Injection laryngoplasty with autologous fascia for treatment of unilateral vocal fold paralysis

The purpose of this dissertation was to study the applicability of minced autologous fascia graft for injection laryngoplasty of unilateral vocal fold paralysis (UVFP). Permanence of augmentation and host versus graft tissue reactions were of special interest. The topic deals with phonosurgery, which is a subdivision of the Ear, Nose and Throat-speciality of medicine. UVFP results from an injury to the recurrent or the vagal nerve. The main symptom is a hoarse and weak voice. Surgery is warranted for patients in whom spontaneous reinnervation and a course of voice therapy fails to improve the voice. Injection laryngoplasty is a widespread surgical technique which aims to restore glottic closure by augmenting the atrophied vocal muscle, and also by turning the paralyzed vocal fold towards midline. Currently, there exists a great diversity of synthetic, xenologous, homologous, and autologous substances available for injection. An autologous graft is perfect in terms of biocompatibility. Free fascia grafts have been successfully used in the head and neck surgery for decades, but fascia had not been previously applied into the vocal fold. The fascia is harvested from the lateral thigh under local anesthesia and minced into paste by scissors. Injection of the vocal fold is performed in laryngomicroscopy under general anesthesia. Three series of clinical trials of injection laryngoplasty with autologous fascia (ILAF) for patients with UVFP were conducted at the Department of Otorhinolaryngology of the Helsinki University Central Hospital. The follow-up ranged from a few months to ten years. The aim was to document the vocal results and possible morbidity related to graft harvesting and vocal fold injection. To address the tissue reactions and the degree of reabsoprtion of the graft, an animal study with a follow-up ranging from 3 days to 12 months was performed at the National Laboratory Animal Center, University of Kuopio. Harvesting of the graft and injection was met with minor morbidity. Histological analysis of the vocal fold tissue showed that fascia was well tolerated. Although some resorption or compaction of the graft during the first months is evident, graft volume is maintained well. When injected deep and laterally into the vocalis muscle, the fascia graft allows normal vibration of the vocal fold mucosa to occur during phonation. Improvement of voice quality was seen in all series by multiple objective parameters of voice evaluation. However, the vocal results were poor in cases where the nerve trauma was severe, such as UVFP after chest surgery. ILAF is most suitable for correction of mild to moderate glottic gaps related to less severe nerve damage. Our results indicate that autologous fascia is a feasible and safe new injection material with good and stable vocal results. It offers a practical solution for surgeons who treat this complex issue.

Shock acceleration in the solar corona

In this thesis acceleration of energetic particles at collisionless shock waves in space plasmas is studied using numerical simulations, with an emphasis on physical conditions applicable to the solar corona. The thesis consists of four research articles and an introductory part that summarises the main findings reached in the articles and discusses them with respect to theory of diffusive shock acceleration and observations. This thesis gives a brief review of observational properties of solar energetic particles and discusses a few open questions that are currently under active research. For example, in a few large gradual solar energetic particle events the heavy ion abundance ratios and average charge states show characteristics at high energies that are typically associated with flare-accelerated particles, i.e. impulsive events. The role of flare-accelerated particles in these and other gradual events has been discussed a lot in the scientific community, and it has been questioned if and how the observed features can be explained in terms of diffusive shock acceleration at shock waves driven by coronal mass ejections. The most extreme solar energetic particle events are the so-called ground level enhancements where particle receive so high energies that they can penetrate all the way through Earth's atmosphere and increase radiation levels at the surface. It is not known what conditions are required for acceleration into GeV/nuc energies, and the presence of both very fast coronal mass ejections and X-class solar flares makes it difficult to determine what is the role of these two accelerators in ground level enhancements. The theory of diffusive shock acceleration is reviewed and its predictions discussed with respect to the observed particle characteristics. We discuss how shock waves can be modeled and describe in detail the numerical model developed by the author. The main part of this thesis consists of the four scientific articles that are based on results of the numerical shock acceleration model developed by the author. The novel feature of this model is that it can handle complex magnetic geometries which are found, for example, near active regions in the solar corona. We show that, according to our simulations, diffusive shock acceleration can explain the observed variations in abundance ratios and average charge states, provided that suitable seed particles and magnetic geometry are available for the acceleration process in the solar corona. We also derive an injection threshold for diffusive shock acceleration that agrees with our simulation results very well, and which is valid under weakly turbulent conditions. Finally, we show that diffusive shock acceleration can produce GeV/nuc energies under suitable coronal conditions, which include the presence of energetic seed particles, a favourable magnetic geometry, and an enhanced level of ambient turbulence.

