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Objective. Gait disturbances causing impaired mobility are common in Parkinson’s disease after bilateral deep brain stimulation of the subthalamic nucleus. We describe subthalamic subregions where neurostimulation had a positive effect on gait or provoked gait disturbances. Methods. Sixty-eight patients were classified according to postoperative gait changes: (1) gait improvement, (2) no change, (3) de novo gait disturbances. We performed a segregation analysis for (1) and (3) by simulating volumes of tissue activated and comparing aggregated spatial data for the two groups and calculated probability maps to forecast gait performance and the parkinsonism control. Results. Twenty patients experienced complete remission of presurgical gait problems after stimulation. Nine patients showed de novo gait disturbances one year post-implantation. Active contacts were more ventrally located for de novo gait disturbances versus gait improvement. Strong correlations were found between clinical alterations in gait and the individual stimulation volume within the probabilistic outcome gait map (R2 = 0.78; p = 0.01), whereby clinical improvement in parkinsonism correlated with individual stimulation volume within the corresponding probabilistic outcome map (R2 = 0.39; p = 0.01). The probabilistic maps predict patients who experience long-term gait benefits based on their volume of tissue activated overlap, which was gait specific and showed no correlation with the global parkinsonism control heatmap. Interpretation. Probabilistic mapping showed high correlation for therapy outcomes, especially gait improvement. The concept of sweet- or badspots could not explain individual differences. The thin delineations between close substructures in the subthalamic nucleus correlated with individual gait changes after neurostimulation. Probabilistic mapping may direct future re-programming approaches for greater mobility in parkinsonian patients.

BACKGROUND: The endothelial glycocalyx (EG) plays a vital role in the physiology and pathophysiology of human microcirculation. Having relevant EG damage model would be important tool for testing new interventions aiming at EG protection and recovery. We describe the first in vivo EG damage model in pig. OBJECTIVE: To investigate the course of animal EG damage induced by specific enzymes. MATERIAL AND METHODS: Four anesthetized piglets received enzymes: 1g hyaluronidase and 25 IU heparanase I intravenously. Blood and urine samples were collected at baseline and 20/40/60/80/100/120 min for detecting markers of endothelial and EG function. Sublingual microcirculation and EG thickness were assessed by Side-stream Dark Field (SDF) imaging and Perfused Boundary Region (PBR) respectively. EG of the mesentery artery was visualized in fluorescent microscopy. RESULTS: Biochemical marker of EG damage syndecan-1 showed temporary increase with return to baseline and was reflected by PBR values. Albumin levels suggested brief period of capillary leakage (decrease in the serum, increase in the urine) with a trend to normalization. Urine glycosaminoglycans peaked at 120 minutes. Microcirculatory perfusion parameter showed significant alteration. Diffusion parameters were altered with no statistical significance. CONCLUSION: EG damage induced by specific enzymes was reflected by temporary changes of biochemical makers together with alteration of microcirculation and changes in fluorescent microscopy of EG layer. Our results support to further validate presented model of EG damage on a larger number of animals.

The paper is focused on the identification, control design, and experimental verification of a two-input two-output hot-air laboratory apparatus representing a small-scale version of appliances widely used in the industry. A decentralized multivariable controller design is proposed, satisfying control-loop decoupling and measurable disturbance rejection. The proposed inverted or equivalent noninverted decoupling controllers serve for the rejection of cross-interactions in controlled loops, whereas open-loop antidisturbance members satisfy the absolute invariance to the disturbances. Explicit controller-structure design formulae are derived, and their equivalence to other decoupling schemes is proven. Three tuning rules are used to set primary controller parameters, which are further discretized. All the control responses are simulated in the Matlab/Simulink environment. In the experimental part, two data-acquisition, communication, and control interfaces are set up. Namely, a programmable logic controller and a computer equipped with the peripheral component interconnect card commonly used in industrial practice are implemented. A simple supervisory control and data acquisition human-machine interface via the Control Web environment is developed. The laboratory experiments prove better temperature control performance measured by integral criteria by 35.3%, less energy consumption by up to 6%, and control effort of mechanical actuator parts by up to 17.1% for our method compared to the coupled or disturbance-ignoring design in practice. It was also observed that the use of a programmable logic controller gives better performance measures for both temperature and air-flow control., Tomas Bata University in Zlin [RVO/CEBIA/2020/001], RVO/CEBIA/2020/001; Univerzita Tomáše Bati ve Zlíně

