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Dysmorfofobia (ang. body dysmorhic disorder – BDD) to problem coraz częściej spotykany w gabinetach chirurgii plastycznej i medycyny estetycznej. Zaburzenie polega na drastycznym, nieadekwatnym braku zadowolenia z własnego ciała i zwracaniu uwagi na jego niedoskonałości. Szacuje się, że 1 na 50 osób w populacji światowej przejawia objawy BDD. Wielu pacjentów miewa myśli samobójcze, a część z nich wieńczy je próbą samobójczą. Skala problemu dowodzi konieczności zwiększenia świadomości o chorobie zarówno wśród lekarzy, jak i pacjentów. Cel pracy Celem niniejszego badania było sprawdzenie stanu wiedzy i opinii pacjentów gabinetów chirurgii plastycznej i medycyny estetycznej na temat BDD. Materiał i metody Za narzędzie badawcze posłużył autorski kwestionariusz składający się z 25 pytań zamkniętych, w tym 5 wielokrotnego wyboru. W badaniu wzięło udział 55 kobiet i 47 mężczyzn. Pytania dotyczyły wiedzy pacjentów na temat BDD: objawów BDD, problemów diagnostycznych związanych z BDD, zachowania osób chorych na BDD, epidemiologii BDD, wielospecjalistycznej opieki nad pacjentami z BDD, ze szczególnym uwzględnieniem roli specjalisty chirurgii plastycznej, implikacji prawnych, a także opinii pacjentów na temat zaangażowania chirurgów plastycznych w proces diagnostyczny BDD. Wyniki Pomimo że większość badanych uważa BDD za zaburzenie, które nie stanowi trudności diagnostycznej, według części respondentów specjaliści chirurgii plastycznej i medycyny estetycznej w zbyt małym stopniu angażują się w walkę z chorobą. Wnioski Należy przywiązywać większą wagę do działań edukacyjnych oraz zachować zwiększoną czujność, konsultując pacjentów z grupy ryzyka, szczególnie biorąc pod uwagę tendencję wzrostową do poddawania się przez osoby chore na BBD operacjom plastycznym i zabiegom medycyny estetycznej.

Ameloblastoma (AM) is the most common, locally aggressive odontogenic tumor. It comprises about 1% of all head and neck neoplasms. It occurs mainly in young adults in their 3rd and 4th decade of life. It localizes in the mandible in about 80% of the cases. According to the 2017 WHO classification, 4 types of ameloblastoma can be distinguished: ameloblastoma (previously referred to as solid/multicystic-SMA; the "conventional type" AM), unicystic (AM-UA), extraosseous/peripheral (AM-PA), and malignant/metastatic (AM-MA). Solid, multicystic is the most common type. It is characteristic for its aggressiveness and high risk of recurrence. Radical resection with consecutive reconstruction is the treatment of choice of mandibular ameloblastomas.In this study, the authors present their experience in the surgical treatment of mandibular ameloblastomas with vascularized free flap reconstructions. They discuss new technological possibilities that could improve the precision of the reconstructive procedure and therefore result in the better aesthetic outcome.The retrospective study of a group of 21 patients suffering from mandibular ameloblastoma who underwent segmental man-dibulectomy with simultaneous microvascular free flap reconstruction was conducted. A thorough clinical analysis with various aspects was performed. Tumors resected before 2017 were double checked patomorphologically and assigned to the corrected subtype group.Seven patients were admitted to the department due to recurrent ameloblastoma. The most common localization of the tumor was the mandibular body ( n = 6) andbodywith ramus of the mandible ( n = 6). A total amount of 10 iliac crest free flaps and 12 fibular free flaps were performed. Complications were reported in 4 patients. A purulent oro-cutaneus fistula occurred in 3 patients. There was a flap failure in each reconstructive group. The virtual surgical planning with intraoperative cone-beam computed tomography was used in 3 patients. Dentition implantation was conducted in 4 patients (3 simultaneously, 1 postponed). The mean follow-up was 5 years and 8 months.Radical resection that covers radical segmental mandibulect-omy with immediate microvascular free flap reconstruction is a first-line and only effective treatment of mandibular ameloblas-tomas, that eliminates the risk of recurrence. The extent of surgical margins seems not to influence the recurrence rate, yet further investigation with statistical analysis should be performed. The choice of the adequate free flap must be adapted to dimensions and localization of the tumor and to each patient individually.New technologies such as virtual surgical planning with 3D models and intraoperative cone-beam computed tomography can make the reconstruction more accurate, improving patient's quality of life.

