The biomechanics of the medialization laryngoplasty(thyroplasty type 1) in an ex vivo canine model

The biomechanics of medialization laryngoplasty are not well understood. An excised canine larynx model was used to test the effects of various sized silicon implants. The vocal fold length, position, and tension were measured. Medialization laryngoplasty did not affect vocal fold length. At the mid-membranous vocal fold, larger shims resulted in greater medialization and tension. Medialization laryngoplasty neither medialized nor stiffened the vocal process to resist lateralizing forces. We conclude that medialization laryngoplasty provides bulk and support for defects of the membranous region of the vocal fold, but does not appear to close a posterior glottal gap. The selection of a surgical procedure to treat glottal incompetence should take into account the unique biomechanical properties of the anterior (membranous vocal folds) and posterior (cartilaginous portion) glottis.     

A comparison of type I thyroplasty and arytenoid adduction

Glottal incompetence is a common laryngeal disorder causing impaired swallowing and phonation. The resultant voice has been characterized as weak and breathy with a restricted pitch range. Currently, medialization thyroplasty and arytenoid adduction are two of the surgical treatments for patients with glottal incompetence. However, few studies have evaluated the changes in objective measures of speech with type I thyroplasty and arytenoid adduction. In this study, 59 patients with glottal incompetence underwent either type I thyroplasty or arytenoid adduction. Acoustic (jitter, shimmer, and harmonics-to-noise ratio) and aerodynamic (airflow, subglottic pressure, and glottal resistance) measures were obtained both pre- and postoperatively. No significant differences were found among acoustic or aerodynamic measures for operation type. However, a significant pre/postsurgery effect was observed for translaryngeal airflow. In addition, no significant differences were found among the measures for patients with traditional compared with nontraditional operative indications. Patients who developed glottal insufficiency due to previous laryngeal surgery (e.g., vocal fold stripping) demonstrated no statistically significant improvement in acoustic or aerodynamic measures following thyroplasty or arytenoid adduction.     

Late complication of type 1 thyroplasty: A case report

We present a previously unreported late complication of medialization laryngoplasty (ML), also described as a thyroplasty, type 1. Five years following ML with Silastic, a 64-year-old female presented with dysphonia and a mass in the laryngeal ventricle on the ipsilateral side of the ML. A computed tomography scan of the larynx revealed migration of the thyroid cartilage window into the ventricle without migration of the Silastic implant. These findings were confirmed on surgical exploration. Following removal of the Silastic implant and the thyroid cartilage window fragment, the patient was successfully remedialized with autologous lipoinjection. Migration of the thyroid cartilage window appears to be a late complication of ML when the thyroid cartilage window is left intact and not removed. Complications of ML are discussed; specifically, difficulties resulting from retention of the thyroid cartilage window at the time of the ML are addressed.     

Type I thyroplasty: Pitfalls of modifying the Isshiki approach.How I do it

The Isshiki type I thyroplasty medializes the membranous portion of thevocal fold. Since its introduction into this country more than 10 years ago, several authors have reported modifications of the Isshiki approach primarily for the purpose of speeding the operation and “simplifying” the procedure. The major modifications have included: (a) incision, versus retraction, of the strap muscles; (b) removing the window external perichondrium; (c) varying the placement and size of the window and prosthesis; (d) removal of the window cartilage; (e) fiberoptic versus nonvisualization of the larynx intraoperatively; (f) incision of the inner perichondrium; and (d) use of silastic block substitutes. The principles of Isshiki's original technique will be reiterated in the ongoing discussion, and the reasons for not modifying certain aspects of the technique will be examined from the standpoint of complications and negative impact that manifest when modification is done.     

Combination thyroplasty and the “twisted larynx:” combined type IV and type I thyroplasty for superior laryngeal nerve weakness

Vocal cord medialization through Isshiki type I thyroplasty is part of the standard approach for patients with unilateral vocal cord immobility secondary to recurrent laryngeal nerve paralysis. However, several other modalities have been used to treat the symptomatic “twisted” larynx caused by unilateral superior laryngeal nerve weakness. The Isshiki type IV thyroplasty (cricothyroid approximation) specifically addresses cricothyroid muscle weakness, but, canine studies at the Mayo Clinic demonstrated a trend toward decreased acoustic power and sound intensity with simulated cricothyroid activity. Thus it is reasoned that addition of an ipsilateral type I thyroplasty should help compensate for this power loss.Using videostroboscopic and acoustic analysis, 9 patients with unilateral superor laryngeal nerve weakness were treated with combination type IV and type I thyroplasty. Subjective dysphonia and objective visual and acoustic measurements revealed postoperative improvement in most patients. The combination type IV and type I thyroplasty is recommended for surgical treatment of patients with superior laryngeal nerve weakness, because it addresses cricothyroid muscle weakness without compromising vocal power.     

