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Klepnutím lze upravit styl předlohy nadpisů.
Klepnutím lze upravit styl předlohy podnadpisů.
‹datum a čas›
‹z&aac= ute;patí›
‹#R= 50;
------=_NextPart_01C4EF58.BE345E00 Content-Location: file:///C:/59116902/akutni_a_chronicke_selhani_ledvin_web_soubory/master34.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C4EF58.BE345E00 Content-Location: file:///C:/59116902/akutni_a_chronicke_selhani_ledvin_web_soubory/pres.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C4EF58.BE345E00 Content-Location: file:///C:/59116902/akutni_a_chronicke_selhani_ledvin_web_soubory/slide0001.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Acute and chronic renal failure
Akutní a chronické selhání ledvin
Sylva Skálová, Pavel Rozsíval
Dětská klinika
Fakultní nemocnice Hradec Králové
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Akutn&iacut= e; selhání ledvin
Ø=3D náhlý pokles renálních funkcí, jeho&= 2; následkem je hromadění dusíkatých katabolitů
Etiologie:
= 1.Prerenální
= 2.Renální
= 3.Postrenální
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NSvz1vbg/WVv8aa2o33mq3224ztxnzW/xpWDmPQPLLSOhi3LjI4HBpbdhEx8sSkK2GUJhRmuD/tT Ud3/AB/3P/f5v8aP7U1HB/0+55/6bN/jRYOY9EkwhZ1TaCxBdRkiue11w15EUBYeUOVOAeTXPtqu pc/8TC6/7/N/jWdcXt08gLXMzHHeQmqSJlLQ/9n= ------=_NextPart_01C4EF58.BE345E00 Content-Location: file:///C:/59116902/akutni_a_chronicke_selhani_ledvin_web_soubory/slide0003.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Acute and chronic renal failure
Akutní selhání ledvin – prerenální
ØHypovol&eacu= te;mie
lKrvácen&iacu= te;, ztráty do GIT, hypoproteinémie, popálenin= y, onem. ledvin/nadledvinek se ztrátami soli
ØHypotenze= 3;
lSepse, DIC
ØHypoxie =
lPneumonie, RDS
------=_NextPart_01C4EF58.BE345E00 Content-Location: file:///C:/59116902/akutni_a_chronicke_selhani_ledvin_web_soubory/slide0004.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Acute and chronic renal failure
Akutní selhání ledvin – prerenální
ØPatofyzio= logie: selhání normálních autoregulačn= ích mechanizmů renální perfúze a glomerulární filtrace (vazodil= atace, konstrikce vas efferens…= )
Ø
ØDlouhá hypoperfúze → ischemické poškození parenchymu → selhání ledvin renálního původu (intrinsic renal failure)
------=_NextPart_01C4EF58.BE345E00 Content-Location: file:///C:/59116902/akutni_a_chronicke_selhani_ledvin_web_soubory/slide0005.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Acute and chronic renal failure
Akutní selhání ledvin – prerenální
Hypotenze/hypovolém= ie
↓ perfúze ledvin
↑ aktivita sympatiku
↓ GF
↑ renin
↑ angiotenzin
↑ aldosteron
↑ reabsorpce Na
(sběrný kanálek)
↑ sérové hl. NA
↑ peritubulární onkotický p
↑ reabsorpce Na/tekutin
(proximáln&i= acute; kanálek)
↑ filtrační frakce
↑ sekrece ADH
↑ reabsorpce vody
(sběrný kanálek)
vazokonstrikce
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------=_NextPart_01C4EF58.BE345E00 Content-Location: file:///C:/59116902/akutni_a_chronicke_selhani_ledvin_web_soubory/slide0006.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Acute and chronic renal failure
Akutní selhání ledvin – prerenální
&Oslas= h;Snížená tvorba moči – oligurie
lx normální množství mo&#= 269;i, pokud je porucha sekrece ADH nebo porušená odpověď na ADH !
&Oslas= h;Snížená koncentrace sodí= ku v moči
&Oslas= h;Zvýšená osmolalita moči
------=_NextPart_01C4EF58.BE345E00 Content-Location: file:///C:/59116902/akutni_a_chronicke_selhani_ledvin_web_soubory/slide0007.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Acute and chronic renal failure
Akutn&= iacute; selhání ledvin – intrinsické renáln&iacu= te;
ØNáhl&= yacute; pokles GF a dysfunkce tubulárních buněk → azoté= ;mie, isostenurie, excesivní exkrece sodíku močí
ØPatogeneze multifaktoriáln&iac= ute;
ØSnížená koncentrace sodíku v moči
ØZvýšená osmolalita moči=
------=_NextPart_01C4EF58.BE345E00 Content-Location: file:///C:/59116902/akutni_a_chronicke_selhani_ledvin_web_soubory/slide0008.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Acute and chronic renal failure
Akutn&= iacute; selhání ledvin – intrinsické renáln&iacu= te;
Ischemické/nefrotox= ické poškození
P"= 5;echodná ztráta
konce= ntrační schopnosti <= /div>
(proximální kanálek)
↓ reabsorpce
Na a = vody
↓ GF
Nekr&= oacute;za
tubul= árních buněk&#= 13;
Po= 53;kození
st= 83;ny tubulu <= /span>
↑ Na v distálním k.=
&Uacu= te;nik tubulárního
filtr= átu do parenchymu
Macula densa <= /span>
Lokáln&iac= ute; renin
Konstrikce
vas afferens
Glomerulární poškození
Z&aacu= te;nět
Suben= doteliální otok
Mikrot= romby
Glomerulární okluze
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Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Acute and chronic renal failure
Akutn&= iacute; selhání ledvin – intrinsické renáln&iacu= te;
ØIzostenurie&= #13;
ØZvý&#= 353;ená koncentrace sodíku v moči
ØSní&#= 382;ená osmolalita moči
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Akutn&= iacute; selhání ledvin - postrenální
ØObstrukce:
&= #8226;ureteropelvická junkce
&= #8226;ureterokéla
&= #8226;chlopně uretry
ØVesikoureterální - ureterorenální reflux
ØKameny, krevní sraženiny
ØUZ břicha, cystouretrografie
ØK renálnímu selhání vede oboustranná obstrukce
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Akutní selhání ledvin – klinika
<= span class=3DBB style=3D'position:absolute;left:-4.29%;top:.22em'>ØBledost (anémie)
<= span class=3DBB style=3D'position:absolute;left:-4.29%;top:.22em'>ØSnížená produkce moči
<= span class=3DBB style=3D'position:absolute;left:-4.29%;top:.22em'>ØOtoky (přetížení solí a objemem)
Ø Komplikace:
<= span class=3DBB style=3D'position:absolute;left:-4.11%;top:.22em'>ØMěstnavé srdeční selhání, plicní edém <= /i>
<= span class=3DBB style=3D'position:absolute;left:-4.29%;top:.22em'>ØArytmie
<= span class=3DBB style=3D'position:absolute;left:-4.29%;top:.22em'>ØZměny chování
<= span class=3DBB style=3D'position:absolute;left:-4.29%;top:.22em'>ØKřeče, koma
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Akutn&i= acute; selhání ledvin – vyšetření
&Oslas= h;Anamnéza:
lZvracení, průjem, horečka
•D= ehydratace, prerenální azotémie
•T= rombóza renální žíly
•H= emolyticko-uremický syndrom
lPředcházející respirační nebo kožní infekce
•P= oststreptokoková glomerulonefritida
lVyrážka
•L= upus erythematosus
•A= nafylaktoidní purpura
lHmatný útvar v břiše <= /span>
•T= rombóza renální žíly
•T= umory, cystická nemoc
•O= bstrukce
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Akutn&i= acute; selhání ledvin – vyšetření
&Oslas= h;Fyzikální vyšetření= ;
lCelkový stav
•= Edémy, bledost, hmatné útvary v břiše <= /div>
lHmotnost
•= Hmotnostní přírůstek
lKrevní tlak
•= Normály odpovídajícího věku !
