Restoration of Guyton´s diagram for regulation of the circulation as a basis for quantitative physiological model development.

We present the current state of complex circulatory dynamics model development based on Guyton's famous diagram. The aim is to provide an open-source model that will allow the simulation of a number of pathological conditions on a virtual patient including cardiac, respiratory, and kidney failure. The model will also simulate the therapeutic influence of various drugs, infusions of electrolytes, blood transfusion, etc. As a current result of implementation, we describe a core model of human physiology targeting the systemic circulation, arterial pressure and body fluid regulation, including short- and long-term regulations. The model can be used for educational purposes and general reflection on physiological regulation in pathogenesis of various diseases.

Prevalence of tidal expiratory flow limitation in preschool children with and without respiratory symptoms: application of the negative expiratory pressure (NEP) method.

Negative expiratory pressure (NEP) applied at the mouth during tidal expiration provides a non-invasive method for detecting expiratory flow limitation. Forty-two children were studied, i.e. 25 children with different respiratory symptoms (R) and 17 without any respiratory symptoms (NR). Children were examined without any sedation. A preset NEP of -5 cm H(2)O was applied; its duration did not exceed duration of tidal expiration. A significance of FL was judged by determining of a flow-limited range (in % of tidal volume). FL was found in 48 % children of R group. No patient of the NR group elicited FL (P<0.001 R vs. NR). The frequency of upper airway collapses was higher in R group (12 children) than in NR group (5 children). In conclusion, a high frequency of tidal FL in the R group was found, while it was not present in NR group. A relatively high frequency of expiratory upper airway collapses was found in both groups, but it did not differ significantly. NEP method represents a reasonable approach for tidal flow limitation testing in non-sedated preschool children.

Tetraphenylphosphonium-selective electrode as a tool for evaluating mitochondrial permeability transition pore function in isolated rat hepatocytes.

The changes in mitochondrial membrane potential (Deltapsi(m)) were used as an indicator for evaluating the mitochondrial permeability transition pore (MPTP) function. We found that in situ mitochondria in digitonin-permeabilized hepatocytes were coupled and responded to the addition of substrates, inhibitors and uncouplers. Ca(2+)-induced Deltapsi(m) dissipation was caused by MPTP opening because this process was inhibited by cyclosporin A. MPTP opening was enhanced by the pro-oxidant tert-butyl hydroperoxide.

GOLEM--multimedia simulator for medical education.

We created multimedia medical training simulator "GOLEM" for learning diagnostics and therapy of the critical clinical disorders. The theoretical basis of the simulator is the mathematical formulation of the relationship of homeostasis of the internal environment (acid/base and electrolyte equilibrium, of transport of blood gases, of osmotic and volume homeostasis), respiration, circulation and kidneys including regulatory influence of relevant hormones and the influence of some therapeutic procedures. Mathematical description consists of 39 non-linear differential equations and containing 89 input and 179 output variables. For the development of the simulation models developer's tools from MathWorks (Matlab and Simulink) has been used. The integration of the multimedia components, hypertext and simulation models interface was achieved by using Control Web, developed by Moravian Instruments, originally designed for long distance controls using PC and Internet. We have used our simulator as an efficient educational tool to help medical students learn circulatory, respiratory, acid-base, electrolyte, osmotic and volume disorders and train the diagnostic and therapeutic decisions by executing simulated interventions on virtual "patients".

[Effect of treated genital cancer on sexual functions of the woman]. / Die Wirkung des behandelten Genitalkrebses auf die sexuellen Funktionen der Frau.

By means of a structured interview and four questionnaires (Heterosexual development of woman, Sexual activity of woman, Sexual function of woman and Questionnaire N5 which evaluates the presence and intensity of neurotic symptoms) the authors examined 163 women following treatment of a malignant tumor of the genitalia. The examination was made during balneological therapy in a spa. Their age varied between 20 and 63 years. The feeling of female inferiority was recorded roughly in every eighth proband. Deterioration of sexual function of varying extent affected every second patient. Changes in emotional relations between couples (partners) were more favourable than in sexual life. Emotional and sexual relations improvement was recorded in every fifth and eleventh woman compared with the state before the illness. Husbands or partners of the patients had great understanding and were very tolerant. In the author's opinion it is a pleasant surprise that one quarter of the patients perceived the associated stress only as medium or even small stress. A general change (deterioration) of sexual intercourse correlated directly with subjectively perceived stress. The investigation revealed also that women treated on account of malignant tumors of the genitalia on the territory of former Czechoslovakia have practically no contacts with specialists in sexual rehabilitation.

[Sexuality in women after treatment of malignant genital tumors]. / Sexualita zen po lécbe maligního tumoru rodidel.

