Hradec Kralove Research Articles

Designing E-learning courses in humanities and their use in the interuniversity study programmes

Abstract Since 2005 the Faculty of Informatics and Management, University of Hradec Kralove, has been running interuniversity study programmes within the framework of the selected Czech universities. In co-operation with the University of West Bohemia, Plzen, and Tomas Bata University, Zlin, several subjects are offered to students in the form of e-learning courses. The courses are run by teachers from the abovementioned partner universities. In the project the author personally deals with e-courses. “Ethics”, and “Philosophical seminar”. Both courses are organized every year in winter and summer terms, often at both universities, which is very time demanding. The courses are supported by the virtual learning environment WebCT which enables teacher-supervised self-study, and provides tools for multimedia presentations of the learning content. Contacts with teachers are supported by technical communication means, both asynchronous (mail, discussions) and synchronous (chat, whiteboard). WebCT is an environment which integrates various tools, and it is easily operated and accessible through the internet web browser. While designing courses in WebCT, one has to be aware of the danger of depersonalization and simplifying algorithmization of the educational process. Therefore, in all phases of didactic and technological processing of the appropriate contents, we take into account the necessity to form sets of questions, reflections, or even self-reflections. This dimension of the hermeneutic approach strengthens communicative competences and develops the ability to distribute and share information and knowledge. The contribution in detail deals with constitutive elements of designing e-learning courses in humanities in relation to the requirements of the interuniversity study programme.

Cholesterol metabolism in patients with diabetes mellitus type 1 and the impact of weight reduction

Cholesterol metabolism in patients with diabetes mellitus type 1 and the impact of weight reduction

Phenological observations made by the I. R. Bohemian Patriotic–Economic Society, 1828–1847

Scholarly and economic management societies played an important role in the beginnings of meteorological observations in Central Europe. In Bohemia, one such was the “Imperial Royal Patriotic–Economic Society of Bohemia” which, as well as making meteorological observations, organised a network of phenological stations and published the results of their observations from 1828 to 1847. The phenological observations covered 31 different forest plants, fruit trees and field-crops. Some of the phenological stations continued to make observations within the network of the Central Institute for Meteorology and Earth Magnetism established in Vienna in 1851. Analysis of the above observations led to the collation of information on the temporal and spatial distribution of the observed phenological characteristics (beginning of budding and/or foliage, beginning and end of flowering, ripeness of seeds and fruits) in the 1828–1847 period, which was cooler and generally wetter with respect to more recent temperature and precipitation patterns (1961–1990) in the study area. Phenophases of flowering and ripeness for selected plants are presented for the Hradec Kralove and Loket stations, showing late onsets in this period in comparison with recent phenological stations located nearby and taking measurements in 1993–2009. Working up this topic makes a contribution to the historical phenology of the nineteenth century in the Czech Lands and in Central Europe as well.

Age related changes in the microcirculation… does it really matter?

Department of Anaesthesiology and Intensive Care, University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic

Oral Health-related Quality of Life in Czech Population

The purpose of this study was to assess the oral health-related quality of life in Czech population. Data were collected from 1,380 subjects aged 30 to 69 years attending the Department of Dentistry, Medical Faculty of Charles University in Hradec Králové or attending three private dental practitioners collaborating on the study. Oral health-related quality of life was measured with the Oral Health Impact Profile (OHIP-14) questionnaire that was translated to Czech. The OHIP-14 scores were assessed in relation to chosen clinical and sociodemographic characteristics and oral health behaviour. Statistical analyses included descriptive analyses, the Mann-Whitney test, the Kolmogorov-Smirnov test and the Kruskal-Wallis test using the NCSS 2007 program. The chi2 test of independence in contingency tables or Fisher's exact test was used for qualitative data. Internal reliability for the 14 items overall was very high (Cronbach's ac = 0.924). The two most frequently scored items using the answer other than "never" during the last year were "painful aching" (62% of subjects) and "uncomfortable to eat" (44.4%), representing subdomain physical pain. The domain of social disability was reported least frequently. The OHIP-14 was significantly associated with dental status, dental behaviour, income and age. The findings of this study do suggest that the culturally adapted OHIP-14 version may be a good research instrument to be considered for use in measuring the impact of oral problems on the quality of life in Czech population.

