Kwang-Moon Kim

Voice analysis of patients with diverse types of Reinke's edema and clinical use of electroglottographic measurements

Conclusions. Reinkes edema shows a variety of clinical patterns and differences in voice analysis depending on its type. Electroglottographic measurements help to objectively assess the severity of edema and voice quality before and after surgery. Objectives. Reinkes edema manifests various clinical findings and different voice characteristics depending on the degree of swelling and the severity of voice impairment. The aim of this study was to compare the aerodynamic, acoustic and electroglottographic parameters for the different types of Reinkes edema according to its morphological, perceptual and histopathological classifications, and to assess voice quality in patients with Reinkes edema before and after laryngomicrosurgery. We also aimed to determine which parameter was most associated with the improvement in postoperative voice quality and to investigate the clinical usefulness of electroglottographic analysis in Reinkes edema. Material and methods. The clinical and voice records of 61 patients with Reinkes edema were reviewed. All the patients were classified according to stroboscopic findings (Yonekawas classification), perceptual grade and histopathological findings. Voice analysis of the perceptual, acoustic, aerodynamic and electroglottographic measurements was carried out using various classifications, and the voices of 23 patients who underwent laryngomicrosurgery were evaluated 2 months after surgery. Furthermore, the voices of 30 normal speakers (controls) were recorded and analyzed. Results. The fundamental frequency (FxM) of Yonekawa Type III was significantly lower than those of the other types of Reinkes edema, and the SD of the FxM, the percentage irregularity of the FxM (CFx) and the percentage irregularity of the amplitude were larger than those of the other types of Reinkes edema. The closed quotient was significantly higher in Yonekawa Type III. In addition, the mean flow rate (MFR), maximum phonation time and harmonics:noise ratio (HNR) differed significantly among the different types of Reinkes edema. The postoperative results showed an increase in the FxM and an improvement in the MFR, subglottic pressure, shimmer and HNR. Correlation analysis showed that jitter, the HNR, the mean closed quotient and the irregularity of the frequency were the parameters that had the best correlation with improvement in postoperative voice quality.

Targeted gene therapy of LS174 T human colon carcinoma by anti-TAG-72 immunoliposomes.

Anti-tumor-associated glycoprotein (TAG)-72 PEG-immunoliposomes (PILs) were prepared by conjugation of Fab′ fragments of recombinant humanized monoclonal antibody, HuCC49, to sterically stabilize unilamellar liposomes (90–110 nm in diameter) to target TAG-72-overexpressing cancer cells. The liposomes consisted of 1-palmitonyl-2-oleoyl-sn-glycerol-3-phosphocholine (POPC), 92 mol percent, O,O′-dymyrisyl-N-lysyl aspartate (DMKD cationic lipid), 4 mol percent, distearoyl-phosphatidyl-ethanolamine-polyethylene glycol 2000 (DSPE-PEG2000), 3 mol percent and DSPE-maleimide (DSPE-PEG2000-Mal), 1 mol percent. These anti-TAG-72 PILs were able to adhere to the surface of TAG-72-overexpressing LS174 T human colon cancer cells more effectively than conventional liposomes. Also, in vitro gene transfection of the LS174 T cells by the anti-TAG-72 PILs in the presence of a high concentration of fetal bovine serum (up to 60%) was greater than that by conventional cationic lipoplexes. Intravenously administered anti-TAG-72 PILs efficiently localized in the LS174 T tumor tissues, while the non-targeted conventional liposomes did not. Intravenous administration of the anti-TAG-72 PILs containing plasmids encoding antiangiogenic proteins, such as angiostatin K1/3, endostatin and saxatilin, significantly inhibited in vivo growth of LS174 T tumors and angiogenesis in the tumor tissues. These results demonstrated the potential of TAG-72-mediated targeting of immunoliposomes as a modality for systemic gene delivery to human colon cancer cells.

Age Dependence of Laryngeal Chemoreflex in Puppies

Previously collected data have indicated that the laryngeal chemoreflex (lcr) response is exaggerated during a critical period of postnatal development in several experimental animals. These animals had fewer anatomic and physiological similarities to humans than do puppies. This investigation of the lcr in 14 anesthetized puppies was undertaken to determine age-related differences in the response to stimulation of the supraglottic laryngeal mucosa by saline solution, distilled water, cows milk, and acid at pH 1.0. The dogs were divided into 3 age groups: group 1 consisted of 4 dogs that were 2 weeks old, and in groups 2 and 3 there were 5 puppies each, of 4 and 6 weeks of age, respectively. The lcr response (laryngospasm, apnea, respiratory depression, and bradycardia) was found in the puppies only after stimulation of the laryngeal mucosa with acid at pH 1.0, and it was more easily achieved in the 4- and 6-week age groups than in the 2-week group. These findings suggest that the lcr is an age-dependent response that appears in dogs only after 2 weeks of age. The important implication of this finding is that postnatal neural maturation may influence the laryngeal reflex in humans to some extent.

Superior Laryngeal Nerve Brain Stem Evoked Response in the Cat

The generator sources of each wave of the laryngeal brain stem evoked response (LBR) have yet to be precisely demonstrated, although this has been studied in several animal species. This study was carried out to record the near-field brain stem activity as well as the far-field brain stem activity in the cat under the same experimental setup, and to search for the generator sources of the waves. Under general anesthesia, the LBR tracings were recorded adjacent to and within the brain stem following direct electrical stimulation of the internal branch of the superior laryngeal nerve. Reproducible positive and negative waves were detected by the far- and near-field techniques. Mean latencies, configurations, and reproducibility of each wave were demonstrated. From these results, we speculate on the generator sources of each wave.