lAkce srdeční
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Akutn&i= acute; selhání ledvin – vyšetření
ØLaboratorní vyšetření:
lMoč – biochemie, mikroskopicky, osmolali= ta, odpady minerálů a proteinů, frakční exkrece <= span style=3D'position:absolute;top:69.62%;left:3.33%;width:83.52%;height:30.37= %'>sodíku, mikrobiologické vyšetření
lKrev – krevní obraz a diferenciální rozpočet (manuální), plazmatický kreatinin, urea, kyselina močov&aacut= e;, hladina proteinů, ABR, ASLO, CIK, C3, ANA
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Akutn&i= acute; selhání ledvin – vyšetření
ØZobrazovací vyšetření:
lUZ ledvin a radionuklidový scan
lRTG hrudníku
l
ØEKG
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Akutn= í selhání ledvin – abnormality
ØAnémie = (diluční/hemolytická)
ØLeukopenie (lu= pus)
ØTrombocytope= nie (lupus, trombóza renální žíly, HUS)&= #13;
ØHyponatrémie
ØHyperkal&eac= ute;mie
ØAcidó= za
ØZvýšená urea, kreatinin, kyselina močová
ØHyperfosfatémie, hypokalcémie&= #13;
ØSnížená hladina C3 (PSGN)
ØASLO, ANA, A= NCA, ABMA pozitivní
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Akutní selhání ledvin - rozlišení
> 1%
< 1%
Frakční exkrece Na
> 40
< 20
Odpady Na za 24 h
< 20
> 20
= Poměr kreatininu = moč/plazma
< 1.1
> 1.3
Poměr osmolalit moč/plazma
< 350
> 500
Osmolalita moči
Válce, erytrocyty
Normální
Mikroskopická analýza
Variabilní
Variabilní
Produkce moči
Renální
Prerenální
=
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Akut= ní selhání ledvin – frakční exkrece Na=
ØFE (Na) popisuje
lReabsorpci vody = ;
lReabsorpci sodíku
l
ØHodnota <= 1% ukazuje na normální funkci tubulů a potenciálně reverzibilní prerenální azotémii
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Akutní selhání ledvin – léčba
ØHypovol&eacu= te;mie
lExpanze objemu R= 11; F1/1 20ml/kg za 30-60´
lDehydratovaný pacient močí během 2 hodin
ØPřet&ia= cute;žení oběhu (selhání ledvin/volumexpanze) = ;
lOmezení teku= tin
R= 26;vyrovnat insenzibilní ztráty + výdej moči za předchozích 24 h
lTerapie diuretiky u správně hydratovaného pacienta
R= 26;furosemid, manitol
R= 26;furosemid – ne více než 10 mg/kg/d
R= 26;manitol – jednotlivá i.v. dávka 0,5 – 1 g/kg za 30´= ;
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Akutn&= iacute; selhání ledvin – hyperkalémie
Hodiny
Iontoměniče
2 hodiny
Peritoneální dialýza
15 minut
Hemodialýza
10 minut
Glukóza s inzulínem
5 minut
Bikarbonát sodný
Rychle
Beta agonisté
Okamžitě
Kalcium glukonát
Nástup
Terapie
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Akutn&= iacute; selhání ledvin – hyperkalémie
ØZastavit dodávku kália p.o. i i.v.
ØPřesuno= ut kálium do buněk
lAlkalinizace
lGlukóza s inzulínem
lBeta agonisté
ØAntagonizovat účinky kália
lKalcium glukonát
ØOdstranit kálium
lIontoměnič= ;e
lPeritoneáln&= iacute; dialýza, hemodialýza
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Akutn&= iacute; selhání ledvin – hyperkalémie
ØK+ < 5,5 mmol/l
lZastavit příjem draslíku v potravě, tekutinách, lécích
ØK+ 5,5 – 7 mmol/l
lZačít podávání iontoměničů
ØK+ > 7 mmol/l
lBeta agonisté – terbutalin (s.c./inh.), salbutamol (inh.)