Background This systematic review discusses a clinical physiology aspect of chloride in fluid therapy. Crystalloid solutions are one of the most widely used remedies. While generally used in medicine for almost 190 years, studies focused largely on their safety have only been published since the new millennium. The most widely used solution, normal saline, is most often referred to in this context. Its excessive administration results in hyperchloremic metabolic acidosis with other consequences, including higher mortality rates. Methods Original papers and review articles eligible for developing the present paper were identified by searching online in the electronic MEDLINE database. The keywords searched for included hyperchloremia, hypochloremia, and compound words containing the word “chloride,” infusion therapy, metabolic acidosis, renal failure, and review. Results A total of 21,758 papers published before 31 May 2020 were identified; of this number, 630 duplicates were removed from the list. Upon excluding articles based on their title or abstract, 1850 papers were screened, of which 63 full-text articles were assessed. Conclusions According to the latest medical concepts, dyschloremia (both hyperchloremia and hypochloremia) represents a factor indisputably having a negative effect on selected variables of clinical outcome. As infusion therapy can significantly impact chloride homeostasis of the body, the choice of infusion solutions should always take into account the potentially adverse impact of chloride content on chloremia and organ function.

Even though Czech social policy cites child protection as one of its main priorities, there continue to be groups of children whose needs remain unnoticed. As many as forty thousand Czech children with at least one incarcerated parent have failed to gain public attention, find no support in the national legislative framework, and are only slowly attracting the attention of helping professionals. Guided by our research question—“What are the needs of children whose parent leaves the household due to incarceration?”—we describe the individual needs of children of incarcerated parents in their own voices through phenomenological optics. These needs, recorded via individual interviews and focus groups, contextualized using the theoretical methodology of the capability approach, which serves as the framework for assessing the relationship between the stated needs of these children and their overall well-being.

Background Vascular allotransplantations are performed worldwide in selected patients suffering from vascular prosthesis infection or critical limb ischemia. Either fresh or cryopreserved vascular allograft may be used. Objectives In various points, we address several aspects (allograft procurement, cryopreservation and transplantation technique) of the program of vascular allotransplantations in the Czech Republic. Material and methods Vascular grafts retrieval has been done within multiorgan harvests using no-touch technique. Very short time of cold ischemia is achieved due to close cooperation with Tissue Establishment where the following processing of cryopreservation is performed. Meeting all necessary quality criteria is a prerequisity for releasing grafts for clinical application. Standardized thawing protocol and surgical handling aims to minimize microfractures before implantation. Results Based on experimental and clinical work, the first validation of cryopreserved arterial and venous grafts for clinical use was performed between 2011 and 2013 in the Czech Republic. The developement of storage of vascular tissue in banks was stimulated in 2000-2010 by the issue of EU directives and national harmonized norms, aimed at assurance of high quality and safety of cells and tissues used for transplantations in humans. Conclusions There are several crucial moments affecting final quality, including graft retrieval within a multiorgan harvest, short ischemic time, cryopreservation and thawing technique used. The recommended surgical handling during implantation may also affect results and graft-related complications.

Spontanni regrese primarniho nadoru varlete je vzacný fenomen, který se může prezentovat až metastazou, elevaci onkomarkerů a podezřelým nalezem při sonografii varlat. Popis varlete patologem demonstruje morfologicke změny kompletni nebo parcialni regrese primarniho tumoru a nachazi jizveni a dalsi charakteristicke pozůstatky nadoru varlete, dle literatury nejcastěji seminomu. Na kazuistice prezentujeme nasi klinickou, zobrazovaci, laboratorni, cytohistologickou a lecebnou zkusenost s timto připadem.

