Research Note: Irritating flashing light or poultry-friendly lighting-are flicker frequencies of LED luminaires a potential stress factor in the husbandry of male fattening turkeys?

Conventional fluorescent tubes are increasingly being replaced with innovative light-emitting diodes (LEDs) for lighting poultry houses. However, little is known about whether the flicker frequencies of LED luminaires are potential stressors in poultry husbandry. The term "light flicker" describes the fluctuations in the brightness of an electrically operated light source caused by the design and/or control of the light source. In this context, the critical flicker frequency (CFF) characterizes the frequency at which a sequence of light flashes is perceived as continuous light. It is known that CFF in birds is higher than that in humans and that light flicker can affect behavioral patterns and stress levels in several bird species. As there is a lack of knowledge about the impact of flicker frequency on fattening turkeys, this study aimed to investigate the effects of flicker frequency on the behavior, performance, and stress response in male turkeys. In 3 trials, a total of 1,646 male day-old turkey poults of the strain B.U.T. 6 with intact beaks were reared for 20 wk in 12 barn compartments of 18 m² each. Each barn compartment was illuminated using 2 full-spectrum LED lamps. Flicker frequencies of 165 Hz, 500 Hz, and 16 kHz were set in the luminaires to illuminate the compartments. Analyses of feather corticosterone concentration were performed on fully grown third-generation primaries (P 3) of 5 turkeys from each compartment. No significant differences were found in the development of live weight, feed consumption, or prevalence of injured or killed turkeys by conspecifics reared under the above flicker frequencies. The flicker frequencies also did not significantly influence feather corticosterone concentrations in the primaries of the turkeys. In conclusion, the present results indicate that flicker frequencies of 165 Hz or higher have no detrimental effect on growth performance, injurious pecking, or endocrine stress response in male turkeys and, thus, may be suitable for use as animal-friendly lighting.

THU0053 CONTRIBUTION OF DEFECTIVE NON-APOPTOTIC FAS SIGNALING TO IMMUNE DYSREGULATION IN AUTOIMMUNE LYMPHOPROLIFERATIVE SYNDROME (ALPS)

Background:

ALPS patients show impaired generation of humoral memory for T independent antigens whereas they generate memory for self-antigens due to impaired FAS-dependent removal of autoreactive germinal center B cells. It is known that FAS signaling via caspase activation results in cell apoptosis. However, FAS ligation may also initiate or modulate non-apoptotic signaling as shown for example by its ability to activate NF-κB. Recent data implicate a regulatory role of FAS in the modulation of mTOR signaling in ALPS double-negative T cells. Moreover, a recently described C194V FAS mutation disturbs its post-translational modification leading to impaired apoptosis induction while non-apoptotic signalling is still intact. Consequently, C194V FAS protects from the autoimmune phenotype in the murine ALPS system. This supports the view that FAS may prevent autoimmunity with other mechanisms than inducing apoptosis.

Objectives:

We hypothesize that FAS mutations impair this modulatory signaling, leading to hyper-activation of B cells. Therefore we aim to investigate non apoptotic FAS signaling in B cells derived from healthy individuals and ALPS patients.

Methods:

We studied resting and activated B cells in ALPS patients in presence or absence of FAS ligand by flow cytometry analysing relevant molecules to the CD40 signaling pathway. We used mass cytometry to perform functional phenotyping of B cells isolated from secondary lymphoid organs. Proteomic studies were performed to identify potential signaling circuits and RNA sequencing to study the consequences of FAS signaling on B cell fate.

Results:

In CD40L activated B cells, FAS signaling results in specific modulation of the mTOR signaling pathway. This modulation is absent in ALPS derived B cells. In line with these data germinal center B cells and plasmablast from secondary lymphoid organs of ALPS patients show hyperactive mTOR signaling pathway. Proteomic studies identify a circuit that links FAS to the phosphatase PTEN via DAXX and the deubiquitinase USP7.

Conclusion:

We describe a new role of FAS in the regulation of B cell activation. Defects in FAS signaling in ALPS contribute to dysregulation of the mTOR signaling pathway and disturbed B cell development.

