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Chirurgické modely studia proinflamačního vlivu tukové tkáně v rozvoji aterosklerózy / Surgical models of the study of the pro-inflammatory effect of adipose tissue in the development of atherosclerosisThieme, Filip January 2021 (has links)
Univerzita Karlova v Praze 1. lékařská fakulta Doktorský studijní program Studijní obor: Experimentální chirurgie MUDr. Filip Thieme Název závěrečné práce Chirurgické modely studia proinflamačního vlivu tukové tkáně v rozvoji aterosklerózy Title Surgical models of the study of the pro-inflammatory effect of adipose tissue in the development of atherosclerosis Typ závěrečné práce Disertační Školitel: doc. MUDr. Jiří Froněk, Ph.D., FRSC Konzultant doc. MUDr. Libor Janoušek, Ph.D. Klinika transplantační chirurgie, IKEM Praha, 2021 Abstract Background: Atherosclerosis is a serious inflammatory systemic disease. Surgery mainly addresses its vascular complications. Conversely, surgery may also lead to the development and acceleration of atherosclerosis, e.g., in a living kidney donor. This would especially be the case in a donor who meets internationally recognized donation criteria but suffers from metabolic syndrome. The effort to refine assessments of living kidney donors in terms of eliminating the risk of developing atherosclerosis is a long-term project. Our aim is to determine risk factors for living kidney donors and to prevent long-term complications after donation. Collecting tissue from a living donor involves not oly subcutaneous tissue (SCAT) but also visceral (VAT) and perivascular tissue (PVAT),...
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A Study on Endoscopic Live Donor Nephrectomy and Elevated Intraperitoneal PressureLindström, Pernilla January 2002 (has links)
<p>Live donor nephrectomy (LDN) is a unique surgical challenge where surgery is performed on healthy individuals. It is of great importance to keep the morbidity of donors as low as possible, as well as harvesting a kidney in optimal condition. Lowering morbidity is the motive for introducing the endoscopic technique in LDN. Oliguria and impaired kidney function can, however, be seen during pneumoperitoneum and endoscopic LDN have been criticized for not yet being proven safe enough.</p><p>The aims of this study were to investigate the changes in renal function during elevated intraabdominal pressure (IAP) in donors and rats and to evaluate donor morbidity and safety of the new endoscopic techniques compared to the open LDN.</p><p>In two studies, a rat model was used. It was found that elevation of IAP diminished glomerular filtration rate (GFR). Cardiac output (CO) and renal blood flow decreased as well. Elevation of IAP activates the renin system and aldosterone was increased. Acute angiotensin II receptor 1 blockade (candesartan) treatment lowered blood pressure significantly and impaired renal function during elevated IAP. Volume expansion prior to, and during, pneumoperitoneum reduces the deleterious effects on renal function.</p><p>Three studies on kidney live donors show that traditional laparoscopic surgery (TLS) takes longer time to perform than open LDN. Hand-assistance facilitates the operation and increases the safety margin as well as shortens the operation by 27% compared to TLS. Evaluation of a hand-assisted retroperitoneoscopy (HARS), performed for the first time ever in Uppsala 2001, show that the operation is short and safe, the donors experience little pain and the renal function is favourable compared to open surgery, TLS and hand-assisted transperitoneal laparoscopic approaches.</p><p>In conclusion, the results indicate that elevated IAP decreases GFR due to decreased CO and activation of the RAAS, which can be avoided with adequate hydration. Endoscopy can be facilitated if hand-assistance is applied and in particular hand-assisted retroperitoneoscopic nephrectomy shows advantages for the donor.</p>
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A Study on Endoscopic Live Donor Nephrectomy and Elevated Intraperitoneal PressureLindström, Pernilla January 2002 (has links)
