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Sample records for disease vocal cord

  1. Vocal Cord Paralysis

    Science.gov (United States)

    ... Viral infections. Some viral infections, such as Lyme disease, Epstein-Barr and herpes, can cause inflammation and damage directly to the nerves in the larynx. Neurological conditions. If you have certain ... disease, you may experience vocal cord paralysis. Risk factors ...

  2. Vocal cord dysfunction in children.

    Science.gov (United States)

    Noyes, Blakeslee E; Kemp, James S

    2007-06-01

    Vocal cord dysfunction is characterised by paradoxical vocal cord adduction that occurs during inspiration, resulting in symptoms of dyspnoea, wheeze, chest or throat tightness and cough. Although the condition is well described in children and adults, confusion with asthma often triggers the use of an aggressive treatment regimen directed against asthma. The laryngoscopic demonstration of vocal cord adduction during inspiration has been considered the gold standard for the diagnosis of vocal cord dysfunction, but historical factors and pulmonary function findings may provide adequate clues to the correct diagnosis. Speech therapy, and in some cases psychological counselling, is often beneficial in this disorder. The natural course and prognosis of vocal cord dysfunction are still not well described in adults or children.

  3. Comorbidities in severe asthma: frequency of rhinitis, nasal polyposis, gastroesophageal reflux disease, vocal cord dysfunction and bronchiectasis

    Directory of Open Access Journals (Sweden)

    Carla Bisaccioni

    2009-01-01

    Full Text Available OBJECTIVES: Severe asthma is found in approximately 10% of patients with asthma. Some factors associated with worse asthma control include rhinitis, gastroesophageal reflux disease, vocal cord dysfunction (VCD, nasal polyposis and bronchiectasis. Therefore, we evaluated the prevalence of these illnesses in patients with severe asthma. METHODS: We conducted a retrospective analysis of data obtained from electronic medical records of patients with severe asthma between January 2006 and June 2008. Symptoms of rhinitis and gastroesophageal reflux disease were evaluated as well as intolerance to nonsteroidal anti-inflammatory drugs. We evaluated the results of esophagogastroduodenoscopy, videolaryngoscopy and CT scans of the chest in order to confirm gastroesophageal reflux disease, nasal polyposis, vocal cord dysfunction and bronchiectasis. RESULTS: We evaluated 245 patients. Rhinitis symptoms were present in 224 patients (91.4%; 18 (7.3% had intolerance to nonsteroidal anti-inflammatory drugs, and 8 (3.3% had nasal polyposis. Symptoms of gastroesophageal reflux disease were reported for 173 (70.6% patients, although the diagnosis of gastroesophageal reflux disease was confirmed based on esophagogastroduodenoscopy or laryngoscopy findings in just 58 (33.6% patients. Vocal cord dysfunction was suspected in 16 (6.5% and confirmed through laryngoscopy in 4 (1.6%. The patient records provided CT scans of the chest for 105 patients, and 26 (24.8% showed bronchiectasis. DISCUSSION: Rhinitis and gastroesophageal reflux disease were the most common comorbidities observed, in addition to bronchiectasis. Therefore, in patients with severe asthma, associated diseases should be investigated as the cause of respiratory symptoms and uncontrolled asthma.

  4. Imaging evaluation of vocal cord paralysis

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    Garcia, Marcelo de Mattos; Magalhaes, Fabiana Pizanni; Dadalto, Gabriela Bijos; Moura, Marina Vimieiro Timponi de [Axial Centro de Imagem, Belo Horizonte, MG (Brazil)], e-mail: marcelomgarcia@superig.com.br, e-mail: ce@axialmg.com.br

