recently increased. This allows more patients to undergo procedures that involve CM administration. However, the intrinsic CM toxicity leads to the risk of contrast-induced acute kidney injury (CI-AKI). At present, effective therapy of CI-AKI is rather limited. Effective prevention of CI-AKI therefore becomes crucially important. This review presents an in-depth discussion of CI-AKI incidence, pathogenesis, risk prediction, current preventive strategies, and novel treatment possibilities. The review also discusses the difference between CI-AKI incidence following intraarterial and intravenous CM administration. Factors contributing to the development of CI-AKI are considered in conjunction with the mechanism of acute kidney damage. The need for ultimate risk estimation and the prediction of CI-AKI is stressed. Possibilities of CI-AKI prevention is evaluated within the spectrum of existing preventive measures aimed at reducing kidney injury. In particular, the review discusses intravenous hydration regimes and pre-treatment with statins and N-acetylcysteine. The review further focuses on emerging alternative imaging technologies, alternative intravascular diagnostic and interventional procedures, and new methods for intravenous hydration guidance; it discusses the applicability of those techniques in complex procedures and their feasibility in current practise. We put emphasis on contemporary interventional cardiology imaging methods, with a brief discussion of CI-AKI in non-vascular and non-cardiologic imaging and interventional studies

Modern Trends in the Field of Traction Batteries

Import 26/06/2013Bakalářská práce je zaměřena na popis vlastností a aplikačních možností akumulátorů. V úvodu práce je vytvořen ucelený přehled nejrozšířenějších akumulátorů, přičemž největší pozornosti je věnováno lithiovým akumulátorům. Na základě celkového zhodnocení vlastností akumulátorů je možné vybrat nejvhodnější typ pro dané aplikace. V této práci jsou pro tři konkrétní aplikace vybrány nejvhodnější akumulátory z hlediska vlastností a v samotném závěru práce jsou pro tyto tři aplikace vypočítány potřebné parametry akumulátoru.The bachelor’s thesis is focused on the description of the properties and application possibilities of batteries. In the introduction is created a comprehensive overview of the most widely used batteries, where the greatest attention is paid to the lithium batteries. On the basis of an overall assessment of the preformance of the battery it is possible to choose the best type for your application. In this work are selected the most appropriate batteries for three specific applicaions in terms of features and in the final paper there are calculated required parameters of battery for these three applications.430 - Katedra elektronikyvýborn

The Design of the Medium-frequency SiC Semiconductor Converter for Usage in Photovoltaic Application

Import 22/07/2015Diplomová práce se zaměřuje na návrh a realizaci výkonového zvyšujícího DC/DC měniče pro využití ve fotovoltaice s použitím moderních SiC polovodičových prvků. V úvodu práce je snahou vytvořit podrobný popis stávajícího fotovoltaického systému v Technologickém centru Ostrava Vítkovice včetně popisu DC/DC měničů. Následně je vytvořen model a provedena simulace zvyšujícího DC/DC měniče v programu LTspice se zaměřením na porovnání účinností Si a SiC spínacích prvků. Z výsledků simulace je navrženo konstrukční řešení měniče, které je následně fyzicky realizováno a experimentálním měřením otestováno. V závěru práce je vytvořen konstrukční návrh měniče v 3D CAD systému Autodesk Inventor a vytvořena výkresová dokumentace pro pozdější malosériovou výrobu.The diploma thesis focuses on a design and realization of performance-enhancing DC/DC converter for use in photovoltaics while using the modern Sic semiconductor elements. The introduction of the thesis attempts to provide a detailed description of the existing photovoltaic system at the Technology Centre of Ostrava Vítkovice including a description of the DC/DC converters. Subsequently, a model is created and a simulation of increasing DC/DC converter in the LTspice program focused on a comparison of the effects of Si and SiC switching elements is carried out. A structural solution of converter based on the results of simulation is designed there and it is subsequently physically realized and tested by an experimantal meassuring. The conclusion provides a structural design of the converter in 3D CAD Autodesk Inventor system and a drawing documentation is created for a future small series production.430 - Katedra elektronikyvýborn

The Central Effects of Botulinum Toxin in Dystonia and Spasticity

In dystonic and spastic movement disorders, however different in their pathophysiological mechanisms, a similar impairment of sensorimotor control with special emphasis on afferentation is assumed. Peripheral intervention on afferent inputs evokes plastic changes within the central sensorimotor system. Intramuscular application of botulinum toxin type A (BoNT-A) is a standard evidence-based treatment for both conditions. Apart from its peripheral action on muscle spindles, a growing body of evidence suggests that BoNT-A effects could also be mediated by changes at the central level including cerebral cortex. We review recent studies employing electrophysiology and neuroimaging to investigate how intramuscular application of BoNT-A influences cortical reorganization. Based on such data, BoNT-A becomes gradually accepted as a promising tool to correct the maladaptive plastic changes within the sensorimotor cortex. In summary, electrophysiology and especially neuroimaging studies with BoNT-A further our understanding of pathophysiology underlying dystonic and spastic movement disorders and may consequently help develop novel treatment strategies based on neural plasticity

Cytokinin Plant Hormones Have Neuroprotective Activity in In Vitro Models of Parkinson’s Disease

Cytokinins are adenine-based phytohormones that regulate key processes in plants, such as cell division and differentiation, root and shoot growth, apical dominance, branching, and seed germination. In preliminary studies, they have also shown protective activities against human neurodegenerative diseases. To extend knowledge of the protection (protective activity) they offer, we investigated activities of natural cytokinins against salsolinol (SAL)-induced toxicity (a Parkinson’s disease model) and glutamate (Glu)-induced death of neuron-like dopaminergic SH-SY5Y cells. We found that kinetin-3-glucoside, cis-zeatin riboside, and N6-isopentenyladenosine were active in the SAL-induced PD model. In addition, trans-, cis-zeatin, and kinetin along with the iron chelator deferoxamine (DFO) and the necroptosis inhibitor necrostatin 1 (NEC-1) significantly reduced cell death rates in the Glu-induced model. Lactate dehydrogenase assays revealed that the cytokinins provided lower neuroprotective activity than DFO and NEC-1. Moreover, they reduced apoptotic caspase-3/7 activities less strongly than DFO. However, the cytokinins had very similar effects to DFO and NEC-1 on superoxide radical production. Overall, they showed protective activity in the SAL-induced model of parkinsonian neuronal cell death and Glu-induced model of oxidative damage mainly by reduction of oxidative stress