The problem of advanced supraglottic carcinoma.

Sixty-four cases of advanced supraglottic laryngeal carcinoma, and the possible therapeutic errors in these cases, have been analyzed. The available time for the investigation and treatment in these cases is short because of the ease and rapidity of spread of these tumors; thus, it is of great importance: that the nature, site and extent of the tumor is determined quickly; that the patient's general condition is determined and improved as far as possible and the patient receives treatment also for other diseases he may have; and that the tumor is radically eliminated whenever possible without delay. The main causes of poor results have been: late admission for treatment; inadequate (too conservative) surgery; and development of metastases during preoperative treatment which includes radiation.     

Factors influencing cortical silent period: optimized stimulus location, intensity and muscle contraction

Inhibitory silent period (SP) is a transient suppression of voluntary muscle activity after depolarization of representative motor neuronal populations following transcranial magnetic stimulation (TMS). Our aim was to evaluate and present an optimal protocol for the measurement of SP by (1) determining the impact of muscle activation level and stimulus intensity (SI) on the duration of SP, and, (2) studying the relationship between motor evoked potential (MEP) and SP, using targeted stimulus delivery. Single magnetic pulses were focused on the optimal representation area of the thenar musculature on primary motor cortex. We utilized real-time 3D-positioning of TMS-evoked electric field on anatomical structures derived from individual MR-images. The SI varied from 80% to 120% of individual resting motor threshold (MT). Muscle activation levels varied from 20% to 80% of the maximal voluntary contraction (MVC). Contralateral SP lengthened significantly with increasing SI independent of target muscle activation. The peak amplitude of the MEP was affected by SI and force. Latency and duration of the MEP were practically unaffected by SI or force. Focal stimulation at 110-120% MT and approximately 50% MVC (with only negligible need for control) provides most stable and informative SP. MEP should be included in SP as the error from marking the onset diminishes. This study provides a guideline for the consistent measurement of SP, which is applicable when using navigated or traditional TMS.     

Die Phoniatrie in den otolaryngologischen Kliniken

Ohne Zusammenfassung     

Audiometrische Untersuchungen über Ohrenschäden im Kriege

Ohne ZusammenfassungVortrag gehalten an der Jahresversammlung der Finnischen Oto-Laryngologischen Gesellschaft am 20. Februar 1943.