Paradoxical vocal fold motion: Presentation and treatment options

Paradoxical vocal fold motion is a rare disorder in which adduction of the folds occurs on inspiration. The disorder presents with signs of airway obstruction and often airway distress, so proper diagnosis by the otorhinolaryngologist is critical to subsequent management. We present a retrospective review of 10 patients with the diagnosis of paradoxical vocal fold motion seen over a 6-year period. Eight patients were females, and 6 required an acute airway intervention at presentation; 3 patients eventually underwent tracheotomy for respiratory decompensation. Six patients had a prior diagnosis of asthma, and this was determined to contribute to their respiratory status. Five patients were treated with botulinum toxin and 2 with flexible nasolaryngoscopic biofeedback, which improved the outcome. A review of the literature confirms a female predominance of patients presenting with paradoxical adduction and airway distress, often with a history of asthma and psychopathology. Our experience with botulinum toxin and biofeedback suggests that these procedures are viable treatment options in the management of patients with this disorder.     

Phonomicrosurgical management of vocal fold polyps: The subepithelial microflap resection technique

Vocal fold polyps are typically caused by acute and chronic trauma to the microvasculature of the superficial lamina propria (SLP). Shearing stresses that are induced by hyperfunctional glottal sound production lead to bleeding into the SLP and malformed neo-vascularized masses. Because the primary process does not involve the epithelium, the authors designed a technique to resect hemorrhagic polyps by epithelial cordotomy with partial or complete preservation of the vocal fold epithelium. This approach is different from the traditional microsurgical resection of hemorrhagic polyps by amputation with or without the carbon dioxide laser. Forty patients who underwent microlaryngoscopic resection of hemorrhagic polyps from 1996 through 1998 were reviewed retrospectively. Thirty-six of the 40 procedures were by epithelial cordotomy and subepithelial removal of the polyp contents. Sixteen of 36 were assisted by a subepithelial infusion of saline and epinephrine, and all were 3 mm to 6 mm. Four of 40 polyps were amputated; all of these were less than 3 mm and were pedicled on a narrow base. Cold instruments were used exclusively in all 40 patients. Postoperative laryngeal stroboscopy within 2 weeks revealed improved mucosal wave propagation and improved glottal closure in all 33 patients in whom postoperative strobovideolaryngoscopy was available. The epithelial cordotomy technique was introduced to minimize disturbance of normal SLP and epithelium. Despite the hemorrhagic nature of these lesions, cold instruments could be used exclusively with facility due to careful microdissection between the polyp and the residual normal SLP and the enhanced hemostasis provided by the subepithelial infusion of saline and epinephrine. The rapid return to improved glottal function is the result of this ultra tissue-sparing technique.     

Predicted Singers' Vocal Fold Lengths and Voice Classification—A Study of X-Ray Morphological Measures

Students admitted to the solo singing education at the University of Music Dresden, Germany have been submitted to a detailed physical examination of a variety of factors with relevance to voice function since 1959. In the years 1959–1991, this scheme of examinations included X-ray profiles of the singers' vocal tracts. This material of 132 X-rays of voice professionals was used to investigate different laryngeal morphological measures and their relation to vocal fold length. Further, the study aimed to investigate if there are consistent anatomical differences between singers of different voice classifications. The study design used was a retrospective analysis. Vocal fold length could be measured in 29 of these singer subjects directly. These data showed a strong correlation with the anterior-posterior diameter of the subglottis and the trachea as well as with the distance from the anterior contour of the thyroid cartilage to the anterior contour of the spine. These relations were used in an attempt to predict the 132 singers' vocal fold lengths. The results revealed a clear covariation between predicted vocal fold length and voice classification. Anterior-posterior subglottic-tracheal diameter yielded mean vocal fold lengths of 14.9, 16.0, 16.6, 18.4, 19.5, and 20.9 mm for sopranos, mezzo-sopranos, altos, tenors, baritones, and basses, respectively. The data support the assumption that there are consistent anatomical laryngeal differences between singers of different voice classifications, which are of relevance to pitch range and timbre of the voice.     

蛋白质折叠类型的分类建模与识别

蛋白质的氨基酸序列如何决定空间结构是当今生命科学研究中的核心问题之一. 折叠类型反映了蛋白质核心结构的拓扑模式, 折叠识别是蛋白质序列-结构研究的重要内容. 我们以占Astral 1.65序列数据库中α, β和α/β三类蛋白质总量41.8%的36个无法独立建模的折叠类型为研究对象, 选取其中序列一致性小于25%的样本作为训练集, 以均方根偏差(RMSD)为指标分别进行系统聚类, 生成若干折叠子类, 并对各子类建立基于多结构比对算法(MUSTANG)结构比对的概形隐马尔科夫模型(profile-HMM). 将Astral 1.65中序列一致性小于95%的9505个样本作为检验集, 36个折叠类型的平均识别敏感性为90%, 特异性为99%, 马修斯相关系数(MCC)为0.95. 结果表明: 对于成员较多, 无法建立统一模型的折叠类型, 基于RMSD的系统分类建模均可实现较高准确率的识别, 为蛋白质折叠识别拓展了新的方法和思路, 为进一步研究奠定了基础.     

Fold optics path: an improvement for an atomic fountain

A fold optical path is utilized to capture and launch atoms in the atomic fountain.This improved technique reduces the laser power needed by 60 percent,facilitates suppression of the laser power fluctuations,and leads to a more simple and stable system.     

基于大鼠背部视窗显微观测的微血管网的三维重建

微循环是循环系统中最基层的结构和功能单位,它在保持人体正常生理功能中占有突出地位,许多疾病的发生也是从微循环开始. 因此,利用脊背视窗技术,并通过体视显微镜观察视窗内的血管结构, 进一步对所获血管图像进行一系列图像处理,得到了血管边界和中心线等结构信息. 同时,根据血管分叉处相贯线的信息确定分叉血管的连接方式. 在网格划分时,采用了改进的超限插值算法,构建了三维血管网的有限元网格模型,实现了对任意分支血管网的三维重建. 为微循环的体外实验和数值分析奠定基础.