lKalcium glukonát 10% - 0,5 ml/kg během 10´
lBikarbonát sodný 3 mmol/kg
lGlukóza 40% 1 ml/kg + inzulín 1 U / 5 g glukózy
lDialýza
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Akutn&i= acute; selhání ledvin – acidóza
ØMírn&= aacute; acidóza je u ARS běžná
lNedostatečn&aa= cute; exkrece H+ a NH3+
lVzácně vyžaduje léčbu
ØZáva&= #382;ná acidóza
lArteriáln&ia= cute; pH <7,15
lSérový bikarbonát < 8 mmol/l
lČást= ečná korekce – i.v. NaHCO3 k dosažení pH 7,20 (12 mmol/l NaHCO3)
l0,3 x hmotnost (kg)= x (12-sérový NaHCO3)
lPřidat orální suplementaci
lRychlá alkalinizace = → tetanie (↓ iCa)
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Akutn&= iacute; selhání ledvin – hypertenze
ØNásledek ARS a/nebo volumexpanze
ØMírná hypertenze
lRestrikce soli a vody
lBeta blokátory
ØTěžká akutní hypertenze
lDiazoxid
ØHypertenzní krize
lNitroprusid sodný
lLabetalol
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Akutn&ia= cute; selhání ledvin – dieta
ØZpočátku omezená na tuky a uhlovodany
&Osla= sh;
ØPokud ARS přetrvává > 3 dny
lRozšířená orální dieta pro ledvinné selhání
lZvážit parenterální hyperalimentaci s esenciálními aminokyselinami
lKalorický příjem by měl být 300 kcal/m2/d
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Akutn&i= acute; selhání ledvin – dialýza
ØIndikač= ní kritéria:
lPřetí&#= 382;ení tekutinami refrakterní k ostatní léčb&= #283;, spojené s hypertenzí, městnavým srdečním selháním
lHyperkalémie refrakterní k léčbě, kalémie > 7 mmol/l
lAcidóza refrakterní k léčbě
lTěžk&aacu= te; hyponatrémie, Na+ < 120 mmol/l
lSymptomatická urémie
lRychle narůstající urea a kreatinin
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Chronické selhání ledvin
ØDefinice: ireverzibilně poškozené ledviny nejsou schopny udržet homeostázu
ØNení obnova funkce, úbytek funkce přesto, že primární onemocnění již není/neaktivní
ØKlinicky normální období (korektivní mechanizmy) → snížená renální rezerva, snížená GF → manifestní chronické selhání
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Normální GF u dětí a dospělých
2,10 ± 0,36
Ž
13 – 21 r
2,33 ± 0,50
M
13 – 21 r
2,20 ± 0,45
M/Ž
2 – 12 r
1,60 ± 0,36
M/Ž
8 tý – 2 r
1,10 ± 0,41
M/Ž
2 – 8 tý
0,68 ± 0,25
M/Ž
1 týden
Průměrná= GF &plusm= n; SD
(ml/s/1,73 m2)
Pohlaví
Věk
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Progresivní postižení ledvin
Kritéria jednotlivých fází
<= span style=3D'mso-special-format:"numbullet7\,1";color:#99FF99;mso-color-index:= 6; position:absolute;left:-9.77%;top:.22em;font-size:80%'>I.Ča= sná fáze poškození renálních funkcí= 3;
•Mírn&e= acute; snížení počtu nefronů
•Reziduá= lní renální funkce mezi 50-80%
•GF 1,33 ̵= 1; 0,80 ml/s/1,73 m2
•Sérový kreatinin > m= ax kreatinin pro věk,    < = 176 μmol/l (134 μmol/l < 5 let věku)
•Max hodnota kreatininu =3D vý&= #353;ka (cm) x 0,61
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Progresivní postižení ledvin
Kritéria jednotlivých fází
<= span style=3D'mso-special-format:"numbullet7\,2";color:#99FF99;mso-color-index:= 6; position:absolute;left:-11.34%;top:.22em;font-size:80%'>II.Chron= ická renální insuficience
•Reziduál= ní renální funkce mezi 25-50%
<= span style=3D'mso-special-format:bullet;color:#CCECFF;mso-color-index:3;positio= n: absolute;left:-10.17%;top:.91em;font-size:50%'>•GF 0,8 – 0,16 ml/s/1,73 m2
•Sérov&y= acute; kreatinin > 176 μmol/l (>= 134 μmol/l < 5 let) více než 6 měsíců
•Pacient symptomatický porucham= i elektrolytů, špatný růst, dysbalance kalcium – fosfor
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Progresivní postižení ledvin
Kritéria jednotlivých fází
<= span style=3D'mso-special-format:"numbullet7\,3";color:#99FF99;mso-color-index:= 6; position:absolute;left:-11.34%;top:.22em;font-size:80%'>III.Chro= nické selhání ledvin
•Reziduá= lní renální funkce < 25% normálu
<= span style=3D'mso-special-format:bullet;color:#CCECFF;mso-color-index:3;positio= n: absolute;left:-10.17%;top:.91em;font-size:50%'>•GF 0,16 - 0,08 ml/s/1,73 m2
<= span style=3D'mso-special-format:bullet;color:#CCECFF;mso-color-index:3;positio= n: absolute;left:-10.17%;top:.91em;font-size:50%'>•Sérov&= yacute; kreatinin > 700-800 μmol/l <= /span>
•Metabolické abnormality související s významným snížením počtu nefronů – metabolická acidóza, renální osteodystrofie, anémie, hypert= enze …
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Progresivní postižení ledvin
Kritéria jednotlivých fází
IV.Konečná fáze ledvinného onemocnění
•Reziduální renální funkce se může pohybovat mezi 12= % a < 5% normálu
•GF < 0,08 ml/s/1,73 m2 = ;
•Sérov&y= acute; kreatinin individuální, obvykle přesahuje 9= 00 μmol/l
•
•= Pacienti ve fázi III a IV jsou léč= eni chronickou dialýzou nebo transplantací ledviny
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Progresivní postižení ledvin
Etiologie
•Etiologie chronického selhání ledvin v dětství závisí na věku
•< 5 let věku
•Anatomick&e= acute; abnormality (hypoplázie, dysplázie, obstrukc= e, malformace…)
•> 5 let věku
•Získ= aná glomerulární onemocnění (GN, HUS)
•Vrozené poruchy (Alportův syndrom, cystická nemoc)
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Chronické selhání ledvin
&Oslas= h;Klinické příznaky: =
lRozvoj selhání může b&yac= ute;t plíživý
