[Cortisone treatment in prevention of pharyngocutaneous fistula after total laryngectomy]. / Tratamentul cortizonic în prevenirea fistulei faringo-cutanate postlaringectomie totala.

PURPOSE: To identify a method of prophylaxis in pharyngocutaneous fistula (PCF) after radical surgery for cancer of larynx and pyriform fossa. MATERIALS AND METHODS: A prospective longitudinal study on patients who were operated for cancer of larynx and pyriform fossa, in year 2007 in ENT Department of Clinic Emergency County Hospital Cluj-Napoca, with total laryngectomy and partial hypo-pharyngectomy. These patients were distributed in two lots: case (who received postoperative treatment with hemisuccinate of hydrocortisone or dexamethasone) and witness (they didn't received cortisone or other treatment except the standard therapy). We followed the detection of PCF at these 2 lots of patients and the time of resumption for naturally feeding and hospitalization. We performed the bi-variant analysis (Spearman). RESULTS: 23 patient were accomplished the inclusion and exclusion criteria. 4 of those patients developed postoperative pharyngo-cutaneous fistula, only one in the case lot. Statistically, cortisone administrated postoperative brought benefits: PCF was developed in a significant reduced proportion (p=0.02) and the resumption of naturally feeding was made in a significant shorter time (p=0.003) and hospitalization time was significantly reduced (p=0.001). CONCLUSION: Cortisone administration after total laryngectomy and partial hypo-pharyngectomy seems to be a prophylactic method for pharyngocutaneous fistula.

Formation of nanocrystalline phases during thermal decomposition of amorphous Ni-P alloys by isothermal annealing.

The microstructure and the average grain size were investigated by x-ray diffraction and transmission electron microscopy for nanocrystalline (n) Ni-P alloys with 18, 19, and 22 at.% P. A detailed study of the nanocrystalline states obtained along different heat treatment routes has been performed: (1) a-->ni by isothermal annealing of the melt-quenched amorphous (a) Ni-P alloys; (2) ni-->nii by isothermal annealing of the nanocrystalline ni state; (3) ni-->nii by linear heating of the ni state. The heats evolved during the structural transformations were determined by differential scanning calorimetry. From these studies, a scheme of the structural transformations and their energetics was constructed, which also includes previous results on phases obtained by linear heating of the as-quenched amorphous state of the same alloys. Grain boundary energies also have been estimated. In some cases it was necessary to assume a variation of the specific grain boundary energy during the phase transformation to understand the enthalpy and microstructure changes during the different heat treatments.