Complications of collagen injection of the vocal fold: report of several unusual cases and review of the literature

Injection laryngoplasty is one of the most frequently performed procedures in patients with voice complaints. Various biomaterials have been used to medialize vocal folds or to treat symptoms of vocal fold scar. The ideal biomaterial would be easily injected through a fine-gauge needle, well tolerated, and long lasting. Injectable collagen preparations fulfill at least two of these criteria, and collagen has been used widely for vocal fold injections. MATERIALS AND METHODS: We present a retrospective review of two unusual complications of collagen injection and a review of the relevant literature on the complications of medical use of collagen compounds. RESULTS: Two patients in whom collagen was injected formed firm submucosal deposits that interrupted the normal mucosal wave and produced significant dysphonia. Surgical removal of these deposits restored the mucosal wave and improved voice quality. Management of this unusual complication of human collagen injection in the vocal fold has not been reported previously. Other complications of collagen injection include hypersensitivity reactions to bovine collagen, local abscess formation at injection sites, and possibly induction of collagen vascular disease in some patients. CONCLUSIONS: Although collagen injections of the vocal fold rarely result in complications, physicians using collagen must be familiar with the types of complications that can occur. Proper diagnosis and prompt management of complications can result in good outcomes.     

A Model of the Perishable Inventory System With Reference to Consumer-Realized Product Expiration

A new model of the perishable inventory system is presented, which recognizes and incorporates the effects of consumer-realized product expiration. Such expiration has not been explicitly treated within the perishable inventory literature, and occurs when units are expired at the time of sale or expire within some short period of time subsequent to purchase. The model treats the age at which the vendor outdates units as a decision variable, and allows for analysis of the interaction between inventory ordering and outdate policy for a perishable item with random lifetime. As such, the model represents a synthesis of the fixed versus random lifetime perishable inventory literatures. Sensitivity analysis conducted with respect to the new model provides insight into the trade-offs between the costs of carrying, shortage, outdating, and consumer-realized product expiration.     

Postmodification of poly(9‐alkyl‐9H‐carbazole‐2,7‐diyl)s as a route to new main‐chain‐functionalized carbazole polymers

The postmodification of poly[9‐(2‐hexyldecyl)‐9H‐carbazole‐2,7‐diyl] ( P1 ) upon its reaction with N‐bromosuccinimide affords exclusive and full bromination of the 3,6‐positions of the carbazole repeat units to yield poly[3,6‐dibromo‐9‐(2‐hexyldecyl)‐9H‐carbazole‐2,7‐diyl] ( P2 ). Brominated polymer P2 can be used as a precursor for further functionalization at the 3,6‐positions with the desired functional group to afford other useful polymers. Polymer P2 has hence been reacted with copper(I) cyanide to afford poly[3,6‐dicyano‐9‐(2‐hexyldecyl)‐9H‐carbazole‐2,7‐diyl] ( P3 ). Full substitution of the bromide groups with nitrile‐functional groups has been achieved. The preparation and structural characterization of polymers P2 and P3 are presented together with studies on their electronic conjugation and photoluminescence properties. Cyclic voltammetry studies on polymer P3 indicate that the new polymer is easier to reduce (n‐dope) but more difficult to oxidize than its unsubstituted counterpart ( P1 ) as a result of the introduction of the electron‐withdrawing nitrile‐functional groups at the 3,6‐positions on the carbazole repeat units on the polymer chains. © 2006 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 44: 3336–3342, 2006     

Bis(amino acid) derivatives of 1,4-diamino-2-butyne that adopt a C2-symmetric turn conformation

1,4-Diamino-2-butyne was prepared from 1,4-dichloro-2-butyne via 1,4-diazido-2-butyne. Bis(amino acid) derivatives of 1,4-diamino-2-butyne having the general structure (Boc-Xxx-NHCH2C[triple bond])2 (Xxx = Ala, Phe and Met) were prepared and examined by 1H NMR spectroscopy. Using chemical shift, coupling constant and DMSO titration data it is found that these compounds adopt a C2-symmetric turn conformation featuring two intramolecular hydrogen bonds.     

Aromatic antimony compounds. Transition metal complexes of 2,5-dimethylstibacyclopentadienyl

Hydrostannation of 2,4-hexadiyne with dibutyltin dihydride gave 1,1-dibutyl-2,5-dimethylstannole, which was converted to 2,5-dimethylstibacymantrene and to bis(2,5-dimethylstibacyclopentadienyl)iron.