lNespecifické obtíže
•= Bolesti hlavy, únava, letargie
•= Anorexie, zvracení
•= Polydypsie, polyurie
•= Selhání růstu
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Chronické selhání ledvin
ØDiagnóza
lAnamnéza
lFyzikální vyšetření R= 11; výška, váha, TK
lLaboratorní vyšetření
R= 26;Moč – biochemie, mikroskopické vyšetření, osmolalita, odpady elektrolytů a proteinů ve 24 h sběru, mikrobiologické vyšetření
R= 26;Krev – krevní obraz a diferenciální rozpočet, <= /span>kreatinin, urea, kys. močová, elektrolyty, kalcium a fosfor, aktivita alkalické fosfatázy, ABR
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Chronické selhání ledvin
&Oslas= h;Diagnóza
lZobrazovací vyšetření = ;
•= UZ ledvin
•= Radionuklidový scan
•= Rentgenografické studie kostí
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Chronic= ké selhání ledvin – léčba
ØVoda a elektrolyty
lU kongenitálních abnormalit je častá polyurie a plýtvání solí, vyžadující zvýšený přísun
lU onemocnění glomerulů s progresivní ztrátou funkce ledvin může být nezbytná restrikce
lU většiny dětí s chronickým selháním se udrží homeostáza K+ dokud renální funkce neklesnou na úroveň dialýzy
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Chronic= ké selhání ledvin – léčba
ØAcidóza
lVyvine se téměř u všech dětí s renální insuficiencí
lKorekce není nezbytná, dokud sérový bikarbonát nepoklesne < 15 mmol/l
ØAnémie
lPostupný vývoj během rozvoje nemoci&= #13;
lSnížená produkce a uvolňování erytropoetinu
lSnížené přežívání krvinek kvůli hemolýz= e
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Chronic= ké selhání ledvin – léčba
ØRenální osteodystrofie
lHypokalcémie, hyperfosfatémie, zvýšená hladina <= span style=3D'position:absolute;top:36.25%;left:14.23%;width:78.27%;height:5.25= %'>PTH a sérové aktivity ALP
lSérová hladina P stoupá, když GF klesne < 30%
lHypokalcémie v důsledku hyperfosfatémie, neadekvátního příjmu a <= /span>͛= 5; vstřebávání ve střevě
lKorekce hyperfosfatémie: omezení příjmu, vazače fosfátů (Ca karbonát, Ca acetát)
lKorekce hypokalcémie: léčba hyperfosfatémie, orální suplementace kalcia, aktivn&i= acute; forma dihydroxyvitam&ia= cute;nu D
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Chronic= ké selhání ledvin – léčba
&Oslas= h;Růstová retardace <= /span>
lHladina GH je obvykle normální/vysoká, ale neudrží normální růst kvůli nízké aktivitě IGF
lSelhání růstu je více vyjádřené u kongenitálních vad
lLéčba rGH může zlepšit růstovou rychlost
lNezbytností je léčba metabolické acidózy a kostní nemoci, odpovídající nutričn&iacut= e; příjem
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Chronic= ké selhání ledvin – léčba
ØHypertenze&#= 13;
lPrevalence se liší podle původu chronické insuficience
lNení častá u kongenitálních nemocí, častá je u primární glomerulární nemoci a u renálního poškození způsobeného systémovým onemocněním
lU všech renálních onemocnění zrychluje deterioraci
lLéčba:
•Z= měna životního stylu (restrikce Na, hubnutí, cvičení…)
•F= armakoterapie: 1. ACE inhibitory =
• 2. Blokátory kalciových kanálů
• … přímé vazodilatátory, inhibitory CNS receptorů sympatiku
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Chronic= ké selhání ledvin – léčba
ØDieta
lRestrikce proteinů není u dětí doporučována, dokud GF nepoklesne < 0,33 ml/s&#= 13;
lMinimální příjem bílko= vin u dětí je 1 g/kg/d
lAdekvátní kalorický pří= ;jem – stejný nebo lehce vyšší, ne&= 2; doporučovaný pro zdravou populaci, může být zvýšen neomezeným množstv&iacu= te;m karbohydrátů a tuků (triglyceridy o středně dlouhém řetězci)
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Děkuji Vám za pozornost !=
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=3D=3D 0 ) gSldJumpIdx =3D 1; var jumpTo =3D parseInt(gSldJumpIdx); gSldJump =3D 0; gSldJumpIdx =3D ""; win.GoToSld( parent.GetSldList().mList[jumpTo-1].mSldHref ) } } } function _KDH() { if( event.keyCode =3D=3D 8 ) { event.returnValue =3D 0; parent.GoToPrevSld(); } }function DocumentOnClick() { if( IsNts() || parent.HideMenu() ) return; if( ( g_allowAdvOnClick && (window.name=3D=3D"PPTSld") && !parent.IsFrames= Mode() ) || (event && event.keyCode=3D=3D32) ) { =09 if( g_animUseRuntime && g_animMainSequence && g_animMainSequence.cangonex= t ) return; parent.GoToNextSld(); } } var g_supportsPPTHTML =3D SupportsPPTHTML(), g_scaleInFrame =3D 1, gId=3D""= , g_bgSound=3D"", g_scaleHyperlinks =3D false, g_allowAdvOnClick =3D 1, g_showInBrowser = =3D 0, gLoopCont =3D 0, gUseSldTimings =3D 1; var g_showAnimation =3D g_supportsPPTHTML && SupportsPPTAnimation() && ( (w= indow.name=3D=3D"PPTSld" && !parent.IsFramesMode()) || g_showInBrowser );va= r g_animManager =3D null; var g_animUseRuntime =3D false; var g_animItemsToHide, g_animInteractiveItems, g_animSlideTime; var g_animMainSequence =3D null; var ENDSHOW_MESG=3D"Konec prezentace, klepnutím ukončíte= předvádění.", SCREEN_MODE=3D"Frames", gIsEndShow= =3D0, NUM_VIS_SLDS=3D43, SCRIPT_HREF=3D"script.js", FULLSCR_HREF=3D"fullscr= een.htm"; var gCurSld =3D gPrevSld =3D 1, g_offset =3D 0, gNtsOpen =3D gHasNts =3D gO= tlTxtExp =3D 0, gHasNarration =3D 0, gOtlOpen =3D true window.gPPTHTML=3DSupportsPPTHTML() var gMainDoc=3Dnew Array(new