Background: It has been suggested that applying the negative pressure wound therapy (NPWT) to a closedsurgical incision may hasten the healing of the incision and decrease the incidence of wound healing complications. The goal of this study is to present the new idea of a simple, self-made, low-cost wound vacuum dressing for closed-incision NPWT that may become an alternative to currently manufactured medicalindustry products.Method: We designed a simple dressing for closed-incision NPWT from gauze pads, polyurethane adhesive film, stoma paste, and a drain tube. Negative pressure was created using a standard 50 ml syringe connected to the drain. First, the dressing was applied to the wound model and on the healthy volunteer. Finally, the dressing was applied to 10 patients after low anterior rectal resection. The vacuum dressing was left in place for 3 days, then changed and placed once more for the next 3 days.Results: We did not observe any adverse effects associatedwith the dressing. All postoperative wounds healed properly. 18 out of 20 dressings were still air-tight 72h post-placement.Conclusions: This simple, self-made dressing for NPWT is safe and effective and may decrease the wound infection rate. However future studies are needed to confirm that hypothesis.

The paper presents tests of fault tolerance of a regulated drive with a multi-phase squirrel-cage induction motor. The drive was controlled using variable frequency with switching the output voltage sequence of the inverter. The damages were mainly caused by break of one or several motor phase currents. The reason was bad inverter operation or phase connection interruption. Additionally, the effect of blocking a single transistor of the inverter half bridge was investigated. The faulty drive was to perform the same task of speed regulation as the healthy drive. The permissible extent of damage has been determined. The research was carried out in Simulink using the developed multi-harmonic model of a multi-phase induction motor.

The subject of the publication is recognition of the functions of the uninterruptible power supply system with a diesel engine called Diesel Rotary Uninterruptible Power Supply (DRUPS). The system features a diesel engine, a synchronous machine and an asynchronous machine as a kinetic energy storage and as well as two electromechanical exciters. In the paper a mathematical model of the DRUPS system was built and a typical work cycle simulated. Calculating the energy balance of the system resulted in the selection of its components at the design stage.

The subject of the article is a computer model of a multi-phase squirrel cage induction motor with a stator number phases greater than 3. This model is written in the Matlab / Simulink language and is presented graphically in the form of a multi-terminal block. A system of differential equations describing a multiphase motor was introduced by the use of Simulink library blocks. This system of equations takes into account the interaction of higher spatial harmonics. The block of equations is connected to the external power circuit by means of the so-called ideal transformers. This allows for modeling not only the electric drive, but also the internal waveforms of the converter and the power supply system. Application of the model was illustrated by the operation of a nine-phase motor powered by a frequency-controlled voltage source inverter at a variable supply sequence and referred to measurements.

The nine-phase induction motor operating at a variable frequency was presented in the paper. The control method was supplemented with the additional possibility based on the supplied voltages sequence switching of the 9-phase supply system made of the IGBT voltage source inverter. This allows for shaping of the motor mechanical characteristics increasing the maximum torque for a greater number determining the sequence. So, such a motor work can be suitable for some electric vehicles where the sequence switching gives a similar effect as the mechanical gear-box. In this paper the 9-phase motor work comprising the mentioned effects was shown by the results of practical laboratory tests and computer simulations.

In this paper the circuit-oriented model of the 3-phase induction machine with a double stator winding was developed. The double winding (dual winding) is created by two 3-phase windings mutually displaced by 30 electrical degrees. The machine model is presented as the circuit composed of resistances, inductances and controlled electrical sources. It results from the transformed voltage equations. Such a model is not offered by the Simulink library, however it can be directly introduced using Sim-Power-Systems and additionally into other circuit simulators as the Spice family programs. The whole model can be masked and connected with other models of power electronics, electrical sources or various electrical and mechanical devices. Operation of the frequency controlled drive, where the both stator windings were supplied with two current source inverters, illustrates application of this circuit oriented machine model. Further applications have been left for the users invention.

In this paper the mathematical model of the brushless DC motor (BLDCM) with a double 3-phase stator winding is analysed. Both the 3-phase windings are mutually displaced by 30 electrical degree. Special care has been sacrificed to influence of higher harmonics of induced electromotive forces (EMF) on electromagnetic torque and zero sequence voltages that may be used for sensorless control. The mathematical model has been presented in natural variables and, after transformation to symmetrical components, in a vector form. This allows, from one side, for formulating the equivalent circuit suitable for circuit oriented simulators (e.g.: Spice, SimPowerSystems of Simulink) and, from the other point of view, for analysis of higher harmonics influence on control possibilities. These considerations have been illustrated with some results of four quadrant operation obtainded due to simulation at automatic control.

