REFLECTIONS OF THE FRENCH ART BETWEEN THE MID-19TH AND THE EARLY 20TH CENTURIES IN VINCENTE MINNELLI’S FILMS

This paper examines and presents some heretofore familiar, as well as new suppositions: one being the influence of the French art between the mid-19th and early 20th centuries on two films by Vincente Minnelli directed in the 1950s – An American in Paris (1951) and Gigi (1958). Following a brief discussion on some biographical details that may have been the reason for Minnelli’s affection for such art, and the development of his career, what follows is an overview of the production of both films, and more importantly an analysis of the references to art that shaped their visual component, while simultaneously attempting to disclose possible reasons for their appearance.Keywords: film musical, art, France, Vincente Minnelli, Arthur Freed

Vocal Cord Paralysis and Parathyroid Cyst

Aim: Parathyroid gland lesions are an extremely rare clinical entity, mostly manifesting as adenoma and hyperplasia, rarely as parathyroid cysts, and most infrequently as carcinoma. Parathyroid cysts are frequently asymptomatic lesions of the neck and the superior mediastinum with only 300 cases reported in the literature. Symptomatic parathyroid cysts are very rare. Vocal cord paralysis due to recurrent laryngeal nerve dysfunction may herald the presence of neck and mediastinal disease including a variety of neoplastic, inflammatory and vascular conditions. The aim of this report is to describe their clinical presentation, diagnostic procedures, and therapeutic approaches. The objective of the study was to assess the presence of vocal cord paralysis and recurrent laryngeal nerve dysfunction, as well as their association in patients with recurrent laryngeal nerve. Methods. We performed a 12-year departmental review of parathyroid lesions and parathyroid cysts. Retrospective analysis of clinical data on 20630 unselected patients submitted to thyroid gland and neck ultrasonography yielded 149 (0.007%) patients with parathyroid lesions, six (0.0003%) of them with parathyroid cysts. A comprehensive review of the literature revealed 18 patients with vocal cord paralysis and parathyroid cysts. Results: Parathyroid adenoma were present in 97/149 (0.65%) and hyperplasia in 46/149 (0.30%) patients with parathyroid lesions. Parathyroid cysts were present only in six of 149 (0.04%) patients with parathyroid lesions. Five patients had asymptomatic nonfunctional parathyroid cysts, with vocal cord paralysis diagnosed in one female patient. In the 19 patients with parathyroid cysts and vocal cord paralysis reported in the literature (including the patient reported here), nine and ten patients had parathyroid cysts localized in the neck and mediastinum, respectively. Mediastinal cysts were twofold greater than those localized on the neck, while left recurrent laryngeal nerve dysfunction was recorded in 80% of cases. Cyst removal resulted in recurrent laryngeal nerve functional recovery in two-thirds of patients. Conclusion: Parathyroid cysts are rare, mostly asymptomatic pathologic lesions of parathyroid glands that should be taken into consideration in patients with hyperparathyroidism or vocal cord paresis

Kvalitet glasa laringealnih pacijenata kod kojih je primenjena aspiraciona i degluticiona metoda