    2009-09-15

    Vocal cord paralysis is a common cause of hoarseness. It may be secondary to many types of lesions along the cranial nerve X pathway and its branches, particularly the laryngeal recurrent nerves. Despite the idiopathic nature of a great number of cases, imaging methods play a very significant role in the investigation of etiologic factors, such as thyroid and esophagus neoplasias with secondary invasion of the laryngeal recurrent nerves. Other conditions such as aortic and right subclavian artery aneurysms also may be found. The knowledge of local anatomy and related diseases is of great importance for the radiologist, so that he can tailor the examination properly to allow an appropriate diagnosis and therapy planning. Additionally, considering that up to 35% of patients with vocal cord paralysis are asymptomatic, the recognition of radiological findings indicative of this condition is essential for the radiologist who must warn the referring physician on the imaging findings. In the present study, the authors review the anatomy and main diseases related to vocal cord paralysis, demonstrating them through typical cases evaluated by computed tomography and magnetic resonance imaging, besides describing radiological findings of laryngeal abnormalities indicative of this condition. (author)

  5. Vocal cord paralysis due to extralaryngeal causes : evaluation with CT

    International Nuclear Information System (INIS)

    Lee, Jong Hwa; Mo, Jong Hyun; Moon, Sung Hee; Na, Dong Gyu; Byun, Hong Sik; Cho, Jae Min; Han, Boo Kyung; Son, Young Ik; Baek, Chung Whan

    1999-01-01

    To evaluate the use of CT in patients with vocal cord paralysis due to extralaryngeal causes, and to use CT for the assessment of extralaryngeal diseases causing vocal cord paralysis. We prospectively studied the results of CT in 41 patients with vocal cord paralysis in whom laryngoscopy revealed no laryngeal cause and physical examination demonstrated no definite extralaryngeal cause. The extralaryngeal cause of vocal cord palsy was determined after comprehensive clinical diagnosis. Enhanced CT scans were acquired from the skull base and continued to the level of the aorticopulmonary window. We used CT to assess the detection rate for extralaryngeal causes and to extimate the extent of extralaryngeal disease and the distribution of lesions. CT revealed that in 20 of 41 patients(49%) the extralarygeal causes of vocal paralysis were as follows : thyroid cancer(n=10), nodal disease(n=6), esophageal cancer(n=2), neurogenic tumor(n=1), aortic aneurysm(n=1). Lesions were located on the left side in 13 patients(65%), and in the tracheoesophageal groove in 15(75%). In patients with vocal cord paralysis in whom no definite lesion is seen on physical examination , CT could be a useful primary imaging method for the assessment of extralaryngeal causes

  6. [Varices of the vocal cord: report of 21 cases].

    Science.gov (United States)

    Li, Jin-rang; Sun, Jian-jun

    2006-04-01

    To study the diagnosis and treatment of varices of the vocal cord. The clinical data of 21 cases with varix of vocal cord were analyzed. All the patients presented hoarseness. There were 15 female and 6 male cases with their ages ranged from 23 to 68 years (median 44 years old). The varix was found on the right vocal cord in 12 cases, on the left vocal cord in 9 cases. Isolated varix existed on the vocal cord in 10 cases, varix with vocal cord polyps or nodules in 10 cases, varix with vocal cord paralysis in 1 case. All the patients were diagnosed under the laryngovideoscopy. The lesions appeared on the superior surface of the vocal cord. Varices manifested as abnormally dilated capillary running in the anterior to posterior direction in 6 cases, as clusters of capillary in 3 cases, as a dot or small sheet or short line of capillary in 12 cases. The varices were disappeared in 2 of 8 cases with vocal cord varices and polyps after removed the polyps. The varices of others patients had no change after following up for more than 6 months, but one patient happened hemorrhage of the contralateral vocal cord. Varices are most commonly seen in female. Laryngovideoscopy is the key in determining the vocal fold varices. Management of patients with a varix includes medical therapy, speech therapy, and occasionally surgical vaporization.

