EAU Guidelines z roku 2011 klasifikují roboticky asistovanou cystektomii (RARC) jako experimentální operaci. Operatéři v řadě center se nacházeli teprve ve fázi nácviku této techniky, což znemožňovalo vyvodit jednoznačné závěry o její bezpečnosti a účinnosti. V roce 2012 byla RARC klasifikována jako možnost volby, ovšem bez prokázaných výsledků. V roce 2013 již ovšem bylo možné RARC zařadit na seznam ověřených a bezpečných operačních zákroků. Vzhledem k tomu, že se jedná o velmi složitou operaci sestávající z mnoha kroků, je nutné, aby RARC prováděl pouze dobře školený tým operatérů, sester a anesteziologů, kteří mají s touto technikou zkušenosti a ovládají všechny její fáze. Publikované údaje nasvědčují tomu, že RARC je spojena s menší krevní ztrátou, kratší délkou hospitalizace a menším výskytem časných i pozdních komplikací. Dále poskytuje benefit v podobě intrakorporální techniky derivace moči (ve srovnání s extrakorporální). Nejnovější dlouhodobé onkologické výsledky RARC jsou navíc srovnatelné s otevřenou cystektomií. Ovšem dokud nebudeme mít k dispozici kvalitní, randomizované kontrolované studie s dostatečně dlouhým intervalem sledování, zůstává otevřená radikální cystektomie nadále zlatým standardem. Tento přehledový článek detailně popisuje naši techniku (krok za krokem) včetně užitečných tipů a triků a prezentuje aktuální přehled různých výsledných parametrů této operační techniky., In 2011, the EAU Guidelines were describing robot–assisted radical cystectomy (RARC) as an experimental procedure. Many centers were still in their learning curve and safe conclusions about the safety and efficacy of the procedure could not be drawn. In 2012, RARC was an option, but not proven. But, in 2013, RARC is a feasible and safe operation. It is advocated that RARC, being a highly complex surgery, consisting of multiple steps, should be performed by a devoted team of robotic surgeons, nurses and anesthetists, which are all experienced and have mastered the above steps. Literature data show that RARC trends to be superior in blood loss, hospitalization, and early and late complication rates. Additionally, there seems to be an advantage of the totally intracorporeal technique of urinary diversion compared to the extracorporeal technique. Moreover, recent long‑term oncological results show similar outcomes for RARC to open cystectomy. Until, high‑powered, randomized controlled trials with sufficient follow‑up will be published, open radical cystectomy remains the gold standard. In this review paper, we will describe our technique step by step, providing useful tips and tricks and present an update on multiple outcomes of the operation., and Tyritzis S. I., Wiklund N. P.
Ultrasonic velocity anisotropy in the rock provides information of variability of the dynamic elastic moduli. Young’s modulus and Poisson’s ratio calculated from waves velocities can be used to determine brittleness index, which is usually used to predict rock susceptibility for hydraulic fracturing. This paper describes laboratory ultrasonic measurements carried out in order to improve hydraulic fracturing designing. The research was conducted over two types of rock: shale and limestone. The samples were cut out perpendicularly and parallel to the bedding planes. Next they were tested for effective porosity and mineral composition using XRD method. Directionally depended seismic velocities revealed noticeable anisotropy of laminated shale, caused by orientation of the bedding planes and weak anisotropy of limestone. Based on the velocities, dynamic elastic moduli and its anisotropy coefficients were determined. Calculations of brittleness index based on Young’s modulus to Poisson’s ratio relation and three types of mineral composition brittleness indexes, revealed strong variability in brittleness for both kind of tested formations. These results show, that different types of brittleness indexes should be used complementary, to better describe fracability of the rock. and Moska Rafal, Kasza Piotr, Maslowski Mateusz.
