scholarly journals NEODYMIUM LASER IN LARINGOTRACHEOSTENOSIS TREATMENT AFTER TRACHEOSTOMY IN CHILDREN

2021 ◽  
Vol 29 (1) ◽  
pp. 38-45
Author(s):  
A.N. Voronetsky ◽  
◽  
A.E. Danovich ◽  
I.N. Shanaev ◽  
A.A. Nekliudov ◽  
...  
Keyword(s):  
Tracheal Stenosis ◽  
Soft Tissues ◽  
Subsequent Development ◽  
High Energy ◽  
Neodymium Laser ◽  
Direct Approach ◽  
Laser Application ◽  
Tracheal Lumen ◽  
Medical Systems ◽  
Laser Emitter

Objective. To evaluate the effect of neodymium laser application for successful decannulation in infants with a congenital and acquired tracheal stenosis and tracheostomy. Methods. 6 children were being treated in the 1<sup>st</sup> City Clinical Hospital of Minsk in 2011-2014. All children underwent tracheostomy with a prolonged tracheal intubation and subsequent development of tracheostenosis. The children were examined using X-ray, esophagogastroscopy (PentaxEG-16K10), and bronchoscopy (Olympus MAF TYPE GM). Tracheal stenosis was treated using a medical multifunctional laser complex Multiline (“Linline Medical systems” Ltd, Belarus) equipped with a high-energy neodymium laser emitter. Children with excessive growth of granulations in thelumenof thetrachea underwent vaporization of granulations by means of a bulbous probe with a neodymium laser emitter (wavelength of 1340 nm, power: 15 W, 2 sec. exposure). In cicatricial tracheal stenosis, incisions were made with a laser scalpel (the wavelength of 1064 nm, power of 20 W). Results. Effective decannulation was observed in 5 children, including 4 children who underwent3-5 treatment sessions. In 1 child with the congenital subglottic larynx stenosis, to perform the decannulation became possible after 2 years and 24 sessions of laser recanalizationofstenosis and ablation of granulations. One child, after 9 treatment sessions, dropped out of observation, the result has not been defined. Conclusion. Tracheostomy in children promotes the formation of granulations in the tracheal lumen with the formation of stenosis, which subsequently hinders a successful decannulation. The neodymium laser application with the endoscopic access provides the visual direct approach to the focus of impact with the aim of laser-induced vaporization of soft tissues and recanalization of the trachealmass in children with short tracheal stenosis leads to successful decannulation. What this paper adds Firstly the neodymium laser for the treatment of congenital and acquired tracheal stenosis in children after tracheotomy has been used. The method has been developed for restoring the tracheal lumen by laser-inducedvaporization of excessive tracheal granulation and making scalpel incisions in the scar area. It is shown the neodymium laser application with the endoscopic access provides the visual direct approach to the focus of impact. Laser-induced vaporization of soft tissues and recanalization of the tracheal lumen in children with short tracheal stenosis leads to successful decannulation.

scholarly journals Histological and ultrastructural changes in turkey liver under intensive rear-ing and influence of xenobiotics

2020 ◽  
Vol 22 (99) ◽  
pp. 63-68
Author(s):  
O. М. Shchebentovska ◽  
A. K. Kostyniuk
Keyword(s):  
Energy Content ◽  
Clinical Manifestations ◽  
Subsequent Development ◽  
Fatty Degeneration ◽  
Ultrastructural Level ◽  
High Energy ◽  
Ultrastructural Changes ◽  
Synthetic Activity ◽  
Standard Diet ◽  
Limited Mobility

