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Sample records for abductor spasmodic dysphonia

  1. Abnormal Activation of the Primary Somatosensory Cortex in Spasmodic Dysphonia: An fMRI Study

    Simonyan, Kristina; Ludlow, Christy L.

    2010-01-01

    Spasmodic dysphonia (SD) is a task-specific focal dystonia of unknown pathophysiology, characterized by involuntary spasms in the laryngeal muscles during speaking. Our aim was to identify symptom-specific functional brain activation abnormalities in adductor spasmodic dysphonia (ADSD) and abductor spasmodic dysphonia (ABSD). Both SD groups showed increased activation extent in the primary sensorimotor cortex, insula, and superior temporal gyrus during symptomatic and asymptomatic tasks and d...

  2. Disfluency in Spasmodic Dysphonia: A Multivariate Analysis.

    Cannito, Michael P.; Burch, Annette Renee; Watts, Christopher; Rappold, Patrick W.; Hood, Stephen B.; Sherrard, Kyla

    1997-01-01

    This study examined visual analog scaling judgments of disfluency by normal listeners in response to oral reading by 20 adults with spasmodic dysphonia (SD) and nondysphonic controls. Findings suggest that although dysfluency is not a defining feature of SD, it does contribute significantly to the overall clinical impression of severity of the…

  3. Speech Intelligibility in Severe Adductor Spasmodic Dysphonia

    Bender, Brenda K.; Cannito, Michael P.; Murry, Thomas; Woodson, Gayle E.

    2004-01-01

    This study compared speech intelligibility in nondisabled speakers and speakers with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (Botox) injection. Standard speech samples were obtained from 10 speakers diagnosed with severe ADSD prior to and 1 month following Botox injection, as well as from 10 age- and gender-matched…

  4. Abnormal Striatal Dopaminergic Neurotransmission during Rest and Task Production in Spasmodic Dysphonia

    Simonyan, Kristina; Berman, Brian D.; Herscovitch, Peter; Hallett, Mark

    2013-01-01

    Spasmodic dysphonia is a primary focal dystonia characterized by involuntary spasms in the laryngeal muscles during speech production. The pathophysiology of spasmodic dysphonia is thought to involve structural and functional abnormalities in the basal ganglia–thalamo-cortical circuitry; however, neurochemical correlates underpinning these abnormalities as well as their relations to spasmodic dysphonia symptoms remain unknown. We used positron emission tomography with the radioligand [11C]rac...

  5. Emotional Considerations in Spasmodic Dysphonia: Psychometric Quantification.

    Cannito, Michael P.

    1991-01-01

    This study examined emotional characteristics of 18 female spasmodic dysphonic subjects in comparison to matched normal controls across psychometric measures of depression, anxiety, and somatic complaints. Statistically significant differences were noted between groups for all measures and over half of the dysphonic subjects exhibited clinically…

  6. Spasmodic dysphonia: description of the disease and associated neurologic disorders

    Coelho, Marina Serrato

    2010-06-01

    Full Text Available Introduction: Spasmodic dysphonia (SD is a problem that affects speech and vocalization, one of the most devastating disorders of oral communication. It is characterized by vocal quality tensaestrangulada, harshly and / or interspersed with abrupt vocal attack and a great tension in the vocal tract. The etiology of spasmodic dysphonia is unclear. Some authors point to psychogenic causes, neurological or even unknown. Objective: To assess the prevalence of muscular dystonias and other neurological symptoms in patients with ED. Method: A retrospective study of 10 cases with diagnosis of ED for symptoms and neurological disorders associated. Results: There was a significant predominance of the disease in females (9:1. The average age of onset of symptoms was 32 years, ranging between 14 and 60 years. The mean disease duration was 10 years. Among the patients, 87.5% had a diagnosis of disorders of movement made by a neurologist, including orofacial dystonias (50%, essential tremor (50% and spastic paraparesis (12%. Conclusion: The presence of movement disorders followed almost all cases of spasmodic dysphonia. More studies are needed to clarify the pathophysiological basis of disease.

  7. Adductor spasmodic dysphonia: Relationships between acoustic indices and perceptual judgments

    Cannito, Michael P.; Sapienza, Christine M.; Woodson, Gayle; Murry, Thomas

    2003-04-01

    This study investigated relationships between acoustical indices of spasmodic dysphonia and perceptual scaling judgments of voice attributes made by expert listeners. Audio-recordings of The Rainbow Passage were obtained from thirty one speakers with spasmodic dysphonia before and after a BOTOX injection of the vocal folds. Six temporal acoustic measures were obtained across 15 words excerpted from each reading sample, including both frequency of occurrence and percent time for (1) aperiodic phonation, (2) phonation breaks, and (3) fundamental frequency shifts. Visual analog scaling judgments were also obtained from six voice experts using an interactive computer interface to quantify four voice attributes (i.e., overall quality, roughness, brokenness, breathiness) in a carefully psychoacoustically controlled environment, using the same reading passages as stimuli. Number and percent aperiodicity and phonation breaks correlated significanly with perceived overall voice quality, roughness, and brokenness before and after the BOTOX injection. Breathiness was correlated with aperidocity only prior to injection, while roughness also correlated with frequency shifts following injection. Factor analysis reduced perceived attributes to two principal components: glottal squeezing and breathiness. The acoustic measures demonstrated a strong regression relationship with perceived glottal squeezing, but no regression relationship with breathiness was observed. Implications for an analysis of pathologic voices will be discussed.

  8. Botulinum Toxin in Secondarily Nonresponsive Patients with Spasmodic Dysphonia.

    Mor, Niv; Tang, Christopher; Blitzer, Andrew

    2016-09-01

    Chemodenervation with botulinum toxin (BoNT) has been effective and well tolerated for all types of dystonia for >30 years. We reviewed outcomes of our patients treated with BoNT serotype A (BoNT-A) for spasmodic dysphonia (SD) who became secondarily nonresponsive. We found that 8 of 1400 patients became nonresponsive to BoNT-A (0.57%), which is lower than the secondary nonresponse rate in other dystonias. After a cessation period, 4 of our patients resumed BoNT-A injections, and recurrence of immunoresistance was not seen in any of them. When compared with patients with other dystonias, patients with SD receive extremely low doses of BoNT. Small antigen challenge may explain the lower rate of immunoresistance and long-lasting efficacy after BoNT-A is restarted among secondary nonresponsive patients with SD. PMID:27143711

  9. A STUDY OF VOICE CHANGES IN SPASMODIC DYSPHONIA AFTER BOTULINUM THERAPY

    Sanajeet Kumar

    2016-03-01

    Full Text Available BACKGROUND Spasmodic dysphonia is a neurological disorder, which can give the voice a strained quality. There is currently no cure for spasmodic dysphonia. The most common treatment for spasmodic dysphonia is the injection of botulinum toxin. METHODS Botulinum toxin A injection was performed in 10 patients with adductor spasmodic dysphonia. Voice handicap index scoring and voice analysis was done pre- and post-injection. Fundamental frequency, standard deviation of fundamental frequency, jitter, shimmer, mean phonation time and voice noise energy was studied in voice analysis. These voice parameters were measured from sustained phonation of vowel /a/. RESULTS Results of study indicated, a Spasmodic dysphonia patients had high mean values for voice handicap index score and all voice parameters. b All parameters were reduced significantly post botulinum therapy, but remained higher than their normal value. c All voice parameters except jitter showed strong positive correlation with voice handicap index in all domains. Jitter showed moderate positive correlation with total score, physical and emotional domain and strong positive correlation with functional domain. CONCLUSION Botulinum toxin A injection improves voice in cases of spasmodic dysphonia, significantly still post procedure voice does not return to normal.

  10. Tridimensional assessment of adductor spasmodic dysphonia pre- and post-treatment with Botulinum toxin

    Dejonckere, P. H.; Neumann, K. J.; Moerman, M. B. J.; Giordano, A.; Manfredi, C.; Martens, J.P.

    2012-01-01

    Spasmodic dysphonia voices form, in the same way as substitution voices, a particular category of dysphonia that seems not suited for a standardized basic multidimensional assessment protocol, like the one proposed by the European Laryngological Society. Thirty-three exhaustive analyses were perform

  11. Adductor spasmodic dysphonia and botulinum toxin treatment : The effect on well-being

    Langeveld, TPM; Luteijn, F; van Rossum, M; Drost, HA; De Jong, RJB

    2001-01-01

    Adductor spasmodic dysphonia (AdSD) is a controversial and enigmatic voice disorder. It is generally accepted that it has a neurologic, although undetermined, cause, and it is accompanied by much psychological and physical distress. In this prospective study, standardized psychometric tests were use

  12. Acoustic Variations in Adductor Spasmodic Dysphonia as a Function of Speech Task.

    Sapienza, Christine M.; Walton, Suzanne; Murry, Thomas

    1999-01-01

    Acoustic phonatory events were identified in 14 women diagnosed with adductor spasmodic dysphonia (ADSD), a focal laryngeal dystonia that disturbs phonatory function, and compared with those of 14 age-matched women with no vocal dysfunction. Findings indicated ADSD subjects produced more aberrant acoustic events than controls during tasks of…

  13. Focal white matter changes in spasmodic dysphonia: a combined DTI and neuropathological study

    Simonyan, Kristina; Tovar-Moll, Fernanda; Ostuni, John; Hallett, Mark; Kalasinsky, Victor F.; Lewin-Smith, Michael R.; Rushing, Elisabeth J.; Vortmeyer, Alexander O.; Ludlow, Christy L.

    2007-01-01

    Spasmodic dysphonia (SD) is a neurological disorder characterized by involuntary spasms in the laryngeal muscles during speech production. Although clinical symptoms of SD are well characterized, the pathophysiology of this voice disorder is unknown. We describe here, for the first time to our knowledge, disorder-specific brain abnormalities in SD patients as determined by a combined approach of diffusion tensor imaging (DTI) and postmortem histopathology. We used DTI to identify brain change...

  14. Diagnosis of Spasmodic Dysphonia Manifested by Swallowing Difficulty in Videofluoroscopic Swallowing Study

    Yeo, Han Gyeol; Lee, Seong Jae; Hyun, Jung Keun; Kim, Tae Uk

    2015-01-01

    Spasmodic dysphonia is defined as a focal laryngeal disorder characterized by dystonic spasms of the vocal cord during speech. We described a case of a 22-year-old male patient who presented complaining of idiopathic difficulty swallowing that suddenly developed 6 months ago. The patient also reported pharyngolaryngeal pain, throat discomfort, dyspnea, and voice change. Because laryngoscopy found no specific problems, an electrodiagnostic study and videofluoroscopic swallowing study (VFSS) we...

  15. Vocal aging and adductor spasmodic dysphonia: Response to botulinum toxin injection

    Michael P Cannito

    2008-03-01

    Full Text Available Michael P Cannito, Joel C Kahane, Lesya ChornaSchool of Audiology and Speech-Language Pathology, The University of Memphis, Memphis, TN, USAAbstract: Aging of the larynx is characterized by involutional changes which alter its biomechanical and neural properties and create a biological environment that is different from younger counterparts. Illustrative anatomical examples are presented. This natural, non-disease process appears to set conditions which may influence the effectiveness of botulinum toxin injection and our expectations for its success. Adductor spasmodic dysphonia, a type of laryngeal dystonia, is typically treated using botulinum toxin injections of the vocal folds in order to suppress adductory muscle spasms which are disruptive to production of speech and voice. A few studies have suggested diminished response to treatment in older patients with adductor spasmodic dysphonia. This retrospective study provides a reanalysis of existing pre-to-post treatment data as function of age. Perceptual judgments of speech produced by 42 patients with ADSD were made by two panels of professional listeners with expertise in voice or fluency of speech. Results demonstrate a markedly reduced positive response to botulinum toxin treatment in the older patients. Perceptual findings are further elucidated by means of acoustic spectrography. Literature on vocal aging is reviewed to provide a specific set of biological mechanisms that best account for the observed interaction of botulinum toxin treatment with advancing age.Keywords: vocal aging, adductor spasmodic dysphonia, botulinum toxin, voice quality, speech fluency

  16. Anatomic considerations in botulinum toxin type A therapy for spasmodic dysphonia.

    Castellanos, P F; Gates, G A; Esselman, G; Song, F; Vannier, M W; Kuo, M

    1994-06-01

    Chemodenervation by injection of botulinum toxin type A into the vocal fold(s) has become the preferred treatment for patients with adductor spasmodic dysphonia. Injection may be done either perorally or transcutaneously; each method has its advocates and advantages. The authors have used the transcutaneous transcricothyroid membrane route exclusively with satisfactory results in more than 50 patients. Temporary breathliness and aspiration are common. The preferred injection site should be as close as possible to the motor end plates of the affected muscle. The thyroarytenoid muscle end plates are distributed throughout the muscle, whereas in the lateral cricoarytenoid muscle they are located in band in the center of the muscle. The transcutaneous injection site is below and posterior to the midpoint of the vibrating vocal fold as visualized by indirect laryngoscopy. The proximity of this site to the lateral cricoarytenoid muscle suggests that postinjection breathiness and aspiration may be related to spread of botulinum toxin type A to the lateral cricoarytenoid muscle. However, it is likely that thyroarytenoid muscle paresis is mainly responsible for this side effect and that the rapid clearing of the breathy dysphonia in the face of prolonged relief of spasmodic dysphonia symptoms suggests the action of an adaptive neural response, such as axonal sprouting. Further research of this subject is warranted. PMID:8196438

  17. Spasmodic dysphonia in an adolescent patient with an autoimmune neurologic disorder.

    Boseley, Mark E; Gherson, Shirley; Hartnick, Christopher J

    2007-01-01

    Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) has been primarily described in the neurology and psychiatry literature. The symptoms of this syndrome typically are a range of obsessive compulsive disorders and neuromuscular tics. The otolaryngologist occasionally becomes involved with these children when it is deemed that chronic tonsil infections are the source. We report here on a child diagnosed with PANDAS who presented with severe ventricular hyperfunction and adductor spasmodic dysphonia. She was treated with botulinum toxin, which resulted in a significant improvement in subjective voice as well as reduced jitter and shimmer on objective voice measurements. PMID:17362824

  18. Unilateral versus bilateral thyroarytenoid Botulinum toxin injections in adductor spasmodic dysphonia: a prospective study

    Abiola Jesuloba

    2009-10-01

    Full Text Available Abstract Objectives In this preliminary prospective study, we compared unilateral and bilateral thyroarytenoid muscle injections of Botulinum toxin (Dysport in 31 patients with adductor spasmodic dysphonia, who had undergone more than 5 consecutive Dysport injections (either unilateral or bilateral and had completed 5 concomitant self-rated efficacy and complication scores questionnaires related to the previous injections. We also developed a Neurophysiological Scoring (NPS system which has utility in the treatment administration. Method and materials Data were gathered prospectively on voice improvement (self-rated 6 point scale, length of response and duration of complications (breathiness, cough, dysphagia and total voice loss. Injections were performed under electromyography (EMG guidance. NPS scale was used to describe the EMG response. Dose and unilateral/bilateral injections were determined by clinical judgment based on previous response. Time intervals between injections were patient driven. Results Low dose unilateral Dysport injection was associated with no significant difference in the patient's outcome in terms of duration of action, voice score (VS and complication rate when compared to bilateral injections. Unilateral injections were not associated with any post treatment total voice loss unlike the bilateral injections. Conclusion Unilateral low dose Dysport injections are recommended in the treatment of adductor spasmodic dysphonia.

  19. The Consequences of Spasmodic Dysphonia on Communication-Related Quality of Life: A Qualitative Study of the Insider's Experiences

    Baylor, C.R.; Yorkston, K.M.; Eadie, T.L.

    2005-01-01

    The purpose of this study was to explore the biopsychosocial consequences of spasmodic dysphonia (SD) as experienced by people with SD. Qualitative research methods were used to investigate the insider's perspective of living with SD. Six adults with SD participated in face-to-face phenomenological interviews. The results are summarized in a model…

  20. Mutations in THAP1 (DYT6) and generalised dystonia with prominent spasmodic dysphonia: a genetic screening study

    Djarmati, Ana; Schneider, Susanne A; Lohmann, Katja;

    2009-01-01

    -onset generalised dystonia with spasmodic dysphonia. This combination of symptoms might be a characteristic feature of DYT6 dystonia and could be useful in the differential diagnosis of DYT1, DYT4, DYT12, and DYT17 dystonia. In addition to the identified mutations, a rare non-coding substitution in THAP1 might...

  1. Spasmodic Dysphonia

    ... version Order free publications Find organizations Related Topics Autism Spectrum Disorder: Communication Problems in Children Hoarseness Taking ... NIH… Turning Discovery Into Health ® National Institute on Deafness and Other Communication Disorders 31 Center Drive, MSC ...

  2. Spasmodic dysphonia follow-up with videolaryngoscopy and voice spectrography during treatment with botulinum toxin.

    Esposito, Marcello; Dubbioso, R; Apisa, P; Allocca, R; Santoro, L; Cesari, U

    2015-09-01

    Spasmodic dysphonia (SD) is a focal dystonia of laryngeal muscles seriously impairing quality of voice. Adductor SD (ADSD) is the most common presentation of this disorder that can be identified by specialized phoniatricians and neurologists firstly on a clinical evaluation and then confirmed by videolaryngoscopy (VL). Botulinum toxin (BTX) injection with electromyographic guidance in muscles around vocal cords is the most effective treatment. Voice Handicap Index (VHI) questionnaire is the main tool to assess dysphonia and response to treatment. Objective of this study is to perform VL and voice spectrography (VS) to confirm the efficacy of BTX injections over time. 13 patients with ADSD were studied with VHI, VL and VS before and after 4 consecutive treatment with onobotulinumtoxin-A. For each treatment vocal improvement was proved by a significant reduction of VHI score and increase of maximum time phonation and harmonic-to-noise ratio while VL showed the absence of spasm in most of patients. No change of the response to BTX was found between injections. This study supports the efficacy of the treatment of SD with BTX with objective measurements and suggests that the efficacy of recurring treatments is stable over time. PMID:25966878

  3. Focal white matter changes in spasmodic dysphonia: a combined DTI and neuropathological study

    Simonyan, Kristina; Tovar-Moll, Fernanda; Ostuni, John; Hallett, Mark; Kalasinsky, Victor F.; Lewin-Smith, Michael R.; Rushing, Elisabeth J.; Vortmeyer, Alexander O.; Ludlow, Christy L.

    2008-01-01

    Spasmodic dysphonia (SD) is a neurological disorder characterized by involuntary spasms in the laryngeal muscles during speech production. Although clinical symptoms of SD are well characterized, the pathophysiology of this voice disorder is unknown. We describe here, for the first time to our knowledge, disorder-specific brain abnormalities in SD patients as determined by a combined approach of diffusion tensor imaging (DTI) and postmortem histopathology. We used DTI to identify brain changes in SD and to target those brain regions for neuropathological examination. DTI showed rightsided decrease of fractional anisotropy in the genu of the internal capsule and bilateral increase of overall water diffusivity in the white matter along the corticobulbar/corticospinal tract in 20 SD patients compared to 20 healthy subjects. In addition, water diffusivity was bilaterally increased in the lentiform nucleus, ventral thalamus, and cerebellar white and gray matter in SD patients. These brain changes were substantiated with focal histopathological abnormalities presented as a loss of axonal density and myelin content in the right genu of the internal capsule and clusters of mineral depositions containing calcium, phosphorus and iron in the parenchyma and vessel walls of the posterior limb of the internal capsule, putamen, globus pallidus, and cerebellum in the postmortem brain tissue from one SD patient compared to three controls. The specificity of these brain abnormalities is confirmed by their localization limited only to the corticobulbar/corticospinal tract and its main input/output structures. We also found positive correlation between the diffusivity changes and clinical symptoms of SD (r = 0.509, p = 0.037). These brain abnormalities may alter the central control of voluntary voice production and, therefore, may underlie the pathophysiology of SD. PMID:18083751

  4. Abnormal motor cortex excitability during linguistic tasks in adductor-type spasmodic dysphonia.

    Suppa, A; Marsili, L; Giovannelli, F; Di Stasio, F; Rocchi, L; Upadhyay, N; Ruoppolo, G; Cincotta, M; Berardelli, A

    2015-08-01

    In healthy subjects (HS), transcranial magnetic stimulation (TMS) applied during 'linguistic' tasks discloses excitability changes in the dominant hemisphere primary motor cortex (M1). We investigated 'linguistic' task-related cortical excitability modulation in patients with adductor-type spasmodic dysphonia (ASD), a speech-related focal dystonia. We studied 10 ASD patients and 10 HS. Speech examination included voice cepstral analysis. We investigated the dominant/non-dominant M1 excitability at baseline, during 'linguistic' (reading aloud/silent reading/producing simple phonation) and 'non-linguistic' tasks (looking at non-letter strings/producing oral movements). Motor evoked potentials (MEPs) were recorded from the contralateral hand muscles. We measured the cortical silent period (CSP) length and tested MEPs in HS and patients performing the 'linguistic' tasks with different voice intensities. We also examined MEPs in HS and ASD during hand-related 'action-verb' observation. Patients were studied under and not-under botulinum neurotoxin-type A (BoNT-A). In HS, TMS over the dominant M1 elicited larger MEPs during 'reading aloud' than during the other 'linguistic'/'non-linguistic' tasks. Conversely, in ASD, TMS over the dominant M1 elicited increased-amplitude MEPs during 'reading aloud' and 'syllabic phonation' tasks. CSP length was shorter in ASD than in HS and remained unchanged in both groups performing 'linguistic'/'non-linguistic' tasks. In HS and ASD, 'linguistic' task-related excitability changes were present regardless of the different voice intensities. During hand-related 'action-verb' observation, MEPs decreased in HS, whereas in ASD they increased. In ASD, BoNT-A improved speech, as demonstrated by cepstral analysis and restored the TMS abnormalities. ASD reflects dominant hemisphere excitability changes related to 'linguistic' tasks; BoNT-A returns these excitability changes to normal. PMID:26061279

  5. Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

    Jae Wook Kim

    2014-01-01

    Full Text Available Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group. Methods. Thirty patients with adductor spasmodic dysphonia (ADSD, who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI before injection and at 1, 3, and 6 months after injection. Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P>0.05. There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration. Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable.

  6. Alterations in CNS Activity Induced by Botulinum Toxin Treatment in Spasmodic Dysphonia: An H[subscript 2][superscript 15]O PET Study

    Ali, S. Omar; Thomassen, Michael; Schulz, Geralyn M.; Hosey, Lara A.; Varga, Mary; Ludlow, Christy L.; Braun, Allen R.

    2006-01-01

    Speech-related changes in regional cerebral blood flow (rCBF) were measured using H[subscript 2][superscript 15]O positron-emission tomography in 9 adults with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (BTX) injection and 10 age- and gender-matched volunteers without neurological disorders. Scans were acquired at rest…

  7. Acoustic characteristics of adductor spasmodic dysphonia%内收型痉挛性发音障碍的语音特征

    杨扬; 王丽萍

    2008-01-01

    Objective To explore the acoustic characteristics of adductor spasmodic dysphonim Methods The acoustic characteristics,including acoustic signal of recorded voice,three-dimensional sonogranl patterns and subjective assessment of voice,between 10 patients(7 women,3 men)with adductor spasmodic dysphonia and 10 healthy volunteers(5 women,5 men),were compared.Results The main clinical manifestation of adductor spasmodic dysphonia included the disorders of sound quality,rhyme and fluency.It demonstrated the tension dysphonia when reading,acoustic jitter,momentary fluctuation of frequency and volume,voice squeezing,interruption,voice prolongation,and losing normal chime.Among 10 patients,there were l mild dysphonia(abnormal syllable number<25%),6 moderate dysphonia (abnormal syllable number 25%-49%),1 severe dysphonia(abnormal syllable number 50%-74%) and 2 extremely severe dysphonia (abnormal syllable number≥75%).The average reading time in 10 patients Was 49 S,with reading time extension and aphasia area interruption in acoustic signals,whereasc the average reading time in health control group was 30 S,without voice interruption.The aphasia ratio averaged 42%.The respective symptom syllable in different patients demonstrated in the three-dimensional sonograrm There were voice onset time prolongation,irregular,interrupted and even absent vowel formants. The consonant of symptom syllables displayed absence or prolongation of friction murmur in the block-friction murmur occasionally.Conclusions The acoustic characteristics of adductor spasmodic dysphonia is the disorders of sound quality,rhyme and fluency.The three-dimensional sonogTam of the symptom syllables show distinctive changes of proportional vowels or consonant phonemes.%目的 探讨内收型痉挛性发音障碍的语音特征.方法 采用嗓音和语音的声信号和三维语图分析及主观评价的方法对1O例内收型痉挛性发音障碍患者(女7例,男3例)的语音特征与10

  8. Qualidade de Vida em Voz: estudo na doença de Parkinson idiopática e na disfonia espasmódica adutora Quality of life in voice: a study in Parkinson's disease and in adductor spasmodic dysphonia

    Bárbara Pereira Lopes

    2013-04-01

    Full Text Available OBJETIVO: avaliar o impacto causado pela alteração vocal na qualidade de vida (QV dos pacientes com doença de Parkinson (DP idiopática e com disfonia espasmódica adutora (DEA. MÉTODO: o estudo foi realizado com 56 indivíduos do sexo feminino, dos quais 28 compunham o grupo controle; 14, o grupo de DEA, no período anterior ao tratamento com toxina botulínica; e 14, o grupo de DP idiopática. Os participantes preencheram o questionário de Qualidade de Vida em Voz (QVV validado para o português brasileiro. Para verificar a diferença entre as médias dos grupos foi utilizado o método de análise de variância por postos de Kruskal-Wallis e o teste de Tamhane para comparações múltiplas, com significância PURPOSE: to evaluate the impact of voice disorders on quality of life of patients with idiopathic Parkinson's disease and with adductor spasmodic dysphonia. METHOD: the study consisted of 56 females, 28 in the control group; 14, the adductor spasmodic dysphonia group in the period prior to treatment with botulinum toxin; and 14, the group of idiopathic Parkinson's disease. The participants filled in the Voice-Related Quality of life (V-RQOL questionnaire validated for Brazilian Portuguese. To check the difference between averages of the groups it was used the method of analysis of variance by Kruskal-Wallis and Tamhane test for multiple comparisons, with significance <0.05. RESULTS: the average age of the groups were 66.18 for the control group, 67.21 for the Parkinson's disease group and 59.7 for the adductor spasmodic dysphonia group, with no statistical difference between the groups. In the V-RQOL protocol the mean domain social-emotional, physical functioning and total score were higher in the control group, followed by group of Parkinson's disease and, finally, the group of adductor spasmodic dysphonia with statistically significant difference between them. In addition, there was statistical difference for each pair of groups

  9. Qualidade de Vida em Voz: estudo na doença de Parkinson idiopática e na Disfonia Espasmódica Adutora Quality of life in voice: a study in Parkinson's disease and in adductor spasmodic dysphonia

    Bárbara Pereira Lopes

    2012-01-01

    Full Text Available OBJETIVO: avaliar o impacto causado pela alteração vocal na qualidade de vida (QV dos pacientes com doença de Parkinson (DP idiopática e com disfonia espasmódica adutora (DEA. MÉTODO: o estudo foi realizado com 56 indivíduos do sexo feminino, dos quais 28 compunham o grupo controle; 14, o grupo de DEA, no período anterior ao tratamento com toxina botulínica; e 14, o grupo de DP idiopática. Os participantes preencheram o questionário de Qualidade de Vida em Voz (QVV validado para o português brasileiro. Para verificar a diferença entre as médias dos grupos foi utilizado o método de análise de variância por postos de Kruskal-Wallis e o teste de Tamhane para comparações múltiplas, com significância PURPOSE: to evaluate the impact of voice disorders on quality of life of patients with idiopathic Parkinson's disease and with adductor spasmodic dysphonia. METHOD: the study consisted of 56 females, 28 in the control group; 14, the adductor spasmodic dysphonia group in the period prior to treatment with botulinum toxin; and 14, the group of idiopathic Parkinson's disease. The participants filled in the Voice-Related Quality of life (V-RQOL questionnaire validated for Brazilian Portuguese. To check the difference between averages of the groups it was used the method of analysis of variance by Kruskal-Wallis and Tamhane test for multiple comparisons, with significance <0.05. RESULTS: the average age of the groups were 66.18 for the control group, 67.21 for the Parkinson's disease group and 59.7 for the adductor spasmodic dysphonia group, with no statistical difference between the groups. In the V-RQOL protocol the mean domain social-emotional, physical functioning and total score were higher in the control group, followed by group of Parkinson's disease and, finally, the group of adductor spasmodic dysphonia with statistically significant difference between them. In addition, there was statistical difference for each pair of groups

  10. 发音中断分析用于内收性痉挛性发音障碍和肌紧张性发音障碍的鉴别诊断%Differential diagnosis of adductor spasmodic dysphonia and musde tension dysphonia using phonatory break analys

    Roy N; 郭颖

    2011-01-01

    @@ 内收性痉挛性发声障碍(adductor spasmodic dysphonia,ADSD)是一种神经源性的、活动引起的喉局部肌张力失调,患者在说话时会感受到声带不自主地过度内收,从而导致无力的发音中断和言语挤卡、发抖.当前,内收性痉挛性发声障碍的诊断几乎完全依靠其听觉特征,发音中断常被认为是诊断ADSD的绝对必要条件.

  11. Tratamento médico e fonoaudiológico da disfonia espasmódica: uma revisão bibliográfica Medical treatment and speech therapy for spasmodic dysphonia: a literature review

    Eliana Maria Gradim Fabron

    2013-01-01

    Full Text Available A disfonia espasmódica (DE é um distúrbio vocal caracterizado por voz tensa-estrangulada, com quebras de sonoridade e que compromete a comunicação do indivíduo. O objetivo deste estudo é apresentar uma revisão bibliográfica dos tratamentos médico e fonoaudiológico proposto para a DE no período entre 2006 e 2010. Os tratamentos descritos foram: injeção de toxina botulínica (TB, miectomia, neurectomia, denervação e reinervação laríngea seletiva adutora, tireoplastia, miotermia tiroaritenóidea com radiofrequência, injeção de lidocaína, homeopatia e tratamento fonoaudiológico (fonoterapia. O uso de injeção de TB mostrou resultados que indicaram a satisfação dos pacientes tratados, embora alguns dos artigos apontassem a necessidade de reaplicação da toxina frequentemente, como desvantagem. Os procedimentos cirúrgicos foram considerados duradouros e indicados para os pacientes que não quiseram se submeter às aplicações de TB. Tais estudos, no entanto, apresentaram contingência de pacientes restrita e os resultados foram baseados, na maioria das investigações, no julgamento dos próprios pacientes sobre a sua qualidade vocal. Os tratamentos, com uso de lidocaína e homeopatia, mostraram resultados positivos em relação à qualidade vocal dos pacientes e foram sugeridos como uma opção, também, para aqueles que não gostariam de ser submetidos ao tratamento cirúrgico ou à aplicação de TB. Os poucos estudos que reportam fonoterapia assinalaram bons resultados quando a mesma foi associada à injeção de TB, mostrando a escassez de informações nesta área. Futuras pesquisas envolvendo a fonoterapia no tratamento da DE são necessárias.Spasmodic dysphonia (SD is a voice disorder characterized by a strained-strangled voice, with sound breaks and has implications in one's communication. The purpose of this study is to present a bibliographic review of the speech therapy and medical treatment suggested for SD

  12. Adductor Spasmodic Dysphonia Treated by Injecting of Botulinum Toxin A into Vocal Cords%A型肉毒毒素声带注射 治疗内收型痉挛性发声障碍

    刘波; 屈季宁; 李再香; 袁琨

    2001-01-01

    Objective To investigate the effect of botulinum toxin A(BTA) injected into vocal cords for the treatment of adductor spasmodic dysphonia (SD) by direct lanyngoscopy.Methods 11 patients with adductor SD were treated by injection on both vocal cords each with 2.5U of BTA by direct laryngoscopy.Results All patient's phonation improved within the first 24 hours,with sustained improvement from 12 to 21 weeks with an average of 16.2 weeks.The local side effect included breathy voice in all cases and mild choking sensation when drinking fluids in 5 cases,dysphagia in 3 cases.No systemic adverse reactions were noted.Conclusion The injection of BTA on both vocal cords by direct laryngoscopy is an effective,safe and simple method for the treatment of adductor SD.%目的探讨双侧声带注射A型肉毒毒素治疗内收性痉挛性发声障碍疗效。方法在直接喉镜下于双侧声带近外侧甲杓肌处注射A型肉毒毒素各2.5U治疗内收性痉挛性发声障碍11例。结果均在注射后24h即显效,发声改善平均持续时间16.2wk,不良反应有暂时过度呼吸音11例、饮水呛咳5例,吞咽困难3例,未发现A型肉毒毒素全身毒副作用。结论直接喉镜下A型肉毒毒素双侧声带注射是治疗内收性痉挛性发声障碍有效、安全、简便的方法。

  13. Impacto na qualidade vocal da miectomia parcial e neurectomia endoscópica do músculo tireoaritenóideo em paciente com disfonia espasmódica de adução Impact in vocal quality in partial myectomy and neurectomy endoscopic of thyroarytenoid muscle in patients with adductor spasmodic dysphonia

    Domingos Hiroshi Tsuji

    2006-04-01

    Full Text Available A disfonia espasmódica de adução é um distúrbio vocal grave, caracterizado por espasmos dos músculos laríngeos durante a fonação, produzindo voz quebrada, tensa, forçada e estrangulada. Seus sintomas decorrem da contração intermitente e involuntária dos músculos tireoaritenóideos durante a fonação, o que resulta em pregas vocais tensas, pressionadas uma contra a outra, e no aumento da resistência glótica. OBJETIVO: Apresentar os resultados preliminares do impacto na qualidade vocal da cirurgia de Neurectomia do ramo tireoaritenóideo do laríngeo inferior, via endoscópica, associada à miectomia parcial do músculo tireoaritenóideo com laser de CO2. MATERIAL E MÉTODO: A cirurgia foi realizada em 7 pacientes (6 mulheres e 1 homem, com idades variando entre 22 e 75 anos, com diagnóstico de disfonia espasmódica de adução. Os pacientes foram submetidos ao VHI (Voice Handicap Index no pré e pós-operatório. RESULTEDOS E CONCLUSÃO: A melhora vocal foi conseguida em todos os pacientes estudados não ocorrendo deterioração da qualidade vocal ao longo do período pós-operatório. Houve uma diferença evidente no VHI antes e após a cirurgia. Essa técnica cirúrgica mostrou-se eficaz e inovadora no tratamento da disfonia espasmódica de adução.Impact in vocal quality in partial myectomy and neurectomy endoscopic of thyroarytenoid muscle in patients with adductor spasmodic dysphonia the adductor spasmodic dysphonia is a severe vocal disorder characterized by muscle laryngeal spasms during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms come from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold strain, pressed one against another and increased glottic resistance. AIM: report the results in the impact in vocal quality in neurectomy of the thyroarytenoid branch of the inferior laryngeal nerve by endoscopic route associated with

  14. 心理疗法并呼吸训练治疗痉挛性发声障碍%Psychotherapy combined with breathing training on the treatment of spasmodic dysphonia

    周涛; 雷培香; 屈季宁; 曹永茂

    2005-01-01

    背景:目前痉挛性发声障碍病因不明,缺乏统一明确的诊断标准,故治疗较为困难,关于该病的治疗有限的报道主要是喉部肉毒杆菌毒素注射,喉返神经切断,发声语言训练等,其中后一种方法无副作用及并发症,是较为理想的治疗及辅助治疗手段之一.目的:探讨发声训练治疗痉挛性发声障碍的意义,为该病的临床治疗提供一种简便易行的方法.设计:以患者为研究对象,病例分析、验证性研究.单位:一所大学医院的耳鼻咽喉-头颈外科.对象:1985-02/2002-12武汉大学人民医院耳鼻咽喉科确诊的36例痉挛性发声障碍患者为治疗对象.方法:采用心理疗法和呼吸及发声功能训练使患者呼吸器官随意运动协调,变高位呼吸和逆呼吸为正常的胸腹联合式呼吸,降低喉肌张力,以发声正常、好转、无效为疗效判定标准,全部病例随访一两年.主要观察指标:疗效评估结果.结果:36例痉挛性发声障碍患者,经上述发声康复训练后,均取得满意的效果,其中30例患者发声恢复正常,6例好转.结论:心理疗法和呼吸及发声功能训练是痉挛性发声障碍康复训练较理想的方法.%BACKGROUND: The mechanism of spasmodic dysphonia(SD) is still unclear and lacks of confirmed diagnostic standards. Limited reports on the treatment mainly focused on botulinum toxin infiltration; recurrent laryngeal nerve section, and voice training, amongst which voice training has been considered as one of the ideal complementary therapeutic means for SD because of less side effects and complications.OBJECTIVE: To investigate the significance of voice training in the treatment of SD and provide a method for the clinical treatment.DESIGN: Clinical case analysis and retrospective study based on patients.SETTING: Department of otolaryngology and cerebral surgery in a university hospital.PARTICIPANTS: Thirty-six confirmed SD patients in Wuhan College affiliated Renmin

  15. Análise vocal em pacientes com disfonia espasmódica nos momentos pré e pós tratamento com toxina Botulínica A Vocal analysis in patients with spasmodic dysphonia before and after treatment with Botulinum toxin A

    Ana Cristina Côrtes Gama

    2012-10-01

    Full Text Available OBJETIVO: avaliar de forma objetiva e subjetiva a voz de pacientes com disfonia espasmódica nos momentos pré e pós aplicação de toxina botulínica A. MÉTODO: as emissões vocais de onze pacientes do sexo feminino foram registradas antes e após (15 dias o tratamento. As amostras vocais foram analisadas por duas fonoaudiólogas com experiência em voz por meio da análise perceptivo-auditiva (escala GRBASI e da análise espectrográfica. RESULTADOS: na análise perceptivo-auditiva com vogal sustentada os parâmetros que alteraram após o tratamento foram o grau de severidade, tensão e instabilidade, enquanto na fala encadeada foram o grau de severidade e a tensão. Na análise espectrográfica ocorreu melhora do traçado após o tratamento sem significância estatística entre os parâmetros. CONCLUSÃO: ocorreu melhora significante dos aspectos perceptivo-auditivos após o tratamento e, portanto, as injeções de toxina botulínica A mostraram-se eficazes no tratamento da disfonia espasmódica no grupo estudado.PURPOSE: to analyze in an objective and subjective manner the voice of patients with spasmodic dysphonia in the moments before and after botulinum toxin A. METHOD: the vocal emissions of eleven women patients were recorded before and after (15 days treatment. The vocal samples were analyzed by two experienced speech therapists through the perceptual analysis (GRBASI scale and spectrographic analysis. RESULTS: in the perceptual analysis with subtended vowel, the altered parameters were degree of severity, strain and instability, while in connected speech only degree of severity and strain changed after treatment. In the perceptual analysis with sustained vowel, the parameters that have changed, were the degree of severity, strain and instability, while in connected speech only degree of severity and strain changed after treatment. The spectrographic analysis was improved after treatment with no statistical significance found among

  16. National Spasmodic Torticollis Association

    ... with: » One years subscription of the ST Quarterly Magazine (Four issues are published a year) » Member prices for "Helpful Products" including literature such as the Spasmodic Torticollis Handbook and Living ...

  17. O uso da toxina botulínica no tratamento da distonia laríngea (disfonia espasmódica: estudo preliminar com doze pacientes Use of botulinum toxin in the treatment of laryngeal dystonia (spasmodic dysphonia: preliminary study of twelve patients

    Hélio A. G. Teive

    2001-03-01

    Full Text Available A distonia laríngea (disfonia espasmódica é distúrbio do movimento caracterizado por contrações involuntárias da musculatura laríngea envolvida no processo de vocalização. A utilização da toxina botulínica no tratamento da distonia laríngea trouxe consideráveis benefícios clínicos. Descrevemos os resultados preliminares do uso terapêutico da toxina botulínica no tratamento da distonia laríngea em 12 pacientes. Após investigação clínica, os pacientes foram submetidos a videolaringoestroboscopia para confirmação diagnóstica e as injeções de toxina botulínica foram realizadas através de punção da membrana cricotireóidea em direção ao músculo tireoaritenóideo, com uso de eletromiografia. A maioria dos pacientes submetidos ao tratamento com toxina botulínica apresentou melhora significativa da distonia laríngea (83% dos casos, com duração média do efeito de quatro meses, sem efeitos colaterais significativos.Laryngeal dystonia (spasmodic dysphonia is a movement disorder characterized by involuntary contractions of laryngeal muscles involved with vocalization. The introduction of botulinum toxin in the treatment of laryngeal dystonia had a major clinical impact due to the striking improvement of symptoms. We report the preliminary results of therapeutical use of botulinum toxin in the treatment of twelve patients with laryngeal dystonia. After an extensive clinical evaluation, the patients underwent a videostroboscopic exam for diagnostic confirmation. Botulinum toxin was injected in the cricothyreoid membrane, directed towards the thyreoaritenoid muscle, with the aid of eletromyography needles. Most of patients who underwent botulinum toxin injection had a significant improvement of their symptoms (83%, with effects lasting for four months in average and without important side effects.

  18. Whispering dysphonia (DYT4 dystonia) is caused by a mutation in the TUBB4 gene

    Lohmann, Katja; Wilcox, Robert A.; Winkler, Susen; Ramirez, Alfredo; Rakovic, Aleksandar; Park, Jin-Sung; Arns, Bjoern; Lohnau, Thora; Kasten, Meike; Brueggemann, Norbert; Hagenah, Johann; Schmidt, Alexander; Kaiser, Frank J.; Kumar, Kishore R.; Zschiedrich, Katja; Alvarez-Fischer, Daniel; Altenmueller, Eckart; Ferbert, Andreas; Lang, Anthony E.; Muenchau, Alexander; Kostic, Vladimir; Simonyan, Kristina; Agzarian, Marc; Ozelius, Laurie J.; Langeveld, Antonius P. M.; Sue, Carolyn M.; Tijssen, Marina A. J.; Klein, Christine; Groen, Justus

    2013-01-01

    Objective A study was undertaken to identify the gene underlying DYT4 dystonia, a dominantly inherited form of spasmodic dysphonia combined with other focal or generalized dystonia and a characteristic facies and body habitus, in an Australian family. Methods Genome-wide linkage analysis was carried

  19. Aplicação da técnica de emissão em tempo máximo de fonação em paciente com disfonia espasmódica adutora: relato de caso Applying the technique of sustained maximum phonation time in a female patient with adductor spasmodic dysphonia: case report

    Luiz Alberto Alves Mota

    2012-01-01

    Full Text Available A Disfonia Espasmódica Adutora é uma desordem neurológica do processamento motor central, caracterizada por contrações involuntárias e inapropriadas da musculatura fonatória, produzindo uma hiperadução das pregas vocais, o que promove uma voz trêmula, entrecortada e tensa-estrangulada. O objetivo deste estudo foi descrever os parâmetros vocais, acústicos e laríngeos pré e pós-tratamento fonoaudiológico realizado por meio da aplicação da Técnica de Emissão em Tempo Máximo de Fonação (TETMF em paciente com Disfonia Espasmódica de Adução. Esta técnica tem como objetivo promover o aumento da resistência glótica, melhorar a estabilidade fonatória e adequar a coaptação glótica. Participou deste estudo de caso uma paciente de 66 anos de idade, gênero feminino, com Disfonia Espasmódica Adutora. A paciente foi submetida à avaliação otorrinolaringológica e fonoaudiológica pré e pós-aplicação da TETMF. Foi verificada modificação de parâmetros vocais, acústicos e laríngeos, tais como a classificação da disfonia de G3R1B1A0S3I3 para G2R1B1A0S2I2, pitch de grave a adequado, traçado espectrográfico instável para mais estável e expressivo aumento da frequência fundamental média e da intensidade vocal média, além da melhora da eficiência glótica com o fechamento da fenda glótica anteroposterior. A terapia fonoaudiológica com a aplicação da TETMF foi considerada uma adequada opção de tratamento para o caso, tendo em vista os resultados alcançados, com destaque para a qualidade vocal e estabilidade fonatória. Ressalta-se a importância de novos estudos para comprovação da eficácia da técnica no tratamento da Disfonia Espasmódica Adutora.Adductor Spasmodic Dysphonia (ASD is a neurological disorder of central motor processing, characterized by involuntary and inappropriate contractions of the phonatory muscles, producing hyperadduction of the vocal folds, which causes a tremulous, faltering

  20. Social phobia in spasmodic torticollis

    Gundel, H; Wolf, A; Xidara, V; Busch, R.; Ceballos-Baumann, A

    2001-01-01

    OBJECTIVES—To study the prevalence of psychiatric comorbidity assessed by the use of a structured clinical interview in a large, representative sample of patients with spasmodic torticollis (ST) and to test the hypothesis that social phobia would be highly prevalent.
METHODS—In a consecutive cohort of 116 patients with ST treated with botulinum toxin overall psychiatric comorbidity was studied prospectively with the structured clinical interview (SCID) for DSM-IV axis I d...

  1. Spasmodic torticollis: the dental connection.

    Sims, Anthony B; Stack, Brendan C; Demerjian, G Gary

    2012-07-01

    Spasmodic torticollis or cervical dystonia (CD) is the most common form of focal dystonia and is characterized by sustained abnormal muscle contractions in the head and neck area resulting in abnormal positioning or posturing of the head. The dystonic muscle spasms associated with spasmodic torticollis may affect any combination of neck muscles. Three cases are reported of spasmodic torticollis that were treated by a dental appliance with individual varying occlusal heights to open the maxillomandibular vertical dimension. Upon increasing the vertical dimension of occlusion, there was a slowing and/or discontinuance of the symptoms of cervical dystonia. The proposed hypothesis for this reversal is that there may be neuritis of the auriculotemporal branch of the trigeminal nerve, which has direct input into the reticular formation (RF), and it may activate the cells of the pontine region of the RF known for the control and deviation of head posture. There is growing clinical evidence that temporomandibular joint (TMJ) dysfunction may be a factor in this neurological and painful disorder when it coexists. PMID:22916671

  2. Dysphonia risk screening protocol

    Katia Nemr

    2016-03-01

    Full Text Available OBJECTIVE: To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia. METHOD: This descriptive cross-sectional study included 365 individuals (41 children, 142 adult women, 91 adult men and 91 seniors divided into a dysphonic group and a non-dysphonic group. The protocol consisted of 18 questions and a score was calculated using a 10-cm visual analog scale. The measured value on the visual analog scale was added to the overall score, along with other partial scores. Speech samples allowed for analysis/assessment of the overall degree of vocal deviation and initial definition of the respective groups and after six months, the separation of the groups was confirmed using an acoustic analysis. RESULTS: The mean total scores were different between the groups in all samples. Values ranged between 37.0 and 57.85 in the dysphonic group and between 12.95 and 19.28 in the non-dysphonic group, with overall means of 46.09 and 15.55, respectively. High sensitivity and specificity were demonstrated when discriminating between the groups with the following cut-off points: 22.50 (children, 29.25 (adult women, 22.75 (adult men, and 27.10 (seniors. CONCLUSION: The protocol demonstrated high sensitivity and specificity in differentiating groups of individuals with and without dysphonia in different sample groups and is thus an effective instrument for use in voice clinics.

  3. Vocal therapy of hyperkinetic dysphonia

    Mumović Gordana

    2014-01-01

    Full Text Available Introduction. Hyperkinetic (hyperfunctional dysphonia is a common pathology. The disorder is often found in vocal professionals faced with high vocal requirements. Objective. The objective of this study was to evaluate the effects of vocal therapy on voice condition characterized by hyperkinetic dysphonia with prenodular lesions and soft nodules. Methods. The study included 100 adult patients and 27 children aged 4-16 years with prenodular lesions and soft nodules. A subjective acoustic analysis using the GIRBAS scale was performed prior to and after vocal therapy. Twenty adult patients and 10 children underwent objective acoustic analysis including several acoustic parameters. Pathological vocal qualities (hoarse, harsh and breathy voice were also obtained by computer analysis. Results. The subjective acoustic analysis revealed a significant (p<0.01 reduction in all dysphonia parameters after vocal treatment in adults and children. After treatment, all levels of dysphonia were lowered in 85% (85/100 of adult patients and 29% (29/100 had a normal voice. Before vocal therapy 9 children had severe, 13 had moderate and 8 slight dysphonia. After vocal therapy only 1 child had severe dysphonia, 7 had moderate, 10 had slight levels of dysphonia and 9 were without voice disorder. The objective acoustic analysis in adults revealed a significant improvement (p≤0.025 in all dysphonia parameters except SD F0 and jitter %. In children, the acoustic parameters SD F0, jitter % and NNE (normal noise energy were significantly improved (p=0.003-0.03. Pathological voice qualities were also improved in adults and children (p<0.05. Conclusion. Vocal therapy effectively improves the voice in hyperkinetic dysphonia with prenodular lesions and soft nodules in both adults and children, affecting diverse acoustic parameters.

  4. The hip abductors at MR imaging

    Hoffmann, A., E-mail: adrienne.hoffmann@balgrist.ch [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zürich (Switzerland); Pfirrmann, C.W.A., E-mail: christian.pfirrmann@balgrist.ch [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zürich (Switzerland)

    2012-12-15

    Imaging of the hip abductors plays an increasing role for the evaluation of greater trochanteric pain in patients with and without total hip arthroplasty. This review article addresses the anatomy of the hip abductors and their intervening bursae. It highlights different possible imaging appearances such as tendinopathy or partial and full thickness tears of the gluteal tendons. Muscle atrophy or fatty degeneration of the gluteal muscles is an important reason for limping. Inflammatory diseases such as hydroxyapatite crystal deposition disease or spondylarthritis have to be considered. Knowledge of these different entities is important to achieve optimal treatment and outcomes.

  5. Multiple tendons of abductor pollicis longus

    Mansur DI; Krishnamurthy A; Nayak SR; Kumar CG; Rai R; Sujatha D’costa S; Mansur DI, Krishnamurthy A, Nayak SR, Kumar CG, Rai R, Sujatha D’costa S, Prabhu LV.; Prabhu LV

    2010-01-01

    Anatomic variations of the tendons of the abductor pollicis longus (APL) and its knowledge is important to assess the diseased and traumatized hand and when considering tendons for repair or graft. During routine dissection of a 63-year-old male cadaver, in the Department of Anatomy, Kasturba Medical College, Mangalore, Karnataka, India we came across an unusual APL in the right upper limb. The muscle had altogether 9 tendons and they were inserted to the lateral and anterolateral sides of th...

  6. The anatomy of the hip abductor muscles.

    Flack, N A M S; Nicholson, H D; Woodley, S J

    2014-03-01

    The anatomy of the hip abductors has not been comprehensively examined, yet is important to understanding function and pathology in the gluteal region. For example, pathology of the hip abductor muscle-tendon complexes can cause greater trochanteric pain syndrome, and may be associated with gluteal atrophy and fatty infiltration. The purpose of this study was to investigate the detailed morphology of gluteus medius (GMed), gluteus minimus (GMin), and tensor fascia lata (TFL), and determine whether the muscles comprised anatomical compartments. The gluteal region from 12 cadavers was dissected and data collected on attachment sites, volume, fascicular and tendinous anatomy, and innervation. Three sites of GMed origin were identified (gluteal fossa, gluteal aponeurosis, and posteroinferior edge of the iliac crest) and the distal tendon had lateral and posterior parts. GMed was the largest in volume (27.6 ± 11.6 cm(3); GMin 14.1 ± 11.1 cm(3); TFL 1.8 ± 0.8 cm(3)). Fascicles of GMin originated from the gluteal fossa, inserting onto the deep surface of its distal tendon and the hip joint capsule. TFL was encapsulated in the fascia lata, having no bony attachment. Primary innervation patterns varied for GMed, with three or four branches supplying different regions of muscle. Distinct secondary nerve branches entered four regions of GMin; no differential innervation was observed for TFL. On the basis of architectural parameters and innervation, GMed, and GMin each comprise of four compartments but TFL is a homogenous muscle. It is anticipated that these data will be useful for future clinical and functional studies of the hip abductors. PMID:23625344

  7. Vocal aging and adductor spasmodic dysphonia: Response to botulinum toxin injection

    Cannito, Michael

    2008-01-01

    Michael P Cannito, Joel C Kahane, Lesya ChornaSchool of Audiology and Speech-Language Pathology, The University of Memphis, Memphis, TN, USAAbstract: Aging of the larynx is characterized by involutional changes which alter its biomechanical and neural properties and create a biological environment that is different from younger counterparts. Illustrative anatomical examples are presented. This natural, non-disease process appears to set conditions which may influence the effectiveness of botu...

  8. Developing the Communicative Participation Item Bank: Rasch Analysis Results from a Spasmodic Dysphonia Sample

    Baylor, Carolyn R.; Yorkston, Kathryn M.; Eadie, Tanya L.; Miller, Robert M.; Amtmann, Dagmar

    2009-01-01

    Purpose: The purpose of this study was to conduct the initial psychometric analyses of the Communicative Participation Item Bank--a new self-report instrument designed to measure the extent to which communication disorders interfere with communicative participation. This item bank is intended for community-dwelling adults across a range of…

  9. Dysphonia after Bevacizumab Rechallenge: A Case Report

    Corey A. Carter

    2015-10-01

    Full Text Available Inhibition of vascular endothelial growth factor (VEGF signaling, an initiator of tumor angiogenesis, inhibits tumor growth and invasion. Bevacizumab, a monoclonal antibody to VEGF, in common use as an adjunct to standard chemotherapy like irinotecan in advanced colorectal cancer, also affects the normal (nontumor vasculature. Dysphonia or voice changes have been anecdotally reported in patients that have been exposed to antiangiogenics. In this case report, we present an occurrence of severe dysphonia in a 60-year-old male with metastatic colorectal cancer after reintroduction of irinotecan and bevacizumab. To our knowledge, this is the first case of dysphonia associated with bevacizumab rechallenge.

  10. Vocal dose in teachers: correlation with dysphonia.

    Gama, Ana Cristina Côrtes; Santos, Juliana Nunes; Pedra, Elisângela de Fátima Pereira; Rabelo, Alessandra Terra Vasconcelos; Magalhães, Max de Castro; Casas, Estevam Barbosa de Las

    2016-04-01

    Teachers are professionals with high prevalence of dysphonia, whose main risk factors are the large work hours in classrooms with the presence of background noise. The purpose of the study was to calculate the phonation time and the cycle dose of teachers with dysphonia and teachers without voice disorders during the class. There were two groups analyzed: five teachers with functional dysphonia were the first group and five teachers without voice disorders were the second group. For the data was used the VoxLog® dosimeter and the parameters were: intensity; fundamental frequency; phonation time and cycle dose. The statistical analysis used ANOVA, Student's T-test, and Kruskal-Wallis test. Dysphonic teachers showed major values of phonation time and cycle dose compared with teachers without voice disorders. The dysphonia is related to extended period of speech time and greater exposure of the tissue of the vocal fold to phonotrauma. PMID:27191884

  11. Etiological factors for muscle tension dysphonia

    Kušar, Rozalija

    2012-01-01

    This thesis discusses muscle tension dysphonia and etiological factors for its emergence. Muscle tension dysphonia is a consequence of irregular formation of the sound and is connected to increased and unnecessary muscle tension and phonation, and is usually without any anatomical and peripheral neurological irregularities and also without any changes on the mucous membrane. In the theoretical part of this thesis voice disorders and various classifications of voice disorders that occur in the...

  12. Proton MR spectroscopy in idiopathic spasmodic torticollis

    Federico, F.; Lucivero, V.; Simone, I.L.; Defazio, G.; De Salvia, R.; Mezzapesa, D.M.; Petruzzellis, M.; Tortorella, C.; Livrea, P. [Dept. of Neurology and Psychiatry, Bari (Italy)

    2001-07-01

    Single-voxel proton magnetic resonance spectroscopy ({sup 1}H-MRS), localised to the basal ganglia, was used to determine changes in metabolite levels in idiopathic spasmodic torticollis (IST). We examined nine patients and 13 healthy subjects. The mean values ({+-} SD) of peak area ratios were: IST: N-acetyl-aspartate (NAA)/choline-containing compounds (Cho) 1.79 {+-} 0.39, NAA/creatine and phosphocreatine compounds (Cr) 1.61 {+-} 0.38, Cho/Cr 0.91 {+-} 0.19; controls: NAA/Cho 2.07 {+-} 0.35, NAA/Cr 1.82 {+-} 0.31, Cho/Cr 0.89 {+-} 0.12. Statistical analysis showed that NAA/Cho and NAA/Cr were significantly lower in patients than in controls (P = 0.0304 and 0.0431, respectively). These results indicate a reduction in NAA, and suggest striatal involvement in the pathogenesis IST. (orig.)

  13. Proton MR spectroscopy in idiopathic spasmodic torticollis

    Single-voxel proton magnetic resonance spectroscopy (1H-MRS), localised to the basal ganglia, was used to determine changes in metabolite levels in idiopathic spasmodic torticollis (IST). We examined nine patients and 13 healthy subjects. The mean values (± SD) of peak area ratios were: IST: N-acetyl-aspartate (NAA)/choline-containing compounds (Cho) 1.79 ± 0.39, NAA/creatine and phosphocreatine compounds (Cr) 1.61 ± 0.38, Cho/Cr 0.91 ± 0.19; controls: NAA/Cho 2.07 ± 0.35, NAA/Cr 1.82 ± 0.31, Cho/Cr 0.89 ± 0.12. Statistical analysis showed that NAA/Cho and NAA/Cr were significantly lower in patients than in controls (P = 0.0304 and 0.0431, respectively). These results indicate a reduction in NAA, and suggest striatal involvement in the pathogenesis IST. (orig.)

  14. Laryngeal Function Features of Spasmodic Dysphonia%痉挛性发音障碍的喉功能特点

    王丽萍; 张玉富; 张澍; 杨式麟

    2001-01-01

    目的为了探讨痉挛性发音障碍的喉功能特点及其发音障碍的表现形式.方法对24例痉挛性发音障碍患者(男6例,女18例)的发病诱因、发音障碍特征、喉镜所见、喉肌电及喉空气动力学改变进行了分析.结果痉挛性发音障碍主要表现为音韵及声音的流畅性障碍,主观听觉上以紧张性发音障碍为特点;喉镜检查可看到痉挛性发音时声带过度内收,室带不同程度的内收超越,重者声带强烈内收,会厌、室带以及整个喉呈闭锁状态;典型的喉肌电图所见为束发性放电;喉呼气流率明显减少.结论痉挛性发音障碍伴随着紧张性发音的同时声带或整个喉强烈内收痉挛,同时伴有呼气流率下降,典型病例可看到喉肌电的改变.

  15. Hip abductor moment arm - a mathematical analysis for proximal femoral replacement

    Temple H Thomas; Cheong David; Marulanda German A; Henderson Eric R; Letson G Douglas

    2011-01-01

    Abstract Background Patients undergoing proximal femoral replacement for tumor resection often have compromised hip abductor muscles resulting in a Trendelenberg limp and hip instability. Commercially available proximal femoral prostheses offer several designs with varying sites of attachment for the abductor muscles, however, no analyses of these configurations have been performed to determine which design provides the longest moment arm for the hip abductor muscles during normal function. M...

  16. Functional dysphonia: strategies to improve patient outcomes

    Behlau M; Madazio G; Oliveira G

    2015-01-01

    Mara Behlau, Glaucya Madazio, Gisele Oliveira Voice Department, Centro de Estudos da Voz – CEV, São Paulo, Brazil Abstract: Functional dysphonia (FD) refers to a voice problem in the absence of a physical condition. It is a multifaceted voice disorder. There is no consensus with regard to its definition and inclusion criteria for diagnosis. FD has many predisposing and precipitating factors, which may include genetic susceptibility, psychological traits, and the vocal be...

  17. Hip abductor moment arm - a mathematical analysis for proximal femoral replacement

    Temple H Thomas

    2011-01-01

    Full Text Available Abstract Background Patients undergoing proximal femoral replacement for tumor resection often have compromised hip abductor muscles resulting in a Trendelenberg limp and hip instability. Commercially available proximal femoral prostheses offer several designs with varying sites of attachment for the abductor muscles, however, no analyses of these configurations have been performed to determine which design provides the longest moment arm for the hip abductor muscles during normal function. Methods This study analyzed hip abductor moment arm through hip adduction and abduction with a trigonometric mathematical model to evaluate the effects of alterations in anatomy and proximal femoral prosthesis design. Prosthesis dimensions were taken from technical schematics that were obtained from the prosthesis manufacturers. Manufacturers who contributed schematics for this investigation were Stryker Orthopaedics and Biomet. Results Superior and lateral displacement of the greater trochanter increased the hip abductor mechanical advantage for single-leg stance and adduction and preserved moment arm in the setting of Trendelenberg gait. Hip joint medialization resulted in less variance of the abductor moment arm through coronal motion. The Stryker GMRS endoprosthesis provided the longest moment arm in single-leg stance. Conclusions Hip abductor moment arm varies substantially throughout the hip's range of motion in the coronal plane. Selection of a proximal femur endoprosthesis with an abductor muscle insertion that is located superiorly and laterally will optimize hip abductor moment arm in single-leg stance compared to one located inferiorly or medially.

  18. Body Concept, Disability, and Depression in Patients with Spasmodic Torticollis

    M. Jahanshahi

    1990-01-01

    Full Text Available Eighty-five patients with idiopathic spasmodic torticollis were compared with an equally chronic group of 49 cervical spondylosis sufferers in terms of body concept, depression, and disability. The torticollis patients were significantly more depressed and disabled and had a more negative body concept. Depression had different determinants in the two groups. Extent of disfigurement was a major predictor of depression in torticollis. Neuroticism accounted for the greatest proportion of the variance of depression in cervical spondylosis.

  19. Body Concept, Disability, and Depression in Patients with Spasmodic Torticollis

    M. Jahanshahi; Marsden, C D

    1990-01-01

    Eighty-five patients with idiopathic spasmodic torticollis were compared with an equally chronic group of 49 cervical spondylosis sufferers in terms of body concept, depression, and disability. The torticollis patients were significantly more depressed and disabled and had a more negative body concept. Depression had different determinants in the two groups. Extent of disfigurement was a major predictor of depression in torticollis. Neuroticism accounted for the greatest proportion of the var...

  20. Factors Associated with Dysphonia in High School Cheerleaders.

    Campbell, Shari L.; And Others

    1988-01-01

    Questionnaire responses from 146 high school cheerleaders indicated that acute, cheering-related dysphonia may be preceded or accompanied by a set of clinical signs that could be incorporated easily into a screening protocol for prospective cheerleaders. (Author/DB)

  1. Functional dysphonia: strategies to improve patient outcomes

    Behlau M

    2015-12-01

    Full Text Available Mara Behlau, Glaucya Madazio, Gisele Oliveira Voice Department, Centro de Estudos da Voz – CEV, São Paulo, Brazil Abstract: Functional dysphonia (FD refers to a voice problem in the absence of a physical condition. It is a multifaceted voice disorder. There is no consensus with regard to its definition and inclusion criteria for diagnosis. FD has many predisposing and precipitating factors, which may include genetic susceptibility, psychological traits, and the vocal behavior itself. The assessment of voice disorders should be multidimensional. In addition to the clinical examination, auditory-perceptual, acoustic, and self-assessment analyses are very important. Self-assessment was introduced in the field of voice 25 years ago and has produced a major impact in the clinical and scientific scenario. The choice of treatment for FD is vocal rehabilitation by means of direct therapy; however, compliance has been an issue, except for cases of functional aphonia or when an intensive training is administered. Nevertheless, there are currently no controlled studies that have explored the different options of treatment regimens for these patients. Strategies to improve patient outcome involve proper multidisciplinary diagnosis in order to exclude neurological and psychiatric disorders, careful voice documentation with quantitative measurement and qualitative description of the vocal deviation for comparison after treatment, acoustic evaluation to gather data on the mechanism involved in voice production, self-assessment questionnaires to map the impact of the voice problem on the basis of the patient's perspective, referral to psychological evaluation in cases of suspected clinical anxiety and/or depression, identification of dysfunctional coping strategies, self-regulation data to assist patients with their vocal load, and direct and intensive vocal rehabilitation to reduce psychological resistance and to reassure patient's recovery. An

  2. A controlled intervention study assessing the relation between hip abductor strength and knee valgus

    Grytdal, Are

    2015-01-01

    Background: Anterior cruciate ligament (ACL) injury is a common and severe lower limb injury. Knee abduction moment has been associated with risk of non-contact ACL injury, and knee valgus angle has been reported as part of the non-contact ACL injury mechanism. Fatigued and weak hip abductors have been correlated with increased knee abduction moment and knee valgus angle. Strengthening the hip abductor muscles might play an important role in ACL injury prevention. Purpose: T...

  3. 75 FR 76020 - Prospective Grant of Exclusive License: Devices for Treating Dysphagia and Dysphonia

    2010-12-07

    ... Treating Dysphagia and Dysphonia AGENCY: National Institutes of Health, Public Health Service, HHS ACTION... limited to devices for treating dysphagia and dysphonia. DATES: Only written comments and/or...