hrefList("slide0001.htm",1,-1,1),new hrefList(= "slide0002.htm",1,-1,1),new hrefList("slide0003.htm",1,-1,1),new hrefList("= slide0004.htm",1,-1,1),new hrefList("slide0005.htm",1,-1,1),new hrefList("s= lide0006.htm",1,-1,1),new hrefList("slide0007.htm",1,-1,1),new hrefList("sl= ide0008.htm",1,-1,1),new hrefList("slide0009.htm",1,-1,1),new hrefList("sli= de0010.htm",1,-1,1),new hrefList("slide0011.htm",1,-1,1),new hrefList("slid= e0012.htm",1,-1,1),new hrefList("slide0013.htm",1,-1,1),new hrefList("slide= 0014.htm",1,-1,1),new hrefList("slide0015.htm",1,-1,1),new hrefList("slide0= 016.htm",1,-1,1),new hrefList("slide0017.htm",1,-1,1),new hrefList("slide00= 18.htm",1,-1,1),new hrefList("slide0019.htm",1,-1,1),new hrefList("slide002= 0.htm",1,-1,1),new hrefList("slide0021.htm",1,-1,1),new hrefList("slide0022= .htm",1,-1,1),new hrefList("slide0023.htm",1,-1,1),new hrefList("slide0024.= htm",1,-1,1),new hrefList("slide0025.htm",1,-1,1),new hrefList("slide0026.h= tm",1,-1,1),new hrefList("slide0027.htm",1,-1,1),new hrefList("slide0028.ht= m",1,-1,1),new hrefList("slide0029.htm",1,-1,1),new hrefList("slide0030.htm= ",1,-1,1),new hrefList("slide0031.htm",1,-1,1),new hrefList("slide0032.htm"= ,1,-1,1),new hrefList("slide0033.htm",1,-1,1),new hrefList("slide0034.htm",= 1,-1,1),new hrefList("slide0035.htm",1,-1,1),new hrefList("slide0036.htm",1= ,-1,1),new hrefList("slide0037.htm",1,-1,1),new hrefList("slide0038.htm",1,= -1,1),new hrefList("slide0039.htm",1,-1,1),new hrefList("slide0040.htm",1,-= 1,1),new hrefList("slide0041.htm",1,-1,1),new hrefList("slide0042.htm",1,-1= ,1),new hrefList("slide0043.htm",1,-1,1)); /********************************************* Frameset functions These functions control slide navigation and state of the frameset. **********************************************/ function FullScrInit() { g_allowAdvOnClick =3D GetCurSld().mAdvOnClk document.body.style.backgroundColor=3D"black" document.oncontextmenu=3Dparent._CM; document.onkeydown =3D _KDH; document.ondragstart=3DCancel document.onselectstart=3DCancel self.focus() } function Redirect( frmId ) {=09 var str=3Ddocument.location.hash,idx=3Dstr.indexOf('#'), sId=3DGetSldId() if(idx>=3D0) str=3Dstr.substr(1); if( window.name !=3D frmId && ( sId !=3D str) ) { obj =3D GetObj("Main-File") window.location.href=3Dobj.href+"#"+sId return 1 } return 0 } var MHTMLPrefix =3D CalculateMHTMLPrefix();=20 function CalculateMHTMLPrefix() { if ( document.location.protocol =3D=3D 'mhtml:') {=20 href=3Dnew String(document.location.href)=20 Start=3Dhref.indexOf('!')+1=20 End=3Dhref.lastIndexOf('/')+1=20 if (End < Start)=20 return href.substring(0, Start)=20 else=20 return href.substring(0, End)=20 } return ''; } function GetTags(base,tag) { if(g_supportsPPTHTML) return base.all.tags(tag); else return base.getElementsByTagName(tag); } function UpdNtsPane(){ if(frames["PPTNts"]) PPTNts.location.replace( MHTMLP= refix+GetHrefObj( gCurSld ).mNtsHref ) } function UpdNavPane( sldIndex ){ if(gNavLoaded) PPTNav.UpdNav() } function UpdOtNavPane(){ if(gOtlNavLoaded) PPTOtlNav.UpdOtlNav() } function UpdOtlPane(){ if(gOtlLoaded) PPTOtl.UpdOtl() } function SetHasNts( fVal ) { if( gHasNts !=3D fVal ) { gHasNts=3DfVal UpdNavPane() } } function ToggleOtlText() { gOtlTxtExp=3D!gOtlTxtExp UpdOtlPane() } function ClearMedia() { // Clear any sounds playing before launching another browser window. Other= wise, // in fullscreen mode, you'll continue to hear the sound in the frames mod= e. if (PPTSld.pptSound) PPTSld.pptSound.loop =3D 0; } function FullScreen() {=20 if ( PPTSld.g_animUseRuntime ) PPTSld.document.body.pause(); ClearMedia(); var href =3D ( document.location.protocol =3D=3D 'mhtml:') ? FULLSCR_HREF = : FULLSCR_HREF+"#"+GetHrefObj(gCurSld).mSldHref; if(PPTNav.event.ctrlKey) { var w =3D (window.screen.availWidth * 1.0) / 2.0 var h =3D w * (PPTSld.g_origH * 1.0) / PPTSld.g_origW win =3D window.open( MHTMLPrefix+href,null,"toolbar=3D0,resizable=3D1,top= =3D0,left=3D0," + "width=3D"+ w + ",height=3D" + h ); if( win.document.body && PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } else { win =3D window.open( MHTMLPrefix+href,null,"fullscreen=3Dyes" ); if( win.document.body && PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } } function ToggleVNarration() { rObj=3DPPTSld.document.all("NSPlay") if( rObj && !PPTSld.g_animUseRuntime ) { if( (rObj.playState =3D=3D 1)||(rObj.playState =3D=3D 0) ) rObj.Play() else if( rObj.playState =3D=3D 2 ) rObj.Pause() else return; } else if( PPTSld.g_animUseRuntime ) { narObj =3D PPTSld.document.all("narrationID") if( narObj ) narObj.togglePause() } } function GetCurSldNum() { =20 obj=3DGetHrefObj(gCurSld) if( obj.mOrigVis =3D=3D 1 ) return obj.mSldIdx else =20 return gCurSld } function GetNumSlds() { =20 if( GetHrefObj(gCurSld).mOrigVis =3D=3D 1 ) return GetSldList().mNumVisSlds; else return GetSldList().mList.length } function GetSldNum( href ) { for(ii=3D0; ii 1 ) PopSldList(); else if( !IsFramesMode() ) { if( gLoopCont ) GoToFirst() else EndShow() } } function GoToPrevSld() { ii=3DgCurSld-1 if( ii > 0 ) { obj=3DGetHrefObj(ii) while ( obj && ( obj.mVis =3D=3D 0 ) && ( ii>0 ) ) obj=3DGetHrefObj(--ii) if( ii =3D=3D 0 ) ii=3D1 GoToSldNum(ii) } } function GoToFirst(){ GoToSld( GetHrefObj(1).mSldHref ) } function GoToLast() { ii=3DGetSldList().mList.length if( ii !