Can we routinely identify the external branch of the superior laryngeal nerves with neural monitoring?: a prospective report on 176 consecutive nerves at risk

The external branch of the superior laryngeal nerve (EBSLN) provides motor function to the cricothyroid muscle (CTM). EBSLN damage produces changes in voice quality and projection. Intraoperative neuromonitoring (IONM) in thyroid surgery aims to optimize EBSLN control during dissection. We prospectively collected the data of 88 consecutive patients who underwent total thyroidectomy with IONM from July 2019 to December 2019. IONM was offered in the intermittent mode of application. We routinely searched for the EBSLN electromyographic (EMG) signal before (S1) and after (S2) dissection of the superior vascular peduncle. In the absence of the EMG signal, we observed the CTM twitch. We identified 141 (80%) S1 EMG signals, while we recorded the CTM twitch in 15 cases (8.5%). In 20 (11.3%) cases, we were unable to identify the EMG signal. Analysing the S2 results, we found loss of EBSLN signal in 11/141 cases (7.8%) identified with IONM in pre-dissection stimulation. Among the 20 cases without pre-dissection identification (we had not identified the external branch of the superior laryngeal nerve or the muscle twitch), in the post-dissection evaluation, we confirmed the loss of signal in 17 of 20 cases, equal to 85% (p < 0.001). Our data clearly show that intraoperative stimulation and recognition of EBSLN, performed before any dissection manoeuvre to the superior vascular thyroid pole, leads to a much higher rate of nerve conservation.

Holographic memory updated by contradictory information: influence of low frequency attenuation on response stability

A 6f-scheme of Fourier holography with resonant architecture is considered, which implements memory replenishment with new information that contradicts the previously recorded. It is shown that the low-frequency attenuation due to the nonlinearity of the exposure characteristics of holographic recording media in the initial reference holographic image recorded in a narrow filtering range corresponding to the degradation in the correlation plane of the global maximum of the autocorrelation function below the lateral maxima leads to the response instability — an intermittent mode. It is shown that the intermittent mode corresponds to the restructuring of the autocorrelation function of a composite standard recorded in holograms from one range of values of the approximation model parameters to another. It is shown that the correlation length of the composite image recorded in holograms is an order parameter of the system; its rapid change precedes the loss of response stability and the transition to an unstable regime with intermittency. The results of numerical simulation are presented.

Luteinizing hormone releasing hormone analogues in the treatment of patients with prostate cancer

Prostate cancer (PC) is the most pressing oncourological pathology due to a steady increase in morbidity and mortality from this pathology in the Russian Federation. The detection frequency of the common forms of the disease remains high. The combined chemo-hormonal therapy is the main method of treatment of metastatic prostate cancer. The refractoriness of the tumour to the ongoing castration therapy is an inevitable stage of the course of the disease in all patients receiving androgen deprivation therapy. However, castration therapy aimed at reducing endogenous testosterone in this cohort of patients should be continued. Eligard is one of the most studied drugs to conduct the drug castration therapy in patients with prostate cancer, which efficacy has been proven in numerous clinical studies in both continuous and intermittent mode using depot forms of various durations of action. The article presents a review of clinical studies that assessed the efficacy of Eligard therapy in different regimens and with the use of depot forms of various duration, which demonstrated equal effectiveness of such forms.

Hybrid and intermittent drying of carrot (Daucus carota var. Nantes)

A combination of high power airborne ultrasound and microwaves in hot air drying was developed to investigate the effect of intermittent mode on process effectiveness and quality of carrot. The drying experiments were carried out in an innovative hybrid dryer. The course of moisture ratio, drying rate, specific energy and water consumption, colour, water activity and shrinkage were discussed. The results showed that intermittent ultrasound and microwaves in convective drying accelerate the heat and mass transfer, leading to shorter drying time and faster drying rate. It was found that hybrid-intermittent drying can improve the energy efficiency and product quality. Keywords: intermittent drying; ultrasound; microwaves; energy; shrinkage