Liver problems of various etiologies in turkeys have been reported in many countries for the last 20 years. Poultry dies having no clinical manifestations of the disease, and at pathological autopsy, diffuse haemorrhages and marked dystrophic changes of the organ are noted. To date, there are several factors that can cause such changes, these are unbalanced amino-acid feed, insufficient calcium, biotin, selenium, the very high energy content of feed; zootechnical factors – limited mobility of birds due to cage density violations, high temperature; genetic factors – the influence of estrogens; infectious factors – E. coli, Clostridium, and viruses of Picornaviridae family. The article describes the histopathological and ultrastructural changes in the turkey liver under the influence of various factors. The material for the research was obtained from a farm where turkeys of the “Hybrid Converter” cross are grown, same age, fed with a standard diet that changed according to the technological map of cultivation. On the 50th day of life, a pathological autopsy of the dead poultry was performed, pieces of liver were selected for histological and ultrastructural examination. The visual assessment revealed significantly enlarged liver, the colour from dark red to light brown, flabby consistency. In some cases, diffuse fatty infiltrations of hepatocytes were histologically revealed, in other cases, focal necrosis with the growth of the connective tissue and the formation of massive perivascular couplings were registered. Large vacuolar fatty degeneration of hepatocytes with subsequent development of fibrosis indicates chronic intoxication, probably caused by slow breakdown of fatty acids in cells due to insufficient oxidative phosphorylation, as well as reduced levels of lipotropic factors: choline, methionine and the vitamins. At the ultrastructural level, a large number of lipid inclusions of various sizes, dystrophic changes in mitochondria were observed, which indicates a decrease in the synthetic activity of cells.

scholarly journals Major Trauma and Severe Burn: A Synergistic Mortality. Case Report and Literature Review

2020 ◽  
Vol 61 (01) ◽  
pp. 023-027
Author(s):  
Oriol Pujol ◽  
Jordi Selga ◽  
Jordi Serracanta ◽  
Juan Antonio Porcel ◽  
José Vicente Andrés-Peiró
Keyword(s):  
Synergistic Effect ◽  
Multidisciplinary Approach ◽  
Open Fracture ◽  
Major Trauma ◽  
Soft Tissues ◽  
Total Body Surface Area ◽  
High Energy ◽  
Complex Case ◽  
Severe Burns ◽  
The Right

Abstract Case Presentation A 42-year-old man was transferred to our institution after a high-energy accident (an explosion). He presented second-degree burns on 20% of the total body surface area (TBSA), affecting the lower hemiabdomen and the lower right limb. He also presented a supraintercondylar open fracture of the right femur (Gustilo I). The burns were treated with debridement and coverage with mesh graft, while the fracture required an early transitory transarticular external fixation with delayed definitive osteosynthesis. Our patient presented good local and systemic evolution. We can offer a eleven-month follow-up. Discussion The literature supports that the combination of trauma and burn injuries is a relatively rare pattern, which may explain the lack of knowledge and studies on this subject. This double injury has demonstrated a synergistic effect on mortality. The management of soft tissues in the coexistence of an open fracture and a burn in the same limb is a challenge. The method and timing of the treatment of the fracture directly impacts the treatment of the burn (and vice versa), and most authors tend to treat the fracture first. All of the studies reviewed emphasized the importance of the multidisciplinary approach. Conclusions We have presented a complex case combining major trauma and severe burns. Although there is a lack of studies in the literature on this subject, the papers state that this is an unusual pattern with a synergistic effect on mortality. In our experience, the management of soft tissues and the multidisciplinary approach play a central role, as it is also stated in the literature. The management of these patients is still controversial, and more studies are needed.

Talus Fracture Accompanied by Irreducible Dislocation of Talar Trochlea – Treatment Strategy

2020 ◽  
Vol 22 (1) ◽  
pp. 55-61
Author(s):  
Jan Poszepczyński ◽  
Krzysztof Andrzejewski ◽  
Robert Rokicki ◽  
Michał Krzymiński( ◽  
Radosław Grabowski ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Fracture Morphology ◽  
High Energy ◽  
Crucial Importance ◽  
Talus Fracture ◽  
Accurate Analysis ◽  
Permanent Disability ◽  
Invasive Method ◽  
Therapeutic Problem ◽  
Immediate Surgery

A talus fracture accompanied by trochlear dislocation is an ever-present therapeutic problem as it requires immediate surgery since any delay may result in necrosis of soft tissues and the talus, which, consequently, leads to permanent disability. Of crucial importance in the treatment of such injury is accurate analysis of fracture morphology, immediate institution of treatment and minimally invasive surgery allowing early movement of the affected limb. We operated on a male patient after a high-energy injury using a low-invasive method we had modified, which allowed for early kinesiotherapy. The functional outcome of the procedure was very good.