Disclosure of Interests:

None declared

One Iron Injection Is Not Enough-Iron Status and Growth of Suckling Piglets on an Organic Farm

Suckling piglets cannot satisfy their demand for the essential trace element iron from sows' milk alone, which is poor in iron. Therefore, iron is usually supplemented by injecting 200 mg iron (as iron dextran) on day 3 post natum. However, the longer suckling period in organic pig herds leads to iron intake from feed starting later. We hypothesized that one iron injection is not enough for organically reared piglets, and that a second and third injection would improve their iron status and growth. On an organically certified experimental farm, 288 piglets from 32 litters were allocated to three treatments with one iron injection on day 3, two injections on day 3 and 14 and three injections on day 3, 14 and 21 post natum, respectively. One injection resulted in the lowest hematocrit and serum iron levels until day 28 post natum and the lowest daily weight gains until weaning, while piglets receiving two or three iron injections did not differ from each other. Based on these observations, we conclude that one iron injection is not enough to ensure adequate iron supply and unimpaired growth of organically reared piglets, and additional iron supply is necessary.

Coherent Excitation of Heterosymmetric Spin Waves with Ultrashort Wavelengths

In the emerging field of magnonics, spin waves are foreseen as signal carriers for future spintronic information processing and communication devices, owing to both the very low power losses and a high device miniaturization potential predicted for short-wavelength spin waves. Yet, the efficient excitation and controlled propagation of nanoscale spin waves remains a severe challenge. Here, we report the observation of high-amplitude, ultrashort dipole-exchange spin waves (down to 80 nm wavelength at 10 GHz frequency) in a ferromagnetic single layer system, coherently excited by the driven dynamics of a spin vortex core. We used time-resolved x-ray microscopy to directly image such propagating spin waves and their excitation over a wide range of frequencies. By further analysis, we found that these waves exhibit a heterosymmetric mode profile, involving regions with anti-Larmor precession sense and purely linear magnetic oscillation. In particular, this mode profile consists of dynamic vortices with laterally alternating helicity, leading to a partial magnetic flux closure over the film thickness, which is explained by a strong and unexpected mode hybridization. This spin-wave phenomenon observed is a general effect inherent to the dynamics of sufficiently thick ferromagnetic single layer films, independent of the specific excitation method employed.

Soft X-ray microscopy for probing of topical tacrolimus delivery via micelles

The penetration of topically applied tacrolimus formulated in micelles into murine skin is reported, measured by X-ray microscopy. Tacrolimus and micelles are probed for the first time by this high spatial resolution technique by element-selective excitation in the C 1s- and O 1s-regimes. This method allows selective detection of the distribution and penetration depth of drugs and carrier molecules into biologic tissues. It is observed that small, but distinct quantities of the drug and micelles, acting as a drug carrier, penetrate the stratum corneum. A comparison is made with the paraffin-based commercial tacrolimus ointment Protopic^®, where local drug concentrations show to be low. A slight increase in local drug concentration in the stratum corneum is observed, if tacrolimus is formulated in micelles, as compared to Protopic^®. This underscores the importance of the drug formulations for effective drug delivery. Time-resolved penetration shows presence of drug in the stratum corneum 100 min after formulation application, with penetration to deeper skin layers at 1000 min. High resolution micrographs give indications for a penetration pathway along the lipid membranes between corneocytes, but also suggest that the compound may penetrate corneocytes.

OMNY-A tOMography Nano crYo stage

For many scientific questions gaining three-dimensional insight into a specimen can provide valuable information. We here present an instrument called "tOMography Nano crYo (OMNY)," dedicated to high resolution 3D scanning x-ray microscopy at cryogenic conditions via hard X-ray ptychography. Ptychography is a lens-less imaging method requiring accurate sample positioning. In OMNY, this in achieved via dedicated laser interferometry and closed-loop position control reaching sub-10 nm positioning accuracy. Cryogenic sample conditions are maintained via conductive cooling. 90 K can be reached when using liquid nitrogen as coolant, and 10 K is possible with liquid helium. A cryogenic sample-change mechanism permits measurements of cryogenically fixed specimens. We compare images obtained with OMNY with older measurements performed using a nitrogen gas cryo-jet of stained, epoxy-embedded retina tissue and of frozen-hydrated Chlamydomonas cells.