Management of benign intrahepatic bile duct strictures: initial experience with polydioxanone biodegradable stents

to manage. They often affect young patients, and although they have a good long-term prognosis, they frequently recur and patients remain at risk of lifethreatening cholangitis and liver cirrhosis. Older patients may not be fit for surgery or multiple procedures, but permanent stent insertion has a poor outcome. Balloon dilation often only results in short-term improvement. Long-term patency can be improved by “splinting” the stricture endoscopically with multiple plastic stents [1], but biliary dilation is extremely painful and repeated endoscopic retrograde cholangiopancreatography (ERCP) is expensive and associated with significant morbidity. Temporary stenting with removable metal stents is a promising new strategy [2], however, these require removal. A new biodegradable stent theoretically allows long-term dilatation without the need for removal. It is woven from a monofilament of specially treated polydioxanone (● Fig. 1), a resorbable suture and implant material that has been in use for over 20 years [3]. Degradation occurs by hydrolysis [4]. The monofilament loses 50% of its breaking strength after 3 weeks and is absorbed within 6 months [5]; a reduced pH hastens hydrolysis. Larger stent versions are already available for benign esophageal strictures. We describe the first use of 10-mm stents in the biliary tree. Two patients (74 and 70 years) who had undergone bilioenteric anastomosis for stone disease presented 2 years after surgery with intrahepatic biliary strictures causing new stone formation and chronic cholangitis. Percutaneous balloon dilation, cholangioscopy, and lithotripsy were carried out and biodegradable EllaDV biliary stents (ELLA-CS, Hradec Kralove, Czech Republic) inserted to prevent stricture recurrence (● Figs. 2–6). The patients developed transient cholangitis as stent fragments were passed three months later. However, no further intervention was required, and 2 years after implantation the patients remain asymptomatic with normal liver function. The optimal aftercare to prevent cholangitis at stent disintegration needs further investigation, but initial results regarding stent insertion and stricture patency are encouraging. Acknowledgment !

Formal written English revisited

The article shows cultural differences in perception and understanding of the academic register in the English speaking countries and Central European countries and explains the reasons why students at a Czech university are not proficient enough at writing. Moreover, it analyses student's written works and highlights the most frequent mistakes students usually tend to make in their formal writing, particularly in their essays at the Faculty of Informatics and Management of the University of Hradec Kralove, Czech Republic.

Parking in the City: an Example of Limited Resource Sharing

During the attempt to park a car in the city the drivers have to share limited resources (the available roadside). We show that this fact leads to a predictable distribution of the distances between the cars that depends on the length of the street segment used for the collective parking. We demonstrate in addition that the individual parking maneuver is guided by generic psychophysical perceptual correlates. Both predictions are compared with the actual parking data collected in the city of Hradec Kralove (Czech Republic).

Left Coronary Artery Compression Caused by a False Aneurysm Expansion after Perforation of Type A Aortic Dissection

(J Card Surg 2010;25:72-73)

Patterns of land snail diversity over a gradient of habitat degradation: a comparison of three Czech cities

Terrestrial snail faunas were studied at 273 sites in three large Czech cities (Prague, Pilsen and Hradec Kralove). The aim was to explore the effect of habitat degradation on land snail diversity in urban environments. Of the 81 species recorded, 12 were considered synanthropic and 29 anthropophobic. We assessed the power of habitat degradation and distance from the city centre as predictors of species richness for: (1) all species combined; (2) synanthropic species alone; and (3) anthropophobic alone. The highest correlation was observed between richness of athropophobic species and habitat degradation (average r = −0.69, P < 0.001), which explained on average 48% of the variation, whereas distance from the city centre explained a negligible amount of independent variation. A similar pattern was found for all species combined; however, the amount of explained variation was lower (10% on average). We found a contrasting pattern for the richness of synanthropic species whose occurrence was mainly and negatively driven by the distance from the city centre. However, the amount of explained variation was very unequal among the cities, being very low in Prague and Pilsen (8%) and quite high in Hradec Kralove (36%). In conclusion, the response of local snail assemblages along a gradient of habitat degradation can be generalised as a gradual decline in species richness, especially of rare and anthropophobic species. This reduction was independent of the sites’ position within the city, which highlights the importance of natural habitats for the maintenance of snail diversity in urban environments.

