[Vocal fold paralysis in the Medical University of Warsaw's Ambulatory of Phoniatry in years 2000-2011]. / Porazenia krtani w materiale Poradni Foniatrycznej Warszawskiego Uniwersytetu Medycznego w latach 2000-2011.

INTRODUCTION: Vocal fold paralysis it is an important problem in Phoniatrics' Ambulatory. There are a lot of difficulties in estimation a precise incidence of vocal fold paralysis in the population. As many as 50% of cases with paralysis might present nonspecific symptoms. AIM OF THE STUDY: The aim of the research it was to determine a vocal fold paralysis' epidemiology and etiology in material of the Medical University of Warsaw's Ambulatory of Phoniatry. MATERIAL AND METHODS: Authors present a group of 593 patients with vocal cord paralysis who were diagnosed and treated in The Ambulatory of Phoniatry from 2000 to 2011. The paralysis was observed in 439 women and in 154 men. In 488 patients paralysis was unilateral and in 105 - bilateral. RESULTS: In the study, surgery was responsible for most vocal fold paralysis (79.0%). In 357 patients, paralysis was caused by thyroid surgery. Other surgical causes of the paralysis there were: endarterectomy, thoracic surgery and skull base surgery. Of the total group, 1.2% of cases were diagnosed after intubation. In the review, in another 19.8% cases, paralysis was caused by thoracic, neck or brain tumors, by traumas and in 21 patients there was no obvious reason (idiopathic cases). CONCLUSIONS: Etiology of vocal fold paralysis seems to be affected by a character of institutions or hospitals who make a study and by geographic location. The most common etiology of vocal cord paralysis is iatrogenic.

[The complications after CO2 laser endoscopic surgery for early glottic cancer]. / Powiklania leczenia wczesnego raka glosni za pomoca lasera CO2.

INTRODUCTION: CO(2) laser endoscopic surgery, introduction in the treatment of early glottic malignancies in the early seventies is the method has been well studied in such cases, and its utility for these lesions is well-established. Transoral resection with the CO(2) laser, open partial laryngectomy and radiotherapy are the main options for treatment of early laryngeal cancer. As all the therapies are all equally effective in controlling an early glottic cancer the choice of treatment must consider such factors as possible complications, functional outcome and patient compliance. For properly selected patients the laser therapy provides equivalent oncologic outcomes when compared to traditional surgical therapies while improving the functional aspects of postoperative speech, voice and swallowing. Its advantages over open surgery include quicker recovery, less morbidity, fewer side effects and greater cost-effectiveness too. The disadvantages of radiotherapy are: duration of treatment, loss of time for work and social activities, higher rate of other possible complications, and partial preclusion of further conservative salvage surgery. Some authors report radiotherapy offers the better quality of voice but further investigations are needed to compare the voice following endoscopic resections with that obtained after radiotherapy. AIMS: The aim of the study was to analyze the character of the peri- and postoperative complications after CO(2) laser endoscopic surgery for the early glottis cancer. MATERIAL AND METHODS: [corrected] This was a retrospective study of a files of 55 patients (7 female and 48 male) in age range 38-85 with early glottic carcinoma (Tis - T2) treated by cordectomy. Diagnosis was based on histopathological examination of the biopsy specimen of the lesion and ultrasonographical examination of the lymphonodules of the neck. Videolaryngostroboscopy and acustic analize of the voice was complicated. All of them underwent one of the types of cordectomy using a CO(2) laser, between 2007 and 2010. Cordectomies were categorized according to the classification of the European Laryngological Society (2000 and rev. 2007). In our series most cordectomies were type III 24 patients. Type IV - 2 patients, type Va - 18, type Vb - 4, type Vc - 6 and type VI - 1 patient. We observed peri-and postoperative complication and functional result of the treatment such as quality of voice and swallowing difficulties. CONCLUSIONS: Among 55 patient postoperative bleeding was the most commonly seen complication. It appeared in 34 of them (62%). All the cases of bleeding were easy to control. In 23 cases pain and mild laryngeal oedema were observed. It resolved in 3-4 day after medical treatment. None of our patient required tracheotomy. Eight patients needed revision procedures: four due to granulation tissue formation, two due to adhesion and another two due to laryngocele. This entire patient was manageable locally with repeated surgery. Our functional data, including stroboscopic findings and perceptual and objective voice evaluations, demonstrate that patients who underwent cordectomy and foniatric rehabilitation presents social efficient voice but with pathological components. All the patients have good long-term swallowing function.

Cloning and characterization of a region responsible for the maintenance of megaplasmid pTAV3 of Paracoccus versutus UW1.

Using cointegrate formation, we constructed a basic replicon of the megaplasmid/mini-chromosome pTAV3 of Paracoccus versutus UW1. It is composed of two adjacent modules, responsible for plasmid replication (rep) and partitioning (par). Functional analysis of the par region identified a determinant of incompatibility (inc2), whose presence is crucial for proper partitioning (the partitioning site). Database searches revealed that the only known replicon with significant homology to that of pTAV3 is encoded by the chromosome cII of Rhodobacter sphaeroides 2.4.1. Incompatibility studies showed that closely related basic replicons are also encoded by megaplasmids (above 400 kb) harbored by four strains of P. pantotrophus. Basic replicons of the pTAV3-type are able to maintain large bacterial genomes, therefore they appear to be good candidates for the construction of vectors specific for Alphaproteobacteria.