Introduction: Symptomatic lymphocele could impair the function of a graft kidney. The aim of our research was to conduct a five-year follow-up after symptomatic lymphocele therapy. Methods: Overall 50 patients undergoing the therapy of symptomatic lymphocele were enrolled in the study cohort. Demographic data, renal failure causes, indication of therapy and lymphocele management were retrospectively evaluated. Laboratory tests were done to evaluate serum creatinine, total plasma protein and albumin levels. Survival rates of the patients and of the grafts were analysed using Kaplan-Meier curves. Results: The mean age of the 50 patients (44% females, 56% males) was 51.5±11.8 years, and the time between kidney transplantation and symptomatic lymphocele diagnosis was 12.8±21.5 months. Average lymphocele diameter was 71±35 mm. Causes of the native kidney failure were: glomerulonephritis (34%), tubulointerstitial nephritis (30%), polycystosis (24%), diabetic nephropathy (10%) and nephrosclerosis (2%). The therapy indications were: serum creatinine elevation (44%), graft hydronephrosis (38%), serum creatinine elevation associated with hydronephrosis (8%), infection associated with hydronephrosis (6%) and infection (4%). The lymphocele was managed by: open surgical intraperitoneal drainage (40%), percutaneous aspiration (26%), percutaneous long-term drainage (18%) and laparoscopic intraperitoneal drainage (16%). Mean serum creatinine levels at the time of the therapy and 60 months later were 231 μmol/L and 172 μmol/L, respectively; total plasma protein levels were 59 g/L and 69 g/L, respectively; albumin plasma levels were 36 g/L and 43 g/L, respectively. The five-year patient survival rate was 86% and the graft survival rate was 66%. Conclusion: Adequate management of symptomatic lymphocele stabilizes the graft function. If the post-transplant lymphocele is indicated for therapy, the therapy should be applied as soon as possible to prevent fibrous changes in the surrounding tissues. No patient death or graft loss had any direct relationship with lymphocele management.

The aim of this empirical paper was to answer the following question: “What are the desirable and the actually achieved capabilities in relation to the well-being of children and adolescents using social services in the Czech Republic from their own point of view, from that of their parents or foster parents and social workers?“ Our research study was based on the capability approach and looked at the well-being of vulnerable children who are clients of social service providers in the Czech Republic. It was conducted through a combination of qualitative and quantitative research techniques. Children and adolescents aged 11–22 years (n = 28) and their parents or foster parents (n = 16) were surveyed using the technique of in-depth semi-structured interviews and a questionnaire survey. We also held a focus group with 15 social workers working with these clients. The study has shown that what children need the most for their sense of well-being are harmonious relationships, particularly with their parents. This finding is all the more serious as parents are not fully aware of the importance of their love and care for their children’s lives, as also evidenced in our empirical findings. The research finding that we consider the most disturbing is that children lack capabilities that would allow them to experience a meaningful life. This is most pronounced in their views of their future, which they do not associate with any hope. They do not see their future as providing opportunities for a positive life experience. Another key finding is that both children and parents marginalise capabilities developed through education. What is particularly alarming is that parents were much more likely to marginalise education than their children. Although these children are users of social services, these services proved unable to provide adequate formal support for them and their parents. Based on our study of children and families using social services we recommend that social services should focus on fostering the relationship between parents/foster parents and children. Particular attention should be paid to developing adolescents’ potential, while taking into consideration their natural need to learn new skills so that they could live a more active life translating into a more meaningful life experience at present, as well as into a sustained sense of meaning in life in the future.

The aim of the study was to evaluate the role of colloid osmotic pressure in post-transplant lymphocele pathogenesis. We have analyzed total plasmatic protein and albumin levels, and electrophoresis has been completed in blood samples before transplantation and in days 3 and 14 after transplantation in 50 patients with lymphocele (Lymphocele) and 198 patients without lymphocele (control), respectively. Colloid osmotic pressure (COP) was calculated according to the Hoefs formula. Statistically significant differences were confirmed in albumin levels (42.2 respectively 44.8 g/L) before transplantation (day 0); in total protein (52.5 resp. 55.5 g/L), in albumin (30.1 resp. 32.1 g/L), and COP (15.6 respectively 17.7 kPa) in day 3; and in total protein (52.8 resp. 58.9 g/L), in albumin (30.5 respectively 35.4 g/L), in COP (16.1 respectively 21.2 kPa) in day 14. A potentially critical albumin level was established in 44.1 g/L in the blood analyzed, but its sensitivity was only 62%. The main risk element for the lymphocele formation remains the surgeon's hand. We can proclaim the role of proteins and their COP in the post-transplant lymphocele formation as one of possible pathogenetic cofactors. It is responsible for the impaired mechanisms of the reabsorption the lymph back to the tissues. Better metabolic care could help to reduce incidence of this surgical complication.

Autoři popisuji připad pacienta s oboustranně diagnostikovanými tumory varlat. Jednalo se o muže s vrozenou nedostatecnosti nadledvin, který dlouhodobě užival substitucni terapii. I přes podezřeni na nadorove onemocněni vedlo spravne stanoveni diagnozy u tohoto pacienta k zachovani varlat.

