Mechanical debulking of laryngeal papillomas is associated with voice disorders due to impairment of the vocal fold's mucosa. Intraepithelial injection of cidofovir reduces damage to the laryngeal structures and thus improves vocal parameters. The aim of our study was to compare vocal quality before and after cidofovir and CO 2 laser treatment by means of objective phoniatric parameters and to obtain evidence concerning voice outcomes. The vocal parameters of 42 patients with RRP were assessed before and after intralesional cidofovir and CO 2 laser debulking treatment (Lumenis AcuPulse 40 CO 2 laser, wavelength 10.6 μm; Lumenis Ltd., Yokneam, Israel). The laser was used in SuperPulse ™ mode with power tailored on the target structures (average 7 W). The depth of tissue penetration was 1 mm with a single burst of energy lasting 0.3 ms. Most of the patients had previously undergone traditional surgery (1-105 procedures); in 7/42, the video stroboscopic examination revealed extensive scar tissue covering the mucosa of the vocal folds, limiting the mucosal wave. The significance level for all calculations was p < 0.05. Statistical analysis was performed using Statistica 10 by StatSoft Polska. The methodology included subjective voice evaluation (GRBAS), videostroboscopy, analysis of the acoustic laryngeal tone (MDVP), spectrographic analysis, and voice handicap index (VHI). The GRBAS scale during spontaneous conversation revealed better phonation results after cidofovir treatment in all 42 patients. Scars were not observed in the presented group. In the MDVP laryngeal tone analysis before surgery parameters defining the amplitude and frequency of laryngeal tone were significantly elevated compared to the state after surgery. After treatment, both jitter and shimmer were reduced in all subjects. Even more pronounced changes were observed in the spectrographic analysis. In all analyzed patients, there was a significant reduction in VHI scores showing improvement in voice self-assessment. A satisfactory improvement in voice quality was observed in all RRP patients treated with cidofovir and CO 2 laser.
A Ni-P plated layer of 20 μm thickness containing 11 wt.% P was formed on the surface of a stainless steel (SUS304) plate by electroplating. The microstructure and joint strength of the brazed joint with the electroplated Ni-11P layer were investigated. The results indicated that the filler metal was homogeneously distributed between the SUS304 plates and no voids or flaws formed in the brazed filler zone. Fe-Ni-Cr solid solutions were formed at the brazed interface. Moreover, P was mainly concentrated in such brazed filler zone to form P-containing phases. The average shear strength of the brazed joints was determined to be 47.3 MPa. The results demonstrated that the brazing of SUS304 plates using the electroplated Ni-11P layer as the filler metal was successfully realized.
Electrodeposited Ni-11 mass%P alloy plating film was fabricated on the surface of stainless steel SUS304 to conduct brazing of SUS304 plates for a heat exchanger. Brazing of SUS304 plates with electrodeposited Ni-11P layers was carried out using a hydrogen reducing furnace. The microstructure and joint strength of the brazed joint were also investigated. From the result of the microstructural observation of the cross section of the joint, it was found that the brazing filler metal is homogeneously distributed without defects such as voids between the SUS304 plates. The results of electrochemical measurements showed that the P-concentrated phase in the Ni-11P alloy is preferentially dissolved in NaCl aqueous solution.
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