High-energy (neodymium) laser pyrolysis of U.S. coals

1982 ◽  
Vol 4 (1) ◽  
pp. 21-31 ◽  
Author(s):  
Nicholas E. Vanderborgh ◽  
William J. Verzino ◽  
Michael A. Fletcher ◽  
Beth A. Nichols
Keyword(s):  
High Energy ◽  
Neodymium Laser ◽  
Laser Pyrolysis

scholarly journals The influence of protein nutrition in early life on growth and development of the pig

1983 ◽  
Vol 50 (3) ◽  
pp. 605-617 ◽  
Author(s):  
R. G. Campbell ◽  
A. C. Dunkin
Keyword(s):  
Body Composition ◽  
Growth Performance ◽  
Early Life ◽  
Protein Intake ◽  
Subsequent Development ◽  
Live Weight ◽  
High Energy ◽  
Protein Retention ◽  
Protein Nutrition ◽  
Low Protein

1. The effects of feeding either a high-protein (HP) diet or a low-protein (LP) diet between 1·8 and 15 kg live weight (LW) and a low-energy (LE) or a high-energy (HE) intake but at the same protein intake subsequent to 15 kg LW on the performance and body composition of pigs growing to 75 kg LW were investigated.2. During the LW period 1·8–15 kg, pigs given the LP diet exhibited poorer growth performance (P < 0·01) and at 15 kg contained more fat (P < 0·01) in their empty bodies than pigs given the HP diet.3. On the LE treatment subsequent to 15 kg LW, pigs previously given the LP diet deposited protein at a faster rate and exhibited more rapid and efficient growth to 60 kg LW than those given the HP diet before 15 kg. However, on the HE treatment, pigs previously given the LP diet deposited protein at a slower rate and exhibited poorer growth performance (P < 0·05) between 15 and 45 kg LW but grew at a faster rate between 45 and 60 kg LW than pigs previously given the HP diet.4. On the LE treatment subsequent to 15 kg LW the differences in body composition between the two protein groups were no longer significant at 45 kg. However, on the HE treatment, pigs previously given the LP diet remained fatter (P < 0·05) to 60 kg LW than those previously given the HP diet.5. The results suggested that restricting protein intake between 1.8 and 15 kg LW reduced, temporarily, the upper limit of protein retention and growth performance during subsequent development. This finding is discussed in relation to the effects of protein nutrition in early life on the hyperplasic development of muscle tissue.

Altered high-energy phosphate metabolism predicts contractile dysfunction and subsequent ventricular remodeling in pressure-overload hypertrophy mice

2007 ◽  
Vol 292 (1) ◽  
pp. H387-H391 ◽  
Author(s):  
M. Y. Maslov ◽  
V. P. Chacko ◽  
M. Stuber ◽  
A. L. Moens ◽  
D. A. Kass ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Ventricular Remodeling ◽  
Pressure Overload ◽  
Subsequent Development ◽  
High Energy ◽  
Left Ventricular ◽  
Resonance Spectroscopy ◽  
Contractile Dysfunction ◽  
Lv Mass

To study the role of early energetic abnormalities in the subsequent development of heart failure, we performed serial in vivo combined magnetic resonance imaging (MRI) and 31P magnetic resonance spectroscopy (MRS) studies in mice that underwent pressure-overload following transverse aorta constriction (TAC). After 3 wk of TAC, a significant increase in left ventricular (LV) mass (74 ± 4 vs. 140 ± 26 mg, control vs. TAC, respectively; P < 0.000005), size [end-diastolic volume (EDV): 48 ± 3 vs. 61 ± 8 μl; P < 0.005], and contractile dysfunction [ejection fraction (EF): 62 ± 4 vs. 38 ± 10%; P < 0.000005] was observed, as well as depressed cardiac energetics (PCr/ATP: 2.0 ± 0.1 vs. 1.3 ± 0.4, P < 0.0005) measured by combined MRI/MRS. After an additional 3 wk, LV mass (140 ± 26 vs. 167 ± 36 mg; P < 0.01) and cavity size (EDV: 61 ± 8 vs. 76 ± 8 μl; P < 0.001) increased further, but there was no additional decline in PCr/ATP or EF. Cardiac PCr/ATP correlated inversely with end-systolic volume and directly with EF at 6 wk but not at 3 wk, suggesting a role of sustained energetic abnormalities in evolving chamber dysfunction and remodeling. Indeed, reduced cardiac PCr/ATP observed at 3 wk strongly correlated with changes in EDV that developed over the ensuing 3 wk. These data suggest that abnormal energetics due to pressure overload predict subsequent LV remodeling and dysfunction.