  4. Functional dysphonia: strategies to improve patient outcomes.

    Behlau, Mara; Madazio, Glaucya; Oliveira, Gisele

    2015-01-01

    Functional dysphonia (FD) refers to a voice problem in the absence of a physical condition. It is a multifaceted voice disorder. There is no consensus with regard to its definition and inclusion criteria for diagnosis. FD has many predisposing and precipitating factors, which may include genetic susceptibility, psychological traits, and the vocal behavior itself. The assessment of voice disorders should be multidimensional. In addition to the clinical examination, auditory-perceptual, acoustic, and self-assessment analyses are very important. Self-assessment was introduced in the field of voice 25 years ago and has produced a major impact in the clinical and scientific scenario. The choice of treatment for FD is vocal rehabilitation by means of direct therapy; however, compliance has been an issue, except for cases of functional aphonia or when an intensive training is administered. Nevertheless, there are currently no controlled studies that have explored the different options of treatment regimens for these patients. Strategies to improve patient outcome involve proper multidisciplinary diagnosis in order to exclude neurological and psychiatric disorders, careful voice documentation with quantitative measurement and qualitative description of the vocal deviation for comparison after treatment, acoustic evaluation to gather data on the mechanism involved in voice production, self-assessment questionnaires to map the impact of the voice problem on the basis of the patient's perspective, referral to psychological evaluation in cases of suspected clinical anxiety and/or depression, identification of dysfunctional coping strategies, self-regulation data to assist patients with their vocal load, and direct and intensive vocal rehabilitation to reduce psychological resistance and to reassure patient's recovery. An international multicentric effort, involving a large population of voice-disordered patients with no physical pathology, could produce enough data for

  5. The strength and function of hip abductors following anterolateral minimally invasive total hip arthroplasty

    Tan Jixiang

    2014-04-01

    Full Text Available Objective: To analyze the extent of postoperative hip abductor insufficiency in primary total hip arthroplasty (THA patients undergoing anterolateral minimally invasive (ALMI approach, and to investigate whether the clinical outcomes are more favorable in femoral neck fracture (FNF patients than in non-femoral neck fracture (nFNF patients. Methods:A total of 48 patients were enrolled in this study. Each patient underwent a clinical examination preoperatively and 6, 12, 24 and 48 weeks postoperatively. The abductor torque, Trendelenburg's sign, gait velocity, Harris hip score, Oxford hip score, Westren Ontario and McMaster Universities (WOMAC score and visual analog scale pain score were recorded. Statistical evaluation was performed with SPSS software version 18.0. The significance level was set at P<0.05. Results:The abductor torque of the operated hip and the recovery ratio showed a gradual improving tendency from 6 weeks postoperatively until the last follow-up. Gait velocity, Harris hip score, Oxford hip score and WOMAC score improved significantly after the operation until 24 weeks postoperatively. In the FNF group, the abductor torque of the operated side and the recovery ratio were significantly higher than in nFNF group at 6 weeks postoperatively, however, as time passed, this trend tended to disappear. Conclusion:This study demonstrates that patients can obtain good abductor strength and function in the early postoperative period and the hip abductor function of patients who suffer from hip osteoarthritis, rheumatoid arthritis, avascular necrosis of the femoral head could be significantly improved following ALMI THA. Key words: Arthroplasty, replacement, hip; Surgical procedures, minimally invasive; Recovery of function

  6. Psychosocial Aspects of Adolescent Dysphonia: An Approach to Treatment.

    Beery, Quinter C.

    1991-01-01

    This paper presents an approach to voice therapy with adolescents, emphasizing the importance of psychosocial and family influences as they relate to vocal behavior. The goals of therapy for the adolescent with dysphonia usually follow an orderly sequence, first dealing with individual behavior and later with family and peer group influences. (JDD)

  7. Aerodynamic Profiles of Women with Muscle Tension Dysphonia/Aphonia

    Gillespie, Amanda I.; Gartner-Schmidt, Jackie; Rubinstein, Elaine N.; Abbott, Katherine Verdolini

    2013-01-01

    Purpose: In this study, the authors aimed to (a) determine whether phonatory airflows and estimated subglottal pressures (est-P[subscript sub]) for women with primary muscle tension dysphonia/aphonia (MTD/A) differ from those for healthy speakers; (b) identify different aerodynamic profile patterns within the MTD/A subject group; and (c) determine…

  8. Comprehensive Management of Psychogenic Dysphonia: A Case Illustration

    Sudhir, Paulomi M.; Chandra, Prabha S.; Shivashankar, N.; Yamini, B. K.

    2009-01-01

    Psychogenic dysphonia refers to the loss of voice, in the absence of apparent structural or neurological pathology. It is a disorder seen more often in women and is usually associated with significant life events and emotional difficulties that may lead to conflict over speaking. Therapeutic interventions in voice disorders recommend the adoption…

  9. Exploring Genetic and Environmental Effects in Dysphonia: A Twin Study

    Simberg, Susanna; Santtila, Pekka; Soveri, Anna; Varjonen, Markus; Sala, Eeva; Sandnabba, N. Kenneth

    2009-01-01

    Purpose: To explore the existence of genetic effects as well as the interaction between potential genetic effects and a voice-demanding occupation on dysphonia. Method: One thousand seven hundred and twenty-eight Finnish twins (555 male; 1,173 female) born between 1961 and 1989 completed a questionnaire concerning vocal symptoms and occupation.…

  10. Dysphonia Detected by Pattern Recognition of Spectral Composition.

    Leinonen, Lea; And Others

    1992-01-01

    This study analyzed production of a long vowel sound within Finnish words by normal or dysphonic voices, using the Self-Organizing Map, the artificial neural network algorithm of T. Kohonen which produces two-dimensional representations of speech. The method was found to be both sensitive and specific in the detection of dysphonia. (Author/JDD)

  11. [Incidence of dysphonia in teaching staff of schools].

    Bellia, S; Serafino, L; Luca, N; Farruggia, E; Bellia, M

    2007-01-01

    Some categories of workers (actors, teachers, singers) use a particular working tool: their voice. In order to assess the spread of dysphonia and its possible causes across a specific class of workers--the teachers of some schools in the city of Catania--we have set up a ad hoc questionnaire. A special database has been subsequently arranged, aimed at the statistical analysis of the responses obtained. The analysis of the responses shows that the phenomenon is more present in female than male teachers, 48% versus 30%. The dysphonia occurs mainly at the end of the working day, lasts throughout the school year and improves in summer, demonstrating the importance of teaching activity in its pathogenesis. One aspect especially stands out: dysphonia occurs exclusively in those individuals suffering from diseases with possible alterations of the voice, such as allergopathies, tireopathies and gastropathies. Therefore, work activity alone does not seem able to cause a chronic dysphonia, whereas the presence of diseases causing disability of vocal cords appears to play an important role. PMID:18409864

  12. Visual assessment of voice disorders in patients with occupational dysphonia

    Bożena Kosztyła-Hojna

    2014-11-01

    Full Text Available [b]introduction[/b]. In a group of persons using the voice occupationally, the frequent symptoms are hoarseness, voice fatigability and aphonia. Pathological changes in the larynx may have organic or functional character which require different methods of treatment and rehabilitation. Visualization of vibrations of the vocal folds is an essential condition for an appropriate assessment of the causes of dysphonia. [b]objective[/b]. The purpose of the study is assessment of the usefulness of a high-speed imaging (HSI system in the diagnosis of functional and organic dysphonia of occupational character, compared with digital kymography (DKG and digital stroboscopy (DS with a high resolution module. [b]material and methods[/b]. The study group consisted of 64 patients with voice quality disorders with features of occupational dysphonia. The control group consisted of 15 patients with euphonic voice. Analysis of the voice quality parameters during phonation of the ‘e’ vowel was performed using HSI, DKG and stroboscopy of high resolution, by means of a digital HS camera (HRES Endocam, Richard Wolf GmbH, Knittlingen, Germany. Vocal folds vibrations were registered at the rate of 4,000 frames per second. [b]results[/b]. HSI is the most reliable diagnostic tool giving the possibility of an analysis of the true vibrations of the vocal folds. It also enables an observation of the aperiodicity of vibrations of the vocal folds, while DS with high resolution allows diagnosis of the periodicity of the vibrations. [b]conclusions[/b]. HSI is particularly useful in the diagnosis of neurologically-based pathology of the voice (paralytic dysphonia and organic dysphonia. The quickest method of diagnosing the phonatory paresis of the glottis is DKG. The advantage of both HSI and DKG is the non-invasiveness of examinations; however, their limitations are time-consuming and the high cost of equipment.

  13. EFFECT OF HIP ABDUCTOR STRENGTHENING AMONG NON-PROFESSIONAL CYCLISTS WITH ILIOTIBIAL BAND FRICTION SYNDROME

    Jayanta Nath

    2015-02-01

    Full Text Available Background and Objectives: The study was carried out to find out the effect of hip abductor strengthening among non-professional cyclists with iliotibial band friction syndrome. Subjects: 40 non-professional cyclists with ipsilateral ITBFS subject including male and female age between 18 to 50 with positive ober’s and nobble test were included in this study. Methods: 40 subject were selected according to the inclusion criteria and they were assessed pre and post for ROM (hip adduction, IR, hip abductor strength and pain using goniometer,sphygmomanometer and VAS. Subject were assign experimental group(group A 20 subject who received IT band stretching,US,and hip abductor strengthening exercise and control group (group B 20 subject who received same treatment except hip abductor strengthening. Data Analysis and Results: Based on statistical analysis using Wilcoxon test to compare the pre and post test pain in both group,Mann- whitney U- test to compare the post test pain scores of between groups ,Paired t - test to compare the pre and post ROM and strength in both groups, Unpaired t – test to compare post test ROM in between groups showed that pre post difference within group A there was significant difference for adduction ROM (p value <.0001,IR (p value <.0001,VAS(p value <.0001,and strength improve pre mean 40.80 to post mean 66.30 (p value <.0001.However in group B adduction ROM and VAS were found to be significant. In comparision in difference between groups it was found that adduction ROM,IR ROM,VAS and strength all were significant. Baseline data for outcome variable were not statistically significant. Conclusion: Based on outcome variable there was significant difference of hip abductor strengthening among non-professional cyclist with iliotibial band friction syndrome.

  14. Is dysphonia permanent or temporary after anterior cervical approach?

    Kahraman, Serdar; Sirin, Sait; Erdogan, Ersin; Atabey, Cem; Daneyemez, Mehmet; Gonul, Engin

    2007-01-01

    The rate, causes and prognosis of dysphonia after anterior cervical approach (ACA) were investigated in our clinical series. During a 10-year interval, 235 consecutive patients with cervical disc disease underwent surgical treatment using anterior approach. Retrospective chart reviews showed recurrent laryngeal nerve (RLN) injury in 3 (1.27%) patients. All three patients were men and only one patient had multilevel surgery. These patients had RLN injury after virgin surgery. Laryngoscopic exa...

  15. Dysphonia – the single symptom of rifampicin resistant laryngeal tuberculosis

    Paulauskienė Iveta

    2016-01-01

    Full Text Available Tuberculosis is still the most frequent granulomatous laryngeal disease. Absence of pathognomonic symptoms and change in clinical pattern frequently leads to misdiagnosis and delayed treatment. Hoarseness is the commonest symptom of laryngeal tuberculosis and constitutional symptoms are usually rare. However dysphonia can be caused by many other more common conditions. Hoarseness can be a symptom of organic (nodules and polyps of vocal folds, tumors, vocal fold paresis or functional (functional dysphonia, laryngeal conversion disorder, paradoxical vocal folds motion conditions. Rarely systemic diseases as amyloidosis, sarcoidosis, Wegener’s granulomatosis or tuberculosis can cause vocal dysfunction too. That is why laryngeal tuberculosis is often forgotten in case of persistent hoarseness. In this article, we present a case of a young previously healthy woman, complaining of persistent hoarseness with no other leading symptoms. Though endoscopic image suggested a malignancy, histology showed granulomatous lesion. Detailed examination revealed laryngeal and pulmonary tuberculosis resistant to rifampicin. Conclusion: Dysphonia can be the only one symptom of laryngeal tuberculosis. The disease should be taken into consideration when a patient complains of persistent hoarseness in order to avoid delays in treatment and spread of infection.

  16. 痉挛性发声障碍的康复训练%The vocal rehabilitation training for patients with spasmodic dysphonia

    雷培香; 屈季宁; 周涛; 曹永茂

    2003-01-01

    目的探讨康复训练治疗痉挛性发声障碍的疗效及意义. 方法采用心理疗法、针灸疗法、呼吸及发声功能训练等综合手段促使患者呼吸器官随意性运动协调,变高位呼吸、逆呼吸为正常的胸腹联合式呼吸,降低患者喉肌张力. 结果 36例痉挛性发声障碍患者经过上述综合康复训练后,均取得了满意效果,其中30例患者痊愈,6例患者好转,治愈率达83.3%. 结论综合应用心理疗法、针灸疗法、呼吸及发声功能训练等是痉挛性发声障碍患者较理想的康复训练方法.

  17. Adolescent Spasmodic Torticollis Treated by Moxibustion——A Report on 30 Cases

    Zhou Liwu

    2007-01-01

    @@ Spasmodic torticollis is characterized by involuntary contraction of the cervical muscles and the patient will have uni-directional paroxysmal vibration of the neck. The author has treated the disease by applying moxibustion and achieved quite satisfactory therapeutic effects. A report follows.

  18. The outcome of unilateral endoscopic posterior cordotomy in bilateral abductor vocal cord paralysis

    Salih Bakır; Ülkü Tuncer

    2009-01-01

    Aim: In this study, we aimed to investigate outcome of the endoscopic posterior cordotomy (EPC) operation in patients with bilateral abductor vocal cord paralysis (BAVCP), between January 1997 and March 2006 at Ear-Nose-Throat Department of Çukurova University Medical Faculty.Materials and Methods: The major cause of BAVCP was thyroidectomy operation (87.5%). We performed bilateral cordotomy only in two patients and unilateral cordotomy in the remaining 38 patients. In postoperative period, w...

  19. BILATERAL ABDUCTOR PARALYSIS VOCAL CORD LATERALISATION Vs ENDOSCOPIC ARYTENOIDECTOMY – OUR STUDY

    Rajasekar

    2013-11-01

    Full Text Available ABSTRACT: We are presenting a retrospective study in managing b/l abductor palsy in our hospital from 1986. From 1986 to 2006 we did vocal cord lateralisation in 54 patients and from 2006 we are doing endoscopic arytenoidectomy, so far 33 patients. We found endoscopic arytenoidectomy to be successful than vocal cord lateralisation in giving serviceable voice with no aspi ration

  20. Bilateral variations of abductor pollicis longus and extensor pollicis brevis: Surgical significance

    Gurude PV, Bahetee BH

    2013-01-01

    Abductor pollicis longus (APL) and extensor pollicis brevis (EPB) muscles are known to exhibit numerous variations. Aims: We would like to put across an accidental unusual finding of APL and EPB muscles. Materials and Methods: During routine cadaveric dissection of a 52 year old female cadaver, we found an unusual APL and EPB muscles variations bilaterally. Results: Duplication of APL tendon was noted, one showing normal attachment and the additional one on trapezium. EPB muscle had an ...

  1. Effects of Compliance on Trunk and Hip Integrative Neuromuscular Training on Hip Abductor Strength in Female Athletes

    Sugimoto, Dai; Myer, Gregory D; Bush, Heather M.; Hewett, Timothy E.

    2014-01-01

    Sugimoto, D, Myer, GD, Bush, HM, and Hewett, TE. Effects of compliance on trunk and hip integrative neuromuscular training on hip abductor strength in female athletes. Recent studies demonstrate the link between reduced hip abductor strength and increased risk for knee injury such as patellofemoral pain syndrome in women athletes. Meta-analytic reports indicate that the efficacy of integrative neuromuscular training (INT) is associated with compliance to the prescribed programming. Thus, the ...

  2. The Effect of Listener Experience and Anchors on Judgments of Dysphonia

    Eadie, Tanya L.; Kapsner-Smith, Mara

    2011-01-01

    Purpose: To determine the effect of auditory anchors on judgments of overall severity (OS) and vocal effort (VE) in dysphonic speech when judgments are made by experienced and inexperienced listeners, and when self-rated by individuals with dysphonia (speaker-listeners). Method: Twenty individuals with dysphonia and 4 normal controls provided…

  3. Toward the Development of an Objective Index of Dysphonia Severity: A Four-Factor Acoustic Model

    Awan, Shaheen N.; Roy, Nelson

    2006-01-01

    During assessment and management of individuals with voice disorders, clinicians routinely attempt to describe or quantify the severity of a patient's dysphonia. This investigation used acoustic measures derived from sustained vowel samples to predict dysphonia severity (as determined by auditory-perceptual ratings), for a diverse set of voice…

  4. Dystonias

    ... and speech and swallowing can be affected. Spasmodic dysphonia, also called laryngeal dystonia, involves the muscles that ... be quite helpful for some affected by spasmodic dysphonia. Physical therapy, the use of splints, stress management, ...

  5. Taking Care of Your Voice

    ... of the larynx Neurological diseases (such as spasmodic dysphonia or vocal fold paralysis ) Psychological trauma. Most voice ... conditions such as vocal fold paralysis and spasmodic dysphonia, which can damage the voice. It may also ...

  6. Is the Internal Rotation Lag Sign a Sensitive Test for Detecting Hip Abductor Tendon Ruptures after Total Hip Arthroplasty?

    Simmen Hans-Peter

    2011-04-01

    Full Text Available Abstract Introduction Total hip arthroplasty (THA is one of the most frequently performed procedures in orthopaedics and weakness of external rotators is often recognized thereafter. However, the etiology of lateral hip pain is multifaceted. For the diagnosis of abductor tendon rupture, magnetic resonance imaging (MRI is the gold standard. As not every patient can be subjected to MRI, a clinical diagnostic test for easy detection of lesions of the abductor tendon is missing. Here, we present the internal rotation lack sign indicating abductor tendon pathology. Methods The patient is placed in lateral position on a stretcher with hips and knees in neutral position. The knee is flexed to 45° and the hip passively abducted and elevated by the investigator. With the foot passively abducted, the patient is then asked to bring his knee in direction to the examination table. This motion is also tested passively. The test is regarded positive, if no internal rotation is possible and/or if this is painful. If groin pain is elicited during either of the exercises, the test is also rated positive. Results We evaluated this test in 20 patients clinically and by magnetic resonance imaging (MRI. All patients demonstrated a positive internal rotation lag sign. Twelve of them lag of internal rotation and evidence of anterior abductor tendon rupture on MRI, 8 with lag of internal rotation and no evidence of abductor tendon rupture. Conclusion The new clinical diagnostic sign presented here may improve the diagnosis of abductor tendon rupture in the future. Level of Evidence: Diagnostic study, level I.

  7. Effects of Omeprazole Over Voice Quality in Muscle Tension Dysphonia Patients With Laryngopharyngeal Reflux

    Kandogan, Tolga; Aksoy, Gökce; Dalgic, Abdullah

    2012-01-01

    Backround Laryngopharyngeal reflux (LPR) is the backflow of stomach contents above upper esophageal sphincter, into the pharynx, larynx, and upper aerodigestive system. Objectives In this study, effects of omeprazole over voice quality in muscle tension dysphonia with laryngopharyngeal reflux was ınvestigated. Patients and Methods Nine patients, 7 males and 2 females, aged between 27-43 (mean age:31) were included to this study. The diagnosis of muscle tension dysphonia with LPR was establish...

  8. The Influence of Hip Abductor Weakness on Frontal Plane Motion of the Trunk and Pelvis in Patients with Cerebral Palsy

    Krautwurst, Britta K.; Wolf, Sebastian I.; Heitzmann, Daniel W. W.; Gantz, Simone; Braatz, Frank; Dreher, Thomas

    2013-01-01

    Trendelenburg walking pattern is a common finding in various disorders, including cerebral palsy (CP), where it is seen in children and adults. Clinically, this deviation is viewed as a consequence of hip abductor weakness resulting in pelvic obliquity. Trunk lean to the ipsilateral side is a common compensatory mechanism to counteract pelvic…

  9. The effect of hip abductor exercise on muscle strength and trunk stability after an injury of the lower extremities.

    Kak, Hwang-Bo; Park, Sun-Ja; Park, Byun-Joon

    2016-03-01

    [Purpose] The gluteus medius, a hip abductor, controls femoral movement and stabilizes the pelvis during lower extremity mobilization. [Subjects] This study enrolled 24 subjects into control and experimental groups. [Methods] This randomized controlled study included patients who underwent arthroscopy after meniscus injury and started a rehabilitative exercise program 8 weeks after surgery. Subjects were divided into the experimental gluteus medius resistance exercise group (n=12) and the control group (n=12). The study investigated muscle strength and balance of the flexors, extensors, and abductors of the knee for 8 weeks. [Results] Strengths of knee extensors in patients who underwent rehabilitative exercise for 8 weeks were measured. Strength of the knee extensors of the experimental and control groups increased by 40% and 31%, respectively; strength of the hip flexors of the experimental and control groups increased by 31% and 18%, respectively. Strength of the hip joint muscles showed a 40% increase in the experimental group and a 14% increase in the control group. However, there was a significant difference (18%) in muscle strength of the hip abductors between the groups. Measurements of trunk lateral flexion showed a difference within a group, but no intergroup difference was found. [Conclusion] This study investigated the effect of hip abductor exercise on muscular strength and trunk stability in patients with a meniscus injury. PMID:27134387

  10. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function☆

    Almeida, Gabriel Peixoto Leão; Silva, Ana Paula de Moura Campos Carvalho e; França, Fábio Jorge Renovato; Magalhães, Maurício Oliveira; Burke, Thomaz Nogueira; Marques, Amélia Pasqual

    2016-01-01

    Objective To investigate the relationship between the q-angle and anterior knee pain severity, functional capacity, dynamic knee valgus and hip abductor torque in women with patellofemoral pain syndrome (PFPS). Methods This study included 22 women with PFPS. The q-angle was assessed using goniometry: the participants were positioned in dorsal decubitus with the knee and hip extended, and the hip and foot in neutral rotation. Anterior knee pain severity was assessed using a visual analog scale, and functional capacity was assessed using the anterior knee pain scale. Dynamic valgus was evaluated using the frontal plane projection angle (FPPA) of the knee, which was recorded using a digital camera during step down, and hip abductor peak torque was recorded using a handheld dynamometer. Results The q-angle did not present any significant correlation with severity of knee pain (r = −0.29; p = 0.19), functional capacity (r = −0.08; p = 0.72), FPPA (r = −0.28; p = 0.19) or isometric peak torque of the abductor muscles (r = −0.21; p = 0.35). Conclusion The q-angle did not present any relationship with pain intensity, functional capacity, FPPA, or hip abductor peak torque in the patients with PFPS. PMID:27069887

  11. Eccentric hip abductor weakness in patients with symptomatic external snapping hip

    Jacobsen, Julie Sandell; Thorborg, Kristian; Søballe, K; Ulrich-Vinther, M

    2012-01-01

    Symptomatic external snapping hip can be a long-standing condition affecting physical function in younger people between 15-40 years. Gluteal weakness has been suggested to be associated with the condition. The aim of this study was to investigate whether eccentric hip abduction strength is...... decreased in patients with external snapping hip compared with healthy matched controls, and to examine isometric hip abduction, adduction, extension, flexion, internal rotation, and external rotation in patients with external snapping hip and matched controls. Thirteen patients with external snapping hip....... Eccentric hip abduction strength was 16% lower in patients with external snapping hip compared with healthy matched controls (1.50± 0.47 Nm/kg versus 1.82 ± 0.48 Nm/kg, P = 0.01). No other strength differences were measured between patients and controls (P > 0.05). Eccentric hip abductor weakness was...

  12. EFFECT OF MENSTRUAL CYCLE IN LONG LATENCY REFLEX OF ABDUCTOR POLLICIS BREVIS AMONG HEALTHY FEMALE VOLUNTEERS.

    Rekha.D

    2015-07-01

    Full Text Available Background: Long Latency Reflex (LLR is one of the late responses occurring after H reflex from a mixed nerve by submaximal stimulation. LLR has been found to be absent in patients with multiple sclerosis, spastic patients and in Huntington’s disease. A change in body temperature affects conduction velocity. It is a known fact that there is a change in body temperature during menstrual cycle. However, no studies are available to indicate changes in latency of LLR during the menstrual cycle. Aim: To determine the effect of menstrual cycle on Long Latency Reflex of Abductor Pollicis Brevis among healthy female volunteers. Material and Methods: A cross sectional study was carried out in 30 healthy female volunteers aged 20-30 yrs. The study was conducted between 9.00 a.m.-11.00 a.m using Digital Nerve Conduction/EMG/EP machine (Recorders Medicare system, India in a laboratory maintained at 22º±3ºC. LLR was recorded during early follicular and mid-luteal phases by stimulation of median nerve while abducting the thumb and recording the EMG response of Abductor Pollicis Brevis. Body temperature was recorded. Latency of LLR obtained during two phases of menstrual cycle was compared. Result: The mean value of latency for LLR was 45.45±2.95 ms (mean±SD in the mid luteal phase. It was significantly (Wilcoxon test, p<0.001 shorter than the value in the early follicular phase 47.10±2.51ms (mean±SD. This is possibly due to the higher body temperature in the mid luteal phase. Conclusion: Long Latency Reflex was found to be affected during the phases of the menstrual cycle in healthy female volunteers.

  13. Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series

    Regina Helena Garcia Martins

    2014-12-01

    Full Text Available Introduction: Psychogenic dysphonia is a functional disorder with variable clinical manifestations. Objective: To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series. Methods: The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings. Results: 28 patients (26 women and 2 men were assessed. Their occupations included: housekeeper (n = 17, teacher (n = 4, salesclerk (n = 4, nurse (n = 1, retired (n = 1, and psychologist (n = 1. Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms. Conclusions: In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed.

  14. EXTRA WORKING FACTORS IN DYSPHONIA PATHOGENESIS OF TEACHERS

    Salvatore Biondi

    2007-01-01

    Full Text Available Objective: to estimate the incidence of teacher dysphonic disease in order to subsequently delineate prevention programs. Methods: a representative sample of teachers from different institutes in Catania, i.e. nursery, elementary, secondary and high school, were admitted to a test program. Results: The analysed cards were 379. 46-% of teachers frequently showed an alteration of the characters of the voice, 43% rarely showed it while only 11% did not show such alteration. The dysphonic disease was present in teachers that reported one or more of following pathologies: allergies, gastric disturb and thyroid pathologies. Onthe contrary this disease was not present in those who were not suffering from such a pathologies. 24% of teachers have reported to have been absent from school because of dysphonia. Conclusions: this study puts in evidence that teacher vocal sickness is only partially referable to the specific professional activity, but it is largely due to a psycho-physics predisposition. More studies are however necessary in order to specify the role of working and extra working factors in this group of voice practitioners.

  15. Limitations of the Vastus Lateralis Muscle as a Substitute for Lost Abductor Muscle Function: An Anatomical Study.

    Grob, Karl; Monahan, Rebecca; Gilbey, Helen; Ackland, Timothy; Kuster, Markus S

    2015-12-01

    Abductor insufficiency after hip arthroplasty resulting from an impaired gluteus medius and minimus remains an unsolved problem in orthopaedic surgery. The vastus lateralis (VL) was described as a functional substitute for abductor insufficiency in 2004. We carried out a macrodissection of twelve cadaveric hemipelvises to investigate the innervation of the VL and adjacent muscles to assess the extent the VL can be safely transferred. Results showed that direct muscle branches to proximal portions of the VL are too short to allow a significant shift; the shift may be as small as 13 mm. Nerves that supply the VL also extend to the vastus intermedius. This innervation pattern makes it impossible to shift the VL significantly without damaging branches to both. PMID:26264179

  16. The Effect of an Inclined Ankle on the Activation of the Abductor Hallucis Muscle during Short Foot Exercise

    Heo, Hyo-Jin; An, Duk-hyun

    2014-01-01

    [Purpose] The purpose of this study was to identify the effects of an inclined ankle on the activation of the abductor hallucis muscle during short foot exercises. [Subjects] We recruited 14 healthy volunteers who were free of pain, and did not suffer from arthritis or osteomuscular problems related to the foot or ankle. [Methods] The subjects performed short foot exercises and short inclined foot exercises with 30° passive ankle dorsiflexion. [Results] The exercise with an inclined foot show...

  17. The outcome of unilateral endoscopic posterior cordotomy in bilateral abductor vocal cord paralysis

    Salih Bakır

    2009-01-01

    Full Text Available Aim: In this study, we aimed to investigate outcome of the endoscopic posterior cordotomy (EPC operation in patients with bilateral abductor vocal cord paralysis (BAVCP, between January 1997 and March 2006 at Ear-Nose-Throat Department of Çukurova University Medical Faculty.Materials and Methods: The major cause of BAVCP was thyroidectomy operation (87.5%. We performed bilateral cordotomy only in two patients and unilateral cordotomy in the remaining 38 patients. In postoperative period, we assessed the patients both subjectively and objectively.Results: The success ratio was % 87.5 with the first intervention. Only 5 patients (12.5% needed a revision operation.In subjective assessment, 23 patients found to had a good postoperative exercise tolerance (57.5%, and 17 patients had very good postoperative exercise tolerance (42.5%. In postoperative period, alterations of respiration and voice were investigated in 26 patients objectively. We used peak expiratory flow (PEF measurement for assessment of respiration function. We found a significantly increased PEF value after endoscopic posterior cordotomy compared with preoperative period (p=0.004. Conclusion: In conclusion, unilateral EPC operation was seen as safe, effective, easy to do and short duration method for bilateral BAVCP

  18. Primary abductor hip contracture as diagnostic, prognostic and therapeutic problem in child hip pathology

    Pajić Miloš

    2007-01-01

    Full Text Available Coxa obliqua represents a special functional entity in the pathology of the child hip. Authors have confirmed the results of S.L. Weissman and B. Strinovic which claimed that the abductor contracture of the hip was a primary congenital condition that developed as a result of intrauterine malposition, leading later to the contralateral adductor contracture. Critical period for the development of complications was between 6 and 8 month after birth, adductor contracture might keep persisting together with the development of acetabular dysplasia, and later on with ipsilateral subluxation. This malformation has usually been diagnosed within 3 and 6 months of age. It could be connected with some other signs of malposition, such as plagiocephaly, torticollis or infantile thoracic C scoliosis. For the diagnosis of coxa obliqua, the examination of hips in the prone position was very important and the ultrasonic and radiological examinations were crucial. The applied treatment used to be exclusively physical rehabilitation. Wide diapering has been contraindicated. In this study, we included 2,500 newborns, 1,300 boys and 1,200 girls (5,000 hips. In 22 cases of coxa obliqua (10‰, the excellent results were obtained in 96% of cases. In two unsuccessfully treated cases, a contralateral dysplasia developed, and in one untreated, subluxation. The authors are advocating a systematic and early detection and treatment of the primary coxa obliqua. .

  19. The effects of gluteus maximus and abductor hallucis strengthening exercises for four weeks on navicular drop and lower extremity muscle activity during gait with flatfoot.

    Goo, Young-Mi; Kim, Tae-Ho; Lim, Jin-Yong

    2016-03-01

    [Purpose] The purpose of the present study is to examine the effects of abductor hallucis and gluteus maximus strengthening exercises on pronated feet. [Subjects and Methods] The present study was conducted with 18 adults without no history of surgery on the foot or ankle. One group performed both gluteus maximus strengthening exercises and abductor hallucis strengthening exercises, while the other group performed only abductor hallucis strengthening exercises five times per week for four weeks. [Results] The group that performed both gluteus maximus and abductor hallucis strengthening exercises showed smaller values in the height of navicular drop than the group that performed only abductor hallucis strengthening exercises. The muscle activity of the gluteus maximus and the vastus medialis increased during heel-strike in the group that added gluteus maximus exercises, and the muscle activity of the abductor hallucis significantly increased in both groups. [Conclusion] Given the results of the present study, it can be suggested that strengthening the gluteus maximus while also performing exercises to correct the pronated foot is an effective method for achieving normal gait. PMID:27134383

  20. Articulatory Changes in Muscle Tension Dysphonia: Evidence of Vowel Space Expansion Following Manual Circumlaryngeal Therapy

    Roy, Nelson; Nissen, Shawn L.; Dromey, Christopher; Sapir, Shimon

    2009-01-01

    In a preliminary study, we documented significant changes in formant transitions associated with successful manual circumlaryngeal treatment (MCT) of muscle tension dysphonia (MTD), suggesting improvement in speech articulation. The present study explores further the effects of MTD on vowel articulation by means of additional vowel acoustic…

  1. Functional Dysphonia during Mental Imagery: Testing the Trait Theory of Voice Disorders

    van Mersbergen, Miriam; Patrick, Christopher; Glaze, Leslie

    2008-01-01

    Purpose: Previous research has proposed that persons with functional dysphonia (FD) present with temperamental traits that predispose them to their voice disorder. We investigated this theory in a controlled experiment and compared them with social anxiety (SA) and healthy control (HC) groups. Method: Twelve participants with FD, 19 participants…

  2. Intensified Voice Therapy: A New Model for the Rehabilitation of Patients Suffering from Functional Dysphonias

    Fischer, Michael J.; Gutenbrunner, Christoph; Ptok, Martin

    2009-01-01

    The objective of this study was to evaluate a new intervention for chronic dysphonias, consisting of a 2-week outpatient treatment period using intensified voice therapy combined with elements of physical medicine, including physiotherapy (orthotherapy, detonisation and training of the trunk muscles, respiratory therapy and others), manual therapy…

  3. Articulatory Changes Following Treatment of Muscle Tension Dysphonia: Preliminary Acoustic Evidence

    Dromey, Christopher; Nissen, Shawn L.; Roy, Nelson; Merrill, Ray M.

    2008-01-01

    Purpose: Primary muscle tension dysphonia (MTD), a voice disturbance that occurs in the absence of structural or neurological pathology, may respond to manual circumlaryngeal techniques, which ostensibly alter the posture of the larynx and/or the configuration of the vocal folds without directly targeting supralaryngeal articulatory structures.…

  4. The interobserver and test-retest variability of the dysphonia severity index

    M.M. Hakkesteegt (Marieke); M.H. Wieringa (Marjan); M.P. Brocaar (Michael); P.G.H. Mulder (Paul); L. Feenstra (Louw)

    2008-01-01

    textabstractObjective: The purpose of this study was to investigate the interobserver variability and the test-retest variability of the Dysphonia Severity Index (DSI), a multiparametric instrument to assess voice quality. Methods: The DSI was measured in 30 nonsmoking volunteers without voice compl

  5. Anterior-posterior and medial compression of the supraglottis : Signs of nonorganic dysphonia or normal postures?

    Behrman, A; Dahl, LD; Abramson, AL; Schutte, HK

    2003-01-01

    Two vocal tract postures commonly identified as hallmarks of nonorganic dysphonia are anterior-posterior and medial compression of the supraglottis. However, insufficient data exist to support their diagnostic utility. The purpose of this study was to compare these two postures in patients with nono

  6. Early Motor Unit Disease Masquerading as Psychogenic Breathy Dysphonia: A Clinical Case Presentation

    Aronson, Arnold E.

    1971-01-01

    Presented is a study of a 20-year-old girl with mild, breathy dysphonia, previously diagnosed as psychogenic. In actuality, her voice change was a sign of early myasthenia gravis. It is pointed out that voice changes can be a first and only sign of early neurologic disease. (Author/KW)

  7. The Hip Lag Sign--prospective blinded trial of a new clinical sign to predict hip abductor damage.

    Alexander Kaltenborn

    Full Text Available This study introduces and validates the Hip Lag Sign, a new clinical parameter to determine hip abductor damage, which appears to be one major cause for greater trochanteric pain syndrome. 26 patients who underwent standardized MRI-examination were prospectively enrolledbetween October 2009 and March 2012. A standard physical examination of the hip was performed, including the Hip Lag Sign as it is defined for the first time in this work. Hip Lag Sign results were statistically compared toMR images, to pain levels measured with the visual analogue scale and to results of the modified Harris Hip Score as a universal and well established diagnostic tool for the hip. Chi2- and Mann-Whitney-U-analysis were applied. Diagnostic accuracy was tested with 2×2-table-calculations.Kappa statistics were used to analyze inter-observer variability. A positive Hip Lag Sign is significantly associated with MRI-proven hip abductor damage (p<0.001. The Hip Lag Sign has a sensitivity of 89.47% and a specificity of 96.55%. The positive and negative predictive values are 94.44%, resp. 93.33%. Its diagnostic Odds Ratio is 239.000 (p<0.001; 95%-CI: 20.031-2827.819. The number needed to diagnose was 1.16.Inter-observer consistency was 98.1% and kappa statistics for inter-observer variability were 0.911. The Hip Lag Sign is specific and sensitive, easy and fast to perform and allows a reliable assessment on the hip abductors' status, especially when there is no access to further diagnostic devices such as MRI for example due to restricted resources like in developing countries. Thus, we recommend the inclusion of the Hip Lag Sign into everyday hip examinations, especially dealing with patients suffering from greater trochanteric pain syndrome.

  8. Variations in abductor pollicis longus and extensor pollicis brevis tendons in the Quervain syndrome: a surgical and anatomical study.

    Kulthanan, Teerawat; Chareonwat, Boonsong

    2007-01-01

    Eighty-two wrists of Thai cadavers and the wrists of 66 patients with de Quervain syndrome were studied, and the variation in the number of tendons and the fibro-osseous tunnel in the first extensor compartment were recorded. The abductor pollicis longus had more than one tendon in 73 of the cadavers (89%) and in 32 of the patients (49%) (p de Quervain syndrome (p = 0.01). The results indicate that the number of fibro-osseous tunnels and multiple compartments in the first extensor compartment may be associated with a predisposition to de Quervain syndrome. PMID:17484184

  9. Spasmodic Torticollis—A Multicentre Study on Behavioural Aspects IV: Psychopathology

    C. E. Scheidt

    1996-01-01

    Full Text Available The GSI (General Symptom Index of the Symptom Checklist 90 R (SCL 90 R (as a global indicator of the severity of psychiatric symptoms of 27% of the spasmodic torticollis (ST sample fell outside the 95% range of the normal control group (two standard deviations. Patients with a higher GSI were younger, more functionally disabled and subject to higher psychosocial stress due to the illness. The highest scores were reached on the subscales of somatization, interpersonal sensitivity and depression. On the depression scale, 23% of the patients' scores were abnormal. This scale correlated significantly with the neurological signs, particularly the TSUI-index and laterocollis. A statistically significant correlation also existed between psychiatric morbidity and a family history of mental disorder. More than 50% of the patients reported that stressful life events had triggered their illness. In order of frequency, a death came first, followed by marital strife, changes in employment and family arguments. The data suggest that psychopathology in ST should generally be considered as a result of a variety of interacting factors, biological, psychological and social.

  10. Etiologies of Dysphonia in Patients Referred to ENT Clinics Based on videolaryngoscopy

    Keyvan Kiakojury

    2014-07-01

    Full Text Available Introduction: Laryngeal dysfunction may be divided into three categories; organic, neurologic and functional disorders. Dysphonia and hoarseness are the most common symptoms and, in some cases, the only signs of laryngeal dysfunction. In differential diagnosis of any type of chronic hoarseness, a neoplastic process must be considered and, thus continuous light video laryngoscopy can provide important information on the presence of neoplastic lesions in order to prevent disease progression via early detection and action.   Materials and Methods: This cross-sectional, descriptive-analytical study was carried out on 197 patients with voice disorders admitted to Ayatollah Rouhani Hospital for video laryngoscopy. Available sampling was used and the results achieved were analyzed using SPSS17 statistical software.   Results: A total of 197 patients (mean age, 40.72 ±15.17 years participated in this study, 56.9% of whom were male. From analysis of video laryngoscopy, organic dysphonia was found to be the most common cause of voice disorders, while functional and neurologic dysphonia were observed in 8.6% and 5.6% of patients, respectively. Vocal nodules and Reinke's edema were among the most common causes of organic dysphonia, with a frequency of 24.4% and 23.4%, respectively; while laryngeal carcinoma accounted for 2.5% of all diagnosed cases with organic causes.   Conclusion:  Since the presence of voice disorders for more than 3 weeks can be a sign of laryngeal dysfunction, early diagnosis using noninvasive methods such as video laryngoscopy and appropriate medical measures can help prevent the disease progression and eliminate the need for actions such as laryngectomy.

  11. Anterior Cervical Osteophytes Causing Dysphagia and Paradoxical Vocal Cord Motion Leading to Dyspnea and Dysphonia

    Seo, Joon Won; Park, Ji Woong; Jang, Jae Chil; Kim, Jae Wook; Lee, Yang Gyun; Kim, Yun Tae; Lee, Seok Min

    2013-01-01

    Anterior cervical osteophytes are common and usually asymptomatic in elderly people. Due to mechanical compressions, inflammations, and tissues swelling of osteophytes, patients may be presented with multiple complications, such as dysphagia, dysphonia, dyspnea, and pulmonary aspiration. Paradoxical vocal cord motion is an uncommon disease characterized by vocal cord adductions during inspiration and/or expiration. This condition can create shortness of breath, wheezing, respiratory stridor o...

  12. CLINICAL OBSERVATION ON SCALP ACUPUNCTURE TREATMENT OF WINDSTROKE-CAUSED DYSPHAGIA-DYSPHONIA SYNDRONE

    HAN Jianhua; DONG Yingli; ZHANG Ru

    2002-01-01

    Objective: To observe the therapeuticeffect of scalp acupuncture on cerebral blood flow in pseudobulbar paralysis patients for analyzing mechanisms of scalp-acupunoture in the treatment of wind stroke. Methods: A total of 38 inpatients (26 males and 12 females) were treated with electroacupuncture (EA) of scalp-point Dingzhongxian (MS 5), Dingnie Houxiexian (MS 7), Dingpangxian Ⅱ (MS 9) and Dingnie Qianxiexian (MS 6). Before and after acupuncture treatment, clinical symptoms of dysphagia and dysphonia were compared, and the mean blood flow speed (MBFS) values of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) detected by using Doppler blood flow meter. Results: Following two courses (4 weeks) of scalp-acupuncture treatment, of the 38 cases, 23 had their dysphagia and dysphonia cured (60.5%), 10 (25.3%) had remarkable improvement, 3(7.9% ) experienced improvement and 2 (5.3%) had no apparent changes. Simultaneously, MBFS of ACA, MCA and PCA increased significantly in comparison with that of pre-treatment (P < 0.01 ). Additionally, results also showed that scalp acupuncture could stabilize the blood circulation between both hemispheres of the brain. Conclusion: Scalp acupuncture has a fairly good therapeutic effect in improving stroke caused dysphagia and dysphonia and in facilitating cerebral blood flow.

  13. Electroacupuncture Treatment for Constipation Due to Spasmodic Syndrome of the Pelvic Floor- A Report of 36 Cases

    2001-01-01

    @@Thirty-six cases of constipation due to spasmodic syndrome of the pelvic floor were treated by electroacupuncture, with satisfactory therapeutic results reported as follows. Clinical Data There were 36 cases in this series, 12 males and 24 females, ranging in age from 25 to 76 years, averaging 42 years. The course of disease ranged from 6 months to 22 years, with an average of 6 years. All the 36 cases were previously treated by purgative and emollient cathartic for promoting the bowl movement.

  14. 内收型痉挛性发声障碍元音音长及语长研究%A study on vowel duration and word length of adductor spasmodic dysphonia

    陈志鹏; 葛平江

    2016-01-01

    目的:了解内收型痉挛性发声障碍(SD)元音音长和语句朗读时程与正常人之间的区别,为临床诊疗提供思路.方法:以29例内收型SD患者为痉挛组,31例正常人为对照组.所有研究对象自填嗓音障碍指数表(VHI).所有患者发/a/音测试最长发声时间(MPT)和最响最长发声时间(MLPT),并让其朗读《父母心》标准汉语普通话文,录音后采用Praat 5.0软件测量其所需时间.比较痉挛组与对照组各参数之间的差异及相关性.结果:痉挛组、对照组VHI分别为89.0±12.0、15.0±16.0(P<0.01).痉挛组、对照组MPT分别为(16.9±9.8)s、(25.3±10.0)s(P<0.01).痉挛组、对照组MLPT分别为(15.7±7.6)s、(26.5±11.4) s(P<0.01).标准句朗读时程痉挛组、对照组分别为(55.0±14.2)s、(37.8±4.8)s(P<0.01).MPT与MLPT在痉挛组具有相关性(r=0.697,P<0.01),其余各测试指标之间无明显相关.结论:SD患者嗓音障碍情况明显差于正常人,与正常人比较,其发持续元音不能持久,同时朗读句子的能力也明显差于正常人,需要更长时间完成朗读任务.MLPT与MPT有明显相关性,可以作为替代MPT的方法.

  15. The Assessment Methods of Laryngeal Muscle Activity in Muscle Tension Dysphonia: A Review

    Seyyedeh Maryam Khoddami

    2013-01-01

    Full Text Available The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD. The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG are objective methods to provide physiological information about MTD. Recent studies show that surface EMG can be an effective tool for assessing muscular tension in MTD.

  16. Species and tissue-specificity of prokinetic, laxative and spasmodic effects of Fumaria parviflora

    Najeeb-ur-Rehman

    2012-03-01

    Full Text Available Abstract Background Fumaria parviflora Linn. (Fumariaceae, is a small branched annual herb found in many parts of the world including Saudi Arabia and Pakistan. This study was designed to provide pharmacological basis for the medicinal use of Fumaria parviflora in gut motility disorders. Methods The in-vivo prokinetic and laxative assays were conducted in mice. Isolated intestinal preparations (ileum and jejunum from different animal species (mouse, guinea-pig and rabbit were separately suspended in tissue baths containing Tyrode's solution bubbled with carbogen and maintained at 37°C. The spasmogenic responses were recorded using isotonic transducers coupled with PowerLab data acquisition system. Results The aqueous-methanol extract of Fumaria parviflora (Fp.Cr, which tested positive for the presence of alkaloids, saponins, tannins and anthraquinones showed partially atropine-sensitive prokinetic and laxative activities in the in-vivo in mice at 30 and 100 mg/kg. In the in-vitro studies, Fp.Cr (0.01-1 mg/ml caused a concentration-dependent atropine-sensitive stimulatory effect both in mouse tissues (jejunum and ileum, and rabbit jejunum but had no effect in rabbit ileum. In guinea-pig tissues (ileum and jejunum, the crude extract showed a concentration-dependent stimulatory effect with higher efficacy in ileum and the effect was partially blocked by atropine, indicating the involvement of more than one types of gut-stimulant components (atropine-sensitive and insensitive. This could be a plausible reason for the greater efficacy of Fp.Cr in gut preparations of guinea-pig than in rabbit or mouse. Conclusions This study shows the prokinetic, laxative and spasmodic effects of the plant extract partially mediated through cholinergic pathways with species and tissue-selectivity, and provides a sound rationale for the medicinal use of Fumaria parviflora in gut motility disorders such as, indigestion and constipation. This study also suggests using

  17. Comparison of Perceptual Signs of Voice before and after Vocal Hygiene Program in Adults with Dysphonia

    Seyyedeh Maryam khoddami

    2011-12-01

    Full Text Available Background and Aim: Vocal abuse and misuse are the most frequent causes of voice disorders. Consequently some therapy is needed to stop or modify such behaviors. This research was performed to study the effectiveness of vocal hygiene program on perceptual signs of voice in people with dysphonia.Methods: A Vocal hygiene program was performed to 8 adults with dysphonia for 6 weeks. At first, Consensus Auditory- Perceptual Evaluation of Voice was used to assess perceptual signs. Then the program was delivered, Individuals were followed in second and forth weeks visits. In the last session, perceptual assessment was performed and individuals’ opinions were collected. Perceptual findings were compared before and after the therapy.Results: After the program, mean score of perceptual assessment decreased. Mean score of every perceptual sign revealed significant difference before and after the therapy (p≤0.0001. «Loudness» had maximum score and coordination between speech and respiration indicated minimum score. All participants confirmed efficiency of the therapy.Conclusion: The vocal hygiene program improves all perceptual signs of voice although not equally. This deduction is confirmed by both clinician-based and patient-based assessments. As a result, vocal hygiene program is necessary for a comprehensive voice therapy but is not solely effective to resolve all voice problems.

  18. Effective dysphonia detection using feature dimension reduction and kernel density estimation for patients with Parkinson's disease.

    Shanshan Yang

    Full Text Available Detection of dysphonia is useful for monitoring the progression of phonatory impairment for patients with Parkinson's disease (PD, and also helps assess the disease severity. This paper describes the statistical pattern analysis methods to study different vocal measurements of sustained phonations. The feature dimension reduction procedure was implemented by using the sequential forward selection (SFS and kernel principal component analysis (KPCA methods. Four selected vocal measures were projected by the KPCA onto the bivariate feature space, in which the class-conditional feature densities can be approximated with the nonparametric kernel density estimation technique. In the vocal pattern classification experiments, Fisher's linear discriminant analysis (FLDA was applied to perform the linear classification of voice records for healthy control subjects and PD patients, and the maximum a posteriori (MAP decision rule and support vector machine (SVM with radial basis function kernels were employed for the nonlinear classification tasks. Based on the KPCA-mapped feature densities, the MAP classifier successfully distinguished 91.8% voice records, with a sensitivity rate of 0.986, a specificity rate of 0.708, and an area value of 0.94 under the receiver operating characteristic (ROC curve. The diagnostic performance provided by the MAP classifier was superior to those of the FLDA and SVM classifiers. In addition, the classification results indicated that gender is insensitive to dysphonia detection, and the sustained phonations of PD patients with minimal functional disability are more difficult to be correctly identified.

  19. The effect of abductor muscle and anterior-posterior hip contact load simulation on the in-vitro primary stability of a cementless hip stem

    Frei Hanspeter

    2010-06-01

    Full Text Available Abstract Background In-vitro mechanical tests are commonly performed to assess pre-clinically the effect of implant design on the stability of hip endoprostheses. There is no standard protocol for these tests, and the forces applied vary between studies. This study examines the effect of the abductor force with and without application of the anterior-posterior hip contact force in the in-vitro assessment of cementless hip implant stability. Methods Cementless stems (VerSys Fiber Metal were implanted in twelve composite femurs which were divided into two groups: group 1 (N = 6 was loaded with the hip contact force only, whereas group 2 (N = 6 was additionally subjected to an abductor force. Both groups were subjected to the same cranial-caudal hip contact force component, 2.3 times body weight (BW and each specimen was subjected to three levels of anterior-posterior hip contact load: 0, -0.1 to 0.3 BW (walking, and -0.1 to 0.6 BW (stair climbing. The implant migration and micromotion relative to the femur was measured using a custom-built system comprised of 6 LVDT sensors. Results Substantially higher implant motion was observed when the anterior-posterior force was 0.6BW compared to the lower anterior-posterior load levels, particularly distally and in retroversion. The abductor load had little effect on implant motion when simulating walking, but resulted in significantly less motion than the hip contact force alone when simulating stair climbing. Conclusions The anterior-posterior component of the hip contact load has a significant effect on the axial motion of the stem relative to the bone. Inclusion of the abductor force had a stabilizing effect on the implant motion when simulating stair climbing.

  20. Plantar fasciitis and calcaneal spur formation are associated with abductor digiti minimi atrophy on MRI of the foot

    Chundru, Usha [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Liebeskind, Amy; Beltran, Javier [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Beachwood, Franklin and Seidelmann Subspecialty Radiology, Beachwood, OH (United States); Seidelmann, Frank; Franklin, Peter [Beachwood, Franklin and Seidelmann Subspecialty Radiology, Beachwood, OH (United States); Fogel, Joshua [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Brooklyn College, Department of Economics, Brooklyn, NY (United States)

    2008-06-15

    To determine the association of atrophy of the abductor digiti minimi muscle (ADMA), an MRI manifestation of chronic compression of the inferior calcaneal nerve suggesting the clinical diagnosis of Baxter's neuropathy, with MRI markers of potential etiologies, including calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and posterior tibial tendon dysfunction (PTTD). Prevalence of calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and PTTD was assessed retrospectively on 100 MRI studies with ADMA and 100 MRI studies without ADMA. Patients ranged in age from 10-92 years. Pearson chi-square analyses and Fisher's exact test were used to compare prevalence of the above findings in patients with and without ADMA. Logistic regression was used to determine which variables were significantly associated with ADMA. Among patients with ADMA, there was significantly greater age (57.2 years vs 40.8 years, p < 0.001), presence of Achilles tendinosis (22.0% vs 3.0%, P<0.001), calcaneal edema (15.0% vs 3.0%, P = 0.005), calcaneal spur (48.0% vs 7.0%, P < 0.001), plantar fasciitis (52.5% vs 11.0%, P<0.001), and PTTD (32.0% vs 11.0%, P<0.001). After multivariate logistic regression analysis, only age [odds ratio (OR) 1.06, 95% confidence interval (CI) 1.03, 1.09], calcaneal spur (OR 3.60, 95% CI 1.28, 10.17), and plantar fasciitis (OR 3.35, 95% CI 1.31, 8.56) remained significant. Advancing age, calcaneal spur, and plantar fasciitis are significantly associated with ADMA. Their high odds ratios support the notion of a possible etiologic role for calcaneal spur and plantar fasciitis in the progression to Baxter's neuropathy. (orig.)

  1. De novo FUS P525L mutation in Juvenile amyotrophic lateral sclerosis with dysphonia and diplopia.

    Leblond, Claire S; Webber, Alina; Gan-Or, Ziv; Moore, Fraser; Dagher, Alain; Dion, Patrick A; Rouleau, Guy A

    2016-04-01

    Juvenile amyotrophic lateral sclerosis (jALS) is characterized by progressive upper and lower motor neuron degeneration leading to facial muscle spasticity, spastic dysarthria, and spastic gait with an early onset (before 25 years old). Unlike adult-onset amyotrophic lateral sclerosis (ALS), patients with jALS tend to have slower progression of motor neuron disease and prolonged survival to a normal life expectancy. Mutations in FUS gene have been reported in jALS,(1) including p.P525L mutation that has been consistently associated with early onset and aggressive presentation.(2) Here, we report a patient carrying p.P525L FUS mutation and experiencing an aggressive course of ALS presenting with dysphonia and diplopia. PMID:27123482

  2. Inharmonicity Analysis: A Novel Physical Method for Acoustic Screening of Dysphonia

    Matteson, Sam; Lu, Fang-Ling

    2008-10-01

    In the United States 6.8% of men, women, and children report current voice problems and approximately 29% will report some problems during their lifetime. Often this dysphonia is due to pathologies of the vocal folds. The authors (a physicist and a speech pathologist) describe an interdisciplinary approach that shows promise of detecting physiological abnormalities of the vocal folds from an analysis of the Fourier spectrum of spoken ``tokens.'' The underlying principle maintains that the normal human vocal fold is a linear oscillator that emits overtones that are very nearly precise integral values of the fundamental. Physiological problems of the vocal folds, however, introduce mechanical non-linearities that manifest themselves as frequency deviations from the ideal harmonic (that is, integral) values. The authors quantify this inharmonicity, describing and illustrating how one can obtain and analyze such data. They outline, as well, a proposed program to assess the clinical sensitivity and significance of the analysis discussed in this work.

  3. Effect of toe-spread-out exercise on hallux valgus angle and cross-sectional area of abductor hallucis muscle in subjects with hallux valgus

    Kim, Moon-Hwan; Yi, Chung-hwi; Weon, Jong-hyuck; Cynn, Heon-Seock; Jung, Do-Young; Kwon, Oh-yun

    2015-01-01

    [Purpose] This study investigated whether the toe-spread-out exercise affects the hallux valgus angle, the cross-sectional area of the abductor hallucis muscle, and the hallux valgus angle during active abduction. [Subjects and Methods] Twenty-four subjects with hallux valgus were randomly assigned to orthosis and orthosis plus toe-spread-out exercise groups. The orthosis group wore the orthosis for 8 weeks, while the orthosis plus toe-spread-out group also performed the toe-spread-out exerci...

  4. Misdiagnosis of dysphonia plicae ventricularis%室性发音障碍的误诊分析

    张帅; 谢常宁; 刘勇; 吴平; 郭莹; 唐瑶云

    2012-01-01

    目的 总结室性发音障碍的临床特征及误诊原因.方法 回顾性分析10例被误诊的室性发音障碍病例的性别、年龄、职业、临床嗓音表现、检查结果及治疗方法.结果 10例被误诊的病例中,代偿型8例,被误诊为声带炎、慢性喉炎及声带闭合不全等;肥厚型2例被误诊为慢性喉炎和声带息肉.通过发音治疗、手术治疗及药物治疗后室性发音障碍均消失.结论 室性发音障碍在临床上不多见,临床症状也不典型,容易被误诊为其他嗓音疾病,需要做详细的喉镜检查和嗓音分析.%Objective To study the clinical characteristics of ventricular bands dysphonia and the reasons for misdiagnosis. Methods The clinical data of 10 patients suffering from ventricular bands dysphonia which was misdiagnosed as other diseases was analyzed retrospectively. Results Eight cases of compensatory type were misdiagnosed as chorditis, chronic laryngitis and two of hypertrophic type were misdiagnosed as chronic laryngitis and vocal polyp. Ventricular bands dysphonia in all cases disappeared after various therapeutic measures including voice therapy, surgical and drug treatment. Conclusion The clinical manifestations of ventricular bands dysphonia are untypical. It can easily be misdiagnosed as other voice diseases. Meticulous voice assessment, and laryngeal videostroboscopy should be considered.

  5. Hip abductors and thigh muscles strength ratios and their relation to electromyography amplitude during split squat and walking lunge exercises

    Petr Stastny

    2015-06-01

    Full Text Available Background: The hip abductors (HAB, quadriceps (Q and hamstrings (H reciprocal strength ratios are predictors of electromyography (EMG amplitude during load carrying walking at moderate intensity. Therefore, these strength ratios might predict also the EMG during the exercises as walking lunge (WL or split squat (SSq at submaximal intensity. Objective: To determine whether the EMG amplitude of vastus mediali (VM, vastus laterali (VL, biceps femoris (BF and gluteus medius (Gmed is associated with muscle strength ratio during SSqs and WLs. To determine whether the EMG amplitude differs between individuals with HAB/H ratio above and below one and between individuals with H/Q or HAB/Q ratio above and below 0.5 during SSqs and WLs. Methods: 17 resistance-trained men (age 29.6 ± 4.6 years with at least 3 years of strength training performed in cross-sectional design 5 s maximal voluntary isometric contractions (MVIC on an isokinetic dynamometer for knee extension, knee flexion, and hip abduction. The MVIC was used to normalize the EMG signal and estimate the individual strength ratios. Than participants performed WL and SSq for a 5 repetition maximum, to find out muscle activity at submaximal intensity of exercise. Results: The H/Q ratio was associated by Kendall's tau (τ with VM (τ = .33 and BF (τ = -.71 amplitude, HAB/Q ratio was associated with BF (τ = -.43 and Gmed (τ = .38 amplitude, as well as HAB/H was associated with VM (τ = -.41 and Gmed (τ = .74 amplitude. ANOVA results showed significant differences between SSq and WL (F(4, 79 = 10, p < .001, ηp2 = .34 in Gmed amplitude, where WL resulted in higher Gmed amplitude compared to SSq. Other significant differences were found between H/Q groups (F(4, 29 = 3, p = .04, ηp2 = .28 in VM and Gmed amplitude, where group with H/Q > 0.5 showed higher VMO amplitude and lower Gmed amplitude. Furthermore, significant difference was found

  6. CLINICAL OBSERVATION ON SCALP ACUPUNCTURE TREATMENT OF EINDSTROKE—CAUSED DYSKPHAGIA—DYSPHONIA SYNDRONE

    韩舰华; 董颖丽; 等

    2002-01-01

    Objective:To observe the therapeutic effect of scalp acupuncture on cerebral blood flow in pseudobulbar paralysis patients for analyzing mechanisms of scalp-acupuncture in the treatment of wind strokek.Methods:A total of 38 inpatients (26 males and 12 females) were treated with electroacupuncture (EA) of scalp-point Dingzhougxian (MS 5),Dingnie Houxiexian (MS 7),Dingpangxian Ⅱ (MS 9) and Dingnie Qianxiexian (MS 6).Before and after acupuncture treatment,clinical symptoms of dysphadia and dyskphonia sere compared,and the mean blood flow speed (MBFS) values of the anterior cerebral artery (ACA),middle cerebral artery (MCA) and posterior cerebral artery (PCA) detected by using Doppler blood flow meter.Results:Following two courses (4 weeks) of scalp-acupuncture treatment,of the 38 cases,23 had their dysphagia and dyskphonia cured (60.5%),10 (25.3%) had remarkable improvement,3(7.9%) experienced improvement and 2(5.3%) had no apparent changes.Simultaneously.MBFS of ACA,MCA and PCA increased significantly in comparison with that of pre-treatment (P<0.01).Additionally,results also showed that scalp acupuncture could stabilize the blood circulation between both hemispheres of the brain.Conclusion:Scalp acupuncture has a fairly good therapeutic effect in improving stroke caused dysphagia and dysphonia and in facilitating carebral blood flow.

  7. Quantifying Dysphonia Severity Using a Spectralcepstral-Based Acoustic Index: Comparisons with Auditory-Perceptual Judgements from the CAPE-V

    Awan, Shaheen N.; Roy, Nelson; JettE, Marie E.; Meltzner, Geoffrey S.; Hillman, Robert E.

    2010-01-01

    This study investigated the relationship between acoustic spectral/cepstral measures and listener severity ratings in normal and disordered voice samples. CAPE-V sentence samples and the vowel /[script]/were elicited from eight normal speakers and 24 patients with varying degrees of dysphonia severity. Samples were analysed for measures of the…

  8. Back-and-Forth Methodology for Objective Voice Quality Assessment: From/to Expert Knowledge to/from Automatic Classification of Dysphonia

    Corinne Fredouille

    2009-01-01

    Full Text Available This paper addresses voice disorder assessment. It proposes an original back-and-forth methodology involving an automatic classification system as well as knowledge of the human experts (machine learning experts, phoneticians, and pathologists. The goal of this methodology is to bring a better understanding of acoustic phenomena related to dysphonia. The automatic system was validated on a dysphonic corpus (80 female voices, rated according to the GRBAS perceptual scale by an expert jury. Firstly, focused on the frequency domain, the classification system showed the interest of 0–3000 Hz frequency band for the classification task based on the GRBAS scale. Later, an automatic phonemic analysis underlined the significance of consonants and more surprisingly of unvoiced consonants for the same classification task. Submitted to the human experts, these observations led to a manual analysis of unvoiced plosives, which highlighted a lengthening of VOT according to the dysphonia severity validated by a preliminary statistical analysis.

  9. Back-and-Forth Methodology for Objective Voice Quality Assessment: From/to Expert Knowledge to/from Automatic Classification of Dysphonia

    Fredouille, Corinne; Pouchoulin, Gilles; Ghio, Alain; Revis, Joana; Bonastre, Jean-François; Giovanni, Antoine

    2009-12-01

    This paper addresses voice disorder assessment. It proposes an original back-and-forth methodology involving an automatic classification system as well as knowledge of the human experts (machine learning experts, phoneticians, and pathologists). The goal of this methodology is to bring a better understanding of acoustic phenomena related to dysphonia. The automatic system was validated on a dysphonic corpus (80 female voices), rated according to the GRBAS perceptual scale by an expert jury. Firstly, focused on the frequency domain, the classification system showed the interest of 0-3000 Hz frequency band for the classification task based on the GRBAS scale. Later, an automatic phonemic analysis underlined the significance of consonants and more surprisingly of unvoiced consonants for the same classification task. Submitted to the human experts, these observations led to a manual analysis of unvoiced plosives, which highlighted a lengthening of VOT according to the dysphonia severity validated by a preliminary statistical analysis.

  10. Botulinum toxin injection - larynx

    Injection laryngoplasty; Botox-larynx: spasmodic dysphonia-BTX; Essential voice tremor (EVT)-btx; Glottic insufficiency; Percutaneous electromyography-guided botulinum toxin treatment; Percutaneous indirect laryngoscopy-guided botulinum toxin Treatment; ...

  11. Spectrophotometric determination of some anti-tussive and anti-spasmodic drugs through ion-pair complex formation with thiocyanate and cobalt(II) or molybdenum(V)

    El-Shiekh, Ragaa; Zahran, Faten; El-Fetouh Gouda, Ayman Abou

    2007-04-01

    Two rapid, simple and sensitive extractive specrophotometric methods has been developed for the determination of anti-tussive drugs, e.g., dextromethorphan hydrobromide (DEX) and pipazethate hydrochloride (PiCl) and anti-spasmodic drugs, e.g., drotaverine hydrochloride (DvCl) and trimebutine maleate (TM) in bulk and in their pharmaceutical formulations. The proposed methods depend upon the reaction of cobalt(II)-thiocyanate (method A) and molybdenum(V)-thiocyanate ions (method B) with the cited drugs to form stable ion-pair complexes which extractable with an n-butnol-dichloromethane solvent mixture (3.5:6.5) and methylene chloride for methods A and B, respectively. The blue and orange red color complexes are determined either colorimetrically at λmax 625 nm (using method A) and 467 or 470 nm for (DEX and PiCl) or (DvCl and TM), respectively (using method B). The concentration range is 20-400 and 2.5-50 μg mL -1 for methods A and B, respectively. The proposed method was successfully applied for the determination of the studied drugs in pure and in pharmaceutical formulations applying the standard additions technique and the results obtained in good agreement well with those obtained by the official method.

  12. Dysphonia in geriatric cases always needs fiberoptic laryngoscopy/bronchoscopy: Spindle cell carcinoma of larynx, a rare entity

    Shivaji Patil

    2016-01-01

    Full Text Available Spindle cell (sarcomatoid carcinoma is a rare variant of squamous cell carcinoma (SCC. It compromises of 2–3% of laryngeal cancers. Tumor arises from the oral cavity, tonsil larynx, and pharynx. Tumor is majority times misdiagnosed as reactive lesions or mesenchymal malignancies. It is considered to be a biphasic tumor that is composed of an SCC (in situ or invasive and spindle cell carcinoma (SpCC with sarcomatous appearance. In this case report, 61-year-male with minimal throat pain and acute onset dysphonia misdiagnosed and treated as a case of bronchial asthma with gastroesophageal reflux confirmed to have exophytic laryngeal growth is the cause for clinical presentation. We performed fiberoptic laryngoscopy and diagnosed to have SpCC of larynx. High index of suspicion is a must in geriatric cases with documented history of smoking and fiberoptic laryngoscopy/bronchoscopy found to be crucial in the evaluation. Histopathology expertise in surgical oncology is essential while planning treatment.

