Módosított Kleinsasser-laringoszkóp bemutatása két eset kapcsán

Összefoglaló. Az algaratot és a gégét érintő, minimálisan invazív transoralis műtéti eljárások elvégzésekor elsődleges ezen relatíve szűk anatómiai régiók megfelelő feltárása. A hagyományos operációs endoszkópok lehetővé teszik ugyan a műtéti terület kellő vizualizációját, kialakításukból adódóan azonban nem optimálisak a különböző mikrosebészeti eszközök koordinációja és szimultán használata szempontjából. A mikroszkóp és a feltáró eszköz közötti relatíve nagy távolság pedig negatívan hat a célterület megvilágíthatóságára és a lézernyaláb fizikai tulajdonságaira is. A szerzők egy, az algaratot, valamint a gégét érintő elváltozások lézer-mikrosebészetében használt feltáróeszközt módosítottak: az endoszkóp oldalain kialakított nyílások lehetővé teszik a mikrosebészeti eszközök oldalsó bevezetését, emellett a mikroszkóp és a célterület közötti távolság jelentős csökkentését. A glotticus területet és a nyelvgyököt érintő műtét kapcsán bemutatott módosított operációs endoszkóp lehetővé teszi a műtéti terület megfelelő feltárását, a lézer optimális használatát és több mikrosebészeti eszköz egyidejű, szabad mozgatását. Orv Hetil. 2022; 163(17): 688-692. Summary. In cases of transoral laryngeal and hypopharyngeal surgeries, the exploration of these relatively narrow anatomical regions is paramount. The conventional operational endoscopes allow the visualization of the surgical field, but - due to their structure - are not optimal regarding the coordination and simultaneous moving of microsurgical instruments. Furthermore, the relatively great distance between the surgical microscope and the endoscope has a negative impact on the illumination of the surgical area and the physical characteristics of the laser beam. The authors introduce a modified laryngoscope used in the field of laryngeal and hypopharyngeal surgery. The openings in the sides of the endoscope allow the lateral insertion of microsurgical devices, while the distance between the microscope and the target area can be significantly reduced. The endoscope is presented in addition to a tongue base and a glottic surgery. The introduced operational endoscope allows optimal exploration of the area of interest, the free and simultaneous moving of the microsurgical instruments, and the optimal usage of the laser beam. Orv Hetil. 2022; 163(17): 688-692

Endoscopic Arytenoid Abduction Lateropexy with Endolaryngeal Thread Guide Instrument for Bilateral Vocal Fold Paralysis

The treatment of upper airway stenosis is considered to be one of the most difficult fields in laryngology. In the 100-year-old history of airway stenosis surgery several important works of Hungarian authors (Rethi, Lichtenberger, Pytel) are found.At the Department of Oto-Rhino- Laryngology and Head- Neck Surgery, University of Szeged our workgroup has been working on the treatment of upper airway stenosis for more than 30 years.Hereby we introduce our surgical concept for bilateral vocal fold paralysis, the minimally invasive endoscopic arytenoid abduction lateropexy (EAAL), which provides an immediate adequate airway with acceptable voice quality, and good swallow function.A new Endolaryngeal Thread Guide instrument (ETGI) is also presented here, which is essential for a safe, accurate, and fast suture loop creation around the arytenoid cartilage for this surgical procedure

Módosított Kleinsasser-laringoszkóp bemutatása két eset kapcsán

Az algaratot és a gégét érintő, minimálisan invazív transoralis műtéti eljárások elvégzésekor elsődleges ezen relatíve szűk anatómiai régiók megfelelő feltárása. A hagyományos operációs endoszkópok lehetővé teszik ugyan a műtéti terület kellő vizualizációját, kialakításukból adódóan azonban nem optimálisak a különböző mikrosebészeti eszközök koordinációja és szimultán használata szempontjából. A mikroszkóp és a feltáró eszköz közötti relatíve nagy távolság pedig negatívan hat a célterület megvilágíthatóságára és a lézernyaláb fizikai tulajdonságaira is. A szerzők egy, az algaratot, valamint a gégét érintő elváltozások lézer-mikrosebészetében használt feltáróeszközt módosítottak: az endoszkóp oldalain kialakított nyílások lehetővé teszik a mikrosebészeti eszközök oldalsó bevezetését, emellett a mikroszkóp és a célterület közötti távolság jelentős csökkentését. A glotticus területet és a nyelvgyököt érintő műtét kapcsán bemutatott módosított operációs endoszkóp lehetővé teszi a műtéti terület megfelelő feltárását, a lézer opti- mális használatát és több mikrosebészeti eszköz egyidejű, szabad mozgatását