Objectives. This research comprises rehabilitation of voice and speech in 30 patients to whom have been done total laryngectomy on Clinic for Illness of Ear, Throat and Nose in Novi Sad. Methodology. In these patients it was examined clearness of speech, height ( Voice Assesment Dr Speech softver ) , comparison of maximal duration of eructation in these two methods, comparison of time needed for reading of phonetically balanced text, articulation test between different methods of esophagus voice. Results. From 30 patients, 21 patients (70%) were rehabilitated, while 9 patients (30%) did not finish successfully rehabilitation of voice and speech… Examined parameters in both methods show that pronunciation of phonetically balanced text is between minimally 1,50 min to maximally 5,5 min, while number of words in one eructation is minimally 4 to maximally 5 words. Conclusion. Parameters of voice obtained with help of aspiration method were similar to parameters of normal voice, as also parameters of speech, while the same parameters with help of deglutition method were significantly different and significantly lower.Ovo istraživanje obuhvata rehabilitaciju glasa i govora kod 30 pacijenata kojima je na Klinici za bolesti uva, grla i nosa, Klinički Centar u Novom Sadu, urađena totalna laringektomija. Kod ovih pacijenata ispitivani su razumljivost govora, visina glasa (Voice Assesment Dr Speech softver), poređenje maksimalnog trajanja eruktacije kod aspiracione i degluticione metode, poređenje vremena potrebnog za čitanje fonetski izbalansiranog teksta, artikulacionog testa, između različitih metoda ezofagusnog glasa. Od tridest pacijenata 21 pacijent (70%) je rehabilitovan, dok 9 pacijenata (30%) nije uspešno završilo rehabilitaciju glasa i govora. Ispitivani parametri kod obe metode pokazuju da se izgovor fonetski izbalansiranog teksta kreće od minimum 1 min. i 50 sek. do maksimum 5 min. i 5 sekundi, dok broj reči na jednoj eruktaciji je od minimum 4 do maksimum 5 reči. Parametri glasa dobijeni uz pomoć aspiracione metode bili su slični parametrima normalnog glasa, kao i parametri govora, dok su se isti parametri uz pomoć degluticione metode značajno razlikovali i značajno su niži

Kvalitet glasa laringealnih pacijenata kod kojih je primenjena aspiraciona i degluticiona metoda

Objectives. This research comprises rehabilitation of voice and speech in 30 patients to whom have been done total laryngectomy on Clinic for Illness of Ear, Throat and Nose in Novi Sad. Methodology. In these patients it was examined clearness of speech, height ( Voice Assesment Dr Speech softver ) , comparison of maximal duration of eructation in these two methods, comparison of time needed for reading of phonetically balanced text, articulation test between different methods of esophagus voice. Results. From 30 patients, 21 patients (70%) were rehabilitated, while 9 patients (30%) did not finish successfully rehabilitation of voice and speech… Examined parameters in both methods show that pronunciation of phonetically balanced text is between minimally 1,50 min to maximally 5,5 min, while number of words in one eructation is minimally 4 to maximally 5 words. Conclusion. Parameters of voice obtained with help of aspiration method were similar to parameters of normal voice, as also parameters of speech, while the same parameters with help of deglutition method were significantly different and significantly lower.Ovo istraživanje obuhvata rehabilitaciju glasa i govora kod 30 pacijenata kojima je na Klinici za bolesti uva, grla i nosa, Klinički Centar u Novom Sadu, urađena totalna laringektomija. Kod ovih pacijenata ispitivani su razumljivost govora, visina glasa (Voice Assesment Dr Speech softver), poređenje maksimalnog trajanja eruktacije kod aspiracione i degluticione metode, poređenje vremena potrebnog za čitanje fonetski izbalansiranog teksta, artikulacionog testa, između različitih metoda ezofagusnog glasa. Od tridest pacijenata 21 pacijent (70%) je rehabilitovan, dok 9 pacijenata (30%) nije uspešno završilo rehabilitaciju glasa i govora. Ispitivani parametri kod obe metode pokazuju da se izgovor fonetski izbalansiranog teksta kreće od minimum 1 min. i 50 sek. do maksimum 5 min. i 5 sekundi, dok broj reči na jednoj eruktaciji je od minimum 4 do maksimum 5 reči. Parametri glasa dobijeni uz pomoć aspiracione metode bili su slični parametrima normalnog glasa, kao i parametri govora, dok su se isti parametri uz pomoć degluticione metode značajno razlikovali i značajno su niži

Subglotična visokofrekventna jet ventilacija u kirurškom liječenju obostrane pareze glasnica nakon operacije štitne žlijezde