A New Design Fully Covered Metal Stent (SX-ELLA Stent Esophageal HV) for the Palliation of Malignant Dysphagia: A Prospective Follow-Up Study

Background: Self-expandable metal stents (SEMS) are frequently used for the palliation of malignant dysphagia. Recurrent dysphagia due to stent migration in covered stents and non-tumoral or tumoral tissue growth in uncovered stents is the main cause of stent failure and occurs in 15-30% and 10-30% of patients, respectively. Aim: We aimed to determine efficacy, recurrent dysphagia, particularly due to migration and tissue growth, and complications of the SX-ELLA stent Esophageal HV (Ella-CS, Hradec Kralove, Czech Republic). This novel design is fully covered to resist tissue ingrowth and has an anti-migration ring to resist migration. Furthermore, it is braided in one piece to improve flexibility and expected to resist hyperplastic tissue reaction. Methods: Between February 2007 and May 2008, 45 patients with malignant dysphagia from inoperable or metastatic esophageal or gastric cardia cancer (n=43) or lung cancer (n=2) underwent placement of an SX-ELLA stent Esophageal HV in two tertiary referral centers. Patients were followed by scheduled telephone calls at 14 days after stent placement, and then monthly until death. Outcome measures were dysphagia score, recurrent dysphagia, complications, endoscopic reinterventions and mortality. Results: At 4 weeks, dysphagia score improved from a median of 3 (liquids only) prior to stent placement to a median of 1 (ability to eat some solid food) (p<0.001). Twelve of 45 (27%) patients developed recurrent dysphagia, in 6 (13%) patients due to stent migration and in 2 (4%) due to tissue overgrowth. Others causes of recurrent dysphagia were food obstruction, stent fracture and partial stent deployment. Major complications (severe pain, hemorrhage, fistula and fever) occurred in 10/45 (22%) patients. Minor complications, i.e., mild pain and gastro-esophageal reflux were observed in 12/45 (27%) patients. In total, 26 endoscopic reinterventions were performed in 18 patients (40%) for recurrent dysphagia or complications. Until November 2008, 39 patients died of whom 5 (11%) due to hemorrhage after a median of 107 days, most likely due to a combination of tumor progression and/or stent compression. Conclusions: The use of the SX-Ella stent Esophageal HV is effective and relatively safe for the palliation of malignant dysphagia. Recurrent dysphagia due to tissue growth and stent migration was reduced compared with other currently available covered stents, although still 40% of patients needed a reintervention for recurrent dysphagia or complications.

Four cases of venous thromboembolism associated with olanzapine

Psychiatric disorders and treatment with conventional antipsychotic medications have been associated with venous thromboembolism, but only a few data on recent antipsychotics such as olanzapine are available. We describe four subjects treated with olanzapine who developed venous thromboembolism, and were hospitalized at the University Hospital in Hradec Kralove during the period 2004-2006. We found a combination of several clinical and laboratory risk factors in our patients. A cohort study or case-control studies are needed to better elucidate the possible role of olanzapine in etiopathogenesis of venous thromboembolism.

Four years of experience with administration of the recombinant factor VIII in children

Vier Jahre Erfahrung mit der Gabe des rekombinanten Faktors VIII bei Kindern Hamostaseologie 2009; 29 (Suppl 1): S105–S107 In the Czech Republic the care for children suffering from haemophilia is concentrated in eight centers (Praha, Brno, Ostrava, Olomouc, Hradec Kralove, Plzen, Ceske Budejovice, Usti nad Labem) associated in the Czech Paediatric Haematology Working Group (CPH) ( Fig. 1). Plasma-derived factors became wide available in our country after 1989 and the quality of life of haemophiliacs dramatically improved. We have not observed seriously damaged joints or limitation of movement in children since that time. A growing number of patients are now transitioning to adult care with healthy joints. The enthusiasm was damped when patients suffering from HIV and hepatitis C transmitted by blood products appeared. We are now meeting an increasing number of very well informed patients demanding a safe and effective replacement therapy without the risk of transfusion transmitted infections, i.e. the recombinant products.

