Episodic paroxysmal laryngospasm: Voice and pulmonary function assessment and management

Episodic paroxysmal laryngospasm (EPL) is a sign of laryngeal dysfunction, often without a specific organic etiology, which can masquerade as asthma, vocal fold paralysis, or a functional voice disorder. The intermittent respiratory distress of EPL may precipitate an apparent upper airway obstructive emergency, resulting in unnecessary endotracheal intubation, cardiopulmonary resuscitation, or tracheostomy. During 27 months, seven women and three men, ages 30–76 years, were assessed by a high diagnostic index of suspicion, an intensive history including psychosocial factors, physical examination of the airways, provocative asthma testing, and swallowing studies. Videolaryngoscopy, stroboscopy, and pulmonary flow-volume loop testing were definitive. The classic appearance was paradoxic inspiratory adduction of the anterior vocal folds with a posterior diamond-shaped glottic gap. During an attack of stridor or wheezing, attenuation of the inspiratory flow rate as depicted by the flow-volume loop suggested partial extrathoracic upper airway obstruction. Swallowing evaluation by videolaryngoscopy and videoesophagography may uncover gastroesophageal reflux disease. Hallmarks of management include patient and family education by observation of laryngoscopic videos, a specific speech therapy program, psychotherapy, and medical treatment of associated disorders. Electromyography may become a valuable future adjunct. Unlike laryngeal dystonia, patients with EPL do not benefit from botulinum toxin type A.     

Aging of supersaturated Al-Cu-Co decagonal phase

Aging of the supersaturated Al₆₈Cu₁₁Co₂₁ decagonal phase was studied by transmission and scanning electron microscopy. Changes in the twofold [12100] electron diffraction patterns are reported. The decagonal phase aged at 700–800°C exhibited a reduction of the intensities of the quasiperiodic odd-n reflections and the appearance of extra-reflections along quasiperiodic directions.     

Genetics of Vocal Quality Characteristics in Monozygotic Twins: A Multiparameter Approach

The main purpose of this study was to determine the vocal quality characteristics among the 45 monozygotic cotwins (MT). As the performance of the voice is related to several genetically determined anatomical and physiological factors, the authors hypothesized that the vocal characteristics and the overall vocal quality by means of the Dysphonia Severity Index (DSI) will be identical in MT. An additional objective of this study was to determine whether sex and age influence vocal similarities in MT and to compare the voice characteristics of MT with the normative data of unrelated peers. As more environmental factors influence the aging of the voice, age-related differences were expected. No sex-related differences were expected. Subjective and objective assessment techniques determined the vocal quality. No significant differences were obtained, and most comparisons resulted in significant correlation coefficients. For the acoustic parameters jitter and shimmer only, no significant correlation coefficients could be obtained. It is clear that the perceptual voice characteristics, the laryngeal aerodynamic measurements of maximum phonation time (MPT), the vocal performances, and the overall vocal quality by means of the DSI are similar in MT. These vocal characteristics are not influenced either by the subjects' age or sex and are situated within the normative range of unrelated peers. To what extent other aspects (environment, anxiety, tension, etc) might play a role in the acoustical dimensions regarding frequency and amplitude perturbation, which were in the normal range, is a subject of further research.     

Evaluation of Support in Singing

This study searched for perceptual, acoustic, and physiological correlates of support in singing. Seven trained professional singers (four women and three men) sang repetitions of the syllable [pa:] at varying pitch and sound levels (1) habitually (with support) and (2) simulating singing without support. Estimate of subglottic pressure was obtained from oral pressure during [p]. Vocal fold vibration was registered with dual-channel electroglottography. Acoustic analyses were made on the recorded samples. All samples were also evaluated by the singers and other listeners, who were trained singers, singing students, and voice specialists without singing education (a total of 63 listeners). We rated both the overall voice quality and the amount of support. According to the results, it seemed impossible to observe any auditory differences between supported singing and good singing voice quality. The acoustic and physiological correlates of good voice quality in absolute values seem to be gender and task dependent, whereas the relative optimum seems to be reached at intermediate parameter values.     

Durability of polyurethanes elastomers

The effect of thermal aging on three different elastomeric polyurethane adhesives was studied. Consequently, an attempt was made to predict the polyurethanes' service lifetimes from the changes in tensile properties, hardness of bulk specimens and adhesion strength properties (lap shear and butt joints) of polycarbonate bonded joints. Aging temperatures ranged from ambient to 70 °C (at 50% relative humidity) for durations from 20 days to 18 months. Experimental results were analyzed according to a kinetic rate theory and using limit values for the various properties. Consequently, service lifetimes were determined and compared to results from actual service life. Predictions of long-term performance from accelerated tests proved to be reasonable for the properties and materials studied.     