  7. Vocal cord hemangioma in an adult

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    Muzaffer Kanlıkama

    2011-03-01

    Full Text Available Hemangioma is one of the most common benign tumorsin the head and neck region. Laryngeal hemangiomasare benign vascular tumors of unknown etiology thatarise from subglottic region with stridor in infants. Thistype also known as congenital laryngeal hemangioma, isthe more common. Congenital hemangiomas occur usuallyin subglottic region and more frequent in girls. Laryngealhemangioma in adults is a very rare conditionand main symptom is hoarseness and breathing difficulties.Adult hemangiomas can be seen in different locationssuch as the epiglottis, aryepiglottic folds, arytenoidsand false and true vocal cords. They are more oftenof cavernous form and cause hoarseness. In this reportwe present an adult patient with hemangioma ofthe left vocal fold and review the literature. Diagnosticinvestigation revealed a pink-purple mass which was extendedfrom the anterior comissure to the posterior partof true vocal cord and false vocal cord, filling the ventriculeand extending to supraglottic region. Directlaryngoscopy was performed, but the lesion was not excisedbecause of its widespread extension in the larynx. JClin Exp Invest 2010; 2(1: 91-94

  8. Using image processing technology and mathematical algorithm in the automatic selection of vocal cord opening and closing images from the larynx endoscopy video.

    Science.gov (United States)

    Kuo, Chung-Feng Jeffrey; Chu, Yueng-Hsiang; Wang, Po-Chun; Lai, Chun-Yu; Chu, Wen-Lin; Leu, Yi-Shing; Wang, Hsing-Won

    2013-12-01

    The human larynx is an important organ for voice production and respiratory mechanisms. The vocal cord is approximated for voice production and open for breathing. The videolaryngoscope is widely used for vocal cord examination. At present, physicians usually diagnose vocal cord diseases by manually selecting the image of the vocal cord opening to the largest extent (abduction), thus maximally exposing the vocal cord lesion. On the other hand, the severity of diseases such as vocal palsy, atrophic vocal cord is largely dependent on the vocal cord closing to the smallest extent (adduction). Therefore, diseases can be assessed by the image of the vocal cord opening to the largest extent, and the seriousness of breathy voice is closely correlated to the gap between vocal cords when closing to the smallest extent. The aim of the study was to design an automatic vocal cord image selection system to improve the conventional selection process by physicians and enhance diagnosis efficiency. Also, due to the unwanted fuzzy images resulting from examination process caused by human factors as well as the non-vocal cord images, texture analysis is added in this study to measure image entropy to establish a screening and elimination system to effectively enhance the accuracy of selecting the image of the vocal cord closing to the smallest extent. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Asthma mimic: Case report and literature review of vocal cord nodule associated with wheezing.

    Science.gov (United States)

    Kashif, Muhammad; Singh, Tushi; Aslam, Ahsan; Khaja, Misbahuddin

    2017-01-01

    Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. Various clinical conditions can mimic asthma, such as foreign body aspiration, subglottic stenosis, congestive heart failure, diffuse panbronchiolitis, aortic arch anomalies, reactive airway dysfunction syndrome, chronic obstructive pulmonary disease, retrosternal goiter, vocal cord tumors, other airway tumors, and vocal cord dysfunction. Upper airway obstruction can be a life-threatening emergency. Here, we present the case of a 58-year-old female with recurrent hospital visits for wheezing and exacerbations of asthma, who was later found to have a vocal cord nodule confirmed to be squamous cell carcinoma, which was mimicking like asthma.

  10. Vocal cord paralysis in children.

    Science.gov (United States)

    King, Ericka F; Blumin, Joel H

    2009-12-01

    Vocal fold paralysis (VFP) is an increasingly commonly identified problem in the pediatric patient. Diagnostic and management techniques honed in adult laryngologic practice have been successfully applied to children. Iatrogenic causes, including cardiothoracic procedures, remain a common cause of unilateral VFP. Neurologic disorders predominate in the cause of bilateral VFP. Diagnosis with electromyography is currently being evaluated in children. Treatment of VFP is centered around symptomology, which is commonly divided between voice and airway concerns. Speech therapy shows promise in older children. Surgical management for unilateral VFP with injection laryngoplasty is commonly performed and well tolerated. Laryngeal reinnervation is currently being applied to the pediatric population as a permanent treatment and offers several advantages over laryngeal framework procedures. For bilateral VFP, tracheotomy is still commonly performed. Glottic dilation procedures are performed both openly and endoscopically with a high degree of success. VFP is a well recognized problem in pediatric patients with disordered voice and breathing. Some patients will spontaneously recover their laryngeal function. For those who do not, a variety of reliable techniques are available for rehabilitative treatment.