Interfacial properties of ion beam mixed Cu/SiO2 system

Abstract A thin Cu layer (35 nm) deposited on SiO 2 has been mixed with 80 keV Ar + at room temperature, 550 and 650 K. Interfacial properties of irradiated samples were investigated with Rutherford backscattering spectroscopy, grazing angle X-ray diffraction and scratch test. Adhesion of Cu films was improved by a factor of 3 at a dose of 1.5 × 10 16 Ar 4 /cm 2 in the case of ion beam mixing at room temperature, while the high temperature ion beam mixing enhanced the adhesion by a factor of 5. The ballistic mixing effects on the improvement of adhesion for the room temperature ion mixing and the creation of Cu 2 O phase at the interface, which contributes to the enhancement of adhesion induced by ion beam mixing at high temperature, are described in the present paper.

Sulcus configurations of vocal folds during phonation.

Conclusion: A detailed understanding of clinical and voice characteristics will help to differentiate sulcus configuration and plan rational management strategies for each type. Objectives: To investigate the clinical and voice characteristics of patients with sulcus configuration of vocal folds during phonation. Patients and methods: A total of 146 patients with bilateral sulcus configuration of vocal folds were enrolled in this study. Based on videostroboscopic findings, patients were classified into three groups: physiologic sulcus configuration group (type I), pathologic sulcus configuration group, including sulcus vergeture (type II), and sulcus vocalis (type III). Voice analyses were obtained from a recorded speech sample. Results: Thirty-two patients (21.9%) were type I, 61 (41.8%) were type II, and 53 (36.3%) were type III. Different sulcus configuration groups had significantly different roughness and mean fundamental frequency. Type III was significantly different from type I and type II in grade, breathiness, mean flow rate, subglottic pressure, maximum phonation time, Jitter%, and harmonics to noise ratio. The pathologic sulcus showed distinctive features in electroglottograph waveform.

GROWTH MODE OF AU LAYER ON SI(001)

Abstract We investigated the annealing effect on the behavior of Au atoms on the Si(001) surface using coaxial impact collision ion scattering spectroscopy. We found that the growth mode of Au atoms on Si(001) at room temperature is layer by layer growth, whereas Au atoms on Si(001) are transformed into three dimensional islands above 400°C. We found that the structure of the Au islands is a crystalline {001} orientation with the 〈110〉 direction aligned with a 〈100〉 direction in the substrate. The crystalline portion of the islands is about 42% of the top two atomic layers.

New method for thermal desorption spectroscopy using field electron emission microscopy

We have developed a new method for thermal desorption spectroscopy using field electron emission microscopy. To investigate the validity of our method, we have performed hydrogen adsorption experiments on the well known W(100) and W(110) surfaces and also on W(310). The thermal desorption spectra of these systems show that this method permits the study of adsorption on various single crystal plans of a metal with one sample. This method also gives information about the dipole direction of the adsorbates directly from the thermal desorption spectrum without additional measurement of the work function change induced by adsorbates.

Devising an objective nasal vibration test for nasal resonatory disorders.

The present study investigates the clinical applicability of a new device, which objectively measured nasal resonating vibration via piezoelectric vibratory sensor in 10 normal volunteers, 10 patients with definite hypernasality, and 10 nasal polyposis patients. For the assessment of the hypernasality, the ratio of /ng/ to /a/ as well as the ratio of /mama/ to /papa/ passages were used. For the evaluation of hyponasality, the ratio of nasal vibration postinduced to preinduced cul-de-sac resonation was calculated. The control group showed the ratio of /ng/ to /a/ and /mama/ to /papa/ passages to be larger than 8, whereas the ratio was markedly lower in the hypernasality group. The vibratory signals of /a/ and /ng/ increased markedly in the control and the hypernasality groups after inducing cul-de-sac resonation, but the change was minimal in the hyponasality group. This new device could detect nasal resonatory disorders and readily differentiate between hypernasality and hyponasality.

42: Rigid Videoendoscopy-Guided Peroral Injection Of Botulinum Toxin in Spasmodic Dysphonia

Objective: Choice of a reconstructive method for pharyngoesophageal defect and its indication still varies, and there are few reports comparing the results of each method. This study evaluates the advantages and disadvantages of the three kinds of reconstructive methods that are most commonly used. Methods: During the 9-year period, 26 pharyngoesophageal reconstructions were performed in head and neck cancers (1 esophageal, 4 laryngeal, and 21 hypopharyngeal cancers). Seven patients were reconstructed with radial forearm free flap, 11 by jejunal free flap, and 8 with gastric pull-up. All the flaps were used simultaneously with ablative oncologic surgery. Results: There were no flap failures. Two operative mortality cases were gastric pull-up cases (the causes of which were ARDS and innominate artery rupture). Fistula was most common in forearm cases with complete tubing (3 of 4), but partial conduit cases had no fistulas or complications (0 out of 3). Morbidity of donor site was common in jejunal group (2 of 11). Successful swallowing was accomplished in 84.6% (22 of 26). Conclusions: For choice of a flap for pharyngoesophageal reconstruction, we prefer forearm free flap for partial conduit defect, jejunal free flap for complete tubed defect, and gastric pull-up for total pharyngolaryngoesophagectomy cases.