Prediction of taxi drivers' safe-driving behaviors based on the theory of planned behavior: The role of habit

BACKGROUND: Safe-driving behaviors of taxi drivers are fundamental to health. The present research aimed to predict the taxi drivers' safe-driving behaviors based on the theory of planned behavior (TPB) and habit. MATERIALS AND METHODS: The present research is of a descriptive/analytical cross-sectional type conducted on 184 taxi drivers in Bandar Abbas who were selected through a multiple-stratified sampling method. Data collection instrument was a questionnaire comprised of two sections (demographic information and the constructs of TPB. STATISTICAL ANALYSIS USED: The data were later on analyzed via SPSS ver 19 and Pearson's correlation coefficient as well as multiple regressions. RESULTS: The mean age of the participants was 45.1 (standard deviation [SD = 11.1) years, and they had an average experience of taxi driving for 10.3 years (SD = 7.5). Subjective norms, perceived behavioral control, and habits were the predictors of one's intention of driving safely (r2 = 0.30, F = 18.7, P < 0.001). Moreover, attitude, perceived behavioral control, and habits were found to be the predictors of safe-driving behaviors (r2 = 0.19, F = 8.1, P < 0.001). Finally, habits showed to be a stronger predictor of safe-driving behaviors than attitude and perceived behavioral control. CONCLUSION: Consideration of individuals' behavioral habits and correction of unsafe habits, focus on the adverse effects of unsafe-driving behaviors, goal setting to change incorrect driving habits, attention to influential groups in altering unsafe-driving behaviors, and careful monitoring of abiding by the rules are suggested to promote safe-driving behaviors

Improving Animal Model of Induced Colitis by Acetic Acid in Terms of Fibrosis and Inflammation Incidence in the Colon

Background: One of the animal models of colitis is induced by acetic acid, which mimics some features of ulcerative colitis disease. In order to increase the similarity of this model to human IBD and determine the suitable duration of acid contact to the colon and the day of induction of colitis were investigated in this study. Methods Fifty rats were randomly separated into five groups (n = 10) with different durations (30 s, 5, 10, and 20 min) of exposure of the colon to 4% acetic acid and colitis was investigated for 0-9 days. The extent of the mucosal ulcers, colon tissue thickening, and mucosal bleeding were scored by the Gerald classification system score. Slides of tissues were prepared for pathologic assay using the modified Wallace method. Results In all groups, inflammation was severe three days after the colitis induction, but no inflammation was observed in the 30 s group after five days. Acid contact with the colon surface did not result in fibrosis for the 30 s and the colon fibrosis was mild in 5 min group and severe in 10 and 20 min groups. The tissue damage was higher in groups of 20, 10, 5 min, and 30 s, respectively. Over time, the recovery rates in the 30 s and 5 min groups were higher than other groups. Conclusion Our results showed that the evaluation of the disease process from 3 days to nine days after a 10 min contact of acid to the colon is a suitable model that mimics the histological features of the disease

A new solution for neonatal bilateral vocal cord paralysis: Endoscopic arytenoid abduction lateropexy