=3D gCurSld ) GoToSld( GetHrefObj(ii).mSldHref ) } function GoToSldNum( num ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue obj =3D GetHrefObj( num ) obj.mVis=3D1 gPrevSld=3DgCurSld gCurSld =3D num; PPTSld.location.replace(MHTMLPrefix+obj.mSldHref) if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function GoToSld( href ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue GetHrefObj( GetSldNum(href) ).mVis=3D1 PPTSld.location.replace(MHTMLPrefix+href) } function SldUpdated( id ) { if( id =3D=3D GetHrefObj(gCurSld).mSldHref ) return gPrevSld=3DgCurSld gCurSld=3DGetSldNum(id) if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function PrevSldViewed(){ GoToSld( GetHrefObj(gPrevSld).mSldHref ) } function HasPrevSld() { return ( gIsEndShow || ( gCurSld !=3D 1 && GetHrefO= bj( gCurSld-1 ).mVis =3D=3D 1 )||( GetCurSldNum() > 1 ) ) } function HasNextSld() { return (GetCurSldNum() !=3D GetNumSlds()) } function CloseWindow() { if( HideMenu() ) return; =09 var event =3D PPTSld.event; if( !IsFramesMode() && event && (event.keyCode=3D=3D27 || event.keyCode=3D= =3D32 || event.type=3D=3D"click" ) ) window.close( self ); CatchNumKeys( self, event ); } function Unload() { gIsEndShow=3D0; } function SetupEndShow() { gIsEndShow=3D1; PPTSld.document.body.scroll=3D"no"; PPTSld.document.onkeypress=3DCloseWindow; PPTSld.document.onclick=3DCloseWindow; PPTSld.document.oncontextmenu=3D_CM; } function EndShow() { if( IsFramesMode() ) return if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue doc=3DPPTSld.document var dir =3D doc.body.dir if( dir !=3D "rtl" ) dir =3D "ltr"; doc.open() doc.writeln('


' + ENDSHOW_MESG + '

') doc.close() } function SetSldVisited(){ GetSldList().mList[gCurSld-1].mVisited=3Dtrue } function IsSldVisited(){ return GetSldList().mList[gCurSld-1].mVisited } function hrefList( sldHref, visible, advDelay, advClk ) { this.mSldHref=3D this.mNtsHref =3D sldHref this.mOrigVis=3D this.mVis =3D visible this.mVisited=3D false this.mAdvDelay=3D advDelay this.mAdvOnClk=3D advClk } function SldList(arr,curSld,fEnd) { this.mCurSld =3D curSld; this.mList =3D new Array(); var idx =3D 1; for(ii=3D0;ii 0) { PushSldList(sldList,fEnd); gCurSld =3D 1; } else if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue } function PushSldList(arr,fEnd) { var ii =3D gSldStack.length; gSldStack[ii] =3D new SldList(arr,gCurSld,fEnd); GoToSld( gSldStack[ii].mList[0].mSldHref ); } function PopSldList() { if (gSldStack[gSldStack.length-1].fEndShow) EndShow() else { gCurSld =3D gSldStack[gSldStack.length-1].mCurSld; gSldStack[gSldStack.length-1] =3D null; gSldStack.length--; var sldList =3D gSldStack[gSldStack.length-1]; GoToSld( sldList.mList[gCurSld - 1].mSldHref ); } } var custShowList=3Dnew Array(); /********************************************* Navigation button implementation There are 2 types of buttons: ImgBtn, TxtBtn implemented as function objects. They share a similiar interface so the event handlers can call SetActive, for example, on a button=20 object without needing to know exactly=20 what type of button it is. **********************************************/ //---------------------------------- function ImgBtn( oId,bId,w,action ) //---------------------------------- { var t=3Dthis t.Perform =3D _IBP t.SetActive =3D _IBSetA t.SetInactive=3D _IBSetI t.SetPressed =3D _IBSetP t.SetDisabled=3D _IBSetD t.Enabled =3D _IBSetE t.ChangeIcon =3D null t.UserAction =3D action t.ChgState =3D _IBUI t.mObjId =3D oId t.mBorderId=3D bId t.mWidth =3D w t.mIsOn =3D t.mCurState =3D 0 } function _IBSetA() { if( this.mIsOn ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _IBSetI() { if( this.mIsOn ) { obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 ) obj.style.posTop=3D0=20 } } function _IBSetP() { if( this.mIsOn ) { obj=3Dthis.ChgState( gShadowClr,gHiliteClr,2 ) obj.style.posLeft+=3D1; obj.style.posTop+=3D1 } } function _IBSetD() { =20 obj=3Dthis.ChgState( gFaceClr,gFaceClr,0 ) obj.style.posTop=3D0=20 } function _IBSetE( state ) { var t=3Dthis GetObj( t.mBorderId ).style.visibility=3D"visible" if( state !=3D t.mIsOn ) { t.mIsOn=3Dstate if( state ) t.SetInactive() else t.SetDisabled() } } function _IBP() { var t=3Dthis if( t.mIsOn ) { if( t.UserAction !=3D null ) t.UserAction() if( t.ChangeIcon ) { obj=3DGetObj(t.mObjId) if( t.ChangeIcon() ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-4)*t.mWidth else obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-0)*t.mWidth } t.SetActive() } =20 } function _IBUI( clr1,clr2,nextState ) { var t=3Dthis SetBorder( GetObj( t.mBorderId ),clr1,clr2 ) obj=3DGetObj( t.mObjId ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-nextState)*t.mWidth-obj= .style.posTop t.mCurState=3DnextState return obj } //----------------------------------------- function TxtBtn( oId,oeId,action,chkState ) //----------------------------------------- { var t=3Dthis t.Perform =3D _TBP t.SetActive =3D _TBSetA t.SetInactive=3D _TBSetI t.SetPressed =3D _TBSetP t.SetDisabled=3D _TBSetD t.SetEnabled =3D _TBSetE t.GetState =3D chkState t.UserAction =3D action t.ChgState =3D _TBUI t.mObjId =3D oId t.m_elementsId=3D oeId t.mIsOn =3D 1 } function _TBSetA() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gHiliteClr,gShadowClr,0,0 ) } function _TBSetI() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) } function _TBSetP() { if( this.mIsOn ) this.ChgState( gShadowClr,gHiliteClr,1,1 ) } function _TBSetD() { =20 this.ChgState( gFaceClr,gFaceClr,0,0 ) this.mIsOn =3D 0 } function _TBSetE() { var t=3Dthis if( !