This paper is aimed at the description of hardware design, software equipment and the functionality of the second evolution of the intelligent multipurpose input/output microcontroller converter and control unit designed and assembled by the authors. Preceding stages of the unit development are concisely overviewed first, the deficiencies of which give rise to the primary motivation of this contribution. Then separate hardware parts of the novel unit are described in detail including electronic schematic diagrams. The device firmware and software capabilities are introduced as well. The advantages of the unit are highlighted compared to older versions. Its functionality, performance and efficiency are then verified by a laboratory control-related dynamic responses measurement example. In the contrary to previous evolutions, a more compact hardware design, increased A/D and D/A converter resolutions, added USB communication capability, better and more accurate analog circuits with more advanced operation amplifiers, the use of OLED instead of LCD display, the pulse-width modulated signal generated by the microcontroller unit itself can be considered among the most important improvements. Moreover, the direct use of the serial link may reduce noise significantly and makes the device more universal. © by Petr Dostálek 2017., Ministry of Education, Youth and Sports of the Czech Republic [LO1303 (MSMT-7778/2014)]

Background: The design and initial experience with the e-learning course “Basis of Harvest and Preservation of Tissues” used as a support of an elective subject is presented. The aim of the e-learning course was to enable the students to learn the theoretical principles of the subject individually and to present the gained knowledge at the final seminar. Methods: All functions of the course were operated in Moodle, local application of the Charles University in Prague, Faculty of Medicine in Hradec Králové. The course was divided into 3 main topics corresponding with topics of lectures: 1. Principles of tissue and organ donation, 2. Low temperature preservation of cells, tissues and organs, 3. Quality and safety assurance in practice of tissue and procurement establishments. A test consisting of 5 questions selected randomly from the bank of questions followed each topic. If the student answers correctly at least 3 questions he is allowed to pass to the next topic. The fourth topic “Basic processes in the tissue establishment and principles of their validation” was added into the electronic version as a tool for repeating and improving of knowledge. The fifth topic was represented by a database for uploading theses presented by students at the final seminar. The final test consisted of 15 questions (5 ones from each basic topic). It was necessary to answer correctly at least 10 questions to receive a certificate of completing the course. Results: The course was put into operation during the summer term of the academic year 2012/2013. To the date 15 of September the total of 23 students enrolled (17, i.e. all students of the elective subject in the Czech version, 2 students of this subject in the English version, 2 postgraduate students and 2 medical doctors). All enrolled students used the course for on-line learning, downloading, or printing course study materials. All undergraduate students were obliged to use it for preparation, consultation and presentation of seminar theses, i.e. 10 minute Power Point presentations followed by 5 minute discussion. Verification of the course was planed during the summer term of the academic year 2013/2014. Conclusions: The first experience showed that the presented e-learning course could serve as a useful support of the elective subject “Basis of Harvest and Preservation of Tissues”. It substantially enlarged the choice of study materials that can be regularly updated, so that the students receive the newest information. It can be also attractive for students that are not enrolled in the elective subject because of its limited capacity (not more than 20 persons) The efficiency of such form of education is being a subject of further verification.

Smisene epitelialni a stromalni nadory ledviny (Mixed Epithelial and Stromal Tumors, MEST) jsou typicky benigni nadory, relativněvzacne, s ženskou predominanci. Zobrazovaci metody nejsou diagnosticke, ale odhaluji solidně-cysticke masy. Spadaji dokategorie Bosniak III nebo IV, a jsou tudiž indikovane k operacnimu řeseni. Histopatologicky se u nich nachazeji mezenchymalnia epitelialni komponenty s charakteristickým imunohistochemickým průkazem estrogenových a progesteronových receptorů.V clanku je předložena kazuistika s přehledem literatury.