  13. Proposta de modelo de atendimento multidisciplinar para disfonias relacionadas ao trabalho: estudo preliminar Multidisciplinary protocol proposal for professional dysphonia: preliminary study

    Erica Ortiz

    2004-10-01

    Full Text Available A disfonia tem recebido um enfoque ocupacional crescente e torna-se necessário, ao otorrinolaringologista, atualizar a abordagem clínica dos trabalhadores que usam a voz como instrumento de trabalho, onde novas catagorias profissionais têm surgido e, com elas, as disfunções vocais conseqüentes às condições de trabalho. Hoje, há grandes preocupações com o prejuízo econômico e produtivo que o ditúrbio vocal possa gerar. Sabe-se que a disfunção vocal tem como característica a multicausalidade e, por isso, a avaliação, conclusão e emissão de relatórios médicos tornam-se incertos. OBJETIVO: Para melhor avaliar estes profissionais e garantir um atendimento com respaldo científico adequado, estabeleceu-se um protocolo multidisciplinar, que consiste em anamnese dirigida, exame físico, endoscopia laríngea, análise perceptiva da voz e aplicação do Voice Handicap Index (VHI. FORMA DE ESTUDO: Coorte histórica transversal. MATERIAL E MÉTODO: Para testar o uso do método, em caráter preliminar, o protocolo foi aplicado em 15 profissionais que usavam a voz para trabalhar. Então, realizou-se um estudo retrospectivo com estes pacientes. RESULTADO: Demonstrou-se que 13,3% dos profissionais apresentaram performance vocal normal; 33,3%, disfonia funcional e 46%, disfonia orgânico-funcional. A disfunção vocal foi relacionada ao exercício do trabalho em 40% dos pacientes e em 46,6% ela foi descartada. CONCLUSÃO: Concluiu-se que o método é suficientemente abrangente e pode ser de utilidade ao otorrinolaringologista, para a avaliação clínico-ocupacional deste grupo de pacientes.Dysphonia has an occupational view nowadays. A shift in the voice-oriented professional's clinical approach has been required. New voice-oriented job categories have emerged and, as a result, the voice disorder in the professional enviroment has increased. The economic and productivity harm due to voice disorders are a preocupation. Dysphonia has

  14. Artikulacija in govorne navade oseb z mišično tenzijsko disfonijo: Articulation and speech habits in patients with muscle tension dysphonia:

    Hočevar-Boltežar, Irena; Jarc, Ana; Trpkov, Klara

    2008-01-01

    Background Muscle tension dysphonia (MTD) is a functional voice disorder characterized by irregular phonatory musclesć activity. It is a cause for hoarseness in almost one half of dysphonic patients. We wanted to find out whether there are particularities in voice-speech production in patients with MTD, which are not observed in subjects without voice disorders or appear in alesser extent. Methods There were 30 subjects with MTD (27 women, 3 men) and 30 control subjects of the same age and ge...

  15. "King archie, who was quite grouchy" - a vocal dysphonia health education project O rei Sebastião que era muito resmungão

    Maria Rosário Dias

    2012-01-01

    Full Text Available PURPOSE: one major cause of dysphonia can be linked to the presence of vocal folds nodules - a condition commonly seen in children due to vocal misuse and/or vocal abuse. The present health education project, also directed to parents and educators, aims at making children (the project's chief target-population aware of how to make a correct use of their voice. METHOD: the target population includes parents, educators and children from both sexes and aged between five and eight years old. RESULT: a health education initiative was developed, which main instrument consists in a children's literature book, supplemented by an interactive CD. The instrument relies on a simple and easy-to-follow story where the issue of child dysphonia is addressed. CONCLUSIONS: the developed health education instrument is substantial for its chief target-population; it works as a suitable vehicle for promoting, in children, access, sensibility and awareness regarding aspects of one's voice one should be attentive to.

  16. Presurgical evaluation of hemifacial spasm and spasmodic torticollis caused by a neurovascular conflict from AICA with 3T MRI integrated by 3D drive and 3D TOF image fusion: A case report and review of the literature

    Concetta Alafaci

    2014-01-01

    Full Text Available Background: Hemifacial spasm (HS and spasmodic torticollis (ST are well-known disorders that are caused by a neurovascular conflict. HS is characterized by irregular, involuntary muscle contractions on one side of the face due to spasms of orbicularis oris and orbicularis oculi muscles, and is usually caused by vascular compression of the VII cranial nerve. ST is an extremely painful chronic movement disorder causing the neck to involuntary turn to the side, upward and/or downward. HS is usually idiopathic but it is rarely caused by a neurovascular conflict with the XI cranial nerve. Case Description: We present a case of a 36-year-old woman with a 2-year history of left hemifacial spasm and spasmodic torticollis. Pre-surgical magnetic resonance imaging MRI examination was performed with 3TMRI integrated by 3Ddrive and 3DTOF image fusion. Surgery was performed through a left suboccipital retrosigmoid craniectomy. The intraoperative findings documented a transfixing artery penetrating the facial nerve and a dominant left anteroinferior cerebellar artery (AICA in contact with the anterior surface of the pons and lower cranial nerves. Microvascular decompression (MVD was performed. Postoperative course showed the regression of her symptoms. Conclusions : Transfixing arteries are rarely reported as a cause of neurovascular conflicts. The authors review the literature concerning multiple neurovascular conflicts.

  17. CO2激光治疗室带肥厚导致的发音障碍%Treatment of hypertrophic ventricular dysphonia with CO2 laser

    宋维杰; 杜建群

    2015-01-01

    目的:探讨显微支撑喉镜下CO2激光治疗室带肥厚导致的发音障碍的临床疗效。方法2011年12月~2013年12月因室带肥厚导致发音障碍就诊于我科的40例经保守治疗无效的患者,所有患者均经动态喉镜和嗓音分析检查(包括基频、基频微扰、振幅微扰和谐燥比),并在全身麻醉下行显微支撑喉镜CO2激光手术切除肥厚的室带,术后再次查动态喉镜和嗓音分析,并与术前进行对比。结果40例患者术后声嘶明显改善,室带恢复正常水平,基频微扰、振幅微扰均降低,基频和谐燥比升高,声带黏膜波恢复正常,无并发症发生。结论显微支撑喉镜CO2激光治疗室带肥厚导致的发音障碍是安全、可靠的,实用性强。%[ABSTRACT]OBJECTIVETo study the clinical effect of CO2 laser in the treatment of hypertrophic ventricular dysphonia.METHODSFrom December 2011 to December 2013, 40 patients with hypertrophic ventricular dysphonia were treated in our department. Conservative treatment had no valid for all of them. All the patients were examined with strobolaryngoscope and voice analysis (including fundamental frequency, jitter, shimmer and harmonic to noise). After general anesthesia, the hypertrophic ventricular cords were excised with CO2 laser under suspension laryngoscope.RESULTS The Hoarseness were better in all the patients after operation. The ventricular cord and mucosal waves of the vocal cord were normal. The jitter and shimmer were lower than that before operation, but the fundamental frequency and harmonic to noise were higher than that before operation. There were no complications. CONCLUSIONThe treatment of hypertrophic ventricular dysphonia with CO2 laser under suspension laryngoscope is safe, reliable and practical.

  18. The influence of spasmodic torticollis on the clinical prognosis of patients with neurogenic dysphagia%神经源性吞咽障碍伴痉挛性斜颈的临床治疗观察

    郭钢花; 王国胜; 李哲

    2012-01-01

    目的 观察痉挛性斜颈对神经源性吞咽障碍患者康复预后的影响及不同治疗方法的疗效比较.方法 选取神经源性吞咽障碍患者103例,其中伴有痉挛性斜颈患者82例,采用随机数字表法分为单纯训练组(21例,仅给予常规吞咽康复训练)、药物训练组(21例,给予常规吞咽康复训练及药物治疗)、支持训练组(20例,给予常规吞咽康复训练及一般性支持治疗)及联合治疗组(20例,给予常规吞咽康复训练、药物及一般性支持治疗),余21例无痉挛性斜颈的神经源性吞咽障碍患者则归入无斜颈组(给予常规吞咽康复训练).于治疗前、治疗2个月对各组患者吞咽功能改善情况进行评定.结果 治疗前药物训练组、支持训练组、联合治疗组和单纯训练组吞咽功能均显著低于无斜颈组(P<0.05);各组患者分别经2个月治疗后,发现5组患者吞咽功能均较治疗前显著改善(P<0.05),其中药物训练组、支持训练组、联合治疗组和无斜颈组吞咽功能均显著优于单纯训练组(P<0.05);联合治疗组吞咽功能亦显著优于药物训练组及支持训练组(P<0.05);联合治疗组和无斜颈组吞咽功能组间差异无统计学意义(P>0.05).结论 痉挛性斜颈能影响神经源性吞咽障碍患者吞咽功能恢复,对痉挛性斜颈进行治疗可明显提高神经源性吞咽障碍患者吞咽功能.%Objective To observe the influence of spasmodic torticollis on the rehabilitation prognoses of patients with neurogenic dysphagia.Methods One hundred and three dysphagic patients were recruited,of which 82 had spasmodic torticollis and 21 did not.The subjects with spasmodic torticollis were divided randomly into a medication therapy group (21 cases) which accepted medication plus swallowing training,a common therapy group (20 cases) accepting common support treatment plus swallowing training,a combined therapy group (20 cases) accepting common support treatment

  19. 小趾展肌神经与神经源性跟痛症关系的解剖学基础%Anatomic relationship of abductor digiti miniini nerve and neuragenic painful heel syndrome

    冯成安; 孙俊; 刘宗良; 范炜; 张东葵; 陆地

    2012-01-01

    目的 探讨小趾展肌神经的局部解剖特点及其与神经源性跟痛症的关系,为临床诊断治疗提供解剖学依据.方法 32侧防腐成人尸体下肢标本,解剖观察小趾展肌神经的起源、分支、走行和分布特点.结果 小趾展肌神经81.25%起源于足底外侧神经,起点59.38%位于后上象限;起点与参考线的垂直深度,左侧( 10.81±0.96)mm,右侧(10.24±1.10)mm;小趾展肌神经发出1~3支骨膜支到达跟骨结节内侧突的骨膜;小趾展肌神经与跟骨结节内侧突该的水平距离左侧(19.95±1.82)mm,右侧(20.89±2.48)mm.结论 小趾展肌神经行经(足母)展肌和足底方肌内侧头之间,跟骨结节内侧突前可能被卡压,卡压或病变(特别是骨膜支)可能与足底腱膜炎发生有关;跟骨骨刺不一定会造成神经源性跟痛症.%Objective To investigate anatomic relationship between abductor digiti minimi nerve (ADMN) and neurogenic painful heel syndrome (NPHS) for clinical diagnosis and therapy. Methods 32 fixed adult lower limb specimens were used in the study. The ADMN was dissected for observing it's origin, course, branches and distribution. Results For cases of 81.25%, ADMN originated from the lateral plantar nerve, which consisted of 19 trunks (59.38%) located in the postcrosuperior quadrant. The vertical depth of the origin site to the reference line was (10.81±0.96)mm and (10.24±1.10) mm at left and right sides respectively. ADMN firstly issued 1-3 periosteum branches, which arrived the periosteum of medial process of calcaneal tuberosity. The horizontal distances from the site of medial process of calcaneal tuberosity to the left or right tuberosities were (19.95*1.82) mm and (20.89 ±2.48)mm, seperately. Conclusions ADMN is probably stamped when it goes through the abductor hallucis, the medial head of quadratus plantae and the medial process of calcaneal tuberosity. The stamp or lesion of ADMN (especially periosteum branch) is probably

  20. Disfonias: relação S/Z e tipos de voz Dysphonias: S/Z ratio and types of voice

    Carla Aparecida Cielo

    2008-12-01

    Full Text Available OBJETIVO: verificar o resultado da relação s/z e do tipo de voz em pacientes com diagnóstico de disfonias orgânico-funcionais (DOF e disfonias funcionais por uso incorreto da voz (DFUIV, bem como a ocorrência das diferentes patologias dentro das DOF. MÉTODOS: 70 indivíduos, de ambos os sexos, entre cinco e 65 anos de idade, atendidos numa clínica-escola, cadastrados em Banco de Dados, entre 1998 e 2006, com DOF e DFUIV, ambos classificados em três subgrupos: casos em que a relação s/z indicava hipercontração, normalidade, e falta de coaptação das pregas vocais durante a fonação. Os tipos de voz foram classificados conforme a ocorrência em: sem alteração; ruidosa; ruidosa, comprimida e/ou apresentando alteração de f0h; ruidosa e/ou apresentando alteração de f0h; e comprimida. RESULTADOS: ocorrência significativa de DOF e de DOF com nódulos vocais; nas DOF e DFUIV, ocorrência significante de relação s/z normal com tempos isolados de /s/ e /z/ abaixo do normal e voz ruidosa. CONCLUSÕES: O resultado da relação s/z foi estatisticamente significativo a favor da faixa de normalidade estabelecida, tanto nos pacientes com diagnóstico de DOF, quanto naqueles com DFUIV, sendo que, em ambos os grupos de pacientes, a voz ruidosa foi a mais freqüente. Dentro das DOF, os nódulos vocais foram significativamente mais freqüentes do que as demais patologias.PURPOSE: to check the result of s/z ratio and types of voice in patients with diagnosis of organic-functional dysphonias (DOF and functional dysphonias by incorrect use of voice (DFUIV, as well as the occurrence of the various pathologies within the DOF. METHODS: 70 subjects of both genders, between 5 and 65 years old, seen in a clinic-school, registered in a data bank from 1998 to 2006, with DOF and DFUIV, both classified in three sub-groups: cases in which the s/z ratio indicated hypercontraction, normality and lack of coaptation of the vocal folds during phonation

  1. Comparação do corticoide inalatório e oral no tratamento da disfonia aguda Use of inhaled versus oral steroids for acute dysphonia

    Andréa Moreira Veiga de Souza

    2013-04-01

    Full Text Available A disfonia aguda é um quadro comum na prática clínica. Seu tratamento, principalmente em adultos, não é bem definido na literatura. O corticoide é o tratamento medicamentoso mais recomendado. Os estudos existentes, entretanto, não são suficientes para a determinação da superioridade entre diferentes corticoides e a melhor forma de administração. OBJETIVO: Este estudo clínico prospectivo teve como objetivo comparar o efeito do corticoide inalatório na forma de pó seco com o efeito do corticoide oral, no tratamento da disfonia aguda. MÉTODO: Foram avaliados 32 pacientes adultos, divididos em dois grupos de 16 pacientes para cada um dos tratamentos, antes e após sete dias do uso da medicação. Os pacientes foram submetidos à videolaringosocpia e avaliação perceptiva e acústica da voz. RESULTADOS: O tratamento inalatório e oral reduziram significativamente a hiperemia, o edema e melhorou o movimento muco-ondulatório; entretanto, a redução do edema foi estatisticamente mais significativa (p = 0,012 nos pacientes tratados com a forma inalatória. A comparação dos valores da análise perceptiva auditiva e das medidas acústicas após tratamento entre os grupos, entretanto, não apresentou significância estatística. CONCLUSÃO: Houve melhora significativa da laringite aguda nas avaliações realizadas, em todos os pacientes estudados, com os dois tratamentos. O tratamento com corticoide inalatório foi significativamente mais efetivo na redução do edema.Acute dysphonia is a frequent condition in clinical practice. Its treatment, especially in adults, is not well established in the literature. Steroids are the most recommended drug treatment. However, the existing studies are not enough to establish superiority among the different steroids and the best route of administration. OBJECTIVE: This prospective clinical study aimed at comparing the effect of inhaling steroids as a dry powder with the effect of oral steroids to

  2. The Effectiveness of Voice Training for 30 Patients with Functional Dysphonia%嗓音训练治疗30例功能性嗓音障碍的疗效观察

    谭嘉升; 祁斌时; 刘中良

    2014-01-01

    Objective To observe the effectiveness of voice training for patients with functional dysphonia.Methods The voice therapy (voice health education, improvement of respiration and resonance enhancement) was performed for 30 patients who were diagnosed with functional dysphonia. The patients were assessed before and after the treatment to observe the effectiveness.Results The voice handicap index(VHI) decreased from 67.8±10.1 to 30.7±8.2 after the voice training and the difference was significant(P<0.01). The functional, physiological and emotional scores decreased significantly after the training. The maximum phonation time(MPT) increased significantly from 9.2±2.6 s to 13.5±3.1 s, jitter decreased was from 0.59%±0.07% to 0.42%±0.05%,shimmer decreased from 2.23±0.45 to 1.78±0.27 and noise-to-harmonic ratio (NHR) decreased from 0.185±0.088 to 0.142±0.065,all showing significant differences(P<0.05).Conclusion Voice training can effectively reduce the severity of voice dysphonia and enhance the voice quality of patients with functional dysphonia. This therapy can also improve the communicative and emotional skills of the patients so that they will be confident in daily communication.%目的:观察嗓音训练治疗功能性嗓音障碍的疗效。方法对30例诊断为功能性嗓音障碍的患者进行嗓音治疗(嗓音卫生教育、改善呼吸及增强共鸣),并在治疗前后进行评估。结果30例功能性嗓音障碍患者接受训练后嗓音障碍指数值(Voice Handicap Index,VHI)由67.8±10.1分降至30.7±8.2分,差异有统计学意义(P<0.01),患者在功能、生理和情感上均有明显改善;同时最长发声时间(Maximum Phonation Time,MPT)由9.2±2.6秒延长至13.5±3.1秒,基频微扰由0.59%±0.07%降至0.42%±0.05%,振幅微扰由2.23±0.45降至1.78±0.27,噪谐比由0.185±0.088降至0.142±0.065,差异有统计学意义(P<0.05)。结论嗓音训练能够降低嗓音障碍程度,改善嗓

  3. Estudo epidemiológico de disfonias em crianças de 4 a 12 anos Epidemiological study of dysphonia in 4-12 year-old children

    Elaine Lara Mendes Tavares

    2011-12-01

    Full Text Available Estudos sobre disfonias infantis apontam incidência entre 4,4 a 30,3% das crianças. OBJETIVOS: Determinar a prevalência de disfonia em crianças, baseando-se nos julgamentos dos pais, nas ava-liações vocais perceptivas e acústicas, analisar sintomas associados, fatores de risco e achados vide-olaringoscópicos. CASUÍSTICA E MÉTODOS: Os pais de 2.000 crianças responderam questionário sobre qualidade vocal do filho. As crianças foram submetidas às avaliações vocais perceptiva, acústicas e videolaringoscopias. RESULTADOS: Participaram 1.007 meninos e 993 meninas. Sintomas esporádicos foram reportados por 206 pais e permanentes, por 123. Na avaliação perceptiva, o parâmetro G (Grau de disfonia recebeu escore 0 em 694 vozes, 1 em 1065 e 2 em 228. Houve diminuição de f0 com a idade e os demais parâmetros acústicos mostraram-se mais elevados nas crianças com escore de G em 2. Nas videolaringoscopias, destacaram-se nódulos, espessamentos e inflamação. CONCLUSÕES: O julgamento dos pais indicou prevalência de disfonia em 6,15%, e as análises perceptivas em 11,4%. Os sintomas vocais relacionaram-se à sobrecarga fonatória. Quadros nasossinusais, abuso vocal e ruído foram importantes fatores de risco. As análises acústicas mantiveram relação direta com as perceptivo-auditivas. Lesões laríngeas foram detectadas nas videolaringoscopias, destacando nódulos, espessamentos e inflamação.Children dysphonia studies have reported an incidence of 4.4 to 30.3%. GOALS: To establish the prevalence of dysphonia in children, based on the opinion of the parents, acoustic and vocal-perceptual assessments, associated symptoms, risk factors and videolaryngoscopy findings. MATERIALS AND METHODS: The parents from 2,000 children answered a questionnaire about the vocal quality of their children, and these children were submitted to perceptual vocal, acoustic and videolaryngoscopy assessments. RESULTS: We had 1,007 boys and 993 girls

  4. A Qualitative Study of Interference with Communicative Participation across Communication Disorders in Adults

    Baylor, Carolyn; Burns, Michael; Eadie, Tanya; Britton, Deanna; Yorkston, Kathryn

    2011-01-01

    Purpose: To explore the similarities and differences in self-reported restrictions in communicative participation across different communication disorders in community-dwelling adults. Method: Interviews were conducted with 44 adults representing 7 different medical conditions: spasmodic dysphonia, multiple sclerosis, stroke, stuttering,…

  5. Considerações teóricas sobre a relação entre respiração oral e disfonia Theoretical considerations on the relationship between mouth breathing and dysphonia

    Juliana Gomes Tavares

    2008-01-01

    Full Text Available Sabe-se que a respiração oral pode ocasionar diversas alterações ósseas, posturais, musculares e funcionais, como também, alterações na qualidade e/ou comportamento vocal. Estas alterações podem comprometer a comunicação oral, na qual a voz não consegue desempenhar seu papel básico de transmissão da mensagem verbal e emocional do indivíduo. O indivíduo com respiração oral pode apresentar ressonância nasalizada e a voz pode apresentar alterações no traço de sonoridade, hiper ou hiponasal, ou rouca. A partir de pesquisa nas bases de dados LILACS, SciELO, livros, revistas especializadas sobre o tema, buscamos fazer uma revisão na literatura sobre a relação entre respiração oral e disfonia, analisando a influência das alterações causadas pela respiração oral na qualidade e/ou comportamento vocal. No entanto, foi possível observar que a respiração oral promove uma série de alterações estruturais significativas que refletem nas funções estomatognáticas, interferindo também na fonação. Contudo, poucos autores relatam a possível correlação entre esses dois parâmetros (respiração oral e disfonia.It is known that mouth breathing can lead to several bone, postural, muscular and functional alterations, and also changes on vocal quality and/or vocal behavior. These alterations can compromise oral communication, in which the voice cannot perform its basic role on the transmission of an individual's verbal and emotional message. Individuals with mouth breathing can present hiper or hiponasal resonance, changes on voicing features and hoarseness. From researches on LILACS and SciELO databases, books and specialized magazines about the subject, it was carried a literature review about the relationship between mouth breathing and dysphonia, analyzing the influence of alterations caused by mouth breathing on vocal quality and/or vocal behavior. It was possible observe that mouth breathing promotes several

  6. The Voice Aerodynamic Analysis of 21 Patients with Muscular Tension Dysphonia%肌紧张性发声障碍患者发声空气动力学特点分析

    张碧茹; 龚坚; 郑亿庆; 梁茂金; 彭解人

    2010-01-01

    目的 分析肌紧张性发声障碍(muscular tension dysphonia,MTD)患者发声空气动力学特性,探讨该方法在MTD诊治中的应用价值.方法 采用言语发声空气动力学测试系统分别测量21例肌紧张性发声障碍患者及20例正常成人舒适发声时的声门下压、声门阻力、平均气流率及最长声时,并进行统计学分析.结果 与正常成人比较,MTD患者声门下压和声门阻力升高,平均气流率下降.最长声时缩短,差异有统计学意义(P<0.05或0.01).结论 空气动力学分析能有效评估MTD患者的发声功能,可用于MTD疾病的诊断和疗效观察.

  7. The Application of Dysphonia Severity Index to Patients with Vocal Cord Polys%声带息肉患者的嗓音障碍客观指数测定

    毛兔峰; 王一鸣; 王建波; 滕尧树

    2012-01-01

      目的研究嗓音障碍客观指数(dysphonia severity index,DSI)测试在声带息肉患者嗓音分析中的临床应用.方法对31例声带息肉患者和12例正常受试者分别进行主观自我评估和客观嗓音声学检测.主观自我评估采用嗓音障碍指数(voice handicap index,VHI)量表进行评估,客观声学检测采用德国XION公司生产的嗓音分析软件DiVAS进行测试.结果声带息肉患者组DSI均低于正常对照组,差别有统计学意义(P<0.05);VHI高于正常对照组,结果具有统计学差异(P<0.05).声带息肉患者的DSI与VHI之间没有显著相关性.结论嗓音障碍客观指数(DSI)能够客观评估声带息肉患者的嗓音障碍程度.%10.3969/j.issn.1672-4933.2012.05.005

  8. 足内侧跨供区(姆)展肌肌皮瓣重建大鱼际缺损的临床研究%Reconstruction of thenar eminence defects using modified medial pedis flap combined with abductor hallucis muscle transfer

    李涛; 郑怀远; 陈振兵; 丛晓斌; 洪光祥

    2013-01-01

    Objective To explore the surgical technique of functional myocutaneous flap transfer for reconstruction of the appearance of the thenar eminence and thumb opposition,and to improve the design and harvest of medial pedis myocutaneous flap.Methods From November 2010 to January 2012,6 cases with skin and muscle defects of the thenar eminence were treated by modified medial pedis flap combined with abductor hallucis muscle transfer using microsurgical techniques.Functional exercises and physical therapy were initiated 3 weeks postoperatively.Electromyogram (EMG) of the thenar muscles was performed at 6 and 12 months after the transfer.Grip strength,pinch strength,British Medical Research Council (BMRC) muscle strength and sensory recovery grading were performed during the follow-up periods.Results Flaps in all cases survived well.The appearance of the flaps was similar to the normal skin of the hand.All cases had more than 12 months' followup.In all cases,voluntary abduction of the thumb by the transferred abductor hallucis was achieved and confirmed by EMG.EMG of the thenar muscles at 6 months showed a mixed pattern upon maximum voluntary contraction and an interference pattern at 12 months.Pain and touch perception returned at 6 months,while twopoint discrimination was 7.5 to 11.2 mm (mean,7.9 mm) at 12 months.BMRC sensory grading was S3+,while muscle power recovery was M3 to M4.Conclusion As a new myocutaneous flap,the modified medial pedis flap combined with abductor hallucis muscle transfer is effective for repairing thenar eminence defects.The flap had not only good appearance and sensory reinnervation,but also the transplanted hallucis abductor muscle results in satisfactory opposition function of the thumb once it is innervated.%目的 探索肌皮瓣动力重建大鱼际缺损的手术方式,改进足底内侧肌皮瓣的设计和切取方法,更好地重建大鱼际缺损区的逼真外形和对掌功能.方法 自2010年11月至2012年1月,游离移植足

  9. Observation of the dysphonia severity index in evaluating curative effect of vocal cord polyp surgery%嗓音障碍严重指数评价声带息肉手术疗效的研究

    周舟; 葛平江; 刘倩; 刘明; 张伟

    2015-01-01

    目的 应用嗓音障碍严重指数(dysphonia severity index,DSI)对声带息肉患者手术治疗效果进行评估,讨论DSI评估嗓音障碍程度的有效性和可靠性.方法 本研究选取正常人(34名)与声带息肉患者(70例),分别进行嗓音障碍指数(voice handicap index,VHI)评估、GRBAS评分、纤维电子喉镜检查,测量最大声时(maximum phonatory time,MPT)、jitter、shimmer及DSI值.运用方差分析DSI值在两组及手术前后组间的差异,并用VHI、GRBAS评分、shimmer与DSI值做相关性分析.结果 70例患者术前DSI值均值为(-2.92±1.59),术后均值(1.87±1.33),正常组均值为(2.30±2.16),术前与术后的DSI值,以及正常组与患者术前DSI均值比较差异均有统计学意义(P<0.05).通过Pearson相关分析,得到DSI值与VHI值(r=-0.632),G值(r=-0.740),R值(r=-0.756),shimmer(r=-0.500)之间有相关关系(P<0.01).结论 DSI可有效地评估声带息肉患者的病理嗓音障碍程度,可作为一个独立使用的评估嗓音障碍程度的多参数方法,并可对声带息肉的手术疗效进行客观评价.%Objective To investigate the applicability of the eysphonia severity index (DSI) in evaluating effects of surgery between before and after groups of vocal polyp patients.Methods Analyses of measurement data pre and pro-surgery of 70 vocal polyp patients and 35 no voice disorders volunteers(control group).The voice quality was measured subjectively with the voice handicap index(VHI),the GRBAS and fiber electronic laryngoscopy.Measures of maximum phonation time (MPT),shimmer and jitter were obtained for each subject by using DiVAS 2.30 (XION,Germany).The DiVAS 2.30 had spotanenously calculate the scores of DSI.Using SPSS 17.0 to find the differences of DSI scores among the three groups by one-way ANOVA variance analysis.And finding out of the correlation with DSI scores and VHI scores,GRBAS,MPT,jitter and shimmer.Results DSI improved significantly after surgery in the vocal polyps

  10. Clinical Characteristics and Acoustics Evaluation in Patients with Muscular Tension Dysphonia%肌紧张性发声障碍的临床特征及嗓音声学评估

    徐洁洁; 陆美萍; 陈曦; 王娟

    2008-01-01

    目的 观察肌紧张性发声障碍(muscular tension dysphonia,MTD)患者的临床特点,探讨喉镜检查及计算机嗓音声学检测技术在此类发声障碍诊断中的应用价值.方法 观察46例MTD患者发声特点及颈部体征,采用电子喉镜和计算机嗓音声学测试系统对46例MTD患者和40例正常成人进行检查.分析评估MTD患者临床表现、喉镜图像及嗓音声学特征.结果 MTD患者发声呈过强、挤压、粗糙、嘶哑等特点;发声时呼吸表浅、颈部肌肉紧张、颈静脉怒张、喉结上移.喉镜显示喉腔缩小、声门前后径缩短、声门暴露差等,声带外观正常,张力增加,闭合过紧,假声带代偿性内收.嗓音声学检测显示患者嗓音具有正常和病理声学特征交替出现的特点.其特征为频率微扰(jitter)、振幅微扰(shimmer)数值较正常升高(P0.05),声谱图高频区谐波及第2、3共振峰不规则、不连续、波纹抖动或消失.结论 MTD患者发声过强及颈部肌肉紧张.喉镜检查声门过度闭合、声带正常.能检测到正常jitter、shimmer,NNE及声谱图.

  11. 早期声带息肉患者嗓音障碍调查与对策%Investigation of subjective and objective dysphonia on patients with early vocal cord polyp and corresponding nursing interventions

    姜宇英; 王珊; 诸葛盼; 尤慧华

    2015-01-01

    目的 了解早期声带息肉患者主客观嗓音障碍的临床特征,为进一步实施综合干预,改善患者的发音质量提供依据.方法 对实验组66例早期声带息肉患者及对照组31例健康志愿者进行动态喉镜检查;应用中文版嗓音障碍指数量表(Voice Handicap Index,VHI)评估主观嗓音障碍,包括功能(F)、生理(P)、情感(E)3部分,计算总分(T);应用DiVAS嗓音分析软件分析最长发声时间(maximum phonation time,MPT)、基频微扰(Jitter)、最高基频(highest frequency,F0-High)、最低音强(lowest intensity,I-Low),计算嗓音障碍严重指数(Dysphonia Severity Index,DSI)评估客观嗓音障碍.结果 实验组15例(22.7%)患者存在声门闭合不全,而对照组为2例(6.5%).独立样本t检验结果显示,实验组与对照组间E、F、P、T差异存在统计学意义(t值分别为2.31,P值<0.05;3.79、8.55、5.02,P值均<0.01);2组MPT、Jitter、I-Low、DSI差异存在统计学意义(t值分别为-7.86、3.97、4.20、-9.22,P值均<0.01).结论 动态喉镜、VHI、DSI可以反应出早期声带息肉患者嗓音障碍特征,医护人员应根据患者嗓音障碍的临床特征,进行嗓音的健康教育及心理疏导,进而改善患者的发音质量.

  12. Clinical study of the influence of laryngopharyngeal reflux on quality of life in patients with dysphonia%咽喉反流对嗓音疾病患者生活质量影响的临床研究

    王宇光; 张立红; 余力生; 李晶兢; 李进让; 赵一馨; 曹杰

    2015-01-01

    definitely.2 643 volunteers were recruited to fill in the RSI scale through physical examination, outpatient , the ward and web survey.Results 46.46% (59/127) patients were diagnosed with LPR definitely.1 241 of 2 643 volunteer, who filled in the RSI, score more than zero in the first entry of hoarseness or dysphonia, 65.0% (807/1 241) of them, scoring 13 points or higher, were diagnosed with clinically suspected LPR.Based on the 24-hour ambulatory double pH monitoring, VHI total scores and subscores in the emotional domains were higher in positive group than in negative group.There was no statistical difference (P > 0.05) in functional and physical domains.The SF-36 scale was used to evaluate the quality of life of the patients.The difference of 6 dimensionality, scoreshad statistical significance(P < 0.05) , including role-physical, general health, validity, social function, role-emotional and mental health.There was no statistical difference in dimensionalities of rolephysical and bodily pain.Conclusions The volunteers who were diagnosed with hoarseness or dysphonia had the higher morbidity rate of LPR.At the time of treatment, more attention should be paid to the quality of life.

  13. Vertebrobasilar Dolichoectasia Presented with Dysphagia and Dysphonia: a Report of Two Cases%以吞咽困难和言语含糊为表现的椎基底动脉延长扩张症2例报告及文献复习

    黄纯臣; 王钦; 马昱; 毛悦时; 刘骏桢; 张宇浩

    2012-01-01

    Objective: To improve the understanding of vertebrobasilar dolichoectasia (VBD). Methods: The clinical features,imaging findings,diagnosis,treatment and follow-up data of two cases of VBD presented with dysphagia and dysphonia were analyzed retrospectively,and the literatures were reviewed. Results; As a cerebrovascular disease,the main characteristics of VBD were the marked elongation,widening and tortuosity of the intracranial vertebral and basilar arteries. The clinical manifestations of VBD included not only cerebral ischemia or hemorrhage of brainstem,subarachnoid hemorrhage,compression symptoms of brainstem and hydrocephalus,but also dysphagia and dysphonia. The diagnosis of VBD mostly depended on imaging examinations. The treatment of VBD was still unclear,and anticoagulation therapy might be effective for some patients,but the risk of bleeding must be noticed. Conclusion: The VBD mainly presenting with dysphagia and dysphonia is easily misdi-agnosed and missed. Enough attention should be payed to this type of VBD.%目的:通过个案报告及文献复习,企盼提高对椎基底动脉延长扩张症(vertebrobasilar dolichoectasia,VBD)的认识.方法:分析2例以吞咽困难和言语含糊为主要表现的VBD患者的临床资料并复习相关文献.结果:VBD是一种以椎基底动脉的增长、增粗及扭曲为主要特点的脑血管病,其临床表现除了脑干缺血或出血、蛛网膜下腔出血、脑干压迫所引起的症状以及脑积水以外,还包括吞咽困难和言语含糊.VBD的诊断主要依靠影像学检查,目前尚无理想的治疗方法,抗凝治疗对部分患者可能有效,但有出血风险.结论:以吞咽困难和言语含糊为主要表现的VBD易被误诊和漏诊,临床医师应注意提高对VBD的认识.

  14. A型肉毒毒素治疗痉挛性发音障碍

    胡兴越; 范正刚; 蒋红; 章士正; 邵宇权

    2002-01-01

    @@ 痉挛性发音障碍(spasmodic dysphonia,SD)又称局灶性喉肌肌张力障碍(focal laryngeal dystonia)为一种中枢运动信息处理程序障碍所致的慢性神经系统疾病,以讲话诱发声带痉挛为特征,表现为讲话时痉挛性发音.

  15. 痉挛性发音障碍的临床特征

    杨扬; 王丽萍

    2006-01-01

    痉挛性发音障碍(spasmodic dysphonia,SD)是耳鼻咽喉科的疑难病之一,发病率有逐渐上升的趋势.本文总结分析了国内、外近5年来的研究成果,主要对SD的临床特征、评价标准进行了详述.

  16. Tardive Dystonia: Clinical Spectrum and Novel Manifestations

    R. Jeffrey Davis

    1988-01-01

    Full Text Available Tardive dystonia was identified in 25 patients: involvement of the face and neck was most common; truncal and limb dystonia were also observed. There were 3 cases of laryngospasm and 2 of spasmodic dysphonia. The latter has not been previously reported as a manifestation of tardive dystonia. In all cases, movements typical of classic tardive dyskinesia could be demonstrated. This group illustrates the variety of dystonic disorders that may occur in conjunction with tardive dyskinesia.

  17. Eccentric training for shoulder abductors improves pain, function and isokinetic performance in subjects with shoulder impingement syndrome: a case series Treino excêntrico para abdutores do ombro melhora dor, função e desempenho isocinético em sujeitos com síndrome do impacto: série de casos

    Paula R. Camargo

    2012-02-01

    Full Text Available BACKGROUND: Conservative treatments have been proposed for people with shoulder impingement syndrome (SIS, such as strengthening of the rotator cuff and scapular muscles and stretching of the soft tissues of the shoulder. However, there is a lack of studies analyzing the effectiveness of eccentric training in the treatment of SIS. OBJECTIVES: To evaluate the effects of eccentric training for shoulder abductors on pain, function, and isokinetic performance during concentric and eccentric abduction of the shoulder in subjects with SIS. METHODS: Twenty subjects (7 females, 34.2 SD 10.2 years, 1.7 SD 0.1 m, 78.0 SD 16.3 kg with unilateral SIS completed the study protocol. Bilateral isokinetic eccentric training at 60º/s for shoulder abductors was performed for six consecutive weeks, twice a week, on alternate days. For each training day, three sets of 10 repetitions were performed with a 3-minute rest period between the sets for each side. The range of motion trained was 60° (ranging from 80° to 20°. The Disabilities of the Arm, Shoulder and Hand (DASH questionnaire was used to evaluate functional status and symptoms of the upper limbs. Peak torque, total work and acceleration time were measured during concentric and eccentric abduction of the arm at 60º/s and 180º/s using an isokinetic dynamometer. RESULTS: DASH scores, peak torque, total work and acceleration time improved (pCONTEXTUALIZAÇÃO: Tratamentos conservadores têm sido propostos para pessoas com síndrome do impacto (SI do ombro, como fortalecimento do manguito rotador e dos músculos escapulares e alongamento dos tecidos moles do ombro. No entanto, são escassos os estudos que analisaram a eficácia do treinamento excêntrico no tratamento da SI. OBJETIVOS: Avaliar os efeitos do treinamento excêntrico para abdutores do ombro na dor, função e desempenho isocinético durante a abdução concêntrica e excêntrica do ombro em indivíduos com SI. MÉTODOS: Vinte indivíduos (sete

  18. Articulatory changes in muscle tension dysphonia:Evidence of vowel space expansion following manual circumlaryngeal therapy%肌紧张性发声障碍患者的言语改变:喉部手法治疗后元音间距延长

    Roy N; 王刚

    2010-01-01

    @@ 肌紧张性发声障碍(muscle tension dysphonia,MTD)是一种与喉及喉外肌肉张力过强有关的发声障碍,不但影响发声质量,同时也影响发音清晰度.目前,尽管其机制尚不明确,但大量临床资料证据显示,言语矫治可使原发性MTD患者的发声质量得到快速而持久的改善.本研究通过元音声学参数测量探讨喉部手法治疗对MTD患者元音发音清晰度改善的效果.

  19. Closing and opening phase variability in dysphonia

    Fourcin, A; Ptok, M.

    2003-01-01

    Four examples of the use of vocal fold contact phase measurement are discussed for unilateral paresis. In each case this aspect of voice quality is of greater importance than the physical measurement of loudness and pitch related parameters. For three of the cases electro-stimulation has been used as a main part of the treatment. Phonation in both connected speech and, for comparison, in sustained sound production has been used with electro-laryngograph / egg signals providing the basis for m...

  20. Brain mechanism of semantic processing by native Chinese speaker with dysphonia%母语为汉语者言语障碍的语义加工及其脑区机制

    赵鸣; 杨亦鸣; 王梅; 刘红; 方环海; 方环非

    2007-01-01

    BACKGROUND:The brain mechanism of semantic processing is one of the focus problems in cognitive neuroscience.With the research technologies plentiful and diversified, the brain mechanism of semantic processing is gradually distinct.However, at present, the related researches on Chinese semantic processing are not enough. The brain mechanism of semantic processing by Chinese language obstacle should be studied more deeply.OBJECTIVE: To further identify the neuropsychological significance of clinical diagnosis, treatment and rehabilitation by concluding the study fruits on the brain mechanism of semantic processing by native Chinese speaker with dysphonia and analyze the relationship between the related brain mechanism and the local brain system of semantic processes as well as brain anatomical parts.RETRIEVE STRATEGY: The retrieve staffs are the research personnel for this paper. The range of retrieve time focuses since 1984. A computer-based online search was conducted in CNKI for literatures related to basic neuropsychology and its clinical application published between January 1994 and May 2006, in Elsevier for articles between January 1984 and May 2006, in Academic Source Premier and MEDLINE of EBSCOhost for studies between January 1984 and May 2006 with the key words of "semantic processing", and the language was limited to English. Meanwhile, relevant data were searched manually. The number of total retrieved articles was 264, among which 43 enrolled studies were in accordance with the inclusion criteria and excluded articles involving semantic processing or encephalic region but without their relationship. The unpublished articles were only used for references LITERATURE EVALUATION: The literatures are selected from related works, collected analyses, reports from single case or research. Evaluated persons are related research staffs.DATA SYNTHESIS: Processing of Chinese semantic relied primarily on the left superior temporal region, middle temporal gyrus, the

  1. The Effects of Phonosurgery Combined with Voice Therapy for Vocal Polyps Accompanied with Muscle Tension Dysphonia%手术联合嗓音训练对伴肌紧张性发声障碍声带息肉患者的疗效分析

    高晓葳; 黄永望; 刘丽燕; 李超; 牛俊涛; 傅德慧; 欧阳杰

    2015-01-01

    Objective To evaluate the effects of phonosurgery combined with voice therapy in patients with vocal polyps accompanied with muscle tension dysphonia (MTD) .Methods The study retrospectively enrolled 117 patients with a diagnosis of vocal polyps accompanied with MTD .All the patients were divided into two groups ac‐cording to the different remedies:the surgery group (n=57) ,and the combination group (n=60) .The Xion acous‐tic analysis was carried out on the two groups before and after therapy .We compared the results in each group ,the results of post-therapy between two groups ,and that of post-therapy with the control group(n=50) .The acous‐tic parameters were jitter percent (jitter) ,shimmer percent (shimmer) ,dysphonia severity index (DSI) .Results The results obtained in the study showed that all the voice analysis parameters were significantly improved after therapy in both the surgery group and combination group(P0 .05) .Conclusion As for vocal polyps accompanied with M TD ,successful phonosurgical treatment and voice therapy can improve patients’ voice quality .%目的:探讨手术联合嗓音训练对伴肌紧张性发声障碍声带息肉患者的疗效。方法117例伴肌紧张性发声障碍的声带息肉患者分为单纯手术组(手术组,57例)和手术联合嗓音训练组(联合组,60例),另随机选取50例无嗓音疾患的正常人作为正常对照组。采用Xion声学分析软件对正常对照组及手术组、联合组患者治疗前后的嗓音基频微扰(jitter)、振幅微扰(shimmer)、嗓音障碍指数(DSI)进行测试并比较。结果手术组、联合组治疗后jitter和shimmer值均较治疗前明显降低,DSI明显升高(P<0.05),而联合组的jitter和shimmer值更低,DSI值更高(P<0.05);手术组治疗后的jitter和shimmer值高于正常组,DSI值低于正常组(P<0.05);联合组治疗后jit‐ter和shimmer与正常组比较

  2. 声带息肉患者手术前后VHI量表主观评估和 DSI 嗓音检测结果分析%The Significance of the Self -assessments of Voice Handicap Index and the Detection of Dysphonia Severity Index in Polyp of Vocal Cord

    张武宁; 唐安洲; 徐志文; 吴铖林; 李永湘; 钟晖; 毛海燕

    2013-01-01

    Objective To explore the significance of the Self -assessments of Voice Handicap Index (VHI) and The objective detection of Dysphonia Severity Index (DSI) in polyp of vocal cord perioperatively .Methods The Self -assessments of VHI had been completed in 28 patients with polyp of vocal cord before the operation and one week after the operation ,including function(F) ,physiological(P) ,emotion(E) ,and the sum denoted by T .In the meantime ,The DSI had been completed in these patients by acoustic analysis of DIVAS 2 .5 .After one month ,19 pa-tients had been re -examined .Results The DSI value was increasing ,but there was no significant difference be-tween pre-operation and one week after the operation(P>0 .05) ,indicating that the function of vocal cord was not recovered .In VHI scale ,the parameters were significantly different between the time preoperatively and one week postoperatively in F ,E and T(P0 .05) ,indicating that the function of vocal cord was not completely recovered as same as the result of DSI .After one month ,there were significant differences in DSI and VHI ,which showed a full recovery of vocal cord fanction .Conclusion The Self -assessments of VHI and The objective detection of DSI in polyp of vocal cord can evaluate simultaneouly the function of laryngeal .Additionally ,there was a good correlation between the DSI and the VHI score .%目的探讨声带息肉患者手术前后嗓音障碍指数(voice handicap index ,VHI)量表自我评估和嗓音障碍严重指数(dysphonia severity index ,DSI)评估的价值。方法对28例声带息肉患者手术前及手术后1周、术后1月(19例)进行VHI量表自我评估,并运用DIVAS2.5声学分析软件评估DSI ,分析其结果。结果与术前比较,声带息肉患者术后1周DSI值升高,但差异无统计学意义(P>0.05);VHI量表中,功能F、情感E、总分T得分较术前降低,差异有统计学意义(P<0.05),而生理P得分

  3. 单侧声带麻痹患者的嗓音主观RBH评估与DSI的相关性研究%Correlation Between Dysphonia Severity Index (DSI) and Voice Perceptual Evaluation RBH System in Patients with Unilateral Vocal Cord Paralysis

    李燕; 郑宏良

    2012-01-01

    目的:探讨嗓音主观RBH 评估与发音障碍严重指数(dysphonia severity index,DSI) 用于单侧声带麻痹患者的临床意义及其相关性,并进一步验证DSI 的实用性.方法:对45 例单侧声带麻痹患者( 患者组) 及13 例嗓音正常人( 对照组) 进行主观RBH 评估和DSI 测定.主观RBH 评估分四个等级;DSI 测定由公式DSI=0.13×MPT+0.0053×F(0)-High-0.26×I-Low-1.18×Jitter(%)+12.4 计算得来,也分四个等级.比较单侧声带麻痹患者RBH 分级和DSI 分级间差异.结果:患者组的R、B、H 均高于对照组,差异有统计学意义(P<0.05) ;患者组DSI 的平均值0.35±0.74,而正常组的平均值为4.23±0.81,两组比较差异有统计学意义(P<0.05).单侧声带麻痹患者主观RBH 评估与DSI 分级之间相关性显著.结论:选择DSI 作为嗓音障碍评估的客观参数,应用于单侧声带麻痹患者具有较好的临床应用价值,其与主观评估参数R、B、H 具有很好的相关性.

  4. Laryngeal electromyography in movement disorders: preliminary data

    Kimaid Paulo A.T.

    2004-01-01

    Full Text Available This study describes preliminary laryngeal electromyography (LEMG data and botulinum toxin treatment in patients with dysphonia due to movement disorders. Twenty-five patients who had been clinically selected for botulinum toxin administration were examined, 19 with suspected laryngeal dystonia or spasmodic dysphonia (SD, 5 with vocal tremor, and 1 with Gilles de la Tourette syndrome (GTS. LEMG evaluations were performed before botulinum toxin administration using monopolar electrodes. Electromyography was consistent with dystonia in 14 patients and normal in 5, and differences in frequency suggesting essential tremor in 3 and Parkinson tremors in 2. The different LEMG patterns and significant improvement in our patients from botulinum toxin therapy has led us to perform laryngeal electromyography as a routine in UNICAMP movement disorders ambulatory.

  5. Qualidade de vida em voz: o impacto de uma disfonia de acordo com gênero, idade e uso vocal profissional Voice-related quality of life: the impact of a dysphonia according to gender, age and occupational use of voice

    Daniele de Souza Putnoki

    2010-12-01

    were observed for individuals with ages between 20 and 29 years (total 82.2; physical 77.8; socio-emotional 89.2. CONCLUSION: The self-reported impact of a vocal disorder in the quality of life was similarly noticed by men and women. The subjects aged between 20 and 29 years had different perceptions regarding the impact of dysphonia in their quality of life when compared to individuals of the other age ranges. Vocal disorders caused less impact on the quality of life of elite vocal performers.

  6. Praat软件及DSI对改良杓状软骨内收术治疗单侧声带麻痹的疗效评估%Objective Evaluation of Modified Arytenoid Adduction in the Treatment of Unilateral Vocal Cord Paralysis using Praat Software and Dysphonia Severity Index (DSI)

    吴红敏; 王伟; 郑宏良; 李玎; 李孟

    2011-01-01

    Objective To assess the effectiveness of modified arytenoid adduction in the treatment of unilateral vocal cord paralysis using Praat software and Dysphonia Severity Index (DSI). Methods Six-five vocal cord paralysis patients treated with modified arytenoid adduction were retrospectively studied between Feb 2001 and Dec 2010. Parameters including fundamental frequency (F0), intensity, NHR, jitter local,jitter local absolute,jitter ppq5,shimmer local,shimmer local dB, shimmer apq5,were compared before, 3 and 12 months after treatment using Praat software. DSI was also compared before, 3 and 12 months after treatment. Results F0, jitter local, jitter local absolute,jitter ppq5,shimmer local,shimmer local dB, shimmer apq5,NHR decreased significantly 3 and 12 months after surgery compared with those of before surgery(P<0. 05). There was no significant difference in intensity before, 3 and 12 months after surgery. DSI increased significantly3 and 12 months after surgery(P<0. 05), There was no significant difference in all the parameters between 3 and 12 months groups. Conclusion Modified arytenoid adduction, as a treatment for unilateral vocal cord paralysis, is of long-term stable results. Applcation Praat software and DSI for assessment of the treatment of voice disorder is effecive, convenient and reliable.%目的 探讨Praat软件及嗓音障碍严重程度指数(dysphonin severity index,DSI)对改良杓状软骨内收术治疗单侧声带麻痹疗效评估的意义.方法 65例单侧声带麻痹患者均于患侧行改良杓状软骨内收术.全部病例于手术前及术后3月、12月分别行DSI分析及以praat软件分析基频(fundamental frequency,F0)、声音强度(intensity)、噪谐比(NHR)、基频微扰[包括:局部基频微扰(jitter local)、局部绝对基频微扰(jitter local absolute)、基频微扰间期系数5(jitter ppq5)]、振幅微扰[包括:局部振幅微扰(shimmer local)、局部振幅微扰dB(shimmer local dB

  7. 嗓音训练前后对女性肌紧张性发声障碍患者发声空气动力学结果分析%Influence of Voice Therapy on Vocal Aerodynamic Characteristics in Female Patients with Muscular Tension Dysphonia

    梁发雅; 杨金珊; 蔡谦; 梅祥胜; 张碧茹; 王雅静; 关中; 龚坚; 彭解人

    2014-01-01

    目的 分析嗓音训练治疗女性肌紧张性发声障碍(muscular tension dysphonia,MTD)前后患者发声空气动力学的变化,探讨空气动力学检测对噪音训练治疗MTD疗效评估的意义.方法 对19例诊断为MTD的女性患者(病例组)进行12周嗓音训练,训练内容包括凸腹凹腹气息练习、凸腹控制膈肌练习、快速呼吸练习、放松舌根和喉部肌肉练习及诵读发声练习,于训练前、训练12周后采用言语发声空气动力学测试系统分别检测病例组的肺活量、舒适发声时的声门下压、空气动力能、平均气流率、声门阻力及最长声时,并与19例正常成年女性(对照组)进行对比分析.结果 病例组训练前的中位声门下压(10.80 cmH2O)、声门阻力[108.01 cm H2O/(Lit/Sec)]及空气动力能(0.15 watts)较正常对照组升高,中位肺活量(2.7 L)及最长声时(12.51 s)缩短,差异有统计学意义(P<0.05);训练12周后患者组中位声门下压(7.87 cmH2O)、声门阻力[67.25 cm H2 O/(Lit/Sec)]及空气动力能(0.08 watts)较训练前下降,中位肺活量(3.0 L)及最长声时(20.85 s)较训练前增加,差异有统计学意义(P<0.05);训练12周后病例组上述各指标与正常对照组相比差异均无统计学意义(P>0.05).结论 嗓音训练可降低MTD患者发声时的声门下压、声门阻力及空气动力能,增大肺活量,延长最长声时;通过发声空气动力学检测能定量评估嗓音训练治疗女性MTD的效果.

  8. Reliability and Applicability of Aerodynamic Measures in Dysphonia Assessment

    Yiu, Edwin M.-L.; Yuen, Yuet-Ming; Whitehill, Tara; Winkworth, Alison

    2004-01-01

    Aerodynamic measures are frequently used to analyse and document pathological voices. Some normative data are available for speakers from the English-speaking population. However, no data are available yet for Chinese speakers despite the fact that they are one of the largest populations in the world. The high variability of aerodynamic measures…

  9. Role of Laryngological Consultation in the Intervention of Dysphonia

    Stone, Ed.; And Others

    1978-01-01

    Described and provided is a laryngology consult form that has been found useful by speech therapists in obtaining information important to the diagnosis and management of children with voice disorders. (CL)

  10. EXTRA WORKING FACTORS IN DYSPHONIA PATHOGENESIS OF TEACHERS

    Salvatore Biondi; Luca La Manna; Carlo Sciacchitano; Maria Zappalà

    2007-01-01

    Objective: to estimate the incidence of teacher dysphonic disease in order to subsequently delineate prevention programs. Methods: a representative sample of teachers from different institutes in Catania, i.e. nursery, elementary, secondary and high school, were admitted to a test program. Results: The analysed cards were 379. 46-% of teachers frequently showed an alteration of the characters of the voice, 43% rarely showed it while only 11% did not show such alteration. The dysphonic disease...

  11. Isolated subglottic lymphoma: an interesting cause of dysphonia.

    Yardley, M P; Chui, P

    1993-01-01

    Isolated laryngeal lymphomas are exceedingly rare tumours: they tend to be greyish submucosal swellings and to respond well to radiotherapy. A case of subglottic lymphoma is presented, along with a review of previously reported cases of subglottic lymphomas. PMID:8461251

  12. Experimentally reduced hip abductor function during walking: Implications for knee joint loads

    Henriksen, Marius; Aaboe, Jens; Simonsen, Erik B; Alkjaer, Tine; Bliddal, Henning

    2009-01-01

    -dimensional trunk and lower extremity joint kinematics and kinetics. Surface electromyography (EMG) of the glutei, quadriceps, and hamstring muscles were also measured. The peak GM EMG activity had temporal concurrence with peaks in frontal plane moments at both hip and knee joints. The EMG activity in the GM...... muscle was significantly reduced by pain (-39.6%). All other muscles were unaffected. Peaks in the frontal plane hip and knee joint moments were significantly reduced during pain (-6.4% and -4.2%, respectively). Lateral trunk lean angles and midstance hip joint adduction and knee joint extension angles...... loads at the knee joint during level walking....

  13. Isolation of peridininol, an anti-spasmodic carotenoid pigment, from Zoanthus sp.

    Parameswaran, P.S.; Achuthankutty, C.T.

    as these compounds readily decompose in alkaline medium. Recently, a new method involving acetone-methanol extraction of powdered dry alga followed by chromatography over silica gel column and crystallization have been reported for isolation of these compounds...

  14. Magnetically Controlled Spasmodic Accretion During Star Formation. I. Formulation of the Problem and Method of Solution

    Tassis, K; Tassis, Konstantinos; Mouschovias, Telemachos Ch.

    2004-01-01

    We formulate the problem of the late accretion phase of the evolution of an isothermal magnetic disk surrounding a forming star. The evolution is described by the six-fluid MHD equations, accounting for the presence of neutrals, atomic and molecular ions, electrons, and neutral, positively, and negatively charged grains. Only the electron fluid is assumed to be attached to the magnetic field, in order to investigate the effect of the detachment of the ions from the magnetic field lines that begins at densities as low as 10^8 cm^-3. The "central sink approximation" is used to circumvent the problem of describing the evolution inside the opaque central region for densities greater than 10^11 cm^-3. In this way, the structure and evolution of the isothermal disk surrounding the forming star can be studied at late times without having to implement the numerically costly radiative transfer required by the physics of the opaque core. The mass and magnetic flux accumulating in the forming star arecalculated , as are...

  15. 痉挛性发声障碍的脑干病理学

    王刚

    2011-01-01

    @@ 痉挛性发声障碍(spasmodic dysphonia,SD)是一种原因不明的原发性局部张力障碍,其特征为言语产生时喉肌不自主的痉挛.由于尸体组织难以获取,对SD和其他原发性局部张力异常性疾病的神经病理学研究极少.既往研究在Meige综合征、头颈部张力障碍患者中发现了黑质、蓝斑、中缝背核、顶盖及齿状核中神经元的缺失,黑质、基底核、疑核中可见罕见的Lewy小体.

  16. 肉毒毒素对内收型痉挛性喉发音障碍的治疗

    刘雪莱

    2015-01-01

    痉挛性喉发音障碍(spasmodic dysphonia,SD)是一种局部肌张力障碍疾病,对该病的研究已持续50余年,但对其病因、诊断及治疗仍处于探索阶段,目前尚无系统、客观的标准或指南可供参考.本病的治疗现状主要以对症治疗为主.肉毒毒素作为一种安全、有效的治疗方式,现已广泛应用于临床.本文就肉毒毒素对该病的治疗现状做一综述.

  17. Brain studies may alter long-held concepts about likely causes of some voice disorders

    1989-02-17

    Two voice disorders long considered to be psychological problems, stuttering and spasmodic dysphonia, have been shown in many persons to have a neurophysiological basis. Investigators at the 155th national meeting of the American Association for the Advancement of Science, in San Francisco, described their findings, which are based on new analytic techniques. The research is being done at the Dallas Center for Vocal Motor Control, Callier Center for Communication Disorders, University of Texas at Dallas Health Science Center. The technology employed to learn what's wrong with the brains, rather than the psyches, of persons with certain speech disorders includes magnetic resonance imaging (MRI), brain electrical activity mapping (BEAM), and single photon emission computerized tomography (SPECT). The results of applying these techniques are combined with quantitative behavioral measures of vocal and nonvocal motor control, language performance, and cognition to arrive at a better understanding of the problem.

  18. Cross-innervation of the thyroarytenoid muscle by a branch from the external division of the superior laryngeal nerve.

    Nasri, S; Beizai, P; Ye, M; Sercarz, J A; Kim, Y M; Berke, G S

    1997-07-01

    The neuroanatomy of the larynx was explored in seven dogs to assess whether there is motor innervation to the thyroarytenoid (TA) muscle from the external division of the superior laryngeal nerve (ExSLN). In 3 animals, such innervation was identified. Electrical stimulation of microelectrodes applied to the ExSLN resulted in contraction of the TA muscle, indicating that this nerve is motor in function. This was confirmed by electromyographic recordings from the TA muscle. Videolaryngostroboscopy revealed improvement in vocal fold vibration following stimulation of the ExSLN compared to without it. Previously, the TA muscle was thought to be innervated solely by the recurrent laryngeal nerve. This additional pathway from the ExSLN to the TA muscle may have important clinical implications in the treatment of neurologic laryngeal disorders such as adductor spasmodic dysphonia. PMID:9228862

  19. Brain studies may alter long-held concepts about likely causes of some voice disorders

    Two voice disorders long considered to be psychological problems, stuttering and spasmodic dysphonia, have been shown in many persons to have a neurophysiological basis. Investigators at the 155th national meeting of the American Association for the Advancement of Science, in San Francisco, described their findings, which are based on new analytic techniques. The research is being done at the Dallas Center for Vocal Motor Control, Callier Center for Communication Disorders, University of Texas at Dallas Health Science Center. The technology employed to learn what's wrong with the brains, rather than the psyches, of persons with certain speech disorders includes magnetic resonance imaging (MRI), brain electrical activity mapping (BEAM), and single photon emission computerized tomography (SPECT). The results of applying these techniques are combined with quantitative behavioral measures of vocal and nonvocal motor control, language performance, and cognition to arrive at a better understanding of the problem

  20. High-throughput mutational analysis of TOR1A in primary dystonia

    Truong Daniel D

    2009-03-01

    Full Text Available Abstract Background Although the c.904_906delGAG mutation in Exon 5 of TOR1A typically manifests as early-onset generalized dystonia, DYT1 dystonia is genetically and clinically heterogeneous. Recently, another Exon 5 mutation (c.863G>A has been associated with early-onset generalized dystonia and some ΔGAG mutation carriers present with late-onset focal dystonia. The aim of this study was to identify TOR1A Exon 5 mutations in a large cohort of subjects with mainly non-generalized primary dystonia. Methods High resolution melting (HRM was used to examine the entire TOR1A Exon 5 coding sequence in 1014 subjects with primary dystonia (422 spasmodic dysphonia, 285 cervical dystonia, 67 blepharospasm, 41 writer's cramp, 16 oromandibular dystonia, 38 other primary focal dystonia, 112 segmental dystonia, 16 multifocal dystonia, and 17 generalized dystonia and 250 controls (150 neurologically normal and 100 with other movement disorders. Diagnostic sensitivity and specificity were evaluated in an additional 8 subjects with known ΔGAG DYT1 dystonia and 88 subjects with ΔGAG-negative dystonia. Results HRM of TOR1A Exon 5 showed high (100% diagnostic sensitivity and specificity. HRM was rapid and economical. HRM reliably differentiated the TOR1A ΔGAG and c.863G>A mutations. Melting curves were normal in 250/250 controls and 1012/1014 subjects with primary dystonia. The two subjects with shifted melting curves were found to harbor the classic ΔGAG deletion: 1 a non-Jewish Caucasian female with childhood-onset multifocal dystonia and 2 an Ashkenazi Jewish female with adolescent-onset spasmodic dysphonia. Conclusion First, HRM is an inexpensive, diagnostically sensitive and specific, high-throughput method for mutation discovery. Second, Exon 5 mutations in TOR1A are rarely associated with non-generalized primary dystonia.

  1. High-throughput mutational analysis of TOR1A in primary dystonia

    Xiao, Jianfeng; Bastian, Robert W; Perlmutter, Joel S; Racette, Brad A; Tabbal, Samer D; Karimi, Morvarid; Paniello, Randal C; Blitzer, Andrew; Batish, Sat Dev; Wszolek, Zbigniew K; Uitti, Ryan J; Hedera, Peter; Simon, David K; Tarsy, Daniel; Truong, Daniel D; Frei, Karen P; Pfeiffer, Ronald F; Gong, Suzhen; Zhao, Yu; LeDoux, Mark S

    2009-01-01

    Background Although the c.904_906delGAG mutation in Exon 5 of TOR1A typically manifests as early-onset generalized dystonia, DYT1 dystonia is genetically and clinically heterogeneous. Recently, another Exon 5 mutation (c.863G>A) has been associated with early-onset generalized dystonia and some ΔGAG mutation carriers present with late-onset focal dystonia. The aim of this study was to identify TOR1A Exon 5 mutations in a large cohort of subjects with mainly non-generalized primary dystonia. Methods High resolution melting (HRM) was used to examine the entire TOR1A Exon 5 coding sequence in 1014 subjects with primary dystonia (422 spasmodic dysphonia, 285 cervical dystonia, 67 blepharospasm, 41 writer's cramp, 16 oromandibular dystonia, 38 other primary focal dystonia, 112 segmental dystonia, 16 multifocal dystonia, and 17 generalized dystonia) and 250 controls (150 neurologically normal and 100 with other movement disorders). Diagnostic sensitivity and specificity were evaluated in an additional 8 subjects with known ΔGAG DYT1 dystonia and 88 subjects with ΔGAG-negative dystonia. Results HRM of TOR1A Exon 5 showed high (100%) diagnostic sensitivity and specificity. HRM was rapid and economical. HRM reliably differentiated the TOR1A ΔGAG and c.863G>A mutations. Melting curves were normal in 250/250 controls and 1012/1014 subjects with primary dystonia. The two subjects with shifted melting curves were found to harbor the classic ΔGAG deletion: 1) a non-Jewish Caucasian female with childhood-onset multifocal dystonia and 2) an Ashkenazi Jewish female with adolescent-onset spasmodic dysphonia. Conclusion First, HRM is an inexpensive, diagnostically sensitive and specific, high-throughput method for mutation discovery. Second, Exon 5 mutations in TOR1A are rarely associated with non-generalized primary dystonia. PMID:19284587

  2. Temporal discrimination thresholds in adult-onset primary torsion dystonia: an analysis by task type and by dystonia phenotype.

    Bradley, D

    2012-01-01

    Adult-onset primary torsion dystonia (AOPTD) is an autosomal dominant disorder with markedly reduced penetrance. Sensory abnormalities are present in AOPTD and also in unaffected relatives, possibly indicating non-manifesting gene carriage (acting as an endophenotype). The temporal discrimination threshold (TDT) is the shortest time interval at which two stimuli are detected to be asynchronous. We aimed to compare the sensitivity and specificity of three different TDT tasks (visual, tactile and mixed\\/visual-tactile). We also aimed to examine the sensitivity of TDTs in different AOPTD phenotypes. To examine tasks, we tested TDT in 41 patients and 51 controls using visual (2 lights), tactile (non-painful electrical stimulation) and mixed (1 light, 1 electrical) stimuli. To investigate phenotypes, we examined 71 AOPTD patients (37 cervical dystonia, 14 writer\\'s cramp, 9 blepharospasm, 11 spasmodic dysphonia) and 8 musician\\'s dystonia patients. The upper limit of normal was defined as control mean +2.5 SD. In dystonia patients, the visual task detected abnormalities in 35\\/41 (85%), the tactile task in 35\\/41 (85%) and the mixed task in 26\\/41 (63%); the mixed task was less sensitive than the other two (p = 0.04). Specificity was 100% for the visual and tactile tasks. Abnormal TDTs were found in 36 of 37 (97.3%) cervical dystonia, 12 of 14 (85.7%) writer\\'s cramp, 8 of 9 (88.8%) blepharospasm, 10 of 11 (90.1%) spasmodic dysphonia patients and 5 of 8 (62.5%) musicians. The visual and tactile tasks were found to be more sensitive than the mixed task. Temporal discrimination threshold results were comparable across common adult-onset primary torsion dystonia phenotypes, with lower sensitivity in the musicians.

  3. Distonia laríngea: relato de caso e tratamento com toxina botulínica Laryngeal dystonia: case report and treatment with botulinum toxin

    Victor José Barbosa Santos

    2006-06-01

    Full Text Available Distonia laríngea, ou disfonia espasmódica, é caracterizada por contrações involuntárias e inapropriadas da musculatura responsável pela fonação, sendo a do tipo adutora a mais comum. Caracteriza-se por quebras fonatórias, sendo seu diagnóstico confirmado por videolaringoestroboscopia. O tratamento de escolha é feito com a aplicação direta de toxina botulínica nos músculos responsáveis pelo movimento incoordenado. O objetivo desse trabalho é relatar o caso de uma paciente com diagnóstico de distonia laríngea do tipo adutora, tratada com toxina botulínica e discutir as vantagens e observações descritas na literatura a respeito desse tratamento.Laryngeal dystonia or spasmodic dysphonia is characterized by involuntary and innapropiate spasms of vocal muscles, having the adductor type as the most common one. It is chacterized by strain-strangled voice with pitch breaks. Diagnosis is made by means of videolaryngostroboscopic exam. The treatment of choice is done with botulinum toxin directly injected in the muscles responsible for the mismatched movement. The aim of this study is to report on an adductor- type dysphonia patient and to discuss the advantages and observations about this treatment reported in the literature.