Live donor nephrectomy (LDN) is a unique surgical challenge where surgery is performed on healthy individuals. It is of great importance to keep the morbidity of donors as low as possible, as well as harvesting a kidney in optimal condition. Lowering morbidity is the motive for introducing the endoscopic technique in LDN. Oliguria and impaired kidney function can, however, be seen during pneumoperitoneum and endoscopic LDN have been criticized for not yet being proven safe enough. The aims of this study were to investigate the changes in renal function during elevated intraabdominal pressure (IAP) in donors and rats and to evaluate donor morbidity and safety of the new endoscopic techniques compared to the open LDN. In two studies, a rat model was used. It was found that elevation of IAP diminished glomerular filtration rate (GFR). Cardiac output (CO) and renal blood flow decreased as well. Elevation of IAP activates the renin system and aldosterone was increased. Acute angiotensin II receptor 1 blockade (candesartan) treatment lowered blood pressure significantly and impaired renal function during elevated IAP. Volume expansion prior to, and during, pneumoperitoneum reduces the deleterious effects on renal function. Three studies on kidney live donors show that traditional laparoscopic surgery (TLS) takes longer time to perform than open LDN. Hand-assistance facilitates the operation and increases the safety margin as well as shortens the operation by 27% compared to TLS. Evaluation of a hand-assisted retroperitoneoscopy (HARS), performed for the first time ever in Uppsala 2001, show that the operation is short and safe, the donors experience little pain and the renal function is favourable compared to open surgery, TLS and hand-assisted transperitoneal laparoscopic approaches. In conclusion, the results indicate that elevated IAP decreases GFR due to decreased CO and activation of the RAAS, which can be avoided with adequate hydration. Endoscopy can be facilitated if hand-assistance is applied and in particular hand-assisted retroperitoneoscopic nephrectomy shows advantages for the donor.
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Non-Contrast-Enhanced Magnetic Resonance Venography using Magnetization-Prepared Rapid Gradient-Echo in the Preoperative Evaluation of Living Liver Donor Candidates: Comparison with Conventional Computed Tomography Venography / MPRAGE法を用いた非造影MR Venographyによる生体肝移植ドナー候補者の術前評価:従来法であるCT Venographyとの比較Yamashita, Rikiya 23 May 2017 (has links)
京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20564号 / 医博第4249号 / 新制||医||1022(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 増永 慎一郎, 教授 妹尾 浩, 教授 鈴木 実 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM
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A selection of constitutional perspectives on human kidney salesVenter, Bonnie 13 November 2012 (has links)
There are thousands of desperate people globally who need a kidney for
transplantation. The number of people who require a kidney transplant continues to
escalate faster than the number of kidneys available for a transplant. The aim of this
dissertation is to examine and analyse the judicial framework pertaining to kidney
transplants in South Africa. The examination is conducted within the framework of the
South African Constitution and the National Health Act 61 of 2003. The specific focus of
this dissertation is to determine whether the payment of kidney donors could be
regarded as constitutionally acceptable. A comparative study is undertaken, with
Singapore and Iran as a background against which recommendations for the South
African regulatory framework are made. The most important finding is that people should
at least be granted the choice whether they would prefer to receive payment for their
kidney donations or not. / Jurisprudence / LL.M.
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A selection of constitutional perspectives on human kidney salesVenter, Bonnie 13 November 2012 (has links)
There are thousands of desperate people globally who need a kidney for
transplantation. The number of people who require a kidney transplant continues to
escalate faster than the number of kidneys available for a transplant. The aim of this
dissertation is to examine and analyse the judicial framework pertaining to kidney
transplants in South Africa. The examination is conducted within the framework of the
South African Constitution and the National Health Act 61 of 2003. The specific focus of
this dissertation is to determine whether the payment of kidney donors could be
regarded as constitutionally acceptable. A comparative study is undertaken, with
Singapore and Iran as a background against which recommendations for the South
African regulatory framework are made. The most important finding is that people should
at least be granted the choice whether they would prefer to receive payment for their
kidney donations or not. / Jurisprudence / LL.M.
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