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) else t.ChgState( gShadowClr,gHiliteClr,1,1 ) t.mIsOn =3D 1 } function _TBP() { var t=3Dthis if( t.mIsOn ) {=20 if( t.UserAction !=3D null ) t.UserAction() if( !t.GetState ) return if( t.GetState() ) t.SetPressed() else t.SetActive() } =20 } function _TBUI( clr1,clr2,lOffset,tOffset ) { SetBorder( GetObj( this.mObjId ),clr1,clr2 ) Offset( GetObj( this.m_elementsId ),lOffset,tOffset ) } function Offset( obj, top, left ){ obj.style.top=3Dtop; obj.style.left=3Dle= ft } function SetBorder( obj, upperLeft, lowerRight ) { s=3Dobj.style; s.borderStyle =3D "solid" s.borderWidth =3D 1=20 s.borderLeftColor =3D s.borderTopColor =3D upperLeft s.borderBottomColor=3D s.borderRightColor =3D lowerRight } function GetBtnObj(){ return gBtnArr[window.event.srcElement.id] } function BtnOnOver(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetActive() } function BtnOnDown(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetPressed() } function BtnOnOut(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetInactive() } function BtnOnUp() { b=3DGetBtnObj() if( b !=3D null ) b.Perform() else Upd() } function GetNtsState(){ return parent.gNtsOpen } function GetOtlState(){ return parent.gOtlOpen } function GetOtlTxtState(){ return parent.gOtlTxtExp } function NtsBtnSetFlag( fVal ) { s=3Ddocument.all.item( this.m_flagId ).style s.display=3D"none" if( fVal ) s.display=3D"" else s.display=3D"none" } function _BSetA_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etActive() } function _BSetI_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etInactive() } function _BSetP_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etPressed() } function _BSetA_BorderImg() {=20 b =3D gBtnArr[this.mBorderId]=20 if( b !=3D null && this.mIsOn && !b.GetState() ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _BSetI_BorderImg() {=20 b =3D gBtnArr[this.mBorderId] if( b !=3D null && this.mIsOn && !b.GetState() ) { obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 ) obj.style.posTop=3D0 } } var gHiliteClr=3D"THREEDHIGHLIGHT",gShadowClr=3D"THREEDSHADOW",gFaceClr=3D"= THREEDFACE" var gBtnArr =3D new Array() gBtnArr["nb_otl"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOtlPan= e,GetOtlState ) gBtnArr["nb_otlElem"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOt= lPane,GetOtlState ) gBtnArr["nb_nts"] =3D new ImgBtn( "nb_nts","nb_ntsBorder",10,parent.ToggleN= tsPane ) gBtnArr["nb_nts"].SetActive =3D _BSetA_BorderImg; gBtnArr["nb_nts"].SetInactive =3D _BSetI_BorderImg; gBtnArr["nb_ntsBorder"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.= ToggleNtsPane,GetNtsState ) gBtnArr["nb_ntsElem"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.To= ggleNtsPane,GetNtsState ) gBtnArr["nb_prevBorder"] =3D gBtnArr["nb_prev"]=3D new ImgBtn( "nb_prev","n= b_prevBorder",30,parent.GoToPrevSld ) gBtnArr["nb_nextBorder"] =3D gBtnArr["nb_next"]=3D new ImgBtn( "nb_next","n= b_nextBorder",30,parent.GoToNextSld ) gBtnArr["nb_sldshw"]=3D new ImgBtn( "nb_sldshw","nb_sldshwBorder",18,parent= .FullScreen ) gBtnArr["nb_sldshwBorder"] =3D new TxtBtn( "nb_sldshw","nb_sldshwBorder",pa= rent.FullScreen,null ) gBtnArr["nb_sldshwBorder"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwBorder"].SetInactive =3D _BSetI_Border; gBtnArr["nb_sldshwText"] =3D new TxtBtn( "nb_sldshw","nb_sldshwText",parent= .FullScreen,null ) gBtnArr["nb_sldshwText"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwText"].SetInactive =3D _BSetI_Border; gBtnArr["nb_voice"] =3D gBtnArr["nb_voiceBorder"] =3D new ImgBtn( "nb_voice= ","nb_voiceBorder",18,parent.ToggleVNarration ) gBtnArr["nb_otlTxtBorder"] =3D gBtnArr["nb_otlTxt"]=3D new ImgBtn( "nb_otlT= xt","nb_otlTxtBorder",23,parent.ToggleOtlText ) gBtnArr["nb_ntsBorder"].m_flagId=3D "nb_nts" gBtnArr["nb_ntsBorder"].SetFlag =3D NtsBtnSetFlag gBtnArr["nb_otlTxt"].ChangeIcon=3D GetOtlTxtState /********************************************* Context menu implementation _CM() is the function that's hooked up to the oncontextmenu event. Once we're asked to show the menu, we first build it by creating DIVs on-the-fly. Then we position it=20 within the screen area so it doesn't get clipped. Creating the DIVs using createElement() means we don't have to write out any extra HTML into the slide HTML files. **********************************************/ var sNext=3D"Další",sPrev=3D"Předchozí",sEnd=3D"Kon= ec prezentace",sFont=3D"Arial",sArrow=3D"Šipka",sFreeform=3D"Voln&yacu= te; tvar",sRect=3D"Obdélník",sOval=3D"Ovál" function ShowMenu() { BuildMenu(); var doc=3DPPTSld.document.body,x=3DPPTSld.event.clientX+doc.scrollLeft,y= =3DPPTSld.event.clientY+doc.scrollTop m =3D PPTSld.document.all.item("ctxtmenu") m.style.pixelLeft=3Dx