  4. The clinical spectrum of laryngeal dystonia includes dystonic cough: observations of a large series.

    Payne, Susannah; Tisch, Stephen; Cole, Ian; Brake, Helen; Rough, Judy; Darveniza, Paul

    2014-05-01

    Laryngeal dystonia is a movement disorder of the muscles within the larynx, which most commonly manifests as spasmodic dysphonia (SD). Rarer reported manifestations include dystonic respiratory stridor and dyscoordinate breathing. Laryngeal dystonia has been treated successfully with botulinum neurotoxin (BTX) injections since 1984. We reviewed prospectively collected data in a consecutive series of 193 patients with laryngeal dystonia who were seen at St. Vincent's Hospital between 1991 and 2011. Patient data were analyzed in Excel, R, and Prism. Laryngeal dystonia manifested as SD (92.7%), stridor (11.9%), dystonic cough (6.2%), dyscoordinate breathing (4.1%), paroxysmal hiccups (1.6%), and paroxysmal sneezing (1.6%). There were more women (68.4%) than men (31.6%), and the average age at onset was 47 years. A positive family history of dystonia was present in 16.1% of patients. A higher incidence of extra-laryngeal dystonia (ie, torticollis and blepharospasm) and concurrent manifestations of laryngeal dystonia were present in patients with dystonic cough, dyscoordinate breathing, paroxysmal sneezing, and hiccups than in other patients (P = 0.003 and P Technical failures were rare (1.1%). Dysphonia secondary to vocal cord paresis followed 38.7% of treatments. Laryngeal dystonia manifests predominantly as SD, but other manifestations include stridor, dyscoordinate breathing, paroxysmal cough, hiccups, and sneezing. BTX injections are very effective across all subgroups. Severe adverse events are rare. PMID:24753288

  5. Acoustic and Perceptual Analysis of Modal and Falsetto Registers in Females with Dysphonia

    Li, Nicole Y. K.; Yiu, Edwin M-L.

    2006-01-01

    Modal and falsetto registers are the basic vocal qualities used in female speaking voices. The purpose of this study was to identify the frequency at which modal register changed to falsetto register and the frequency range of each modal and falsetto register produced under three loudness levels: soft, comfortable and loud phonations in normal and…

  6. Outcomes Measurement in Voice Disorders: Application of an Acoustic Index of Dysphonia Severity

    Awan, Shaheen N.; Roy, Nelson

    2009-01-01

    Purpose: The purpose of this experiment was to assess the ability of an acoustic model composed of both time-based and spectral-based measures to track change following voice disorder treatment and to serve as a possible treatment outcomes measure. Method: A weighted, four-factor acoustic algorithm consisting of shimmer, pitch sigma, the ratio of…

  7. Objective Dysphonia Measures in the Program Praat: Smoothed Cepstral Peak Prominence and Acoustic Voice Quality Index

    Y. Maryn; D. Weenink

    2015-01-01

    Purpose A version of the "smoothed cepstral peak prominence" (ie, CPPS) has recently been implemented in the program Praat. The present study therefore estimated the correspondence between the original CPPS from the program SpeechTool and Praat's version of the CPPS. Because the CPPS is the main fac

  8. Evaluation of Voice Disorders: Dysphonia Severity Index and Voice Handicap Index

    M.M. Hakkesteegt (Marieke)

    2009-01-01

    textabstractThe voice is arguable still the most important tool of communication despite the growing importance of e-mails and text messaging (SMS) in daily contact. Indeed in modern society people are probably even more dependent on their voice than in the rural societies of old. Approximately one

  9. An Unusual Cause of Dysphonia with Hemoptysis: A Laryngeal Live Leech

    Mohsen Rajati

    2014-07-01

    Full Text Available Introduction: Foreign bodies in the upper airway are one of the most challenging otolaryngology emergencies and have various presentations depending on their physical properties and location. Leeches are blood-sucking hermaphroditic worms that vary in color, length, and shape. They usually reside in fresh-water streams and lakes. When rural untreated water is drunk, leeches may localize in the nose, pharynx, and esophagus, or rarely in the larynx. CaseReport: This case is a man who was referred to our otolaryngology clinic with a complaint of hemoptysis and mild respiratory distress. The patient’s symptoms were all relieved post operatively and he was discharged on the second day following the procedure.     Conclusion: Leeches should be suspected as an airway foreign body in patients with a recent history of drinking stream water.     

  10. [Dysarthria across Parkinson's disease progression. Natural history of its components: dysphonia, dysprosody and dysarthria].

    Pinto, S; Ghio, A; Teston, B; Viallet, F

    2010-10-01

    Dysarthria refers to a collective name for a group of neurologic motor speech disorders, resulting from central and/or peripheral nervous system abnormalities. Speech alteration in Parkinson's disease, so-called hypokinetic dysarthria, presents with prosodic insufficiency, related to a monotony of pitch and intensity, a reduction of accentuation, variable speech rate and possible phoneme imprecision. In most cases, voice is harsh and breathy. This symptom can affect both voice and speech quality, as well as prosody and intelligibility. As a consequence, many patients complain about speech impairments, which affect their communication in daily living activities. Perceptual and instrumental assessments require different and numerous investigation methods, which use may help to further understand the specific dysarthria pathophysiology. This is of importance in order to adjust treatments for dysarthria; as a matter of fact, dopa-therapy, functional neurosurgery or even behavioural speech therapy have variable effects on voice and speech quality in Parkinson's disease. PMID:20800250

  11. Comparing Voice-Therapy and Vocal-Hygiene Treatments in Dysphonia Using a Limited Multidimensional Evaluation Protocol

    Rodriguez-Parra, Maria J.; Adrian, Jose A.; Casado, Juan C.

    2011-01-01

    Purpose: This study evaluates the effectiveness of two different programs of voice-treatment on a heterogeneous group of dysphonic speakers and the stability of therapeutic progress for longterm follow-up post-treatment period, using a limited multidimensional protocol of evaluation. Method: Forty-two participants with voice disorders were…

  12. 痉挛性发音障碍研究进展

    刘玮

    2015-01-01

    痉挛性发音障碍(Spasmodic dysphonia ,SD)是一种中枢运动神经系统病变,发音时喉部肌肉非随意运动。病因和发病机理不明,流行病学调查提示女性多发,该病根据喉部肌肉痉挛时声带开放、关闭位置不同主要分为三种类型:内收型、外展型、混合型。诊断主要依靠病态声音特征的感性判断,需神经科医师、嗓音医师、耳鼻喉科医师联合组成诊疗小组共同工作。临床上这种疾病的治疗方案基本是对症治疗,缓解声带痉挛状态,尚无一长期根治方法。

  13. Irony in Tennyson's "Little Hamlet".

    Harrison, Antony H.

    1981-01-01

    Points out similarities between the events and characters of Tennyson's "Maud" and Shakespeare's "Hamlet." Identifies traits which "Maud" shares with Spasmodic poetry. Argues that Tennyson consciously employed these similarities to expose the deficiencies of the Spasmodic school. (DMM)

  14. Myxoma Virus Leukemia-Associated Protein Is Responsible for Major Histocompatibility Complex Class I and Fas-CD95 Down-Regulation and Defines Scrapins, a New Group of Surface Cellular Receptor Abductor Proteins

    Guerin, Jean-Luc; Gelfi, Jacqueline; Boullier, Severine; Delverdier, Maxence; Bellanger, Frederique-Anne; Bertagnoli, Stephane; Drexler, Ingo; Sutter, Gerd; Messud-Petit, Frederique

    2002-01-01

    Down-modulation of major histocompatibility class I (MHC-I) molecules is a viral strategy for survival in the host. Myxoma virus, a member of the Poxviridae family responsible for rabbit myxomatosis, can down-modulate the expression of MHC-I molecules, but the viral factor(s) has not been described. We cloned and characterized a gene coding for an endoplasmic reticulum (ER)-resident protein containing an atypical zinc finger and two transmembrane domains, which we called myxoma virus leukemia...

  15. Inter-rater reliability of isometric hip abductor strength, 1RM leg press, hamstrings flexibility and the Star Excursion Balance Test in elite female football- and handball players: A methodological stud

    Harøy, Joar

    2013-01-01

    Strength-, flexibility- and balance measures are tools used to examine risk factors for injuries in a clinical setting. In an on-going prospective cohort study at the Oslo Sports Trauma Research Center aimed at investigating risk factors for ACL injuries in elite female football- and handball players several of these tests are used. The different tests have shown high inter-rater reliability, but the studies are rarely conducted on elite female football- or handball players. Th...

  16. Thalamic Volume Is Reduced in Cervical and Laryngeal Dystonias

    Waugh, Jeff L.; Kuster, John K.; Levenstein, Jacob M.; Makris, Nikos; Multhaupt-Buell, Trisha J.; Sudarsky, Lewis R.; Breiter, Hans C.; Sharma, Nutan; Blood, Anne J.

    2016-01-01

    Background Dystonia, a debilitating movement disorder characterized by abnormal fixed positions and/or twisting postures, is associated with dysfunction of motor control networks. While gross brain lesions can produce secondary dystonias, advanced neuroimaging techniques have been required to identify network abnormalities in primary dystonias. Prior neuroimaging studies have provided valuable insights into the pathophysiology of dystonia, but few directly assessed the gross volume of motor control regions, and to our knowledge, none identified abnormalities common to multiple types of idiopathic focal dystonia. Methods We used two gross volumetric segmentation techniques and one voxelwise volumetric technique (voxel based morphometry, VBM) to compare regional volume between matched healthy controls and patients with idiopathic primary focal dystonia (cervical, n = 17, laryngeal, n = 7). We used (1) automated gross volume measures of eight motor control regions using the FreeSurfer analysis package; (2) blinded, anatomist-supervised manual segmentation of the whole thalamus (also gross volume); and (3) voxel based morphometry, which measures local T1-weighted signal intensity and estimates gray matter density or volume at the level of single voxels, for both whole-brain and thalamus. Results Using both automated and manual gross volumetry, we found a significant volume decrease only in the thalamus in two focal dystonias. Decreases in whole-thalamic volume were independent of head and brain size, laterality of symptoms, and duration. VBM measures did not differ between dystonia and control groups in any motor control region. Conclusions Reduced thalamic gross volume, detected in two independent analyses, suggests a common anatomical abnormality in cervical dystonia and spasmodic dysphonia. Defining the structural underpinnings of dystonia may require such complementary approaches. PMID:27171035

  17. Art and dystonia.

    Garcia-Ruiz, Pedro J; Slawek, Jaroslaw; Sitek, Emilia J; Martinez Castrillo, Juan Carlos

    2015-09-15

    Dystonia has a recent history in medicine. Focal dystonia was described in the 19th century by classic authors including Gowers, whilst generalized dystonia was described at the turn of the century. However, it is possible to find precise descriptions of dystonia in art, centuries before the medical definition. We have reviewed several pieces of art (sculpture, painting and literature) across the history that might represent descriptions of dystonia, from ancient period to nowadays. In classic times, the first reference to abnormal postures can be tracked back to the new Empire of Egypt (equinus foot), not to mention some recently described examples of dystonia from the Moche sculptures in Peru or Veracruz culture from Mexico. In Middle Ages it is possible to find many examples of sculptures in European cathedrals representing peasants with dramatic, presumably dystonic postures that coexist with amputation of limbs. This unique combination of dystonia and limb amputation probably represents ergotism. The painters Brueghel, Ribera and Velazquez also represented figures with postures likely to be dystonic. Literature is also a source of precise pre-neurological descriptions, especially during the 19th century. In David Copperfield, Dickens depicts characters with generalized dystonia (Uriah Heep), cervical dystonia (Mr. Sharp) and spasmodic dysphonia (Mr Creakle). Finally, even in modern Art (19th and 20th centuries), there are dramatic descriptions of abnormal postures that are likely to be dystonic, such as painful cervical dystonia (Brancusi), cervical dystonia with sensory trick (Modigliani) and upper limb dystonia (Wyspianski). However some postures presented in works of art may simply be a form of artistic expression and only bear unintentional resemblance to the dystonic postures. Art may be a source of neurological information, and that includes primary and secondary dystonia. PMID:26139341

  18. Sporadic adult onset primary torsion dystonia is a genetic disorder by the temporal discrimination test.

    Kimmich, Okka

    2012-02-01

    Adult-onset primary torsion dystonia is an autosomal dominant disorder with markedly reduced penetrance; patients with sporadic adult-onset primary torsion dystonia are much more prevalent than familial. The temporal discrimination threshold is the shortest time interval at which two stimuli are detected to be asynchronous and has been shown to be abnormal in adult-onset primary torsion dystonia. The aim was to determine the frequency of abnormal temporal discrimination thresholds in patients with sporadic adult-onset primary torsion dystonia and their first-degree relatives. We hypothesized that abnormal temporal discrimination thresholds in first relatives would be compatible with an autosomal dominant endophenotype. Temporal discrimination thresholds were examined in 61 control subjects (39 subjects <50 years of age; 22 subjects >50 years of age), 32 patients with sporadic adult-onset primary torsion dystonia (cervical dystonia n = 30, spasmodic dysphonia n = 1 and Meige\\'s syndrome n = 1) and 73 unaffected first-degree relatives (36 siblings, 36 offspring and one parent) using visual and tactile stimuli. Z-scores were calculated for all subjects; a Z > 2.5 was considered abnormal. Abnormal temporal discrimination thresholds were found in 1\\/61 (2%) control subjects, 27\\/32 (84%) patients with adult-onset primary torsion dystonia and 32\\/73 (44%) unaffected relatives [siblings (20\\/36; 56%), offspring (11\\/36; 31%) and one parent]. When two or more relatives were tested in any one family, 22 of 24 families had at least one first-degree relative with an abnormal temporal discrimination threshold. The frequency of abnormal temporal discrimination thresholds in first-degree relatives of patients with sporadic adult-onset primary torsion dystonia is compatible with an autosomal dominant disorder and supports the hypothesis that apparently sporadic adult-onset primary torsion dystonia is genetic in origin.

  19. 脑卒中言语障碍患者心理分析及护理对策%Psychoanalysis and nursing countermeasure for dysphonia sufferers after stroke

    唐惠兰

    2007-01-01

    目的 通过分析50例脑卒中言语障碍患者的心理变化特点,指导制定相应护理对策以协助患者达到最佳康复效果.方法 采用综合医院焦虑/抑郁(HAD)情绪测定表和自制调查问卷对50例脑卒中言语障碍患者进行心理特点分析,比较不同性别、年龄和文化程度患者的心理变化特点,制定相应护理对策.结果 本组焦虑情绪占46%,抑郁情绪占38%.因病导致性格改变的比例表现出随年龄增长而增大的趋势.患者均表现出不同程度运动迟滞和动作不协调.男性患者有行为异常表现的比例高于女性患者(89.5%>58.1%).结论 卒中后女性患者较男性患者易产生焦虑和抑郁;60岁以上患者易出现抑郁情绪和情绪波动,60岁以上男性患者易出现性格改变和行为异常.应及时准确掌握患者心理特点,制定相应的护理对策.

  20. Treatment with Acupuncture and Psychological Counseling Hysterical Dysphonia%针刺配合心理疏导治疗癔症性发声障碍26例

    邓荣瑛; 李巧玉

    2010-01-01

    目的:观察推广针刺配合心理疏导治疗癔症性发声障碍的治疗效果.方法:采用针刺配合心理疏导治疗本病26例.结果:治疗总有效率84.6%.结论:本法对本病具有宣畅气机,疏肝解郁之功效.

  1. Objective multi-parameters analysis of the voice dysphonia%成人女性嗓音障碍的客观多参数分析

    于萍; 王国建; 韩冰; 杨伟炎; 韩东一

    2004-01-01

    目的:探讨嗓音客观多参数分析与主观听感知评估的相关性,建立嗓音客观多参数评估模型,实现嗓音评估的客观化和数据化.方法:声音样本采自83例嗓音障碍患者和40例嗓音正常者,全部受试者均为女性.客观检测采用Dr.Speech Science for Windows嗓音评估软件,在长元音/α:/上测试下列参数:基频、基频微扰(jitter)、振幅微扰(shimmer)、基频标准差、基频震颤、振幅震颤、标准化噪声能量(NNE)、谐噪比(HNR)、信噪比和最大发声时间(MPT).主观听感知评估参数采用日本言语音声学会声音嘶哑评估GRBAS系统中的总嘶哑度,4级评估标准.结果:应用逐步判别分析方法,建立了5个参数(MPT、jitter、NNE、HNR和shimmer)的嗓音客观评估模型.客观评估结果与主观评估结果的一致性达到79.8%.结论:嗓音的客观评估是多参数的;嗓音的客观多参数评估模型与主观听感知结果有较好的一致性.

  2. Optimization and Selection of Feature Parameters in Dysphonia Recognition%病态噪声识别特征参数的优化选择

    彭策; 熊屹; 陈文西; 万柏坤

    2007-01-01

    为提高病态嗓声识别效率,本研究首次采用主分量分析方法对目前常用的27个噪声特征参数进行了优化分析,考察了仅用少数主分量参数的识别效果及其分量数对结果的影响;同时根据参数对病态噪声信息敏感程度,使用正交试验法优选出9个较优特征参数,其识别率即可达到原27个参数的识别结果.经两种方法对参数进行优选后识别率分别达到97.23%和98.10%,显著高于未经优选、使用全部27个参数的92.10%识别率.研究结果表明:原27个参数中,2/3的参数不能很好地反映嗓声的病态变化特征,使用优选的含有大量病态嗓声信息的少量特征参数即可大幅提高病态嗓声识别效率.

  3. 不同嗓音样本对嗓音听感知评估的影响%Choice of Voice Material in Perceptive Evaluation of Dysphonia

    于萍; 黄冬雁; Revis Joana; Giovanni Antoine

    2004-01-01

    目的探讨不同声样对嗓音障碍听感知评估结果的影响,指导嗓音研究中语音材料的选择.方法受试者为60例嗓音障碍患者和20名嗓音正常者.对所有受试者录制3类声样:话语声、完整长元音/α:/、平稳段长元音/α:/.所有声样随机排列3次,共进行9次评估(3个声样×3次).评估参数为日本言语语音学会制定的嗓音嘶哑评估标准GRBAS系统中的总嘶哑度(G)、粗糙度(R)、气息音(S).计算统计学上的Kappa系数值确定听评委评估结果的一致性.根据听评委对每一受试者评估的平均值比较3类声样的差异性.结果评委自身和评委之间评估结果的一致性好;评估参数以总嘶哑度(G)的一致性和稳定性最好;不同声样类型对评委评估的一致性无影响.3类声样的评估结果有高度的相关性(P<0.001);话语声与完整长元音/α:/对嗓音障碍的评估结果基本一致,平稳段长元音/α:/有过低评估嗓音障碍的倾向,且随着嗓音障碍程度的加重而更加明显.结论平稳段长元音对嗓音障碍的评估程度过低,完整长元音与话语声对嗓音障碍的评估基本一致.建议嗓音障碍的听感知分析选择话语声作为嗓音材料,客观检测选择完整长元音作为嗓音材料.

  4. 原发性肌紧张性发音障碍患者的嗓音矫治%Voice Therapy for Patients with Primary Muscle Tension Dysphonia

    2016-01-01

    目的 评价一种治疗原发性肌紧张性发音障碍的综合嗓音矫治方法.方法 回顾性分析17例采用嗓音矫治方法治疗的患者,使用声学分析、语图、电子喉镜评估治疗前后的声音质量、喉腔发音状态,对声学分析参数基频(F0)、频率微扰(jitter)、振幅微扰(shimmer)进行统计分析.结果 嗓音矫治后,jitter、shimmer值明显降低,语图显示声音信号的噪音成分减少,电子喉镜显示声门闭合、声门上收缩情况改善.结论 该综合嗓音矫治方法明显改善了患者的嗓音质量,可用于肌紧张性发音障碍患者的临床治疗.

  5. Hip Revision

    Full Text Available ... C-reactive protein. And we -- on everybody -- send tissue back down for frozen. We just got that ... looking at here more is this abductor soft tissue tension. And with this in place, that abductor ...

  6. Some Personality Variables in Functional Neurological Disorders

    Mary M. Robertson

    1988-01-01

    Full Text Available Patients with spasmodic torticollis, writer's cramp and the Gilles de la Tourette Syndrome (GTS were given rating scales to assess personality dimensions, especially hostility and obsessionality. The data have been compared with age and sex matched controls. Significant differences arose, especially for hostility for the GTS and writer's cramp patients, whereas those with spasmodic torticollis do not differ from controls.

  7. Análise visual de parâmetros espectrográficos pré e pós-fonoterapia para disfonias Visual analysis of spectrographic parameters before and after dysphonia therapy

    Marcela Guimarães Côrtes; Ana Cristina Côrtes Gama

    2010-01-01

    OBJETIVO: Avaliar os efeitos da fonoterapia nos distúrbios da voz por meio de diferentes parâmetros acústicos pré e pós-fonoterapia. MÉTODOS: Trata-se de estudo experimental retrospectivo no qual se analisou as gravações de vozes de 67 indivíduos submetidos à reabilitação vocal. Os espectrogramas pré e pós-terapia fonoaudiológica foram julgados por quatro fonoaudiólogas. Os parâmetros para análise foram: forma do traçado, grau de escurecimento dos harmônicos, estabilidade do traçado dos harmô...

  8. 神经外科意识障碍病人躁动原因分析及对策%Causes of Neurosurgery Consciousness Barrier Patient's Dysphonia and the Countermeasures

    郑巧; 段辉菊; 吴洁

    2011-01-01

    目的 分析65例神经外科意识障碍病人躁动原因及来取的对策.方法 按照病人入院时间编号,GCS评分评定意识障碍,查找原因,分析危害,观察解决效果.结果 65例病人分别采取医疗手段和护理手段,消除或减轻因不同躁动原因所致的危害.结论 对于意识障碍病人而言,准确判断其躁动原因,积极来取预防措施,对于保证病人安全、避免医疗纠纷、促进病人康复至关重要.

  9. 以发声困难为首发症状的重症肌无力患者的临床特点%Clinical characteristics of myasthenia gravis with dysphonia as the initial symptom

    孙文海; 刘华敏; 梁大鹏; 万秀明; 丛志强; 王海萍

    2006-01-01

    目的 探讨以发声困难为首发症状的重症肌无力患者的临床特征,提高早期诊断率,减少误诊.方法 报告以发声困难为首发症状的重症肌无力患者31例,观察和分析其临床症状和体征以及疾病的发展和转归过程.结果 患者早期症状包括发声无力9例,不能发高音1例,不能维持正常的音量或音调3例,声音嘶哑18例,均有病态性发声疲劳反复发作.纤维喉镜检查喉部表现为一侧或双侧声带内收、外展受限,声带松弛,声带麻痹,声门不能完全闭合,梨状窝积液等.新斯的明试验发声困难症状及喉部体征均有改善.19例患者检测血液中乙酰胆碱受体抗体,5例高于正常参考值.所有患者经过治疗其症状均改善或消失,但在疾病的进程中,均相继出现全身肌无力和球肌麻痹症状.结论 嗓音变化可能是某些重症肌无力患者早期惟一症状,对临床具有晨轻暮重,病态疲劳性发声困难的患者应注意采用新斯的明试验或检测血液中乙酰胆碱受体抗体,以除外重症肌无力.

  10. 发音障碍严重指数在25例声带息肉患者中的应用%The detection of dysphonia severity index and its significance in 25 patients with polyp of vocal cord

    张武宁; 吴铖林; 李永湘; 钟晖; 毛海燕

    2014-01-01

    目的 探讨发音障碍严重指数(DSI)在声带息肉患者中的应用价值.方法 通过DIVAS2.5声学分析软件对25例声带息肉患者(病例组)术前及术后1周、2周、3周进行DSI检测及嗓音声学分析,与30例正常者(对照组)进行比较,分析DSI的特征及可靠性.结果 声带息肉患者术前均有较高的基频微扰、振幅微扰及较低的DSI,结果均能提示嗓音功能受损.声带息肉患者术后1周与术前比较,基频微扰、振幅微扰无明显改变,差异无统计学意义;DSI升高,差异有统计学意义(P0.05),而DSI差异仍有统计学意义(P0.05),提示嗓音完全恢复.结论 在25例声带息肉患者中,DSI较扰动分析能够更敏感地反映嗓音变化情况.

  11. Ectopic thyroid gland causing dysphonia: imaging and molecular studies%异位甲状腺引发的发音困难:影像学及分子研究

    柴维敏

    2011-01-01

    @@ 一 8.5岁临床甲状腺功能正常的女孩因发现舌部肿块、发音困难及偶发呼吸困难而前来就诊.于就诊后3天行先天性甲状腺功能低下筛查呈阳性[TSH 37 mU/L(正常<15),总T4112 nmol/L(正常值86~260)],但就诊后18天复查未见明显异常[TSH 12 mU/L(正常<15),总T4 99 nmol/L(正常值86~260)],因此未能予以作出明确诊断.

  12. Application of Laryngoscopy and Acoustic Analysis by Computer in the Diagnosis of Functional Dysphonia%功能性发声障碍的喉镜检查及计算机声学分析

    黄卫; 徐洁洁; 陈曦; 陆美萍

    2003-01-01

    目的观察功能性发声障碍的临床特征、嗓音声学参数和声谱图特征,探讨喉镜检查及计算机声学分析在功能性发声障碍诊断中的应用价值.方法采用喉镜和计算机声学测试系统对71例功能性发声障碍患者和50例正常人进行喉镜检查及嗓音元音/a:/进行测试,分析各项声学参数特点并行统计学分析.结果高功能性发声障碍患者基频较正常升高;低功能性发声障碍患者基频较正常降低;基频微扰、振幅微扰、NNE较正常增高,最大发声时间缩短.均有统计学意义.90.14%(64/71) 功能性发声障碍患者的嗓音信号中可发现正常声学特征.声谱图特征为谐波及共振峰不规则、断裂甚至消失,噪声成分增加等.结论应用计算机声学分析对功能性发声障碍患者的声学特征进行客观分析,有助于功能性发声障碍的诊断.

  13. 嗓音的客观多参数分析与主观听觉分析相关性的研究%Correlation Between Objective Multi- parametric Analysis and Perceptual Analysis for Dysphonia

    于萍; Giovanni Antoine

    2003-01-01

    目的探讨嗓音的客观多参数检测与主观听觉评估的相关性,建立嗓音客观多参数评估模式,实现嗓音评估的客观化、数据化.方法声音样本采自135例声音嘶哑患者和29例嗓音正常者.客观检测采用法国开发的"EVA"嗓音工作站,测试对象发长元音/α:/时,检测下列参数:基频(F0)、音强(intensity)、基频微扰(jitter)、信噪比(signal-to-noise ratio,SNR)、Lyapunov系数、口腔气流量(oral airflow,OAF)、音域(range)及最大发声时间(maximumphonatory time,MPT);发/pα/音时,检测声门下压(estimated subglottic pressure,ESGP).主观听觉评估采用日本言语语音学会声音嘶哑评估GRBAS系统中的总嘶哑度(grade,G)4级评估标准.所有受试者以自然的音调及音强读一段统一的标准文字,听评委由4名嗓音学家组成.结果应用判别分析方法,建立了7参数客观评估模式(音域、Lya-punov系数、声门下压、最大发声时间、口腔气流量、信噪比和基频).客观评估结果与主观评估结果的一致性达到84%.结论嗓音的客观检测是多参数的,客观评估能够反映出主观听觉印象.

  14. Clinical observation on muscle tension dysphonia treated with acupuncture and moxibustion therapy%针灸及推拿治疗肌紧张性发音障碍临床观察

    陈陆泉; 王翰菁; 支楠; 马小丽; 王军

    2011-01-01

    目的 观察针灸及推拿治疗肌紧张性发音障碍的临床疗效.方法 将35例肌紧张性发音障碍患者随机分成治疗组和声休组.治疗组18例,选择针刺疗法治疗,并配合颈周穴位推拿,共治疗3周.声休组17例,患者休息,无特殊治疗.观察3周后2组声道不适指数(VTD)评分、嗓音障碍指数(VHI)评分和嗓音主观评分(GRABS)等变化.结果 治疗组治疗后VTD程度和频率评分较治疗前比较差异有统计学意义(P<0.05);对照组治疗前后VTD程度评分无显著差异,频率评分治疗前后比较差异有统计学意义(P<0.05);治疗组VHI分值治疗前后比较,差异有统计学意义(P<0.01),对照组治疗前后无显著差异.治疗组GRBAS评分治疗前后比较差异有统计学意义(P<0.01),对照组治疗前后无显著差异.结论 针灸及推拿治疗肌紧张性发音障碍疗效优于声音休息方法.

  15. Disfonia e bulimia: avaliação dos sintomas e sinais vocais e laríngeos Dysphonia and bulimia: evaluation of vocal and laryngeal signs and symptoms

    Cynthia Priscila Ferreira

    2009-01-01

    Full Text Available OBJETIVO: Descrever os sintomas e sinais vocais e laríngeos de pacientes com diagnóstico de bulimia. MÉTODOS: Estudo transversal, descritivo, randomizado, com experimento cego. Avaliou-se 11 indivíduos com diagnóstico de bulimia, com o subtipo purgativo, do sexo feminino e idade variando de 18 a 34 anos, que foram submetidas à avaliação fonoaudiológica e otorrinolaringológica. RESULTADOS: Os sintomas laríngeos e vocais mais relatados foram: o pigarro e a sensação de globus faríngeo relatados por dez sujeitos (90,9%. Na avaliação perceptivo-auditiva, os escores de maior ocorrência foram de grau leve em todos os parâmetros analisados. Os achados laríngeos de maior ocorrência foram os acúmulos de secreção espessa na laringe em cinco paciente (45,4%, seguido de fenda triangular médio-posterior e espessamento de mucosa na região interaritenoidea, ambos, ocorrendo em quatro sujeitos (36,3%. CONCLUSÃO: Os achados laringológicos e perceptivo-auditivos foram menos expressivos que os sintomas vocais e laríngeos relatados pelas pacientes.PURPOSE: To describe vocal and laryngeal signs and symptoms in patients with bulimia. METHODS: A blind, descriptive, randomized, transversal study was carried out. Eleven female subjects with the diagnosis of purgative bulimia nervosa and ages ranging from 18 to 34 years underwent otorhinolaryngological and vocal evaluations. RESULTS: The most common vocal and laryngeal symptoms were throat clearing and globus faringeus, related by 10 subjects (90.9%. In the auditory-perceptive evaluation, the most common scores were characterized as light in all analyzed parameters. The accumulation of thick mucus over the larynx occurred in five patients (45.4%, followed by median-posterior triangular glottic chink and mucosal thickening at the interaytenoid region, in four patients (36.3%. CONCLUSION: The laryngeal and perceptual findings were less expressive than vocal and laryngeal complaints.

  16. 药物结合发声训练治疗功能性发音障碍的临床研究%Clinic research on voice training in the treatment of functional dysphonia

    王飞; 肖永涛; 黄昭明

    2010-01-01

    目的 探讨发声训练在功能性发音障碍治疗中的疗效及意义.方法 运用药物结合发声训练的方法 对66例功能性发音障碍患者进行嗓音治疗,并与69例单纯药物治疗者进行对照.比较分析其治疗前后基频微扰、振幅微扰、标准化噪声能量三个参数的变化和症状改善情况.结果 试验组患者治疗后的基频微扰、振幅微扰和标准化噪声能量与治疗前相比差异均有显著统计学意义(均P<0.01),基频微扰、振幅微扰在治疗后达到正常值范围:与对照组相比较,试验组患者的基频微扰、振幅微扰和标准化噪声能量治疗后差异也有显著统计学意义(均P<0.01).结论 在功能性发音障碍治疗中,发声训练是一种有效治疗手段;应将药物治疗与发声训练相结合.

  17. Research of Functional Dysphonia by Laryngoscopy Acoustic Analysis and Aero-dynamic Measurement%功能性发声障碍的喉镜观察及声学、空气动力学研究

    黄卫; 徐洁洁; 陈曦; 陆美萍

    2005-01-01

    目的观察功能性发声障碍患者的喉镜图像、嗓音声学特征及空气动力学变化,探讨其在功能性发声障碍诊断、分类中的价值.方法对78例功能性发声障碍患者和50例正常成人进行喉镜检查,并对嗓音元音信号/a:/进行声学和空气动力学测试,观察喉部图像特征,分析声学和空气动力学参数特点并行统计学分析.结果根据颈部及喉镜检查结果将功能性发声障碍分为高功能性发声障碍及低功能性发声障碍两组.高功能性发声障碍患者基频升高,平均气流率降低.低功能性发声障碍患者基频降低,平均气流率增加.所有功能性发声障碍患者频率微扰(jitter)、振幅微扰(shimmer)、标准化噪声能量(NNE)较正常增高,最大发声时间(MPT)均缩短.91.03%的功能性发声障碍患者嗓音信号中出现正常声学特征.声谱图均表现为谐波及共振峰不规则、断裂甚至消失,噪声成分增加等.结论采用喉镜、声学和空气动力学检测方法有助于功能性发声障碍的分类、诊断及鉴别诊断.

  18. 嗓音训练治疗声带小结的疗效观察%The Effects of Voice Training Therapy on Dysphonia in Patients with Vocal Nodules

    李艳; 葛平江; 彭莉佳; 盛晓丽; 许咪咪; 任庆宜; 陈少华

    2015-01-01

    目的:探讨嗓音训练对声带小结患者发声障碍的治疗效果。方法对21例声带小结患者进行嗓音训练,包括嗓音教育和发声训练,根据“呼吸-发声-共鸣”平衡原理,采用喉部按摩、无声练习及发大开口咽音的训练方法,每周训练一次,每次1~2小时,共5次。训练前后对患者进行嗓音障碍指数量表(VHI)评估、GRBAS评估、动态喉镜检查、空气动力学检测、计算机嗓音声学分析,比较治疗前后评估结果。结果21例患者治疗后VHI评分总分(29.48±21.21分)明显低于治疗前(52.95±24.30分)(P<0.01);GRBAS评分中总嘶哑度G(0.67±0.76)明显低于训练前(1.88±1.05)(P<0.01),粗糙声R(0.52±0.58)明显低于训练前(1.36±0.55)(P<0.01);治疗后动态喉镜检查患者声带闭合、运动的对称性、粘膜波、振动规律性均改善(P<0.01);3例患者声带小结完全消失,13例患者声带小结缩小,5例与治疗前比较无明显变化;最长发声时间也由治疗前的8.87±3.75秒变为治疗后的12.54±3.68秒( P<0.01);治疗后嗓音的频率微扰、振幅微扰、噪谐比(分别为0.18%±0.08%、2.10%±0.98%、0.0034±0.0022 dB )均明显低于治疗前(分别为0.43%±0.31%、4.55%±1.80%、0.0184±0.028 dB )( P<0.01或0.05)。结论嗓音训练对声带小结患者发声障碍有良好的治疗效果。%Objective To investigate the effect of voice training therapy on the voice improvement in patients with vocal nodules .Methods Twenty one patients with vocal nodules were recruited and were evaluated by the GRBAS perpetual evaluation ,voice handicap index (VHI)-30 subjective assessment ,vocal laryngostroboscopy , maximum phonation time (MPT) and acoustic analysis pre- and post-therapy .These patients completed 5 cour‐ses of voice training .Results The VHI value(29 .48 ± 21 .21) of post-therapy was less than the value (52 .95 ± 24 . 30)of pre -therapy (P< 0 .01) .There were significantly differences in voice perpetual evaluation between pre -training and post-training ,especially for G (grade) (P<0 .01) and R (roughness) (P<0 .01) .The post-training laryngostrobescopy vocal vibration improved comparing with pre-therapy in the closure of vocal cords ,symmetry of vibration ,the mucosal wave and vibration regularity of the vocal cords .After therapy ,three patient nodules dis‐appeared ,thirteen patient nodules became smaller ,and five patient nodules remained the same .The maximum pho‐nation time (MPT) (12 .54 ± 3 .68)of post-therapy was longer than MPT(8 .87 ± 3 .75) of pre-therapy MPT(P<0 .01) .The jitter value (0 .18% ± 0 .08% ) of post -therapy was less than that of pre-therapy(0 .43% ± 0 .31% ) (P<0 .01) .The shimmer of post -therapy (2 .10% ± 0 .98% ) was less than that of pre -therapy (4 .55% ± 1 .80% )(P<0 .01) ,The ratio of noise to harmonic(NHR)(0 .0034 ± 0 .0022 dB) of post-therapy was significantly less than NHR(0 .0184 ± 0 .028 dB)(P<0 .05) of pre-therapy .Conclusion The voice therapy could significantlyimprove voice of patients with vocal nodules .

  19. The Clinical Significance of Calculating the Coefficients of Lyapunov in the Objective Assessment of Dysphonia%Lyapunov系数在嗓音障碍评估中的意义

    于萍; Ouaknine Maurice; Giovanni Antoine

    2006-01-01

    目的探讨Lyapunov系数在嗓音障碍客观分析中的意义,完善嗓音障碍的客观测试方法.方法声音样本采自132例嗓音障碍患者和47例嗓音正常者.采用法国开发的"EVA"嗓音工作站,选择2秒平稳段长元音/α:/声信号作为分析样本,测试基频微扰(jitter)和计算Lyapunov系数.主观听感知评估采用日本言语音声学会制定的嗓音障碍评估系统GRBAS中的总嘶哑度(grade, G),4级评估标准.结果Lyapunov系数在不同的嗓音障碍分级组间均有统计学差异,jitter只在中度和重度嗓音障碍组间有统计学差异;Lyapunov系数与听感知评估结果的一致性达到46%,jitter的一致性为36%.回归分析结果显示,Lyapunov系数和jitter之间既有相关性,但又有不同(r2=0.582,P<0.001).结论Lyapunov系数对嗓音障碍的测试优于jitter;非线性动态系统(相位图)的引入,为嗓音的客观分析开辟了新的研究领域.

  20. Laryngoscopic evaluation the hyper functional dysphonia with the polyps of vocal cord%高功能型发声障碍继发声带息肉的视频下活动状态分析

    路承; 李革临; 张道行

    2013-01-01

    Objective Research of the incidence of hyper functional dysphonic among the patients with polyps or nodules in vocal cord by analyzing the pictures and videos of laryngoscopy, and initially try to find out the necessity of vocal rehabilitation training for the patients after operations and also provide quantitative reference value for voice correction after vocal cord polyp surgery. Methods Choose 302 cases from almost 2000 patients with polyps or nodules in vocal cords, evaluate their laryngoscopic videos and concluding data. Results Hyper functional dysphonic was divided into four types by Koufman criterion according to the laryngoscopy results based on morphological, which was made by, type 1 41 cases(13.57%), type 2 23 cases(7.61%), type 3 38 cases(12.58%), type 4 19 cases(6.29%). Therefore, the ratios of hyper functional dysphonic was 121/302(40.6%).Conclusion Laryngoscopy is very helpful for evaluating and analysing hyper funtional dysphonic of the patients with polyps or nodules in vocal cord.%目的 ①通过电子喉镜检查声带息肉患者术前术后的喉镜视频及图像,归纳分析,探讨声带息肉患者中有高功能性发声障碍者的发生概率.初步分析嗓音发声训练对于声带息肉术后嗓音治疗的必要性.②为声带息肉手术后进行嗓音矫治提供量化参考数值.方法 对2006年10月~2010年1月期间,302例年龄在20~68岁声带息肉患者进行喉镜检查,观察喉部视频及图像特征,评价并做分析.结果 对喉镜检查结果根据形态特点以KOUFMAN标准将高功能性发声障碍分为四种类型其中Ⅰ型41例占13.57%,Ⅱ型23例占7.61%,Ⅲ型38例占12.58%,Ⅴ型19例占6.29%(共121例).高功能性发声障碍比例为121/302,占40.06%.结论 采用喉镜检查有助于对声带息肉患者进行嗓音评价,以决定是否术后进行嗓音矫治.

  1. Application of acoustic analysis by computer in diagnosis and voice therapy of functional dysphonia%计算机声学测试在功能性发音障碍诊断和治疗中的应用

    陆美萍; 徐洁洁; 陈曦; 王娟

    2008-01-01

    目的:观察功能性发音障碍嗓音声学参数及声谱图特征并进行视听反馈性发声训练,探讨计算机声学测试技术在功能性发音障碍诊断和治疗中的应用价值.方法:采用计算机嗓音声学测试系统对68例功能性发音障碍患者及50例正常成人嗓音元音信号"α"进行测试,观察分析声学参数jitter、shimmer、NNE及声谱图特征,同时利用同一软件对功能性发音障碍患者进行视听反馈性发声训练,并观察治疗前后声学特征的改变.结果:功能性发音障碍噪音shimmer、NNE值较正常升高并有统计学意义;声谱图主要表现中、高频区谐波及共振峰病理改变.75%(51/68)患者能在某次元音信号的一段或几段声样中找到正常声学特征.通过视听反馈矫治86%(59/68)患者首次门诊就诊时即能掌握正确的发声方法,声学测试可显示一次元音信号的全程声样出现正常或明显改善的声学参数及声谱图.结论:计算机声学测试可通过观察嗓音的声学特征与器质性发音障碍相鉴别,视听反馈性发声训练简单、直观、有效.

  2. Análise visual de parâmetros espectrográficos pré e pós-fonoterapia para disfonias Visual analysis of spectrographic parameters before and after dysphonia therapy

    Marcela Guimarães Côrtes

    2010-01-01

    Full Text Available OBJETIVO: Avaliar os efeitos da fonoterapia nos distúrbios da voz por meio de diferentes parâmetros acústicos pré e pós-fonoterapia. MÉTODOS: Trata-se de estudo experimental retrospectivo no qual se analisou as gravações de vozes de 67 indivíduos submetidos à reabilitação vocal. Os espectrogramas pré e pós-terapia fonoaudiológica foram julgados por quatro fonoaudiólogas. Os parâmetros para análise foram: forma do traçado, grau de escurecimento dos harmônicos, estabilidade do traçado dos harmônicos, presença de ruído, presença de harmônicos e de sub-harmônicos. Os dados obtidos foram submetidos a análise estatística, em que também se buscou observar a eventual diferença de padrões entre gêneros e diagnósticos. RESULTADOS: Não houve diferença estatisticamente significante entre a forma do traçado espectrográfico nas condições pré e pós-fonoterapia, porém a maioria dos pacientes (58% obteve melhora. O grau de escurecimento manteve-se estável nas condições pré e pós-fonoterapia (p=0,000. Houve significativa melhora espectrográfica, após a fonoterapia, para os parâmetros de estabilidade do traçado (p=0,006, presença de ruído (p=0,007, harmônicos (p=0,000 e sub-harmônicos (p=0,001. Não houve relação entre o gênero do paciente e o grau de melhora espectrográfica. Em relação ao diagnóstico, apenas o parâmetro forma do traçado apresentou diferenças significativas. CONCLUSÃO: Apesar de não terem sido encontradas mudanças significativas em todos os parâmetros avaliados, a espectrografia acústica demonstrou ser um instrumento eficaz para avaliar a evolução da voz do paciente no processo terapêutico, sendo complementar à avaliação perceptivo-auditiva e fazendo parte de um protocolo multidimensional.PURPOSE: To evaluate the effects of vocal therapy on voice disorders using different spectrographic parameters, before and after therapy. METHODS: This experimental retrospective study analyzed voice recordings of 67 dysphonic patients that had attended vocal therapy. Pre- and post-treatment spectrograms were analyzed by four speech-language pathologists. The following parameters were analyzed: spectrogram regularity, harmonic colors, spectrogram stability, presence of noise components, presence of harmonic and sub-harmonics. Data were submitted to statistical analysis, which aimed at identifying different patterns between genders and diagnoses. RESULTS: There was no difference between pre and post-therapy conditions for spectrogram regularity, however, most patients (58% showed improvement. Harmonic colors remained stable (p=0.000. Significant improvement was observed, after voice therapy, regarding spectrogram stability (p=0.006, and presence of noise (p=0.007, harmonics (p=0.000 and sub-harmonics components (p=0.001. No relation was found between patient's gender and spectrographic improvement. Regarding diagnoses, differences caused by therapy were only significant for spectrogram regularity. CONCLUSIONS: Not all evaluated parameters showed significant improvements with therapy, however, acoustic spectrography proved to be an efficient tool to evaluate patients' progresses during vocal rehabilitation, complementing auditory-perceptual evaluation and composing a multidimensional assessment protocol.

  3. [Voice quality following CO2 laser cordectomy].

    Höfler, H; Bigenzahn, W

    1986-11-01

    The voice of patients after CO2 laser cordectomy was evaluated by subjective assessment, registration of voice parameters and sonegraphic classification. The results proved to be closely concordant, the main result being a slight or medium degree of dysphonia. Severe dysphonia or aphonia occurred in about one fifth of patients. This result is somewhat inferior to radiotherapy, but superior to standard translaryngeal cordectomy. Yanagihara's sonegraphic classification of dysphonia is recommendable for future comparative studies. PMID:3807602

  4. Effect of general anesthesia on voice

    Balegh Hamdy

    2016-07-01

    Conclusion: Traumatic manifestations of the laryngeal structures that occur during intubation are the most common causes of postoperative dysphonia, with a tendency toward a regressive course of the resulting dysphonia. As such, it is important to establish an early diagnosis and adopt preventive measures.

  5. IncobotulinumtoxinA Injection

    ... injection is used to relieve the symptoms of cervical dystonia (spasmodic torticollis; uncontrollable tightening of the neck ... is injected into a muscle, it blocks the nerve signals that cause uncontrollable tightening and movements of ...

  6. 嗓音疾病自我评估特点及影响因素%Self-assessment characteristics of voice handicap index for voice disorders and its influencing factors

    李红艳; 徐文; 韩德民; 胡蓉; 胡慧英; 侯丽珍; 张丽; 叶京英; 王军

    2009-01-01

    in order among spasmodic dysphonia, vocal fold paralysis, functional dysphoina, sulcus vocalis, benign and malignant tumor of vocal fold, vocal fold cyst, Reinke' s edema, vocal fold polyp, vocal fold keratosis and chronic laryngitis, vocal nodule. The emotional scores were the highest in spasmodic dysphunia, and followed by functional dysphoina. In another group, the physical scores were higher than functional scores and emotional scores. Treatment resulted in statistical improvement in VHI scores (P<0.05). The total scores were different significantly between different educational background and age groups(F from 8.701 to 27. 371, P=0.000). The higher the educational degree, the higher the VHI scores. As to age groups, the juvenile group' s scores were the lowest, while the youth' s group the highest, then the scores declined when ages increased. Conclusion As a useful supplementary instrument to measure the voice disorder severity and the treatment' s effect, VHI can comprehensively assess the voice handicap' s affect to the life quality and the difference after the treatment, especially in physical, functional and emotional aspects, but it is somehow subject to the educational degree and age.

  7. Hip Revision

    Full Text Available ... the abductor fibers -- kind of a more vertical fashion so you kind of create a recess for ... Thank you, Todd. Have a good night. [Exit music] Thank you for watching this OR Live webcast ...

  8. Corticospinal tract conduction block results in the prolongation of central motor conduction time in compressive cervical myelopathy

    Nakanishi, Kazuyoshi; Tanaka, Nobuhiro; Fujiwara, Yasushi; Kamei, Naosuke; Ochi, Mitsuo

    2006-01-01

    Objective: The objective of this study was to analyze corticospinal function in patients with compressive cervical myelopathy and to elucidate the mechanism underlying its prolonged central motor conduction time (CMCT). Methods: Motor evoked potentials following transcranial magnetic stimulation (TMS) and peripheral conduction time in the ulnar and tibial nerves following electrical stimulation were measured from the abductor digiti minimi (ADM) and abductor hallucis (AH) muscles in 24 patien...

  9. Speech and Communication Disorders

    ... or understand speech. Causes include Hearing disorders and deafness Voice problems, such as dysphonia or those caused by cleft lip or palate Speech problems like stuttering Developmental disabilities Learning disorders Autism spectrum disorder Brain injury Stroke Some speech and ...

  10. INDIRECT MICROLARYNGOSTROBOSCOPIC SURGERY

    MAHIEU, HF; DIKKERS, FG

    1992-01-01

    Detailed preoperative laryngostroboscopic examination is a prerequisite for phonosurgical correction of organic dysphonia. Although suspension microlaryngoscopic surgery has proved its value in the past, it excludes functional control during the removal of vocal fold swellings. Using an indirect mic

  11. Speech impairment (adult)

    ... impairment; Impairment of speech; Inability to speak; Aphasia; Dysarthria; Slurred speech; Dysphonia voice disorders ... in others the condition does not get better. DYSARTHRIA With dysarthria, the person has ongoing difficulty expressing ...

  12. Laughter as Immanent Life-Affirmation: Reconsidering the Educational Value of Laughter through a Bakhtinian Lens

    Vlieghe, Joris

    2014-01-01

    In this article I try to conceive a new approach towards laughter in the context of formal schooling. I focus on laughter in so far as it is a bodily response during which we are entirely delivered to uncontrollable, spasmodic reactions. To see the educational relevance of this particular kind of laughter, as well as to understand why laughter is…

  13. Muscle selection for treatment of cervical dystonia with botulinum toxin : A systematic review

    Nijmeijer, S. W. R.; Koelman, J. H. T. M.; Kamphuis, D. J.; Tijssen, M. A. J.

    2012-01-01

    Rationale: Cervical dystonia, also called spasmodic torticollis, is the most common form of (primary) dystonia. Intramuscular injections with botulinum toxin are the first line of treatment for cervical dystonia. To optimise the treatment response to botulinum toxin correct muscles should be selecte

  14. Common Acupoints in the Upper Limb

    Journal of Acupuncture and Tuina Science editor; CUI Xue-jun

    2003-01-01

    @@ Chize (LU 5) Location: On the cubital crease, near the radial border of the tendon of m.biceps brachii (Fig. 1). Indications: Cough, asthma, hemoptysis, tidal fever,fullness in the chest, sore throat, infantile convulsion,vomiting, diarrhea, spasmodic pain of the elbow and arm.

  15. The irradiated larynx and voice: a perceptual study.

    Stoicheff, M L; Ciampi, A; Passi, J E; Fredrickson, J M

    1983-12-01

    The voices of patients with laryngeal cancer following a specific radiotherapy regimen were subjected to perceptual evaluation. Interval scaling of the severity of perceived dysphonia was completed for the voices of male patients sampled before and 1 year following radiation therapy and for a set of male controls. Eight listeners did this quantitative rating and also specified the predominant quality in each voice. The results indicated that the degree of dysphonia in the pretreatment group was highest. Radiotherapy decreased this dysphonia but not to the point that posttreatment voices were indistinguishable from those of normal subjects. Also, the voice qualities of laryngeal cancer patients shifted toward those of the control group following radiotherapy with over one half of the irradiated patients judged to have rough or normal qualities. PMID:6668937

  16. Differences in Dysfunction of Thenar and Hypothenar Motoneurons in Amyotrophic Lateral Sclerosis.

    Fang, Jia; Cui, Liying; Liu, Mingsheng; Guan, Yuzhou; Li, Xiaoguang; Li, Dawei; Cui, Bo; Shen, Dongchao; Ding, Qingyun

    2016-01-01

    This study aimed to determine differences in spinal motoneuron dysfunction between the abductor pollicis brevis (APB) and the abductor digiti minimi (ADM) in amyotrophic lateral sclerosis (ALS) patients based on studying F-waves. Forty ALS patients and 20 normal controls (NCs) underwent motor nerve conduction studies on both median and ulnar nerves, including F-waves elicited by 100 electrical stimuli. The F-wave persistence (P CMAP) amplitude ratio. Thus, F-waves may reveal subclinical alterations in anterior horn cells, and may potentially help to distinguish ALS from mimic disorders. PMID:27014030

  17. Normative values of eccentric hip abduction strength in novice runners

    Jørgensen, Daniel Ramskov; Pedersen, Mette Broen; Kastrup, Kristrian; Lønbro, Simon; Jacobsen, J S; Thorborg, K; Nielsen, R O; Rasmussen, S

    2014-01-01

    PURPOSE: Low eccentric strength of the hip abductors, might increase the risk of patellofemoral pain syndrome and iliotibial band syndrome in runners. No normative values for maximal eccentric hip abduction strength have been established. Therefore the purpose of this study was to establish norma...

  18. Kashima's Posterior cordectomy using coablator our experience

    Balasubramanian Thiagarajan

    2014-03-01

    Full Text Available Aim: To study the effectiveness of coblation technology in performing Kashima's procedure for bilateral abductor vocal fold paralysis. Methodology: Managing patients with bilateral vocal fold abductor paralysis is rather tricky one. It calls for delicate balance between airway and phonation. Various endolaryngeal techniques have been used to manage this problem. Here the authors describe their experience with posterior cordectomy using coablator. This study includes 10 patients who presented with stridor following bilateral abductor paralysis. All our patients were on tracheostomy tubes. They were very anxious with the tube and wanted decannulation done. All of these patients were operated by the same senior surgeon. These patients were managed with posterior cordotomy using coablation. Laryngeal wands were used in all these patients. These patients underwent spiggoting of their tracheostomy tube on the first post operative day. Decannulation was completed on the third post operative day. Early decannulation was made possible because there was negligible soft tissue oedema as these patients underwent coblation procedure. Observation: On discharge all of them had a good voice and adequate airway. These patients were able to climb two flights of stairs without discomfort.Although the causes of bilateral abductor paralysis of vocal cords are multifactorial post traumatic paralysis formed a large majority of our patients ( 8 who developed bilateral vocal fold paralysis following total thyroidectomy.

  19. Inter-Tester Reliability and Precision of Manual Muscle Testing and Hand-Held Dynamometry in Lower Limb Muscles of Children with Spina Bifida

    Mahony, Kate; Hunt, Adrienne; Daley, Deborah; Sims, Susan; Adams, Roger

    2009-01-01

    Reliability and measurement precision of manual muscle testing (MMT) and hand-held dynamometry (HHD) were compared for children with spina bifida. Strength measures were obtained of the hip flexors, hip abductors, and knee extensors of 20 children (10 males, 10 females; mean age 9 years 10 months; range: 5 to 15 years) by two experienced physical…

  20. Hip Revision

    Full Text Available ... your cable pass kind of scrape along the femur. Yeah, and same thing here then. I'm just going to make a little nick kind of in line. I'm always amazed -- the abductors up here are really kind of coming in at this angle. So you're saying you're going to ...

  1. Soft tissue injury related to choice of entry point in antegrade femoral nailing : piriform fossa or greater trochanter tip

    Moein, CMA; Verhofstad, MHJ; Bleys, RLAW; van der Werken, C

    2005-01-01

    Intramedullary nailing through the piriform fossa results in some cases in toss of abduction strength and persistent pain. Nail insertion at the tip of the greater trochanter may be favourable. The aim of this study was to assess (possible) iatrogenic injury to the abductor and external rotator musc

  2. Avaliação do Tratamento Cirúrgico da Artrose Trapeziometacárpica

    Azeda, C.; Mendes, MM; Mouzinho, MM

    1998-01-01

    The authors describe their experience, from July 1995 to December 1996, in the management of patients suffering from trapeziometacarpal degenerative arthrosis. Dell's classification is used for disease staging. The results of two different techniques are compared: 1) distal tenotomy of supranumerary insertions of abductor pollicis longus; and 2) trapeziectomy with tendon interposition arthroplasty and ligamentoplasty using the flexor carpi radialis.

  3. Electrolytes,water,acid-base imbalance

    2010-01-01

    2010296 Utility of clinical exercise test in diagnosis of hypokalaemic periodic paralysis. LIU Mingsheng(刘明生),et al. Dept Neurol,PUMC & CAMS,Beijing l00730. Chin J Neurol 2010;43(5):328-330. Objective To assess the utility of changes of muscle strength and compound muscle action potential (CMAP) of abductor digiti minimi (ADM) muscle after the exercise test

  4. Motor Unit Number Index (MUNIX): a novel neurophysiological marker for neuromuscular disorders; test-retest reliability in healthy volunteers.

    Neuwirth, C.; Nandedkar, S.; Stalberg, E.; Barkhaus, P.E.; Carvalho, M.; Furtula, J.; Dijk, J.P. van; Baldinger, R.; Castro, J.; Costa, J.; Otto, M.; Sandberg, A.; Weber, M.

    2011-01-01

    OBJECTIVE: To investigate the intra-rater and inter-rater test-retest reliability of the Motor Unit Number Index (MUNIX) in healthy subjects in a multicentre setting. METHODS: Six study centres applied the MUNIX technique in 66 healthy subjects. Five to six muscles (biceps brachii, BB; abductor digi

  5. Compressive neuropathy of the first branch of the lateral plantar nerve: a study by magnetic resonance imaging

    Rogéria Nobre Rodrigues

    2015-12-01

    Full Text Available Abstract Objective: To assess the prevalence of isolated findings of abnormalities leading to entrapment of the lateral plantar nerve and respective branches in patients complaining of chronic heel pain, whose magnetic resonance imaging exams have showed complete selective fatty atrophy of the abductor digiti quinti muscle. Materials and Methods: Retrospective, analytical, and cross-sectional study. The authors selected magnetic resonance imaging of hindfoot of 90 patients with grade IV abductor digiti quinti muscle atrophy according to Goutallier and Bernageau classification. Patients presenting with minor degrees of fatty muscle degeneration (below grade IV and those who had been operated on for nerve decompression were excluded. Results: A female prevalence (78.8% was observed, and a strong correlation was found between fatty muscle atrophy and plantar fasciitis in 21.2%, and ankle varices, in 16.8% of the patients. Conclusion: Fatty atrophy of the abductor digiti quinti muscle is strongly associated with neuropathic alterations of the first branch of the lateral plantar nerve. The present study showed a significant association between plantar fasciitis and ankle varices with grade IV atrophy of the abductor digiti quinti muscle.

  6. Compressive neuropathy of the first branch of the lateral plantar nerve: a study by magnetic resonance imaging*

    Rodrigues, Rogéria Nobre; Lopes, Alexia Abuhid; Torres, Jardélio Mendes; Mundim, Marina Franco; Silva, Lênio Lúcio Gavio; Silva, Breno Rabelo de Carvalho e

    2015-01-01

    Objective To assess the prevalence of isolated findings of abnormalities leading to entrapment of the lateral plantar nerve and respective branches in patients complaining of chronic heel pain, whose magnetic resonance imaging exams have showed complete selective fatty atrophy of the abductor digiti quinti muscle. Materials and Methods Retrospective, analytical, and cross-sectional study. The authors selected magnetic resonance imaging of hindfoot of 90 patients with grade IV abductor digiti quinti muscle atrophy according to Goutallier and Bernageau classification. Patients presenting with minor degrees of fatty muscle degeneration (below grade IV) and those who had been operated on for nerve decompression were excluded. Results A female prevalence (78.8%) was observed, and a strong correlation was found between fatty muscle atrophy and plantar fasciitis in 21.2%, and ankle varices, in 16.8% of the patients. Conclusion Fatty atrophy of the abductor digiti quinti muscle is strongly associated with neuropathic alterations of the first branch of the lateral plantar nerve. The present study showed a significant association between plantar fasciitis and ankle varices with grade IV atrophy of the abductor digiti quinti muscle. PMID:26811554

  7. Anterior Approach Total Hip Replacement

    Full Text Available ... got coming out in “JBJS,” the early six-week recovery is dramatically different between a direct lateral abductor splitting approach and this anterior supine approach. Let me get this head on. My experience, these patients have full leg control in about 24 hours. Yeah. They can get out of bed and ...

  8. Hip Revision

    Full Text Available ... abductors are always coming in kind like this -- Vertical. -- right in line with the femur. And they're not at this point. So I'm just going to make a little nick up here kind of -- you know the interval that you'd make for an anterior approach -- just so we can pass this cable around ...

  9. Ortner's syndrome: a case report and literature review

    Dutra, Bruno Landim; Campos, Lenilton da Costa; Marques, Helder de Castro; Vilela, Vagner Moyses, E-mail: brunolandim@yahoo.com.br [Universidade Federal de Juiz de Fora (HU/UFJF), MG (Brazil). Hospital Universitario. Unidade de Radiologia e Diagnostico por Imagem; Carvalho, Rodolfo Elias Diniz da Silva [Centro de Diagnostico Medico (CRM), Sao Mateus, ES (Brazil); Duque, Andre Geraldo da Silva [Axial Medicina Diagnostica, Belo Horizonte, MG (Brazil)

    2015-07-15

    The authors report the case of a 55-year-old female, hypertensive, smoker patient presenting with dysphonia, dysphagia and persistent dry cough. Laryngoscopy diagnosed left vocal cord paralysis. Computed tomography demonstrated saccular aneurysm of the inferior wall of the aortic arch, stretching the left recurrent laryngeal nerve, a finding compatible with Ortner's syndrome. (author)

  10. Behavioral and Environmental Analysis of Self-Reported Dysphonic and Non-Dysphonic High School Music Teachers

    Brown, Emily Pence

    2016-01-01

    Vocal fatigue and dysphonia are considered to be common hazards associated with occupational voice users. Teachers, due to the consistent communication demands of the profession, represent the highest percentage of clinical voice disorder patients (Verdolini & Ramig, 2001). Voice related injuries in teachers could result in lost wages due to…

  11. Genetic and Environmental Effects on Vocal Symptoms and Their Intercorrelations

    Nybacka, Ida; Simberg, Susanna; Santtila, Pekka; Sala, Eeva; Sandnabba, N. Kenneth

    2012-01-01

    Purpose: Recently, Simberg et al. (2009) found genetic effects on a composite variable consisting of 6 vocal symptom items measuring dysphonia. The purpose of the present study was to determine genetic and environmental effects on the individual vocal symptoms in a population-based sample of Finnish twins. Method: The sample comprised 1,728 twins…

  12. SUSPENSION MICROLARYNGOSCOPIC SURGERY AND INDIRECT MICROLARYNGOSTROBOSCOPIC SURGERY FOR BENIGN LESIONS OF THE VOCAL FOLDS

    DIKKERS, FG; SULTER, AM

    1994-01-01

    A prospective study was designed to compare the effects on voice capacities after either suspension microlaryngoscopic surgery or indirect microlaryngostroboscopic surgery. Patients where the clinical diagnosis 'dysphonia due to a benign lesion of the vocal fold' was made, and who could be operated

  13. Work-related voice disorder

    Paulo Eduardo Przysiezny

    2015-04-01

    Full Text Available INTRODUCTION: Dysphonia is the main symptom of the disorders of oral communication. However, voice disorders also present with other symptoms such as difficulty in maintaining the voice (asthenia, vocal fatigue, variation in habitual vocal fundamental frequency, hoarseness, lack of vocal volume and projection, loss of vocal efficiency, and weakness when speaking. There are several proposals for the etiologic classification of dysphonia: functional, organofunctional, organic, and work-related voice disorder (WRVD.OBJECTIVE: To conduct a literature review on WRVD and on the current Brazilian labor legislation.METHODS: This was a review article with bibliographical research conducted on the PubMed and Bireme databases, using the terms "work-related voice disorder", "occupational dysphonia", "dysphonia and labor legislation", and a review of labor and social security relevant laws.CONCLUSION: WRVD is a situation that frequently is listed as a reason for work absenteeism, functional rehabilitation, or for prolonged absence from work. Currently, forensic physicians have no comparative parameters to help with the analysis of vocal disorders. In certain situations WRVD may cause, work disability. This disorder may be labor-related, or be an adjuvant factor to work-related diseases.

  14. Vocal Function in Introverts and Extraverts during a Psychological Stress Reactivity Protocol

    Dietrich, Maria; Verdolini Abbott, Katherine

    2012-01-01

    Purpose: To examine the proposal that introversion predictably influences extralaryngeal and vocal behavior in vocally healthy individuals compared with individuals with extraversion and whether differences are of a nature that may support a risk hypothesis for primary muscle tension dysphonia. Method: Fifty-four vocally healthy female adults…

  15. Laryngeal neurinoma. Differential diagnosis of submucosal laryngeal tumors; Neurinoma laringeo. Diagnostico diferencial de tumoraciones submucosas laringeas

    Higuera, A.; Palomo, V.; Munoz, R.; Sanchez, F.

    2002-07-01

    Laryngeal neurinoma is a rare benign tumor that appears as a submucosal mass, generally in the supraglottic region. We report the case of a patient with dysphonia of long evolution caused by a neurinoma. We discuss the radiological findings of the tumor and the value of computed tomography (CT) in the diagnosis of this and other submucosal laryngeal lesions. (Author) 16 refs.

  16. Use of Spectral/Cepstral Analyses for Differentiating Normal from Hypofunctional Voices in Sustained Vowel and Continuous Speech Contexts

    Watts, Christopher R.; Awan, Shaheen N.

    2011-01-01

    Purpose: In this study, the authors evaluated the diagnostic value of spectral/cepstral measures to differentiate dysphonic from nondysphonic voices using sustained vowels and continuous speech samples. Methodology: Thirty-two age- and gender-matched individuals (16 participants with dysphonia and 16 controls) were recorded reading a standard…

  17. Maximum Phonation Time: Variability and Reliability

    R. Speyer; H.C.A. Bogaardt; V.L. Passos; N.P.H.D. Roodenburg; A. Zumach; M.A.M. Heijnen; L.W.J. Baijens; S.J.H.M. Fleskens; J.W. Brunings

    2010-01-01

    The objective of the study was to determine maximum phonation time reliability as a function of the number of trials, days, and raters in dysphonic and control subjects. Two groups of adult subjects participated in this reliability study: a group of outpatients with functional or organic dysphonia v

  18. Phase 1 dose-escalation study of the antiplacental growth factor monoclonal antibody RO5323441 combined with bevacizumab in patients with recurrent glioblastoma

    Lassen, Ulrik; Chinot, Olivier L; McBain, Catherine;

    2015-01-01

    (14 participants, 64%), headache (12 participants, 55%), dysphonia (11 participants, 50%) and fatigue (6 participants, 27%).The pharmacokinetics of RO5323441 were linear, over-the-dose range, and bevacizumab exposure was unaffected by RO5323441 coadministration. Modulation of plasmatic angiogenic...

  19. Ortner’s syndrome: a case report and literature review

    Bruno Landim Dutra

    2015-08-01

    Full Text Available AbstractThe authors report the case of a 55-year-old female, hypertensive, smoker patient presenting with dysphonia, dysphagia and persistent dry cough. Laryngoscopy diagnosed left vocal cord paralysis. Computed tomography demonstrated saccular aneurysm of the inferior wall of the aortic arch, stretching the left recurrent laryngeal nerve, a finding compatible with Ortner’s syndrome.

  20. ‘ SILENT’ LARYNGEAL FOREIGN BODY

    Chandrasekhar

    2015-06-01

    Full Text Available Laryngeal foreign bodies in adults are rare. The foreign bodies accidentally entering the larynx are symptomatic in the form of choking , stridor or even death. We are presenting a rare case of foreign body in the larynx in a 42 year old male who was symptom free except for dysphonia. The foreign body was removed successfully under local anesthesia.