Comparison between thyroplasty type I andArytenoid rotation: a study of vocal fold vibration using excised human larynges

The purpose of this paper was to compare the vibration of the vocal fold submitted to Isshiki thyroplasty type I (TPI) to that of the contralateral one adducted by the arytenoid rotation (AR) technique. The vocal folds of ten human fresh excised larynges were medialized by TPI on one side and by rotation of the arytenoid on the contralateral side. Laryngeal vibration was artificially produced and was recorded by videostroboscopy. The images were subjectively and objectively analyzed. Subjective analysis included periodicity of vibratory cycles, features of the mucosal wave present on the TPI side, amplitude of vibration, and profile of free border of each vocal fold during the opening phase. Objective analyses were carried out on frame-by-frame digitalized images to determine amplitudes of vibrations and phase differences between the folds in three glottic regions (anterior, middle, and posterior). Subjective analysis revealed regular periodicity in 100% of the larynges, a decrease in the mucosal wave on the TPI side in 70%, reduction in amplitude in 30%, and a sigmoid profile of the free border on the TPI side in 80%. Objective analysis showed mean amplitude in the posterior glottic region on the TPI side significantly larger than that on the arytenoids rotation side and phase asymmetry in 90% of the larynges.     

Voice-Related Quality of Life (V-RQOL) following type I thyroplasty for unilateral vocal fold paralysis

Unilateral vocal fold paralysis is a common clinical problem which frequently causes severe dysphonia. Various treatment options exist for this condition, with the type I thyroplasty being one of the more commonly performed surgical procedures for vocal rehabilitation. The Voice-Related Quality of Life (V-RQOL) Measure is a validated outcomes instrument for voice disorders. This study measured the V-RQOL of patients with unilateral vocal fold paralysis who had undergone a type I thyroplasty and compared these scores to those of patients with untreated and uncompensated unilateral vocal fold paralysis and to normals. Treated patients had significantly higher domain and overall V-RQOL scores than untreated patients, but also scored lower than normals. These differences were true across gender and age. Patients who were more distant from surgery had lower V-RQOL scores than those who had more recently been treated. It is concluded that type I thyroplasty leads to a significantly higher V-RQOL for patients with unilateral vocal fold paralysis. This study also demonstrates further the utility of patient-oriented measures of treatment outcome.     

Vibration transmission between coupled plates using finite element methods and statistical energy analysis. Part 2: The effect of window apertures in masonry flanking walls

Part 1 of this paper demonstrated the validity of predictions of vibration transmission across junctions of masonry walls using Finite Element Methods (FEM). Part 2 uses numerical experiments with FEM to calculate the vibration transmission between masonry walls with window apertures at different positions in the flanking wall(s). Results from the numerical experiments are used to assess a simple “rule-of-thumb” estimate for calculating the change in the coupling parameters due to the introduction of an aperture into a flanking wall. Conclusions are drawn concerning use of the “rule-of-thumb” estimate for the coupling loss factor in Statistical Energy Analysis and the vibration reduction index in European standard EN 12354.     

The twistor theory of equations of KdV type: I

This article is the first of two concerned with the development of the theory of equations of KdV type from the point of view of twistor theory and the self-dual Yang-Mills equations. A hierarchy on the self-dual Yang-Mills equations is introduced and it is shown that a certain reduction of this hierarchy is equivalent to then-generalized KdV-hierarchy. It also emerges that each flow of then-KdV hierarchy is a reduction of the self-dual Yang-Mills equations with gauge group SL _n . It is further shown that solutions of the self-dual Yang-Mills hierarchy and their reductions arise via a generalized Ward transform from holomorphic vector bundles over a twistor space. Explicit examples of such bundles are given and the Ward transform is implemented to yield a large class of explicit solutions of then-KdV equations. It is also shown that the construction of Segal and Wilson of solutions of then-KdV equations from loop groups is contained in our approach as an ansatz for the construction of a class of holomorphic bundles on twistor space.A summary of the results of the second part of this work appears in the Introduction.Most of this work was done while Darby Fellow of Mathematics at Lincoln College, Oxford     

Stability of normal state bubbles in the intermediate state of type I superconductors

The intermediate state in a type I superconducting Indium slab is observed with the high resolution magneto-optical imaging technique. The patterns consist of coexisting cylindrical-shape (bubbles) and elongated-shape (lamellae) normal state domains surrounded by the superconducting phase. We show that the shape cylindrical or elongated of the domains is correlated to their surface area. Those first experimental results indicate that there is a maximum surface area above which bubbles are no more observed. This maximum surface area is found to coincide with the stability limit of the bubble shape.     

