[Peripheral nerve injuries].
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Biomedical subjects
Publications and source records attributed to R Hagen.
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Tracheoesophageal puncture and insertion of a prosthetic voice device is currently the most widely surgical procedure for vocal rehabilitation after total laryngectomy. The disadvantages of voice prostheses are high initial phonation pressure, formation of granulation tissue around the voice shunt, blockage, displacement of the prosthesis, leakage of the prosthesis or the voice shunt, spontaneous occlusion when the prosthesis is accidentally removed and difficulties in replacing and cleaning the prosthesis. In an effort to avoid these problems, a substitute laryngeal tube (laryngoplasty) was fashioned from a revascularized forearm flap and connected to the trachea and pharynx in seven patients with extensive laryngohypopharyngeal carcinoma. All seven developed a voice comparable with patients fitted with a voice prosthesis. An advantage of this graft is the low phonation pressure required for voice production. Problems with aspiration have not occurred even after radiotherapy. While still in the hospital, five patients learned to speak without using their hands through the use of a tracheostomal valve. Judging by these results, this surgical procedure is a practical alternative to a voice prosthesis.
Zherlock is an open source software that provides state-of-the-art data analysis tools to the user in an intuitive and flexible way. It is a front-end to different numerical "engines" to produce a seamless integration of algorithms written in different computer languages. Of particular interest is creating an interface to high-level scientific languages such as Octave (a Matlab clone) and R (an S-PLUS clone) to enable efficient porting of new data analytical methods. Zherlock uses advanced scientific visualization tools in 2-D and 3-D and has been extended to work on virtual reality (VR) systems. Central to Zherlock is a visual programming environment (VPE) which enables diagram based programming. These diagrams consist of nodes and connection lines where each node is an operator or a method and lines describe the flow of data between nodes. A VPE is chosen for Zherlock because it forms an effective way to control the processing pipeline in complex data analyses. The VPE is similar in functionality to other programs such as IRIS Explorer, AVS or LabVIEW.
Congenital malformations of the inner ear are well described, though the combination with cerebrospinal fluid (CSF) leaks remains controversial. In this paper a case of a bilateral Mondini malformation with a CSF otorrhea on one side is reported. The malformed stapes contains a perforation in the middle of the footplate and associated thinning analogous to a pothole in a mountain stream. The histological findings support the hypothesis of pulsatile flow of CSF as origin of the perforation of the footplate.
The throw and its modifications are integral components of many sports. This study correlates case histories of acute injuries in throwing with a biomechanical analysis of the throwing mechanism. Comparisons are made with a similar analysis of the kick analyzed by the same film technique and computer program. Just prior to ball release, the pitching arm extends through an arc of about 73 degress in 40 msec, beginning with the elbow flexed at 80 degrees. This produces an axial load on the humerus and coincides with a pulse of external torque at the shoulder. This acts as stress protection to the humerus which is developing an internal torque of 14,000 inch-lb prior to ball release. The change in angular velocity, or the angular acceleration, during the throw is acquired in a much shorter time than in the kick. Torque is directly proportional to angular acceleration. This necessitates the development of substantially higher torques in the humerus during the throw than about the knee during a kick. The kinetic energy in the arm is 27,000 inch-lb during the throw. This is much higher than the kinetic energy in the kicking leg because the kinetic energy varies proportionally with the square of the angular velocity of the extremity. The angular velocity of the arm is about twice that of the leg. Thus, the pitching arm contains about four times as much kinetic energy as the kicking leg. These severe overloading conditions predispose the upper extremity to injury in the throwing mechanism.
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