if( (x+m.scrollWidth > doc.clientWidth)&&(x-m.scrollWidth > 0) ) m.style.pixelLeft=3Dx-m.scrollWidth m.style.pixelTop=3Dy if( (y+m.scrollHeight > doc.clientHeight)&&(y-m.scrollHeight > 0) ) m.style.pixelTop=3Dy-m.scrollHeight m.style.display=3D"" } function _CM() { if( !parent.IsFullScrMode() ) return; if(!PPTSld.event.ctrlKey) { ShowMenu() return false } else HideMenu() } function BuildMenu() { if( PPTSld.document.all.item("ctxtmenu") ) return var mObj=3DCreateItem( PPTSld.document.body ) mObj.id=3D"ctxtmenu" mObj.style.visibility=3D"hidden" var s=3DmObj.style s.position=3D"absolute" s.cursor=3D"default" s.width=3D"120px" SetCMBorder(mObj,"menu","black") var iObj=3DCreateItem( mObj ) SetCMBorder( iObj, "threedhighlight","threedshadow" ) iObj.style.padding=3D2 CreateMenuItem( iObj,sNext,M_GoNextSld,M_True ) CreateMenuItem( iObj,sPrev,M_GoPrevSld,M_HasPrevSld ) =09 CreateSeparator( iObj ) CreateMenuItem( iObj,sEnd,M_End,M_True ) mObj.style.visibility=3D"visible" } function Cancel() { window.event.cancelBubble=3Dtrue; window.event.returnVa= lue=3Dfalse } function Highlight() { ChangeClr("activecaption","threedhighlight") } function Deselect() { ChangeClr("threedface","menutext") } function Perform() { e=3DPPTSld.event.srcElement if( e.type=3D=3D"menuitem" && e.IsActive() ) e.Action() else PPTSld.event.cancelBubble=3Dtrue } function ChangeClr( bg,clr ) { e=3DPPTSld.event.srcElement if( e.type=3D=3D"menuitem" && e.IsActive() ) { e.style.backgroundColor=3Dbg e.style.color=3Dclr } } function M_HasPrevSld() { return( parent.HasPrevSld() ) } function M_GoNextSld() { if( gIsEndShow ) M_End(); else GoToNextSld() } function M_GoPrevSld() { if( gIsEndShow ) { gIsEndShow=3D0; history.back();= PPTSld.event.cancelBubble=3Dtrue; } else GoToPrevSld() } function M_True() { return true } function M_End() { window.close( self ) } function CreateMenuItem( node,text,action,eval ) { var e=3DCreateItem( node ) e.type=3D"menuitem" e.Action=3Daction e.IsActive=3Deval e.innerHTML=3Dtext if( !e.IsActive() ) e.style.color=3D"threedshadow" e.onclick=3DPerform e.onmouseover=3DHighlight e.onmouseout=3DDeselect s=3De.style; s.fontFamily=3DsFont s.fontSize=3D"9pt" s.paddingLeft=3D2 } function CreateSeparator( node ) { var sObj=3DCreateItem( node ) SetCMBorder(sObj,"menu","menu") var s=3DsObj.style s.borderTopColor=3D"threedshadow" s.borderBottomColor=3D"threedhighlight" s.height=3D1 s.fontSize=3D"0px" } function CreateItem( node ) { var elem=3DPPTSld.document.createElement("DIV") node.insertBefore( elem ) return elem } function SetCMBorder( o,ltClr,rbClr ) { var s=3Do.style s.backgroundColor=3D"menu" s.borderStyle=3D"solid" s.borderWidth=3D1 s.borderColor=3DltClr+" "+rbClr+" "+rbClr+" "+ltClr } ------=_NextPart_01C4EF58.BE345E00 Content-Location: file:///C:/59116902/akutni_a_chronicke_selhani_ledvin_web_soubory/fullscreen.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" ------=_NextPart_01C4EF58.BE345E00 Content-Location: file:///C:/59116902/akutni_a_chronicke_selhani_ledvin_web_soubory/buttons.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhWAESAPf4AAAAAIAAAACAAICAAAAAgIAAgACAgICAgAQEBISEBASEBISEhAQEhMTExAQE /KTM9Pz8/ERERPz8BAT8/KSkpGRkhMTcxCRkxAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAMDAwP8AAAD/AP//AAAA//8A/wD//////yH5BAEAAPgALAAAAABYARIA QAj/APEJHEiwoMGDCBMqXMiwocOHECNKnEixosWLGCEiQKCRo8YDIEHig2DxAD4LKD1avDDhgUuV GUOGbHBR5QGYFBG4fHAB58EKECJEwCfUYAWPFGAygLCRKQIIUKM6WAohKUGgCikcFWh1INWoYKVS 7SrQ41GbIhGYLAuVQVOoC+IyXUuUAkG1HE3KFDhAwkgJc5/qDZmxsOHDiBMrXsy4sePDGyP7lChT 5MULmDPnlDw5YmW6FTNrfgi0aNGEZPEtbfo2bNTUpYeeRph69dPWrqvCNFuBIGG1A59CYPAVQtwF cw0OxWdTIOiBCQAjaAB17fOFII8voGmRc+eOkilm/z9OvTtnjN4hYk1YoT3H2rnBOphPAB9skgq3 2lcaX/5YnJVt9BloAar12UEIRGCZdQghMABI1Tn32IQUVthYexhmqGGGMBHAgIfEhSiiiATAtOGJ GnYI4ogsEldicAYOGNJGZaml3Y0L3NTZUBz1xlB0PUoUI0jlVWRSVN89xBKSGB1YU1TMoRfVBEle hR9HQs1GEHxQ3RZZbveZthxt/LEmXHyp5XWABSCpaRJwbM13gAACPHVccgJFgF+NEhqUAEkQSCfc ddhVhh5dVTaEAEsTUNlkZUWKN9BNGDE6QU8OrSdbllzpxyVTTrU21Uj3scfhp7nNpyoDaTIEJ3P9 If8J2kbLNYegg9JRBwGhFvbq66+ZUiDssMQWK2yHxiZLrInKNotss8l+B5yBrr5p2UIJvortANoC 6+234IbLla/elRtZjeamh5CC3Sb0YLvixivvYkDFGlZqBNh7r4n6goVvv6/ZlCicN+kL71ALTnpQ dCIZp7CihkLA3UQmoWRBogyxtBPGCTnZncVR1rSTo5nuydC/Eo8kUH+lOoTyyvjoCuZu+PjYIKLD rZybtrM1d10C0QXKEVz48GrQkEeWdFJKlbb0UmEeV0SzyC6RvNB646LWIVjUNeC1zAFb+RDKXksM 9r531bwmpQW9+hQDDsx5pqwDRWBXcFES2hc+gEn/wJGdEEWdE6LoWcoxQweaTNmkhydkKaYMYY2Q p1unbLl/pPKbn3v7EZRvrKvqlja2ONvrtoIw9tn2g32/tQBlhtYkU+MNikZ7QYlPDPuMldpOmuJX nVo5VF3HjI+q89mteX5IDd/fVFClma5kiE4f2XUJhlz09gj2NbTDRifkmu7zXjR++RVJ/lPznuvr QH2iD6S+UewP9Dnon6d2NLwN8n90BB6hC68cFMCHoe+ACASP9c4DowUyEF0OPFcDI0ij/VXPaAKC UfhS95AKGoQ7IBRICI1HwhGaUIQoLGEKT6jCFrLwhSuMoQtlCMMZ2rCGOKShDm+4wxzy8Ic+DGIP B4cIRCKGMCAAOy== ------=_NextPart_01C4EF58.BE345E00 Content-Location: file:///C:/59116902/akutni_a_chronicke_selhani_ledvin_web_soubory/frame.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Acute and chronic renal failure ------=_NextPart_01C4EF58.BE345E00 Content-Location: file:///C:/59116902/akutni_a_chronicke_selhani_ledvin_web_soubory/outline.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii"
 Po= známky
Prezentac= e
Osnova
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