Current-driven dynamics and inhibition of the skyrmion Hall effect of ferrimagnetic skyrmions in GdFeCo films

Magnetic skyrmions are swirling magnetic textures with novel characteristics suitable for future spintronic and topological applications. Recent studies confirmed the room-temperature stabilization of skyrmions in ultrathin ferromagnets. However, such ferromagnetic skyrmions show an undesirable topological effect, the skyrmion Hall effect, which leads to their current-driven motion towards device edges, where skyrmions could easily be annihilated by topographic defects. Recent theoretical studies have predicted enhanced current-driven behavior for antiferromagnetically exchange-coupled skyrmions. Here we present the stabilization of these skyrmions and their current-driven dynamics in ferrimagnetic GdFeCo films. By utilizing element-specific X-ray imaging, we find that the skyrmions in the Gd and FeCo sublayers are antiferromagnetically exchange-coupled. We further confirm that ferrimagnetic skyrmions can move at a velocity of ~50 m s⁻¹ with reduced skyrmion Hall angle, |θ_SkHE| ~ 20°. Our findings open the door to ferrimagnetic and antiferromagnetic skyrmionics while providing key experimental evidences of recent theoretical studies.

Non-zero topological charge prevents the straight motion of ferromagnetic skyrmions and hinders their applications. Here, the authors report the stabilization and current-driven dynamics of skyrmions in GdFeCo films in which the ferrimagnetic skyrmions can move with high velocity and reduced skyrmion Hall angle.

Pinning and hysteresis in the field dependent diameter evolution of skyrmions in Pt/Co/Ir superlattice stacks

We have imaged Néel skyrmion bubbles in perpendicularly magnetised polycrystalline multilayers patterned into 1 µm diameter dots, using scanning transmission x-ray microscopy. The skyrmion bubbles can be nucleated by the application of an external magnetic field and are stable at zero field with a diameter of 260 nm. Applying an out of plane field that opposes the magnetisation of the skyrmion bubble core moment applies pressure to the bubble and gradually compresses it to a diameter of approximately 100 nm. On removing the field the skyrmion bubble returns to its original diameter via a hysteretic pathway where most of the expansion occurs in a single abrupt step. This contradicts analytical models of homogeneous materials in which the skyrmion compression and expansion are reversible. Micromagnetic simulations incorporating disorder can explain this behaviour using an effective thickness modulation between 10 nm grains.

OMNY PIN-A versatile sample holder for tomographic measurements at room and cryogenic temperatures

Nowadays ptychographic tomography in the hard x-ray regime, i.e., at energies above about 2 keV, is a well-established measurement technique. At the Paul Scherrer Institut, currently two instruments are available: one is measuring at room temperature and atmospheric pressure, and the other, the so-called OMNY (tOMography Nano crYo) instrument, is operating at ultra-high vacuum and offering cryogenic sample temperatures down to 10 K. In this manuscript, we present the sample mounts that were developed for these instruments. Aside from excellent mechanical stability and thermal conductivity, they also offer highly reproducible mounting. Various types were developed for different kinds of samples and are presented in detail, including examples of how specimens can be mounted on these holders. We also show the first hard x-ray ptychographic tomography measurements of high-pressure frozen biological samples, in the present case Chlamydomonas cells, the related sample pins and preparation steps. For completeness, we present accessories such as transportation containers for both room temperature and cryogenic samples and a gripper mechanism for automatic sample changing. The sample mounts are not limited to x-ray tomography or hard x-ray energies, and we believe that they can be very useful for other instrumentation projects.

In situ membrane bending setup for strain-dependent scanning transmission x-ray microscopy investigations

We present a setup that allows for the in situ generation of tensile strains by bending x-ray transparent Si₃N₄ membranes with the application of a pressure difference between the two sides of the membrane, enabling the possibility to employ high resolution space- and time-resolved scanning transmission x-ray microscopy for the investigation of the magneto-elastic coupling.

Additive interfacial chiral interaction in multilayers for stabilization of small individual skyrmions at room temperature

Facing the ever-growing demand for data storage will most probably require a new paradigm. Nanoscale magnetic skyrmions are anticipated to solve this issue as they are arguably the smallest spin textures in magnetic thin films in nature. We designed cobalt-based multilayered thin films in which the cobalt layer is sandwiched between two heavy metals and so provides additive interfacial Dzyaloshinskii-Moriya interactions (DMIs), which reach a value close to 2 mJ m(-2) in the case of the Ir|Co|Pt asymmetric multilayers. Using a magnetization-sensitive scanning X-ray transmission microscopy technique, we imaged small magnetic domains at very low fields in these multilayers. The study of their behaviour in a perpendicular magnetic field allows us to conclude that they are actually magnetic skyrmions stabilized by the large DMI. This discovery of stable sub-100 nm individual skyrmions at room temperature in a technologically relevant material opens the way for device applications in the near future.

