Possibilities of surgical correction of vocal cord palsy after thyroid gland operations

  Wstęp: Powikłania po zabiegach chirurgicznych gruczołu tarczowego są stale najczęstszą przyczyną obustronnego porażenia fałdów głosowych, a zaburzenia oddychania są głównym problemem w tych sytuacjach. Istnieje wiele procedur operacyjnych poszerzenia szpary głośni w przypadku obustronnego porażenia fałdów głosowych. Celem pracy była prezentacja możliwości poszerzenia szpary głośni, ocena wykonywanych technik operacyjnych oraz wyników leczenia w przypadku porażeń fałdów głosowych po zabiegach operacyjnych tarczycy. Materiał i metody: W badaniu oceniono pięć technik operacyjnych: laserowa tylna chordektomia według Denisa i Kashimy, laserowa obustronna arytenoidektomia przyśrodkowa według Crumlaya, laserowa tylna wentrykulo-chordektomia według Pia, laserowa całkowita arytenoidektomia z chordektomią tylną według Ossoffa oraz laterofiksacja według Lichtenbergera. Subiektywnej oceny poprawy wentylacyjnej dokonywano przy użyciu skali VAS. Wyniki: W latach 1998–2014 autorzy zoperowali 270 pacjentów z obustronnym porażeniem fałdów głosowych, z czego 255 (94,4%) przypadków jatrogennych po operacjach tarczycy, a 15 (7,6%) z innych przyczyn. U znacznej większości pacjentów — 77,6%, zastosowano laserową całkowitą arytenoidektomię z chordektomią tylną, a u 13,7% laterofiksację metodą Lichtenbergera. Zabieg operacyjny według Ossoffa pozwala na osiągnięcie dobrych wyników wentylacyjnych: udana dekaniulacja (62,9% po pierwszym zabiegu, 97,6% jako ostateczny odsetek) oraz znaczna lub istotna stopnia subiektywna poprawa wydolności oddechowej u 96% pacjentów. Wnioski: Arytenoidektomia według Ossoffa jest bezpieczną procedurą dającą zadowalające wyniki wentylacyjne. Pacjenci relacjonują satysfakcjonującą jakość życia oraz możliwość powrotu do życia zawodowego. Zdaniem autorów pracy, laterofiksacja powinna pozostać jako alternatywa dla czasowej tracheotomii raczej niż zabieg zasadniczy. (Endokrynol Pol 2015; 66 (5): 412–416)    Introduction: Surgery of the thyroid gland remains the main cause of bilateral vocal cord palsy (VCP). Ventilation problem is the main problem in such situations. There are a couple of corrective surgical procedures in the case of VCP. The aim of our study was to show the possibility of widening of the glottis, and to evaluate the techniques and effects of surgical treatments due to bilateral VCP resulting from thyroid gland surgery. Material and methods: Five methods of surgical treatment were used: laser-assisted posterior cordectomy, according to Denis and Kashima; laser-assisted bilateral medial arytenoidectomy, as proposed by Crumley; laser-assisted posterior ventriculocordectomy, as described by Pia; laser-assisted total arytenoidectomy with posterior cordectomy, as presented by Ossoff; and laterofixation, according to Lichtenberger. The postoperative patient’s subjective improvement was assessed using visual analogue scale. Results: Between 1998 and 2014 we operated on 270 patients with bilateral VCP. Paresis occurred as the result of the iatrogenic effect of thyroid gland surgery in 255 patients (94.4%) vs. 15 (7.6%) from other causes. The majority of our patients (77.6%) had undergone laser arytenoidectomy with posterior partial cordectomy, and in 13.7% of them Lichtenberger laterofixation had been performed. Ossoff ’s surgery gives good ventilation results: successful decannulation (62.9% after first surgery; 97.6% final rate) and significant subjective ventilation improvement in 96% of patients. Conclusions: Ossoff ’s laser arytenoidectomy with posterior cordectomy is a safe procedure that gives acceptable ventilation improvement. Patients report satisfactory quality of life and the possibility of returning to active professional life. Laterofixation should be considered as an alternative for tracheotomy rather than permanent procedure. (Endokrynol Pol 2015; 66 (5): 412–416)