  11. Vocal cord paralysis associated with Ramsay Hunt syndrome

    DEFF Research Database (Denmark)

    Rasmussen, Eva Rye; Mey, Kristianna

    2014-01-01

    Ramsay Hunt syndrome is defined by herpes zoster oticus and peripheral facial nerve palsy which is often associated with otalgia. The syndrome is, in rare cases, associated with other cranial nerve paralyses including the vagal nerve causing unilateral vocal cord paralysis. Vocal cord paralysis...

  12. [Vocal cord functions in patients with asthma attack].

    Science.gov (United States)

    Oktay, Burcu; Selçuk, Omer Tarik; Ardiç, Sadik; Saylam, Güleser; Yüceege, Melike; Bilgin, Esra; Korkmaz, Hakan

    2009-01-01

    This study was planned to evaluate vocal cord functions and to establish underlying vocal cord dysfunctions (VCD) in patients with asthma attack. All patients admitted to emergency service of our hospital with asthma attack between February 01, 2007 and June 01, 2007 were included in the evaluation. After the evaluation, all patients regarded to have asthma attacks based on GINA 2006 guide were enrolled in the study. After first intervention, patients underwent endoscopic larynx examination for the evaluation of vocal cord functions. Twenty four (65.7%) male and 11 female (31.4%), overall 35 patients diagnosed with asthma and who did not have the history of another disease were included in the study. At endoscopic larynx examination carried out after first medical examination, at the moment of asthma attack, tongue, tongue base, epiglottis and arytenoid were observed to be within normal limits. In 9 (25.7%) patients, upper respiratory tract was hyperemic and in 2 (5.7%) odematous. One patient had nasal polyposis (p> 0.05). In the evaluation of vocal cord functions, restriction in adduction was observed in merely one patient. All other functions were normal. Rima opening width was established to be mean 8.34 + or - 0.725. VCD was deteced in none of the patients included in the study. Although we did not detect VCD in any patient, VCD should be borne in mind in cases which presents with the clinical picture of asthma and responds weakly to the treatment or in cases of unexplained shortness of breath. This may prevent many unnecessary procedures such as medication, entubation, tracheostomy and iatrogenic mortality. Further longutudial studies are required in order to shed light on the assocation of asthma with VCD.

  13. Vocal cord palsy: An uncommon presenting feature of myasthenia gravis

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    Sethi Prahlad

    2011-01-01

    Full Text Available Vocal cord palsy can have myriad causes. Unilateral vocal cord palsy is common and frequently asymptomatic. Trauma, head, neck and mediastinal tumors as well as cerebrovascular accidents have been implicated in causing unilateral vocal cord palsy. Viral neuronitis accounts for most idiopathic cases. Bilateral vocal cord palsy, on the other hand, is much less common and is a potentially life-threatening condition. Myasthenia gravis, an autoimmune disorder caused by antibodies targeting the post-synaptic acetylcholine receptor, has been infrequently implicated in its causation. We report here a case of bilateral vocal cord palsy developing in a 68-year-old man with no prior history of myasthenia gravis 2 months after he was operated on for diverticulitis of the large intestine. Delay in considering the diagnosis led to endotracheal intubation and prolonged mechanical ventilation with attendant complications. Our case adds to the existing literature implicating myasthenia gravis as an infrequent cause of bilateral vocal cord palsy. Our case is unusual as, in our patient, acute-onset respiratory distress and stridor due to bilateral vocal cord palsy was the first manifestation of a myasthenic syndrome.