BACKGROUND Intensity-modulated radiation therapy (IMRT) is the method of choice in external-beam radiotherapy tolocalized prostate cancer. This work analyses five year results of IMRT with a dose of 78/82 Gy. PATIENTS AND METHODS From June 2003 to December 2007, the IMRT technique was employed to treat 233 patients with T1-3 N0 M0 prostate cancer. It was supplemented by hormone therapy especially in high-risk patients. Two IMRT techniques were applied - IMRT with a dose of 78 Gy in 39 fractions to prostate and seminal vesicles (SV) (IMRT 78) and IMRT with simultaneous integrated 82 Gy boost to prostate concurrently with 73,8 Gy in 41 fractions to SV (IMRT SIB 82). The IMRT 78 technique was used in 160 patients (69%). Seventy-three (31%) patients with intermediate (IR) or high-risk (HR) prostate cancer without SV involvement were treated with IMRT SIB 82 technique. The PSA relapse was defined as an increase in PSA of at least 2.0 ng/mL above the nadir or in comparison to the value at the initiation of hormone therapy. Clinical relapse was defined as an occurence of distant metastases and/or local recurrence. RESULTS The median follow-up of our patients´ population was 4.3 years (range 0.6-8.9 years). The estimated 5-year PSA relapse-free survival in low-risk (LR), IR and HR patients was 86%, 89% and 83%, respectively (p = NS). In a multivariate analysis, Gleason score (GS) 8-10 was associated with significantly higher risk of PSA relapse (RR 2.76), while higher age at the time of diagnosis significantly decreased the PSA relapse risk (RR 0.94). The estimated 5-year clinical relapse-free survival in LR, IR and HR patients was 100%, 99% and 95%, respectively (p = NS). In a univariate analysis, both GS and PSA had a significant impact on the 5-year clinical relapse-free survival - GS 2-7 97 % vs GS 8-10 88 % (p = 0.03), PSA 20 98 % vs PSA > 20 85 % (p < 0.01). CONCLUSION Treatment of localized prostate cancer using IMRT with a dose 78/82 Gy yielded an excellent 5-year tumour control with a risk of clinical relapse being less than 5%.

Human polyomaviruses such as JC polyomavirus and BK polyomavirus have long been well known pathogens of immunocompromised patients. Several new members of this viral family have been described during the last decade. Human polyomavirus 9 seems to be a novel pathogen of transplanted patients according to some studies. The aim of our study was to determine the presence of human polyomavirus 9 in patients after kidney or stem cell transplantation (SCT) at the University Hospital in Hradec Kralove, Czech Republic. Overall 100 patients, 65 after kidney transplantation and 35 after SCT, were included into the study. At least three follow-up samples from each patient were examined for human polyomavirus 9 DNA presentation with the two previously described in-house PCR protocols. Despite the frequent reactivation of human CMV (14.3% in kidney transplantation and 63.3% after SCT) or BK polyomavirus in our patient group, there was no positivity for human polyomavirus 9 either in blood samples or urine samples. One of the possible reasons for this discrepancy versus previous published studies could be a relatively low proportion of patients treated by induction therapy before kidney transplantation in our study cohort.

This contribution is aimed at a possible procedure approximating quasipolynomials by polynomials. Quasipolynomials appear in linear time-delay systems description as a natural consequence of the use of the Laplace transform. Due to their infinite root spectra, control system analysis and synthesis based on such quasipolynomial models are usually mathematically heavy. In the light of this fact, there is a natural research endeavor to design a sufficiently accurate yet simple engineeringly acceptable method that approximates them by polynomials preserving basic spectral information. In this paper, such a procedure is presented based on some ideas of discrete-time (digital) filters designing without excessive math. Namely, the particular quasipolynomial is subjected to iterative discretization by means of the bilinear transformation first; consequently, linear and quadratic interpolations are applied to obtain integer powers of the approximating polynomial. Since dominant roots play a decisive role in the spectrum, interpolations are made in their very neighborhood. A simulation example proofs the algorithm efficiency. © Springer International Publishing Switzerland 2016.

Optimal pole assignment minimizing the spectral abscissa when algebraic control of linear time-invariant time delay systems (LTI-TDS) is focused in this paper. We concentrate on algebraic controller design approach in the R MS ring resulting in delayed controllers as well. In the case of unstable delayed plants, the use a simple feedback loop results in a characteristic quasipolynomial instead of polynomial is obtained which means that the closed loop has an infinite spectrum. Thus, it is not possible to place all feedback poles to the prescribed positions exactly by a finite number of free controller parameters. The pole placement problem is translated to the minimization of the spectral abscissa which is a nonsmooth nonconvex function of free parameters in many cases. We initially solve the problem via standard quasi-continuous shifting algorithm followed by a comparative utilization of three iterative optimization algorithms; namely, Nelder-Mead algorithm, Extended Gradient Sampling Algorithm and Self-Organizing Migration Algorithm. Simulation control of an unstable LTI-TDS - the roller skater on the swaying bow - serves as an illustrative example for the algebraic control with the spectral abscissa minimization.