Using a structured interview and four questionnaires (Heterosexual development of woman, Sexual activity of woman, Sexual function of woman and questionnaire N5 which is used to evaluate the prevalence and intensity of neurotic symptoms, the authors examined 163 women after treatment of a malignant tumour of the genitalia. The examination was made during balneological therapy in a spa. Their age varied between 20 and 63 years. The feeling of female inferiority was recorded roughly in every eighth proband. Deterioration of sexual function of varying extent affected every second patient. Changes in emotional relations between couples (partners) were more favourable than in sexual life. As regards emotional and sexual relations improvement was recorded in every fifth and 11th woman resp., as compared with the state before the illness. Husbands or partners of the patients had great understanding and were very tolerant. In the authors' opinion it is a pleasant surprise that one quarter of the patients perceived the associated stress only as medium or even small stress. A general change (deterioration) of sexual intercourse correlated directly with subjectively perceived stress. The investigation revealed also that women treated on account of malignant tumours of the genitals on the territory of former Czechoslovakia have practically no contacts with specialists in sexual rehabilitation.

[Sexual function in women with breast carcinoma in relation to the time interval after mastectomy]. / Závislost sexuální funkce zen s karcinomem prsu na casovém odstupu od mastektomie.

Within the framework of more extensive research in a group of women after treatment of breast cancer the authors paid attention also to changes of sexual function in relation to the time which elapsed after ablation (modified radical mastectomy). 151 patients replied to the question pertaining to changes of the general status of sexual intercourse after treatment of carcinoma, as compared with the year preceding establishment of the diagnosis. With regard to their replies the probands were divided into four sub-groups: A-paradoxical improvement of sexual life (n = 12, 7.9% of the group, mean age 42.3 years), B-sexual life unaltered (n = 82, 54.3%, mean age 45.1 years), C-slight sexual dysfunction (n = 32, 21.2%, mean age 46.0 years), and D-severe sexual dysfunction (n = 25, 16.6% of the group, mean age 48.3 years). Attention was focused on the time intervals: under one year, 1-2 years and more than 2 years after operation. In addition to an analysis of changes in sexual function the authors compared also the neuroticism of different subgroups assessed by means of a N5 questionnaire. Rather surprisingly the authors proved a significantly more frequent deterioration of sexual function in patients after a prolonged interval following operation. This relationship applies even when the age factor of probands is eliminated. The significantly highest ratio of women with a marked neurotic symptomatology was found in patients with slight sexual dysfunction (subgroup C).

[Psychosexual reactions in women after treatment of breast carcinoma]. / Psychosexuální reakce u zen po lécbe karcinomu prsu.

Within the framework of a more extensive investigation of a group of women after treatment of a malignant breast tumour the authors paid also attention to their psychoesexual reactions. 119 probands were divided with regard to the type of their answers into three sub-groups: A - sthenic reaction (n = 35, i.e. 29.4% of the group), B - asthenic reaction (n = 55, 46.2%) and C - escape reply (n = 29, 24.4% of the group). The above sub-groups were compared, using the final score of four questionnaires (Heterosexual development of woman, Sexual activity of woman, Sexual function of woman and N5 questionnaire of neuroticism). The sub-group of women with the asthenic type of reaction was, as compared with the other two sub-groups, much more neurotic which in the authors' opinion indicates the need of professional psychotherapeutic care along with basic oncological treatment. As expected, in the examined group as a whole poor values were recorded in the questionnaires on sexual activity and sexual function. The values recorded in the three sub-groups with different psychosexual reaction, however, did not differ significantly.

[The impact of breast cancer treatment on sexual functions of the woman]. / Die Wirkung des behandelten Brustkrebses auf die sexuellen Funktionen der Frau.

By means of a structured interview and four questionnaires (Heterosexual development of woman, Sexual activity of woman, Sexual function of woman and Questionnaire N5 which evaluates the presence and intensity of neurotic symptoms) the authors examined 154 women following treatment of a malignant breast tumour. During the examination which took place during spa treatment the age of the probands was 26-67 years. The most frequent adverse subjective sensations were problems of nakedness when seen by healthy women, when "seeing themselves" and when seen by the husband (partner). Changes in emotional relations between partners were more favourable than in sexual life. Emotional as well as sex life improved in every fourth and more than in every 13th woman, as compared with the status before the disease. Men were quite tolerant. Fears and the degree of neuroticism corresponded with the deterioration of sexual function. Two-fifths of the women were interested in a reconstruction operation of the breast, however, only one in 40 of the group the operation was implemented or planned.

[Sexuality in women after treatment of malignant breast tumors]. / Sexualita zen po lécbe maligního tumoru prsu.

By means of a structured interview and four questionnaires (Heterosexual development of woman, Sexual activity of woman, Sexual function of woman and Questionnaire N5 which evaluates the presence and intensity of neurotic symptoms) the authors examined 154 women following treatment of a malignant breast tumour. During the examination which took place during spa treatment the age of the probands was 26-67 years. The most frequent adverse subjective sensations were problems of nakedness when seen by healthy women, when "seening themselves" and when seen by the husband (partner). Adverse feelings developed most frequently during the first week after operation. The adaptation was worst in women aged 40-44 years. Changes in emotional relations between partners were more favourable than in sexual life. Emotional as well as sex life improved in every fourth and more than in every 13th woman, as compared with the status before the disease. Men were quite tolerant. Fears and the degree of neuroticism corresponded with the deterioration of sexual function. Two-fifths of the women were interested in a reconstruction operation of the breast, however, only one in 40 of the group the operation was implemented or planned.