A Monte-Carlo calculation of the secondary electron emission of normal metals: I. The model

A model is proposed to describe the secondary electron emission (SEE) of pure normal metals. The various types of collisions suffered by an electron travelling in the solid are analyzed. The dielectric theory is used to account for the collisions with the jellium, including surface effects in an approximate way. The different damping mechanisms for plasmons are reviewed and their influence on SEE is emphasized. The elastic and ionizing collisions with the ionic cores are described by a randium model. The relative importance of each of the above processes for the SEE of normal metals is discussed.     

Similarity-Projection Structures: The Logical Geometry of Quantum Physics

Similarity-Projection structures abstract the numerical properties of real scalar product of rays and projections in Hilbert spaces to provide a more general framework for Quantum Physics. They are characterized by properties that possess direct physical meaning. They provide a formal framework that subsumes both classical Boolean logic concerned with sets and subsets and quantum logic concerned with Hilbert space, closed subspaces and projections. They shed light on the role of the phase factors that are central to Quantum Physics. The generalization of the notion of a self-adjoint operator to SP-structures provides a novel notion that is free of linear algebra. This work was partially supported by the Jean and Helene Alfassa fund for research in Artificial Intelligence.     

New type of an acoustic plate mode: quasi-longitudinal normal wave

A new type of an acoustic wave belonging to the family of the normal plate modes is discovered numerically and verified experimentally in ST, x-quartz plates with free surfaces. It exists within restricted bands of the normalized plate thickness H/λ, where H is the thickness, λ is the wavelength, separated by forbidden H/λ-bands attributed to the common plate modes. Polarization of the wave over the whole plate thickness is almost longitudinal. Velocity of the wave is close to or equal to the velocity of the longitudinal bulk wave, propagating in the same direction. The proximity or/and equality of the velocities is a necessary, but not sufficient condition of the existence of the new wave.     

Implications of causality for quantum biology – I: topology change

A framework for describing the causal, topology changing, evolution of interacting biomolecules is developed. The quantum dynamical manifold equations (QDMEs) derived from this framework can be related to the causality restrictions implied by a finite speed of light and to Planck's constant to set a transition frequency scale. The QDMEs imply conserved stress-energy, angular-momentum and Noether currents. The functional whose extremisation leads to this result provides a causal, time-dependent, non-equilibrium generalisation of the Hohenberg–Kohn theorem. The system of dynamical equations derived from this functional and the currents J derived from the QDMEs are shown to be causal and consistent with the first and second laws of thermodynamics. This has the potential of allowing living systems to be quantum mechanically distinguished from non-living ones.     

The detection mechanism of LiTaO3 type II pyroelectric detectors.: I. The primary and secondary pyroelectric effects

The contributions of the primary and secondary pyroelectric effects in LiTaO₃ type II pyroelectric detectors are discussed in terms of theories of thermoconductivity and electromagnetic field, and formulas for signal voltage and responsivity are given.     

Confocal microscopy of whole mount embryonic cartilage: Intracellular localization of F-actin, chick prolyl hydroxylase and type II collagen mRNA

We show that whole mount preparations of embryonic chick sterna can be analyzed with confocal laser scanning microscopy (CLSM). This technique replaces the traditional sectioning of cartilage or culturing of chondrocytes. Whole ‘chunks’ of cartilage can be stained with dyes, used for immunohistochemistry or in situ hybridization. Although other stains have been used, the stains presented include phalloidin and propidium iodide which stain filamentous actin (F-actin) and the DNA and RNA of cells, respectively. Collagen secreting endoplasmic reticulum (ER) was localized with a primary antibody to chick prolyl hydroxylase (CPH) that was detected with a secondary antibody conjugated to FITC. The intracellular localization of type II collagen mRNA was analyzed using in situ hybridization. The cDNA probe specific for the C-propeptide region of the 1 type (II) collagen mRNA was nick translated and labeled with biotin-16-dUTP. Biotin labeled probes were visualized with avidin-FITC. Depending on the intensity of the stain, we were able to analyze approximately 3–10 layers of chondrocytes. Stains penetrated into the cartilage better than antibodies and biotin-avidin labeled cDNA probes. The F-actin was located as bands of filaments in the superficial layers of the cartilage and was associated with the membranes that marked cell boundaries as deep as 10 layers of chondrocytes. The ER stained with anti-chick prolyl hydroxylase was prominent in perinuclear regions of the cells, but the antibody was only able to penetrate 4–5 cell layers. Single label in situ hybridization studies show that chondrocytes are positive for type II collagen mRNA. Similar to the immunohistochemistry, in situ hybridization probes were only able to penetrate 4–5 cell layers. The type II collagen mRNA appeared perinuclear in the chondrocytes, similar to the ER staining pattern.     