OBJECTIVES/HYPOTHESIS: Bilateral vocal cord paralysis in early childhood is a life-threatening condition, which often requires immediate intervention. One of the treatment options is a quick, reversible simple suture vocal cord lateralizing technique, whereby the arytenoid cartilage is directly lateralized to the normal abducted position. Considering pediatric laryngeal anatomy, a small endolaryngeal thread guide instrument was designed for precise suture insertion. STUDY DESIGN: New instrument validation. METHODS: Four newborns had inspiratory stridor immediately after birth; two had to be intubated. Laryngotracheoscopy revealed bilateral vocal cord paralysis. Unilateral, left-sided endoscopic arytenoid abduction lateropexy was performed with supraglottic jet ventilation on the 4th, 5th, 5th, and 27th day of life for the four patients, respectively. RESULTS: All babies remained intubated for 3 to 7 days with an uncuffed tracheal tube. After extubation, no dyspnea or swallowing disorder occurred. A subjective quality of life questionnaire, laryngotracheoscopy, clinical growth charts, and voice analysis showed satisfactory functional results. CONCLUSIONS: Minimally invasive, quick, reversible endoscopic arytenoid abduction lateropexy might be a more favorable solution for neonatal bilateral vocal cord paralysis than earlier treatment strategies. In one step, the airway can be maintained without the risk of any permanent damage to voice production. Good swallowing function is also preserved. The specially modified endolaryngeal thread guide instrument gives a fast and effective option for creating the lateralized arytenoid position even in the technically challenging surgical context of a neonate larynx. LEVEL OF EVIDENCE: 4. Laryngoscope, 2016

Risky behaviors of taxi drivers in Bandar Abbas, Iran

Background and aim: It has been revealed that taxi drivers break more traffic rules than ordinary drivers. Such risky behaviors include stopping at prohibited areas and sudden change of direction. The present study aimed to determine the Risky Behaviors of Taxi Drivers in Bandar Abbas, Iran Methods: In this cross-sectional study, 184 taxi drivers were randomly selected from eight taxi stations located at different parts of Bandar Abbas city in 2016. Taxi drivers’ risky behaviors were evaluated via a 20-item questionnaire. Data were analyzed by SPSS version 19, using descriptive statistics and independent-samples ttest. The p-values less than 0.05 were considered as statistically significant. Results: The mean age of the drivers was 45.1 (±11.1) years. The mean of their occupational experience was 18.7 (±10.8) years. The risky behaviors which showed the highest frequency were respectively, failure to use signallights, driving too close to the cars in front, refusing to drive within the lanes and erratic lane changing. The lowest frequency belonged to running a red light, ignoring ‘no entry’ signs and taking illegal U-turns. Risky driving behaviors were shown to be significantly more prevalent among drivers with previous experience of crashes or tickets than drivers with no such experiences (p˂0.01). Conclusion: Increasing the role of police supervision for the strict implementation of driving laws, and modification of the drivers’ behavior and implementation of periodic training programs on drivers’ safety issues can be considered for reducing taxi drivers’ unsafe behavior

Yield and Physiological Response of Red Bean Genotypes (Phaseolus vulgaris L.) to Cutting Irrigation off at Different Growth Stages

Water deficit and graduall reduction of available water resources are the limiting factors of crop production. To investigate the effect of water deficit stress on yield and components of some red bean genotypes a split plot experiment in the form of randomized complete block design with three replications was carried out at the Agricultural Research Station of Islamic Azad University, Arak Branch. The treatments consisted of full irrigation (control), cutting irrigation off during flowering stage, cutting irrigation off of pod filling stage and three genotypes of red bean (derakhshan, goli, and D81083). The results showed that the effect of cutting off irrigation during the growth stages on biological yield, grain yield, harvest index, number of pods per plant, number of seeds per pod was significant. The results also showed that the highest seed yield belonged to the full irrigation (control) treatment, where D81083 and goli produced higher yields than derakhshan. Highest grain yield was belonged to goli at full irrigation (control) treatment. Among the genotypes under study, D81083 had the lowest amount of reduction equal to 60 percent during cutting off irrigation at flowering stage. Number of seeds per pod decreased when irrigation was cutted off during the flowering stage. Derakhshan produced higher yield than the other genotypes and its seed per pod decreased by 38 percent. The results also revealed that red bean genotypes were very sensitive to deficite water stress. As a whole D81083 and goli genotypes were higher yielders than Derakhshan under limited water conditions