Cancer and depression: a prospective study

Cancer diagnosis and treatment often produce psychologic stresses resulting from the actual symptoms of the disease, as well as from perceptions of the disease and its stigma. Depression is seen in many cancer patients. Depression occurs in approximately 25% of palliative care patients. It is widely recognised by clinicians that depression is a difficult symptom to identify amongst patients with advanced illness. The study is aimed for screening of depression among palliative care female patients. This study was local, prospective and cross-sectional. It was carried at Department of Clinical Oncology and Radiation Therapy of Charles University Hospital in Hradec Kralove, Czech Republic. Dates were obtained during year 2007 - 2008 in 64 palliative care female patients. The mean age for all 64 subjects was 60,5 years old (aged 29 - 88 years old). The Czech version of Zung self-rating depression scale was performed. The statistical evaluation presents that mean SDS (self-rating depression score) certifies the presence of signs of mildly depression among palliative care female patients (SDS range was 50-59). The mean SDS in all subjects was 56. The mean SDS in group of healthy females was 38,9 (normal range). The incidence of depression is 71,8% (46 of all 64 subjects). The relevance of depression is characterized: severely depressed was proved in 8 of all 46 subjects, the moderately depressed in 21 subjects of all 46 subjects and mildly depressed in 17 of all 46 subjects. The statistical evaluation not presents statistically significant dependence of SDS on smoking abuse, marital status, age, number of associated diseases and type of palliative care. The statistical evaluation presents that patients with cancer of lung, with cancer of endometrium, with cancer of gallbladder and with melanomas are moderately depressed (SDS 60-69), patients with cancer of ovary, with cancer of breast, with primary brain tumour, with cancer of ventricle, with cancer of pancreas head and with cancer of bucall cavity are mildly depressed (SDS 50-59). The results show that subsists clear association between oncological disease in palliative care and depression.

Interstitial tissue glucose level in critically ill patients during tight glycemia control: Comparison of different methods

Department of Anesthesiology and Intensive Care, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic

ACUTE EFFECTS OF PASSIVE SMOKING ON PULMONARY ARTERY STIFFNESS IN HEALTHY VOLUNTEERS

Aortic stenosis is the most common type of valve disease in the adults. Until recently its treatment was an exclusive domain of cardiac surgery. At the same time the aortic valve replacement (SAVR) was not indicated in about 1/3 of the patients, though the prognosis of conservatively treated patients is very unfavourable with one-year mortality rate of 50%. These facts were the main reasons for starting a new interventional era of the aortic valve disease therapy in 2002 and from 2007 two types of valves fixed in stents have been commercially available.In the early phase the transcatheter aortic valve implantation (TAVI) was used just in patients with contraindication to SAVR or with high perioperative risk after surgery. Before applying this therapy to less risky patients some problems have to be solved: 1. clinical impact of the relatively high rate of paravalvular leaks and 2. long-term function of the implanted valve in follow-up exceeding 5 years.In the Czech Republic the first TAVI was performed in Prague, IKEM in December 2008. During a short period of time the TAVI programme was initiated also in other complex cardiovascular centres in Hradec Kralove, Brno, Prague—FN Kralovske Vinohrady and Trinec. Including the later starting centres (Usti n. Labem, Olomouc, Ceske Budejovice and other three centres in Prague—Nemocnice na Homolce, FN Motol and VFN) there is a total of 11 centres providing the TAVI at present. All centres except one (FN Motol) are part of the Czech TAVI Registry that was developed with the support of the Czech Society of Cardiology and started on 1 September, 2010. In general and more theoretically there are two parts of the Registry: 1. “Retrospective” including all the TAVI procedures from the beginning of the TAVI programme in the Czech Republic that was terminated on June 30, 2011 and 2. “Prospective” that has been following. Institute of Biostatistics and Analyses of Masaryk University takes care of the online and anonymized database.The results of the national Czech TAVI Registry should help to answer the clinical relevant questions mentioned above.