The subject of this paper is the control possibility of the multiphase cage induction motors having number of phases greater than 3. These motors have additional properties for speed control that distinguish them from the standard 3 phase motors: operation at various sequences of supplying voltages due to the inverter control and possible operation with few open-circuited phases. For each supply sequence different no load speeds at the same frequency can be obtained. This feature extends the motor application for miscellaneous drive demands including vector or scalar control. This depends mainly on the type of the stator winding for a given number of phases, since the principle of motor operation is based on co-operation of higher harmonics of magnetic field. Examples of operation are presented for a 9-phase motor, though general approach has been discussed. This motor was fed by a voltage source inverter at field oriented control with forced currents. The mathematical model of the motor was reduced to the form incorporating all most important physical features and appropriate for the control law formulation. The operation was illustrated for various supply sequences for “healthy” motor and for the motor operating at one phase broken. The obtained results have shown that parasitic influence of harmonic fields interaction has negligible influence on motor operation with respect to the useful coupling for properly designed stator winding.

In this paper the circuit-oriented models of the three phase induction machine are developed from the voltage equations and presented as the circuit that can be introduced into Simulink or Spice. The models have both terminals of the stator and the rotor windings available. So, the star, the star with a neutral wiring and the delta connections are allowed. This must be noticed that all built in Simulink library models for 3-phase AC machines are relevant only for the star without neutral connection. The proposed models can be connected with models of power electronics and other models of various electrical and mechanical devices. So, this states an extension of modelling possibilities with the use of Simulink and Spice. Application of the model was illustrated by an example of typical operation of the induction motor. Further applications have been left for the users invention.

In this paper the proposal for filtering AC line currents distortions of AC mains has been presented. The distortions are caused mainly by power electronics drives. Thus, the effectiveness of filtering was illustrated for two popular drives with an induction motor. The applied filter is passive with a wide range of tuning or automatically controlled self-tuning for a required frequency band. Presented results are theoretical, obtained due to simulation.

Objective Evaluate the possibility of performing a complex vascular allotransplant of all neck organs including skin. Summary background data There are 2 previous attempts described in the literature, none of them being that complex. The first one is nonfunctional due to chronic rejection, the second one is viable yet considerably limited in complexity (no parathyroids, no skin). Methods The allotransplantation was performed simultaneously on 2 adjacent operating rooms, using microsurgical techniques. Results The patient's voice, breathing through mouth, swallowing, and endocrinal functions have been fully restored. Conclusions Achieved results show clearly that such operations performed in selected patients can nearly fully restore functional and aesthetic effects in 1 single procedure.

In this paper, the influence of impact damage to the induction motors on the zero-sequence voltage and its spectrum is presented. The signals detecting the damages result from a detailed analysis of the formula describing this voltage component which is induced in the stator windings due to core magnetic saturation and the discrete displacement of windings. Its course is affected by the operation of both the stator and the rotor. Other fault detection methods, are known and widely applied by analysing the spectrum of stator currents. The presented method may be a complement to other methods because of the ease of measurements of the zero voltage for star connected motors. Additionally, for converter fed motors the zero sequence voltage eliminates higher time harmonics displaced by 120 degrees. The results of the method application are presented through measurements and explained by the use of a mathematical model of the slip-ring induction motor

Introduction Laparoscopic cholecystectomy has become the gold standard in treating patients presenting cholecystitis. Standard laparoscopic cholecystectomy involves access to the abdominal cavity through two or three incisions outside the umbilicus, which are potential infection sites and may determine poor cosmetic outcomes. In order to eliminate the aforementioned disadvantages of “traditional” laparoscopic surgery methods, several modifications have been recently introduced, which are significantly less invasive. Effort is being made to reduce the amount of trocars accessing the abdominal cavity via the abdominal wall, or to eliminate them completely. Aim The aim of the work was to describe a modification of traditional laparoscopic cholecystectomy, which consists of reducing the amount of integumental incisions. Material and methods From October 2009 through July 2011, 21 patients were operated on using laparoscopic cholecystectomy in the general surgery department in Kedzierzyn-Koźle District Hospital. Our control group consisted of 25 patients, operated on schedule between March and July 2011 in the same hospital. Results and discussion Postoperative course was uneventful. Aesthetic results were regarded as “very good” by both patients and surgeons. One advantage of the described method is the possibility to convert to “traditional” laparoscopic cholecystectomy at any point during the operation. Conclusions Described method is a safe and efficient alternative for standard laparoscopic cholecystectomy and may be introduced virtually in every surgery department operating by means of laparoscopic techniques.