Paradoxical vocal fold movement: A case report

We present a case of one patient with respiratory stridor that was resolved by speech therapy. Paradoxical vocal fold movements were observed by flexible fiberoptic videolaryngoscopy in this patient during episodes of wheezing and dyspnea. Otherwise, normal vocal fold movement was observed in normal conditions of breathing (out of the crisis) and during phonation. Many different terms have been used to describe this entity in the literature, and it is crucial that clinicians recognize the subtle signs of functional stridor. Paradoxical vocal fold motion has to be considered as an important cause of respiratory disease. Its recognition and treatment are discussed in this report.     

Expanding perspectives in care of the speaking voice

The effective voice clinician has always had to borrow from various disciplines: voice science, otolaryngology, psychology, and speech-language pathology. Such eclecticism requires, however, that the clinician integrate the perspectives of these various disciplines into some kind of theoretical clinical bias. One bias might be that with greater use of instrumentation in voice therapy, the voice clinician must not substitute data collection for attending to the feelings of the patient. By using the clinical input from various disciplines, for example, voice clinicians might develop a useful clinical perspective that vocal hyperfunction is one of the primary causes of many voice disorders. Consequently, from such a clinical view might come a treatment perspective that can clearly define the problem (too much effort while speaking) and offer a rationale for voice remediation.     

Respiratory function in singers: Medical assessment, diagnoses, and treatments

A healthy voice depends upon healthy respiration. An understanding of respiratory function is essential in evaluating disorders that affect the voice. This review addresses the assessment of respiratory complaints by history, physical examination, laboratory testing, and endoscopic procedures. Allergy testing and pulmonary function testing are covered in detail. Special problems that confront the professional voice user, such as the need to optimize respiratory function even in mild disease states, exposure to environmental irritants, and the athletic demands of performance, are related specifically to respiratory function. The discussion of diagnosis and treatment of common ailments such as allergic rhinitis and bronchitis is directed toward treatment of the active singer.     

Dynamic Mechanical Properties of Aged Filled Rubbers

Abstract

It is well known that the macromolecular structure and the microstructure of the fillers play an important role in the mechanical properties of filled rubbers. This paper focuses on the dependence of the complex modulus of aged natural rubber vulcanizates on the filler network and polymer structure. Dynamic mechanical analysis (DMA) at 30°C, 50°C, and 70°C on the aged rubbers with/without prestrain showed the Payne effect, i.e., a storage modulus drop with increasing amplitude, and the appearance of a loss tangent maximum at strain of about a few percent. The storage modulus increased with the aging time at 70°C, 24 < 72 < 240 hr, in the case of nonprestrain. When the prestrain was applied, strain‐induced crystallization was generated that enhanced the storage modulus. As time passed, the prestrain relaxed and the crystalline structures began to disappear. After 72 hr, the crystalline structures had almost disappeared, and they had only a weak effect. Consequently, there existed a higher modulus for an aging time of 24 hr than 72 hr at testing temperatures of 30°C and 50°C. It was concluded that the storage modulus was determined by the postvulcanization, strain‐induced crystallization, aging, and relaxing time.     

THE ROLE OF DOUBLE-HELIX FORMATION IN WATER DIFFUSION AND AGING OF INJECTION-MOLDED STARCH*

Native potato starch has been processed without the use of any additive. Moldings of initial high strength and ductility have been achieved. However, mechanical properties change with time. Thermogravimetric experiments at different temperatures show that aging takes place in three different steps. The first is characterized by a strong formation of double helices (as revealed by wide-angle X-ray scattering [WAXS]) in parallel with strong water loss. Hardness, strength, and elongation at break increase in this time range: Double helices act as reinforcing elements. When the yield elongation is surpassed, double helices are unraveled, providing a higher elongation at break. With further aging (drying), due to a shrinking process, a temporary reduction of double helices, causing a resoftening, seems to take place. In a third step, the starch moldings become quite brittle due to the lack of molecular mobility. At room conditions, it takes approximately 1 year (beginning of range 3) to lose the good mechanical properties. It is proposed that the mechanical behavior of starch moldings is controlled by a molecular network that consists of singlehelix molecules bound by double helices within an amorphous structure.