The collagen type I segment long spacing (SLS) and fibrillar forms: Formation by ATP and sulphonated diazo dyes

The collagen type I segment long spacing (SLS) crystallite is a well-ordered rod-like molecular aggregate, ∼300 nm in length, which is produced in vitro under mildly acidic conditions (pH 2.5–3.5) in the presence of 1 mM ATP. The formation of the SLS crystallite amplifies the inherent linear structural features of individual collagen heterotrimers, due to the punctate linear distribution and summation of the bulkier amino acid side chains along the length of individual collagen heterotrimers. This can be correlated structurally with the 67 nm D-banded collagen fibril that is found in vivo, and formed in vitro. Although first described many years ago, the range of conditions required for ATP-induced SLS crystallite formation from acid-soluble collagen have not been explored extensively. Consequently, we have addressed biochemical parameters such as the ATP concentration, pH, speed of formation and stability so as to provide a more complete structural understanding of the SLS crystallite. Treatment of collagen type I with 1 mM ATP at neutral and higher pH (6.0–9.0) also induced the formation of D-banded fibrils. Contrary to previous studies, we have shown that the polysulphonated diazo dyes Direct red (Sirius red) and Evans blue, but not Congo red and Methyl blue, can also induce the formation of SLS-like aggregates of collagen, but under markedly different ionic conditions to those employed in the presence of ATP. Specifically, pre-formed D-banded collagen fibrils, prepared in a higher than the usual physiological NaCl concentration (e.g. 500 mM NaCl, 20 mM Tris-HCl pH7.4 or x3 PBS), readily form SLS aggregates when treated with 0.1 mM Direct red and Evans blue, but this did not occur at lower NaCl concentrations. These new data are discussed in relation to the anion (Cl⁻) and polyanion (phosphate and sulphonate) binding by the collagen heterotrimer and their likely role in collagen fibrillogenesis and SLS formation.     

The interplay between surface micro-topography and -mechanics of type I collagen fibrils in air and aqueous media: An atomic force microscopy study

Calf skin type I collagen fibrils were regenerated from acidic solution and imaged with contact mode atomic force microscopy in air, water, and buffer solution. When imaged in air at a contact force of 20-150 nN, collagen fibrils exhibited a distinct transverse banding pattern with a period of 65 nm, consisting of high ridges and shallow grooves. The force dependence of the images suggests that such banding pattern is attributed to the transverse contraction of the fibril upon dehydration during sample preparation, which reflects the tangential mass density across the fibril. Imaging in water and phosphate buffer solution at a contact force of 15-80 nN revealed hydrated collagen fibrils with smooth surfaces. The rigidity of the collagen fibrils decreased considerably upon hydration. Scanning the cantilever tip in an aqueous medium at a contact force of 90-280 nN enabled us to probe subunit arrangement in the bulk region of the collagen fibril. The results indicate that the molecular assembly in the hydrated fibril is akin to that in the intact form. The image resolution was improved by stabilizing the collagen molecules through crosslinking with glutaraldehyde, which served to resolve microfibril-like structure on the fibril surface. Received 28 March 2000 and Received in final form 15 June 2001     

I.I. Rabi: The Two Cultures and the Universal Culture of Science

I set forth and discuss I.I. Rabis views on the nature of science and society, focusing specifically on Rabis views on science and government, science and education, and science and religion. I also explore the influence of Rabi and C.P. Snow on each other. In the 1960s, Rabi set forth his mature and boldest positions, advocating science as the center of education and science as the replacement for religion. His positions culminate in science as the universal culture. I highlight Rabi not only as a scientist and public servant, but also as a public intellectual actively engaged with and connected to major issues of his time.Michael A. Day is Professor of Physics at Lebanon Valley College. He holds doctorates in both physics and philosophy.     

Spin-resolved edge states transport in a normal/ferromagnetic/normal topological insulator junction: The role of interface

The spin-resolved edge states transport in a normal/ferromagnetic/normal topological insulator (TI) junction is investigated numerically. It is shown that the transport properties of the hybrid junction strongly depend on the interface shape. For the junction with two sharp interfaces, a nonzero spin conductance can be generated besides the spin-split energy windows. Moreover, the axial symmetries of the in-plane spin conductance amplitude are broken. The underlying physics is attributed to the sharp-interface-induced quantum interference effect. However, for the hybrid junction with two smooth interfaces, a non-zero spin conductance can only be achieved in the spin-split energy windows. Further, the axial symmetries of the in-plane spin conductance amplitude recover. These findings may not only benefit to further apprehend the spin-dependent edge states transport in the hybrid TI junctions but also provide some theoretical bases to the application of the topological spintronics devices.