Search for Maximal Flavor Violating Scalars in Same-Charge Lepton Pairs in pp̅ Collisions at √s=1.96 TeV

Models of Maximal Flavor Violation (MxFV) in elementary particle physics may contain at least one new scalar SU$(2)$ doublet field $\Phi_{FV} = (\eta^0,\eta^+)$ that couples the first and third generation quarks ($q_1,q_3$) via a Lagrangian term $\mathcal{L}_{FV} = \xi_{13} \Phi_{FV} q_1 q_3$. These models have a distinctive signature of same-charge top-quark pairs and evade flavor-changing limits from meson mixing measurements. Data corresponding to 2 fb$^{-1}$ collected by the CDF II detector in $p\bar{p}$ collisions at $\sqrt{s} = 1.96$ TeV are analyzed for evidence of the MxFV signature. For a neutral scalar $\eta^0$ with $m_{\eta^0} = 200$ GeV/$c^2$ and coupling $\xi_{13}=1$, $\sim$ 11 signal events are expected over a background of $2.1 \pm 1.8$ events. Three events are observed in the data, consistent with background expectations, and limits are set on the coupling $\xi_{13}$ for $m_{\eta^0} = 180-300$ GeV/$c^2$.

Exclusion of an Exotic Top Quark with -4/3 Electric Charge Using Soft Lepton Tagging

We present a measurement of the electric charge of the top quark using $\ppbar$ collisions corresponding to an integrated luminosity of 2.7~fb$^{-1}$ at the CDF II detector. We reconstruct $\ttbar$ events in the lepton+jets final state and use kinematic information to determine which $b$-jet is associated with the leptonically- or hadronically-decaying $t$-quark. Soft lepton taggers are used to determine the $b$-jet flavor. Along with the charge of the $W$ boson decay lepton, this information permits the reconstruction of the top quark's electric charge. Out of 45 reconstructed events with $2.4\pm0.8$ expected background events, 29 are reconstructed as $\ttbar$ with the standard model $+$2/3 charge, whereas 16 are reconstructed as $\ttbar$ with an exotic $-4/3$ charge. This is consistent with the standard model and excludes the exotic scenario at 95\% confidence level. This is the strongest exclusion of the exotic charge scenario and the first to use soft leptons for this purpose.

Search for New Bottomlike Quark Pair Decays QQ̅ →(tW∓)(t̅ W±) in Same-Charge Dilepton Events

We report the most restrictive direct limits on masses of fourth-generation down-type quarks b′, and quarklike composite fermions (B or T5/3), decaying promptly to tW∓. We search for a significant excess of events with two same-charge leptons (e, μ), several hadronic jets, and missing transverse energy. An analysis of data from pp̅ collisions with an integrated luminosity of 2.7  fb-1 collected with the CDF II detector at Fermilab yields no evidence for such a signal, setting mass limits mb′, mB>338  GeV/c2 and mT5/3>365  GeV/c2 at 95% confidence level.

Search for New Bottomlike Quark Pair Decays QQ̅ →(tW∓)(t̅ W±) in Same-Charge Dilepton Events

We report the most restrictive direct limits on masses of fourth-generation down-type quarks $b^{\prime}$, and quark-like composite fermions ($B$ or $T_{5/3}$), decaying promptly to $t W^{\mp}$. We search for a significant excess of events with two same-charge leptons ($e$, $\mu$), several hadronic jets, and missing transverse energy. An analysis of data from $p\overline{p}$ collisions with an integrated luminosity of 2.7 fb$^{-1}$ collected with the CDF II detector at Fermilab yields no evidence for such a signal, setting mass limits $m_{b^{\prime}}, m_{B} >$ 338 $\mathrm{GeV}/c^2$ and $m_{T_{5/3}} >$ 365 $\mathrm{GeV}/c^2$ at 95% confidence level.

Direct Measurement of the W Production Charge Asymmetry in pp̅ Collisions at √s=1.96 TeV

We present the first direct measurement of the $W$ production charge asymmetry as a function of the $W$ boson rapidity $\yW$ in $\ppbar$ collisions at $\sqrt{s} = 1.96$ $\TeV$. We use a sample of $\wenu$ events in data from 1 $\ifb$ of integrated luminosity collected using the CDF II detector. In the region $|\yW|