Electric field stimulation setup for photoemission electron microscopes

Manipulating magnetisation by the application of an electric field in magnetoelectric multiferroics represents a timely issue due to the potential applications in low power electronics and the novel physics involved. Thanks to its element sensitivity and high spatial resolution, X-ray photoemission electron microscopy is a uniquely suited technique for the investigation of magnetoelectric coupling in multiferroic materials. In this work, we present a setup that allows for the application of in situ electric and magnetic fields while the sample is analysed in the microscope. As an example of the performances of the setup, we present measurements on Ni/Pb(Mg(0.66)Nb(0.33))O3-PbTiO3 and La(0.7)Sr(0.3)MnO3/PMN-PT artificial multiferroic nanostructures.

[The Grice-Green subtalar arthrodesis using a fibular bone graft--follow-up of 92 patients]

BACKGROUND

The Grice-Green subtalar arthrodesis is considered to be a valid treatment option of severe pes planovalgus deformity especially in children with cerebral palsy. The purpose of this study was to evaluate long term results using Grice-Green procedure with a fibular bone graft.

MATERIAL AND METHODS

Between 3/07 and 11/12 92 patients (36 girls, 56 boys) with 127 feet underwent surgery. The average age of patients was 12.3 years (5-21 years). 68 patients had infantile cerebral palsy, 17 patients suffered from other neuromuscular diseases and 7 had idiopathic pes planovalgus deformities. The preoperative and postoperative radiographs with full weight bearing in the frontal and lateral planes were analysed. The mean follow-up was 22.6 months (6-64 months). In addition to that, 23 of the 92 patients (13 girls, 10 boys) were reviewed preoperatively, in the first year after operation and after more than 24 months.

RESULTS

The mean lateral talocalcanear angle was reduced from 49.52 to 31.49°. The calcaneal pitch angle changed from 2.95 to 7.55°. The mean lateral talo-first-metatarsal angle improved from -36.98 to -12.32°. The mean frontal talo-first-metatarsal-base-angle increased from -28.48 to -2.64° and the TMT index from -66.46 to -14.96°. All measured angles changed significantly (p < 0.0001). There was no significant change after 6-12 month and ≥ 24 month follow-up (p > 0.05). Eight feet were not corrected completely, three feet were overcorrected. In one case the fibular graft was reabsorbed. There were degenerative changes of the talus in three cases. 14 feet developed a dorsal bunion with extension deformity of the first metatarsal bone.

CONCLUSIONS

The Grice-Green subtalar arthrodesis improves foot alignment and can achieve a significant correction also in long-term follow-up.

X-ray ptychographic computed tomography at 16 nm isotropic 3D resolution

X-ray ptychography is a scanning variant of coherent diffractive imaging with the ability to image large fields of view at high resolution. It further allows imaging of non-isolated specimens and can produce quantitative mapping of the electron density distribution in 3D when combined with computed tomography. The method does not require imaging lenses, which makes it dose efficient and suitable to multi-keV X-rays, where efficient photon counting, pixelated detectors are available. Here we present the first highly resolved quantitative X-ray ptychographic tomography of an extended object yielding 16 nm isotropic 3D resolution recorded at 2 Å wavelength. This first-of-its-kind demonstration paves the way for ptychographic X-ray tomography to become a promising method for X-ray imaging of representative sample volumes at unmatched resolution, opening tremendous potential for characterizing samples in materials science and biology by filling the resolution gap between electron microscopy and other X-ray imaging techniques.

Lateral spin transfer torque induced magnetic switching at room temperature demonstrated by x-ray microscopy

Changing and detecting the orientation of nanomagnetic structures, which can be used for durable information storage, needs to be developed towards true nanoscale dimensions for keeping up the miniaturization speed of modern nanoelectronic components. Therefore, new concepts for controlling the state of nanomagnets are currently in the focus of research in the field of nanoelectronics. Here, we demonstrate reproducible switching of a purely metallic nanopillar placed on a lead that conducts a spin-polarized current at room temperature. Spin diffusion across the metal-metal (Cu to CoFe) interface between the pillar and the lead causes spin accumulation in the pillar, which may then be used to set the magnetic orientation of the pillar. In our experiments, the detection of the magnetic state of the nanopillar is performed by direct imaging via scanning transmission x-ray microscopy (STXM).

An instrument for 3D x-ray nano-imaging

We present an instrument dedicated to 3D scanning x-ray microscopy, allowing a sample to be precisely scanned through a beam while the angle of x-ray incidence can be changed. The position of the sample is controlled with respect to the beam-defining optics by laser interferometry. The instrument achieves a position stability better than 10 nm standard deviation. The instrument performance is assessed using scanning x-ray diffraction microscopy and we demonstrate a resolution of 18 nm in 2D imaging of a lithographic test pattern while the beam was defined by a pinhole of 3 μm in diameter. In 3D on a test object of copper interconnects of a microprocessor, a resolution of 53 nm is achieved.