  1. The Acoustic Voice Quality Index: Toward Improved Treatment Outcomes Assessment in Voice Disorders

    Maryn, Youri; De Bodt, Marc; Roy, Nelson

    2010-01-01

    Voice practitioners require an objective index of dysphonia severity as a means to reliably track treatment outcomes. To ensure ecological validity however, such a measure should survey both sustained vowels and continuous speech. In an earlier study, a multivariate acoustic model referred to as the Acoustic Voice Quality Index (AVQI), consisting…

  2. pH monitoring in patients with benign voice disorders

    Grøntved, A M; West, F

    2000-01-01

    -two suffered from reflux laryngitis. A comparison of symptoms in patients with proven reflux to patients with no reflux was made. The symptoms were more frequent in the patients in the reflux group than in the non-reflux group. There was a significant difference between the groups with regard to dysphonia...

  3. Laryngeal

    Brahim Bouaity

    2014-11-01

    Conclusion: Laryngeal amyloidosis is essentially a local clinical form whose main symptom is dysphonia. The treatment is usually based on local endoscopic procedures but may require a laryngectomy in advanced forms, associated with colchicine. The prognosis is much better than systemic forms.

  4. Study of structure and dielectric properties of Pb(Sn,Zr,Ti)O3 solid solutions

    Results of investigation of Pb(Sn,Zr,Ti)O3 solid solutions are presented. It is shown that in the above-mentioned solid solutions at room temperature ferroelectric and antiferroelectric phases coexist. In this range dielectric properties have clearly pronounced anomalies. Phase transition from ferroelectric to antiferroelectric state of polarized materials under the effect of hydrostatic pressure occurs spasmodically. The value of ferroelectric-antiferroelectric phase transition depends on titanium concentration

  5. MEDICINAL USES AND PHYTOCONSTITUENTS OF PAEONIA OFFICINALIS

    Ahmad F; Tabassum N; Rasool S

    2012-01-01

    Paeonia officinalis (European peony, Common peony) has been cultivated in Europe for years. The root has been used medicinally for over 2,000 years mainly in the treatment for epilepsy and to promote menstruation. Root is also antispasmodic, diuretic, sedative and tonic and has been successfully employed in the treatment of convulsions and spasmodic nervous affections such as epilepsy. It has also been used in the treatment of whooping cough whilst suppositories are sometimes made of the root...

  6. Two Cases of Baclofen-Induced Encephalopathy in Hemodialysis and Peritoneal Dialysis Patients

    Lee, Junseop; Shin, Ho Sik; Jung, Yeon Soon; Rim, Hark

    2012-01-01

    Hiccups are a spasmodic contraction of the diaphragm and usually transient phenomenon that affects nearly everyone. When hiccups develop, the patients are administrated antispastic agent, such as balcofen. Baclofen is widely used for the treatment of this spastic movement disorders. Also, baclofen is a gamma-aminobutyric acid (GABA) derivative that induces presynaptic motor neuron inhibition and produces a central antispastic response. Baclofen toxicity is rare and has been reported with intr...

  7. Striatal [11C]-N-methyl-spiperone binding in patients with focal dystonia (torticollis) using positron emission tomography

    Specific binding of [11C]-N-methyl-spiperone to striatal dopamine D2 receptors was assessed using positron emission tomography (PET) in 6 patients with adult-onset focal dystonia (predominantly spasmodic torticollis) and in 5 healthy subjects. No significant difference in average specific striatal tracer uptake between patients and healthy subjects was found. However, in the 5 patients showing lateralisation of clinical signs a trend to higher striatal tracer uptake in the contralateral hemisphere was observed. (authors)

  8. Synthesis and anticonvulsant activity of certain chalcone based pyrazoline compounds

    Sudhakara Rao Gerapati; Kalaichelvan V K; Ganguri Sudhakara Rao

    2015-01-01

    Convulsions are involuntary, violent, spasmodic and prolonged contractions of skeletal muscles. That means a patient may have epilepsy without convulsions and vice versa. Epilepsy is a common neurological abnormality affecting about 1% of the world population. The primary objectives of these synthesized compounds are to suppress seizures and provide neuroprotection by minimizing the effects from seizure attacks. Here some of the chalcones and chalcone based various pyrazolines were evaluated ...

  9. Cardiovascular effects of monoterpenes: a review

    Márcio R. V. Santos; Flávia V. Moreira; Byanka P. Fraga; Damião P. de Souza; Leonardo R. Bonjardim; Lucindo J. Quintans-Junior

    2011-01-01

    The monoterpenes are secondary metabolites of plants. They have various pharmacological properties including antifungal, antibacterial, antioxidant, anticancer, anti-spasmodic, hypotensive, and vasorelaxant. The purpose of this research was to review the cardiovascular effects of monoterpenes. The data in this resarch were collected using the Internet portals Pubmed, Scopus, and ISI Web of Knowledge between the years 1987 and 2010. In the study 33 monoterpenes were included, which were relate...

  10. THE ROLE OF THE SCO IN FORMING THE CENTRAL ASIAN SECURITY ENVIRONMENT: GEOPOLITICAL ASPECTS

    Shaimergenov, Timur; Tusupbaeva, Gulnar

    2006-01-01

    Of course it would be too declamatory to maintain that the Central Asian countries are acquiring a special significance in the international relations system, but we cannot deny the increased attention the global actors are focusing on them, mainly due to the geostrategic and economic potential of the region. The situation is complicated by the spasmodic development of certain processes in some of the region’s countries, the roots of which can be found in political and economic problems, as w...

  11. PSEUDO CENTRAL CERVICAL FIBROID IN A NULLIPAROUS GIRL: A CASE REPORT

    Priyankur; Bivas; Santosh; Anumita; Ruby

    2014-01-01

    Fibroids are benign (non-cancerous) growths on the uterus. There is an overall incidence of 20% in women more than 30yrs of age. The incidence of cervical fibroids is much lower at 1-2%. An unmarried girl presented with complaints of difficulty in passing urine, lower abdominal pain and spasmodic dysmenorrhea for 4 months. Per abdomen there was a firm, non-tender midline mass arising from the pelvis corresponding to 20 weeks size gravid uterus with restricted mobility. Cer...

  12. Allergie affections of the larynx in children-a clinico pathological study

    Sahoo, Gobind Chandra

    1999-01-01

    Laryngeal manifestation of allergy though less common than, Rhinosinusitis, tubotympanitis and bronchopulmanary allergy but it is not that uncommon which is usually misdiagnosed and mistreated in children. Hence the importance of larynx as the allergic shock organ in children with spasmodic croup and laryngotracheo bronchits. In the present study in children bellow five years, presenting with stridor and/or hoarsness were evaluated regarding the history of allergy, direct laryngoscopic findin...

  13. A clinico-pathological study of the role of allergy on larynx in children

    Sahoo, Govind Chandra

    1999-01-01

    Laryngeal manifestation of allergy though less common than rhinosinusitis, tubotympanitis and bronchopulmonary allergy is not that uncommon and is usually misdiagnosed and mistreated in children. Hence, the importance of larynx as the allergic shock organ in children with spasmodic croup and laryngotracheo hronchits. In the present study, children below five years, presenting with Stridor and/or hoarseness were evaluated regarding the history of allergy, direct laryngoscopic finding, measurem...

  14. Reversal of functional disorders by aspiration, expiration, and cough reflexes and their voluntary counterparts

    ZoltanTomori

    2012-01-01

    Agonal gasping provoked by asphyxia can save ~15% of mammals even from untreated ventricular fibrillation (VF), but it fails to revive infants with sudden infant death syndrome (SIDS). Our systematic study of airway reflexes in cats and other animals indicated that in addition to cough, there are two distinct airway reflexes that may contribute to auto-resuscitation. Gasp- and sniff-like spasmodic inspirations (SIs) can be elicited by nasopharyngeal stimulation, strongly activating the brains...

  15. Triad of torticollis, photophobia and epiphora in a child with a posterior fossa tumor

    Buijsrogge, Michiel

    2014-11-01

    Full Text Available [english] A 7-month-old Caucasian girl presented with an acquired, spasmodic torticollis to the right side with the head tilted downwards, photophobia and epiphora. Diagnostic work-out revealed a posterior fossa pilocytic astrocytoma. The symptoms improved after surgical resection. There is evidence of internuclear connections between cranial nerves II, V and VII acting as important mechanisms in this triad (Okamoto et al. 2010.

  16. Ulcer Protective and Spasmolytic Activity of Aqueous Extract of Solanum nigrum Leaves in Experimental Rats

    Muthukumar A; Periyasamy M; Manohar R; Chinna RR; Anandm G

    2013-01-01

    Ethno pharmacological relevance: Solanum nigrum Linn. (solanaceae) is a widely growing and cultivated traditional medicinal plant mainly used for the treatment of gastric illness and mouth ulcer. Aim of the present study was to evaluate the activity of aqueous leaves extract of Solanum nigrum Linn on irritable bowel syndrome and gastric ulcers. Materials and methods: Ulcer protective and anti spasmodic effect was investigated in cold restraint stress, aspirin induced and pyloric ligated ulc...

  17. On Risk Forecast and Risk Reduction of Tectonic Rock Bursts and Earthquakes

    Tazhibaev, Kushbakali

    2015-04-01

    Avershin, Shrepp, Kvochkin, Bojarkin and others observed that before strong rock bursts, considered as weak earthquakes, for several hours, sometimes for 2-5 days, there occurred spasmodic and sign-variable changes in deformations of rock massif adjacent areas. The works of seismologists Rikitaki, Asada, Isibasi, Matsuda, Saverensky, etc. describe a number of cases of an earthquake before which spasmodic and sign-variable deformations of earth's crust have been observed. The results of our own experimental research conducted during last decades show that abnormal spasmodic and sign-variable deformations are observed only in rocks having residual stresses. As a rule, these rocks at test after such abnormal deformations collapse dynamically, like explosions, and as a rule, such rocks represent dangerous rock bursts in deposits, located in seismically active areas (Tazhibaev K. Conditions of dynamic destruction of rocks and causes of rock bursts, Frunze 1989). It is necessary to notice that these spasmodic deformations are accompanied by formation and movement of internal discontinuities: dislocations, micro-cracks, and, hence, by redistribution of electric charges in a crystal lattice, and also in the rock as a whole. Redistribution and change in position of electric charges lead to the change of the natural electric potential and intensity of the magnetic field in the rocks massif. Before tectonic rock bursts and earthquakes together with abnormal changes of deformation, the same spasmodic and sign-variable changes of the natural electric and magnetic fields intensity occur. Based on the above-stated experimental findings, for solution of the problem of tectonic earthquakes forecast, we suggest placing the deformation measuring tool, the magnetic field intensity measuring tool and the device for measurement of natural electric potential along with seismic measurement into the seismic stations. Using abnormal, simultaneous changes of indications of all above listed

  18. Remarkable difference in paralytic shellfish poisoning toxin distribution in tissues of pen shell atrina pectinata exposed to toxic red tide bloom

    Pen shell atrina pectinata is one of the commercially important bivalves in Western Pacific region. In the Philippines, it is marketed as a whole meat or processed by shellfish harvesters to separate the abductor muscle as an export commodity. During blooms of toxic dinoflagellate pyrodinium bahamense var. compressum (Pbc), A. pectinata accumulates paralytic shellfish poisoning (PSP) toxins sometimes exceeding Philippine regulatory limit of 60μgSTXeq/100g tissue and international regulatory limit of 80μgSTXeq/100g tissue for safe human consumption, based on whole tissue analysis. Toxic blooms directly affect the shellfish industry which includes A. pectinata, and this causes not only significant economical losses on shellfish gatherers but also serious public health concerns. In this study, samples of A. pectinata exposed to toxic bloom of Pbc were collected in Sorsogon Bay, Philippines. Bioaccumulation and distribution of PSP toxins were determined in different tissues namely, abductor muscle, mantle, gills, gonads, siphon, stomach and intestine using High Performance Liquid Chromatography post column derivatization method with fluorescence detection. Likewise, green mussels Perna viridis being the sentinel species for PSP monitoring in the Philippines were also collected in the same area and served as control. Interestingly, results showed that the abductor muscle accumulates minimal level of PSP toxins and is several folds lower than the Philippine and international regulatory limits in contrast with the results obtained from P. viridis. Mantle parts showed toxicity values exceeding local regulatory limit and near to go beyond the international regulatory limit. Conversely, the remaining parts showed high toxicity values surpassing both regulation limits. Standard mouse bioassay regulatory used in PSP monitoring in the Philippines was also performed and revealed that the abductor muscle had non-detectable level of toxins. Also, toxicity values from different

  19. Hand weakness in Charcot-Marie-Tooth disease 1X.

    Arthur-Farraj, P J

    2012-07-01

    There have been suggestions from previous studies that patients with Charcot-Marie-Tooth disease (CMT) have weaker dominant hand muscles. Since all studies to date have included a heterogeneous group of CMT patients we decided to analyse hand strength in 43 patients with CMT1X. We recorded handedness and the MRC scores for the first dorsal interosseous and abductor pollicis brevis muscles, median and ulnar nerve compound motor action potentials and conduction velocities in dominant and non-dominant hands. Twenty-two CMT1X patients (51%) had a weaker dominant hand; none had a stronger dominant hand. Mean MRC scores were significantly higher for first dorsal interosseous and abductor pollicis brevis in non-dominant hands compared to dominant hands. Median nerve compound motor action potentials were significantly reduced in dominant compared to non-dominant hands. We conclude that the dominant hand is weaker than the non-dominant hand in patients with CMT1X.

  20. Absence of split hand in the flail arm variant of ALS.

    Sun, Xian; Zhang, Zhecheng; Liu, Na

    2016-04-01

    Flail arm syndrome (FAS), a variant of amyotrophic lateral sclerosis (ALS), has many similarities with upper limb onset ALS (UL-ALS). This study analyzed the compound muscle action potentials (CMAPs) recorded from abductor pollicis brevis (APB) and abductor digiti minimi (ADM) muscles in patients presenting these two types of ALS variants, compared to normal controls. The APB/ADM CMAP amplitude ratio was lower in the UL-ALS group (mean±SEM: 0.56±0.37), consistent with a split hand, compared to the FAS (1.05±0.29) or control (1.11±0.30) groups. An abnormally reduced APB/ADM CMAP amplitude ratio (CMAP in the APB or extremely low APB/ADM CMAP amplitude ratio (<0.25) were observed only in UL-ALS patients (27%) and could be used as diagnostic criteria to differentiate UL-ALS from FAS variant. PMID:27157380

  1. Endoscopic Treatment of Gluteus Medius Tears: A Review.

    Lerebours, Frantz R; Cohn, Randy; Youm, Thomas

    2016-03-01

    Greater trochanteric pain syndrome (GTPS) is a term used to describe disorders of the peritrochanteric region. This constellation of conditions includes greater trochanteric bursitis, gluteus medius (GM) tears, and external coxa saltans or snapping hip syndrome. Tears of the abductor mechanism, more specifically gluteus medius tears, have recently gained a considerable amount of interest in the orthopaedic literature. Abductor tears were first described by Bunker and Kagan in the late 1990s. They used the rotator cuff as an analogous structure to describe the pathological process associated with gluteus medius tears. Tears of the gluteus medius tendon can often be difficult to recognize. The clinical presentation is often attributed to trochanteric bursal inflammation, without any further workup. Provocative hip physical examination findings are an important key to proper diagnosis of abductor injuries. Depending on the size of the tear, patients with abductor tendon pathology may present with a Trendelenburg gait and reduced resisted abduction strength accompanied by pain. Initial noninvasive management of greater trochanteric pain syndrome includes oral or topical anti-inflammatory medication and activity modification. Physical therapy or other treatment modalities can be considered, with a focus on core strengthening, truncal alignment, and iliotibial band stretching. Gluteus medius tears have historically been repaired in an open fashion; however, the advent of new endoscopic surgery techniques has allowed for a less invasive approach. Access to the peritrochanteric space affords the surgeon with access to pathology associated with the greater trochanter, iliotibial band, trochanteric bursa, sciatic nerve, short external-rota tors, iliopsoas tendon, and the gluteus medius and minimus tendon attachments. Over the last decade, we have seen rapid technological advances in hip arthroscopy, improved diagnostic imaging and interpretation, and an improved

  2. Greater Trochanter Reconstruction in Unstabl Intertrochanteric Fractures Treated With Cemented Bipolar Hemiarthroplasty: A Technical Note.

    Subramanian, G V; Guravareddy, A V; Reddy, Anil Kumar K R; Chiranjeevi, T

    2012-01-01

    Cemented Bipolar arthroplasty is an established method for treatment of comminuted Intertrochanteric fractures. Reconstruction of greater trochanter is an essential technical step to avoid complications like abductor lurch gait. We here describe a technique of reconstruction and fixation of greater trochanter using cancellous screws with wide washers made of reconstruction plate and tension band wiring. This gives a stable fixation of greater trochanter and avoids cut out, slippage of implants. PMID:27298870

  3. Greater Trochanter Reconstruction in Unstabl Intertrochanteric Fractures Treated With Cemented Bipolar Hemiarthroplasty: A Technical Note

    Subramanian, G V; Guravareddy, A V; Reddy, Anil Kumar K R; Chiranjeevi, T.

    2012-01-01

    Cemented Bipolar arthroplasty is an established method for treatment of comminuted Intertrochanteric fractures. Reconstruction of greater trochanter is an essential technical step to avoid complications like abductor lurch gait. We here describe a technique of reconstruction and fixation of greater trochanter using cancellous screws with wide washers made of reconstruction plate and tension band wiring. This gives a stable fixation of greater trochanter and avoids cut out, slippage of implants.

  4. Function-Orientated Structural Analysis of the Proximal Human Femur

    Skuban, Tobias P.; Vogel, Tobias; Baur-Melnyk, Andrea; Jansson, Volkmar; Heimkes, Bernhard

    2009-01-01

    In his model of the biomechanics of the proximal human femur, Friedrich Pauwels assumes a resultant force acting on the femoral head that is created by the partial body weight and the force of the abductor muscles inserting at the greater trochanter. This model suggests a tensile force in the region of the greater trochanter. An exact examination of the muscle insertions at the greater trochanter resulted in a contrasting hypothesis assuming a local compression stress in the region of the gre...

  5. Bilateral Simultaneous Heterotopic Ossification of the Reflected Head of Rectus Femoris Muscle: A Case Report and Review of the Literature

    Murat Tonbul; Seyma Ozen; Ayse Tuba Tonbul

    2014-01-01

    Lamellar bone formation in an abnormal location is defined as heterotopic ossification. It commonly occurs around the hip joint and most often involves the abductor muscles. It is a benign condition; however, its etiology remains largely unknown. Most previously reported cases have been due to trauma or intramuscular hemorrhage. In this paper, we present a case of bilateral heterotopic ossification of the reflected head of rectus femoris muscle without antecedent trauma or any other known cau...

  6. Anatomic Landmarks for the First Dorsal Compartment

    Hazani, Ron; Engineer, Nitin J.; Cooney, Damon; Wilhelmi, Bradon J.

    2009-01-01

    Objective: Knowledge of anatomic landmarks for the first dorsal compartment can assist clinicians with management of de Quervain's disease. The radial styloid, the scaphoid tubercle, and Lister's tubercle can be used as superficial landmarks for the first dorsal compartment. Methods: Thirty-two cadaveric wrists were dissected, and measurements were taken from the predetermined landmarks to the extensor retinaculum. The compartments were also inspected for variability of the abductor pollicis ...

  7. Correlation of the Y-Balance Test with Lower-limb Strength of Adult Women

    Lee, Dong-Kyu; Kim, Gyoung-Mo; Ha, Sung-min; Oh, Jae-Seop

    2014-01-01

    [Purpose] The purpose of this study was to elucidate the relationship between Y-balance test (YBT) distance and the lower-limb strength of adult women. [Subjects] Forty women aged 45 to 80 years volunteered for this study. [Methods] The participants were tested for maximal muscle strength of the lower limbs (hip extensors, hip flexors, hip abductors, knee extensors, knee flexors, and ankle dorsiflexors) and YBT distances in the anterior, posteromedial, and posterolateral directions. Pearson’s...

  8. Arthroscopic treatment of chronically painful calcific tendinitis of the rectus femoris

    Peng, Xu; Feng, Yong; Chen, Guangxing; Yang, Liu

    2013-01-01

    Background Relatively large calcific tendinitis with persistent symptoms after extended periods of conservative treatment is an indication for operative therapy. Arthroscopy, as a treatment for calcific tendinitis of the hip abductors and calcinosis circumscripta, has been described previously; however, to our knowledge, the clinical and radiological response to arthroscopic removal of calcific tendinitis of the rectus femoris tendon has not. Methods We present arthroscopic treatment of unusu...

  9. Greater Hip Extension but Not Hip Abduction Explosive Strength Is Associated With Lesser Hip Adduction and Knee Valgus Motion During a Single-Leg Jump-Cut

    Cronin, Baker; Johnson, Samuel T; Chang, Eunwook; Pollard, Christine D.; Norcross, Marc F.

    2016-01-01

    Background: The relationships between hip abductor and extensor strength and frontal plane hip and knee motions that are associated with anterior cruciate ligament injury risk are equivocal. However, previous research on these relationships has evaluated relatively low-level movement tasks and peak torque rather than a time-critical strength measure such as the rate of torque development (RTD). Hypothesis: Females with greater hip abduction and extension RTD would exhibit lesser frontal plane...

  10. Surgical approach in primary total hip arthroplasty: anatomy, technique and clinical outcomes

    Petis, Stephen; Howard, James L.; Lanting, Brent L.; Vasarhelyi, Edward M.

    2015-01-01

    Total hip arthroplasty (THA) has revolutionized the treatment of hip arthritis. A number of surgical approaches to the hip joint exist, each with unique advantages and disadvantages. The most commonly used approaches include the direct anterior, direct lateral and posterior approaches. A number of technical intricacies allow safe and efficient femoral and acetabular reconstruction when using each approach. Hip dislocation, abductor insufficiency, fracture and nerve injury are complications of...

  11. The effects of band exercise using proprioceptive neuromuscular facilitation on muscular strength in lower extremity

    Rhyu, Hyun-seung; Kim, Su-Hyun; Park, Hye-Sang

    2015-01-01

    The purpose of this study was to examine whether a six-week elastic band exercise program using proprioceptive neuromuscular facilitation (PNF) can increase isotonic strength of abductor muscles in the lower extremity. Twenty-eight healthy students from S university were divided into an experimental group and control group. Each group was participated in pre and post-measurement in isotonic strength using an isotonic analyzer, En-treeM. Experimental group performed elastic band exercise using...

  12. Variation and Clinical Significance of Extensor Pollicis Brevis: A Study in South Indian Cadavers

    Potu, Bhagath K; Prima D’Souza; Latha V Prabhu; Dil Islam Mansur; Ashwin Krishnamurthy; Muktyaz Hussein; Nayak, Soubhagya R; Ganesh K. Chettiar

    2009-01-01

    Background: de Quervain’s disease is a condition in which there is pain in the radial styloidprocess caused by stenosing tenosynovitis of the abductor pollicislongus (APL) or/and extensor pollicis brevis (EPB) tendons in the firstextensor compartment of the wrist. In this study we studied variations in thetendons of the EPB in the first extensor compartment and its site of insertion.Methods: One hundred fifty six upper limbs from adult cadavers of south Indian originwere dissected to observe ...

  13. Epiglottic abscess causing acute airway obstruction in an adult

    Acute epiglottitis is an acute inflammation in the supraglottic region of the oropharynx which is a potentially life-threatening condition leading to rapid upper airway obstruction. An infrequent sequel of acute epiglottitis is the epiglottic abscess. Less than 50 cases have been reported in the international literature and even less are the cases that acute surgical intervention was necessary to secure the airway. We report a young man with sudden onset of odynophagia, dysphonia and dyspnea and rapidly progression of upper airway obstruction. Clinical examination with fiberoptic nasopharyngolaryngoscope in emergency department demonstrated an epiglottic abscess. An urgent tracheostomy was performed in order to secure patient's airway and afterward, the patient underwent direct laryngoscopy and drainage of abscess and intravenous antibiotics were administrated. The diagnosis of epiglottic abscess should be considered in adult patients with odynophagia and dysphonia. Principles of treatment include aggressive airway management, surgical drainage of abscess and intravenous antibiotics. (author)

  14. Vocal therapy with larynx compression after partial laryngectomy

    Mumović Gordana M.

    2011-01-01

    Full Text Available The aim of the study was to establish the effects of the vocal therapy by manual compression of the larynx on dysphonia due to a partial laryngectomy and compare them with the effects of the standard vocal therapy. The prospective study included 66 patients submitted to any partial laryngectomy type. The patients were randomly classified into two groups: Group I (33 receiving the standard vocal therapy, and Group II (33 submitted to larynx compression vocal therapy. The 6-week vocal treatment was performed. The treatment effects were evaluated by subjective and objective voice analysis methods. The subjective and objective acoustic voice analysis revealed a significant influence (p<0.05 of either of the two vocal therapy modes on initial dysphonia. The larynx compression vocal therapy had better effects on the acoustic parameters: habitual fundamental frequency, mean fundamental frequency, standard deviation of fundamental frequency, maximal fundamental frequency, harmonics-to-noise ratio, and signal-to-noise ratio.

  15. The effects of hip external rotator exercises and toe-spread exercises on lower extremity muscle activities during stair-walking in subjects with pronated foot.

    Goo, Young-Mi; Kim, Da-Yeon; Kim, Tae-Ho

    2016-03-01

    [Purpose] The purpose of the present study was to examine the effects of toe-spread (TS) exercises and hip external rotator strengthening exercises for pronated feet on lower extremity muscle activities during stair-walking. [Subjects and Methods] The participants were 20 healthy adults with no present or previous pain, no past history of surgery on the foot or the ankle, and no foot deformities. Ten subjects performed hip external rotator strengthening exercises and TS exercises and the remaining ten subjects performed only TS exercises five times per week for four weeks. [Results] Less change in navicular drop height occurred in the group that performed hip external rotator exercises than in the group that performed only TS exercises. The group that performed only TS exercises showed increased abductor hallucis muscle activity during both stair-climbing and -descending, and the group that performed hip external rotator exercises showed increased muscle activities of the vastus medialis and abductor hallucis during stair-climbing and increased muscle activity of only the abductor hallucis during stair-descending after exercise. [Conclusion] Stair-walking can be more effectively performed if the hip external rotator muscle is strengthened when TS exercises are performed for the pronated foot. PMID:27134364

  16. A wider pelvis does not increase locomotor cost in humans, with implications for the evolution of childbirth.

    Anna G Warrener

    Full Text Available The shape of the human female pelvis is thought to reflect an evolutionary trade-off between two competing demands: a pelvis wide enough to permit the birth of large-brained infants, and narrow enough for efficient bipedal locomotion. This trade-off, known as the obstetrical dilemma, is invoked to explain the relative difficulty of human childbirth and differences in locomotor performance between men and women. The basis for the obstetrical dilemma is a standard static biomechanical model that predicts wider pelves in females increase the metabolic cost of locomotion by decreasing the effective mechanical advantage of the hip abductor muscles for pelvic stabilization during the single-leg support phase of walking and running, requiring these muscles to produce more force. Here we experimentally test this model against a more accurate dynamic model of hip abductor mechanics in men and women. The results show that pelvic width does not predict hip abductor mechanics or locomotor cost in either women or men, and that women and men are equally efficient at both walking and running. Since a wider birth canal does not increase a woman's locomotor cost, and because selection for successful birthing must be strong, other factors affecting maternal pelvic and fetal size should be investigated in order to help explain the prevalence of birth complications caused by a neonate too large to fit through the birth canal.

  17. The effect of hip joint muscle exercise on muscle strength and balance in the knee joint after meniscal injury

    Park, Sun Ja; Kim, Young Mi; Kim, Ha Roo

    2016-01-01

    [Purpose] This study aimed to evaluate the effect of hip muscle strengthening on muscle strength and balance in the knee joint after a meniscal injury. [Subjects and Methods] This randomized control study enrolled 24 patients who had undergone arthroscopic treatment after a meniscal injury and began a rehabilitative exercise program 8 weeks after surgery. Subjects were divided into 2 groups of 12 subjects each: gluteus medius resistance exercise group and control group. This study investigated muscle strength and balance in the knee joint flexor, extensor, and abductor during an 8-week period. [Results] Measurements of knee extensor muscle strength revealed no significant difference between the control group and the experimental group. Measurements of abductor muscle strength, however, identified a significant difference between the 2 groups. The groups did not differ significantly with regard to balance measurements. [Conclusion] The results of this study suggest that this subject should be approached in light of the correlation between the hip abductor and injury to the lower extremities.

  18. Isokinetic imbalance of hip muscles in soccer players with osteitis pubis.

    Mohammad, Walaa Sayed; Abdelraouf, Osama Ragaa; Elhafez, Salam Mohamed; Abdel-Aziem, Amr Almaz; Nassif, Nagui Sobhi

    2014-01-01

    In this study, we compared the isokinetic torques of hip flexors/extensors and abductors/adductors in soccer players suffering from osteitis pubis (OP), with normal soccer players. Twenty soccer male athletes with OP and 20 normal soccer athletes were included in this study. Peak torque/body weight (PT/BW) was recorded from hip flexor/extensor and abductor/adductor muscles during isokinetic concentric contraction modes at angular velocity of 2.1 rad · s(-1), for both groups. The results showed a significant difference between the normal and OP groups for hip flexors (P 0.05). Regarding the hip adductor/abductor PT ratio, there was no significant difference between the normal and OP groups of athletes (P > 0.05). The OP group displayed increase in hip flexor strength that disturbed the hip flexor/extensor torque ratio of OP. Therefore, increasing the hip extensor strength should be part of rehabilitation programmes of patients with OP. PMID:24499182

  19. Shorter, rough trunnion surfaces are associated with higher taper wear rates than longer, smooth trunnion surfaces in a contemporary large head metal-on-metal total hip arthroplasty system.

    Brock, Timothy M; Sidaginamale, Raghavendra; Rushton, Steven; Nargol, Antoni V F; Bowsher, John G; Savisaar, Christina; Joyce, Tom J; Deehan, David J; Lord, James K; Langton, David J

    2015-12-01

    Taper wear at the head-neck junction is a possible cause of early failure in large head metal-on-metal (LH-MoM) hip replacements. We hypothesized that: (i) taper wear may be more pronounced in certain product designs; and (ii) an increased abductor moment arm may be protective. The tapers of 104 explanted LH-MoM hip replacements revised for adverse reaction to metal debris (ARMD) from a single manufacturer were analyzed for linear and volumetric wear using a co-ordinate measuring machine. The mated stem was a shorter 12/14, threaded trunnion (n=72) or a longer, smooth 11/13 trunnion (n=32). The abductor moment arm was calculated from pre-revision radiographs. Independent predictors of linear and volumetric wear included taper angle, stem type, and the horizontal moment arm. Tapers mated with the threaded 12/14 trunnion had significantly higher rates of volumetric wear (0.402 mm3/yr vs. 0.123 mm3/yr [t=-2.145, p=0.035]). There was a trend to larger abductor moment arms being protective (p=0.055). Design variation appears to play an important role in taper-trunnion junction failure. We recommend that surgeons bear these findings in mind when considering the use of a short, threaded trunnion with a cobalt-chromium head. PMID:26135357

  20. Characteristics of polypoid lesions in patients undergoing microsurgery of the larynx

    Ido Filho, Jorge Massaaki; Carvalho, Bettina; Mizoguchi, Flavio Massao; Catani, Guilherme Simas do Amaral; Macedo Filho, Evaldo Dacheux de; Malafaia, Osvaldo; Stahlke Jr., Henrique Jorge

    2014-01-01

    Summary Introduction: Dysphonia is the main symptom of lesions that affect the vocal tract. Many of those lesions may require surgical treatment. Polyps are one of the most common forms of vocal cord lesions and the most prevalent indication for laryngeal microsurgery. There are different types of polyps, and their different characteristics can indicate different prognosis and treatments. Aim: To conduct a comparative study of polypoid lesions (angiomatous and gelatinous) in patients undergoi...

  1. Cervical chordoma with retropharyngeal extension presenting with impaired voice

    Nicoucar, Keyvan; Rausch, Thierry; Becker, Minerva; Dulguerov, Pavel

    2008-01-01

    AIMS AND BACKGROUND: We report an extremely rare case of cervical chordoma presenting with impaired voice. METHOD: Case report and a review of the literature concerning the presentation, diagnosis, and treatment of a cervical chordoma. RESULTS: A singing teacher complaining of dysphonia was examined and surgically treated for a retropharyngeal extension of a cervical chordoma. A local recurrence was treated with proton beam therapy. Among primary malignant tumors of bone, chordomas account fo...

  2. An undiagnosed myasthenia gravis presenting as isolated recurrent acute respiratory failure

    Shri Ram Sharma; Nalini Sharma; Yeolekar, M E

    2012-01-01

    Acute respiratory failure is an uncommon initial presentation of myasthenia gravis (MG). In our case a 22-year-old woman of unrecognized MG presented to the emergency department with isolated respiratory failure as the first presenting symptom. Initially she presented with dysphonia and was managed by speech therapist and ENT surgeons for 3 months. Subsequently, she presented with signs and symptoms of sepsis and went into acute respiratory failure. This case highlights the need to consider M...

  3. A microsurgical anterior cervical approach and the immediate impact of mechanical retractors: A case control study

    Rodrigo Ramos-Zúñiga

    2015-01-01

    Full Text Available Introduction: A microsurgical anterior cervical approach with discectomy and fusion (MACDF is one of the most widely used procedures for treating radicular disorders. This approach is highly successful; however, it is not free from complications. These can be associated with soft tissue injuries. Aim of the Study: The recognition of the risks for these complications should be identified for timely prevention and safe treatment. Materials and Methods: Study Design: Retrospective case control study. This study includes a retrospective case series of 37 patients, paying special attention to immediate complications related to the use of mechanical retraction of soft tissue (dysphagia, dysphonia, esophageal lesions and local hematoma; and a comparative analysis of the outcomes after changes in the retraction method. Results: All selected cases had a positive neurological symptom response in relation to neuropathic pain. Dysphagia and dysphonia were found during the first 72 h in 94.1% of the cases in which automatic mechanical retraction was used for more than one hour during the surgical procedure. A radical change was noted in the reduction of the symptoms after the use of only manual protective blades without automatic mechanical retraction: 5.1% dysphagia and 0% dysphonia in the immediate post-operative period, P = 0.001. Conclusions: Soft tissue damage due to the use of automatic retractors in MACDF is not minor and leads to general discomfort in the patient in spite of good neurological results. These problems most often occur when automatic retractors are used continuously for more than 1 hour, as well as when they are used in multiple levels. Dysphagia, dysphonia and local pain decreased with the use of transient manual blades for retraction, and with intermittent release following minimally invasive principles.

  4. Benign Lesions of The Vocal Fold

    Ozgur Surmelioglu

    2013-02-01

    Full Text Available Benign lesions of vocal folds are common disorders. Fifty percent of patients who have sound complaints are found to have these lesions after endoscopic and stroboscopic examinations. Benign vocal fold diseases are primarily caused by vibratory trauma. However they may also occur as a result of viral infections and congenital causes. These lesions are often presented with the complaints of dysphonia. [Archives Medical Review Journal 2013; 22(1.000: 86-95

  5. Occupational voice demands and their impact on the call-centre industry

    Duffy OM; Hazlett, DE; Moorhead SA

    2009-01-01

    Abstract Background Within the last decade there has been a growth in the call-centre industry in the UK, with a growing awareness of the voice as an important tool for successful communication. Occupational voice problems such as occupational dysphonia, in a business which relies on healthy, effective voice as the primary professional communication tool, may threaten working ability and occupational health and safety of workers. While previous studies of telephone call-agents have reported a...

  6. Comparison of Morphometric Aspects of Light and Electron Microscopy of the Hypoglossal Nerve between Young and Aged Male Wistar Rats

    Mohsen Pourghasem; Yasser Asghari Vostacolaee; Nabiollah Soltanpour

    2012-01-01

    Objective: Age-related changes occur in many different systems of the body. Many elderly people show dysphagia and dysphonia. This research was conducted to evaluate quantitatively the morphometrical changes of the hypoglossal nerve resulting from the aging process in young and aged rats. Materials and Methods: Through an experimental study ten male wistar rats (4 months: 5 rats, 24 months: 5 rats) were selected randomly from a colony of wistars in the UWC. After a fixation process and prepar...

  7. A database and digital signal processing framework for the perceptual analysis of voice quality

    Bermúdez de Alvear, Rosa M.; Corral, Jesús; Tardón, Lorenzo J.; Barbancho, Ana M.; Fernández-Contreras, Elena; Rando-Márquez, Sara; Martínez-Arquero, A. Ginés; Barbancho, Isabel

    2015-01-01

    Introduction. Clinical assessment of dysphonia relies on perceptual as much as instrumental methods of analysis [1]. The perceptual auditory analysis is potentially subject to several internal and external sources of bias [2]. Furthermore acoustic analyses which have been used to objectively characterize pathological voices are likely to be affected by confusion variables such as the signal processing or the hardware and software specifications [3]. For these reasons the poor correlation betw...

  8. An unusual presentation of an infected vallecular cyst presenting as supraglottitis

    Pattni, Vijay; Porter, Graham; Omakobia, Eugene

    2013-01-01

    A 50-year-old gentleman presented to the emergency department with a 24 h history of stridor, dysphonia, dysphagia and vomiting. On examination, the patient had fever and tachycardic. There was no palpable cervical lymphadenopathy. Flexible nasendoscopy and lateral neck x-ray revealed soft tissue swelling around the epiglottis. The swelling subsided with conservative management of intravenous antibiotics and steroids, only to later reveal a vallecular cyst, which was confirmed on microlaryngo...

  9. Lingual thyroid in children

    P Singhal; Sharma, K R; Singhal, A.

    2011-01-01

    Lingual thyroid is a rare embryological anomaly and originates from failure of the thyroid gland to descend from the foramen caecum to its normal eutopic pre-laryngeal site. The ectopic gland located at the base of the tongue is often asymptomatic but may cause local symptoms such as dysphagia, dysphonia with stomatolalia, upper airway obstruction and haemorrhage, often with hypothyroidism. One case is presented, in a 5 year-old girl patient, who complained of sensation of a foreign body and ...

  10. Laryngeal cleft type I: a novel method of repair using Bioplastique.

    Ahluwalia, S; Pothier, D; Philpott, J; Sengupta, P; Frosh, A

    2004-08-01

    The authors report a novel treatment of a case of type I laryngeal cleft diagnosed in an adult. They describe a technique of endoscopic obliteration of the posterior commissure defect. Initially, a test implant of starch and adrenaline was used, followed by permanent staged injections of Bioplastique to the posterior commissure. This rare congenital anomaly usually presents in childhood but late presentation should be considered when adults present with lifelong dysphonia especially when associated with gastro-oesophageal reflux disease. PMID:15453945

  11. Acoustic measurement of overall voice quality in sustained vowels and continuous speech

    Maryn, Youri

    2010-01-01

    Measurement of dysphonia severity involves auditory-perceptual evaluations and acoustic analyses of sound waves. Meta-analysis of proportional associations between these two methods showed that many popular perturbation metrics and noise-to-harmonics and others ratios do not yield reasonable results. However, this meta-analysis demonstrated that the validity of specific autocorrelation- and cepstrum-based measures was much more convincing, and appointed ‘smoothed cepstral peak prominence’ as ...

  12. Acute airway failure secondary to thyroid metastasis from renal carcinoma

    Lastilla Gaetano; Gurrado Angela; Lissidini Germana; Testini Mario; Ianora Amato; Fiorella Raffaele

    2008-01-01

    Abstract Background Secondary involvement of the thyroid gland by malignant metastases is uncommon. Acute respiratory crisis due to infiltration of the upper airways is a recognised complication of anaplastic thyroid carcinoma or thyroid lymphoma. Renal cell carcinoma is a tumour that metastasizes diffusely and in an unpredictable manner. Case presentation We report a case of a 73-year-old man with a painful neck mass, dyspnoea, stridor and dysphonia that was evaluated in emergency. A right r...

  13. UNUSUAL PRESENTATION OF BRAINSTEM GLIOMA AS PROGRESSIVE BULBAR PALSY

    Suma

    2015-04-01

    Full Text Available Brain stem gliomas/astrocytomas are slowly growing tumors affecting children and young adults. They usually present with unilateral cranial nerve palsies followed by long tract signs. Here we present a case report of a 42 year old male patient, who initially presented with thyrotoxicosis and slowly progressing dysphagia, dysarthria and dysphonia with no other long tract signs, and was later found to have brain stem glioma.

  14. A RARE CASE OF IMPACTED VEGETATIVE FOREIGN BODY IN LARYNX: XANTHIUM STRUMARIUM (CHHOTA GOKHRU)

    Richa,; Surendra Singh

    2013-01-01

    ABSTRACT: - BACKGROUND : Impaction of foreign bodies in the larynx constit utes a medical emergency and requires immediate intervention. We report a rare case of a Xanthium Strumarium (Chhota Gokhru) impacted in larynx in a 10 year old female who pre sented with complaint of respiratory distress & dysphonia in ENT department, S.S. Medical college and associated hospital, Rewa (M.P.). Direct laryngoscopy was performed for its removal. The case report thus...

  15. Complications of the anterior approach to the cervical spine

    Marcelo Lemos Vieira da Cunha

    2014-09-01

    Full Text Available OBJECTIVE: To evaluate the complications of anterior approach to the cervical spine in patients who underwent cervical arthrodesis with instrumentation. METHODS: Prospective and descriptive study was conducted from January 2009 to April 2010. All patients who underwent arthrodesis of the cervical spine by anterior approach were included, regardless the diagnosis. Access was made by the anterior approach on the right side. We evaluated the number of operated levels (1, 2 or 3 levels and, the type of procedure performed: discectomy and placement of cage and plate (D+C+P, discectomy with placement of a cage (D+C or corpectomy with placement of cage and plate (C+C+P. All complications related to surgical approach were reported. RESULTS: We studied 34 patients, 70% male. The average age was 50 years and mean follow-up was 8 months. Eighteen percent of patients had complications, distributed as follows: dysphasia (33% and dysphonic (67%. Among patients who developed complications, most underwent to D+C+P (83% and no complications were found in patients where no cervical plate was used. Regarding levels, both complications were identified in patients operated to one or two levels. However, in patients operated on three levels, only dysphonia was identified. CONCLUSION: The most frequent complication was dysphonia. Patients who presented more complications were those undergoing discectomy and fusion with cage and anterior cervical plate. All cases of dysphonia were in this group. The number of accessible levels does not seem to have affected the incidence of complications.

  16. Relationships between CSID and vocal fold vibratory function

    Cooke, Melissa L.

    High correlations have been reported between the acoustic-based Cepstral/Spectral Index of Dysphonia (CSID) and perceptual judgments of dysphonia. This study explores whether CSID provides additional insight and explains more of the variance in HSV-based properties of vocal fold vibratory function than has been reported for other acoustic measures. Using the Analysis of Dysphonia in Speech and Voice (ADSV) program, CSID and its component variables were correlated with HSV-based measures of glottal cycle aperiodicity and glottal area for 20 subjects who underwent phonomicrosurgery. Results indicate CSID is only marginally correlated with glottal cycle aperiodicity in pre- and post-surgical conditions and does not correlate as highly as the cepstral peak prominence alone. Additionally, results reveal higher correlations when examining within-subject change from pre-surgical to post-surgical assessments rather than correlating measures across subjects. Future directions are discussed that aim at improving our understanding of the relationships between acoustic parameters and underlying phonatory function.

  17. Reversal of functional disorders by aspiration, expiration and cough reflexes and their voluntary counterparts

    Zoltan eTomori

    2012-12-01

    Full Text Available Agonal gasping provoked by asphyxia can save ~15% of mammals even from untreated ventricular fibrillation, but it fails to revive infants with sudden infant death syndrome. Our systematic study of airway reflexes in cats and other animals indicated that in addition to cough, there are 2 distinct airway reflexes that may contribute to auto-resuscitation. Gasp- and sniff-like spasmodic inspirations can be elicited by nasopharyngeal stimulation, strongly activating the brainstem generator for inspiration, which is also involved in the control of gasping. This aspiration reflex (AspR is characterized by spasmodic inspiration without subsequent active expiration and can be elicited during agonal gasping, caused by brainstem trans-sections in cats. Stimulation of the larynx can activate the generator for expiration to evoke the expiration reflex, manifesting with prompt expiration without preceding inspiration. Stimulation of the oro-pharynx and lower airways provokes the cough reflex which results from activating of both generators. The powerful potential of the AspR resembling auto-resuscitation by gasping can influence the control mechanisms of vital functions, mediating reversal of various functional disorders.The AspR in cats interrupted hypoxic apnea, laryngo- and bronchospasm, apneusis and even transient asphyxic coma, and can normalize various hypo- and hyper-functional disorders. Introduction of a nasogastric catheter evoked similar spasmodic inspirations in premature infants and interrupted hiccough attacks in adults. Coughing on demand can prevent anaphylactic shock and resuscitate the pertinent subject. Sniff representing nasal inspiratory pressure and maximal inspiratory and expiratory pressures are voluntary counterparts of airway reflexes, and are useful for diagnosis and therapy of various cardio-respiratory and neuromuscular disorders.

  18. [Seizure].

    Saito, Ayumi; Terayama, Yasuo

    2013-06-01

    Seizure is defined as "a strong shrinkage state of the skeletal muscle which is involuntary, and occurs spasmodically" and it is often accompanied by disturbance of consciousness. The typical disease which causes seizure is epilepsy. But there is many conditions causing seizure. Therefore, diagnosis of epilepsy should be careful. Seizure among eldery increases in an era of an aging population in Japan. The risk of recurrence of seizure or epilepsy in elderly is higher than that in youth. In considering of the treatment of seizure among elderly, differential diagnosis from various condition must be done. PMID:23855204

  19. Spray drying of Tinospora cordifolia leaf and stem extract and evaluation of antioxidant activity

    Sarala, M.; Velu, V.; Anandharamakrishnan, C.; Singh, R. P.

    2011-01-01

    Tinospora cordifolia (Guduchi) is widely used in folk medicine/ ayurvedic system of medicine, also in ayurvedic ‘Rasayanas’ to improve the immune system and used as general tonic, anti-periodic, anti-spasmodic, anti-inflammatory, anti-arthritic and anti-diabetic agent. Numerous studies have been reported on the health benefits of individual parts or whole Guduchi plant. However, most of the work has focused on the extracts of T. cordifolia. In this study, T. cordifolia leaf and stem extract p...

  20. Extra-Adrenal Myelolipoma: A Rare Entity in Paediatric Age Group

    Chandrashekhar Anil Sohoni

    2013-09-01

    Full Text Available Extra-adrenal myelolipoma is a well-described entity in adult population, however it is extremely rare in paediatric age group. An unusual case of intra-peritoneal extra-adrenal myelolipoma in an 8-year-old child is presented here. The lesion was incidentally detected while evaluating the patient for spasmodic abdominal pain. Ultrasonography followed by CT scan and MRI imaging suggested the diagnosis which was confirmed by histopathology. A non-surgical approach was adopted and there was no progression of the lesion on follow-up imaging.

  1. Variations in the usage and composition of a radial cocktail during radial access coronary angiography procedures.

    Pate, G

    2011-10-01

    A survey was conducted of medication administered during radial artery cannulation for coronary angiography in 2009 in Ireland; responses were obtained for 15 of 20 centres, in 5 of which no radial access procedures were undertaken. All 10 (100%) centres which provided data used heparin and one or more anti-spasmodics; verapamil in 9 (90%), nitrate in 1 (10%), both in 2 (20%). There were significant variations in the doses used. Further work needs to be done to determine the optimum cocktail to prevent radial artery injury following coronary angiography.

  2. Riten der Gewalt: Protest und Aufruhr in Kairo und Damaskus (7./13. bis 10./16. Jahrhundert) (Rites of Violence: Violent Protests in Mamluk Cairo and Damascus)

    Hirschler, Konrad

    2007-01-01

    This article deals with violent forms of ‘popular’ protest and revolt in Cairo and Damascus between the 7th/13th and the 10th/16th centuries. It focuses on the symbolic expressions employed during such periods of violence in order to refine currently employed concepts such as ‘mob-violence’, which tend to describe such events as irrational and spasmodic. The symbolic expressions are analysed with regard to three main themes that played a salient role: the urban spaces that were the theatre of...

  3. Incapacidad vocal en docentes de la provincia de Huelva Voice handicap in Huelva's teachers

    Francisco Javier Barbero-Díaz

    2010-03-01

    Full Text Available Introducción: La prevalencia de trastornos de la voz en docentes en nuestro entorno se sitúa entre el 34% y 57%. Desde el año 2006 la patología por nódulos de las cuerdas vocales se considera enfermedad profesional. El Índice de Incapacidad Vocal es una herramienta validada para valorar el menoscabo asociado a la disfonía que percibe la persona. Objetivos: Valorar el impacto de la disfonía y las posibles diferencias en la incapacidad vocal entre factores relacionados con la disfonía. Material y Métodos: Durante el examen de salud voluntario los docentes son interrogados sobre síntomas de disfonía y cumplimentan el Índice de Incapacidad Vocal. Resultados: Los docentes con incapacidad moderada y severa representan el 16,6% y 1,2% respectivamente. Un 50,9% han presentado síntomas de disfonía en algún momento de su vida laboral. Se encuentran diferencias significativas en la incapacidad vocal según el diagnostico de nódulos de cuerdas vocales, la presencia de síntomas y el número de síntomas. Conclusiones: la disfonía supone un importante impacto en la población estudiada. El diagnostico de nódulos de cuerdas vocales, la presencia de síntomas y el número de síntomas de disfonía conllevan diferencias al valorar el menoscabo. No es posible realizar la extrapolación.Introduction: The prevalence of voice disorders in teachers in our environment is between 34% and 57%. Since 2006, the pathology of vocal cord nodules is considered an occupational disease. Vocal Handicap Index is a validated tool to assess the impairment associated with the perceived dysphonia. Objectives: To assess the impact of dysphonia and the possible differences in the vocal disability in function of dysphonia-related factors in teachers. Methods: During the exam of health, volunteer teachers are interviewed about symptoms of dysphonia and complete the Vocal Handicap Index. Results: Teachers with moderate and severe disability represent 16.6% and 1

  4. Disfonia em professores do ensino municipal: prevalência e fatores de risco Vocal problems in kindergarten and primary school teachers: prevalence and risk factors

    Vera L. R. Fuess

    2003-12-01

    Full Text Available A disfonia é um sintoma muito freqüente em professores, profissionais para os quais a voz é elemento indispensável. OBJETIVOS: Observar a prevalência deste sintoma em professores de pré-escola e da escola primária e avaliar fatores e sintomas associados, facilitando a promoção de medidas de prevenção desta manifestação ocupacional. FORMA DE ESTUDO: Coorte transversal. CASUÍSTICA E MÉTODO: Estudo transversal consistindo de questionários respondidos por 451 professores (pré-escola e quatro primeiras séries do ensino fundamental de 66 escolas municipais de Mogi das Cruzes. Ao lado de dados de identificação e demográficos, o questionário abordou questões relacionadas à atividade de professor, à disfonia, presença de sintomas concomitantes e hábitos. Trinta profissionais com problemas constantes de voz foram submetidos a telescopia laríngea, sendo seus diagnósticos tabulados. RESULTADOS: 80,7% dos professores referiram algum grau de disfonia. Não observamos relação entre idade, tempo de profissão e classe atendida e freqüência referida de disfonia. Não houve associação entre freqüência de disfonia e número de fatores extra-profissionais de abuso da voz ou tabagismo. Observamos relação direta entre a freqüência de disfonia e a carga horária semanal (p Dysphonia is a frequent complaint among teachers, an occupation in which the voice is a fundamental tool. OBJECTIVES: This study aimed at evaluating the prevalence of dysphonia in pre- and primary school teachers, observing associate symptoms and factors, in order to delineate guidelines for future prevention programs. STUDY DESIGN: Transversal cohorte. PATIENTS AND METHOD: This cross-sectional study consisted of a survey that enrolled 451 teachers of 66 primary public schools of Mogi das Cruzes. The teachers answered to a questionnaire that assessed, besides identification and demographic data, their professional activity, dysphonia characteristics

  5. Spasmolytic effect of traditional herbal formulation on guinea pig ileum

    Dushyant Kumar

    2015-01-01

    Full Text Available Background: The herbal formulation consisting of Andrographis paniculata Nees., Cassia fistula L., Foeniculum vulgare Mill. and Cuminum cyminum L. is widely used by the local traditional practitioners in rural Northern Karnataka for spasmodic abdominal pain. Objective: The present study was undertaken to evaluate safety and spasmolytic effect of poly-herbal formulation. Materials and Methods: Acute toxicity studies were carried out in Swiss mice, as per the Organization for Economic Co-operation and Development (OECD guidelines. The spasmolytic activity of the formulation was studied in isolated guinea pig ileum model using histamine and acetylcholine as agonists. The data were analyzed by one-way ANOVA, followed by Dunnetts post-hoc test and P ≤ 0.05 was considered as significant. Results: The formulation did not show any adverse toxic effects and found to be safe. It also showed significant (P < 0.05 relaxation in different agonist like histamine and acetylcholine-induced contractions in guinea pig ileum. Conclusions: Antispasmodic activity of the herbal formulation can be attributed to its atropine-like activity. The present findings, therefore, support its utility in spasmodic abdominal pain.

  6. Dynamic and ultrastructural study of sphincter of Oddi in early-stage cholelithiasis in rabbits with hypercholesterolemia

    Jing Guo Wei; Yao Cheng Wang; Fan Du; Hou Jun Yu

    2000-01-01

    AIM To study the relationship between preformation of gallstone and the kinetics and ultrastructure of sphincter of Oddi.METHODS Adult female rabbits were used and divided into 3 groups, and fed with either normal or high cholesterol diet for four or eight weeks.Each group contained eight rabbits. The manometry of sphincter of Oddi, biliary cineradiography, gallbladder volume measurement and ultrastructure observation under electron microscope were performed.RESULTS In groups Ⅰ and Ⅱ, the basal pressure in low-pressure ampulla or high pressure zone of sphincter of Oddi was elevated, the amplitude of phasic contraction was decreased and the volume of gallbladder were increased, with a significant difference (P<0.01) from those of control. Gallstones were found in group Ⅱ rabbits (7/8). Under cineradiography, low-pressure ampulla showed a spasmodic status without apparent peristaltic contraction. Under electron microscope, inside the muscular cells of sphincter of Oddi,loosening of microfilament and swelling of plasmosomes which congregated at the top were observed. The amount showed no obvious change under nitric oxide synthase (NOS) stain.CONCLUSION Twisting of the microfilament and disarrangement of kink macula densa inside the muscular cells suggested that the sphincter of Oddi was under spasmodic status. The impaired diastolic function caused and aggravated the stasis of cystic bile. The swelling plasmosome could be one of the important factors in elevating the tonic pressure of sphincter of Oddi.

  7. Quality Control of Motor Unit Number Index (MUNIX Measurements in 6 Muscles in a Single-Subject "Round-Robin" Setup.

    Christoph Neuwirth

    Full Text Available Motor Unit Number Index (MUNIX is a neurophysiological measure that provides an index of the number of lower motor neurons in a muscle. Its performance across centres in healthy subjects and patients with Amyotrophic Lateral Sclerosis (ALS has been established, but inter-rater variability between multiple raters in one single subject has not been investigated.To assess reliability in a set of 6 muscles in a single subject among 12 examiners (6 experienced with MUNIX, 6 less experienced and to determine variables associated with variability of measurements.Twelve raters applied MUNIX in six different muscles (abductor pollicis brevis (APB, abductor digiti minimi (ADM, biceps brachii (BB, tibialis anterior (TA, extensor dig. brevis (EDB, abductor hallucis (AH twice in one single volunteer on consecutive days. All raters visited at least one training course prior to measurements. Intra- and inter-rater variability as determined by the coefficient of variation (COV between different raters and their levels of experience with MUNIX were compared.Mean intra-rater COV of MUNIX was 14.0% (±6.4 ranging from 5.8 (APB to 30.3% (EDB. Mean inter-rater COV was 18.1 (±5.4 ranging from 8.0 (BB to 31.7 (AH. No significant differences of variability between experienced and less experienced raters were detected.We provide evidence that quality control for neurophysiological methods can be performed with similar standards as in laboratory medicine. Intra- and inter-rater variability of MUNIX is muscle-dependent and mainly below 20%. Experienced neurophysiologists can easily adopt MUNIX and adequate teaching ensures reliable utilization of this method.

  8. Quality Control of Motor Unit Number Index (MUNIX) Measurements in 6 Muscles in a Single-Subject “Round-Robin” Setup

    Neuwirth, Christoph; Burkhardt, Christian; Alix, James; Castro, José; de Carvalho, Mamede; Gawel, Malgorzata; Goedee, Stephan; Grosskreutz, Julian; Lenglet, Timothée; Moglia, Cristina; Omer, Taha; Schrooten, Maarten; Weber, Markus

    2016-01-01

    Background Motor Unit Number Index (MUNIX) is a neurophysiological measure that provides an index of the number of lower motor neurons in a muscle. Its performance across centres in healthy subjects and patients with Amyotrophic Lateral Sclerosis (ALS) has been established, but inter-rater variability between multiple raters in one single subject has not been investigated. Objective To assess reliability in a set of 6 muscles in a single subject among 12 examiners (6 experienced with MUNIX, 6 less experienced) and to determine variables associated with variability of measurements. Methods Twelve raters applied MUNIX in six different muscles (abductor pollicis brevis (APB), abductor digiti minimi (ADM), biceps brachii (BB), tibialis anterior (TA), extensor dig. brevis (EDB), abductor hallucis (AH)) twice in one single volunteer on consecutive days. All raters visited at least one training course prior to measurements. Intra- and inter-rater variability as determined by the coefficient of variation (COV) between different raters and their levels of experience with MUNIX were compared. Results Mean intra-rater COV of MUNIX was 14.0% (±6.4) ranging from 5.8 (APB) to 30.3% (EDB). Mean inter-rater COV was 18.1 (±5.4) ranging from 8.0 (BB) to 31.7 (AH). No significant differences of variability between experienced and less experienced raters were detected. Conclusion We provide evidence that quality control for neurophysiological methods can be performed with similar standards as in laboratory medicine. Intra- and inter-rater variability of MUNIX is muscle-dependent and mainly below 20%. Experienced neurophysiologists can easily adopt MUNIX and adequate teaching ensures reliable utilization of this method. PMID:27135747

  9. The effects of hip muscle strengthening on knee load, pain, and function in people with knee osteoarthritis: a protocol for a randomised, single-blind controlled trial

    Hunter David J

    2007-12-01

    Full Text Available Abstract Background Lower limb strengthening exercises are an important component of the treatment for knee osteoarthritis (OA. Strengthening the hip abductor and adductor muscles may influence joint loading and/or OA-related symptoms, but no study has evaluated these hypotheses directly. The aim of this randomised, single-blind controlled trial is to determine whether hip abductor and adductor muscle strengthening can reduce knee load and improve pain and physical function in people with medial compartment knee OA. Methods/Design 88 participants with painful, radiographically confirmed medial compartment knee OA and varus alignment will be recruited from the community and randomly allocated to a hip strengthening or control group using concealed allocation stratified by disease severity. The hip strengthening group will perform 6 exercises to strengthen the hip abductor and adductor muscles at home 5 times per week for 12 weeks. They will consult with a physiotherapist on 7 occasions to be taught the exercises and progress exercise resistance. The control group will be requested to continue with their usual care. Blinded follow up assessment will be conducted at 12 weeks after randomisation. The primary outcome measure is the change in the peak external knee adduction moment measured during walking. Questionnaires will assess changes in pain and physical function as well as overall perceived rating of change. An intention-to-treat analysis will be performed using linear regression modelling and adjusting for baseline outcome values and other demographic characteristics. Discussion Results from this trial will contribute to the evidence regarding the effect of hip strengthening on knee loads and symptoms in people with medial compartment knee OA. If shown to reduce the knee adduction moment, hip strengthening has the potential to slow disease progression. Trial Registration Australia New Zealand Clinical Trials Registry ACTR12607000001493

  10. Correlation of MRI findings with clinical findings of trochanteric pain syndrome

    Blankenbaker, Donna G.; Ullrick, Steven R.; Davis, Kirkland W.; De Smet, Arthur A. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); Haaland, Ben; Fine, Jason P. [University of Wisconsin School of Medicine and Public Health, Departments of Biostatistics and Medical Informatics and Statistics, Madison, WI (United States)

    2008-10-15

    Greater trochanter pain syndrome due to tendinopathy or bursitis is a common cause of hip pain. The previously reported magnetic resonance (MR) findings of trochanteric tendinopathy and bursitis are peritrochanteric fluid and abductor tendon abnormality. We have often noted peritrochanteric high T2 signal in patients without trochanteric symptoms. The purpose of this study was to determine whether the MR findings of peritrochanteric fluid or hip abductor tendon pathology correlate with trochanteric pain. We retrospectively reviewed 131 consecutive MR examinations of the pelvis (256 hips) for T2 peritrochanteric signal and abductor tendon abnormalities without knowledge of the clinical symptoms. Any T2 peritrochanteric abnormality was characterized by size as tiny, small, medium, or large; by morphology as feathery, crescentic, or round; and by location as bursal or intratendinous. The clinical symptoms of hip pain and trochanteric pain were compared to the MR findings on coronal, sagittal, and axial T2 sequences using chi-square or Fisher's exact test with significance assigned as p<0.05. Clinical symptoms of trochanteric pain syndrome were present in only 16 of the 256 hips. All 16 hips with trochanteric pain and 212 (88%) of 240 without trochanteric pain had peritrochanteric abnormalities (p=0.15). Eighty-eight percent of hips with trochanteric symptoms had gluteus tendinopathy while 50% of those without symptoms had such findings (p=0.004). Other than tendinopathy, there was no statistically significant difference between hips with or without trochanteric symptoms and the presence of peritrochanteric T2 abnormality, its size or shape, and the presence of gluteus medius or minimus partial thickness tears. Patients with trochanteric pain syndrome always have peritrochanteric T2 abnormalities and are significantly more likely to have abductor tendinopathy on magnetic resonance imaging (MRI). However, although the absence of peritrochanteric T2 MR abnormalities

  11. Greater Trochanteric Pain Syndrome.

    Redmond, John M; Chen, Austin W; Domb, Benjamin G

    2016-04-01

    Patients who have lateral hip pain historically have been diagnosed with trochanteric bursitis and treated with nonsteroidal anti-inflammatory medications, corticosteroid injections, and physical therapy. Although this strategy is effective for most patients, a substantial number of patients continue to have pain and functional limitations. Over the past decade, our understanding of disorders occurring in the peritrochanteric space has increased dramatically. Greater trochanteric pain syndrome encompasses trochanteric bursitis, external coxa saltans (ie, snapping hip), and abductor tendinopathy. A thorough understanding of the anatomy, examination findings, and imaging characteristics aids the clinician in treating these patients. Open and endoscopic treatment options are available for use when nonsurgical treatment is unsuccessful. PMID:26990713

  12. The Gluteus Medius Vs. Thigh Muscles Strength Ratio and Their Relation to Electromyography Amplitude During a Farmer’s Walk Exercise

    Stastny Petr; Lehnert Michal; Zaatar Amr; Svoboda Zdenek; Xaverova Zuzana; Pietraszewski Przemysław

    2015-01-01

    The strength ratio between hamstrings and quadriceps (H/Q) is associated with knee injuries as well as hip abductor muscle (HAB) weakness. Sixteen resistance trained men (age, 32.5 ± 4.2 years) performed 5 s maximal isometric contractions at 75° of knee flexion/extension and 15° of hip abduction on a dynamometer. After this isometric test they performed a Farmer’s walk exercise to find out if the muscle strength ratio predicted the electromyography amplitude expressed as a percentage of maxim...

  13. Quantification of Myosignal Parameters in HD Patients

    S. Vivekanandan

    2014-04-01

    Full Text Available Developments in signal processing techniques, has made possible extraction of useful inside information from diseased myosignals through surface Electromyography (sEMG. This study attempts to quantify the myosignal parameter of Hansen’s Disease (HD patients. The EMG signals acquired from the Abductor Digiti Minimi (ADM muscle were analyzed using time, frequency domain and wavelet techniques vis à vis healthy subjects. Quantifying the myosignals of the diseased-probably attempted for the first time-will help the physician in early diagnosis. Interestingly the test results show drastic deviation between the two. Its development and implementation will save the subjects from developing deformity.

  14. Uso de programas de bipedestación como parte del tratamiento de la displasia de cadera en la parálisis cerebral infantil (PCI). Revisión bibliográfica

    Salgado Caballero, Unai

    2016-01-01

    Introducción: en el momento del nacimiento, las caderas de un/a niño/a con problemas neuromotores no se diferencian de las de otros niños/as. La displasia de cadera se desarrolla debido al retraso en los hitos motores y a un desequilibrio entre el tono muscular de los músculos flexores y aductores y los extensores y abductores. También hay que tener en cuenta el componente de espasticidad ya que es el que va a provocar la excursión de la cabeza femoral y el característico patrón en tijera si ...

  15. Walking on high heels changes muscle activity and the dynamics of human walking significantly

    Simonsen, Erik Bruun; Svendsen, Morten B; Nørreslet, Andreas;

    2012-01-01

    The aim of the study was to investigate the distribution of net joint moments in the lower extremities during walking on high-heeled shoes compared with barefooted walking at identical speed. Fourteen female subjects walked at 4 km/h across three force platforms while they were filmed by five...... joint abductor moment. Several EMG parameters increased significantly when walking on high-heels. The results indicate a large increase in bone-on-bone forces in the knee joint directly caused by the increased knee joint extensor moment during high-heeled walking, which may explain the observed higher...

  16. Damage to the superior gluteal nerve after the Hardinge approach to the hip.

    Ramesh, M

    2012-02-03

    We studied prospectively 81 consecutive patients undergoing hip surgery using the Hardinge (1982) approach. The abductor muscles of the hip in these patients were assessed electrophysiologically and clinically by the modified Trendelenburg test. Power was measured using a force plate. We performed assessment at two weeks, and at three and nine months after operation. At two weeks we found that 19 patients (23%) showed evidence of damage to the superior gluteal nerve. By three months, five of these had recovered. The nine patients with complete denervation at three months showed no signs of recovery when reassessed at nine months. Persistent damage to the nerve was associated with a positive Trendelenburg test.