Endoluminal laser application under percutaneous cardiopulmonary support in severe tracheal stenosis

2000 ◽  
Vol 48 (5) ◽  
pp. 301-303 ◽  
Author(s):  
Yoshimasa Maniwa ◽  
Keiji Ataka ◽  
Hidehiro Yamamoto ◽  
Noboru Ishii ◽  
Masayoshi Okada ◽  
...  
Keyword(s):  
Tracheal Stenosis ◽  
Laser Application ◽  
Percutaneous Cardiopulmonary Support ◽  
Cardiopulmonary Support

scholarly journals Traumatic Spondyloptosis Causing Complete Transaction of Spinal Cord

2014 ◽  
Vol 3 (2) ◽  
pp. 38-40
Author(s):  
Abhay Yadav ◽  
Sashmit Sharma
Keyword(s):  
Spinal Cord ◽  
Soft Tissues ◽  
High Energy ◽  
Special Consideration ◽  
Middle Aged ◽  
Rare Presentation ◽  
High Energy Trauma ◽  
Cord Injury ◽  
Very High Energy ◽  
Very High

Traumatic spondyloptosis is a rare presentation and is usually due to very high energy trauma. It is accompanied with cord injury, mostly complete transaction of the cord. In managing such cases special consideration should be given to soft tissues, surrounding structures and organs in the traumatized area. We present a case of traumatic spondyloptosis of D12/L1 in a middle aged gentleman with complete cord transaction. DOI: http://dx.doi.org/10.3126/noaj.v3i2.9527   NOAJ July-December 2013, Vol 3, Issue 2, 38-40

scholarly journals Staged Subtalar Fusion for Severe Calcaneus Fractures with Bone Loss

2013 ◽  
Vol 7 (1) ◽  
pp. 614-618 ◽  
Author(s):  
Chad G. Williams ◽  
Michael J. Coffey ◽  
Peter Shorten ◽  
James D. Lyions ◽  
Richard T. Laughlin
Keyword(s):  
Soft Tissue ◽  
Bone Loss ◽  
Soft Tissues ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
High Energy ◽  
Fusion Procedure ◽  
Subtalar Fusion ◽  
Thorough Debridement ◽  
Calcaneus Fractures

Background: With high energy fractures to the calcaneus there is the potential for significant bone loss. The loss of bone can make it difficult to fully regain calcaneal alignment. In addition these fractures are often associated with significant soft tissue injury. These two factors make it difficult to address this injury in a single stage, and can have significant complications. To address these issues our initial goal in treatment has been restoration of calcaneal alignment and stabilization of the surrounding soft tissue, followed by delayed/staged subtalar arthrodesis. Methods: Patients with calcaneus fractures treated by a single surgeon from 2002 to 2012 were reviewed. Injuries which were found to have medial extrusion of the posterior facet and bone loss, and subsequently underwent a staged protocol involving early provisional fixation and late subtalar fusion were included. Results: We treated 6 calcaneus fractures with bone loss. All patients were treated with staged subtalar fusion after initial irrigation and debridement and provisional fixation. No soft-tissue complications were noted after the fusion procedure in any of the six cases. Fusion occurred in all six patients at an average of 20.6 weeks (range, 13-23 weeks). All patients were able to ambulate and wear a regular shoe by one year following the initial injury. Conclusion: It is important in the high energy calcaneus fracture to assess for both soft tissue integrity and bone loss. A thorough debridement of both the soft tissues and any devitalized bone should be performed as well as provisional fixation which attempts to restore near normal calcaneal anatomy. Definitive fusion should not be performed until the soft tissues have fully recovered.

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