An in situ cell to study phase transitions in individual aerosol particles on a substrate using scanning transmission x-ray microspectroscopy

A new in situ cell to study phase transitions and chemical processes on individual aerosol particles in the x-ray transmission microscope at the PolLux beamline of the Swiss light source has been built. The cell is machined from stainless steel and aluminum components and is designed to be used in the standard mount of the microscope without need of complicated rearrangements of the microscope. The cell consists of two parts, a back part which contains connections for the gas supply, heating, cooling devices, and temperature measurement. The second part is a removable clip, which hosts the sample. This clip can be easily exchanged and brought into a sampling unit for aerosol particles. Currently, the cell can be operated at temperatures ranging from -40 to +50 °C. The function of the cell is demonstrated using two systems of submicron size: inorganic sodium bromide aerosols and soot originating from a diesel passenger car. For the sodium bromide we demonstrate how phase transitions can be studied in these systems and that O1s spectra from aqueous sodium bromide solution can be taken from submicron sized particles. For the case of soot, we demonstrate that the uptake of water onto individual soot particles can be studied.

High-resolution soft X-ray beamline ADRESS at the Swiss Light Source for resonant inelastic X-ray scattering and angle-resolved photoelectron spectroscopies

The concepts and technical realisation of the high-resolution soft X-ray beamline ADRESS operating in the energy range from 300 to 1600 eV and intended for resonant inelastic X-ray scattering (RIXS) and angle-resolved photoelectron spectroscopy (ARPES) are described. The photon source is an undulator of novel fixed-gap design where longitudinal movement of permanent magnetic arrays controls not only the light polarization (including circular and 0-180 degrees rotatable linear polarizations) but also the energy without changing the gap. The beamline optics is based on the well established scheme of plane-grating monochromator operating in collimated light. The ultimate resolving power E/DeltaE is above 33000 at 1 keV photon energy. The choice of blazed versus lamellar gratings and optimization of their profile parameters is described. Owing to glancing angles on the mirrors as well as optimized groove densities and profiles of the gratings, the beamline is capable of delivering high photon flux up to 1 x 10(13) photons s(-1) (0.01% BW)(-1) at 1 keV. Ellipsoidal refocusing optics used for the RIXS endstation demagnifies the vertical spot size down to 4 microm, which allows slitless operation and thus maximal transmission of the high-resolution RIXS spectrometer delivering E/DeltaE > 11000 at 1 keV photon energy. Apart from the beamline optics, an overview of the control system is given, the diagnostics and software tools are described, and strategies used for the optical alignment are discussed. An introduction to the concepts and instrumental realisation of the ARPES and RIXS endstations is given.

Surface sensitivity in scanning transmission x-ray microspectroscopy using secondary electron detection

The successful integration of electron detection into an existing scanning transmission x-ray microspectroscope (STXM) at the Swiss Light Source is demonstrated. In conventional x-ray detection using a photomultiplier, STXM offers mainly bulk sensitivity combined with high lateral resolution. However, by implementation of a channeltron electron multiplier, the surface sensitivity can be established by the detection of secondary electrons emitted from the sample upon resonant excitation. We describe the experimental setup and discuss several relevant aspects, in particular the schemes to correct for self-absorption in the specimen due to back illumination in case of thicker films.

Magnetization dynamics of Landau structures: tuning the response of mesoscopic magnetic objects using defects

Magnetic vortex cores are interacting with and can even be annihilated by artificial defects, such as holes. These defects have been fabricated by focused ion beam milling (FIB) into the magnetic domains, domain walls and the center of square-shaped vortices, known as Landau structures. We report the imaging of the magnetization dynamics of Landau structures containing holes by means of x-ray magnetic circular dichroism photo-emission electron microscopy (XMCD-PEEM). Due to the high lateral and temporal resolution of this method, the magnetic excitation spectrum, which is characteristic for the vortex-hole interaction, is investigated in detail. We find that the vortex core as well as domain walls can be trapped by small holes. With the help of micromagnetic simulations we show that the vortex gyrotropic motion frequency is enhanced, whereas the amplitude is significantly reduced in the case of non-centric holes in domain walls.