Introduction Lesion resulting from malignant transformation of a non-healing chronic wound of various etiology is referred to as Marjolin's ulcer. Histopathologically in most cases it is a squamous cell carcinoma, while basal cell carcinoma, melanoma malignum and sarcoma cases have been reported in the literature. Aim The aim of the work was to outline major characteristics of the entity and to focus on a variety of lesions which may evolve into this malignancy, based on literature review and patients operated on in the authors' department. Material and methods Four cases of malignant lesions which occurred in patients presenting chronic wounds in the period 2008–2012 were described. Results and discussion All patients presented squamous cell carcinomas which evolved in chronic post-burn wounds (two cases) and a chronic atheroma (one case). The time between the initial injury and malignant transformation was long (over 20 years in all cases). One patient died in the course of the disease. Conclusions Marjolin's ulcer is a non-frequent manifestation of a malignant neoplasm. It is an entity, which should be suspected and meticulously diagnosed and treated in all individuals presenting alerting symptoms such as chronic ulcerations of previously injured skin. It is a highly-virulent kind of malignant skin lesion in most cases due to late diagnosis and to histopathological characteristics of the entity. Surgical wide excision is a treatment of choice. In some cases, radiotherapy and limb amputation in some cases of acral localization are advocated. There is no agreement on prophylactic regional lymph node dissection.

Ichtyosis is an heterogeneous group of diseases characterized by formation of hyperkeratotic, squamous, tile-like scales virtually on the whole body. Depending on the severity and localization of the symptoms, the disease may lead to serious complications including ectropion of the eyelids, which may further lead to ocular disorders, including blindness. The aim of the work was to outline major characteristics of the entity and to focus on surgical methods of ichtyosis-related eyelid ectropion management. Four cases of ichtyosis-related eyelid ectropion, which occurred in patients presenting severe symptoms of the disease treated surgically in the clinic between 2003-2011, were described. In all patients the eyelid contractures were successfully released and relief of conjunctival inflammation was obtained. No postoperative complications occurred. In two patients, a secondary operation was necessary due to skin graft contracture and ectropion recurrence. In some cases, ichtyosis may lead to serious ocular complications. Surgical management of eyelid ectropion is challenging due to the shortage of available lesion-free skin for grafting and due to possible skin graft contracture leading to recurrence.

Introduction Among numerous branches of science, advances in biomedical research are perceived to be the most controversial. This relates to biomedical experiments which involve human and animal trials. This article attempts to outline both historical and current dilemmas in the field of biomedical sciences. Today, scientists face new challenges with respect to humanitarian medicine. Aim The aim of this study was to discuss ethical and moral issues connected with experiments involving animals and human beings. The authors aimed at presenting directions of development for new branches of medicine. Materials and methods This study presents a review of contemporary medical literature and legal regulations concerning experiments on animals and human beings. Discussion The issue and definition of bioethics, its historical evolution, as well as specificity of medical sciences and psychiatrics are presented in the context of medical experiments. Informed consent is discussed: regarded not only as a legal necessity, but as an ethical duty that facilitates desired communication between the researcher and the individual on whom the experiment is to be conducted. Experimental control methods, current implementation of a new operative technique – fetal surgery – and legal regulations concerning the protection of animals used for experimental purposes have also been analyzed, as well as the interrelationships between medicine and the economy. Conclusions Experiments have always been a part of medical developments and it is unlikely that these would ever be abandoned. Over the years, not only the advancement of medical procedures, but also the efficacy of treatment has changed. Along with the developments in medicine, the approach to medical experimentation on humans and animals has changed as well. Currently, medical experimentation has entered a new age which may be termed “humanitarian,” “planned” or “aimed,” which are all connected with devising well-accepted standards and appropriate legal regulations.

