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Jiri Heracek

Publications and source records attributed to Jiri Heracek.

3 recordsLinked to original sources

Parallel optimization and genotyping of multiple single-nucleotide polymorphism markers by sample pooling approach using cycling-gradient CE with multiple injections.

Increasing importance of single-nucleotide polymorphisms (SNPs) in determination of disease susceptibility or in prediction of therapy response brings attention of many molecular diagnostic laboratories to simple and low-cost SNP genotyping methodologies. We have recently introduced a mutation detection technique based on analysis of homo- and heteroduplex PCR fragments resolved in cycling temperature gradient conditions on a conventional multicapillary-array DNA sequencer. The main advantage of this technique is in its simplicity with no requirement for sample cleanup prior to the analysis. In this report we present a practical application of the technology for genotyping of SNP markers in two separate clinical projects resulting in a combined set of 44 markers screened in over 500 patients. Initially, a design of PCR primers and conditions was performed for each SNP marker. Then, optimization of CE running conditions (limited just to the proper selection of temperature cycling) was performed on pools of 20 DNA samples to increase the probability of having each of the two allele types represented in the sample. After selecting the optimum conditions, screening of markers in patients was performed using a multiple-injection approach for further acceleration of the sample throughput. The rate of successful optimization of experimental conditions without any pre-selection based on the SNP sequence or melting characteristics was 80% from the initial SNP marker candidates. By studying the failed markers, we attempt to identify critical factors enabling successful typing. The presented technique is very useful for low to medium sized SNP genotyping projects mostly applied in pharmacogenomic research as well as in clinical diagnostics. The main advantages include low cost, simple setup and validation of SNP markers.

Electrophoresis, Capillary↗

Augmentation cystoplasty in patients with multiple sclerosis.

INTRODUCTION: Augmentation cystoplasty is an effective approach to the detrusor hyperreflexia which is refractory to conservative treatment. Sporadic data have been published in patients with progressive diseases such as multiple sclerosis (MS). MATERIALS AND METHODS: Augmentation ileocystoplasty (Goodwin 'cup-patch') was performed in 9 patients (7 females, 2 males). The average Expanded Disability Status Scale score was 4.1 (range 3.0-6.5); 7 patients had relapse-remitting MS and 2 patients secondary-progressive MS. The indication was a detrusor hyperreflexia refractory to conservative treatment in 8 patients and a detrusor hyperrefluxia with third degree bilateral vesico-ureteral reflux and renal insufficiency in 1 patient. Pre- and postoperative objective parameters were evaluated by urodynamic examination, imaging methods and laboratory examination. Subjective evaluation was performed using a questionnaire on micturition symptoms (score 0-5) and on quality of life (score 0-6). RESULTS: With a follow-up of 6-19 months, we recorded an average increase of the maximum detrusor capacity from 105 to 797 ml and decrease of maximum detrusor pressure from 53 to 30 cm H(2)O. Postmicturition residual urine >25% of the maximum capacity was present in 6 patients who performed clear intermittent autocatheterization postoperatively (2 patients preoperatively). In all patients there was a significant improvement in the irritation micturition symptomatology (pollakisuria, nycturia, urgency and urge incontinence) and the quality of life score improved on average from 5 to 0.7. In the case of the patient with renal insufficiency, the creatinine level decreased from 286 to 150 micromol/l; in the other patients renal function remained normal. CONCLUSIONS: Augmentation cystoplasty is a safe and effective method for indicated patients, which significantly enhances their quality of life.

Adult↗

[Association between neurologic involvement and lower urinary tract dysfunction and their symptoms in patients with multiple sclerosis].

OBJECTIVE: To establish an association between different types and degrees of neurological involvement and lower urinary tract dysfunctions and their symptoms in patients with multiple sclerosis. PATIENTS AND METHODS: The studied group comprises 84 patients with multiple sclerosis with an average of 42.1 years in whom neurological and urological functional involvement had been evaluated. Neurological involvement had been evaluated using Expanded Disability Status Scale (EDSS) score; urinary tract dysfunctions have been diagnosed by urodynamic examinations and lower urinary tract symptoms (LUTS) using the micturition questionnaire. RESULTS: 1) An association between neurological involvement and lower urinary tract dysfunctions: detrusor hyperreflexia depends on the degree of pyramidal system involvement and the presence of detrusor-sphincter dyssynergia depends on overall disability and the degree of pyramidal system involvement. 2) An association between lower urinary tract dysfunctions and LUTS: obstructive symptoms depend on the presence of detrusor-sphincter dyssynergia. 3) An association between neurological involvement and LUTS has not been established. CONCLUSION: An association between neurological involvement, lower urinary tract dysfunctions and their symptoms has been found. Based on this knowledge, it is possible to simplify the diagnostic and therapeutic approaches in certain groups of patients.

Persons with Disabilities↗