Rock landforms in the Sokolský hřbet (ridge) and the adjacent Žulovská pahorkatina (hilly land) have been analysed through detailed field mapping at a scale of 1:10,000; subsequently the spatial distribution of these features was analysed using a DEM within a GIS framework. Particular attention was focused upon the shape of the rock landforms, their arrangement, the aspect of their walls, and their topographic position within the two adjacent geomorphological units. Rock landforms in the Sokolský hřbet include frost-riven cliffs, isolated residual rockforms, and blockfields in metamorphic rocks. In contrast, rock landforms in the Žulovská pahorkatina include rock steps and numerous tors exposed from the basal weathering surface. The Sokolský hřbet has been interpreted as a neotectonically uplifted mountainous region; the rock landforms described here are thought to have formed under periglacial conditions during cold periods in the Pleistocene, whilst the extensive granitoid block accumulations developed on marginal fault scarps are thought to result from the exposure of intensively disintegrated rocks due to uplift. Žulovská pahorkatina has been interpreted as a remodelled stripped etch surface, which has been twice glaciated during the Middle Pleistocene. The rock landforms in both units appear to be structurally and lithologically controlled; moreover, various shapes of granite rock landforms are controlled by various types of jointing and parting. The clear differences recognised in both the rock landforms and overall morphology reflects the considerable disparity associated with relief development between two adjacent morphostructural units; such variability provides evidence for a long polygenetic history within the entire study area., Petra Štěpančíková and Matt Rowberry., and Obsahuje bibliografii
Airway smooth muscle (ASM) me mbrane depolarization through KCl opens L-type voltage dependent Ca 2+ channels (Ca v 1.2); its opening was considered the caus e of KCl contraction. This substance is used to bypass intracellular second messenger pathways. It is now clear that KCl also activates RhoA/Rho kinase (ROCK) pathway. ROCK isoforms are characterized as ROCK1 and ROCK2. Because ROCK1 seems the most abundant isotype in lung, we studied its participation in KCl stimulated bovine ASM. With methyl- β -cyclodextrin (M β CD) we disrupted caveolae, a membrane compartment considered as the RhoA/ROCK assembly site, and found that KCl contraction was reduced to the same extent (~26 %) as Y-27632 (ROCK inhibitor) treated tissues. We confirmed that KCl induces ROCK activation and this effect was annulled by Y-27632 or M β CD. In isolated plasmalemma, ROCK1 was localized in non-caveolar membrane fractions in Western blots from control tissues, but it transferred to caveolae in samples from tissues stimulated with KCl. Ca v 1.2 was found at the non-caveolar membrane fractions in control and M β CD treated tissues. In M β CD treated tissues stimulated with KCl, contraction was abolished by nifedipine; only the response to Ca v 1.2 opening remained as the ROCK component disappeared. Our result s show that, in ASM, the KCl contraction involves the translocation of ROCK1 from non- caveolar to caveolar regions an d that the proper physiological response depends on this translocation., B. Sommer ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy
Hvězdoše patří k nejběžnějším a přitom nejvíce přehlíženým vodním rostlinám naší květeny. Jsou charakterizovány na jedné straně celkovou redukcí tělní stavby, na druhé straně vysokou měrou fenotypové plasticity – schopností pružně reagovat na změny prostředí změnou habitu. Kvůli těmto vlastnostem patří hvězdoše mezi determinačně obtížné skupiny. Překvapivě však existuje u hvězdošů pozoruhodné množství různých opylovacích způsobů: dokáží se opylovat na vzduchu, po vodní hladině i pod vodou. Kombinace všech těchto tří způsobů opylení není známa u žádných jiných rostlin. Všechny opylovací systémy se pak u hvězdošů kombinují s ojedinělými a kuriózními způsoby samoopylení., Water-starworts (Callitriche) are some of the most common and yet largely overlooked aquatic plants in European flora. They are characterized by overall reduction of the plant body and also exhibit an extraordinary phenotypic plasticity in response to environmental changes, which makes the starwort species very difficult to determine. It is the only genus known to possess all three types of pollination: by air, on the water surface and under water, in addition to some unique self-fertilization mechanisms., and Jan Prančl.
The category of linguistic representation of men and women is one of the universal issues of language structure and use. Languages differ not only in that what they can express but also in what they must express. In this respect. Czech deserves a systematic study: Czech must reflect not only the gender of a referent - and does so more systematically than other languages - but regularly also the gender of a speaker and an addressee. The gender analysis of Czech must be related to genre analysis. This article focuses on symmetries and asymmetries in how men and women are named, addressed and referred to. Czech manifests a strong tendency toward separate symmetrical terms for both males and females. Though the processes of derivation of feminine counterparts from originally masculine forms are almost unlimited in Czech, the frequency of derived feminines in texts is much lower. This is due to the fact that masculine forms are used as a norm in gender-neutral and gender-indefinite contexts. The linguistic interpretation of the opposite gender pairs has been formed by the general background of structuralist treatment of linguistic meanings and functions. The concept of markedness and unmarkedness has been acknowledged in Czech linguistics also with regard to the interpretation of masculine terms in their unmarked. generic function (this interpretation is, of course, more legitimate in some of the discourse genres and less in others). The article addresses the issue of the linguistic awareness of Czech speakers and its potential change. New discourse practice might have shifted such masculines from gender-indefinite to gender-definite sphere of interpretation: in some contexts, masculine terms seem to be interpreted in a more gender-specific meaning than their unmarked, „inclusive“ meaning would suggest. The article gives a tentative outline of the scope of sensitive contexts (referential vs predicative positions, contrasting male vs female reference etc.).