PolLux: a new facility for soft x-ray spectromicroscopy at the Swiss Light Source

We report on the successful installation and operation of a scanning transmission x-ray microspectroscope (STXM) at the PolLux facility at the Swiss Light Source. This integration of an advanced STXM with improved sample handling capabilities and a novel beamline provides unique capabilities. PolLux uses linearly or circularly polarized x-rays from a bending magnet with an extended photon energy range (200-1400 eV). It is therefore well suited to determine a sample's quantitative chemical composition, molecular orientation, or thickness of organic as well as condensed matter materials. The local magnetic state of magnetic thin films is accessible through fast helicity switching by steering the electron beam off axis through the bending magnet. Ex vacuo girder movers allow fast and highly reproducible (<1 microm) alignment of the instrument with respect to the photon beam. The present spatial resolution is approximately 20 nm, limited by the zone plates utilized. The instrument has the stability and positional resolution to operate with much higher resolution optics as it becomes available. In addition to characterization experiments, we present several typical examples from materials research and environmental science to exemplify the capabilities.

Soft X-ray spectromicroscopy of phase-change microcapsules

A synchrotron-based scanning transmission X-ray microscope (STXM) is used to investigate Micronal phase-change microcapsules. Prolonged X-ray illumination of the specimen leads to the breaking of the microcapsules' protective polymer shell and a partial separation of the core-shell species occurs. The paraffin wax and acrylic polymer components are characterized by carbon K-edge near X-ray edge absorption fine structure (NEXAFS) spectroscopy and components distribution mapping of the beam-damaged specimen is performed.

Zone-doubling technique to produce ultrahigh-resolution x-ray optics

A method for the fabrication of ultrahigh-resolution Fresnel zone plate lenses for x-ray microscopy is demonstrated. It is based on the deposition of a zone plate material (Ir) onto the sidewalls of a prepatterned template structure (Si) using an atomic layer deposition technique. This results in a doubling of the effective zone density, thus improving the achievable resolution of x-ray microscopes. Test structures with lines and spaces down to 15 nm were resolved in a scanning transmission x-ray microscope at 1 keV photon energy.

Dynamic vortex-antivortex interaction in a single cross-tie wall

A fascinating property of micromagnetism comes from the possibility to control the domain and vortex configuration through the sample shape and size. For instance, in a rectangular platelet a configuration containing a stable combination of vortices and an antivortex can be created. Such a single cross-tie wall can be understood as being a coupled micromagnetic system with three static solitons. Here we report on its magnetization dynamics including the vortex-antivortex interactions. The spectrum of eigenmodes is investigated as well as the effect of different vortex core orientations. We show that the vortex dynamics can be used to identify the core configuration, which is not directly accessible to x-ray microscopy because of its limited spatial resolution.

Quantitative analysis of magnetic excitations in Landau flux-closure structures using synchrotron-radiation microscopy

We have measured the excitation spectrum of six micron magnetic squares using x-ray magnetic circular dichroism. We observe all three excitations expected in a Landau flux-closure pattern. High temporal and spatial resolution allows quantitative analysis of the excitations. A short magnetic in plane pulse excites the magnetic element and we observe precessional motion of the magnetization within the domains as well as a domain wall mode and vortex motion. The vortex moves perpendicular to the excitation field and relaxes without showing a circulating orbit.

[Reinke's edema: an investigation of questions related to etiology, prognosis and the effectiveness of therapeutic methods]

BACKGROUND

The Reinke-oedema is a very common disease. Although different therapeutic courses are reported on--both surgical and using voice therapy--follow-up studies on a larger patient group are rare in the literature.

PATIENTS

48 patients, who consulted the Phoniatric Department of Hamburg-University--more than the half of them after an operation of the oedema--were included in this study. They where reinvestigated for the present research applying the same criteria.

RESULTS

Here it is possible to point out some aspects only: middle aged women in speaking professions, who smoke are often affected. From operating measures used, the so-called "decortication" is the most invasive regarding voice function, but does not prevent recurrences. A consistent voice therapy can also result in a good voice function in these cases. Musosuction leads to faster voice rehabilitation, and there are fewer scars. Voice therapy combined with stopping smoking is necessary in every case. For less severe oedemas operation is not necessary; we would like to stress that voice therapy alone can produce a good voice function. But in all therapy groups a considerable breathing function remained. We found no evidence of beginning carcinomas.

CONCLUSIONS

To obtain a good voice function, not every Reinke-oedema has to be operated on. But if an operation is performed, a consisted voice therapy must follow.