  14. Differentiating vocal cord dysfunction from asthma

    Directory of Open Access Journals (Sweden)

    Fretzayas A

    2017-10-01

    Full Text Available Andrew Fretzayas,1,2 Maria Moustaki,3 Ioanna Loukou,3 Konstantinos Douros4 1Third Department of Pediatrics, Athens University Medical School, “Attikon” University Hospital, Haidari, Greece; 2Athens Medical Center, Department of Pediatrics, Marousi, Greece; 3Department of Cystic Fibrosis, “Aghia Sofia”, Children’s Hospital, Athens, Greece; 4Respiratory Unit, Third Department of Pediatrics, Athens University Medical School, “Attikon” University Hospital, Haidari, Greece Abstract: Vocal cord dysfunction (VCD-associated symptoms are not rare in pediatric patients. Dyspnea, wheezing, stridor, chest pain or tightness and throat discomfort are the most commonly encountered symptoms. They may occur either at rest or more commonly during exercise in patients with VCD, as well as in asthmatic subjects. The phase of respiration (inspiration rather than expiration, the location of the wheezing origin, the rapid resolution of symptoms, and the timing occurring in relation to exercise, when VCD is exercise induced, raise the suspicion of VCD in patients who may have been characterized as merely asthmatics and, most importantly, had not responded to the appropriate treatment. The gold standard method for the diagnosis of VCD is fiberoptic laryngoscopy, which may also identify concomitant laryngeal abnormalities other than VCD. However, as VCD is an intermittent phenomenon, the procedure should be performed while the patient is symptomatic. For this reason, challenges that induce VCD symptoms should be performed, such as exercise tests. Recently, for the evaluation of patients with exercise-induced VCD, continuous laryngoscopy during exercise (such as treadmill, bicycle ergometer, swimming was used. A definite diagnosis of VCD is of importance, especially for those patients who have been erroneously characterized as asthmatics, without adequate response to treatment. In these cases, another therapeutic approach is necessary, which will depend on

  15. [Retention cysts of the vocal cords (author's transl)].

    Science.gov (United States)

    Grundmann, E W

    1979-05-01

    Present day knowledge in laryngology maintains that the free edge of the true cord mucosa is devoid of glands so that retention cysts should not occur in this tissue. When such cysts do occur, it is difficult to define their pathogenesis. Reference is made to the author's earlier study which found a regular occurrence of mucous glands in the squamous epithelial region of the vocal cords. A retention cyst in the true cord is described histologically in the present report. The glands responsible for these cysts are believed to function by moistening the mucous membrane of the vocal cords.

  16. Medical image of the week: bilateral vocal cord paralysis

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    Van Hook CJ

    2017-08-01

    Full Text Available A 59-year-old morbidly obese woman with acute hypoxemic respiratory failure secondary to pulmonary emboli required emergency intubation. She was described by the anesthesiologist as having a difficult airway. The patient was liberated from the ventilator after two days. Following extubation she complained of hoarse voice and dyspnea. Physical exam revealed audible stridor. The upper airway was normal by CAT imaging. Flow-volume curve demonstrated marked flattening of both the inspiratory and expiratory limbs, consistent with a fixed extra-thoracic obstruction (Figure 1. Endoscopy revealed the vocal cords to be in the adducted position, with minimal movement throughout the respiratory cycle, consistent with bilateral vocal cord paralysis (Figure 2. Traumatic intubation follows thyroid surgery as the most common cause of bilateral vocal cord paralysis (1. In a minority of patients spontaneous recovery may occur. Surgical treatment options include cordotomy or tracheostomy. Nocturnal BIPAP has been used in patients who decline surgery (2.