The efficacy of the bipolar endoscopic resection for anastomotic stricture was assessed and compared with holmium laser treatment.We studied a cohort of 39 patients with anastomotic strictures in years 1999 to 2007. Twenty-two patients had undergone bipolar resection, and 17 patients had undergone holmium laser treatment. The mean age of the bipolar cohort was 63.8 years; initial prostate-specific antigen (PSA) level was 10.7 ng/mL. The mean age of the laser cohort was 64 years; initial PSA level was 7.8 ng/mL. The results were evaluated by measurement of the maximum urinary flow (Qmax) and the postvoid residual volume of urine (PVR) before surgery, and at 6 weeks and 6 months after surgery. The Wilcoxon rank-sum test was used for statistical analysis, and a P value0.05 was considered significant.The mean follow-up period was 42 (14-74) months. Improvements in Qmax and PVR were recorded in the two cohorts. In the bipolar cohort, the mean values of Qmax were 3.9 mL/s, 14 mL/s, and 13 ml/s, while PVR values were 46 mL, 10 mL, and 11 mL. The mean values of Qmax in the laser cohort were 3.7 mL/s, 11 mL/s and 6.1 mL/s; PVR were 25 mL, 16 mL, and 19 mL. Statistically significantly better results of Qmax over 6 months were in the bipolar cohort (P0.001). No perioperative complications and no deterioration of urinary continence were recorded.The bipolar resection of an anastomotic stricture is a highly effective method that produces better long-term results than the holmium laser treatment.

Introduction The aim of this research was to create a laboratory instrument for the estimation of post-transplant lymphocele origin. It is based on the enzymatic activity of creatine kinase (CK) in the lymphocele content. Material and methods A total of 120 lymph samples from different retroperitoneal regions were obtained from non-transplanted patients; equal numbers from the iliac region, renal cysts, and the subdiaphragmatic retroperitoneum. Activities of creatine kinase (CK) and γ-glutamyl transpeptidase (GGT) were determined in all samples and statistically analyzed against their activity in serum from patients without surgery. Results Activities of CK in the pelvis, retroperitoneum, renal cysts, and serum were 5.06, 0.83, 6.48 (P < 0.001), 2.50, 0.73, 3.60 (P < 0.001), 0.02, 0.01, 0.05 (P < 0.001), and 0.66, 0.41, 0.79 μkat/l, respectively. Activities of GGT in the same lymph samples were 0.26, 0.16, 0.36 (P = 0.048), 0.41, 0.25, 0.48 (non-significant), 0.11, 0.07, 1.17 (P = 0.003) and 0.34, 0.24, 0.55 μkat/l, respectively. A graph was constructed relating CK activity to lymph origin. Conclusion Significantly different CK enzyme activity was observed in different regions of the retroperitoneum. The presented graph is a simple instrument for the estimation of the lymphocele content origin. The method requires percutaneous aspiration of the lymphocele and evaluation of the CK and GGT activity in the sample. From the graph the estimated proportion of renal lymph in the lymphocele can be read directly. This instrument can provide better understanding of post-transplant lymphocele fluid source.

Objectives: To retrospectively compare late toxicity of conventional-dose three-dimensional conformal radiation therapy (3D-CRT) and high-dose intensity-modulated radiation therapy (IMRT) for prostate cancer. Methods: A total of 340 patients with T1-3 prostate cancer were treated with 3D-CRT (n = 228) and IMRT (n = 112). The median follow-up time was 5.9 years and 3.0 years, respectively. The prescription dose was 70 Gy for 3D-CRT and 78 Gy for IMRT. Late gastrointestinal (GI) and genitourinary (GU) toxicities were graded according to the Fox Chase modification of the Radiation Therapy Oncology Group and Late Effects Normal Tissue Task Force criteria. Results: There was no difference between 3D-CRT and IMRT in the incidence of GI and GU toxicity at 3 years. On multivariate analysis, transurethral resection of prostate/open transvesical prostatectomy (TURP/TVPE) for benign prostatic hyperplasia, carried out before radiotherapy, significantly increased the risk of Grade ≥2 GU toxicity (risk ratio 1.88). Among patients who experienced TURP/TVPE, the 5-year actuarial likelihood of Grade 2–3 urinary incontinence was 23%, compared with 9% for those without prostate surgery (P = 0.01). Conclusions: Tolerance of 3D-CRT and IMRT was similar, despite the use of high radiation dose with IMRT. Previous TURP/TVPE increased the risk of GU toxicity.