  17. Isometric hip muscle strength in posttraumatic below-knee amputees

    Jandrić Slavica

    2007-01-01

    Full Text Available Background/Aim. Traumas and war injuries, next to chronic occlusive artery disease and diabetes mellitus-derived complications, are the most frequent cause of the lower limbs amputation. They affect mostly younger population that need a higher level of activities as compared with the elderly. Medical rehabilitation is very significant for the muscle performance improvement in this population providing their social reintegration. The aim of this study was to investigate the effect of below-knee amputation on the hip isometric muscle strength and effect of rehabilitation on improvement of hip muscle strength in below-knee amputees, secondary to war wounding. Methods. Forty below-knee amputees (after war wounding, average age 35.6±10.6 years, that were included in primary rehabilitation program with prosthetics, were examined. Objective parameters were used to evaluate therapeutical effects. Isometric muscle strength of hip flexors, extensors, abductors and adductors was measured by dynamometer and expressed in Newton (N at admission, control and discharge for each patient. Average length of the treatment was 51 ± 34.1 days. Results. For isometric hip flexors (t = - 1.99346, p < 0.05, extensors (t = -4.629073, p < 0.001, abductors (t = -4.9408, p < 0.001 and adductors (t = -2.00228, p < 0.05, muscle strength was significantly less on the amputated than on nonamputated side. The highest differences in muscle strength between amputated and nonamputated limbs were noted for hip abductors (26.6% and extensors (23.3%. There was significant improvement of mean values of strength for all examined hip muscles after rehabilitation and prosthetics for both legs in comparison to beginning of the therapy. The hip abductor on the amputated side was for 19.4% weaker after rehabilitation in comparison to the nonamputated limb. Conclusion. Decreases of isometric muscle strength in all examined hip muscles were observed, more in the amputated limb. Rehabilitation

  18. Oncological and functional results of CO2 laser cordectomy.

    Policarpo, M; Aluffi, P; Brovelli, F; Borello, G; Pia, F

    2004-10-01

    Laser surgery represents the evolution of endoscopic surgery and, as far as concerns treatment of laryngeal tumours, CO2 laser cordectomy is considered a valid alternative to conventional surgery (laryngofissure cordectomy) and to exclusive radiotherapy for glottic carcinomas, classified as T1a, T1b and T2. The present report focuses on personal experience with CO2 laser cordectomy over the last 11 years, evaluating oncological and functional results. Between October 1990 and December 2001, micro-laryngoscopy has been performed with CO, laser, in 606 cases (benign and malignant lesions), of which 150 laser cordectomies, at the ORL Department, Eastern Piedmont University of Novara. An analysis is made of 63 patients (mean age 64.3 years) who underwent laser cordectomy for glottic carcinoma, observed at follow-up for at least 3 years. Vocal function has been studied on a sample of 20 patients. Of those who underwent CO2 laser cordectomy for T1a and T1s, 95.8% were disease free after a minimum of 3 years follow-up. Video-larynx-stroboscopic test highlighted the presence of a "satisfying" fibrous neocord in cases treated with Type III cordectomy. The speech compensation was of the "cord-neocordal" type (35%), false cordal (40%) and with arytenoideus hyperadduction (25%). The electro-acoustical analysis of the voice highlighted a "serious dysphonia" compatible with Type IV cases according to Yanagihara (70%) and moderate-severe dysphonia (30%). Mean values of vocal parameters were 5.8% for Jitter, 12.2% for Shimmer, 0.34 for NHR. CO2 laser cordectomy is first choice treatment for T1a glottic carcinoma, offering intra- and post-operative advantages: reduced traumatism, lack of tracheostomy, low bleeding, fast functional recovery (deglutition and speech), brief hospital stay, and low management costs. Dysphonia resulting from treatment, characterised by breathed voice, allows the patient to lead a normal life. PMID:15871607

  19. Factors Associated with Clinical and Topographical Features of Laryngeal Tuberculosis

    Reis, João Gustavo Corrêa; Reis, Clarissa Souza Mota; da Costa, Daniel César Silva; Lucena, Márcia Mendonça; Schubach, Armando de Oliveira; Oliveira, Raquel de Vasconcellos Carvalhaes; Rolla, Valéria Cavalcanti; Conceição-Silva, Fátima; Valete-Rosalino, Cláudia Maria

    2016-01-01

    Introduction Laryngeal tuberculosis (LTB) is the most frequent granulomatous disease of the larynx and represents less than 2% of extrapulmonary TB cases. There are no pathognomonic clinical and endoscopic features of this disease and studies on LTB that can assist in its diagnostic characterization are lacking. Objective To identify factors associated with clinical and topographical features of LTB. Method a retrospective cross-sectional study was conducted from the medical records of 36 patients with confirmed LTB diagnosis. Results Dysphonia and cough were the main symptoms presented by patients and the true vocal folds the most frequently affected site. The average of the duration of the disease evolution was significantly higher in patients with dysphonia than in patients without this symptom. We observed association between dysphonia and true vocal fold lesions and between odynophagia and lesions in the epiglottis, arytenoids and aryepiglottic folds. Odynophagia was more frequent in individuals with lesions in four or more laryngeal sites. Weight loss equal or above 10% of the body weight was more frequent in patients with odynophagia as first symptom and in patients with ulcerated lesion. Dyspnea on exertion was more frequent in individuals with more extensive laryngeal lesions. The percentage of smokers with lesions in four or more laryngeal sites was greater than that found in non-smokers. Laryngeal tissue fragment bacilloscopy and culture examinations were less positive than sputum ones. Conclusions Smoking appears to be associated with the development of more extensive LTB lesions, and LTB with dyspnea on exertion and odynophagia with consequent impairment of nutritional status. We emphasize the need for histopathologic confirmation, once positive sputum bacteriological examinations seem not to necessarily reflect laryngeal involvement. PMID:27077734

  20. Recurrent Vocal Fold Paralysis and Parsonage-Turner Syndrome

    Joffily, Lucia; Vincent, Maurice Borges

    2013-01-01

    Background. Parsonage-Turner syndrome, or neuralgic amyotrophy (NA), is an acute brachial plexus neuritis that typically presents with unilateral shoulder pain and amyotrophy but also can affect other peripheral nerves, including the recurrent laryngeal nerve. Idiopathic vocal fold paralysis (VFP) represents approximately 12% of the VFP cases and recurrence is extremely rare. Methods and Results. We report a man with isolated recurrent unilateral right VFP and a diagnosis of NA years before. Conclusions. We emphasize that shoulder pain and amyotrophy should be inquired in any patient suffering from inexplicable dysphonia, and Parsonage-Turner syndrome should be considered in the differential diagnosis of idiopathic VFP. PMID:24288639

  1. Unilateral laryngeal paralysis

    Mitrović Slobodan

    2003-01-01

    Full Text Available Introduction Phoniatric rehabilitation is mainly aimed at restoring satisfactory phonation. Voice quality depends on the capacity of intact vocal cords to compensate the deficiency involved, as well as on automatism of phonation. Material and methods The study included 50 patients. All subjects underwent history taking, reported symptoms that urged them to visit a phoniatrician; they were submitted to a clinical otorhinolaryngologic and phoniatric examinations, voice assessment by subjective acoustic analysis spectral analysis by digital sonography and laryngostroboscopy. All patients underwent Seeman's method of laryngeal compression. Results The examined group of 50 subjects included 17 males (34% and 33 females (66%. Vocal cord palsy was most often due to neck surgery (strumectomy in 19 patients (38% followed by an idiopathic palsy involved in 12 patients (24%. Disocclusion of 1-2 mm and 3-3 mm was registered in 54 % and 24% patients, respectively After treatment total occlusion was established in 20 % of patients, while disocclusion of up to 1mm, 1-2 mm or 2-3 mm persisted in 36 %, 20% and 2% of patients, respectively. T-test revealed a statistically significant difference in glottic incompetence prior to and after treatment (p<0.01. After treatment, using Seeman's method of digital compression of the larynx 48 % of patients regained satisfactory speech and voice clarity and 50% of them still presented mild dysphonia. Moderate dysphonia was registered in 2% but none of the patients had severe dysphonia. Discussion Central laryngeal palsies made 4% of our examined group, while according to the literature they make 1.2-8.7% of all laryngeal palsies. In majority of cases, paralysis of the recurrent laryngeal nerve was due to neck surgery (38%, but literature reports indicate that iatrogenic palsies are mostly due to operation of the thyroid. The well known fact that the left recurrent nerve is more frequently paralyzed, has been confirmed in

  2. Advances in molecular genetic studies of primary dystonia

    MA Ling-yan

    2013-07-01

    Full Text Available Dystonias are heterogeneous hyperkinetic movement disorders characterized by involuntary muscle contractions which result in twisting, repetitive movements and abnormal postures. In recent years, there was a great advance in molecular genetic studies of primary dystonia. This paper will review the clinical characteristics and molecular genetic studies of primary dystonia, including early-onset generalized torsion dystonia (DYT1, whispering dysphonia (DYT4, dopa-responsive dystonia (DYT5, mixed-type dystonia (DYT6, paroxysmal kinesigenic dyskinesia (DYT10, myoclonus-dystonia syndrome (DYT11, rapid-onset dystonia parkinsonism (DYT12, adult-onset cervical dystonia (DYT23, craniocervical dystonia (DYT24 and primary torsion dystonia (DYT25.

  3. Spontaneous retropharynegeal hematoma: A case report and literature overview

    Ryu, Ji Hwa [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2014-02-15

    A spontaneous retropharyngeal hematoma is a rare condition with a difficult diagnostic. This disease may rapidly progress to an airway obstruction. The author reports about a case of a 56-year-old man with an acute onset of sore throat, dysphonia and dyspnea. A retropharyngeal high attenuated soft tissue density could be seen on the neck CT. A rapid improvement of the retropharyngeal abnormality was seen on the 3 days follow-up MR imaging. Signal changes caused by blood products which were visible on the MRI images suggested the diagnosis of retropharyngeal hematoma. The patient was conservatively managed.

  4. Vocal Polyps in Tourette Syndrome

    Michael P Chu

    2011-10-01

    Full Text Available Hoarseness and dysphonia are often a result of vocal cord polyps which in turn, are linked to vocal trauma. We report the case of vocal polyps in the setting of a 27-year old male with a history only remarkable for Tourette syndrome. We review the literature regarding etiology and pathophysiology of vocal cord lesions and propose vocal tics in Tourette syndrome as an under-recognized etiology. In this way, we also review therapies that may aid in treating not only the vocal cord lesions but also particularly in the setting of vocal tics.

  5. A case of mixed type laryngocele presented with deep neck infection and review of the literature

    Salih Bakır

    2012-09-01

    Full Text Available Laryngocele is an abnormal dilatation of the laryngeal ventricular saccule that may extend into the subcutaneous tissues of the neck through the thyrohyoid membrane or confined to the endolarynx. The etiology is still unclear. Many laryngoceles are asymptomatic. An asymptomatic laryngocele appears and produces symptoms only as it enlarges or when it becomes infected. In this report, we present a 40-year-old female patient, which had an asymptomatic neck swelling for 20 years, referred for deep neck infection, dysphonia and dyspnea. J Clin Exp Invest 2012; 3 (3: 415-419Key words: Larynx, laryngocele, laryngopyocele, neck mass

  6. Laryngeal Chondrosarcoma as a Rare Cause of Subglottic Stenosis

    Kerem Kökoğlu

    2014-01-01

    Full Text Available Laryngeal chondrosarcoma (CS is a very rare entity. It is usually seen in 50–80-year olds. It is developed from cricoid cartilage largely. Patients have laryngeal CS complaint of respiratuvar distress, dysphonia, and dysphagia generally. A submucous mass is usually seen in physical examination with an intact mucosa. Distant metastasis is rare in CSs. Main treatment is surgical excision. An 82-year-old patient who has respiratuvar distress is presented in this paper and laryngeal CS is reviewed in the light of the literature.

  7. A Case of Persistent Hiccup after Laparoscopic Cholecystectomy

    Elisa Grifoni

    2013-01-01

    Full Text Available A 79-year-old man, with history of recent laparoscopic cholecystectomy, came to our attention for persistent hiccup, dysphonia, and dysphagia. Noninvasive imaging studies showed a nodular lesion in the right hepatic lobe with transdiaphragmatic infiltration and increased tracer uptake on positron emission tomography. Suspecting a malignant lesion and given the difficulty of performing a percutaneous transthoracic biopsy, the patient underwent surgery. Histological analysis of surgical specimen showed biliary gallstones surrounded by exudative inflammation, resulting from gallbladder rupture and gallstones spillage as a complication of the previous surgical intervention. This case highlights the importance of considering such rare complication after laparoscopic cholecystectomy.

  8. Pharyngeal Aspiration of Complete Upper Denture in 90-Year-Old Man; a Case Report

    Mehrdad Haghighi

    2015-07-01

    Full Text Available Foreign body aspiration is unusual in adults, except those who are debilitated or have neuropsychiatric disorders. It can be a life-threatening situation and it often requires a high index of suspicion, because the diagnosis can be obscure. Prompt diagnosis and intervention through foreign body retrieval are critical to prevent significant morbidity and mortality. We present a case of denture aspiration by a debilitated 90 years old man. He had aspirated his complete upper denture to pharynx causing incomplete obstruction with pleasure whistling respiratory sound, dyspnea, dysphagia and dysphonia. He underwent successful retrieval of the dental plate manually by fingers with complete resolution of symptoms. 

  9. Recurrent Vocal Fold Paralysis and Parsonage-Turner Syndrome

    Marcus Vinicius Pinto

    2013-01-01

    Full Text Available Background. Parsonage-Turner syndrome, or neuralgic amyotrophy (NA, is an acute brachial plexus neuritis that typically presents with unilateral shoulder pain and amyotrophy but also can affect other peripheral nerves, including the recurrent laryngeal nerve. Idiopathic vocal fold paralysis (VFP represents approximately 12% of the VFP cases and recurrence is extremely rare. Methods and Results. We report a man with isolated recurrent unilateral right VFP and a diagnosis of NA years before. Conclusions. We emphasize that shoulder pain and amyotrophy should be inquired in any patient suffering from inexplicable dysphonia, and Parsonage-Turner syndrome should be considered in the differential diagnosis of idiopathic VFP.

  10. CO2激光治疗室带性发声紊乱

    葛平江; 张思毅; 苏小妹

    2010-01-01

    @@ 室带性发声紊乱(ventricular dysphonia, VD)是由于假声带(室带)而非真声带振动导致的发声紊乱,大多数情况同喉肌的异常使用相关,有时是室带振动对声带振动的不合适的补偿行为导致的发声紊乱.其主要症状是发声响度降低和嘶哑,有时候会伴有破音和双音.

  11. Hybrid treatment of penetrating aortic ulcer

    Lara, Juan Antonio Herrero; Martins-Romeo, Daniela de Araujo; Escudero, Carlos Caparros; Falcon, Maria del Carmen Prieto; Batista, Vinicius Bianchi, E-mail: jaherrero5@hotmail.com [Unidade de Gestao Clinica (UGC) de Diagnostico por Imagem - Hosppital Universitario Virgen Macarena, Sevilha (Spain); Vazquez, Rosa Maria Lepe [Unit of Radiodiagnosis - Hospital Nuestra Senora de la Merced, Osuna, Sevilha (Spain)

    2015-05-15

    Penetrating atherosclerotic aortic ulcer is a rare entity with poor prognosis in the setting of acute aortic syndrome. In the literature, cases like the present one, located in the aortic arch, starting with chest pain and evolving with dysphonia, are even rarer. The present report emphasizes the role played by computed tomography in the diagnosis of penetrating atherosclerotic ulcer as well as in the differentiation of this condition from other acute aortic syndromes. Additionally, the authors describe a new therapeutic approach represented by a hybrid endovascular surgical procedure for treatment of the disease. (author)

  12. Vocal Polyps in Tourette Syndrome

    Chu, Michael P.; Karen PM Chu; Kevin Fung

    2011-01-01

    Hoarseness and dysphonia are often a result of vocal cord polyps which in turn, are linked to vocal trauma. We report the case of vocal polyps in the setting of a 27-year old male with a history only remarkable for Tourette syndrome. We review the literature regarding etiology and pathophysiology of vocal cord lesions and propose vocal tics in Tourette syndrome as an under-recognized etiology. In this way, we also review therapies that may aid in treating not only the vocal cord lesions but a...

  13. Recurrent vocal fold paralysis and parsonage-turner syndrome.

    Pinto, Marcus Vinicius; Joffily, Lucia; Vincent, Maurice Borges

    2013-01-01

    Background. Parsonage-Turner syndrome, or neuralgic amyotrophy (NA), is an acute brachial plexus neuritis that typically presents with unilateral shoulder pain and amyotrophy but also can affect other peripheral nerves, including the recurrent laryngeal nerve. Idiopathic vocal fold paralysis (VFP) represents approximately 12% of the VFP cases and recurrence is extremely rare. Methods and Results. We report a man with isolated recurrent unilateral right VFP and a diagnosis of NA years before. Conclusions. We emphasize that shoulder pain and amyotrophy should be inquired in any patient suffering from inexplicable dysphonia, and Parsonage-Turner syndrome should be considered in the differential diagnosis of idiopathic VFP. PMID:24288639

  14. Extramedullary plasmacytoma of the true vocal fold.

    De Zoysa, Nilantha; Sandler, Belinda; Amonoo-Kuofi, Kwame; Swamy, Rajiv; Kothari, Prasad; Mochloulis, George

    2012-08-01

    We report a rare case of extramedullary plasmacytoma (EMP) of the true vocal fold. Our patient, a 62-year-old woman, presented with dysphonia. On workup, fiberoptic laryngoscopy detected a lesion arising from the anterior half of her left true vocal fold. No evidence of other pathology was noted. The patient underwent radical radiotherapy, and the lesion resolved. Follow-up revealed no sign of recurrence. A type of myeloma, EMP is rare, especially in the larynx. To the best of our knowledge, our patient represents the sixth case of glottic EMP to be reported in the literature. PMID:22930090

  15. Prof. Sheng Canruo's experience in acupuncture treatment of throat diseases with yan si xue.

    Yao, W

    2000-06-01

    Yan Si Xue ([symbol: see text]) refer to four points in the throat summarized by Prof. Sheng Canruo in his long-year clinical experience based on the combination of TCM theory and the knowledge of modern medical anatomy. By taking "Yan Si Xue" as main points, and other differential adjunct points, Prof. Sheng has obtained satisfactory therapeutic results in treating various throat diseases such as hoarseness, paralysis of vocal cord, dysphonia after radiotherapy on throat tumor, vocal nodules, disorder of the glossopharyngeal nerve, hysteric aphasia, and acute or chronic laryngopharyngitis. PMID:11039000

  16. Dental implant removal to facilitate suspension laryngoscopy and laser treatment of an obstructed airway.

    Hume-Smith, H; Fowler, A; Vaz, F; Suaris, P

    2010-01-01

    A 29-year-old patient presented with dysphonia, dysphagia and a progressive history of stridor over 6 weeks. His past medical history included childhood nasolabial rhabdomyosarcoma treated by surgery, chemotherapy and radiotherapy. This had resulted in marked abnormalities of the facial skeleton, limited neck extension and restricted mouth opening of 1 cm, in part due to dental implants. After careful discussion and planning within a multidisciplinary team, the airway was optimised by temporary removal of the dental implants. This enabled a suspension laryngoscope to be passed, permitting carbon dioxide laser treatment to an obstruction at the laryngeal inlet and eliminating the need for a tracheostomy. PMID:19849679

  17. [Esophagomediastinal fistula and recurrent laryngeal nerve paralysis after radiotherapy of Hodgkin's disease].

    Rosanowski, F; Tigges, M; Eysholdt, U

    1995-08-01

    The case of a female patient 21 years old at the time of diagnosis is reported. The patient suffered from stage IV Hodgkin's disease of the nodular sclerotic type with head and neck manifestations in cervical lymph nodes and in the esophagus. After radiotherapy; she suffered from an esophageal/mediastinal fistula and unilateral paralysis of the recurrent laryngeal nerve. Fifteen years later, there are no signs of recurrent tumor growth or a secondary neoplasm. Dysphonia was ameliorated by speech therapy, and surgery was not necessary. PMID:7575906

  18. Diagnosis of chordoma by cytologic examination of cerebrospinal fluid.

    Marigil, M A; Pardo-Mindan, F J; Joly, M

    1983-09-01

    This is a case report of a 44-year-old man with a chordoma of the clivus that caused dysphonia, low back pain, and urinary and fecal incontinence. The diagnosis was made by cytologic study of the CSF, which demonstrated vacuolated malignant cells. The patient was treated with intrathecal methotrexate, dexamethasone, and radiotherapy. At autopsy extensive dissemination of chordoma was found at the base of the brain, in the ventricles, and in the leptomeninges of the spinal cord. This is the sixth reported case of intrathecal dissemination of a chordoma and the first diagnosed by cytology of the cerebrospinal fluid. PMID:6881106

  19. LARYNGEAL MYXOMA : EMERGENCY MANAGEMENT

    Budhram Singh

    2014-04-01

    Full Text Available A sixty five years male presented with stridor and dysphonia in emergency clinic of Govt. CIMS medical college, Bilaspur. Indirect laryngoscopic examination revealed a polypoidal lesion in glottic chink. CT scan evaluation confirmed the findings of clinical examination. Patient was relived of symptoms after emergency tracheostomy followed by surgical removal of polypoidal lesion from right vocal cord by microlaryngeal surgery. Histopathological examination revealed myxoma. Clinical examination after eight months showed significant improvement in hoarseness of voice with no evidence of recurrence of lesion. [Natl J Med Res 2014; 4(2.000: 175-177

  20. Hypokalaemic Paralysis Revealing Sjogren's Syndrome in a 16-Year Old Girl

    Skalova, S; Minxova, L; Slezak, R

    2008-01-01

    A 16-year old girl presented with rapid onset of muscular weakness and a history of severe dysphagia, dysphonia and significant wasting. On examination, she was dystrophic (BMI 15.7) and had signs of myopathy. Laboratory findings confirmed myopathy (CPK 106.4 µkat/L (6384 IU/L), AST 2.86 µkat/L (171.6 IU/L), myoglobin 1582 µg/L). There was profound hypokalaemia (S-K 1.8 mmol/L) suggesting hypokalaemic paralysis. Diagnosis of distal renal tubular acidosis (dRTA) was based on combination of hyp...

  1. A RARE CASE OF IMPACTED VEGETATIVE FOREIGN BODY IN LARYNX: XANTHIUM STRUMARIUM (CHHOTA GOKHRU

    Richa

    2013-05-01

    Full Text Available ABSTRACT: - BACKGROUND : Impaction of foreign bodies in the larynx constit utes a medical emergency and requires immediate intervention. We report a rare case of a Xanthium Strumarium (Chhota Gokhru impacted in larynx in a 10 year old female who pre sented with complaint of respiratory distress & dysphonia in ENT department, S.S. Medical college and associated hospital, Rewa (M.P.. Direct laryngoscopy was performed for its removal. The case report thus emphasizes that early detection by meticulous history, clinica l findings, imaging modality & prompt management remains basis for favourable outcome.

  2. Anomalous composition of musculature of the first dorsal fibro-osseous compartment of the wrist.

    Dhuria, Ruchi; Mehta, Vandana; Suri, Rajesh Kumar; Rath, Gayatri

    2012-06-01

    The anomalous orientation of musculature of the first dorsal fibro-osseous compartment of the wrist is clinically relevant to De Quervian's stenosing tenosynovitis and reconstructive surgeries. Split insertion of the abductor pollicis longus (APL) is commonly found in chimpanzees, gorillas and gibbons. A comparable identical pattern of anomalous slips in humans is of anthropological and phylogenetic importance and could be a result of atavism. This case report describes an unusual fused muscle belly of the APL and extensor pollicis brevis (EPB), which split into three slips--medial, intermediate and lateral. Further, the medial slip was seen to divide into two tendons, inserting on the base of the first metacarpal along with the intermediate slip. The lateral slip divided into three tendons, inserting into the base of the proximal phalanx, base of the first metacarpal and abductor pollicis brevis muscle. The fusion and unusual insertion pattern of the APL and EPB merits documentation for reconstructive procedures such as tendon transfer and interposition arthroplasty. PMID:22711053

  3. The impact of adding trunk motion to the interpretation of the role of joint moments during normal walking.

    Patel, Mausam; Talaty, Mukul; Ounpuu, Sylvia

    2007-01-01

    Biomechanical model assumptions affect the interpretation of the role of the muscle or joint moments to the segmental power estimated by induced acceleration analysis (IAA). We evaluated the effect of modeling the pelvis and trunk segments as two separate segments (8 SM) versus as a single segment (7 SM) on the segmental power, support of the body, knee and hip extension acceleration produced by the joint moments during the stance phase of normal walking. Significant differences were observed in the contribution of the stance hip abductor and extensor moments to support, ipsilateral knee and hip acceleration, and ipsilateral thigh and upper body power. The primary finding was that the role of the stance hip moment in generating ipsilateral thigh and upper body power differed based on degrees of freedom in the model. Secondarily, the magnitude of contributions also differed. For example, the hip abductor and extensor moments showed greater contribution to support, hip and knee acceleration in the 8 SM. IAA and segment power analysis are sensitive to the degrees of freedom between the pelvis and trunk. There is currently no gold standard by which to evaluate the accuracy of IAA predictions. However, modeling the pelvis and trunk as separate segments is closer to the anatomical architecture of the body. An 8 SM appears to be more appropriate for estimating the role of joint moments, particularly to motion of more proximal segments during normal walking. PMID:17765906

  4. Correlation of crossed cerebellar diaschisis with motor impairment of the hemiplegic upper extremity in stroke patients

    The aim of this study was to investigate the correlation between crossed cerebellar diaschisis (CCD) and motor evoked potentials (MEPs) and to study the relationship between CCD and the severity and prognosis of stroke. Twenty-eight patients with first-ever unilateral stroke underwent brain perfusion SPECT with Tc-99m ECD. The existence of CCD was evaluated by visual inspection on SPECT images. The central motor conduction times were obtained from Abductor pollicis brevis and Abductor hallucis by recording MEPs. The National Institutes of Health stroke scale, the motricity Index (MI), and the functional outcome scales were measured. Fifteen of 28 patients (53.6%) had CCD. The presence of CCD was significantly correlated with 'not evoked' MEPs in the upper extremity (p0.05) and volume of brain lesion (p>0.05). There was a significant correlation between the presence of CCD and lower MI score of upper extremity (p<0.05). The presence of CCD would indicate the damage on the descending motor pathways and be associated with the severe motor impairment of the upper extremity in stroke patients

  5. Correlation of crossed cerebellar diaschisis with motor impairment of the hemiplegic upper extremity in stroke patients

    Song, Ho Chun; Choi, In Sung; Heo, Young Jun; Min, Jeong Jun; Lee, Sam Gyu; Bom, Hee Seung [School of Medicine, Chonnam National University, Gwangju (Korea, Republic of)

    2004-07-01

    The aim of this study was to investigate the correlation between crossed cerebellar diaschisis (CCD) and motor evoked potentials (MEPs) and to study the relationship between CCD and the severity and prognosis of stroke. Twenty-eight patients with first-ever unilateral stroke underwent brain perfusion SPECT with Tc-99m ECD. The existence of CCD was evaluated by visual inspection on SPECT images. The central motor conduction times were obtained from Abductor pollicis brevis and Abductor hallucis by recording MEPs. The National Institutes of Health stroke scale, the motricity Index (MI), and the functional outcome scales were measured. Fifteen of 28 patients (53.6%) had CCD. The presence of CCD was significantly correlated with 'not evoked' MEPs in the upper extremity (p<0.01). The existence of CCD was not associated with locations (p>0.05) and volume of brain lesion (p>0.05). There was a significant correlation between the presence of CCD and lower MI score of upper extremity (p<0.05). The presence of CCD would indicate the damage on the descending motor pathways and be associated with the severe motor impairment of the upper extremity in stroke patients.

  6. Retrowalking as an adjunct to conventional treatment versus conventional treatment alone on pain and disability in patients with acute exacerbation of chronic knee osteoarthritis: A randomized clinical trial

    Gauri Arun Gondhalekar

    2013-01-01

    Full Text Available Background: Increased external knee adduction moment during walking alters the joint biomechanics; which causes symptoms in chronic knee osteoarthritis patients. Aims: To assess additional effects of Retro-walking over conventional treatment on pain and disability in patients with acute exacerbation of chronic knee osteoarthritis. Materials and Methods: Thirty chronic knee osteoarthritis patients were randomly assigned into 2 groups. Group ′A′ (7 men, 8 women received conventional treatment. Group ′B′ (8 men, 7 women received conventional treatment and Retro-walking. Pain, assessed through visual analogue scale (VAS, and Western Ontario and McMaster Universities Arthritis Index (WOMAC were the primary outcomes and knee range of motion (ROM, hip abductor and extensor strength were secondary outcomes; measured pre-intervention, after 1 week and after 3 weeks of intervention. Results: Two factors analysis of variance for repeated measures was used for all outcomes. At the end of 3 weeks; WOMAC score showed highly significant difference within ( P < 0.0001 and significant difference between groups ( P = 0.040 also by Time × group interaction ( P = 0.024, VAS showed highly significant difference within groups ( P < 0.0001. Knee ROM showed significant difference within groups. Hip abductor and extensor strength showed significant difference by Time × group interaction ( P < 0.05. Conclusion: Retrowalking is an effective adjunct to conventional treatment in decreasing disability in patients with knee osteoarthritis.

  7. Neural correlates of abnormal sensory discrimination in laryngeal dystonia

    Pichet Termsarasab

    2016-01-01

    Full Text Available Aberrant sensory processing plays a fundamental role in the pathophysiology of dystonia; however, its underpinning neural mechanisms in relation to dystonia phenotype and genotype remain unclear. We examined temporal and spatial discrimination thresholds in patients with isolated laryngeal form of dystonia (LD, who exhibited different clinical phenotypes (adductor vs. abductor forms and potentially different genotypes (sporadic vs. familial forms. We correlated our behavioral findings with the brain gray matter volume and functional activity during resting and symptomatic speech production. We found that temporal but not spatial discrimination was significantly altered across all forms of LD, with higher frequency of abnormalities seen in familial than sporadic patients. Common neural correlates of abnormal temporal discrimination across all forms were found with structural and functional changes in the middle frontal and primary somatosensory cortices. In addition, patients with familial LD had greater cerebellar involvement in processing of altered temporal discrimination, whereas sporadic LD patients had greater recruitment of the putamen and sensorimotor cortex. Based on the clinical phenotype, adductor form-specific correlations between abnormal discrimination and brain changes were found in the frontal cortex, whereas abductor form-specific correlations were observed in the cerebellum and putamen. Our behavioral and neuroimaging findings outline the relationship of abnormal sensory discrimination with the phenotype and genotype of isolated LD, suggesting the presence of potentially divergent pathophysiological pathways underlying different manifestations of this disorder.

  8. A clinical comparative study of anatomic parameters before and after total hip replacement on congenital dysplasia.

    Huang, Ziqiang; Zhou, Yonggang; Chai, Wei; Ji, Weiping; Cui, Guopeng; Ma, Miaoqun; Zhu, Yin

    2016-07-01

    [Purpose] To study preoperative and postoperative hip circumference data of various types of congenital dysplasia of the hip treated with total hip replacement, including the femoral offset, femoral neck length, height, and hip abductor arm parameters. [Subjects and Methods] This study included seventy-eight cases of congenital dysplasia of the hip (I-III type). Furthermore, four parameters were measured, including the preoperative and postoperative femoral offset. Statistical data analysis was performed using the SPSS 13.0 software. [Results] The femoral offset was 33.3 ± 8.4 mm (preoperative) and 39.1 ± 7.1 mm (postoperative). The femoral head height was 59.5 ± 8.7 mm (preoperative) and 68.8 ± 11.0 mm (postoperative). The femoral neck length was 50.8 ± 10.8 mm (preoperative) and 61.5 ± 10.4 mm (postoperative). The hip abductor arm was 54.3 ± 9.6 mm (preoperative) 64.7 ± 10.1 mm (postoperative). The preoperative and postoperative parameters showed statistical differences. Furthermore, no significant differences were evidenced when comparing the postoperative hip parameters with the normal data parameters. [Conclusion] Total hip replacement on congenital dysplasia of the hip could lead to the rebuilt of an almost normal physiological anatomy for each hip case (type I-III). PMID:27512242

  9. Characteristics of corticospinal projections to the intrinsic hand muscles in skilled harpists.

    Buick, Alison R; Kennedy, Niamh C; Carson, Richard G

    2016-01-26

    The process of learning to play a musical instrument necessarily alters the functional organisation of the cortical motor areas that are involved in generating the required movements. In the case of the harp, the demands placed on the motor system are quite specific. During performance, all digits with the sole exception of the little finger are used to pluck the strings. With a view to elucidating the impact of having acquired this highly specialised musical skill on the characteristics of corticospinal projections to the intrinsic hand muscles, focal transcranial magnetic stimulation (TMS) was used to elicit motor evoked potentials (MEPs) in three muscles (of the left hand): abductor pollicis brevis (APB); first dorsal interosseous (FDI); and abductor digiti minimi (ADM) in seven harpists. Seven non-musicians served as controls. With respect to the FDI muscle-which moves the index finger, the harpists exhibited reliably larger MEP amplitudes than those in the control group. In contrast, MEPs evoked in the ADM muscle-which activates the little finger, were smaller in the harpists than in the non-musicians. The locations on the scalp over which magnetic stimulation elicited discriminable responses in ADM also differed between the harpists and the non-musicians. This specific pattern of variation in the excitability of corticospinal projections to these intrinsic hand muscles exhibited by harpists is in accordance with the idiosyncratic functional demands that are imposed in playing this instrument. PMID:26673887

  10. [Anatomical variants of the medial calcaneal nerve and the Baxter nerve in the tarsal tunnel].

    Martín-Oliva, X; Elgueta-Grillo, J; Veliz-Ayta, P; Orosco-Villaseñor, S; Elgueta-Grillo, M; Viladot-Perice, R

    2013-01-01

    The tarsal tunnel is composed of the posterior border of the medial malleoulus, the posterior aspect of the talus and the medial aspect of the calcaneus. The medial calcaneal nerve emerges from the posterior aspect of the posterior tibial nerve in 75% of cases and from the lateral plantar nerve in the remaining 25%. Finally, the medial calcaneal nerve ends as a single terminal branch in 79% of cases and in numerous terminal branches in the remaining 21%. To describe the anatomical variants of the posterior tibial nerve and its terminal branches. To describe the steps for tarsal tunnel release. To describe Baxter nerve release. The anatomical variants of the posterior tibial nerve and its terminal branches within the tarsal tunnel were studied. Then the Lam technique was performed; it consists of: 1) opening of the laciniate ligament, 2) opening of the fascia over the abductor hallucis muscle, 3) exoneurolysis of the posterior tibial nerve and its terminal branches, identifying the emergence and pathway of the medial calcaneal branch, the lateral plantar nerve and its Baxter nerve branch and the medial plantar nerve. Baxter nerve was found in 100% of cases. In 100% of cases in our series the nerve going to the abductor digiti minimi muscle of the foot was found; 87.5% of cases had two terminal branches. The dissections proved that a crucial step was the release of the distal tarsal tunnel. PMID:24701749

  11. Preliminary observation of the relationship between intraoperative electrophysiologic testing and surgical outcome of carpal tunnel release%腕管综合征术中神经电生理检测与手术疗效评价的初步探讨

    陈劼; 徐雷; 徐建光; 田东; 朱艺; 韩栋; 顾玉东

    2010-01-01

    Objective To explore a reliable predicator of surgical outcomes of carpal tunnel release(CTR)by exploring the changes of pre-and intraoperative median nerve-abductor pollicis brevis compound muscle action potential(CMAP).Methods Fifteen patients with carpal tunnel syndrome were involved in the study.Electrophysiologic examination was carried out to record CMAP of abductor pollicis brevis muscle at following moments:before CTR right after brachial plexus block,immediate after CTR and tourniquet release,1minute,3 minutes,5 minutes and 7 minutes after tourniquet release.Statistics analysis was done to compare these parameters with preoperative values.Results There were statistically significant changes in both amplitude and latency of the CMAP within 5 minutes after toumiquet release(P0.05).正中神经-拇短展肌CMAP的潜伏期比术前缩短,差异有统计学意义(P<0.05),但波幅与术前相比差异有明显统计学意义(P<0.01).方论 对腕管综合征行神经松解术后,拇短展肌CMAP的波幅比其潜伏期更能体现神经松解的疗效,而在松止血带5 min后进行神经电生理检测来评价手术效果更为可靠.

  12. Efficacy and Safety of a New Botulinum Toxin Type A Free of Complexing Proteins

    Hyun-Mi Oh

    2015-12-01

    Full Text Available MT10107 is botulinum neurotoxin type A derived drug which utilizes the 150 kDa portion without complexing proteins and human serum albumin contents. To evaluate the efficacy and the safety of MT10107, it was compared with onabotulinumtoxinA in this double-blind, randomized controlled trial. Twenty-five healthy males received a randomly selected dose of MT10107 into the extensor digitorum brevis (EDB muscle of one foot, and an equivalent dose of onabotulinumtoxinA (BOTOX was injected into the contralateral EDB muscle. While efficacy of the administered substance was determined by measuring paretic effects on the EDB, the local spread of toxin effects was evaluated by the paretic effects on the nearby abductor hallucis (AH and abductor digiti quinti (ADQ muscles. Paretic effects were defined as the percentage of reduction of the compound muscle action potential (CMAP amplitudes, measured at 14, 30, 90 days after the injection, compared to the baseline value. Intergroup (MT10107 and onabotulinumtoxinA differences were not significant in the percentage reduction of the amplitudes in the EDB muscles. In this study, there was no significant difference in efficacy and safety between the two test drugs. MT10107 may be effective and safe as much as onabotulinumtoxinA to produce the desired paretic effect.

  13. Efficacy and Safety of a New Botulinum Toxin Type A Free of Complexing Proteins.

    Oh, Hyun-Mi; Park, Joo Hyun; Song, Dae Heon; Chung, Myung Eun

    2016-01-01

    MT10107 is botulinum neurotoxin type A derived drug which utilizes the 150 kDa portion without complexing proteins and human serum albumin contents. To evaluate the efficacy and the safety of MT10107, it was compared with onabotulinumtoxinA in this double-blind, randomized controlled trial. Twenty-five healthy males received a randomly selected dose of MT10107 into the extensor digitorum brevis (EDB) muscle of one foot, and an equivalent dose of onabotulinumtoxinA (BOTOX) was injected into the contralateral EDB muscle. While efficacy of the administered substance was determined by measuring paretic effects on the EDB, the local spread of toxin effects was evaluated by the paretic effects on the nearby abductor hallucis (AH) and abductor digiti quinti (ADQ) muscles. Paretic effects were defined as the percentage of reduction of the compound muscle action potential (CMAP) amplitudes, measured at 14, 30, 90 days after the injection, compared to the baseline value. Intergroup (MT10107 and onabotulinumtoxinA) differences were not significant in the percentage reduction of the amplitudes in the EDB muscles. In this study, there was no significant difference in efficacy and safety between the two test drugs. MT10107 may be effective and safe as much as onabotulinumtoxinA to produce the desired paretic effect. PMID:26712786

  14. Comparison of functional outcome of total hip arthroplasties involving four surgical approaches.

    Mostardi, R A; Askew, M J; Gradisar, I A; Hoyt, W A; Snyder, R; Bailey, B

    1988-01-01

    One hundred thirty-seven total hip arthroplasty patients had a follow-up evaluation consisting of an orthopaedic physical evaluation, isokinetic strength testing, and collection of demographic and surgical information from medical records. The intraoperative variables of surgical time and blood loss and the functional outcome status of the subjects, as demonstrated by D'Aubigne--Postel ratings and isokinetic strength tests, were compared for various trochanteric management techniques: no osteotomy; complete Charnley-type osteotomy; sharp abductor release; and a wafer technique, in which a wafer of bone was osteotomized from the trochanter to release the abductors. A comparison of the mean values for the variables indicated that the wafer and sharp techniques were superior to the complete and no osteotomy techniques. The wafer technique resulted in statistically significant superior isokinetic strength measured in adduction, flexion, and extension. Surgical time was significantly greater in the complete osteotomy cases and blood loss was least in the wafer cases, although these differences were not significant. PMID:3183682

  15. Multiple variations of the tendons of the anatomical snuffbox

    Thwin, San San; Zaini, Fazlin; Than, Myo

    2014-01-01

    INTRODUCTION Multiple tendons of the abductor pollicis longus (APL) in the anatomical snuffbox of the wrist can lead to the development of de Quervain's syndrome, which is caused by stenosing tenosynovitis. A cadaveric study was performed to establish the variations present in the tendons of the anatomical snuffbox in a Malaysian population, in the hope that this knowledge would aid clinical investigation and surgical treatment of de Quervain's tenosynovitis. METHODS Routine dissection of ten upper limbs was performed to determine the variations in the tendons of the anatomical snuffbox of the wrist. RESULTS In all the dissected upper limbs, the APL tendon of the first extensor compartment was found to have several (3–14) tendon slips. The insertion of the APL tendon slips in all upper limbs were at the base of the first metacarpal bone, trapezium and fascia of the opponens pollicis muscle; however, in seven specimens, they were also found to be attached to the fleshy belly of the abductor pollicis brevis muscle. In two specimens, double tendons of the extensor pollicis longus located in the third extensor compartment were inserted into the capsule of the proximal interphalangeal joints before being joined to the extensor expansion. In two other specimens, the first extensor compartment had two osseofibrous tunnels divided by a septum that separated the APL tendon from the extensor pollicis brevis tendon. CONCLUSION Multiple variations were found in the anatomical snuffbox region of the dissected upper limbs. Knowledge of these variations would be useful in interventional radiology and orthopaedic surgery. PMID:24452976

  16. Videostroboscopic and morphological aspects of voice disturbances in patients with larynx atrophy and coexisting hypopharynx cancer

    Dawid Falkowski

    2012-01-01

    Full Text Available Vocal folds play a crucial role in voice production. The physiological vibrations of vocal folds depend on the unchanged multilayered structure of the vocal folds mucosa. Morphological changes of mucosa are the cause of voice quality disorders — dysphonia. The aim of this study was to determine the morphological base of dysphonia in patients with vocal folds atrophy. A group of 24 patients with larynx atrophy confirmed by endoscopic (VLS and stroboscopic (VLSS examination of the larynx was included in the study. The morphological assessment of the larynx mucosa was carried out with the use of the transmission electron microscopy (TEM. Ultramorphological examinations revealed changes in the epithelium, basal membrane and lamina propria of the vocal folds mucosa. An increased number of collagenous fibers, fibroblasts with signs of vacuolar degeneration inflammatory cells and a decreased number of blood vessels and pericytes were observed. Morphological changes found in the epithelium, basal membrane and lamina propria of the vocal folds mucosa were the cause of disorders of vocal folds vibrations registered in the stroboscopic examination of the larynx (VLSS. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 4, pp. 659–663

  17. Inhaled corticosteroids: hazardous effects on voice-an update.

    Gallivan, Gregory J; Gallivan, K Holly; Gallivan, Helen K

    2007-01-01

    Inhaled corticosteroids (ICS) have become the prevalent treatment in asthmatics. Hazards to voice are under-recognized. A total of 38 patients with voice complaints associated with the use of ICS were assessed by 79 strobovideolaryngoscopy (SVL) examinations, 24 single and 14 multiple SVL. Hoarseness and dysphonia were the primary reasons for referral. The ICS initially used most frequently was Advair Diskus (fluticasone propionate and salmeterol-inhalation powder-[IP]) in 22 patients, followed by Flovent (fluticasone propionate inhalation aerosol-pressurized metered-dose inhaler-[PMDI]) in 11. Duration of ICS usage varied from 2 weeks to 4-5 years. Higher dosage and frequency of use exacerbated problems. Hazards to voice previously unrecognized by real-time indirect mirror or fiberoptic laryngoscopy were identified by meticulous attention to SVL abnormalities. There was essentially no difference in occurrence of abnormalities whether analyzed from the perspective of the initial 38 or all 79 examinations. These included abnormal mucosal wave symmetry/periodicity (76-63%), phase closure (74-63%), glottic closure (63-59%), mucosal wave amplitude/magnitude (50-35%), supraglottic hyperactivity (39-25%), mucosal quality (34-34%), and glottic plane (10-5%). Candidiasis of the larynx was infrequently observed. Fluticasone ICS were a cause of steroid inhaler laryngitis, and the best treatment was their avoidance or cessation. Further prospective studies ideally might include SVL documented as a pretherapy baseline and then repeated in each ICS patient who developed hoarseness/dysphonia. PMID:16442776

  18. Comparison of Voice Perceptual Charactheristics between Speech - Language Pathologists', Dysphonic and Normal Voiced Adult's View

    Seyyedeh Maryam khoddami

    2010-06-01

    Full Text Available Background and Aim: In recent years, several tools for assessment of quality of patient life have been designed especially for dysphonics. Nowadays, we have useful assessments in health system that are refered for numerous clinical decisions. In this way, this investigation compares clinician and patient perception in dysphonic and normal voiced for first time.Methods: This study was carried out on 30 dysphonic and 30 subjects with normal voice. Their age, sex and job were same. In two groups, Consensus Auditory – Perceptual Evaluation of Voice (CAPE-V was used for evaluation of clinician perception and Voice Handicap Index - 30 (VHI-30 for assessment of patient perception. After collecting data, they were analyzed by Mann- witney and Wilcoxon tests.Results: The research revealed that mean of total and each section score of VHI-30 have significant difference between dysphonic and control group (p<0.01. Comparison of total and every parameter score of CAPE-V and speed also indicated significant difference between two groups (p<0.01. Study of reliability shows weak reliability (r=0.34 between clinician and patient perception of voice in dysphonics.Conclusion: Dysphonic patients percept their voice problem different and severe rather than clinicians that shows physical, psychological and social affects of dysphonia. This research confirms that patient – based assessment of voice is necessary to be part of common assessments of dysphonia.

  19. Voice quality improvement after management of unilateral vocal cord paralysis with different techniques.

    Bihari, A; Mészáros, K; Reményi, A; Lichtenberger, G

    2006-12-01

    The aim of this study was to objectively evaluate the voices of patients suffering from unilateral vocal cord paralysis, before and after endoscopic augmentation and thyroplasty. In the past, we used injectable Teflon to treat this condition; later techniques included collagen injection and Isshiki thyroplasty. In the last 7 years, preferred treatment methods have included Bioplastique injection and lipoaugmentation of the vocal cords as well as medialization thyroplasty using a titanium implant according to Friedrich. Pre- and postoperative data was evaluated and compared to 25 patients. Appropriate glottic closure of the vocal cords was achieved in every case, in most cases after the first intervention. We used voice range profile measurements to evaluate the results. An objective evaluation was performed using the Friedrich dysphonia index. Significant improvements were found: the dysphonia index decreased in every case, from an average of 2.47, preoperatively, to an average of 1.18 postoperatively. In agreement with earlier studies, voice pitch range was the only parameter that not significantly improved. There was no statistical difference between the lipoaugmentation and thyroplasty according to Friedrich. We concluded that both endoscopic methods and thyroplasty can be used to achieve an optimal result. Cases must be evaluated individually so that the best technique, or combination of methods can be determined. PMID:16896756

  20. Laryngeal cancer at the Korle Bu Teaching Hospital Accra Ghana

    Laryngeal cancer is the commonest head and neck cancer seen at the Ear Nose and Throat (ENT) Unit Korle Bu Teaching Hospital. The aim of this study was to determine the number of cases of laryngeal cancer seen at the Korle Bu Teaching Hospital, establish epidemiological parameters of the disease and to outline preventive measures. One hundred and fifteen (115) patients who were managed for laryngeal cancer from 1st January 1998 to 31st December 2003 were studied retrospectively with respect to age, sex, duration of symptoms at presentation, risk factors, symptoms complex, histopathology, stage of tumor, details of treatment offered and follow up. The age range was 17-85 years with a mean of 55.5 years (SD10.7). Majority of the patients (90.4%) were above 40 years. The commonest symptom at presentation was dysphonia. A significant proportion of cases (37.3%) presented with locally advanced disease. The commonest histological type of laryngeal tumour seen was squamous cell carcinoma. The treatment offered consisted of radiotherapy for 83 (79.8%) patients and total laryngectomy with neck dissection when necessary for 17 (16.3%) patients who also had postoperative radiotherapy. Only 58 (69.9%) patients completed radiotherapy treatment and in all 32 (24.3 %) patients did not report for any treatment. Majority of patients failed to report for post treatment follow-up. We conclude that significant number of patients with laryngeal cancer presented with locally advanced disease and dysphonia was the commonest symptom. (au)

  1. MEDICINAL USES AND PHYTOCONSTITUENTS OF PAEONIA OFFICINALIS

    Ahmad F

    2012-04-01

    Full Text Available Paeonia officinalis (European peony, Common peony has been cultivated in Europe for years. The root has been used medicinally for over 2,000 years mainly in the treatment for epilepsy and to promote menstruation. Root is also antispasmodic, diuretic, sedative and tonic and has been successfully employed in the treatment of convulsions and spasmodic nervous affections such as epilepsy. It has also been used in the treatment of whooping cough whilst suppositories are sometimes made of the root to relieve anal and intestinal spasms, hemorrhoids and varicose veins. Experimentally it has been proved to have antihypertensive, abortifacient action and anti-ulcer activity. The roots of this plant are of great medicinal significance in unani system and homeopathy. The roots contain asparagin, benzoic acid, flavonoids, paeoniflorin, paeonin, paeonol, protoanemonin, tannic acid, triterpenoids, and volatile oil. This review covers botany, traditional uses and the phytoconstituents of the roots of Paeonia officinalis.

  2. Fou rire prodromique and history of pathological laughter in the XIXth and XXth centuries.

    Gondim, F A A; Thomas, F P; Oliveira, G R; Cruz-Flores, S

    2004-03-01

    Fou rire prodromique (prodrome of crazy laughter) is a rarely described nosological entity. In 1903, Charles Féré, a French neurologist, introduced the term fou rire prodromique to describe pathological laughter heralding an apoplectic event. He was also among the first to describe gelastic epilepsy. His description was influenced by Edouard Brissaud, who supported the existence of a thalamic center for laughter regulation and suggested that spasmodic laughter and crying were due to lesions of the faisceau psychique (anterior internal capsule) or to irritation of the faisceau géniculé (corticobulbar tract). One hundred Years later, we review the evolution of the theories about pathological laughter and crying from Charles Bell in the early XIXth Century, up to the seminal works of Kinnier Wilson and James Papez and the era of modern neuroscience. PMID:15037840

  3. Lemon grass oil for improvement of oral health

    Ruckmani Rajesvari

    2013-01-01

    Full Text Available Lemon grass essential oil has been used for decades to treat respiratory infections, sinusitis, bladder infections, high cholesterol, digestive problem, varicose veins and also for regeneration of connective tissue. It has anti spasmodic, anti-pyretic, anti-fungal, anti-bacterial, anti-inflammatory, anti-septic, insect repellent, sedative, vasodilator and flavoring properties. In china, it has been used traditionally as a remedy for stomach and liver diseases and also to treat rheumatism. Since lemon grass oil possess various pharmacological actions, it is also quite useful in dentistry. Hence, the objective of this article is to highlight various uses of lemon grass oil in the dental field and in the medical field in order to aid the professionals for future research.

  4. Rectal cancer in pregnancy: A diagnostic and therapeutic challenge

    Introduction: The occurrence of colorectal cancer during pregnancy is rare and is associated with diagnostic and therapeutic challenges. Herein, we report such a case of rectal cancer in pregnancy and review the literature. Case report: A 31-year-old multiparous, pregnant woman, in the 20th week of gestation, presented with rectal bleeding progressing to spasmodic abdominal pain and right flank vague pain. A flexible recto sigmoidoscopy showed a large ulcerative mass located in the recto sigmoid junction, 15 cm away from anal verge. Imaging studies and biopsy proved it to be rectal adenocarcinoma with single liver metastasis. The patient’s pregnancy was terminated and neoadjuvant therapy followed by curative surgery was performed. She is currently receiving adjuvant systemic therapy to eradicate potential micro metastatic disease. Conclusion: This case suggests that colorectal cancer can mimic the signs and the symptoms of pregnancy and tends to present at an advanced stage in pregnant women.

  5. A REVIEW ON THERAPEUTIC USES OF PEDALIUM MUREX LINN

    A. Elumalai

    2011-06-01

    Full Text Available Traditional system of medicinal consists of large number of plants with various medicinal and pharmacological importances and hence represents a priceless tank of new bioactive molecules. Pedalium murex is a small herb distributed in tropical Africa, Ceylon, India and Mexico. It is commonly found in Deccan and some parts of Ceylon and Gujarat and in its costal areas of Southern India. It is commonly called Gokhru (Yaanai Nerinji a member of family Pedaliaceae. The plant is sweet, cooling, mucilaginous, diuretic and inflammatory and used to treat digestive, carminative, tonic, spasmodic affections, amenorrhoea, and vitiated conditions of pita, inflammation and general debility. This review will be helpful to create interest towards Pedalium murex and may be useful in developing new formulations with more therapeutic and economical value.

  6. Cosmological bang as a consequence of a sharp breakdown of quantum statistics in the nuclear matter

    A heuristic hypothesis about dominating of Bose-statistics in the early Universe, at the transition from the Radiation Era to the Matter Era is suggested. The possibility of Bose-Einstein condensate of the matter, consisted of baryon-antibaryon pairs is considered. Due to this phenomenon, the enormous mass may accumulate within the cosmic scales. At the several threshold value of the density these structural bosons decay into composing fermions; as a result the sharp breakdown of symmetry of the particles' wave function occurs and the Bose-Einstein statistics spasmodically transforms into Fermi-Dirac one. A large-scale phase transition occurs due to this process, conducted with enormous pressure jump, which may become apparent as a Cosmological Bang at the beginning stage of Matter Era

  7. Elements of a nuclear criticality safety program

    Nuclear criticality safety programs throughout the United States are quite successful, as compared with other safety disciplines, at protecting life and property, especially when regarded as a developing safety function with no historical perspective for the cause and effect of process nuclear criticality accidents before 1943. The programs evolved through self-imposed and regulatory-imposed incentives. They are the products of conscientious individuals, supportive corporations, obliged regulators, and intervenors (political, public, and private). The maturing of nuclear criticality safety programs throughout the United States has been spasmodic, with stability provided by the volunteer standards efforts within the American Nuclear Society. This presentation provides the status, relative to current needs, for nuclear criticality safety program elements that address organization of and assignments for nuclear criticality safety program responsibilities; personnel qualifications; and analytical capabilities for the technical definition of critical, subcritical, safety and operating limits, and program quality assurance

  8. Ultrasound and Electromyography Guidance for Injection of the Longus Colli With Botulinum Toxin for the Treatment of Cervical Dystonia.

    Allison, Stephen K; Odderson, Ib R

    2016-09-01

    Cervical dystonia, also called spasmodic torticollis, is a painful condition in which neck muscles contract involuntarily, and may cause abnormal head position or movements. The primary (or first line of) treatment of cervical dystonia is chemodenervation with injection of botulinum toxin into the affected muscles. We report a case of a young man with idiopathic cervical dystonia who developed anterocollis (forward flexion of the neck) not responsive to prior scalene and sternocleidomastoid muscle injections. To safely access the deeper cervical musculature, ultrasound (US) was used in conjunction with electromyography, to inject the longus colli muscles bilaterally. The patient responded well and had no complications. The longus colli has been reported to be injected using electromyography, fluoroscopy, computed tomography, and, less frequently, US. We propose that US guidance is an excellent technique for botulinum toxin injection, especially for deep cervical muscles such as the longus colli. PMID:26886108

  9. The 2004-2008 dome-building eruption at Mount St. Helens, Washington: epilogue

    Dzurisin, Daniel; Moran, Seth C.; Lisowski, Michael; Schilling, Steve P.; Anderson, Kyle R.; Werner, Cynthia

    2015-10-01

    The 2004-2008 dome-building eruption at Mount St. Helens ended during winter 2007-2008 at a time when field observations were hampered by persistent bad weather. As a result, recognizing the end of the eruption was challenging—but important for scientists trying to understand how and why long-lived eruptions end and for public officials and land managers responsible for hazards mitigation and access restrictions. In hindsight, the end of the eruption was presaged by a slight increase in seismicity in December 2007 that culminated on January 12-13, 2008, with a burst of more than 500 events, most of which occurred in association with several tremor-like signals and a spasmodic burst of long-period earthquakes. At about the same time, a series of regular, localized, small-amplitude tilt events—thousands of which had been recorded during earlier phases of the eruption—came to an end. Thereafter, seismicity declined to 10-20 events per day until January 27-28, when a spasmodic burst of about 50 volcano-tectonic earthquakes occurred over a span of 3 h. This was followed by a brief return of repetitive "drumbeat" earthquakes that characterized much of the eruption. By January 31, however, seismicity had declined to 1-2 earthquakes per day, a rate similar to pre-eruption levels. We attribute the tilt and seismic observations to convulsive stagnation of a semisolid magma plug in the upper part of the conduit. The upward movement of the plug ceased when the excess driving pressure, which had gradually decreased throughout the eruption as a result of reservoir deflation and increasing overburden from the growing dome, was overcome by increasing friction as a result of cooling and crystallization of the plug.

  10. Seismicity characteristics of a potentially active Quaternary volcano: The Tatun Volcano Group, northern Taiwan

    Konstantinou, Konstantinos I.; Lin, Cheng-Horng; Liang, Wen-Tzong

    2007-02-01

    The Tatun Volcano Group (TVG) is located at the northern tip of Taiwan, near the capital Taipei and close to two nuclear power plants. Because of lack of any activity in historical times it has been classified as an extinct volcano, even though more recent studies suggest that TVG might have been active during the last 20 ka. In May 2003 a seismic monitoring project at the TVG area was initiated by deploying eight three-component seismic stations some of them equipped with both short-period and broadband sensors. During the 18 months observation period local seismicity mainly consisted of high frequency earthquakes either occurring as isolated events, or as a continuous sequence in the form of spasmodic bursts. Mixed and low frequency events were also present during the same period, even though they occurred only rarely. Arrival times from events with clear P-/S-wave phases were inverted in order to obtain a minimum 1D velocity model with station corrections. Probabilistic nonlinear earthquake locations were calculated for all these events using the newly derived velocity model. Most high frequency seismicity appeared to be concentrated near the areas of hydrothermal activity, forming tight clusters at depths shallower than 4 km. Relative locations, calculated using the double-difference method and utilising catalogue and cross-correlation differential traveltimes, showed insignificant differences when compared to the nonlinear probabilistic locations. In general, seismicity in the TVG area seems to be primarily driven by circulation of hydrothermal fluids as indicated by the occurrence of spasmodic bursts, mixed/low frequency events and a b-value (1.17 ± 0.1) higher than in any other part of Taiwan. These observations, that are similar to those reported in other dormant Quaternary volcanoes, indicate that a magma chamber may still exist beneath TVG and that a future eruption or period of unrest should not be considered unlikely.

  11. Laryngeal mask airway and endotracheal tube: odynophagia and dysfhonia incidence under general anesthesia at the University Hospital San Vicente de Paúl, Medellín, 2000 Máscara laríngea y tubo endotraqueal: incidencia de odinogagia y disfonía por su uso en anestesia general en el Hospital Universitario San Vicente de Paúl, Medellín, 2000

    Mónica del Rosario Guzmán Carazo

    2001-03-01

    Full Text Available We describe the odynophagia and dysphonia incidence after the use of either laryngeal mask (LM or endotracheal tube (ETT in adult patients submitted to elective surgery, under general anesthesia, at the University Hospital San Vicente of Paul, Medellín, Colombia, between February 14 and March 16 of 2000. A descriptive and prospective study was carried out in 63 patients, in which the global incidence of odynophagia was 15.9% and that of dysphonia 12.5%; there was a higher odynophagia incidence with the use of ETT, 37.5%, than with LM, 2.6%. The dysphonia incidence was also higher with the use of the TET (25% than with LM (5.1%. The odynophagia incidence was higher in women (19.1% than in men (6.2%. Dysphonia was also more frequent in women (14.8% than in men (6.2%. Accordingly, we can conclude that odynophagia and dysphonia incidences are lower in men, when the time of anesthesia is two hours or less and when LM is used. More studies are necessary to carry out a comparative analysis of the complications with the use of LM and ETT, in order to offer the safest and more effective technique for insuring the airway. Se describe la incidencia de odinofagia y disfonía después del uso de la máscara laríngea (ML o del tubo endotraqueal (TET en pacientes adultos sometidos a cirugía electiva, bajo anestesia general, en el Hospital Universitario San Vicente de Paúl, de Medellín, entre febrero y marzo de 2000. Se hizo un estudio descriptivo, prospectivo, de corte transversal, en 63 pacientes, en los cuales se encontró una incidencia global de odinofagia del 15.9% y de disfonía del 12.5%. Hubo una mayor incidencia de odinofagia con el uso del TET, 37.5%, que con la ML, 2.6%. La incidencia de disfonía también fue mayor con el uso del TET (25% que con la ML (5.1%. La incidencia de odinofagia fue mayor en las mujeres (19.1% que en los hombres (6.2%. La disfonía también fue más frecuente en mujeres (14.8% que en hombres (6.2%. De acuerdo con los

  12. Bringing transcranial mapping into shape: Sulcus-aligned mapping captures motor somatotopy in human primary motor hand area

    Raffin, Estelle; Pellegrino, Giovanni; Di Lazzaro, Vincenzo; Thielscher, Axel; Siebner, Hartwig Roman

    2015-01-01

    resting motor threshold. We pseudorandomly stimulated six targets located on a straight mediolateral line corresponding to the overall orientation of the central sulcus with a fixed coil orientation of 45° to the mid-sagittal line (STRAIGHT-450 FIX) or seven targets in the posterior part of the crown of......Motor representations express some degree of somatotopy in human primary motor hand area (M1HAND), but within-M1HAND corticomotor somatotopy has been difficult to study with transcranial magnetic stimulation (TMS). Here we introduce a “linear” TMS mapping approach based on the individual shape of...... the central sulcus to obtain mediolateral corticomotor excitability profiles of the abductor digiti minimi (ADM) and first dorsal interosseus (FDI) muscles. In thirteen young volunteers, we used stereotactic neuronavigation to stimulate the right M1HAND with a small eight-shaped coil at 120% of FDI...

  13. Symmetry of phrenic nerve motor response in amyotrophic lateral sclerosis.

    Pinto, Susana; de Carvalho, Mamede

    2010-11-01

    To test for interside differences and ipsilateral correlation of compound muscle action potentials (CMAP) from muscles of the cervical region according to El Escorial criteria, we stimulated the phrenic, axillary, and ulnar nerves bilaterally in 67 patients with amyotrophic lateral sclerosis. The diaphragm CMAP was symmetric, but it did not correlate with deltoid or abductor digiti minimi (ADM) CMAPs. The deltoid CMAP in all groups and ADM CMAP in bulbar- and lower-limb-onset patients showed significant interside correlation. The ADM CMAP is asymmetric in upper-limb-onset patients. Unilateral stimulation is sufficient to monitor the phrenic nerve response; its degree of CMAP decrease does not correlate with other cervical muscle involvement. PMID:20928909

  14. Changes of gluteus medius muscle in the adult patients with unilateral developmental dysplasia of the hip

    Liu RuiYu

    2012-06-01

    Full Text Available Abstract Background The gluteus medius muscle is essential for gait and hip stability. Changes that occur in the gluteus medius muscles in patients with developmental dysplasia of the hip (DDH are not well understood. A better understanding of DDH related changes will have positive repercussions toward hip soft tissue reconstruction. Methods 19 adult patients with unilateral DDH scheduled for total hip arthroplasty were assessed for: cross-sectional area (CSA, radiological density (RD and the length of gluteus medius using computed tomograhpy(CT (scanned before THA. Hip abductor moment arm and gluteus medius activation angle were also measured via hip anteroposterior radiographs. Results Both CSA and RD of gluteus medius muscle were significantly reduced (p  Conclusions The gluteus medius showed substantial loss of CSA, RD as well as decreased length in patients with DDH in the affected hip. These changes should be considered in both hip reconstruction and postoperative rehabilitation training in patients with DDH.

  15. STANDARDISED CLINICAL EXAMINATION OF SOFT-TISSUE PAIN IN PATIENTS WITH HIP DYSPLASIA USING THE CLINICAL ENTITIES APPROACH

    Jacobsen, Julie Sandell; Hölmich, Per; Thorborg, Kristian;

    2015-01-01

    Introduction In patients with symptomatic hip dysplasia soft-tissue pain may be a prevalent condition that might affect the outcome of periacetabular osteotomy (PAO). However, the distribution of soft-tissue pain in hip dysplasia has never been examined systematically using a standardised and...... reliable protocol. The aim of this study was to investigate five clinical entities in 100 patients with hip dysplasia using the clinical entities approach identifying the anatomic location of soft-tissue pain. The first 50 patients are presented in this paper. Material and Methods Fifty patients (10 males...... prevalence in the iliopsoas and the hip abductors. This indicates that patients with hip dysplasia also experience pain related to the surrounding soft-tissues, and not only from the hip joint. References (1) Holmich P, Holmich LR, Bjerg AM. Clinical examination of athletes with groin pain: an intraobserver...

  16. Increase in H-reflex gain following 1 week of immobilization

    Jensen, Jesper Lundbye; Sørensen, Mie; Nielsen, Jens Bo

    any changes in the flexion torque elicited by supramaximal stimulation of the median nerve. Both at rest and during tonic contraction the H-reflex increased significantly following immobilization without significant changes in Mmax. MEP amplitudes did not change significantly following immobilization...... the effect of 1 week of immobilization on transmission in the corticospinal pathway and the central part of the monosynaptic stretch reflex. In ten healthy volunteers the nondominant forearm, hand and fingers were immobilized by a cast for one week. EMG was obtained from m. Flexor Carpi Radialis (FCR......) and m. Abductor Pollicis Brevis (APB). Motor evoked potentials (MEPS) elicited by transcranial magnetic stimulation and H-reflexes were obtained at rest and during tonic contraction (10% of MVC) in both muscles. Maximal voluntary flexion torque decreased significantly following immobilization without...