Innovative Power Engineering in a Selected Rural Commune

This paper presents modern solutions of distributed generation in rural communities aiming at the improvement of energy and environmental security, as well as power supply reliability to important customers (e.g. health care, sensitive consumer required continuity). Distributed sources are mainly gas and biogas cogeneration units, as well as wind and photovoltaic sources. Some examples of their applications in a selected Silesian community are given

Comparison of some aspects of the bionomy of Ostrinia nubilalis Hbn. (Lep., Crambidae) on Bt and non-Bt maize in south-eastern Poland

A study on the dynamics of the oviposition and hatching of Ostrinia nubilalis Hbn. larvae on transgenic maize line MON 810 (DKC 3421YG cultivar) and isogenic maize (DKC 3420 cultivar) was carried out in 2008-2011 in Gluchów (south-eastern Poland). No significant differences were found between the number of egg clusters deposited by O. nubilalis on Bt and non-Bt maize based on the carried out observations. A small, statistically significant difference in the number of egg clusters between the studied cultivars was found only in 2011 and was most likely associated with weather changes. Female O. nubilalis did not significantly prefer any of the cultivars when depositing eggs. In addition, we found no differences in the dynamics of oviposition and larvae hatching between Bt and non-Bt maize. The first egg clusters, their maximum number, and the last egg clusters were found on similar dates for both studied cultivars. Empty egg clusters proving larval hatching were also found on similar dates for Bt and non-Bt maize

Broken Rotor Bar Fault Diagnosis Techniques Based on Motor Current Signature Analysis for Induction Motor—A Review

The most often used motor in commercial drives is the induction motor. While the induction motor is operating, electrical, thermal, mechanical, magnetic, and environmental stresses can result in defects. Therefore, many researchers who are involved in condition monitoring have been interested in the development of reliable and efficient fault diagnostic technologies. This paper’s goal is to provide an overview of available fault detection methods for the broken rotor bar problem, one of several defects associated to induction motors. Despite the fact that it is less common than bearing or insulator failure, this fault may cause electrical machines to fail catastrophically. It can be quite harmful, especially in large motors, and it can develop as a result of manufacturing faults, repeated starting of the machine, mechanical stress, and thermal stress. Hence, a review on rotor defect diagnosis was conducted. In order to confirm rotor bar fracture, this research provides probable defect signatures that can be extracted from the current signal. Each defect signature is reported according to (a) loading level, (b) the number of BRBs, (c) validation, and (d) methodologies

Oxidative Stress Markers Patients with Parotid Gland Tumors: A Pilot Study

Salivary gland tumors account for 3–6% of tumors of the head and neck. About 80% of salivary gland tumors occur in parotid glands. Oxidative stress (OS) is implicated in the origin, development, and whole-body effects of various tumors. There are no data on the occurrence of OS in the parotid gland tumors. The aim of this study was to ascertain if whole-body OS accompanies parotid gland tumors, based first of all on oxidative modifications of blood serum proteins and other markers of OS in the serum of the patients. The group studied included 17 patients with pleomorphic adenoma, 9 patients with Warthin’s tumor, 8 patients with acinic cell carcinoma, and 24 age-matched controls. We found increased concentration of interleukin 4 in patients with acinic cell carcinoma, decreased plasma thiols, increased AOPP concentration, and decreased FRAP of blood serum in all groups of the patients while protein oxidative modifications assessed fluorimetrically, protein carbonyls, protein nitration, malondialdehyde concentration, and serum ABTS⁎-scavenging capacity were unchanged. These data indicate the occurrence of OS in patients with parotid gland tumors and point to various sensitivities of OS markers

3356097.pdf

Supplement