Riziko je tematem, ktere je hluboce spjato s historii vzniku a rozvoje socialni prace. Riziko bylo dokonce kontextualni podminkou vzniku a rozvoje socialni prace jako moderni spolecenske instituce, ktera se na přelomu 19. a 20. stoleti zacala v USA a v Zapadni Evropě rozvijet jako profese, jejiž ukol byl mnohými spatřovan pravě v eliminaci důsledků dramatických spolecenských procesů vyvolavajicich obavu, pocit rizika a nejistotu. V uplynulých asi dvaceti letech se tema rizika opět vratilo do diskursu socialnich věd a s novými akcenty je tematizovano take v socialni praci. V nasem přispěvku se zabývame konceptem rizika jako inherentnim aspektem socialni prace. Na zakladě 16ti provedených rozhovorů se socialnimi pracovniky a socialnimi pracovnicemi analyzujeme přitomnost (vědomi) rizika a rizikovosti v jejich cinnostech. Cilem přispěvku je identifikovat zdroje rizika v socialni praci a porozumět proživani nejistoty, rizika a rizikovosti v cinnostech socialnich pracovniků a socialnich pracovnic, kteři působi v socialně pravni ochraně děti.

This paper deals with description of one of possible approaches to control of MIMO control loops with utilisation of the so called binding members and correction members. The designed method of control combinations classical way to ensure of autonomy of control loop via binding members and the use of the method of SISO branched control loops with measurement of dominant disturbance variables to ensure of invariance of control loop by means of correction members. Simulation verification of this method was carried out for three-variable control loop of a steam turbine.

The left renal vein (LRV) reimplantation into the distal inferior vena cava is considered to be the gold standard of care for symptomatic nutcracker syndrome (NCS). The vast majority of these surgical procedures are performed by open surgery. Experiences with minimally invasive laparoscopic surgery in this field are very limited. We present a case of a 17-year-old boy with NCS in whom the transposition of the LRV was done laparoscopically. The patient suffered from left flank pain, painful left-sided varicocele, microscopic hematuria, proteinuria, and oligoasthenospermia. There were no intraoperative complications, and the postoperative course was uneventful. At 12-month follow-up, hematuria, left flank pain, and left testicular pain resolved. Duplex ultrasonography revealed patent LRV. Laparoscopic LRV transposition appears to be safe, feasible, and has favorable postoperative course.

Previous clinical data suggested that with a tacrolimus-based regimen adjunctive immunosuppressives may be withdrawn after an initial treatment period. This study investigated the early discontinuation of mycophenolate mofetil (MMF) from a standard triple regimen. Patients were randomized either to receive a continued tacrolimus/MMF/steroids triple regimen (control group) or to reduce and then stop the MMF dose (MMF stop group). Both groups received identical daily tacrolimus and corticosteroid doses. The initial MMF dose was 1 g/day in both arms, but in the MMF stop group the dose was reduced to 0.5 g/day from week 7 to week 12 and then stopped. The intent-to-treat population consisted of 74 (control) and 78 (MMF stop) patients. MMF was tapered off as planned in 82.9% of the patients in the MMF stop arm. The 6-month incidence of biopsy-proven acute rejection was similar in both arms (21.6% control, 16.7% MMF stop). Graft loss occurred in 5.4% (control) and 3.8% (MMF stop) of the patients. MMF could be safely discontinued from a tacrolimus-based triple therapy early after transplantation without any rebound in efficacy during the 6-month follow-up period. (Name of registry: ClinicalStudyResults.org, number: FG-02-CEE-01, date: 9 June 2006).

The aim of the text is to explain the process of social construction of social work identity / identities, which (the process of social construction) I introduce as an important part in social work institutionalisation. Some social workers think that their work within the frame of their profession has a permanent and unchangeable character. The conception of the permanent and unchangeable character of social work excludes the theory, values and methodology use from possible discussion and ref1exive verification. The orientation towards only one model of values, theory and methods runs the risk of harming clients and in a wider sense risks destabilizing social relations.

