Unilateral Versus Bilateral Injections of Botulinum Toxin in Patients with Adductor Spasmodic Dysphonia

Both unilateral and bilateral thyroarytenoid muscle injections of Botox provide effective management of voice symptoms in patients with adductor spasmodic dysphonia; however, the preferred injection technique has not been established. In this study, 16 patients were treated with unilateral injections (72 injections total) and 33 patients were managed with bilateral injections (133 injections total). Individual assignments to injection type were based on treatment previously received and dose was adjusted according to the patient's previous treatment response. An optimal treatment included a benefit lasting 3 months or more with side effects lasting 2 weeks or less. Compared to patients receiving bilateral injections, those receiving unilateral injections more frequently noted a benefit of 3 months or more (p = 0.03), side effects of 2 weeks or less duration (p = 0.03), as well as both a 3-month benefit and a 2-week or less side effect (p = 0.0004). Injection type had no effect on optimal Botox dosing with repeat injections. Successive unilateral injections at the same dose were more likely (p = 0.012) than successive bilateral injections to produce the same or longer duration of benefit. We conclude that a unilateral injection routine has a more optimal and consistent treatment effect/side effect profile.     

The Relationship Between Cepstral Peak Prominence and Selected Parameters of Dysphonia

Traditional measures of dysphonia vary in their reliability and in their correlations with perceptions of grade. Measurements of cepstral peak prominence (CPP) have been shown to correlate well with perceptions of breathiness. Because it is a measure of periodicity, CPP should also predict roughness. The ability of CPP and other acoustic measures to predict overall dysphonia and the subcategories of breathiness and roughness in pathological voice samples is explored. Preoperative and postoperative speech samples from 19 patients with unilateral recurrent laryngeal nerve paralysis who underwent operative intervention were analyzed by trained listeners and by measures of smoothed CPP (CPPS), noise-to-harmonic ratio (NHR), amplitude perturbation quotient (APQ), relative average perturbation (RAP), and smoothed pitch perturbation quotient (sPPQ). The data were analyzed with bivariate Pearson correlation statistics. Grade of dysphonia and breathiness ratings correlated better with measurements of CPPS than with the other measures. CPPS from samples of connected speech (CPPS-s) best predicted overall dysphonia. None of the measures were useful in predicting roughness.     

Laryngeal and Other Otolaryngologic Manifestations of Crohn''s Disease

Laryngeal and other otolaryngologic manifestations of Crohn's disease are uncommon and may be subtle. Crohn's disease is a well-known inflammatory bowel disease of unknown etiology marked by relapsing and remitting granulomatous inflammation of the alimentary tract. Extraintestinal manifestations of Crohn's disease may appear anytime during the course of the disease process and may be the initial symptom. Findings are nonspecific, primarily edema and ulcerations, and may be confused with a multitude of other disease processes. Awareness of these manifestations in the head and neck will prevent misdiagnosis or a delay in diagnosis.     

Measurement of isomeric yield ratios for 93Nb(??,4n)89m,gNb and natMo(??,xn1p)95m,gNb reactions with 50-, 60-, and 70-MeV bremsstrahlung

We measured the isomeric yield ratios for the photonuclear reactions of ⁹³Nb(??,4n)^89m,gNb and ^natMo(??,xnp)^95m,gNb by using the activation method. The high-purity ⁹³Nb and ^natMo metallic foils in disc shape were irradiated with uncollimated bremsstrahlung beams of 50-, 60-, and 70-MeV generated from an electron linear accelerator in Pohang Accelerator Laboratory. The induced activities in the irradiated foils were measured by the high-resolution ??-ray spectrometry with a calibrated high-purity Germanium (HPGe) detector coupled to a PC-based 4?K multichannel analyzer. The reaction ⁹³Nb(??,4n)^89m,gNb was studied for the first time which has no comparable literature data. The result of ^95m,gNb isomeric pair was measured based on (??,p), (??,np), and (??,2np) reactions which is the first measurement at the intermediate energy region of 50?C70-MeV with a ^natMo target.     

EFFECT OF COMPOSITION AND PROCESSING CONDITION ON MICROSTRUCTURAL PROPERTIES AND DURABILITY OF FLUOROPOLYMER/ACRYLIC BLENDS

Fluoropolymer blends have been widely used as binders for exterior coatings because of their excellent resistance to ultra-violet (UV) radiation as well as to many corrosive chemical agents.It is known that the fluorinated component usually has a lower glass transition temperature and easily crystallizes in the final structure depending upon the blend composition and sample annealing condition.We investigated the effect of blend composition and annealing process (slow and fast cooling) on the surface mor...     