  17. Factors that influence peripheral nerve regeneration

    Krarup, Christian; Archibald, Simon J; Madison, Roger D

    2002-01-01

    median nerve lesions (n = 46) in nonhuman primates over 3 to 4 years, a time span comparable with such lesions in humans. Nerve gap distances of 5, 20, or 50mm were repaired with nerve grafts or collagen-based nerve guide tubes, and three electrophysiological outcome measures were followed: (1) compound...... as outcome predictors. Thus, nerve gap distance and repair type exert their influence through time to muscle reinnervation. These findings emphasize that factors that control early axonal outgrowth influence the final level of recovery attained years later. They also highlight that a time window...... muscle action potentials in the abductor pollicis brevis muscle, (2) the number and size of motor units in reinnervated muscle, and (3) compound sensory action potentials from digital nerve. A statistical model was used to assess the influence of three variables (repair type, nerve gap distance, and time...

  18. GAME PHERSU: PRO ET CONTRA

    Andrew Yanko

    2015-03-01

    Full Text Available Having examined the frescoes from Tarquinia: the Tomb of Augurs, the Tomb of the Pulcinella, and the Tomb of the Olympiads dated back to the sixth century BCE that depict scenes with a personage Phersu, the author deals with Etruscan inscriptions, data of the Antique tradition about origin of scenic and gladiatorial games, as well as a number of interpretations of these scenes to prove that the Etruscan ritual ‘game Phersu’ is a prototype of the Roman gladiatorial games and ‘venatio’. Being a part of Etruscan funeral rite, the ritual game was a substitutive sacrifice that symbolised a fight of a human being against the demon of death Calu – an abductor of souls from the world of the living. The fight was supposed to be guided by an invisible and disguised power, being personified in the image of Phersu. 

  19. Failure of activation of spinal motoneurones after muscle fatigue in healthy subjects studied by transcranial magnetic stimulation

    Andersen, Birgit; Westlund, Barbro; Krarup, Christian

    2003-01-01

    estimate the proportion of motor units activated by a transcranial magnetic stimulus. Following a sustained contraction of the abductor digiti minimi muscle at 50 % maximal force maintained to exhaustion there was an immediate reduction of the TST response from > 95 % to about 60 %. This effect recovered...... to control levels within 1 min and implies that a decreased number of spinal MNs were excited. Additional TST experiments after maximal and submaximal efforts showed that the decrease in size of the TST response was related to duration and strength of exercise. Motor evoked potentials (MEPs) after...... conventional transcranial magnetic stimulation (TMS) and responses to peripheral nerve stimulation were recorded following the same fatigue protocol. The size of both the MEPs and the peripheral responses increased after the contraction and were in direct contrast to the decrease in size of the TST response...

  20. A study of transcranial magnetic stimulation in older (>3 years patients of malnutrition.

    Karak B

    1999-07-01

    Full Text Available Transcranial magnetic stimulation was performed in 40 subjects. Twenty patients in the age group of 3 to 8 years and having different grades of malnutrition were included in the ′study group′ whereas 20 normal children having no complaints comprised the ′control group′. The coil of the magnetic stimulator was applied tangentially over the vertex to stimulate the cortex. The motor evoked potential (MEP was obtained using root stimulation by applying the coil at the cervical and lumbosacral spines. Recordings were made from the abductor pollicis brevis (APB and extensor digitorum brevis (EDB muscles of both sides. Cortical threshold, latency and amplitude of motor evoked potential and central conduction time were recorded. Malnourished children showed significantly increased cortical threshold, prolonged cortical latency and central conduction time and reduction in amplitude of MEP. Observed delay in central motor conduction in malnourished children suggests asymptomatic involvement of corticospinal pathways.

  1. Bilateral Simultaneous Heterotopic Ossification of the Reflected Head of Rectus Femoris Muscle: A Case Report and Review of the Literature

    Murat Tonbul

    2014-01-01

    Full Text Available Lamellar bone formation in an abnormal location is defined as heterotopic ossification. It commonly occurs around the hip joint and most often involves the abductor muscles. It is a benign condition; however, its etiology remains largely unknown. Most previously reported cases have been due to trauma or intramuscular hemorrhage. In this paper, we present a case of bilateral heterotopic ossification of the reflected head of rectus femoris muscle without antecedent trauma or any other known cause, as the first and unique case in the literature. She was treated by excision of the right symptomatic bony mass via a modified Smith-Petersen approach. Postoperatively, she received 75 mg indomethacin daily for six weeks. She was pain-free and obtained full range of motion 3 weeks after the first intervention.

  2. Walking on high heels changes muscle activity and the dynamics of human walking significantly

    Simonsen, Erik B; Svendsen, Morten Bo Søndergaard; Nørreslet, Andreas;

    2012-01-01

    The aim of the study was to investigate the distribution of net joint moments in the lower extremities during walking on high-heeled shoes compared with barefooted walking at identical speed. Fourteen female subjects walked at 4 km/h across three force platforms while they were filmed by five...... digital video cameras operating at 50 frames/second. Both barefooted walking and walking on high-heeled shoes (heel height: 9 cm) were recorded. Net joint moments were calculated by 3D inverse dynamics. EMG was recorded from eight leg muscles. The knee extensor moment peak in the first half of the stance...... joint abductor moment. Several EMG parameters increased significantly when walking on high-heels. The results indicate a large increase in bone-on-bone forces in the knee joint directly caused by the increased knee joint extensor moment during high-heeled walking, which may explain the observed higher...

  3. Force steadiness, muscle activity, and maximal muscle strength in subjects with subacromial impingement syndrome

    Bandholm, Thomas; Rasmussen, Lars; Aagaard, Per;

    2006-01-01

    physically active in spite of shoulder pain and nine healthy matched controls were examined to determine isometric and isokinetic submaximal shoulder-abduction force steadiness at target forces corresponding to 20%, 27.5%, and 35% of the maximal shoulder abductor torque, and maximal shoulder muscle strength......We investigated the effects of the subacromial impingement syndrome (SIS) on shoulder sensory-motor control and maximal shoulder muscle strength. It was hypothesized that both would be impaired due to chronic shoulder pain associated with the syndrome. Nine subjects with unilateral SIS who remained......-group differences in shoulder MVC were observed. The present data suggest that shoulder sensory-motor control is only mildly impaired in subjects with SIS who are able to continue with upper body physical activity in spite of shoulder pain. Thus, physical activity should be continued by patients with SIS, if...

  4. Mechanisms of avian songs and calls

    Larsen, Ole Næsbye

    2008-01-01

    . The use of thin, flexible endoscopes has made direct observation of the syrinx possible in situ. The effects of direct muscle stimulation on the syringeal aperture have identified adductor and abductor muscles, confirming results from electromyographic studies. Endoscopic observations have revealed...... the dynamics of syringeal reconfiguration during phonation, which in most bird species investigated results in simultaneous movement of soft tissue masses (the medial and lateral labia in songbirds and lateral tympaniform membranes in non-songbirds) into the bronchial lumen where they collide. High......-speed video-filming during sound production has revealed that sound pulses coincide with short duration formation of slots between the soft tissue masses forming a pneumatic valve, which suggests that the avian sound generating mechanism is a similar to that in the human larynx. Lately studies have revealed...

  5. Histochemical study of posterior cricoarytenoid muscle reinnervation by a nerve-muscle pedicle in the cat.

    Fata, J J; Malmgren, L T; Gacek, R R; Dum, R; Woo, P

    1987-01-01

    Reinnervation of the posterior cricoarytenoid (PCA) muscle with a nerve-muscle pedicle (NMP) has been proposed for patients with bilateral abductor vocal cord paralysis. Since its success has been controversial, a glycogen depletion histochemical technique was used to examine reinnervation. An ansa cervicalis NMP was implanted into the denervated PCA in nine cats. Eight months later, vocal cord activity was evaluated. The NMP nerve was stimulated extensively in seven cats (experimental group). Optical densities of NMP-supplied PCA muscle fibers from experimental and control groups were compared to detect differences in glycogen content. The results demonstrated quantitative evidence of reinnervation in two experimental animals. Electrical stimulation of the NMP produced abduction in one of these two animals, but was never observed during spontaneous respiration or airway occlusion. These observations indicate that reinnervation can occur but abduction requires electrical stimulation. The NMP technique may be more successful with an electrical pacer. PMID:3674642

  6. Isokinetic performance of hip muscles after revision total hip arthroplasty via previous anterolateral approach.

    Cankaya, Deniz; Aydin, Cemal; Karakus, Dilek; Toprak, Ali; Ozkurt, Bulent; Tabak, Yalçın

    2015-09-01

    We investigated the isokinetic performance of hip muscles and clinical outcomes after revision total hip arthroplasty (THA) via same anterolateral approach used in primary surgery. Thirty patients who had undergone previous THA via an anterolateral approach underwent both acetabular and femoral component revision after aseptic loosening. The Harris Hip Score (HHS) was evaluated during a minimum 2-year follow-up. The isokinetic muscle strength of the operated and nonoperated hips was assessed 1 year after surgery. The HHS improved from 49.0 to 77.4. Operated and nonoperated hips exhibited similar isokinetic performance during all measurements (flexion, extension, and abduction) (p>0.05). This prospective study showed that the anterolateral approach preserves abductor strength after revision THA in aseptic cases with acceptable functional and clinical results. The main clinical relevance of this study is that the same anterolateral approach used in previous primary THA is also safe and viable for revision THA. PMID:26435233

  7. Effects of experimental muscle pain on shoulder-abduction force steadiness and muscle activity in healthy subjects

    Bandholm, Thomas Quaade; Rasmussen, Lars; Aagaard, Per;

    2007-01-01

    We previously demonstrated that the steadiness of shoulder abduction is reduced in patients with subacromial impingement syndrome (SIS), which might be related to shoulder pain associated with the SIS. The aim of the present study was to examine the acute effects of experimental shoulder muscle...... pain on shoulder motor function in healthy subjects. The fluctuations in exerted force (force steadiness) and electromyographic (EMG) activity from eight shoulder muscles were determined during sub-maximal isometric and dynamic contractions with the shoulder abductors in nine healthy subjects (27.......7 +/- 4.2 years, mean +/- 1 SD) before, during and after experimental pain induction. Experimental pain was induced by bolus injections of 6% hypertonic saline into the supraspinatus muscle. Experimental muscle pain reduced shoulder-abduction force steadiness on average by 21% during isometric...

  8. Normative values of eccentric hip abduction strength in novice runners

    Ramskov, D; Pedersen, M B; Kastrup, K;

    2014-01-01

    PURPOSE: Low eccentric strength of the hip abductors, might increase the risk of patellofemoral pain syndrome and iliotibial band syndrome in runners. No normative values for maximal eccentric hip abduction strength have been established. Therefore the purpose of this study was to establish...... normative values of maximal eccentric hip abduction strength in novice runners. METHODS: Novice healthy runners (n = 831) were recruited through advertisements at a hospital and a university. Maximal eccentric hip abduction strength was measured with a hand-held dynamometer. The demographic variables...... associated with maximal eccentric hip abduction strength from a univariate analysis were included in a multivariate linear regression model. Based on the results from the regression model, a regression equation for normative hip abduction strength is presented. RESULTS: A SIGNIFICANT DIFFERENCE IN MAXIMAL...

  9. 术中神经电生理监测和刺激尺神经治疗肘管综合征%Intraoperative monitoring and supramaximal stimulation on ulnar nerve for the treatment of cubital tunnel syndrome

    赵睿; 丛锐; 罗卓荆; 黄景辉; 张航; 臧成五; 鲜航

    2012-01-01

    Objective To evaluate the therapeutic effect of decompression and anterior transposition of ulnar nerve combined with intraoperative supramaximal stimulation. Methods A total of 30 patients diagnosed as cubital tunnel syndrome with moderate to severe damage were performed decompression and anterior transposition of ulnar nerve. The amplitude and latency period of compound muscle action potential ( CMAP) of abductor digiti minimi muscle after decompression were measured and recorded. Then the ulnar nerve was treated with intraoperative supramaximal stimulation (80 mA, 2 Hz, 10 min). The amplitude and latency period of CMAP of abductor digiti minimi muscle were also measured and recorded. The data before and after stimulation were analyzed by statistics. Results The amplitude of CMAP of abductor digiti minimi muscle after decompression and after supramaximal stimulation was (2.5 ±0.4) mV and (6.2 ±0.8) mV, respectively, while the latency period of CMAP was (12.0 ±0.6) ms and (10.3 ±0.3) ms, respectively. There was significant difference in amplitude and latency period before and after stimulation (P<0.05). The latency period of the CMAP of abductor digiti minimi muscle was shortened by 15. 7% and the amplitude was doubled in average. Conclusion The use of intraoperative monitoring and supramaximal stirmlation has the auxiliary therapeutic effect on the recovery of ulnar nerve in cubital tunnel syndrome.%目的 评估尺神经松解前置术结合术中超强电刺激治疗肘管综合征的治疗效果.方法 30例中重度肘管综合征患者首先进行尺神经松解前置术,测定并记录松解后小指展肌复合肌肉动作电位(CMAP)的潜伏期及波幅;然后给予尺神经超强电刺激治疗(80 mA,2Hz,10 min),按照同样的方法再次记录小指展肌CMAP的潜伏期及波幅,并将刺激前后的数据进行统计学分析.结果 患者尺神经外膜松解后与超强电刺激后小指展肌CMAP的波幅分别为(2.5±0.4) mV和(6.2±0.8)m

  10. Muscle strength in myasthenia gravis

    Cejvanovic, S; Vissing, J

    2014-01-01

    related to disease duration or gender. The aim of this study was to quantify the strength of patients with MG and investigate whether it is related to disease duration. METHODS: Eight muscle groups were tested by manual muscle testing and with a hand-held dynamometer in 38 patients with generalized MG and...... 37 healthy age- and gender-matched controls. The disease duration was recorded and compared with strength measures. RESULTS: On average, muscle strength was decreased by 28% compared with controls (P<0.01). Repeated strength measures in individual patients did not differ, suggesting that the muscle...... force reported was not subject to fatigue, but reflected fixed weakness. The male patients showed a greater reduction in muscle force in all eight muscle groups than women with MG (60% vs 77% of normal, P<0.05). In both men and women with MG, strength in shoulder abductors was most affected (51% vs 62...

  11. SOME CLASSICAL HYPOTEXTS IN MARGARET DOODY’S ARISTOTLE AND POETIC JUSTICE

    F. Pauw

    2012-03-01

    Full Text Available

    The philosopher Aristotle appears in seven detective novels by the academic Margaret Doody in which he makes use of hisinvestigative powers to solve murder mysteries. In Aristotle andpoetic justice Stephanos, a friend of Aristotle, narrates how Anthia, the heiress of a silver merchant, has been abducted. While Stephanosand Aristotle pursue the abductor and the heiress on the road to Delphi, two murders complicate their challenge.

    Doody’s novel provides a convenient framework for opening awindow onto the Greek world of 330 BC. In the body of the article,hypertextual allusions introduced by Doody are examined andevaluated, using a modified version of Genette’s scheme ashermeneutic paradigm.

  12. Salter-Harris type III and IV displaced fracture of the hallux in young gymnasts: A series of four cases at 1-year follow-up.

    Perugia, Dario; Fabbri, Mattia; Guidi, Marco; Lepri, Marco; Masi, Vincenzo

    2014-12-01

    The purpose of this study was to describe four exceptional cases of Salter-Harris type III and IV fractures of the proximal phalanx of the hallux in young high-level gymnasts. All gymnasts underwent the same mechanism of injury of hyperadduction, which indicates a role of the abductor hallucis muscle in the genesis and displacement of these fractures. An open reduction and internal fixation was performed to achieve an anatomical reduction and avoid chronic disability. At 1-year follow-up, all patients had an excellent American Orthopaedic Foot and Ankle Society (AOFAS) score (100 points), and there was no shortening or angulation of the first ray and no evidence of degenerative joint disease on X-ray. Moreover, all the gymnasts had returned to pre-injury levels of sporting activity. To our knowledge, there are no previous studies that address these types of injuries and how they are handled in gymnasts. PMID:25457317

  13. Cortical Motor Circuits after Piano Training in Adulthood: Neurophysiologic Evidence.

    Houdayer, Elise; Cursi, Marco; Nuara, Arturo; Zanini, Sonia; Gatti, Roberto; Comi, Giancarlo; Leocani, Letizia

    2016-01-01

    The neuronal mechanisms involved in brain plasticity after skilled motor learning are not completely understood. We aimed to study the short-term effects of keyboard training in music-naive subjects on the motor/premotor cortex activity and interhemispheric interactions, using electroencephalography and transcranial magnetic stimulation (TMS). Twelve subjects (experimental group) underwent, before and after a two week-piano training: (1) hand-motor function tests: Jamar, grip and nine-hole peg tests; (2) electroencephalography, evaluating the mu rhythm task-related desynchronization (TRD) during keyboard performance; and (3) TMS, targeting bilateral abductor pollicis brevis (APB) and abductor digiti minimi (ADM), to obtain duration and area of ipsilateral silent period (ISP) during simultaneous tonic contraction of APB and ADM. Data were compared with 13 controls who underwent twice these measurements, in a two-week interval, without undergoing piano training. Every subject in the experimental group improved keyboard performance and left-hand nine-hole peg test scores. Pre-training, ISP durations were asymmetrical, left being longer than right. Post-training, right ISPAPB increased, leading to symmetrical ISPAPB. Mu TRD during motor performance became more focal and had a lesser amplitude than in pre-training, due to decreased activity over ventral premotor cortices. No such changes were evidenced in controls. We demonstrated that a 10-day piano-training was associated with balanced interhemispheric interactions both at rest and during motor activation. Piano training, in a short timeframe, may reshape local and inter-hemispheric motor cortical circuits. PMID:27309353

  14. Surgical Outcome of Acetabular Fracture Using Trochanteric Flip Osteotomy

    Espandar R

    2012-01-01

    Full Text Available Background: One of the difficulties in acetabulum surgery is appropriate exposure of the site of surgery. Trochanteric flip osteotomy is one of the surgical methods for superoposterior and posterior acetabulum exposure. However, due to possible complications some surgeons prefer to avoid this procedure. This study was undertaken to determine the outcome of surgical treatment of acetabular fracture using trochanteric flip osteotomy. Methods : In this prospective cohort study, 14 patients with acetabular fracture who had been admitted in Imam Khomeini Hospital in Tehran, Iran, during 2003-2006 underwent trochanteric flip osteotomy. The patients were followed for at least one year post-surgically. Demographics, radiologic findings, intensity of pain using visual analogue scale (VAS, Harris hip score (HHS, force of hip abductors and complications were noted. Data analysis was performed using SPSS ver. 13.Results : The mean HHS was 82.5 (55-95. Heterotopic ossification was observed in three patients. There were no cases of postoperative infection or nonunion. Only two patients showed displacement of osteotomized fragments. Reduction was anatomic in 10 patients. In one patient, the force of hip abductors was three-fifth. The mean hip pain was 3.4 based on VAS. There were no cases of femoral head osteonecrosis. With respect to HHS, the final hip status was excellent and good in four and six patients, respectively. Three patients had fair and only one patient had poor condition.Conclusion: It seems that trochanteric flip osteotomy has much fewer complications in comparison to other methods justifying its use in such cases.

  15. Differences in Dysfunction of Thenar and Hypothenar Motoneurons in Amyotrophic Lateral Sclerosis

    Fang, Jia; Cui, Liying; Liu, Mingsheng; Guan, Yuzhou; Li, Xiaoguang; Li, Dawei; Cui, Bo; Shen, Dongchao; Ding, Qingyun

    2016-01-01

    This study aimed to determine differences in spinal motoneuron dysfunction between the abductor pollicis brevis (APB) and the abductor digiti minimi (ADM) in amyotrophic lateral sclerosis (ALS) patients based on studying F-waves. Forty ALS patients and 20 normal controls (NCs) underwent motor nerve conduction studies on both median and ulnar nerves, including F-waves elicited by 100 electrical stimuli. The F-wave persistence (P < 0.05), index repeating neuron (RN; P < 0.001), and index repeater F-waves (Freps; P < 0.001) significantly differed between the APB and the ADM in the NC participants. For the hands of the ALS patients that lacked detectable wasting or weakness and exhibited either no or mild impairment of discrete finger movements, significantly reduced F-wave persistence (P < 0.001), increased index RN (P < 0.001), and increased index Freps (P < 0.001) were observed in APB in comparison with the normal participants, with relatively normal ADM F-wave parameters. For the hands of ALS patients that exhibited wasting and weakness, the mean F-wave amplitude (P < 0.05), the F/M amplitude ratio (P < 0.05), F-wave persistence (P < 0.001), index RN (P < 0.05), and index Freps (P < 0.05) significantly differed between APB and ADM. The differences in the dysfunction of motoneurons innervating APB and ADM are unique manifestations in ALS patients. The F-wave persistence (P = 0.002), index RN (P < 0.001), and index Freps (P < 0.001) in the APB seemed to differentiate ALS from the NCs more robustly than the ADM/APB Compound muscle action potential (CMAP) amplitude ratio. Thus, F-waves may reveal subclinical alterations in anterior horn cells, and may potentially help to distinguish ALS from mimic disorders. PMID:27014030

  16. Cortical Motor Circuits after Piano Training in Adulthood: Neurophysiologic Evidence

    Nuara, Arturo; Zanini, Sonia; Gatti, Roberto; Comi, Giancarlo; Leocani, Letizia

    2016-01-01

    The neuronal mechanisms involved in brain plasticity after skilled motor learning are not completely understood. We aimed to study the short-term effects of keyboard training in music-naive subjects on the motor/premotor cortex activity and interhemispheric interactions, using electroencephalography and transcranial magnetic stimulation (TMS). Twelve subjects (experimental group) underwent, before and after a two week-piano training: (1) hand-motor function tests: Jamar, grip and nine-hole peg tests; (2) electroencephalography, evaluating the mu rhythm task-related desynchronization (TRD) during keyboard performance; and (3) TMS, targeting bilateral abductor pollicis brevis (APB) and abductor digiti minimi (ADM), to obtain duration and area of ipsilateral silent period (ISP) during simultaneous tonic contraction of APB and ADM. Data were compared with 13 controls who underwent twice these measurements, in a two-week interval, without undergoing piano training. Every subject in the experimental group improved keyboard performance and left-hand nine-hole peg test scores. Pre-training, ISP durations were asymmetrical, left being longer than right. Post-training, right ISPAPB increased, leading to symmetrical ISPAPB. Mu TRD during motor performance became more focal and had a lesser amplitude than in pre-training, due to decreased activity over ventral premotor cortices. No such changes were evidenced in controls. We demonstrated that a 10-day piano-training was associated with balanced interhemispheric interactions both at rest and during motor activation. Piano training, in a short timeframe, may reshape local and inter-hemispheric motor cortical circuits. PMID:27309353

  17. The Efficacy of Intraoperative Neurophysiological Monitoring Using Transcranial Electrically Stimulated Muscle-evoked Potentials (TcE-MsEPs) for Predicting Postoperative Segmental Upper Extremity Motor Paresis After Cervical Laminoplasty

    Manabe, Hideki; Izumi, Bunichiro; Tanaka, Hiroyuki; Kawai, Kazumi; Tanaka, Nobuhiro

    2016-01-01

    Study Design: Prospective study. Objective: To investigate the efficacy of transcranial electrically stimulated muscle-evoked potentials (TcE-MsEPs) for predicting postoperative segmental upper extremity palsy following cervical laminoplasty. Summary of Background Data: Postoperative segmental upper extremity palsy, especially in the deltoid and biceps (so-called C5 palsy), is the most common complication following cervical laminoplasty. Some papers have reported that postoperative C5 palsy cannot be predicted by TcE-MsEPs, although others have reported that it can be predicted. Methods: This study included 160 consecutive cases that underwent open-door laminoplasty, and TcE-MsEP monitoring was performed in the biceps brachii, triceps brachii, abductor digiti minimi, tibialis anterior, and abductor hallucis. A >50% decrease in the wave amplitude was defined as an alarm point. According to the monitoring alarm, interventions were performed, which include steroid administration, foraminotomies, etc. Results: Postoperative deltoid and biceps palsy occurred in 5 cases. Among the 155 cases without segmental upper extremity palsy, there were no monitoring alarms. Among the 5 deltoid and biceps palsy cases, 3 had significant wave amplitude decreases in the biceps during surgery, and palsy occurred when the patients awoke from anesthesia (acute type). In the other 2 cases in which the palsy occurred 2 days after the operation (delayed type), there were no significant wave decreases. In all of the cases, the palsy was completely resolved within 6 months. Discussion: The majority of C5 palsies have been reported to occur several days after surgery, but some of them have been reported to occur immediately after surgery. Our results demonstrated that TcE-MsEPs can predict the acute type, whereas the delayed type cannot be predicted. Conclusions: A >50% wave amplitude decrease in the biceps is useful to predict acute-type segmental upper extremity palsy. Further examination

  18. Pattern Differences of Small Hand Muscle Atrophy in Amyotrophic Lateral Sclerosis and Mimic Disorders

    Jia Fang; Ming-Sheng Liu; Yu-Zhou Guan; Hua Du; Ben-Hong Li; Bo Cui; Qing-Yun Ding

    2016-01-01

    Background:Amyotrophic lateral sclerosis (ALS) and some mimic disorders,such as distal-type cervical spondylotic amyotrophy (CSA),Hirayama disease (HD),and spinobulbar muscular atrophy (SBMA) may present with intrinsic hand muscle atrophy.This study aimed to investigate different patterns of small hand muscle involvement in ALS and some mimic disorders.Methods:We compared the abductor digiti minimi/abductor pollicis brevis (ADM/APB) compound muscle action potential (CMAP) ratios between 200 ALS patients,95 patients with distal-type CSA,88 HD patients,43 SBMA patients,and 150 normal controls.Results:The ADM/APB CMAP amplitude ratio was significantly higher in the ALS patients (P < 0.001) than that in the normal controls.The ADM/APB CMAP amplitude ratio was significantly reduced in the patients with distal-type CSA (P < 0.001) and the HD patients (P < 0.001) compared with that in the normal controls.The patients with distal-type CSA had significantly lower APB CMAP amplitude than the HD patients (P =0.004).The ADM/APB CMAP amplitude ratio was significantly lower in the HD patients (P < 0.001) than that in the patients with distal-type CSA.The ADM/APB CMAP amplitude ratio of the SBMA patients was similar to that of the normal controls (P =0.862).An absent APB CMAP and an abnormally high ADM/APB CMAP amplitude ratio (>4.5) were observed exclusively in the ALS patients.Conclusions:The different patterns of small hand muscle atrophy between the ALS patients and the patients with mimic disorders presumably reflect distinct pathophysiological mechanisms underlying different disorders,and may aid in distinguishing between ALS and mimic disorders.

  19. Intracortical inhibition and facilitation in different representations of the human motor cortex.

    Chen, R; Tam, A; Bütefisch, C; Corwell, B; Ziemann, U; Rothwell, J C; Cohen, L G

    1998-12-01

    Intracortical inhibition and facilitation in different representations of the human motor cortex. J. Neurophysiol. 80: 2870-2881, 1998. Intracortical inhibition (ICI) and intracortical facilitation (ICF) of the human motor cortex can be studied with paired transcranial magnetic stimulation (TMS). Plastic changes and some neurological disorders in humans are associated with changes in ICI and ICF. Although well characterized in the hand representation, it is not known if ICI and ICF vary across different body part representations. Therefore we studied ICI and ICF in different motor representations of the human motor cortex. The target muscles were rectus abdominus (RA), biceps brachii (BB), abductor pollicis brevis (APB), quadriceps femoris (QF), and abductor hallucis (AH). For each muscle, we measured the rest and active motor thresholds (MTs), the motor-evoked potential (MEP) stimulus-response curve (MEP recruitment), ICI, and ICF. The effects of different interstimulus intervals (ISIs) were studied with a conditioning stimulus (CS) intensity of 80% active MT. The effects of different CS intensities were studied at ISI of 2 ms for ICI and ISI of 15 ms for ICF. MT was lowest for APB, followed by BB, AH, and QF, and was highest for RA. Except for BB, MEP recruitment was generally steeper for muscles with lower MT. ICI and ICF were present in all the motor representations tested. The stimulus intensity necessary to elicit ICI was consistently lower than that required to elicit ICF, suggesting that they are mediated by separate mechanisms. Despite wide differences in MT and MEP recruitment, the absolute CS intensities (expressed as percentage of the stimulator's output) required to elicit ICI and ICF appear unrelated to MT and MEP recruitment in the different muscles tested. These findings suggest that the intracortical mechanisms for inhibition and facilitation in different motor representations are not related to the strength of corticospinal projections. PMID

  20. A single muscle moves a crustacean limb joint rhythmically by acting against a spring containing resilin

    Burrows Malcolm

    2009-05-01

    Full Text Available Abstract Background The beating or fanning movements of three pairs of maxilliped flagella in crabs and crayfish modify exhalent gill currents while drawing water over chemoreceptors on the head. They play an integral part both in signalling by distributing urine odours, and in active chemosensation. Results The rhythmical maxilliped movements start with maxilliped 3 followed after a delay of 15 to 20 ms in shore crabs by maxilliped 2 and then maxilliped 1, at a frequency of 18 to 20 Hz in crabs and 10 to 13 Hz in signal crayfish. The contraction of a single abductor muscle controls the power stroke (abduction of each flagellum, which is accompanied by flaring of feather-like setae which increase its surface area. No muscle can bring about the return stroke (adduction. Release of an isolated flagellum from an imposed abduction is followed by a rapid recoil to its resting adducted position. The relationship between the extent of abduction and the angular velocity of the return stroke indicates the operation of a spring. Blue fluorescence under UV light, and its dependence on the pH of the bathing medium, indicates that resilin is present at the joint between an exopodite and flagellum, at the annuli of a flagellum and at the base of the setae. Conclusion Resilin is progressively bent as a flagellum is abducted and resumes its natural shape when the joint recoils. Other distortions of the exopodites may also contribute to this spring-like action. The joint is therefore controlled by a single abductor muscle operating against a spring in which the elastic properties of resilin play a key role.

  1. Reflections on clinical applications of yoga in voice therapy with MTD.

    Moore, Carmelle

    2012-12-01

    This paper explores the application of modified yoga techniques, as an adjunct to voice therapy, by a speech pathologist who is also a yoga teacher. Yoga practices, with effects that may be short-term, are not considered a substitute for comprehensive and integrated somatic retraining systems (such as the Alexander Technique or Feldenkrais ATM). However, when yoga is conducted emphasizing kinaesthetic and proprioceptive awareness, the client may achieve an 'awareness state' that facilitates the learning of vocal remediation techniques (for example, by more easily 'tuning in' to the subtle sensations of supralaryngeal deconstriction). Core yoga elements and clinical applications are identified. The potential benefits and considerations when using yoga as an adjunct to the treatment of muscle tension dysphonia (MTD) are explored. PMID:23137146

  2. Effect of continuous cuff pressure regulator in general anaesthesia with laryngeal mask airway.

    Jeon, Y-S; Choi, J-W; Jung, H-S; Kim, Y-S; Kim, D-W; Kim, J-H; Lee, J-A

    2011-01-01

    Postoperative pharyngolaryngeal complications (PPLC) occur during anaesthesia due to increased cuff pressure following the insertion of laryngeal mask airways. The use of a pressure regulator to prevent PPLC was evaluated in a prospective, randomized study. Sixty patients scheduled to receive general anaesthesia were randomly assigned to two equal groups of 30, either with or without the regulator. The 'just seal' cuff pressure (JSCP), cuff pressure at 5-min intervals during anaesthesia, incidence of pharyngeal sore throat (PST), dysphagia, dysphonia and other complications were evaluated at 1 and 24 h postoperatively. The combined mean ± SD JSCP of both groups was 20.3 ± 3.2 mmHg. In the group with the regulator, cuff pressure was maintained at a constant level during anaesthesia. This study demonstrated that the regulator is a simple, functional device that can reduce the incidence of PST significantly at 1 h postoperatively, following general anaesthesia. PMID:22117992

  3. Reactional Plasmacytosis In Plasma Cell Orificial mucositis In A Patient Of Pulmonary Tuberculosis

    Bose Sumit Kumar

    1997-01-01

    Full Text Available Skin biopsy of a 50 year old Moroccan male patient with labial and oro-pharyngeal plasmocytosis showed hyperplastic, with papillomatous eroded epithelium. Dense infiltrates of plasma cells were seen in the dermis, with perivascular prominence. Hypopharynx, epiglottis, adenoids, and tonsils showed the same type of infiltration. Immunofluorescence (IF and peroxidase antiperoxidase (PAP techniques demonstrated the presence of mostly and infiltrate of plasma cells showing IgA (30 â€" 40%, IgM (20-30%, IgG(10-20% after staining with polyclonal antibodies along with T4 & T8 Iymphocytes with monoclonal staining. Electron microscopy showed absence of atypical plasma cells with abundant endoplasmic reticulum. Patient’s symptoms of stomtitis, dysphonia and pharyngitis were temporarily relieved by systemic corticosteroids of plasma cells suggesting a reactive type of benign plasmocytosis.

  4. Giant Cervico-mediastinal Well-differentiated Liposarcoma.

    Rena, Ottavio; Davoli, Fabio; Pia, Francesco; Roncon, Alberto; Papalia, Esther; Casadio, Caterina

    2015-07-01

    Liposarcomas are rare entities and those located in the neck and mediastinum are exceptional. We report the case of a 58 year-old Caucasian male who presented with dysphonia, mild dysphagia to solids, dyspnoea at exertion and cough due to a giant mass of the neck originating from the deep cervical space at C6 vertebral level spreading into the posterior mediastinum. The lesion, that was associated with a right vocal cord palsy, caused severe lateral displacement of the trachea and oesophagus. The case has been managed by complete surgical resection through a combined cervical and thoracic approach associated with a tracheostomy due to the risk of bilateral recurrent nerve dysfunction at the end of the intervention. The tumour was diagnosed as a encapsulated low-grade liposarcoma. Six months after surgery the tracheostomy was closed. At 24 months clinical and radiological follow-up the patient is doing well and disease free. PMID:25837020

  5. VIDEOLARYNGOSCOPIC SURGEY IN BENIGN LARYNGEAL LESIONS-OUR EXPERIENCE

    Satheesh

    2015-11-01

    Full Text Available : Benign laryngeal lesions are commonly encountered causes of dysphonia and are often surgically correctable. A prospective study on 62 cases selected for videolaryngoscopic surgery was undertaken in a single unit in the department of ENT, Medical College Hospital, Thiruvananthapuram. The male: female ratio was 1.8:1 and the most common affected age group was 35-45 yrs. The most common benign lesion was vocal polyp. Preoperative voice assessment and 70 degree endoscopy was done. Follow up visits were done at 1 week, 3 weeks and 6 weeks and voice assessment and laryngoscopic appearances were noted. 98% reported excellent improvement of voice. The varieties of benign lesions which cause hoarseness are sources of concern and worry as it can affect the self esteem of a person. Thus videolaryngoscopic surgery (VLS coupled with voice therapy offers cost effective and safe management in benign laryngeal lesions

  6. Proton radiation therapy for clivus chordoma; Case report

    Yoshii, Yoshihiko; Tsunoda, Takashi; Hyodo, Akio; Nose, Tadao (Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine); Tsujii, Hirohiko; Tsuji, Hiroshi; Inada, Tetsuo; Maruhashi, Akira; Hayakawa, Yoshinori

    1993-03-01

    A 57-year-old male with clival chordoma developed severe hoarseness, dysphagia, and dysphonia 1 month after a second removal of the tumor. Magnetic resonance imaging demonstrated a mass 10 cm in diameter in the region of the middle clivus enhanced inhomogeneously by gadolinium-diethylenetriaminepenta-acetic acid, and a defect in the skull base. There was evidence of compression of the anterior surface of the pons. He received proton irradiation employing a pair of parallel opposed lateral proton beams. The dose aimed at the tumor mass was 75.5 Gy, to the pharyngeal wall less than 38 Gy, and to the anterior portion of the pons less than 30 Gy. Time dose and fractionation factor was calculated at 148. Thirty-one months following treatment, he was free of clinical neurological sequelae. Proton therapy should be considered in treatment planning following initial surgical removal or for inoperable clivus chordoma. (author).

  7. An Improved Time Domain Pitch Detection Algorithm for Pathological Voice

    Mohd R. Jamaludin

    2012-01-01

    Full Text Available Problem statement: The present study proposes a new pitch detection algorithm which could potentially be used to detect pitch for disordered or pathological voices. One of the parameters required for dysphonia diagnosis is pitch and this prompted the development of a new and reliable pitch detection algorithm capable of accurately detect pitch in disordered voices. Approach: The proposed method applies a technique where the frame size of the half wave rectified autocorrelation is adjusted to a smaller frame after two potential pitch candidates are identified within the preliminary frame. Results: The method is compared to PRAATs standard autocorrelation and the result shows a significant improvement in detecting pitch for pathological voices. Conclusion: The proposed method is more reliable way to detect pitch, either in low or high pitched voice without adjusting the window size, fixing the pitch candidate search range and predefining threshold like most of the standard autocorrelation do.

  8. Automatic Assessment of Pathological Voice Quality Using Higher-Order Statistics in the LPC Residual Domain

    JiYeoun Lee

    2009-01-01

    Full Text Available A preprocessing scheme based on linear prediction coefficient (LPC residual is applied to higher-order statistics (HOSs for automatic assessment of an overall pathological voice quality. The normalized skewness and kurtosis are estimated from the LPC residual and show statistically meaningful distributions to characterize the pathological voice quality. 83 voice samples of the sustained vowel /a/ phonation are used in this study and are independently assessed by a speech and language therapist (SALT according to the grade of the severity of dysphonia of GRBAS scale. These are used to train and test classification and regression tree (CART. The best result is obtained using an optima l decision tree implemented by a combination of the normalized skewness and kurtosis, with an accuracy of 92.9%. It is concluded that the method can be used as an assessment tool, providing a valuable aid to the SALT during clinical evaluation of an overall pathological voice quality.

  9. 嗓音障碍性疾病患者应用VHI评估与嗓音声学分析的比较%CORRELATION BETWEEN VHI AND VOICE ACOUSTIC ANALYSIS IN DYSPHONIC PATIENTS

    董金辉; 单春光; 郝芳

    2012-01-01

    Objective To analyse the relationship between voice acoustic analysis ( VAA ) and voice handicap index ( VHI ) in dysphonic patients, and to investigate the characteristic of the VHI. Methods One hundred and fourteen dysphonic patients( dysphonia group ) and 40 subjects with normal voice( control group ) were tested by multi dimensional voice program( MDVP )and underwent VHI. Fundamental frequency, pitch perturbation, amplitude perturbation( shimmer ) and noise to harmonic ratio ( NHR)as objective items of the voice acoustic analysis were evaluated. Voice handicap index( VHI ) concluded function( F )、 physiology ( P ) and emotion ( E ), and the the total scores of the VHI were recorded. Results The parameters such as jitter, shimmer, NHR in dysphonia patients were much higher and Fo was lower than those in the normal voice group. The average score of VHI had obvious significant difference between the two groups. There were well correlations between P and E ( r = 0. 863 ), Fand TVH ( r= 0. 818 ), P and TVH ( r = 0. 929 ), E and TVH ( r = 0. 910 )( P < 0. 01 ). There was no correlation between VHI and VAA ( P > 0. 05 ). Conclusion VAA can not be used as a standard to speculate the subjective evaluation of dysphonia, while VHI can reflect the level of dysphonia in dysphonic patients.%目的 探讨嗓音障碍指数(voice handicap index,VHI)用于嗓音障碍性疾病患者自我评估的临床意义及与声学参数间的相关性.方法 对嗓音障碍性患者114例(患者组) 及嗓音正常者40例(对照组)采用多维嗓音软件(multi dimensional voice program,MDVP)进行嗓音声学分析和VHI调查,嗓音声学分析指标包括基频、基频微扰、振幅微扰、噪声/谐和比(noise to harmonic ratio,NHR),VHI 调查包括功能(function,F) 、生理(physiology,P) 、情感(emotion,E) 3个范畴,记录3方面得分及总分(total scores of the VHI,TVH ) 分值.结果 患者组的基频微扰、振幅微扰、NHR 均高于正常

  10. Laryngeal leishmaniasis in a patient taking inhaled corticosteroids.

    Roberts, Rachel Margaret; Mukherjee, Jayanta; Phillips, David

    2016-01-01

    We present a case of a man in his late 60s, who had spent 3-4 months of the year in rural Spain, presenting with intermittent hoarseness of voice. He had a background of asthma and bronchiectasis, and was taking inhaled corticosteroids. His dysphonia was initially managed as bronchiectasis with little improvement. Bronchoscopy revealed a cystic lesion on his left vocal fold, and tissue biopsy revealed Leishmania amastigotes. This confirmed a diagnosis of laryngeal leishmaniasis. We propose that this is likely secondary to his inhaled corticosteroid therapy. The infection was treated with a 30-day course of miltefosine, and at most recent follow-up the patient was deemed free from leishmanial infection. PMID:27329097

  11. Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy

    Junor, E.J.; Paul, J.; Reed, N.S. (Beatson Oncology Centre, Glasgow (United Kingdom))

    1992-04-01

    Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dyspnagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy. (Author).

  12. Diagnosing the tight building syndrome

    Rogers, S.A.

    1987-12-01

    Formaldehyde is but one of many chemicals capable of causing the tight building syndrome or environmentally induced illness (EI). The spectrum of symptoms it may induce includes attacks of headache, flushing, laryngitis, dizziness, nausea, extreme weakness, arthralgia, unwarranted depression, dysphonia, exhaustion, inability to think clearly, arrhythmia or muscle spasms. The nonspecificity of such symptoms can baffle physicians from many specialties. Presented herein is a simple office method for demonstrating that formaldehyde is among the etiologic agents triggering these symptoms. The very symptoms that patients complain of can be provoked within minutes, and subsequently abolished, with an intradermal injection of the appropriate strength of formaldehyde. This injection aids in convincing the patient of the cause of the symptoms so he can initiate measure to bring his disease under control.

  13. A Rare Early Complication of Tracheostomy

    Manjeet Singh Pawar

    2011-01-01

    Full Text Available A polytrauma patient on ventilator was admitted to ICU with open tracheostomy, GCS 8/15 and unequal pupils. After 10 days, he was weaned from the ventilator. The patient had respiratory problems i.e. expiratory stridor, shortness of breath, dysphonia and dyspnea on closing tracheostomy. It was diagnosed as a case of asthma, and the patient responded to salbutamol nebulization and intravenous steroid therapy. However, after some time, he desaturated and a plan for rapid sequence intubation was made. Endotracheal tube could not be negotiated beyond vocal cords, so an unprepared tracheostomy without proper equipment had to be immediately done by an anesthetist to save the patient’s life. CT scan revealed tracheal stenosis. This case demonstrates that patients with a short 15-days history of previous tracheostomy may have tracheal stenosis.

  14. Inter-device reliability of DSI measurement.

    Aichinger, Philipp; Feichter, Felicitas; Aichstill, Birgitta; Bigenzahn, Wolfgang; Schneider-Stickler, Berit

    2012-12-01

    The Dysphonia Severity Index (DSI) is a measure that quantifies the overall vocal quality. The aim of the study is to evaluate the reliability of DSI measurements. The DSIs of 30 subjects were therefore measured using LingWAVES (WEVOSYS) and DiVAS (XION). To evaluate the inter-device reliability of DSI measurement, the devices' results were compared for each subject. The DSI values of both devices showed great differences. The calculated DSI differences of 95% of the subjects were within the limits of +2.39 and -2.82, which makes a clinical interpretation of severity of voice disorder using different devices questionable. The technical and procedural aspects of measurement divergences are discussed, and the need to define hardware and software standards is shown. PMID:22702894

  15. Nebulized lidocaine in the treatment of intractable cough.

    Truesdale, Kelly; Jurdi, Adham

    2013-09-01

    Cough is one of the most common symptoms prompting patients to be seen by health care providers in the United States. Persistent cough can disrupt daily activities such as conversation, eating, breathing, and sleeping, and it can become extremely debilitating both physically and mentally. Pharmacological treatments include dextramethorphan, opioid cough suppressants, benzonatate, inhaled ipratropium, and guaifenesin. Successful cough suppression has also been demonstrated in several studies with the use of nebulized lidocaine. Nebulized lidocaine also appears to be well tolerated by patients with minimal side effects including dysphonia, oropharyngeal numbness, and bitter taste. Studies conducted thus far have been small, so larger randomized control trials comparing nebulized lidocaine to placebo need to be conducted in the future. PMID:22964341

  16. [Saxitoxins and tetrodotokxins as a new biological weapon].

    Wesołowski, Adam; Płusa, Tadeusz

    2015-09-01

    Saxitoxins (STX) and tetrodotoxins (TTX) are a group of chemical compounds produced by certain species of marine algae and fish. Lethal dose for a human is about 0.5-2.0 mg when the toxin enters the body via food, and 0.05 mg of poisoning at the time of injection. In the case of aerosol the lethal dose for human being is 5 mg/min/m(3). STX and TTX poisoning cause mostly symptoms from the nervous system in the form of: paresthesia around the lips, tongue, gums, distal segments of the limbs, headache, dysphonia, astigmatism, floating feeling, muscle weakness, paralysis of cranial and peripheral nerves. There is no specific antidote for STX and TTX. It is recommended supportive treatment. PMID:26449582

  17. [Diagnostics and therapy in professional voice-users].

    Richter, B; Echternach, M

    2010-04-01

    Voice is one of the most important instruments for expression and communication in humans. Dysphonia remains very frequent. Generally people in voice-intensive professions, such as teachers, call center employees, singers and actors suffer from these complaints. In recent years methods have been developed which facilitate appropriate diagnosis and therapy, based on the criteria of evidence based medicine, in voice patients appropriate to their degree of disease. The basic protocol of the European Laryngological Society offers a standardized evaluation of multidimensional voice parameters. In our own patient collective there were statistically significant improvements in voice quality, according to a pre/post mean value comparison, in both phonomicrosurgical (n=45) and voice therapy (n=30) patients in relation to RBH, DSI and VHI. PMID:20127301

  18. [Mediastinal leiomyosarcoma].

    Auliac, J B; Cuvelier, A; Peillon, C; Louvel, J P; Metayer, J; Muir, J F

    1999-04-01

    Leiomyosarcomas are extremely rare tumors which develop from smooth muscle, usually in the esophagus and large vessels (inferior vena cava, pulmonary artery, and superior vena cava). In very rare cases, leiomyosarcomas develop from small vessels in the soft tissue of the mediastinum. Clinical expression of mediastinal leiomyosarcomas (dysphagia, dysphonia) is related to their large size and the subsequent compression of mediastinal structures. At pathology examination, the gross aspect is one of a single cell tumor. Microscopically, the tumor may be highly undifferentiated making it necessary to use specific immune markers (actin and desmin) or ultra-structural analysis to establish the diagnosis. Treatment of localized tumors is based on surgical excision, either alone or in combination with radiotherapy of the mediastinum. Chemotherapy, generally dexorubicin, is indicated in case of metastatic dissemination, but outcome remains uncertain. As for all soft tissue sarcomas, the prognosis of mediastinal leiomyosarcoma depends on the size of the tumor, its histological structure and its resectability. PMID:10339766

  19. Application of the Voice Handicap Index in 45 patients with substitution voicing after total laryngectomy.

    Moerman, Mieke; Martens, Jean-Pierre; Dejonckere, Philippe

    2004-09-01

    We tested the Voice Handicap Index (VHI) in 45 patients with substitution voicing (that is, without the use of two vocal folds), the majority of them using tracheo-oesophageal speech. We introduced a corrected VHI score (VHI(corr)) whose values are in the range from 0 to 100 and which can be expressed as a percentage. As such, the VHI(corr) is a handy and transparent tool, and it seems to be suited for representing the handicap caused by the voice disorder when some items are unanswered as experienced in patients with substitution voicing. Interestingly, our data reveal that the voice handicap severity of this particular category of patients is (1) moderate and in the range of "common" dysphonia and (2) not affected by additional radiotherapy. It seems that the E domain is overstated due to the number of problematic items in the P and F domains. PMID:14685878

  20. Proton radiation therapy for clivus chordoma

    A 57-year-old male with clival chordoma developed severe hoarseness, dysphagia, and dysphonia 1 month after a second removal of the tumor. Magnetic resonance imaging demonstrated a mass 10 cm in diameter in the region of the middle clivus enhanced inhomogeneously by gadolinium-diethylenetriaminepenta-acetic acid, and a defect in the skull base. There was evidence of compression of the anterior surface of the pons. He received proton irradiation employing a pair of parallel opposed lateral proton beams. The dose aimed at the tumor mass was 75.5 Gy, to the pharyngeal wall less than 38 Gy, and to the anterior portion of the pons less than 30 Gy. Time dose and fractionation factor was calculated at 148. Thirty-one months following treatment, he was free of clinical neurological sequelae. Proton therapy should be considered in treatment planning following initial surgical removal or for inoperable clivus chordoma. (author)

  1. Primary non-Hodgkin's lymphoma of the larynx in an AIDS patient.

    Simo, R; Hartley, C; Malik, T; Wilson, G E; Taylor, P H; Mandal, B K

    1998-01-01

    A case of primary non-Hodgkin's lymphoma of the larynx in an AIDS patient is presented with a review of the literature. Non-Hodgkin's lymphomas in AIDS patients are common but the primary laryngeal presentation is very rare. The symptoms usually include dysphonia and progressive airway obstruction requiring tracheostomy. As with laryngeal non-Hodgkin's laryngeal lymphomas in non-HIV positive patients the majority are of B cell lineage and respond well to radiotherapy. Our patient had a high grade lymphoma of B cell lineage which showed a good response to radiotherapy. The role of chemotherapy and surgery is not yet established. We suggest that the diagnosis of AIDS should not influence the management of these patients unless the individual is in the terminal disease stage. PMID:9538453

  2. [Thyroid's metastasis of tonsillar squamous cell carcinoma].

    Scanelli, Giovanni; Aimoni, Claudia; Marchetti, Elisabetta; Geminiani, Matteo; Pastore, Antonio

    2005-09-01

    The authors describe the case of a 58 years old man, affected by squamous cell carcinoma of the tonsil, who underwent left tonsillectomy with bilateral neck dissection, followed by radiotherapy. After a 6 months period, the patient began to suffer from dysphonia, dysphagia and loss of weight: a painless neoformation was detected at the right lobe of the tyhroid, resulted a metastasis of the tonsillar neoplasm. The search for intranodular thyroglobulin was negative; the patient underwent thyroidectomy which showed a massive infiltration of the right cricothyroid space, cricoid and thyroid wing cartilage necrosis and intralaryngeal tumor infiltration. The authors describe the thyroid metastasis treatment, present an up-to-date review of the literature and suggest a thyroid careful clinical evaluation in every patient with a previous history of oropharyngeal cancer. PMID:16229323

  3. Voice quality after treatment for T1a glottic carcinoma--radiotherapy versus laser cordectomy.

    Krengli, Marco; Policarpo, Mario; Manfredda, Irene; Aluffi, Paolo; Gambaro, Giuseppina; Panella, Massimiliano; Pia, Francesco

    2004-01-01

    The purpose of this study was to assess the anatomic and functional outcomes and compare the voice quality in patients affected by T1a glottic carcinoma treated with curative intent with radiotherapy or laser cordectomy. Fifty-seven cases were analysed: 27 after curative radiotherapy and 30 after laser cordectomy. All patients were studied with videolaryngostroboscopy, voice analysis by narrow spectrogram, and vocal parameters (Jitter, Shimmer, noise/harmonic ratio, and diplophonia). Videolaryngostroboscopy showed severe glottic inadequacy in 25% of cases treated with radiation and insufficient compensation 'ventricular band' or 'with arytenoid hyperadduction' in 65% of cases after surgery. Severe dysphonia on the electro-acoustic analysis of voice was observed in 25% of cases after radiation and 70% after laser (p radiotherapy compared with laser cordectomy. Voice outcome should be carefully considered in the treatment decision for T1 glottic carcinoma. PMID:15244253

  4. [Management of T1a vocal fold carcinoma].

    Reiter, R; Brosch, S; Smith, E; Pickhard, A

    2013-12-01

    About 2/3 of the larynx carcinomas affect the vocal chords. The main risk factor is smoking. Carcinomas in this localisation often arise from leukoplakias with dysplasia. A typical symptom is dysphonia. Arrest of vibration in microlaryngostroboscopy is a hint that a carcinoma could be present. Transoral laser cordectomy or radiotherapy show equivalent oncological results and results in quality of voice in the treatment of vocal fold carcinoma (T1a). As lymph node and distant metastasis are very rare, follow-up can concentrate on microlaryngoscopy. In case of a suspicious area on the vocal fold, biopsy of the affected tissue is needed to plan correct treatment. The prognosis of the T1 vocal chord carcinoma is quite good with a 5-year survival rate of almost 100%. PMID:23929210

  5. [Acute monoarthritis and laryngeal obstruction as extralymphatic manifestations of non-Hodgkin's lymphoma].

    Stemmelin, G R; Venditti, J; Ricardo, A; Ceresetto, J M; Shanley, C M; Bullorsky, E O

    1992-02-01

    Joints and larynx are uncommonly involved by non-Hodgkin's lymphoma (NHL). Synovial involvement has been reported in only 7 cases, mainly located in the knees. When this is the first location of NHL it is usually misdiagnosed. The treatment of choice is local radiotherapy followed by systemic chemotherapy. Laryngeal lymphoma can be either primary or forming part of multifocal disease. The prognosis of the primary form is usually good only with radiotherapy, whereas the prognosis of the laryngeal location of advanced disease is rather poor. The symptoms include dysphonia and slowly progressive dyspnea. A case of NHL is presented who showed initial arthritis of the knee, later evolving into severe laryngeal obstruction, an association not previously reported. PMID:1585240

  6. Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy

    Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dyspnagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy. (Author)

  7. Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy.

    Junor, E J; Paul, J; Reed, N S

    1992-04-01

    Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dysphagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy. PMID:1582515

  8. [Laryngeal epidermoid carcinoma in a young adult without risk factors: a case report].

    M'barek, Basma; Gargouri, W; Maalej, M

    2005-08-01

    Head and neck carcinomas are rare in young patients without a history of tobacco consution, tho two classical risk factors. Our report is about 20 year-old patient without a history exosure to radiations or of alcohol / tobacco consumption, who presented with repeated episodes of dysphonia that didn't improve under medical treatment. Endoscopy showed a fungating hemilaryngeal lesion with a histology of epidermoid carcinoma stage T3N0. The patient initially 3 courses of cisplatin-5 fluorouracil resulting in a 90% objective response, followed by a loco-regional radiotherapy. 36 months after the diagnosis and 24 after the end of therapy, the patient is still alive and in complete remission. PMID:16238282

  9. The effect of age and vocal task on cepstral/spectral measures of vocal function in adult males.

    Watts, Christopher R; Ronshaugen, Rachelle; Saenz, Daniella

    2015-06-01

    This study investigated the effect of aging on cepstral/spectral acoustic measures calculated from clinical stimuli (vowels and sentences from the Consensus Auditory Perceptual Evaluation of Voice). Thirty younger adult males (20-49 years of age) and thirty older males (50-79 years of age) produced sustained vowels and read a connected speech stimulus which were applied to cepstral/spectral acoustic analyses to derive the multiparametric measure of Cepstral/Spectral Index of Dysphonia (CSID). Results indicated that older males exhibited significantly greater CSID measures than younger males in connected speech (p=0.001; d=0.98), but not the vowel. Linear regression revealed a moderate correlation between age and CSID in connected speech. These results further inform our understanding of how aging influences voice production in varied contexts and how commonly utilised clinical voice tasks subjected to cepstral/spectral acoustic analyses might differentially inform our knowledge of underlying vocal physiology. PMID:25651197

  10. Retropharyngeal internal carotid artery: case report

    Figueiredo, Ricardo Rodrigues

    2009-03-01

    Full Text Available Introduction: Variations to the course of carotid arteries may lead to abnormal pharyngeal protrusions, to which the otorhinolaryngologist should always attentive. Objective: To report a case of abnormal pharyngeal protrusion due to vascular anomaly in the course of the internal carotid artery, with literature review. Case Report: A 73- year-old woman complained of globus pharyngeus and intermittent dysphonia. A pulsating convexity was observed at the right part of the oropharynx, associated to laryngoscopic signals of pharyngo-laryngeal reflux. The pharyngeal computed tomography scan showed an abnormal tortuous internal carotid in the retropharyngeal space. The patient was sent to the vascular surgeon, who, after a normal blood flow finding at the Doppler, opted for an expectation conduct. The pharyngeal symptoms improved with the antireflux treatment. Final Comments: Internal carotid vascular anomalies must always be recalled in the pharyngeal wall convexity differential diagnosis.

  11. Isolated Post-Traumatic Syringobulbia; Case Report and Review of the Literature

    Mousa Taghipour

    2014-10-01

    Full Text Available Syringobulbiais very rare condition defined as slit-like fluid cavity in the brain stem. Several conditions have been reported to be associated with syringobulbia including neoplasms, spinal cord traumas or lesions such as tethered cord, hind-brain herniation, infections such as meningitis and in isolation. Although post-traumatic syringomyelia has been wieldy described previously, traumatic brain injury has not been reported as the mechanism and etiology of isolated syringobulbia. We herein report a 24-year old man with previous history of severe traumatic brain injury who presented with recent onset inability to walk or coordinate movements, ataxia, dysphonia, dysarthria, bilateral third nerve palsy with fixed dilated pupils and eyes deviated outward and downward. He was further diagnosed to have isolated syringobulbia extending to upper pons and lower midbrain. Isolated post-traumatic syringobulbia is extremely rare condition presenting insidiously with cranial nerve palsies, ataxia and dysarthria.

  12. Efficacy and Safety of Axitinib Versus Sorafenib in Metastatic Renal Cell Carcinoma: Subgroup Analysis of Japanese Patients from the Global Randomized Phase 3 AXIS Trial

    Ueda, Takeshi; Uemura, Hirotsugu; Tomita, Yoshihiko; Tsukamoto, Taiji; Kanayama, Hiroomi; Shinohara, Nobuo; Tarazi, Jamal; Chen, Connie; Kim, Sinil; Ozono, Seiichiro; Naito, Seiji; Akaza, Hideyuki

    2013-01-01

    Objective Axitinib is a potent and selective second-generation inhibitor of vascular endothelial growth factor receptors 1, 2 and 3. The efficacy and safety of axitinib in Japanese patients with metastatic renal cell carcinoma were evaluated. Methods A subgroup analysis was conducted in Japanese patients enrolled in the randomized Phase III trial of axitinib versus sorafenib after failure of one prior systemic therapy for metastatic renal cell carcinoma. Results Twenty-five (of 361) and 29 (of 362) patients randomized to the axitinib and sorafenib arms, respectively, were Japanese and included in this analysis. Median progression-free survival in Japanese patients was 12.1 months (95% confidence interval 8.6 to not estimable) for axitinib and 4.9 months (95% confidence interval 2.8–6.6) for sorafenib (hazard ratio 0.390; 95% confidence interval 0.130–1.173; stratified one-sided P = 0.0401). The objective response rate was 52.0% for axitinib and 3.4% for sorafenib (P = 0.0001). The common all-causality adverse events (all grades) in Japanese patients were dysphonia (68%), hypertension (64%), hand–foot syndrome (64%) and diarrhea (56%) for axitinib, and hand–foot syndrome (86%), hypertension (62%) and diarrhea (52%) for sorafenib. The safety profiles of axitinib and sorafenib in Japanese patients were generally similar to those observed in the overall population, with the exceptions of higher incidences of hypertension, dysphonia, hand–foot syndrome, hypothyroidism and stomatitis. Conclusions Axitinib is efficacious and well tolerated in Japanese patients with previously treated metastatic renal cell carcinoma, consistent with the results in the overall population, providing a new targeted therapy for these Japanese patients. PMID:23630366

  13. Temporomandibular disorders, voice and oral quality of life in women

    Tatiane Cristina Pereira

    2009-01-01

    Full Text Available Some studies have shown a relationship between temporomandibular disorders (TMD and dysphonia, as well as quality of life in oral health. OBJECTIVE: The purpose of this study was to investigate the correlation between severity of vocal self-perception and TMD severity and the correlation between oral health-related quality of life impairment and TMD severity. MATERIAL AND METHODS: Thirty-three women aged 20 to 40 years, with or without complaint of dysphonia, were recruited at the Bauru campus of the University of São Paulo, Brazil, and the local community. All participants were subjected to an investigation of quality of life related to dental and speech aspects by the application of Oral Health Impact Profile-short form (OHIP-14 and the Voice-Related Quality of Life (V-RQOL protocol. Also, a questionnaire was applied to detect the presence and severity of TMD. RESULTS: There was significant correlation between TMD and quality of life for all aspects analyzed in the oral health protocol, except for function and physical limitation (p>0.05. There was negative correlation between TMD and voice-related quality of life in the total score (p=0.007 as weel as physical (p=0.008 and socio-emotional aspects (p=0.017. In addition, there was statistically significant correlation between TMD and vocal self-perception (p=0.037. CONCLUSION: There is an association between TMD severity, voice-related and oral health-related quality of life. It is important to investigate in future studies the vocal self perception as well as the oral and voice conditions in patients with TMD.

  14. Voice disorders in mucosal leishmaniasis.

    Ana Cristina Nunes Ruas

    Full Text Available INTRODUCTION: Leishmaniasis is considered as one of the six most important infectious diseases because of its high detection coefficient and ability to produce deformities. In most cases, mucosal leishmaniasis (ML occurs as a consequence of cutaneous leishmaniasis. If left untreated, mucosal lesions can leave sequelae, interfering in the swallowing, breathing, voice and speech processes and requiring rehabilitation. OBJECTIVE: To describe the anatomical characteristics and voice quality of ML patients. MATERIALS AND METHODS: A descriptive transversal study was conducted in a cohort of ML patients treated at the Laboratory for Leishmaniasis Surveillance of the Evandro Chagas National Institute of Infectious Diseases-Fiocruz, between 2010 and 2013. The patients were submitted to otorhinolaryngologic clinical examination by endoscopy of the upper airways and digestive tract and to speech-language assessment through directed anamnesis, auditory perception, phonation times and vocal acoustic analysis. The variables of interest were epidemiologic (sex and age and clinic (lesion location, associated symptoms and voice quality. RESULTS: 26 patients under ML treatment and monitored by speech therapists were studied. 21 (81% were male and five (19% female, with ages ranging from 15 to 78 years (54.5+15.0 years. The lesions were distributed in the following structures 88.5% nasal, 38.5% oral, 34.6% pharyngeal and 19.2% laryngeal, with some patients presenting lesions in more than one anatomic site. The main complaint was nasal obstruction (73.1%, followed by dysphonia (38.5%, odynophagia (30.8% and dysphagia (26.9%. 23 patients (84.6% presented voice quality perturbations. Dysphonia was significantly associated to lesions in the larynx, pharynx and oral cavity. CONCLUSION: We observed that vocal quality perturbations are frequent in patients with mucosal leishmaniasis, even without laryngeal lesions; they are probably associated to disorders of some

  15. The application of short-term efficiency analysis in diagnosing occupational voice disorders

    Ewa Niebudek-Bogusz

    2015-06-01

    Full Text Available Background: An objective determination of the range of vocal efficiency is rather difficult. The aim of the study was to assess the possibility of application of short-term acoustic efficiency analysis in diagnosing occupational voice disorders. Material and Methods: The study covered 98 people (87 women and 11 men diagnosed with occupational dysphonia through videostroboscopic examination. The control group comprised 100 people (81 women and 19 men with normal voices. The short-term acoustic analysis was carried out by means of DiagnoScope software, including classical parameters (Jitter group, Shimmer group and the assessment of noise degree NHR, as well as new short-term efficiency parameters determined in a short time period during sustained phonation of the vowel “a.” The results were then compared. Results: The values of all the examined classical parameters were considerably higher in the study group of pathological voices than in the control group of normal voices (p = 0.00. The aerodynamic parameter, maximum phonation time, was significantly shorter by over 0.5 s in the study group than in the control group. The majority of the acoustic efficiency parameters were also considerably worse in the study group of subjects with occupational dysphonia than in the control group (p = 0.00. Moreover, the correlation between the efficiency parameters and most of the classical acoustic parameters in the study group implies that for the voices with occupational pathology the decreased efficiency of the vocal apparatus is reflected in the acoustic voice structure. Conclusions: Efficiency parameters determined during short-term acoustic analysis can be an objective indicator of the decreased phonatory function of the larynx, useful in diagnosing occupational vocal pathology. Med Pr 2015;66(2:225–234

  16. Study of the pathology valued at Phoniatrics Unit Complex Care of Zamora in the first quarter of 2012

    Bajo-Santos C

    2012-06-01

    Full Text Available SummaryIntroduction: We present this study about the activity of the first term of Phoniatrics consulting belongs to the Virgen de la Concha Hospital in ZamoraMaterial and Methods: A statistical study was developedResults: Total number of patients evaluated: 244, with 137 (56.15% who came as first time (new cases and 107 (43.85% who were previously evaluated. Of these, 139 (56, 97% had vocal pathology and 105 (43.3% speech pathology. 38 patients (15, 57% were referred from the phoniatrics unit to speech therapy at the hospital for treatment. Vocal pathology occupies 86.84% (from the 38 submitted, being 32 the number of dysphonia, 19 (59.37% organic (of which 10.52% were professional voice users, 9 were laryngeal microsurgery (28, 13% and 4 functional dysphonia (12.5%. From all the language pathologies analyzed by Phoniatrics unit, only 4.76% is referred to Speech therapy. The remaining 95.24% are sent to the school centers, with specialist teachers in LA whose are responsible for its rehabilitation (in order of SEN 1992. Conclusions: 1. - The number of patients evaluated for first time in the medical consultation is higher than phoniatric revisions. 2. - The percentage of vocal pathology evaluated predominates but the difference versus language pathology is narrowing as pediatricians have medical knowledge of this activity. 3. - The number of patients included in speech rehabilitation is significantly lower than those who have been studied in the consultation. 4 - The Vocal therapy predominates at hospital level and Language therapy in the schools.