This paper deals with the use of computer simulation with the aim of design efficient production in manufacturing and production systems. In our case, the possibilities of such use are demonstrated on particular example from industrial practice. The purpose was to build up a model of the prepared manufacture system and, especially, to propose a solution designed to increase productivity and to find bottlenecks in the system. The Witness simulation environment was used for modeling and subsequent simulation. Simulation study of the manufacture of automotive engines control units is presented herein. This example relates to finding the most balanced solution of operator deployment within the manufacturing line field. On the basis of the predefined requirements of the user, several simulation experiments are suggested. Then, a description of the proposed simulation experiments and evaluation of achieved results is presented.

PubMedID: 20106825 Background. Reducing side effects of immunosuppressive regimens has become a priority in transplantation medicine because of the large number of patients and grafts that succumb to infection in the short term and cardiovascular disease in the long term. The Symphony study was a 12-month prospective, randomized, open-label, multi-centre, four parallel arm study that aimed to evaluate the safety and efficacy of low-dose immunosuppressive regimens compared with a standard-dose regimen in renal transplant recipients. This sub-analysis focuses on specific toxicities observed with the low-dose regimens.Methods. Adult patients (n = 1645) scheduled to undergo renal transplantation received low-dose cyclosporine (CsA), tacrolimus (Tac) or sirolimus (SRL) in addition to daclizumab induction or standard-dose cyclosporine without induction. All patients received mycophenolate mofetil and corticosteroids. We evaluated the incidence of adverse events (AEs), tested specific group differences and assessed the relationship of selected AEs with drug levels.Results. The four arms had similar incidences of AEs, but serious AEs were more common with low-dose SRL and led to more discontinuations. Infections were the most common AEs, with the highest incidence in the standard-dose CsA group, in particular, cytomegalovirus (CMV) infections. Low-dose Tac had the most reports of new-onset diabetes, leucopenia and diarrhoea. Low-dose SRL negatively influenced triglycerides, wound healing, lymphocele and anaemia. We found only weak relationships between specific AEs and drug levels.Conclusions. Despite the low doses, CsA, Tac and SRL retained distinct and different toxicity profiles. These findings may be of relevance for tailoring specific immunosuppressive regimens to patients with particular needs. © 2010 The Author.

The paper deals with Strategy Evolution of Control of Extensive District Heating Systems. There are the experiences from the building up of the advance control algorithms of the of the technological string: combined production of heat and power - transport and distribution of heat - heat consumption. The District Heating Systems (DHS) are being developed in large cities in accordance with their growth. The DHS are formed by enlarging networks of heat distribution to consumers and at the same time they interconnect the heat sources gradually built. DHS is used in larger cities of some European countries e.g. in Germany, France, Denmark, Finland, Sweden, Netherlands, Czech Republic, Poland and others. Production technology of heat by means of combined production of power and heat (CHP) is an important way to increasing of thermal efficiency of closed thermal loop. The paper shows the system access to the control of extensive DHS - controlled plant. It concerns automatic control of technological string "production, transport + distribution, consumption" of extensive district heating and that is the contribution of this paper. Control by means of advanced control algorithms is a tool (up to now neglect) for decreasing cost of energy and increasing the level of environment protectionhese instructions give you basic guidelines for preparing camera-ready papers for conference proceedings.

Previous clinical data suggested that with a tacrolimus-based regimen adjunctive immunosuppressives may be withdrawn after an initial treatment period. This study investigated the early discontinuation of mycophenolate mofetil (MMF) from a standard triple regimen. Patients were randomized either to receive a continued tacrolimus/MMF/steroids triple regimen (control group) or to reduce and then stop the MMF dose (MMF stop group). Both groups received identical daily tacrolimus and corticosteroid doses. The initial MMF dose was 1 g/day in both arms, but in the MMF stop group the dose was reduced to 0.5 g/day from week 7 to week 12 and then stopped. The intent-to-treat population consisted of 74 (control) and 78 (MMF stop) patients. MMF was tapered off as planned in 82.9% of the patients in the MMF stop arm. The 6-month incidence of biopsy-proven acute rejection was similar in both arms (21.6% control, 16.7% MMF stop). Graft loss occurred in 5.4% (control) and 3.8% (MMF stop) of the patients. MMF could be safely discontinued from a tacrolimus-based triple therapy early after transplantation without any rebound in efficacy during the 6-month follow-up period. (Name of registry: ClinicalStudyResults.org, number: FG-02-CEE-01, date: 9 June 2006).