Psychosocial, health and demographic characteristics of quality of life among patients with acute myeloid leukemia and malignant lymphoma who underwent autologous hematopoietic stem cell transplantation.

This study evaluated the effect of selected psychosocial, health and demographic characteristics of quality of life (QOL) among patients treated with autologous hematopoietic stem cell transplantation (HSCT). This was a retrospective study at Charles University Hospital, Hradec Kralove. The Czech version of the international generic European Quality-of-Life questionnaire (EQ-5D) was applied to evaluate QOL among patients with acute myeloid leukemia (AML) and malignant Hodgkins and non-Hodgkins lymphoma (ML). The total number of respondents was 36: 12 with AML (seven males and five females) and 24 with ML (11 males and 13 females). The mean age of AML respondents was 46 years and the mean age of ML respondents was 44.5 years. Age, smoking status and education level had statistically significant effects on QOL among AML respondents (p < 0.05), and age had a statistically significant effect on QOL among ML respondents (p < 0.05). The overall QOL among AML and ML respondents was generally good: the mean EQ-5D score among AML respondents was 71.5% and among ML respondents it was 82.7%. The QOL among AML and ML respondents treated with autologous HSCT was good. However, patients more than 50 years old, smokers and patients with lower education levels presented worse QOL. These findings need to be better evaluated in longitudinal studies, using large samples.

Last Word on Point:Counterpoint “Chronic hypoxia-induced pulmonary hypertension does/does not lead to loss of pulmonary vasculature”

