[The use of microlaryngoscopy in phoniatry (author's transl)]

Definite diagnostic advantages exist in the use of combined microlaryngoscopy and microstroboscopy in vocal rehbilitation since objective determination of vocal pathology can be made. The phoniatric considerations used in determining the indications for operative investigation are described. Reference is made to specific clinical problems, including the "hormone voice" in the Reinke edema from medications used in therapy and arytenoid dislocations from insufflation anesthesias. The postoperative prognosis after endolaryngeal surgery depends on the effectiveness of the surgical intervetion and the appropriate phoniatric-logopedic care employed. The author suggests that post-operative voice pauses should be minimized and not depend upon complete re-epithelialization of operative sites. Phoniatric and logopedic treatment used is based on considerations for appropriate vocal cord movements. The advantages of endolaryngeal faradization for vocal rehabilitation are discussed. In addition, the theoretical considerations of fitness for work are also discussed.

[Analyses of objectifiable ear noises]

The clinical aspects and therapeutical possibilities are presented for two extremely different cases of objectifiable noises in the ears. A specific experimental method (earphones and bone conductor served as microphones) permitted a stereophonic recording. After several amplifications it was possible to tape the noises. By means of two-ray-oscillography and time extension it was possible to analyze the structure of the noises in various ways (oscillogram, synchrony, etc.) Furthermore, sonagraphic analyses of the traditional type as well as isobar sonagraphy were performed. The results achieved were surprising and completely new: It was possible to clearly present, besides typical sound superimpositions, partial tones of varying intensity in sine form up to the 1,5000 Hz range.

Sex-chromosome aberrations in wood lemmings (Myopus schisticolor)

The wood lemming displays certain peculiar features: (1) The sex ratio shows a prevalence of females (FRANK, 1966; KALELA and OKSALA, 1966), and some females produce only female offspring (KALELA and OKSALA, 1966). (2) In a considerable proportion (in the present material, slightly less than half) of the females, an XY chromosome complement is found in the somatic tissues, but the Y is absent in the germ line of those studied (Fredga et al., 1976). Therefore, (3) a mechanism of double nondisjunction in early fetal life of XY females has to be postulated, which replaces the Y in the germ line by duplication of the X. It is assumed (4) that the X of XY females bears a sex-reversal factor that affects the male determining action of the Y (Fredga et al., 1977). There is (5) a strong presumption that in most cases the XY females are those that produce daughters only, but (6) a few exceptions may occur (FRANK, unpublished observations), suggesting that the regulation according to assumption 3 (perhaps also to 4) is incomplete in XY females. In the present report, four females are described with a 31,XO karyotype, two females with 33,XYY or 32,XY/33,XYY, respectively, two males with a 33,XXY, and one male with a 32,XX/33,XXY karyotype, as observed in a consecutive series of 502 wood lemmings. The incidence of sex-chromosome anomalies in liveborn and adult animals was 2.3%; the overall incidence, including embryos, was 1.79%. Neither the somatic XO constitution nor the existence of an extra Y in females precludes fertility. However, the XXY condition in the male results in sterility. There is certain evidence that an instability of the proposed mechanism for double mitotic nondisjunction of the sex chromosomes in oogonia accounts for the high rate of sex-chromosome aberrations in wood lemmings, at least when the mother is XY.

Phase-front distortion of laser radiation in a turbulent atmosphere

The phase-front distortion of laser radiation propagating through the turbulent atmosphere has been measured simultaneously at several wavelengths in the visible using a long-range Mach-Zehnder interferometer with high spatial and temporal resolution (476 nm </= lambda </= 647 nm, 0.5 mm </= Deltar 60 mm Deltat = 0.5 msec, z </= 2 km, C(n) = 1.3 x 10(-7) M(-1/3)). Phase-structure function, transverse coherence length, and arrival-angle fluctuations are interpreted in terms of the meteorological quantities turbulence strength and turbulence structure and inner and outer scale. The investigation covers the strong turbulence regime (scintillation saturation regime) where wave coherence is essentially determined by phase effects. In this regime a breakup of the phase front is found to occur.

Clinical course and prognosis of acute post-traumatic coma

The clinical course and prognosis of 282 cases of acute post-traumatic coma have been studied. Death occurred in 140 cases (49 percent), and, of survivors, about two-thirds achieved complete social reintegration, while one-third were partially reintegrated or not at all. The quality of survival did not depend only on the nature of the physical sequelae, but also on other factors, particularly social ones. With regard to early prognosis, the authors believe it is possible to predict the final outcome of the patient by using the indices of age, level of coma, and the nature of the intracranial lesions.

Clinical course of post-traumatic coma

The Authors describe the clinical course of 331 cases of post-traumatic coma, studied during the two-year period 1970-1971 at the 2nd Division of Neurosurgery (Ospedale Maggiore, Bologna). Among them, 42% died from trauma-related causes; 40% survived and had a complete reintegration into society; 18% survived at a lower social level or remained totally excluded from society. The quality of survival does not depend on the presence and degree of organic sequelae only, but also on psycho-social factors.