Lesion of the recurrent laryngeal nerves as a consequence of thyroid surgery results in bilateral vocal fold paralysis and respiratory obstruction. The initial treatment involves ensuring an adequate airway and it ranges from tracheostomy to endo-extralaryngeal laterofixating operations in general anesthesia. Subglottic high frequency jet ventilation (HFJV) is an alternative ventilatory approach in airway surgery. HFJV offers optimal endolaryngeal working conditions, immobility of vocal cords, adequate oxygenation and ventilation. The HFJV was prospectively studied in 20 consecutive female patients with bilateral vocal fold paralysis. Ventilation was performed as subglottic HFJV via jet catheter inserted through the vocal cord. Anesthesia was administered as total intravenous anesthesia. At the end of the procedure, the jet catheter was exchanged with LMA laryngeal mask until spontaneous breathing was established. Subglottic HFJV was used in 20 patients undergoing endo-extralaryngeal laterofixating operations with suspension microlaryngoscopy. The mean duration of surgery was 32.25 minutes, mean age 47.35 (SD 9.75) years, and mean body mass index 26.39 kg m-2 (SD 5.03). The mean arterial PaCO2 5 min before surgical procedure was 5.39 (SD 0.86) kPa, at 5 min of starting jet ventilation 6.19 (SD 0.91) kPa, and at the end of surgical procedure 5.93 (SD 0.99) kPa. There was significant correlation between PaCO2 obtained 5 min before starting jet ventilation and PaCO2 at 5 min of starting jet ventilation (p<0.05). No complications secondary to the ventilation technique were observed. No perioperative tracheotomy was necessary. It is concluded that subglottic HFJV is an easy and safe way to ventilate patients with bilateral vocal fold paralysis when endoscopic intervention is performed.Obostrana pareza glasnica s posljedičnom opstrukcijom dišnoga puta nastaje kao rezultat lezije rekurentnog laringealnog živca tijekom operacije štitne žlijezde. Inicijalni postupci kojima se osigurava dišni put kod ovih bolesnika uključuju različite endo-ekstralaringealne zahvate te samu traheotomiju, koji se izvode u općoj anesteziji. Subglotična visokofrekventna jet ventilacija (VFJV) je alternativna tehnika ventilacije koja se koristi u kirurgiji dišnog puta. Ova tehnika ventilacije pruža optimalne endolaringealne uvjete za kirurški rad. U ovoj prospektivnoj studiji VFJV se rabio kod 20 bolesnica s obostranom parezom glasnica. Subglotična VFJV je provedena preko jet katetera postavljenog između glasnica u totalnoj intravenskoj anesteziji. Na kraju operacije je jet kateter zamijenjen laringealnom maskom sve do uspostavljanja spontanog disanja. Tehnika subglotične VFJV je upotrijebljena kod 20 bolesnica podvrgnutih endo-ekstralaringealnoj laterofiksaciji u suspenzijskoj mikrolaringoskopiji. Srednje vrijeme kirurške intervencije je bilo 32,25 minuta, srednja dob bolesnica 47,35 (SD 9,75) godina i srednji indeks tjelesne mase 26,39 (SD 5,03) kg m-2. Srednja vrijednost PaCO2 5 minuta prije početka kirurške intervencije je bila 5,39 (SD 0,86) kPa, 5 minuta nakon primjene jet ventilacije 6,19 (SD 0,91) kPa, a na kraju kirurške intervencije 5,93 (SD 0,99) kPa. Uočena je značajna korelacija između vrijednosti PaCO2 dobivenih 5 minuta prije početka kirurške intervencije i 5 minuta nakon početka primjene jet ventilacije (p<0,05). Komplikacije vezane za primjenu VFJV nisu primijećene. Tijekom perioperacijskog razdoblja nije bilo potrebe za traheotomijom. U zaključku, subglotična VFJV je sigurna tehnika ventilacije koja se primjenjuje tijekom endoskopskih intervencija kod bolesnika s obostranom parezom glasnica

Surgical approach and results of treating two subcategories pT2 glottic carcinoma of the larynx