LETTERS TO THE EDITORLast Word on Point:Counterpoint “Chronic hypoxia-induced pulmonary hypertension does/does not lead to loss of pulmonary vasculature”Paul McLoughlin, and Ivan McMurtryPaul McLoughlin, and Ivan McMurtryPublished Online:01 Oct 2007https://doi.org/10.1152/japplphysiol.00716.2007MoreSectionsPDF (27 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInEmailWeChat To the Editor: There are several points that Dr. Rabinovitch and colleagues (6) make in their rebuttal that might be usefully clarified by some final comments. First, our discussion of the topic of vascular loss relates only to chronic hypoxic pulmonary hypertension; the vascular changes that occur in other models of pulmonary hypertension, including the monocrotaline model, are likely to be very different and cannot provide reliable information regarding the effects of chronic hypoxic pulmonary hypertension. Second, Dr. Rabinovitch and colleagues were not able to find the evidence for an absence of vessel loss in two manuscripts that we had cited in our original Counterpoint (Refs. 3, Refs. 1 and 3 therin). Regarding the manuscript of Brusselmans et al. (1) our statement was based on the data presented in Table 1 of that manuscript in which the authors reported that the mean (± SE) total number of vessels per 100 alveoli in wild-type normoxic mice (3.0 ± 0.06) was not significantly different from that in wild-type hypoxic (2.8 ± 0.16) mice. In the paper of Meyrick and Reid (4), Fig. 4 shows that no reduction in the total number of vessels per square millimeter could be found in hypoxic lungs, a finding that they discuss in some detail. While we do not believe the methods of vessel enumeration used were reliable, for the reasons outlined in our original Counterpoint (3), we cited these papers to demonstrate the lack of agreement between investigators using this “traditional” approach. Finally, our opponents in this debate cite previous work (5) to rebut our argument that the problem of changing alveolar number has not been adequately considered. In that study, vessel numbers were expressed per 100 alveoli observed on the tissue sections. The problem is that the number of alveoli seen per section does not reliably indicate the number of alveoli per unit volume of lung. The number seen in each field of view is also affected by the volume of the alveoli and their shape (more specifically their dimension perpendicular to the plane of section), the thickness of the sections and bias due to edge effects (see Ref. 2 for detailed review of this issue). Moreover, this technique cannot take account of increased numbers of alveoli in an enlarging lung. For these reasons the method used does not take account of changes in the total alveolar number.REFERENCES1 Brusselmans K, Compernolle V, Tjwa M, Wiesener MS, Maxwell PH, Collen D, Carmeliet P. Heterozygous deficiency of hypoxia-inducible factor-2alpha protects mice against pulmonary hypertension and right ventricular dysfunction during prolonged hypoxia. J Clin Invest 111: 1519–1527, 2003.Crossref | PubMed | ISI | Google Scholar2 Howell K, Hopkins N, McLoughlin P. Combined confocal microscopy and stereology: a highly efficient and unbiased approach to quantitative structural measurement in tissues. Exp Physiol 87: 747–756, 2002.Crossref | ISI | Google Scholar3 McLoughlin P, McMurtry I. Counterpoint: Chronic hypoxia-induced pulmonary hypertension does not lead to loss of pulmonary vasculature. J Appl Physiol; doi:10.1152/japplphysiol.00274a.2007.Google Scholar4 Meyrick B, Reid L. Hypoxia and incorporation of 3H-thymidine by cells of the rat pulmonary arteries and alveolar wall. Am J Pathol 96: 51–70, 1979.PubMed | ISI | Google Scholar5 Rabinovitch M, Gamble WJ, Miettinen OS, Reid L. Age and sex influence on pulmonary hypertension of chronic hypoxia and on recovery. Am J Physiol Heart Circ Physiol 240: H62–H72, 1981.Link | ISI | Google Scholar6 Rabinovitch M, Chessler N. Molthen RC. Point: Chronic hypoxia-induced pulmonary hypertension does lead to loss of pulmonary vasculature. J Appl Physiol; doi:10.1152/japplphysiol.00274.2007.Google ScholarAUTHOR NOTESAddress for reprint requests and other correspondence: P. McLoughlin (e-mail: [email protected]) Download PDF Previous Back to Top Next FiguresReferencesRelatedInformationCited ByRecovery from Hypoxic Pulmonary Hypertension in Rats22 May 2016 | Acta Medica (Hradec Kralove, Czech Republic), Vol. 54, No. 2l-Arginine promotes angiogenesis in the chronically hypoxic lung: a novel mechanism ameliorating pulmonary hypertensionK. Howell, C. M. Costello, M. Sands, I. Dooley, and P. McLoughlin1 June 2009 | American Journal of Physiology-Lung Cellular and Molecular Physiology, Vol. 296, No. 6 More from this issue > Volume 103Issue 4October 2007Pages 1456-1456 Copyright & PermissionsCopyright © 2007 the American Physiological Societyhttps://doi.org/10.1152/japplphysiol.00716.2007PubMed17916682History Published online 1 October 2007 Published in print 1 October 2007 Metrics

The effect of femoral and popliteal percutaneous transluminal balloon angioplasty on patients' quality of life.

Peripheral arterial occlusive disease (PAOD) is a prevalent atherosclerotic disorder characterized by limb pain on exertion, limb loss and a high mortality rate. Because of its chronic nature, it often has a negative impact on patients' quality of life (QOL). This study aimed to assess QOL among patients with PAOD that was treated by endovascular intervention using femoral and popliteal percutaneous transluminal balloon angioplasty (PTBA). This study was local, prospective and longitudinal. It was carried at the Second Department of Internal Medicine of Charles University Hospital in Hradec Kralove, Czech Republic. Thirty PAOD patients (20 male and 10 female) were treated by endovascular intervention using femoral and popliteal PTBA. The Czech version of the international generic European Quality of Life Questionnaire (EQ-5D) was applied. The statistical evaluation demonstrated that QOL presented highly significant statistical dependence on femoral and popliteal PTBA (p < 0.0001). The results showed that femoral and popliteal PTBA had a highly positive effect on the QOL of patients with PAOD.

Prolonged hypervolemic hemodilution impairs functional capillary density of ileal mucosa in pigs

Department of Anesthesiology and Intensive Care Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic