Multimodal transport of goods between the Czech Republic and seaports of the North sea using the Czech-Saxon ports Ltd

Tato bakalářská práce zpočátku pojednává o historii nákladní dopravy v Děčíně a překladiště v Loubí. V další části práce je popis současné dopravní infrastruktury a zbožových proudů s vazbou na vnitrozemskou vodní cestu, řeku Labe. Následuje nákladová analýza multimodálních přeprav a nalezení příčin krizového stavu vodní dopravy na Labi.At the beginning this bachelor thesis deal history of freight transport in Děčín and terminal in Loubí. In the next part is described actual transport infrastructure and commodity flows in relation to inland waterway, the Elbe. After that there is the analysis of cost in multimodal transport and results of finding reasons of distress in inland waterway transport on the Elbe.Katedra dopravního managementu, marketingu a logistikyStudent přednesl ucelenou a logicky uspořádanou obhajobu své bakalářské práce. V ní dokázal přesvědčivým způsobem obhájit závěry svých řešení. U doplňkových otázek prokázal schopnost logického myšlení, pohotové reakce, jasného a srozumitelného vysvětlení.Dokončená práce s úspěšnou obhajobo

The transport efficiency of large container carriers in maritime transport

Bodem zájmu této práce je efektivita provozu velkých kontejnerových lodí z pohledu jednotkových nákladů na 1 TEU jednotku. Řešenou problematikou je výpočet těchto přepravních nákladů na modelové námořní relaci u kontejnerové lodě typu Triple E class a typu Suezmax. Náplní práce je porovnání provozní nákladnosti obou lodí a nalezení stavu a podmínek, při kterých se stává provoz doposud největších kontejnerových lodí světa opravdu ekonomický.This thesis deals with the operational efficiency of large container vessels from the point of view of TEU unit costs. The main issue is the calculation of unit costs which is implemented into a model maritime transport route for two different type of container ships: Triple E class and Suezmax. The principal content of the thesis is a comparison of operating expenditure for each type of container ship. In conclusion, there is a determination of conditions under which the operation of the actual biggest container ship is really economical.Katedra dopravního managementu, marketingu a logistikyDiplomant přednesl ucelenou a logicky uspořádanou obhajobu svého diplomového projektu. V ní dokázal přesvědčivým způsobem obhájit závěry svých řešení. Na připomínky recenzenta reagoval správně a v plném rozsahu je zodpověděl. U doplňkových otázek prokázal schopnost logického myšlení, pohotové reakce, jasného a srozumitelného vysvětlení

Bipolar radiofrequency-induced thermotherapy of haemorrhoids: a new minimally invasive method for haemorrhoidal disease treatment. Early results of a pilot study

Introduction: Haemorrhoidal disease is the most frequent benign anorectal disease. Conservative, minimally invasive and surgical methods are used in the treatment of haemorrhoidal disease. Radiofrequency thermoablation is a popular new technique in the treatment of varicose veins. Aim: Assessment of the use of the method in the treatment of haemorrhoidal disease using bipolar radiofrequency-induced thermotherapy (RFITT or so-called Celon method). Material and methods: We used the CelonLab PRECISION (Celon AG medical instruments, Teltow, Germany) with the bipolar RFITT applicator Celon ProBREATH for the treatment of haemorrhoidal disease stages III and IV. Results: In the Department of Surgery at the Atlas Hospital in Zlin, Czech Republic, a total of 71 patients were treated from 9/2007 to 10/2010 with this new treatment approach. The success rate was 100%, local recurrence rate was 2.8%, and medium-term satisfaction of patients who underwent the procedure was 99.5%. Complications appeared in 4.26% of cases. Conclusions: The new RFITTH technique for treatment of advanced stages of haemorrhoidal disease is a new treatment modality with good curative response, low level of complications, minimum pain and quick return of patients to their usual activities

THE EFFECTIVENESS OF LARGE CONTAINER CARRIERS IN MARITIME TRANSPORT

Tento příspěvek se zabývá porovnáním dvou typů kontejnerových lodí používanýchv námořní přepravě kontejnerů a to lodě typu Triple E a Suezmax. V příspěvku jsouporovnány jednotkové náklady na danou relaci a je zde vyčíslena efektivita provozutěchto velkých nosičů kontejnerů.The article deals with the operational efficiency of large container vessels from thepoint of view of TEU unit costs. The main issue is the calculation of unit costs whichis implemented into a model maritime transport route for two different type ofcontainer ships: Triple E class and Suezmax

Endovascular reflux-elimination of perforating veins by RFITT and foam sclerotherapy

Introduction: During the last years, many endovascular techniques have been developed in order to eliminate not only the reflux in stem veins but in perforating veins and their tributaries, too. Aim: The aim of this study was to use endo - vascular RFITT and the foam sclerotherapy for the occlusion of perforating veins as the prime source of reflux and their tributaries. Material and Methods: The Celon method was used for the thermal treatment. Polydocalon with the concentration 1% and 2% with DSS technique was used for the foam sclerotherapy. The RFITT was accomplished in 127 perforating veins in total. This group was divided into three subgroups. The first one consists of patients where only RFITT was carried out (n= 41), in the second, there were patients with RFITT realized with sclerotherapy during one session (n= 48), in the third, RFITT was completed with sclerotherapy in one month after the RFITT intervention (n= 38). The control group included perforating veins treated only with sclerotherapy (n= 81). The power setting 6W was used on the generator during the RFITT with Celon- ProSurge micro and 18W for usage of Celon ProCurve probe. Results: The effectiveness of the procedure in the group 1 was 8.8%, in the group two 93.7%, in the group three 92.1% and in the control group 76.5% in one year follow up. There was no significant difference between the effectiveness in groups 1, 2 and 3. The marginal difference was among all three groups with RFITT and the control group. Significant differences were in the parameter of the extinction of visible varicose veins with the reflux from perforators. The extinction was faster in group 3 than in group 2 and in the control group and the slowest was in group 1. The significant difference was observed between groups 2 and 3 compared with group 1 and the margin difference was between groups 2 and 3 compared with the control group. No significant difference was observed between groups 1 and the control group. Conclusions: All procedures are effective. The most important is the combination of RFITT and the sclerotherapy one month after thermal intervention. This is associated with a low risk of recanalization and the fastest extinction of visible varicose veins

Initial results of the bipolar RFITT coagulation in advanced stages of hemorrhoidal disorder study

Cíl práce: Ověřit v praxi novou metodiku radiofrekvenční bipolární koagulace hemoroidů. Použité metody: Metoda bipolární radiofrekvenční indukované termoterapie vnitřních a zevních hemoroidů přístrojem Olympus Celon. Za použití radiofrekvenční bipolární elektrody koagulace vnitřních a zevních hemoroidálních uzlů pod vizuální kontrolou za pomoci zpětné vazby. Aplikace RF energie průměrně z 12 vpichů nad linea dentata na ošetření vnitřních hemoroidů III. stadia. U lY. stadia hemoroidů pak podle rozsahu prolapsu i do zevních hemoroidálních uzlů. Ve 4 případech byla metodika použita v kombinaci s klasickým ošetřením podle Parkse při excizi análních fibromů či markíz. Výsledky: Od září 2007 do června 2008 byla metodika použita u 18 pacientů ve III. a lV. stadiu hemoroidální nemoci. 15 pacientů bylo podle protokolu sledováno 7. a 21. den po operaci. Prvních 5 pacientů pak po 6 měsících a v další fázi budou sledováni po 12 měsících. Průměrná doba výkonu byla 20 minut, doba hospitalizace 24 hodin. Pooperační krvácení trvalo průměrně 0-10 dní. Větší otok po operaci se vyskytl u 2 pacientů. Bolestivost byla průměrně (ve škále 0-10) 7. den 1,5; 21. den 0,46. Komplikací výkonu byl vznik anální fisury u 2 pacientů po předchozích výkonech na konečníku provázený zvýšenou bolestivostí. Průvodním jevem při ošetření IV. stadia je přechodný otok zevních hemoroidálních uzlů. Závěr: Bipolární radiofrekvečně indukovaná termoterapie hemoroidů je nová metoda semiinvazivního ošetření hemoroidů. Je bezpečná, s minimálním množstvím časných pooperačních komplikací. Pacienty je dobře snášena a dobře hodnocena. Dlouhodobé výsledky budou dále publikovány.Aim of the Study: The aim is to verify a new methodology of radiofrequency bipolar coagulation for treatment of hemorrhoids in practice. Used Methods: The method of bipolar radiofrequency- induced thermotherapy of internal and external hemorrhoids using the Olympus Celon apparatus. Radiofrequency bipolar electrode was app lied to perform coagulation of internal and external hemorrhoids under visual control and feedback. RF energy was applied, on average, at 12 sites above the dentate line to treat internal, stage III hemorrhoids. In stage IV hemorrhoids, based on the prolapse extent, it was applied to external hemorrhoids, as well. In four subjects, the method was used in combination with a standard Parks management to perform excision of perianal fibromas. Results: From September 2007 to June 2008, the method was used in 18 patients with stage III and IV hemorrhoids. 15 patients underwent a per-protocol follow up on postoperative Day 7 and Day 21. Then, the first 5 subjects were checked in a 6-month interval and will be re-assessed in 12 months. The average duration of the procedure was 20 minutes and duration of hospitalization was 24 hours. Postoperative bleeding lasted for average 0-10 days. Major postoperative edema occured in 2 subjects. The average pain intensity (on 0-10 scale) was 1.5 on Day 7; 0.46 on Day 21. The postoperative complications included anal fissures with increased pain intensity in 2 subjects with a preoperative history of anal procedures. Transient edema of external hemorrhoids occured upon management of the stage IV hemorrhoidal disorder. Conclusion: Bipolar radiofrequency-induced thermotherapy of hemorrhoids is a new, semiinvasive method of the management of hemorrhoids. It is safe, with minim al rates of early postoperative complications. It is well- tolerated and evaluated by patients. Long-term results will be published further