Introduction Among numerous branches of science, advances in biomedical research are perceived to be the most controversial. This relates to biomedical experiments which involve human and animal trials. This article attempts to outline both historical and current dilemmas in the field of biomedical sciences. Aim The aim of this study was to discuss ethical and moral issues connected with experiments involving animals and human beings. The authors aimed at presenting directions of development for new branches of medicine. Materials and methods This study presents a review of contemporary medical literature and legal regulations concerning experiments on animals and human beings. Discussion The issue and definition of bioethics, its historical evolution, as well as specificity of medical sciences, experimental control methods, current implementation of a new operative technique – fetal surgery – and legal regulations concerning the protection of animals used for experimental purposes are presented. Conclusions Experiments have always been a part of medical developments and it is unlikely that such would ever be abandoned. Over the years, not only the advancement of medical procedures, but also the efficacy of treatment has changed. Along with developments in medicine, the approach to medical experimentation on humans and animals has changed as well. Currently, medical experimentation has entered a new age which may be termed “humanitarian,” “planned” or “aimed,” which are all connected with devising well-accepted standards and appropriate legal regulations.

The traction substation composed of the 3-phase transformer and the output diode rectifier is still the fundamental device for DC traction supply. In this paper two technical solutions (power electronic converters) allowing for braking energy recuperation to the AC mains are discussed. This has been thought as the modernisation of the existing traction substations allowing for high speed trains regenerative braking and braking of heavy train hollers. Such a solution brings some profits: energy recuperation, mechanical brakes saving and enhanced quality of traction vehicle control. For the proposed converters technical and economical advantages and drawbacks are indicated.

Fetal surgery, also referred to as in utero, prenatal or intrauterine surgery, consists of treatment of congenital malformations during fetal period. The idea of treating malformations diagnosed in the course of intrauterine life dates back to 1963, when Lilly performed first blood transfusion in the fetus. Ever since then, it has been introduced as treatment option in series of lethal malformations. Efforts are being made to treat nonlethal malformations by means of fetal surgery.A comprehensive search of the literature using MEDLINE and PubMed between 1925 and February 2009 was performed. Search terms for MEDLINE and PubMed were: fetal surgery, foetal surgery, in utero surgery, prenatal surgery, and in utero treatment. In addition, information was obtained at Web sites of International Medicine and Surgery Society and the University of California Fetal Treatment Centre.Our attention focused on the overall view on fetal surgery history, its development and perspectives. Moreover, owing to the authors' interest in plastic surgery, some remarks on the role of intrauterine medicine and surgery in this branch of medicine were made.In utero surgery may be regarded as an efficient tool of preventive medicine. It offers some advantages that no other branch of medicine may offer. However, its implementation is more troublesome than it used to be regarded as before. Therefore only selected cases may benefit from its advantages. Nevertheless, current tendencies are to include, after thorough evaluation of benefit - risk ratio, some new indications for fetal surgery.

The electrical energy produced by a p.m. synchronous generator can be converted to the desired value by an appropriate power electronic voltage converter. The influence of the converter on the power system composed of the 9-phase p.m. synchronous generator and the driving gas turbine is the subject of this paper. The high speed generator is loaded directly with a multiphase rectifier supplying the output inverter. The main analysed problem is connected with fault cases of the converter which may cause a significant increase in alternating component of the electromagnetic torque. This torque loads the gas turbine. The short circuit and breaking in the generator output are the main analysed failures. This paper additionally elaborates on the increase in the gas turbine velocity and the short circuit in the converter output or short circuit on any diode of the converter.

Background Anterolateral thigh flap (ALTF) has gain popularity as a workhorse flap in the management of simple as well as complex tissue defects. The purpose of this study was to investigate the differences in ALTF’s perforators’ location in male and female human cadavers. Methods The study involved 30 fresh human cadavers of both sexes. A total of 60 flaps were examined. The flaps were raised as originally designed. After location of vessels, the distance from the anterior superior iliac spine (ASIS) to subsequent perforators was measured. Also, the kind of the perforator, its diameter and origin were marked. Perforators were designated according to Yu’s classification (A, B, and C). The perforators were divided into thin (1 mm). Ratio of the ASIS–patella distance to the distance of a given perforator from the ASIS (AP rate) was calculated. Results The mean AP rate (perforator location) was different in both sexes. Mean AP rate in men was calculated as 0.498 ± 0.117, and in women, 0.559 ± 0.114. Differences in AP rate between female and male were statistically significant (t = −3.144; p < 0.002). Mean flap thickness was 3.65 cm in women and 1.17 cm in men (t = −14.444; p < 0.00001). In men, 63 perforators originated from descending branch, and seven perforators originated from oblique branch. In women, there were 67 and one, respectively. Conclusions In men, perforators are located closer to the ASIS in comparison to women. Clinically significant perforators (Φ > 0.5 mm), in majority of cases, occur in A and B positions. Thickness of the flap was higher in women. The oblique branch was more common in men.