A scheme to produce a dense positronium plasma for an antihydrogen experiment

A 6 MeV industrial electron linac with 0.2 mA average current will be installed in December 2007 in CEA-Saclay. Equipped with a tungsten target and moderator, it is aimed at producing rates of order 10⁸ s⁻¹ slow positrons. This setup is part of a project to demonstrate the feasibility of an experiment to produce the ion for a free fall measurement of . The energy is below the neutron activation threshold. Its small size and cost could be of interest for a university laboratory or industry, and could be envisaged as a replacement source for the antihydrogen experiments at CERN.     

Bridging a Century-Old Problem: The Pathophysiology and Molecular Mechanisms of HA Filler-Induced Vascular Occlusion (FIVO)—Implications for Therapeutic Interventions

Biocompatible hyaluronic acid (HA, hyaluronan) gel implants have altered the therapeutic landscape of surgery and medicine, fostering an array of innovative products that include viscosurgical aids, synovial supplements, and drug-eluting nanomaterials. However, it is perhaps the explosive growth in the cosmetic applications of injectable dermal fillers that has captured the brightest spotlight, emerging as the dominant modality in plastic surgery and aesthetic medicine. The popularity surge with which injectable HA fillers have risen to in vogue status has also brought a concomitant increase in the incidence of once-rare iatrogenic vaso-occlusive injuries ranging from disfiguring facial skin necrosis to disabling neuro-ophthalmological sequelae. As our understanding of the pathophysiology of these injuries has evolved, supplemented by more than a century of astute observations, the formulation of novel therapeutic and preventative strategies has permitted the amelioration of this burdensome complication. In this special issue article, we review the relevant mechanisms underlying HA filler-induced vascular occlusion (FIVO), with particular emphasis on the rheo-mechanical aspects of vascular blockade; the thromboembolic potential of HA mixtures; and the tissue-specific ischemic susceptibility of microvascular networks, which leads to underperfusion, hypoxia, and ultimate injury. In addition, recent therapeutic advances and novel considerations on the prevention and management of muco-cutaneous and neuro-ophthalmological complications are examined.     

En route to the formation of high-efficiency, osmium(II)-based phosphorescent materials

Triosmium cluster complexes [Os3(CO)8(fppz)2] (2a) and [Os3(CO)8(fptz)2] (2b) bearing two 2-pyridyl azolate ligands were synthesized in an attempt to establish the reaction mechanism that gives rise to the blue-emitting phosphorescent complexes [Os(CO)2(fppz)2] (1a) and [Os(CO)2(fptz)2] (1b) [(fppz)H = 3-(trifluoromethyl)-5-(2-pyridyl)pyrazole; (fptz)H = 3-(trifluoromethyl)-5-(2-pyridyl)triazole]. X-ray structural analysis of 2b showed an open triangular metal framework incorporating multisite-coordinated 2-pyridyltriazolate ligands. Treatment of 2 with the respective 2-pyridylazolate ligand led to the formation of blue-emitting complex 1b, confirming their intermediacy, while the reaction of 2b with phosphine ligand PPh2Me afforded two hitherto novel hydride complexes 3 and 4, for which the reversible interconversion was clearly established at higher temperatures (> 180 degrees C). The single-crystal X-ray diffraction analyses of 3 and 4 confirmed their monometallic and isomeric nature, together with the coordination of two phosphine ligands located in the trans-disposition and one CO and one hydride located opposite to the pyridyl triazolate chelate. Subtle differences in photophysical properties were examined for isomers 3 and 4 on the basis of steady state absorption and emission, the relaxation dynamics, and temperature-dependent luminescent studies. The results, in combination with time-dependent density function theory (TDDFT) calculations, provide fundamental insights into the future design and preparation of highly efficient phosphorescent emitters.     

A tandem synthesis of 3-aroylcoumarinoflavones catalyzed by <Emphasis Type="SmallCaps">l</Emphasis>-proline and their antioxidant activity

A facile, convenient, efficient and high-yielding synthesis of 3-aroylcoumarinoflavones has been developed by the condensation of easily synthesized 7-hydroxy-8-formylflavones and benzoyl acetonitriles in the presence of catalytic amount of l-proline in ethanol reflux. All the synthesized compounds were evaluated for their antioxidant activity. Some of the compounds showed very good activity compared to standard BHT.