Micrometastases in the sentinel lymph node - Necessity of axillar lymph node dissection?

Either radical mastectomy with axillar lymphadenectomy or conservative surgery with axillar lymph node dissection are the standard treatments for patients with breast carcinoma. Sentinel lymph node biopsy is a new method that - if negative - allows axillar lymph node preservation and so minimizes major complications associated with this operation (especially lymphedema of the upper extremity). However, the development of the diagnostic means gave rise to new clinical entities - micrometastases and findings of clusters or solitary cells in the sentinel lymph node. Even though the probability of non-sentinel lymph node metastasis is only 10 %, all patients with the finding of micrometastases in the sentinel lymph node are currently indicated for axillar lymph node dissection. Based on the present retrospective study involving 398 females with breast carcinoma, the authors define a risk group for non-sentinel lymph node metastases. The other patients may be spared from successive axillar dissection

Sentinel node biopsy and neoadjuvant chemotherapy in the treatment of breast cancer

Purpose: Sentinel lymph node biopsy (SLNB) has become a safe and accurate alternative to axillary lymph node dissection (ALND) in the surgical management of early breast cancer. The aim of this study was to determine the false negative rate of SLNB in patients with advanced breast cancer after neoadjuvant chemotherapy. Methods: Forty-eight patients with 49 advanced breast cancers (one patient had bilateral disease) underwent neoadjuvant chemotherapy. All of them had SLNB, followed by standard level I/II ALND. SLNs were identified in 47 out of 49 tumors (detection rate 95.9%). Results: Axillary nodal metastases were detected in 28 patients; SLNs were positive only in 14 patients. Four sentinel internal mammary nodes were removed in 4 patients, while one of them was positive with micrometastasis but axillary nodes were negative. False-negative results occurred in 2 (7.14%) patients. The results of our study confirm that SLNB in patients with advanced breast cancer is not significantly altered by the preoperative chemotherapy. Biopsy results were very similar to those without any neoadjuvant chemotherapy. Conclusion: ALND, known for its serious complications, can be replaced in some cases by SLNB. © 2012 Zerbinis Medical Publications

Does probiotic application improve clinical outcomes in colorectal surgery?

Aim: To evaluate the effects of pre-operative administration of type-specific probiotics in colorectal surgery on the rate of post-operative (especially infection-related) complications; on the period of antibiotic administration; and on the speed of restoration of gut motility and length of hospital stay. Methods: Patients undergoing elective colon or rectal resection with anastomosis from June 2011 to April 2013 were in turns randomly divided into the probiotics group (22 patients) and the control group (23 patients). Patients with probiotics received (twice daily, 10 days before surgery) enterosolvent capsules consisting of 6 × 109 of five different freeze-dried Lactobacilli and Bifidobacteria species (L. rhamnosus 55%, B. breve 20%, L. casei 15%, L. acidophilus 5%, B. longum 5%). Postoperatively, the inflammatory complications, duration of antibiotic treatment, speed of restoration of intestinal peristalsis in patients and length of hospital stay were evaluated. Results: The interval to first peristalsis was significantly shorter in the probiotics group compared with the control group (1.5 days vs 2.0 days; p = 0.01). The decrease in infection-related complications (surgical wound infection, pneumonia) in the probiotics group was not statistically significant. The shorter antibiotic administration period in the probiotics group was statistically significant at the significance level p = 0.089. The length of hospital stay in patients with probiotics was shorter than in the control group, but not significantly. An improvement of health in the probiotics patients occurred in 21 of 25 clinical and laboratory numerically assessed parameters (p = 0.01). Conclusion: Pre-operative probiotic administration (L. rhamnosus, B. breve, L. casei, L. acidophilus, B. longum) in patients undergoing colorectal resection with anastomosis resulted in faster restoration of intestinal peristalsis, and in an improved clinical state of the patients (especially reduced infection-related complications) described by 25 clinical and laboratory parameters