  17. Voice amplification for primary school teachers with voice disorders: A randomized clinical trial

    Roberto Bovo

    2013-06-01

    Full Text Available Objectives: Several studies have demonstrated a high prevalence of voice disorders in teachers, together with the personal, professional and economical consequences of the problem. Good primary prevention should be based on 3 aspects: 1 amelioration of classroom acoustics, 2 voice care programs for future professional voice users, including teachers and 3 classroom or portable amplification systems. The aim of the study was to assess the benefit obtained from the use of portable amplification systems by female primary school teachers in their occupational setting. Materials and Methods: Forty female primary school teachers attended a course about professional voice care, which comprised two theoretical lectures, each 60 min long. Thereafter, they were randomized into 2 groups: the teachers of the first group were asked to use a portable vocal amplifier for 3 months, till the end of school-year. The other 20 teachers were part of the control group, matched for age and years of employment. All subjects had a grade 1 of dysphonia with no significant organic lesion of the vocal folds. Results: Most teachers of the experimental group used the amplifier consistently for the whole duration of the experiment and found it very useful in reducing the symptoms of vocal fatigue. In fact, after 3 months, Voice Handicap Index (VHI scores in "course + amplifier" group demonstrated a significant amelioration (p = 0.003. The perceptual grade of dysphonia also improved significantly (p = 0.0005. The same parameters changed favourably also in the "course only" group, but the results were not statistically significant (p = 0.4 for VHI and p = 0.03 for perceptual grade. Conclusions: In teachers, and particularly in those with a constitutional weak voice and/or those who are prone to vocal fold pathology, vocal amplifiers may be an effective and low-cost intervention to decrease potentially damaging vocal loads and may represent a necessary form of prevention.

  18. Voice therapy and assistive techniques in voice disorders caused by unilateral vocal cord pareses

    Kašterović Bojana

    2014-01-01

    Full Text Available Introduction. Dysphonias due to primary neurogenic disorders are a group of voice disorders that can be caused by both central and peripheral disorders of the larynx innervation. There are numerous causes leading to paralysis of superior and/or inferior laryngeal nerves, particularly of the inferior laryngeal or recurrent nerve. Voice Therapy in Unilateral Vocal Cord Paresis. Vocal therapy is an integral part of the conservative treatment. Specific methods are applied to individual vocal problems, while the non-specific ones are applied to a number of dysphonias. Non-specific methods are further divided into integrated and focused vocal methods. Integrated methods treat the voice and speech disorders as a unified entity of all quality and segments of voice and speech. Focused non-specific methods treat the segments and the quality of voice and speech individually. Assistive Techniques in Voice Disorders Caused by Unilateral Vocal Cord Paresis. Digital compression of the larynx by Seeman includes the treatment of voice with compression of the thyroid cartilage, thus moving the paralyzed and healthy vocal cord medially and upwards, and medially and downwards, respectively. This leads to the proper occlusion of vocal cords because in these conditions the paralyzed vocal cord is lower than the healthy one. According to the theoretical assumption, when the head anc neck are rotated to one or the other side, the anatomic relations in the neck are change and thus the vocal cords are brought into contact with the resulting reduction of the gap between them and the reduced air flow. Conclusion. Studies assessing the efficiency of different methods of vocal therapy are scarce bearing in mind the importance of vocal therapy and the fact that many patients refuse surgical treatment. Research on the efficiency of assistive techniques in phoniatric rehabilitation of patients with unilateral vocal cord paresis yields conflicting results. However, assistive

  19. A report on alterations to the speaking and singing voices of four women following hormonal therapy with virilizing agents.

    Baker, J

    1999-12-01

    Four women aged between 27 and 58 years sought otolaryngological examination due to significant alterations to their voices, the primary concerns being hoarseness in vocal quality, lowering of habitual pitch, difficulty projecting their speaking voices, and loss of control over their singing voices. Otolaryngological examination with a mirror or flexible laryngoscope revealed no apparent abnormality of vocal fold structure or function, and the women were referred for speech pathology with diagnoses of functional dysphonia. Objective acoustic measures using the Kay Visipitch indicated significant lowering of the mean fundamental frequency for each woman, and perceptual analysis of the patients' voices during quiet speaking, projected voice use, and comprehensive singing activities revealed a constellation of features typically noted in the pubescent male. The original diagnoses of a functional dysphonia were queried, prompting further exploration of each woman's medical history, revealing in each case onset of vocal symptoms shortly after commencing treatment for conditions with medications containing virilizing agents (eg, Danocrine (danazol), Deca-Durabolin (nandrolene decanoate), and testosterone). Although some of the vocal symptoms decreased in severity with the influences from 6 months voice therapy and after withdrawal from the drugs, a number of symptoms remained permanent, suggesting each subject had suffered significant alterations in vocal physiology, including muscle tissue changes, muscle coordination dysfunction, and propioceptive dysfunction. This retrospective study is presented in order to illustrate that it was both the projected speaking voice and the singing voice that proved so highly sensitive to the virilization effects. The implications for future prospective research studies and responsible clinical practice are discussed. PMID:10622516

  20. Experimental study of different nickel-titanium memory tracheal stents in dogs

    Objective: Since membrane -covered metal tracheal stent was applied successfully to treat the airway stenosis, it has been widely used and obtained satisfactory result during the past years. The purpose of our study was provide theoretical rational for treatment with membrane-covered tracheal stent by using animal experiment. Methods: The nickel- titanium memory stents of 22 mm in diameter and 6 cm in length were deployed in 18 dogs. The dogs were grouped into full- length membrane-covered group (n=6), partial-length membrane-covered group (membrane was covered for 4 cm in the medial part of the stent, n=6), and naked stent group (n=6). After the stent placement dysphagia or dysphonia was monitored daily. Twenty-four weeks later, the dogs were executed. Speiments were taken from the cephalic, medial, and caudal trachea under the stent. HE stain and proliferating cell nuclear antigen (PCNA) were evaluated. Results: After the stent placement, no dyspnea, dysphagia or dysphonia but cough was present in each dog. There was no significant difference in symptom between the three groups. Inflammation reaction, metaplasia from low columnar epithelium to spuamous epithelium, and mild granulation tissue hyperplasia in the underlying mucosa were present in each group. However, fibrosis and tracheal straitness were present only in the non-membrane-covered area, but not in the membrane-covered area. More PCNA expression was observed in the non-membrane -covered area than in the membrane-covered area. Conclusion: Both membrane-covered and non-membrane-covered stents can cause similar symptoms. However, the membrane -covered tracheal stent has good biological compatibility and would not induce tracheal straitness. The non-membrane -covered tracheal stent could induce a severe pathologic reaction and tracheal straitness. (authors)

  1. A case of laryngeal neurofibroma associated with neurofibromatosis type 2

    Purpose: Laryngeal neurofibromas have been reported in 16 patients with NF1, and schwannomas, in two patient with NF1 and 2 patients with NF2. To the best our knowledge our case is the first to document a laryngeal neurofibroma in a patient with NF2. Another unique feature of our case is the coexistence of multiple intramedullary tumors, which has not previously been reported in a patient with a laryngeal neurofibroma. Material and methods: A 32-year-old woman presented with a history of cataract, hoarseness and dysphonia since childhood, which had recently become worse. The patient also had hearing disability for low frequencies. Results: Laryngoscopy revealed a 2x2x3.5 cm smooth-surfaced submucosal supraglottic mass. On CT of the neck, the lesion was seen as a round and well-defined hypopharyngeal mass extended through and obliterating the left supraglottic space. It was hypodense on unenhanced CT images and slightly enhanced with IV contrast administration. On MR imaging, the mass was heterogeneously hypointense on T1-weighted images and hyperintense on T2-weighted images, with moderate homogenous enhancement after gadolinium administration. Bilateral vestibular schwannomas and multiple intramedullary masses (presumed to be ependymoma or astrocytoma) were delineated on these MR images The patient was diagnosed as having NF-2 and the laryngeal mass was totally resected. On histopathological examination, the mass were consistent with neurofibroma. Conclusion: Dysphonia and hoarseness may be the only presenting symptoms suggesting the possibility of a laryngeal nerve sheath tumor, and neurofibroma should be included in differential diagnosis of laryngeal masses in patients with NF2. (authors)

  2. Development and validation of the Newcastle laryngeal hypersensitivity questionnaire

    2014-01-01

    Background Laryngeal hypersensitivity may be an important component of the common disorders of laryngeal motor dysfunction including chronic refractory cough, pdoxical vocal fold movement (vocal cord dysfunction), muscle tension dysphonia, and globus pharyngeus. Patients with these conditions frequently report sensory disturbances, and an emerging concept of the ‘irritable larynx’ suggests common features of a sensory neuropathic dysfunction as a part of these disorders. The aim of this study was to develop a Laryngeal Hypersensitivity Questionnaire for patients with laryngeal dysfunction syndromes in order to measure the laryngeal sensory disturbance occurring in these conditions. Methods The 97 participants included 82 patients referred to speech pathology for behavioural management of laryngeal dysfunction and 15 healthy controls. The participants completed a 21 item self administered questionnaire regarding symptoms of abnormal laryngeal sensation. Factor analysis was conducted to examine correlations between items. Discriminant analysis and responsiveness to change were evaluated. Results The final questionnaire comprised 14 items across three domains: obstruction, pain/thermal, and irritation. The questionnaire demonstrated significant discriminant validity with a mean difference between the patients with laryngeal disorders and healthy controls of 5.5. The clinical groups with laryngeal hypersensitivity had similar abnormal scores. Furthermore the Newcastle Laryngeal Hypersensitivity Questionnaire (LHQ) showed improvement following behavioural speech pathology intervention with a mean reduction in LHQ score of 2.3. Conclusion The Newcastle Laryngeal Hypersensitivity Questionnaire is a simple, non-invasive tool to measure laryngeal pesthesia in patients with laryngeal conditions such as chronic cough, pdoxical vocal fold movement (vocal cord dysfunction), muscle tension dysphonia, and globus pharyngeus. It can successfully differentiate patients from

  3. The potential contributing effect of ketorolac and fluoxetine to a spinal epidural hematoma following a cervical interlaminar epidural steroid injection: a case report and narrative review.

    Chien, George C Chang; McCormick, Zack; Araujo, Marco; Candido, Kenneth D

    2014-01-01

    Cervical interlaminar epidural steroid injections (ESIs) are commonly performed as one part of a multi-modal analgesic regimen in the management of upper extremity radicular pain. Spinal epidural hematoma (SEH) is a rare complication with a reported incidence ranging from 1.38 in 10,000 to 1 in 190,000 epidurals. Current American Society of Regional Anesthesia (ASRA), American Society of Interventional Pain Physicians (ASIPP), and the International Spine Intervention Society (ISIS) recommendations are that non-steroidal anti-inflammatory drugs (NSAIDs) do not need to be withheld prior to epidural anesthesia. We report a case wherein intramuscular ketorolac and oral fluoxetine contributed to a SEH and tetraplegia following a cervical interlaminar (ESI). A 66 year-old woman with chronic renal insufficiency and neck pain radiating into her right upper extremity presented for evaluation and was deemed an appropriate CESI candidate. Cervical magnetic resonance imaging (MRI) revealed multi-level neuroforaminal stenosis and degenerative intervertebral discs. Utilizing a loss of resistance to saline technique, an 18-gauge Tuohy-type needle entered the epidural space at C6-7. After negative aspiration, 4 mL of saline with 80 mg of methyl-prednisolone was injected. Immediately thereafter, the patient reported significant spasmodic-type localized neck pain with no neurologic status changes. A decision was made to administer 30 mg intramuscular ketorolac as treatment for the spasmodic-type pain. En route home, she developed a sudden onset of acute tetraplegia. She was brought to the emergency department for evaluation including platelet and coagulation studies which were normal. MRI demonstrated an epidural hematoma extending from C5 to T7. She underwent a bilateral C5-T6 laminectomy with epidural hematoma evacuation and was discharged to an acute inpatient rehabilitation hospital. Chronic renal insufficiency, spinal stenosis, female gender, and increasing age have been

  4. Analysis of Seismicity Related to the December 2002 - February 2003 Eruptions at Popocatepetl Volcano, Mexico

    Quezada-Reyes, A.; Valdes-Gonzalez, C.; Lesage, P.

    2007-05-01

    Since its reactivation in 1994 Popocatepetl Volcano has undergone several activity stages, some of which comprise cycles of intrusion, extrusion and destruction of a lava dome. Popocatepetl has produced up to several tens of daily long-period (LP) events and several volcanic tremor episodes, along with a few volcano-tectonic earthquakes. A lava dome was extruded on May 2002 and subsequently destroyed by 19 explosions from December 2002 to February 2003. The seismicity accompanying the destruction of the lava dome was dominated by long-period (LP) events and a mix of harmonic and spasmodic tremor. We analysed the seismity related to this explosive phase and classified the majority of LP events into three families according to their frequency content. Most of the LP events are characterized by a dominant frequency near 2 Hz throughout the eruptive period. Many events also exhibited a low-amplitude short-period (SP) phase ocurring a few seconds before the LP signal. The SP signal was not observed without the LP event, although several events occurred in the absence of the precursory signal. We also found a notably decrease of LP events activity prior to December 18, 2002 and February 14 to 28, 2003 explosive episodes. Three different types of tremor lasting from a few minutes to several hours were also observed: spasmodic, harmonic and a very low-amplitude pulse-like type of tremor, the latter occurring on November 11, 12 and 30 with a duration of about 120 minutes each. Harmonic tremor episodes lasted from a few minutes to a few hours and there was no tremor occurrence days before the explosive events. Tremor spectra display a fundamental frequency which can vary in the range 0.6-1.3 Hz within a one-hour-long series of tremor. Similar observations are obtained for the peak spacing of the harmonic tremor spectra. These variations may reflect short-term fluctuations of the acoustic properties of the source while no long-term evolutions of the LP sources are detected

  5. Localization of dystonic muscles using {sup 18}F-FDG PET/CT in idiopathic cervical dystonia

    Choi, J. Y.; Seung, D. H.; Kim, D. H.; Kim, E. S.; Sohn, Y. I.; Choi, Y.; Choi, E. S.; Lee, K. H.; Kim, B. T. [Samsung Medical Center, Seoul (Korea, Republic of)

    2007-07-01

    Chemodenervation with botulinum toxin (BT) is regarded as a first-line treatment for idiopathic cervical dystonia (ICD), sometimes referred to as spasmodic torticollis. Moreover, because effective treatment involves the injection of BT into most dystonic muscles, the accurate localization of dystonic muscles is clinically important. In this preliminary study, we investigated whether {sup 18}F-FDG PET/CT is useful for localizing dystonic cervical muscles in ICD by comparing disease severity after and before BT injection into muscles determined to be hypermetabolic by PET/CT. Six consecutive patients (all males; age 37 16 y) underwent {sup 18}F-FDG PET/CT once (n = 4) or twice (n = 2) in a supine (n = 5) or sitting position (n = 3) during the {sup 18}F-FDG uptake period. Dystonic muscles suitable for BT injection therapy were defined as those showing diffusely increased {sup 18}F-FDG uptake. To evaluate response to BT injection, the Tsui scale and the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) were applied. On PET/CT, hypermetabolic cervical muscles were identified in all 6 patients (3 in a supine position and 3 in a sitting position during {sup 18}F-FDG uptake periods). In 2 patients who underwent PET/CT in a supine and in a sitting position during 18F-FDG uptake, abnormal hypermetabolic muscles were observed only by PET/CT in a sitting position with patients heads and necks in the assumed abnormal involuntary posture. Symptoms were significantly improved, according to the Tsui (10.0 2.9 to 1.8 1.3, 82% reduction) and TWSTRS scales (severity: 21.3 2.1 to 5.8 5.3, 73% reduction; disability: 19.8 1.9 to 3.8 3.8, 81 % reduction) in all 4 patients who underwent BT injection therapy guided by PET/CT and who were clinically follow-up. {sup 18}F-FDG PET/CT is potentially useful for identifying dystonic cervical muscles in patients with ICD.

  6. Complex behavior and source model of the tremor at Arenal volcano, Costa Rica

    Lesage, Philippe; Mora, Mauricio M.; Alvarado, Guillermo E.; Pacheco, Javier; Métaxian, Jean-Philippe

    2006-09-01

    Typical records of volcanic tremor and explosion quakes at Arenal volcano are analyzed with a high-resolution time-frequency method. The main characteristics of these seismic signals are: (1) numerous regularly spaced spectral peaks including both odd and even overtones; (2) frequency gliding in the range [0.9-2] Hz of the fundamental peak; (3) frequency jumps with either positive or negative increments; (4) tremor episodes with two simultaneous systems of spectral peaks affected by independent frequency gliding; (5) progressive transitions between spasmodic tremor and harmonic tremor; (6) lack of clear and systematic relationship between the occurrence of explosions and tremor. Some examples of alternation between two states of oscillation characterized by different fundamental frequencies are also observed. Some tremor and explosion codas are characterized by acoustic and seismic waves with identical spectral content and frequency gliding, which suggests a common excitation process. We propose a source model for the tremor at Arenal in which intermittent gas flow through fractures produces repetitive pressure pulses. The repeating period of the pulses is stabilized by a feedback mechanism associated with standing or traveling waves in the magmatic conduit. The pressure pulses generate acoustic waves in the atmosphere and act as excitation of the interface waves in the conduit. When the repeating period of the pulses is stable enough, they produce regularly spaced spectral peaks by the Dirac comb effect and hence harmonic tremor. When the period stability is lost, because of failures in the feedback mechanism, the tremor becomes spasmodic. The proposed source model of tremor is similar to the sound emission process of a clarinet. Fractures in the solid or viscous layer capping the lava pool in the crater act as the clarinet reed, and the conduit filled with low velocity bubbly magma is equivalent to the pipe of the musical instrument. The frequency gliding is

  7. A Study on Genetic Analysis and Extract Cytotoxicity of Scolopendra subspinipes multilans L. Koch

    Kim Sung-Nam

    2006-06-01

    Full Text Available Objective : The purpose of this study is to investigate nucleotide sequence and extract cytotoxicity of Scolopendrae corpus. The nature and taste of Scolopendrae corpus is hot, Warm and toxic, and the effect of this is dispelling wind, anti-spasmodic action and detoxication so it has been used for C.V.A, facial palsy, sensory disorder at extremities, wounds and arthritis. Methods : Scolopendrae corpus were collected by locality on the market. They were morphologically classified. Their nucleotide sequence was investigated and compared among them. In addition, the water-alcohol extract cytotoxicity of them was studied by MTT-based cytotoxicity assay. Results : It was shown that the each Scolopendrae corpus by locality is almost identical at genetic result and is identified as Scolopendra subspinipes mutilans L. Koch. Nucleotide sequence of Scolopendra subspinipes mutilans L. Koch in this study will help to discriminate other species of Scolopendrae corpus. The water-alcohol extract of Scolopendra subspinipes mutilans L. Koch did not induce cytotoxicity on Hep G2, L929 cell and peritoneal macrophages. Besides, it did not influence nitrite production of peritoneal macrophages. These results can be used as basic data for genetic discrimination with another species of scolopendrae corpus.

  8. Apigenin Reduces Survival of Choriocarcinoma Cells by Inducing Apoptosis via the PI3K/AKT and ERK1/2 MAPK Pathways.

    Lim, Whasun; Park, Sunwoo; Bazer, Fuller W; Song, Gwonhwa

    2016-12-01

    Apigenin is a flavonoid found in parsley, onions, oranges, tea, chamomile, wheat, and sprouts. It has a variety of biological properties including anti-oxidant, anti-mutagenic, anti-carcinogenic, anti-inflammatory, anti-proliferative, and anti-spasmodic effects. Based on epidemiological and case-control studies, apigenin is regarded as a novel chemotherapeutic agent against various cancer types. However, little is known about the effects of apigenin on choriocarcinoma cells. Therefore, we investigated the anti-cancer effects of apigenin on choriocarcinoma cells (JAR and JEG3) in the present study. Apigenin reduced viability and migratory properties, increased apoptosis, and suppressed mitochondrial membrane potential in both the JAR and JEG3 cells. In addition, apigenin predominantly decreased phosphorylation of AKT, P70RSK, and S6 whereas the phosphorylation of ERK1/2 and P90RSK was increased by apigenin treatment of JAR and JEG3 cells in a dose-dependent manner. Moreover, treatment of JAR and JEG3 cells with both apigenin and pharmacological inhibitors of PI3K/AKT (LY294002) and ERK1/2 (U0126) revealed synergistic anti-proliferative effects. Collectively, these results indicated that the apigenin is an invaluable chemopreventive agent that inhibits progression and metastasis of choriocarcinoma cells through regulation of PI3K/AKT and ERK1/2 MAPK signal transduction mechanism. J. Cell. Physiol. 231: 2690-2699, 2016. © 2016 Wiley Periodicals, Inc. PMID:26970256

  9. Imaging of total colonic Hirschsprung disease

    Hirschsprung disease (HD) is a functional obstruction of the bowel caused by the absence of intrinsic enteric ganglion cells. The diagnosis of total colonic HD (TCHD) based on contrast enemas is difficult in newborns because radiological findings vary. To evaluate the radiographic and contrast enema findings in patients with pathologically proven TCHD. From 1966 to 2007, 17 records from a total of 31 patients with TCHD were retrospectively evaluated for diameter and shape of the colon, diameter of the small bowel, bowel wall contour, ileal reflux, abdominal calcifications, pneumoperitoneum, filling defects, transitional zones and rectosigmoid index. Three colonic patterns of TCHD were found: microcolon, question-mark-shape colon and normal caliber colon. Additional findings included spasmodic colon, ileal reflux, delayed evacuation and abdominal calcifications. Colonic transitional zones were found in eight patients with TCHD. The diagnosis of TCHD is difficult to establish by contrast enema studies. The length of the aganglionic small bowel and the age of the patient can influence the radiological findings in TCHD. The transitional zone and the rectosigmoid index can be false-positive in TCHD. The colon can appear normal. Consider TCHD if the contrast enema study is normal but the patient remains symptomatic and other causes of distal bowel obstruction have been excluded. (orig.)

  10. Imaging of total colonic Hirschsprung disease

    Stranzinger, Enno; DiPietro, Michael A.; Strouse, Peter J. [University of Michigan Health System, Section of Pediatric Radiology, Ann Arbor, MI (United States); Teitelbaum, Daniel H. [University of Michigan Health System, Section of Pediatric Surgery, Ann Arbor, MI (United States)

    2008-11-15

    Hirschsprung disease (HD) is a functional obstruction of the bowel caused by the absence of intrinsic enteric ganglion cells. The diagnosis of total colonic HD (TCHD) based on contrast enemas is difficult in newborns because radiological findings vary. To evaluate the radiographic and contrast enema findings in patients with pathologically proven TCHD. From 1966 to 2007, 17 records from a total of 31 patients with TCHD were retrospectively evaluated for diameter and shape of the colon, diameter of the small bowel, bowel wall contour, ileal reflux, abdominal calcifications, pneumoperitoneum, filling defects, transitional zones and rectosigmoid index. Three colonic patterns of TCHD were found: microcolon, question-mark-shape colon and normal caliber colon. Additional findings included spasmodic colon, ileal reflux, delayed evacuation and abdominal calcifications. Colonic transitional zones were found in eight patients with TCHD. The diagnosis of TCHD is difficult to establish by contrast enema studies. The length of the aganglionic small bowel and the age of the patient can influence the radiological findings in TCHD. The transitional zone and the rectosigmoid index can be false-positive in TCHD. The colon can appear normal. Consider TCHD if the contrast enema study is normal but the patient remains symptomatic and other causes of distal bowel obstruction have been excluded. (orig.)

  11. [Panmedullary ependymoma with complete excision in several stages. Apropos of a case].

    Fuentes, J M; Benezech, J; Abounader, M; Lamur, M; Aubert, D; Marty, M

    1986-01-01

    Treatment of a panmedullary ependymoma involved a three-stage operation with total excision under microscopic control and the use of the Cavitron. The patient, a 22 year old woman, presented with a three-year history, with clinical onset of staged spinal pain and cervicobrachial neuralgia, of spasmodic paraparesis with sensory and sphincter disturbances. The extent of the lesion from C3 to L2 was determined from data from conventional myelography with Iopamiron, a CT scan with intrathecal contrast and nuclear magnetic resonance imaging of sagittal and frontal sections. The tumor, a grade I ependymoma, was treated by three-stage laminectomies (L2-T12, T12-T3, T3-C3), total excision being obtained by ultrasound fragmentation (Cavitron). Gross pathology showed a heterogeneous appearance with two cysts, one capping the tumor from the bulbospinal junction to C3, the other attached to the medullary cone. Hemorrhagic cavities were noted at cervicothoracic region and multiple microcysts in the dorsal expansion. The postoperative course was uneventful with recovery of walking wearing a bivalve acrylic corset, the most disturbing functional complication being the posterior cord syndrome responsible for an ataxia. PMID:3822026

  12. Effects of a fungicide formulation on embryo-larval development, metamorphosis, and gonadogenesis of the South American toad Rhinella arenarum.

    Svartz, Gabriela; Meijide, Fernando; Pérez Coll, Cristina

    2016-07-01

    Sublethal toxicity of the formulated fungicide Maxim(®) XL on embryonic, larval and juvenile development of Rhinella arenarum was evaluated by means of standardized bioassays. Maxim(®) XL, one of the most used fungicides in Argentina, is based on a mixture of two active ingredients: Fludioxonil and Metalaxyl-M. Maxim(®) XL exposure induced severe sublethal effects on the embryos, expressed as general underdevelopment, axial flexures, microcephaly, cellular dissociation, abnormal pigmentation, underdeveloped gills, marked edema and wavy tail. As the embryo development advanced, alterations in behavior as spasmodic contractions, general weakness and inanition were observed. Maxim(®) XL did not affect neither the time required to complete metamorphosis nor sex proportions, but gonadal development and differentiation were impaired. Gross gonadal analysis revealed a significant proportion of exposed individuals with underdevelopment of one or both gonads. Histological analysis confirmed that 18% and 10% of the individuals exposed to 0.25 and 2mg/L Maxim(®) XL, respectively, exhibited undifferentiated gonads characterized by a reduced number (or absence) of germ cells. Taking into account the risk evaluation performed by means of Hazard Quotients, this fungicide could be a threat to R. arenarum populations under chronic exposure. This study represents the first evidence of toxic effects exerted by Maxim(®) XL on amphibians. Finally, our findings highlight the properties of this fungicide that might jeopardize non-target living species exposed to it in agricultural environments. PMID:27214195

  13. High-Resolution X-Ray Spectroscopy of the Bursting Pulsar GRO J1744-28

    Degenaar, N; Harrison, F A; Kennea, J A; Kouveliotou, C; Younes, G

    2014-01-01

    The bursting pulsar GRO J1744-28 is a Galactic low-mass X-ray binary that distinguishes itself by displaying type-II X-ray bursts: brief, bright flashes of X-ray emission that likely arise from spasmodic accretion. Combined with its coherent 2.1 Hz X-ray pulsations and relatively high estimated magnetic field, it is a particularly interesting source to study the physics of accretion flows around neutron stars. Here we report on Chandra/HETG observations obtained near the peak of its bright 2014 accretion outburst. Spectral analysis suggests the presence of a broad iron emission line centered at E_l ~ 6.7 keV. Fits with a disk reflection model yield an inclination angle of i ~ 52 degrees and an inner disk radius of R_in ~ 85 GM/c^2, which is much further out than typically found for neutron star low-mass X-ray binaries. Assuming that the disk is truncated at the magnetospheric radius of the neutron star, we estimate a magnetic field strength of B ~ (2-6)E10 G. Furthermore, we identify an absorption feature nea...

  14. Opportunizing: A classic grounded theory study on business and management

    Ólavur Christiansen

    2006-11-01

    Full Text Available Opportunizing emerged as the core variable of this classic GT study on business and management. Opportunizing is the recurrent main concern that businesses have to continually resolve, and it explains how companies recurrently create, identify, seize or exploit situations to maintain their growth or survival. Opportunizing is the recurrent creation and re-creation of opportunities in business. Opportunizing is basically what business managers do and do all the time. The problematic nature of opportunizing is resolved by a core social process ofopportunizing and its attached sub-processes that account for change over time and for the variations of the problematic nature of its resolution.Opportunizing has five main facets. These are conditional befriending (confidence building & modifying behavior,prospecting (e.g. information gaining, weighing up (information appraisal & decision-making, moment capturing (quick intervention for seizing strategic opportunities, andconfiguration matching (adjusting the business organization to abet the other activities of opportunizing.On a more abstract level, opportunizing has three more organizational facets: the physically boundary-less, the valuehierarchical, and the physically bounded. The first of these called perpetual opportunizing. This emerges from the conjunction of conditional befriending and prospecting. The second facet is called triggering opportunizing. It arises from the coming together of weighing up and moment capturing. The final facet is called spasmodic opportunizing. This happens when moment capturing and configuration matching unite.

  15. PSEUDO CENTRAL CERVICAL FIBROID IN A NULLIPAROUS GIRL: A CASE REPORT

    Priyankur

    2014-08-01

    Full Text Available Fibroids are benign (non-cancerous growths on the uterus. There is an overall incidence of 20% in women more than 30yrs of age. The incidence of cervical fibroids is much lower at 1-2%. An unmarried girl presented with complaints of difficulty in passing urine, lower abdominal pain and spasmodic dysmenorrhea for 4 months. Per abdomen there was a firm, non-tender midline mass arising from the pelvis corresponding to 20 weeks size gravid uterus with restricted mobility. Cervix could not be felt. Ultrasonographic examination showed 10.2x10.7 cm fibroid in the posterior wall with no adnexal pathology and bilateral mild hydronephrosis. On laparotomy, the uterus was found to be sitting like a lantern on the dome of St. Paul's Cathedral. A 25x18 cm pseudo central cervical fibroid, partly intramural, partly sub mucous was seen to arise from the posterior cervico isthmic region. Myomectomy was performed successfully. Central cervical fibroid expands the cervix equally in all directions and the uterus is elevated on top of the large tumor. Diagnosis is by ultrasonogram and HSG. Management in cervical fibroid of supravaginal portion is hysterectomy if fertility is not desired and myomectomy if the patient is young and fertility is desired, as in our case.

  16. A case of cephalic tetanus in a developed country.

    Fusetti, S; Ghirotto, C; Ferronato, G

    2013-01-01

    Tetanus is a potentially life-threatening infection that results from contamination of skin wound by Clostridium Tetani spores. Although, it remains an important health problem in developing countries without strict national immunization programs, this condition is rare in the developed world. The most frequent presenting symptoms are trismus and dysphagia, due to the spasmodic contraction of the masticatory muscles. Then the disease usually diffuses with a descending pattern inducing a generalized contraction of the agonist and antagonistic muscles, which characterize a tetanic spasm. Mortality usually results from respiratory failure, cardiovascular collapse, or autonomic dysfunctions. Treatment usually requires the prompt admission to the intensive care unit to avoid the development of potential life-threatening complications. We report the case of a 78-year-old farmer, who was referred to us with progressive onset of lock-jaw and muscular stiffness of the facial region, that had occurred after he had scratched himself with a rose. The recognition of the presenting signs of cephalic tetanus allowed the prompt management of the infection. However, because of the rarity of this condition, the clinicians may be unfamiliar with the clinical presentation, and be unsuspecting of the diagnosis. PMID:23527734

  17. Glycine receptor mutants of the mouse: what are possible routes of inhibitory compensation?

    Nicolas Vogel

    2012-10-01

    Full Text Available Defects in glycinergic inhibition result in a complex neuromotor disorder in humans known as hyperekplexia (OMIM 149400 with similar phenotypes in rodents characterized by an exaggerated startle reflex and hypertonia. Analogous to genetic defects in humans, single point mutations, microdeletions, or insertions in the Glra1 gene but also in the Glrb gene underlie the pathology in mice. The mutations either localized in the α (spasmodic, oscillator, cincinnati, Nmf11 or the β (spastic subunit of the GlyR are much less tolerated in mice than in humans, leaving the question for the existence of different regulatory elements of the pathomechanisms in humans and rodents. In addition to the spontaneous mutations, new insights into understanding of the regulatory pathways in hyperekplexia or glycine encephalopathy arose from the constantly increasing number of knock-out as well as knock-in mutants of GlyRs. Over the last five years, various efforts using in vivo whole cell recordings provided a detailed analysis of the kinetic parameters underlying glycinergic dysfunction. Presynaptic compensation as well as postsynaptic compensatory mechanisms in these mice by other GlyR subunits or GABAA receptors, and the role of extra-synaptic GlyRs is still a matter of debate. A recent study on the mouse mutant oscillator, displayed a novel aspect for compensation of functionality by complementation of receptor domains that fold independently. This review focuses on defects in glycinergic neurotransmission in mice discussed with the background of human hyperekplexia en route to strategies of compensation.

  18. Model of the volcano-hydrothermal system of Tatun Volcano Group, northern Taiwan, inferred from seismicity and gas geochemistry

    Konstantinou, K. I.; Rontogianni, S.; Lin, C.-H.

    2012-04-01

    The Tatun Volcano Group (TVG) is located in northern Taiwan near the capital Taipei. In this study we selected and analyzed almost four years (2004 - 2007) of its seismic activity. The seismic network established around TVG initially consisted of eight three component seismic stations with this number increasing to twelve by 2007. Local seismicity mainly involved High Frequency (HF) earthquakes occurring as isolated events or as spasmodic bursts. Mixed and Low Frequency (LF) events were observed during the same period but more rarely. During the analysis we estimated the magnitudes for the HF earthquakes and used a probabilistic non-linear method to locate all these events. We examined the temporal and spatial distribution of our data-set for each year and the monthly seismic energy distribution. In addition, complex frequencies for LF events were analyzed with the Sompi method. We juxtapose these results with gas geochemistry studies of fumaroles covering a similar period. A model for the volcano-hydrothermal system is proposed where fluids and magmatic gases ascend from a magma body that lies at around 7- 8 km depth. The movement of fluids to shallow depths increases the heat, the fracturing and also creates resonance and vibrations in cracks and conduits. This detailed analysis and previous physical volcanology observations at TVG suggest that the region is volcanically active and that measures to mitigate the risks have to be considered by the local authorities.

  19. Stiff-person syndrome (SPS) and anti-GAD-related CNS degenerations: protean additions to the autoimmune central neuropathies.

    Ali, Fatima; Rowley, Merrill; Jayakrishnan, Bindu; Teuber, Suzanne; Gershwin, M Eric; Mackay, Ian R

    2011-09-01

    Stiff Person Syndrome (SPS) is a rare autoimmune neurological disease attributable to autoantibodies to glutamic acid decarboxylase (anti-GAD) more usually associated with the islet beta cell destruction of autoimmune type 1 diabetes (T1D). SPS is characterized by interference in neurons with the synthesis/activity of the inhibitory neurotransmitter gamma amino butyric acid (GABA) resulting in the prototypic progressive spasmodic muscular rigidity of SPS, or diverse neurological syndromes, cerebellar ataxia, intractable epilepsy, myoclonus and several others. Remarkably, a single autoantibody, anti-GAD, can be common to widely different disease expressions, i.e. T1D and SPS. One explanation for these data is the differences in epitope engagement between the anti-GAD reactivity in SPS and T1D: in both diseases, anti-GAD antibody reactivity is predominantly to a conformational epitope region in the PLP- and C-terminal domains of the 65 kDa isoform but, additionally in SPS, there is reactivity to conformational epitope(s) on GAD67, and short linear epitopes in the C-terminal region and at the N-terminus of GAD65. Another explanation for disease expressions in SPS includes ready access of anti-GAD to antigen sites due to immune responsiveness within the CNS itself according to intrathecal anti-GAD-specific B cells and autoantibody. Closer study of the mysterious stiff-person syndrome should enhance the understanding of this disease itself, and autoimmunity in general. PMID:21680149

  20. Synthesis and anticonvulsant activity of certain chalcone based pyrazoline compounds

    Sudhakara Rao Gerapati

    2015-09-01

    Full Text Available Convulsions are involuntary, violent, spasmodic and prolonged contractions of skeletal muscles. That means a patient may have epilepsy without convulsions and vice versa. Epilepsy is a common neurological abnormality affecting about 1% of the world population. The primary objectives of these synthesized compounds are to suppress seizures and provide neuroprotection by minimizing the effects from seizure attacks. Here some of the chalcones and chalcone based various pyrazolines were evaluated for anticonvulsant activity. Their structures have been elucidated on the basis of elemental analyses and spectroscopic studies (IR, 1H-NMR & Mass spectroscopy. A preliminary evaluation of the prepared compounds has indicated that some of them exhibit moderate to significant anticonvulsant activity compared to a diazepam standard1-3.  All compounds were tested for their anticonvulsant activity using maximal electroshock induced convulsions (MES in mice at a dose level of 4 mg/kg.b.w. The compounds  Ph1, Ph2 , Py2 ,Py3 and Py4 have shown  to  good anticonvulsant activity when doses are administered as 25mg/ kg.b.w  , reduced the phases of seizures severity and  found to be active and also  increased survival rate. Remaining compounds are less efficacious.

  1. APPLICATION OF SINGLE PHOTON EMMISSION COMPUTED TOMOGRAPHY TO CLINICAL STUDY ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE IN TREATMENT OF CHILD CEREBRAL PARALYSIS

    于海波; 鞠琰莉; 贾少微

    2001-01-01

    Subjective: To identify the practicability and clinical values of acupuncture in the treatment of child cerebral paralysis, try to provide visualized evidence and mechanisms for acupuncture treatment of this disease. Methods: 13 cerebral palsy children including 9 cases of spasmodic type, 2 cases of ataxia type and 2 cases of mixed type, 9 males and 4 females were subjected into this study. Acupoints used were Hegu (LI 4), Quchi (LI 11 ), Zusanli (ST 36) and Sanyinjiao (SP 6) that were punctured and stimulated electrically with parameters of frequency 2/15 Hz, electric current 5 mA, and duration of stimulation 30 min. Under monitoring of Siemens ECAM/ICON SPECT System, blood flow volumes of different brain regions were observed before, during and after elctroacupuncture (EA) stimulation of the above-mentioned acupoints. Results: SPECT revealed that in these 13 infantile patients, 18 regions of the brain in-cluding 12 in the frontal lobe and 6 in the temporal lobe presented insufficiency of blood perfusion and hypofunction; during EA, these cerebral regions and parietal lobe, visual cortex, thalamus, basal ganglion and cerebellum showed improvement in blood perfusion and function in different degrees. Results of the quantitative analysis on blood flow function changing rate (BFCR)% showed a significant increase in 83.3 % of the focal regions during EA. Conclusion: Acupuncture therapy can effectively improve cerebral blood perfusion of the focus and is of clinical value in treatment of infantile cerebral paralysis.

  2. The expression of calpain-I in cerebral vasospasm:a preliminary investigation in experimental rabbits

    Objective: To investigate the expression of calpain-I in rabbit model with cerebral vasospasm and to discuss the clinical significance of calpain-I in cerebral vasospasm. Methods: Twenty-five healthy New Zealand white rabbits were randomly divided into two groups: normal control group (n = 5) and subarachnoid hemorrhage (SAH) group (n = 20). The subarachnoid hemorrhage was created by endovascular punctures. The SAH group, according to the time of sacrifice, was randomly and equally subdivided into 12-hour, 1-day, 3-day, and 7-day subgroups with 5 rabbits in each group. The expressions of calpain-I of the smooth muscles of basilar arteries in both groups were determined by means of immunohistochemistry technique, and the semi-quantitative analysis of calpain-I was evaluated by histochemistry score. Results: The expression of calpain-I was slightly elevated at 12 hours after SAH, it reached to its peak at the third day, and then declined on the seventh day. The semi-quantitative analysis of calpain-I showed that the difference in the expression of calpain-I between two groups was of statistic significance (P < 0.01). Conclusion: After subarachnoid hemorrhage, the expression of calpain-I in the spasmodic smooth muscles of basilar artery is enhanced, and the changes of the expression level is early, gradual and continuous. Most probably, the calpain-I participates in the process of vessel wall structural signal transduction change in cerebral vasospasm. (authors)

  3. Remote Effects of Local Injection of Botulinum Toxin Type A

    Wan Xinhua; Tang Xiaofu; Cui Liying

    2000-01-01

    Objective To assess the seventy and temporal profile of remote effects of botulinum toin type A, BTX-A (Botox from Allergan Inc.,USA and CBTX-A made by Lanzhou Biological Products Institute, China ) injected locally on neuromuscular transmission. Background Recently the local injection of BTX-A has been accepted as a breakthrough in the treatment of a variety of spasmodic disorders, and remote effects of BTX-A on the neuromuscular transmission are concemed. Methods Fourty patients who had enrolled in a prospective open study with Botox or CBTX-A for their movement disorders were studied, 18 cases with Botox and 22 cases with CBTX-A. SFEMG in the extensor digitorum communis muscle or tibialis anterior muscle was performed before and 2-3weeks, 5-8weeks, 4-5 months after injection of Botox or CBTX-A, totally 119 times. Results The significant increase of jitter was demonstrated 2-3weeks after injections in both groups and MCD was in direct proportion to dose of injections.Fiber density value increased at the same time or later and still existed until 4-5 months after injections. Conclusion There are subclinical effects on neuromuscular transmission of remote uninjected muscles after injections of Botox and CBTX A, which indicates that the toxin spread remotely from the site of injection.

  4. The physical, social and emotional aspects are the most affected in the quality of life of the patients with cervical dystonia

    Roberta Weber Werle

    2014-06-01

    Full Text Available Objective : Describe the functional, clinical and quality of life (QoL profiles in patients with cervical dystonia (CD with residual effect or without effect of botulinum toxin (BTX, as well as verify the existence of correlation between the level of motor impairment, pain and QoL. Method : Seventy patients were assessed through the Craniocervical dystonia questionnaire-24 (CDQ-24 and the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS. Results : The greater the disability, pain and severity of dystonia, the worse the QoL (p<0.0001. Greater severity relates to greater disability (p<0.0001. Pain was present in 84% of the sample, being source of disability in 41%. The most frequent complaints were: difficulty in keeping up with professional and personal demands (74.3%, feeling uneasy in public (72.9%, hindered by pain (68.6%, depressed, annoyed or bitter (47.1%, lonely or isolated (32.9%. Conclusion : The physical, social and emotional aspects are the most affected in the QoL of these patients.

  5. Clinical Applications of Successive Spot Radiographs in Esophagography for Diagnosing the Early Esophageal Cancer

    TANGLi-jun; KONGFan-fu; WANGDe-hang

    2004-01-01

    To introduce primary experience of clinical applications of successive spot radiographs in esophagography for the din mlosis of early esoplmgeal cancer (EEC). Methods: Six patients with EEC were examined and doagnosed dlaarmsed by a digital X-ray machine. According to the routine double contrast study of esophagus, the patient gulped a barimn suspension in the upright position when the successive films were taken by 2 frmnes per second lasting for about 10 seconds. Various phases were obtained including barimn-filled views,mucosal relief views and double contrast views. Results: Functional changes and abnormal mucosal folds of esophagus were present on successive spot radiographs of esophagography in patients with EEC and those patients with EEC were confirmed by endoscopic and pathologic findings. Four patients had mild loss of distensibility, 2 patients had spasmodic contraction and 1 patient had barium retention. Thickened or interrupted folds were found in all cases.Little niches were detected in 5 of 6 patients. Conctusion: Evidence presented in barimn studies of esophagus is more comprehensive and intact for the diagnosis of EEC when successive spot radiographs are employed. Functional changes of esophagus are more evident with this approach.

  6. Topiramate-associated acute, bilateral, angle-closure glaucoma: case report

    Lucas Barasnevicius Quagliato

    2013-02-01

    Full Text Available This paper describes a topiramate induced acute bilateral angle-closure glaucoma. This rare adverse effect is an idiosyncratic reaction characterized by uveal effusion and lens forward displacement, leading to increased intraocular pressure and vision loss. We describe a 55 year-old white woman with migraine, spasmodic torticollis and essential tremor, who developed bilateral acute angle-closure glaucoma, one week after starting topiramate 25 mg/day. She was seen at the Ophthalmology Emergency Department of the Fundação João Penido Burnier (Campinas, SP, Brazil with a 4 hours history of blurry vision, ocular pain and bright flashes vision. Slit lamp examination revealed moderate conjunctival injection and corneal edema, and shallow anterior chambers. Intraocular pressure was 48 mmHg in both eyes. Fundoscopic examination findings were normal. She was treated with timolol, brimonidine, dorzolamide, pilocarpine, prednisone acetate eye drops and acetazolamide. One hour after those measures, as the intraocular pressure was 30 mmHg, she received a manitol intravenous injection and the intraocular pressure normalized. After 24 hours an iridotomy with Yag laser was performed. Topiramate was discontinued and she was totally recovered after one week.

  7. A Systematic Review of the Botanical, Phytochemical and Pharmacological Profile of Dracaena cochinchinensis, a Plant Source of the Ethnomedicine “Dragon’s Blood”

    Jia-Yi Fan

    2014-07-01

    Full Text Available “Dragon’s blood” is the name given to a deep red resin obtained from a variety of plant sources. The resin extracted from stems of Dracaena cochinchinensis is one such source of “dragon’s blood”. It has a reputation for facilitating blood circulation and dispersing blood stasis. In traditional Chinese medicine, this resinous medicine is commonly prescribed to invigorate blood circulation for the treatment of traumatic injuries, blood stasis and pain. Modern pharmacological studies have found that this resinous medicine has anti-bacterial, anti-spasmodic, anti-inflammatory, analgesic, anti-diabetic, and anti-tumor activities, while it is also known to enhance immune function, promote skin repair, stop bleeding and enhance blood circulation. Various compounds have been isolated from the plant, including loureirin A, loureirin B, loureirin C, cochinchinenin, socotrin-4'-ol, 4',7-dihydroxyflavan, 4-methylcholest-7-ene-3-ol, ethylparaben, resveratrol, and hydroxyphenol. The present review summarizes current knowledge concerning the botany, phytochemistry, pharmacological effects, toxicology studies and clinical applications of this resinous medicine as derived from D. cochinchinenesis.

  8. Paralisia de prega vocal esquerda secundária à lesão do nervo laríngeo recorrente após cirurgia de ligadura do canal arterial: relato de caso Parálisis de pliegue vocal izquierdo secundario a la lesión del nervio laríngeo recurrente después de cirugía de ligadura del canal arterial: relato de caso Paralysis of the left vocal cord secondary to left recurrent nerve lesion following surgery for ligation of the arterial canal: case report

    Marcius Vinícius M. Maranhão

    2002-07-01

    .800 g, sometida a cirugía para ligadura del canal arterial. Recibió como medicación pré-anestésica, midazolam (0,8 mg.kg-1, sesenta minutos antes de la cirugía. La inducción y la manutención de la anestesia fueron hechas con sevoflurano, alfentanil y pancuronio. La disección del canal arterial fue realizada con dificultad. En el 4º día del pós-operatorio presentó disfonia persistente. La videolarin- goscopia mostró parálisis de pliegue vocal izquierdo y pequeña abertura paramediana. CONCLUSIONES: Por su íntima relación con el canal arterial, el nervio laríngeo recurrente izquierdo puede ser lesionado, durante la cirugía correctiva, principalmente cuando existen dificultades en la disección y ligadura del canal arterial. Diferentemente de las disfonias decurrentes de la intubación y extubación traqueal, surgen más tardíamente y permanecen por largos períodos, pudiendo inclusive ser irreversibles.BACKGROUND AND OBJECTIVES: Postoperative dysphonia is commonly associated to tracheal intubation and extubation complications, but other causal factors may be involved, including surgical procedures. This article aimed at reporting a late postoperative dysphonia as a consequence of left vocal cord paralysis secondary to left recurrent laryngeal nerve injury during ductus arteriosus ligation procedure. CASE REPORT: Female patient, 6 years old, physical status ASA II, 18.8 kg, submitted to ductus arteriosus ligation. Patient was premedicated with oral midazolam (0.8 mg.kg-1 60 minutes before surgery. Anesthesia was induced and maintained with sevoflurane, alfentanil and pancuronium. The ductus arteriosus was difficult to dissect. In the 4th postoperative day, patient presented with persistent dysphonia. Videolaryngoscopy has evidenced paralysis of the left vocal cord and a small paramedian gap. CONCLUSIONS: For its close relationship with the ductus arteriosus, the left recurrent laryngeal nerve may be damaged during corrective procedures, especially when

  9. UNSTABLE INTERTROCHANTERIC FRACTURE IN ELDERLY TREATED WITH CEMENTED BIPOLAR HEMIARTHROPLASTY AND TROCHANTERIC RECONSTRUCTION

    Jagadeesh Kumar

    2015-06-01

    Full Text Available INTRODUCTION : Unstable inter - trochanteric fracture in the geriatric population is a common injury and is associated with poor bone quality, excessive collapse, loss of fixation, and cut - out of the lag screw, are the common problems of attempts to fix these fractures. Pr esent study is an attempt to evaluate the functional outcome of primary cemented bipolar hemiarthroplasty and trochanter reconstruction in these patients. MATERIALS AND METHOD S : This prospective study included 30 cases of elderly osteoporotic patients with mean age of 65.4 years who sustained comminuted inter - trochanteric femur fracture treated with cemented bipolar hemiarthroplasty& tension band wiring for greater trochanter rec onstruction. It is an essential technical step to avoid complication like abductor lurch gait. W e here describe a technique of reconstruction and fixation of greater trochanter using tension band wiring in figure of eight pattern. The patients were followe d up at six week, three month, six month and one year postoperatively and assessed using Harris Hip Score (HHS. RESULTS : The mean HHS score was was 85.6+SD 9.5 (range from 74 to 96. B y the end of one year. The main clinical measures were early post - opera tive full weight bearing, post - operative complication & functional outcome. The time to full weight bearing, the rate of post - operative complications & functional outcome was significantly better in cemented bipolar arthroplasty group . DISCUSSION : The chan ges in HHS up to six months periods are much greater which starts showing a stable trend thereafter. Fair to good scores were observed in all the patients. The purpose of its use was that while Harris Hip Score (HHS provides information on a multitude of factors. Superficial infection in 2 patients, anterior thigh pain in a patient, shortening less than 2cms in 2 patients, abductor lurch in a patient are the complications noted in post - operative period, but no patient required

  10. Excitability decreasing central motor plasticity is retained in multiple sclerosis patients

    Zeller Daniel

    2012-09-01

    Full Text Available Abstract Background Compensation of brain injury in multiple sclerosis (MS may in part work through mechanisms involving neuronal plasticity on local and interregional scales. Mechanisms limiting excessive neuronal activity may have special significance for retention and (re-acquisition of lost motor skills in brain injury. However, previous neurophysiological studies of plasticity in MS have investigated only excitability enhancing plasticity and results from neuroimaging are ambiguous. Thus, the aim of this study was to probe long-term depression-like central motor plasticity utilizing continuous theta-burst stimulation (cTBS, a non-invasive brain stimulation protocol. Because cTBS also may trigger behavioral effects through local interference with neuronal circuits, this approach also permitted investigating the functional role of the primary motor cortex (M1 in force control in patients with MS. Methods We used cTBS and force recordings to examine long-term depression-like central motor plasticity and behavioral consequences of a M1 lesion in 14 patients with stable mild-to-moderate MS (median EDSS 1.5, range 0 to 3.5 and 14 age-matched healthy controls. cTBS consisted of bursts (50 Hz of three subthreshold biphasic magnetic stimuli repeated at 5 Hz for 40 s over the hand area of the left M1. Corticospinal excitability was probed via motor-evoked potentials (MEP in the abductor pollicis brevis muscle over M1 before and after cTBS. Force production performance was assessed in an isometric right thumb abduction task by recording the number of hits into a predefined force window. Results cTBS reduced MEP amplitudes in the contralateral abductor pollicis brevis muscle to a comparable extent in control subjects (69 ± 22% of baseline amplitude, p  Conclusions Long-term depression-like plasticity remains largely intact in mild-to-moderate MS. Increasing brain injury may render the neuronal networks less responsive toward lesion

  11. Greater Hip Extension but Not Hip Abduction Explosive Strength Is Associated With Lesser Hip Adduction and Knee Valgus Motion During a Single-Leg Jump-Cut

    Cronin, Baker; Johnson, Samuel T.; Chang, Eunwook; Pollard, Christine D.; Norcross, Marc F.

    2016-01-01

    Background: The relationships between hip abductor and extensor strength and frontal plane hip and knee motions that are associated with anterior cruciate ligament injury risk are equivocal. However, previous research on these relationships has evaluated relatively low-level movement tasks and peak torque rather than a time-critical strength measure such as the rate of torque development (RTD). Hypothesis: Females with greater hip abduction and extension RTD would exhibit lesser frontal plane hip and knee motion during a single-leg jump-cutting task. Study Design: Descriptive laboratory study. Methods: Forty recreationally active females performed maximal isometric contractions and single-leg jump-cuts. From recorded torque data, hip extension and abduction RTD was calculated from torque onset to 200 ms after onset. Three-dimensional motion analysis was used to quantify frontal plane hip and knee kinematics during the movement task. For each RTD measure, jump-cut biomechanics were compared between participants in the highest (high) and lowest (low) RTD tertiles. Results: No differences in frontal plane hip and knee kinematics were identified between high and low hip abduction RTD groups. However, those in the high hip extension RTD group exhibited lower hip adduction (high, 3.8° ± 3.0°; low, 6.5° ± 3.0°; P = .019) and knee valgus (high, –2.5° ± 2.3°; low, –4.4° ± 3.2°; P = .046) displacements during the jump-cut. Conclusion: In movements such as cutting that are performed with the hip in a relatively abducted and flexed position, the ability of the gluteus medius to control hip adduction may be compromised. However, the gluteus maximus, functioning as a hip abductor, may take on a pivotal role in controlling hip adduction and knee valgus motion during these types of tasks. Clinical Relevance: Training with a specific emphasis on increasing explosive strength of the hip extensors may be a means through which to improve frontal plane hip and knee

  12. Anterior cervical discectomy with arthroplasty versus arthrodesis for single-level cervical spondylosis: a systematic review and meta-analysis.

    Aria Fallah

    Full Text Available OBJECTIVE: To estimate the effectiveness of anterior cervical discectomy with arthroplasty (ACDA compared to anterior cervical discectomy with fusion (ACDF for patient-important outcomes for single-level cervical spondylosis. DATA SOURCES: Electronic databases (MEDLINE, EMBASE, Cochrane Register for Randomized Controlled Trials, BIOSIS and LILACS, archives of spine meetings and bibliographies of relevant articles. STUDY SELECTION: We included RCTs of ACDF versus ACDA in adult patients with single-level cervical spondylosis reporting at least one of the following outcomes: functionality, neurological success, neck pain, arm pain, quality of life, surgery for adjacent level degeneration (ALD, reoperation and dysphonia/dysphagia. We used no language restrictions. We performed title and abstract screening and full text screening independently and in duplicate. DATA SYNTHESIS: We used random-effects model to pool data using mean difference (MD for continuous outcomes and relative risk (RR for dichotomous outcomes. We used GRADE to evaluate the quality of evidence for each outcome. RESULTS: Of 2804 citations, 9 articles reporting on 9 trials (1778 participants were eligible. ACDA is associated with a clinically significant lower incidence of neurologic failure (RR = 0.53, 95% CI = 0.37-0.75, p = 0.0004 and improvement in the Neck pain visual analogue scale (VAS (MD = 6.56, 95% CI = 3.22-9.90, p = 0.0001; Minimal clinically important difference (MCID = 2.5. ACDA is associated with a statistically but not clinically significant improvement in Arm pain VAS and SF-36 physical component summary. ACDA is associated with non-statistically significant higher improvement in the Neck Disability Index Score and lower incidence of ALD requiring surgery, reoperation, and dysphagia/dysphonia. CONCLUSIONS: There is no strong evidence to support the routine use of ACDA over ACDF in single-level cervical spondylosis. Current trials lack long-term data required to

  13. Occupational voice demands and their impact on the call-centre industry

    Duffy OM

    2009-04-01

    Full Text Available Abstract Background Within the last decade there has been a growth in the call-centre industry in the UK, with a growing awareness of the voice as an important tool for successful communication. Occupational voice problems such as occupational dysphonia, in a business which relies on healthy, effective voice as the primary professional communication tool, may threaten working ability and occupational health and safety of workers. While previous studies of telephone call-agents have reported a range of voice symptoms and functional vocal health problems, there have been no studies investigating the use and impact of vocal performance in the communication industry within the UK. This study aims to address a significant gap in the evidence-base of occupational health and safety research. The objectives of the study are: 1. to investigate the work context and vocal communication demands for call-agents; 2. to evaluate call-agents' vocal health, awareness and performance; and 3. to identify key risks and training needs for employees and employers within call-centres. Methods and design This is an occupational epidemiological study, which plans to recruit call-centres throughout the UK and Ireland. Data collection will consist of three components: 1. interviews with managers from each participating call-centre to assess their communication and training needs; 2. an online biopsychosocial questionnaire will be administered to investigate the work environment and vocal demands of call-agents; and 3. voice acoustic measurements of a random sample of participants using the Multi-dimensional Voice Program (MDVP. Qualitative content analysis from the interviews will identify underlying themes and issues. A multivariate analysis approach will be adopted using Structural Equation Modelling (SEM, to develop voice measurement models in determining the construct validity of potential factors contributing to occupational dysphonia. Quantitative data will be

  14. Step-by-step synchronous variations of planetary natural processes in 1997-1998 and their uniform mechanism: phenomenon of "galloping of the core"

    Barkin, Yu. V.

    2009-04-01

    "For an explanation of observably step-by-step variations of geodynamic and geophysical processes the mechanism of sharp sporadic relative displacements of the core and the mantle and deformations of the mantle in the certain periods of time (the phenomenon of "galloping of the core") is offered. Apparently, this mechanism results in spasmodic variations of axial rotation of the Earth, causes gallop in value of a phase of Chandler motion of a pole, to sharp changes of the intense condition in zones of catastrophes" ([1], p. 61). According to geodynamic model the step changes first of all should to be observed in motion of a geocenter as it reflects relative displacement of the centers of mass of the core and the mantle [1]. A gallop of natural processes in northern and southern hemispheres is characterized by the certain asymmetry. In result the step changes are tested by trend components of secular changes of parameters. In another words and activity (intensity) and trends of its secular changes test synchronous certain steps. Geocenter. According to observation data of DORIS spasmodic changes of polar rotation of a geocenter in a projection to an equatorial coordinate plane in 1997-1999 are revealed. On data DORIS in values of polar coordinate of a geocenter were observed gallop up to 20-30 cm. Changes of trend components have tested gallop which can be estimated in -2 mm in coordinate x, -5 mm in coordinate y and in -10 mm in coordinate z. Trajectory of a geocenter. A bend of a trajectory of long - periodic trend "trace" of a geocenter (its epicentre) on a surface of the Earth in 1997-1998 has been discovered (Zotov, Barkin, Lyubushin, 2008). It serves as direct confirmation of the assumption about a fundamental role of interaction and the forced relative displacements of the basic shells of the Earth, first of all the core and the mantle, both their stimulating and directing role in all planetary processes (Barkin, 2002). Gravitational field. On the data of

  15. Recurrent CSPs after Transcranial Magnetic Stimulation of Motor Cortex in Restless Legs Syndrome

    Aulikki Ahlgrén-Rimpiläinen

    2012-01-01

    Full Text Available Aims. The aim of this study was to investigate the motor control and central silent period (CSP in restless legs syndrome (RLS. Methods. Transcranial magnetic stimulation was focused on the dominant and nondominant hemispheric areas of motor cortex in six subjects with RLS and six controls. The responses were recorded on the contralateral abductor digiti minimi (ADM and tibialis anterior (TA muscles with intramuscular needle electrodes. Results. No significant differences were found in the motor conduction or central motor conduction time, in the latency, or in the duration of the CSPs between or within the groups, but multiple CSPs were observed in both groups. The number of the CSPs was significantly higher in both ADMs and in the dominant TA (P≤0.01 in the RLS group compared to the controls. Conclusion. Descending motor pathways functioned correctly in both groups. The occurrence of the recurrent CSPs predominantly in the RLS group could be a sign of a change of function in the inhibitory control system. Further research is needed to clarify the role of the intramuscular recording technique and especially the role of the subcortical generators in the feedback regulation of the central nervous system in RLS.

  16. Development of a portable anchored dynamometer for collection of maximal voluntary isometric contractions in biomechanics research on dancers.

    Krasnow, Donna; Ambegaonkar, Jatin P; Stecyk, Shane; Wilmerding, M Virginia; Wyon, Matthew; Koutedakis, Yiannis

    2011-12-01

    Surface electromyography (sEMG) has been used in dance medicine research since the 1970s, but normalization procedures are not consistently employed in the field. The purpose of this project was to develop a portable anchored dynamometer (PAD) specifically for dance-related research. Due to the limited studies in the dance research literature using normalization procedures for sEMG data, a review of the procedures used in the exercise science literature was conducted. A portable anchored dynamometer was then developed and tested with dancers, using methods validated in previous literature. We collected sEMG maximum voluntary isometric contractions (MVIC, mV) from 10 female dancers (mean age 31.0 ± 15 yrs, mean height 163 ± 7.6 cm, mean weight 57.6 ± 6.9 kg, and 17.0 ± 13.9 yrs of training in ballet and/or modern dance) over three trials (5 sec each) for eight muscles bilaterally (quadriceps, tibialis anterior, abductor hallucis, gastrocnemius, hamstrings, gluteus maximus, erector spinae, and rectus abdominus). Consistency of data and feedback from dancers suggest that this dance-specific portable anchored dynamometer is effective for future sEMG studies in dance research. PMID:22211194

  17. Can explicit visual feedback of postural sway efface the effects of sensory manipulations on mediolateral balance performance?

    Cofré Lizama, L Eduardo; Pijnappels, Mirjam; Reeves, N Peter; Verschueren, Sabine M P; van Dieën, Jaap H

    2016-02-01

    Explicit visual feedback on postural sway is often used in balance assessment and training. However, up-weighting of visual information may mask impairments of other sensory systems. We therefore aimed to determine whether the effects of somatosensory, vestibular, and proprioceptive manipulations on mediolateral balance are reduced by explicit visual feedback on mediolateral sway of the body center of mass and by the presence of visual information. We manipulated sensory inputs of the somatosensory system by transcutaneous electric nerve stimulation on the feet soles (TENS) of the vestibular system by galvanic vestibular stimulation (GVS) and of the proprioceptive system by muscle-tendon vibration (VMS) of hip abductors. The effects of these manipulations on mediolateral sway were compared with a control condition without manipulation under three visual conditions: explicit feedback of sway of the body center of mass (FB), eyes open (EO), and eyes closed (EC). Mediolateral sway was quantified as the sum of energies in the power spectrum and as the energy at the dominant frequencies in each of the manipulation signals. Repeated-measures ANOVAs were used to test effects of each of the sensory manipulations, of visual conditions and their interaction. Overall, sensory manipulations increased body sway compared with the control conditions. Absence of normal visual information had no effect on sway, while explicit feedback reduced sway. Furthermore, interactions of visual information and sensory manipulation were found at specific dominant frequencies for GVS and VMS, with explicit feedback reducing the effects of the manipulations but not effacing these. PMID:26631143

  18. Effect of galvanic vestibular stimulation on movement-related cortical potential.

    Lee, Jeong-Woo

    2015-06-01

    [Purpose] This study examined the effects of galvanic vestibular stimulation on motion-related cortical potential. [Subjects and Methods] Fourty healthy female adult subjects each received galvanic vestibular stimulation or sham treatment. For galvanic vestibular stimulation, the anode and cathode were applied to the right and left mastoid processes, respectively, for 10 minutes. Motion-related cortical potential was tested pre- and post-treatment. To measure motion-related cortical potential, surface electromyography signals were generated by 50 thumb abductions with electrode application on the abductor pollicis brevis of the left (i.e., non-dominant) hand. [Results] The negative slope cortical potential on the C3 area (i.e., dominant hand) and cortical negative slope and motor potential on the C4 area (i.e., non-dominant hand) showed significant interaction effects. The galvanic vestibular stimulation group showed an increased negative slope amplitude in the C3 area, and increased negative slope and motor potential amplitudes in the C4 area compared to the sham group. [Conclusion] Galvanic vestibular stimulation increases the negative slope and motor potential amplitudes of the homonymous brain cortex area, which controls hand function and motion-related cortical potential, and the negative slope amplitude of the opposite cortical area, thus activating the brain areas for hand function. PMID:26180369

  19. Thoracic limb morphology of the red panda (Ailurus fulgens evidenced by osteology and radiography

    Modesta Makungu

    2015-02-01

    Full Text Available The red panda (Ailurus fulgens is distributed primarily in the Himalayas and southern China. It is classified as a vulnerable species by the International Union for Conservation of Nature. The aim of this study was to describe the normal osteology and radiographic anatomy of the thoracic limb of the red panda. Radiography of the right thoracic limb was performed in seven captive adult red pandas. Radiographic findings were correlated with bone specimens from three adult animals. The scapula was wide craniocaudally and presented with a large area for the origin of the teres major muscle. The square-shaped major tubercle did not extend proximal to the head of the humerus. The medial epicondyle was prominent. A supracondylar foramen was present. The radial tuberosity and sesamoid bone for the abductor digiti I longus were prominent. The accessory carpal bone was directed palmarolaterally. Metacarpal bones were widely spread. The thoracic limb morphology of the red panda evidenced by osteology and radiography indicated flexibility of the thoracic limb joints and well-developed flexor and supinator muscles, which are important in arboreal quadrupedal locomotion. Knowledge gained during this study may prove useful in identifying skeletal material or remains and diagnosing musculoskeletal diseases and injuries of the thoracic limb.

  20. Basic study on the influence of inhibition induced by the magnetic stimulation on the peripheral nerve

    Sato, Aya; Torii, Tetsuya; Iwahashi, Masakuni; Iramina, Keiji

    2015-05-01

    The purpose of this study is to analyze the inhibition mechanism of magnetic stimulation on motor function. A magnetic stimulator with a flat figure-eight coil was used to stimulate the peripheral nerve of the antebrachium. The intensity of magnetic stimulation was 0.8 T, and the stimulation frequency was 1 Hz. The amplitudes of the motor-evoked potentials (MEPs) at the abductor pollicis brevis muscle and first dorsal interosseous muscle were used to evaluate the effects of magnetic stimulation. The effects of magnetic stimulation were evaluated by analyzing the MEP amplitude before and after magnetic stimulation to the primary motor cortex. The results showed that MEP amplitude after magnetic stimulation compared with before magnetic stimulation decreased. Because there were individual differences in MEP amplitude induced by magnetic stimulation, the MEP amplitude after stimulation was normalized by the amplitude of each participant before stimulation. The MEP amplitude after stimulation decreased by approximately 58% (p peripheral nerve. We suggest that the decrease in MEP amplitude found in this study was obtained via the feedback from a peripheral nerve through an afferent nerve to the brain. This study suggests that peripheral excitement by magnetic stimulation of the peripheral nerve may control the central nervous system via afferent feedback.