Background: T2 glottic carcinoma is a nonhomogenous localization of laryngeal carcinoma with two subcategories. The aim of the study was to retrospectively analyze the results of surgically treated pT2 glottic carcinomas and to determine the importance of subcategories of glottic carcinomas in diagnostics, surgical treatment, and patients’ survival. Methods: During the period 1990-2000, 71/701 (10%) patients were diagnosed. with pT2 glottic carcinoma. All patients were treated with different surgical techniques. Results: Total laryngectomy was performed in 14/71 patients. Involvement of anterior commisure in local spreading of the cancer was found in 24/71 patients; total laryngectomy was performed in 13/24 and reconstructive surgery in 11/24. Selective resection of neck was done in 49 patients and metastases were found in 2 of these patients. Out of fifty-seven patients who had reconstructive laryngeal surgery local disease recurrence appeared in 8 patients. These 8 patients were treated with total laryngectomy. Overall 5-year survival was 90.1% with a slight difference between subcategories (89.1% subcategory I; 93.7% subcategory II) which was not statistically significant (p&gt;0.05). Disease free 5-year survival was 83.6% with a difference between subcategories (81.1% subcategory I; 93.3% subcategory II) which was not statistically significant (p&gt;0.05). Conclusion: Spreading of glottic carcinoma toward supraglottic and subglottic structures complicates exact preoperative evaluation of tumor size regardless to preoperative diagnostic procedures. Just owing to that, larger surgical resections performed bring more radicalness with less percentage of local recurrence and better effects on overall survival and disease free survival rate

Brown tumor of the maxilla in patient with secondary hyperparathyroidism

Brown tumor or parathyroid osteopathy is a kind of bony lesion caused by hyperparathyroidism. It appears as an expansive osteolytic lesion mostly in mandible, ribs, pelvis and femur, but rarely in the upper jaw. Bone resorption is the result of osteoclastic activity due to an increased activity of parathyroid hormone. A 25-years-old male patient was operated on due to clinicaly and radiographicaly obvious maxillary tumor and increased values of parathyroid hormon (PTH - 1 050 ng/l). The level of calcium in blood was normal (Ca 2.34 mEq/L). The patient was dialyzed for years because of the chronic renal failure. Histopathologic analysis confirmed brown tumor, that appeared as bony lesion of secondary hyperparathyroidism due to the chronic renal failure. The operation of the upper jaw had been performed before parathyroidectomy, due to an excessive growth of tumor followed by heavy epistaxes. The subsequent parathyroidectomy was followed by the regression of remaining bony lesions

Comparison between auditory steady-state responses and pure-tone audiometry

Background/Aim. A more recent method, the auditory steadystate response (ASSR), has become more and more important test method due to difference that was found in previous investigations between hearing thresholds determined by the ASSR and the pure-tone audiometry (PTA). The aim of this study was to evaluate the reliability of the ASSR in determining the frequency specific hearing thresholds by establishing a correlation between the thresholds determined by PTA, as well as to evaluate the reliability of ASSR in determining the hearing threshold with respect to the level of hearing loss and the configuration of the PTA findings. Methods. The prospective study included 46 subjects (92 ears) which were assigned to groups based on their level of hearing loss and audiometric configuration. All the subjects underwent determination of hearing thresholds by PTA and ASSR without insight into their previously obtained PTA results. Results. The overall sample differences between the ASSR and PTA thresholds were 4.1, 2.5, 4.4, and 4.2 dB at 0.5, 1, 2, and 4 kHz, respectively. A high level of correlation was achieved in groups with different configurations of PTA findings. The correlation coefficients between the hearing thresholds determined by ASSR and PTA were significant in subjects with all levels of hearing loss. The differences between hearing thresholds determined by ASSR and PTA were less than 10 dB in 85% of subjects (ranging from 4 dB for moderately severe hearing loss to 7.2 dB for normal hearing). Conclusion. The ASSR is an excellent complementary method for the determination of hearing thresholds at the 4 carrier frequencies, as well as determination of the level of hearing loss and the audiometric configuration

Sad, Serbia

Surgical approach and results of treating two subcategorie