  17. Vocal Cord Dysfunction Masquerading as Astma Like Symptoms

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    Sami Ozturk

    2007-04-01

    Full Text Available Vocal cord dysfunction (VCD is a nonorganic disorder of the larynx that involves unintentional paradoxical adduction of the vocal cords while breathing. VCD is a relatively rare condition that may mimic asthma or upper airway obstruction. VCD often coexists with asthma, and should be suspected in any patient in whom asthma treatment fails. Confirming the diagnosis involves direct visualization of abnormal vocal cord motion, and this usually only occurs during symptoms. In this report, we describe a 65-years-old male patient who has psychological problems due to a relative loss, and a military collage student who experiencing respiratory problems during vigorous exercises. [TAF Prev Med Bull 2007; 6(2.000: 148-150

  18. A fenestration approach to arytenoid adduction for unilateral vocal cord paralysis. Results of 32 cases

    International Nuclear Information System (INIS)

    Motohashi, Ray; Tokashiki, Ryoji; Hiramatsu, Hiroyuki; Nakamura, Mari; Funato, Nobutoshi; Suzuki, Mamoru

    2009-01-01

    The objective of this study was to develop and evaluate the voice outcomes of an approach to arytenoid adduction (AA) for unilateral vocal cord paralysis through fenestration of the thyroid ala. Thirty-two patients with unilateral vocal cord paralysis underwent laryngoplasty using an approach to AA performed through fenestration of the thyroid ala combined with type I thyroplasty. Thirty-two patients with unilateral vocal cord paralysis were treated between October 2004 and February 2008. In all cases, maximum phonation time (MPT) and mean airflow rate (MFR) were measured before and after the operation. The voices were analyzed using shimmer and jitter. Two surgical windows were made in the lower part of the thyroid ala. The anterior one was for typical type I thyroplasty and the posterior one was for arytenoid adduction (AA). The locations of the two windows were determined based on three-dimensional computer tomography (3DCT) data. AA was performed by muscular process through the posterior window without releasing the cricothyroid joint. The operations were performed under local anesthesia with sedation. Vocal cord medialization was confirmed endoscopically during the operation. Twenty-nine of the 32 patients achieved an MPT of over 10 s after surgery. The other 3 cases, whose MPTs were 9 s after the operation, had low breathing capacity because of lung disease and normal side vocal cord sulcus. The MFRs, which ranged from 236 to 1908 ml/s before the operation, improved to under 200 ml/s except in 3 patients, whose MFRs were 210 ml/s, 214 ml/s and 216 ml/s. Jitter and shimmer improved significantly after the operation. Perceptual evaluation using the GRBAS scale also improved significantly. Our new procedure simplified the combination of AA and type I thyroplasty because the two treatments can be performed in the same operating field, obtaining good voice improvement. Determination of the surgical approach using 3DCT and endoscopic vocal cord observation may

  19. IMRT for Image-Guided Single Vocal Cord Irradiation

    International Nuclear Information System (INIS)

    Osman, Sarah O.S.; Astreinidou, Eleftheria; Boer, Hans C.J. de; Keskin-Cambay, Fatma; Breedveld, Sebastiaan; Voet, Peter; Al-Mamgani, Abrahim; Heijmen, Ben J.M.; Levendag, Peter C.

    2012-01-01

    Purpose: We have been developing an image-guided single vocal cord irradiation technique to treat patients with stage T1a glottic carcinoma. In the present study, we compared the dose coverage to the affected vocal cord and the dose delivered to the organs at risk using conventional, intensity-modulated radiotherapy (IMRT) coplanar, and IMRT non-coplanar techniques. Methods and Materials: For 10 patients, conventional treatment plans using two laterally opposed wedged 6-MV photon beams were calculated in XiO (Elekta-CMS treatment planning system). An in-house IMRT/beam angle optimization algorithm was used to obtain the coplanar and non-coplanar optimized beam angles. Using these angles, the IMRT plans were generated in Monaco (IMRT treatment planning system, Elekta-CMS) with the implemented Monte Carlo dose calculation algorithm. The organs at risk included the contralateral vocal cord, arytenoids, swallowing muscles, carotid arteries, and spinal cord. The prescription dose was 66 Gy in 33 fractions. Results: For the conventional plans and coplanar and non-coplanar IMRT plans, the population-averaged mean dose ± standard deviation to the planning target volume was 67 ± 1 Gy. The contralateral vocal cord dose was reduced from 66 ± 1 Gy in the conventional plans to 39 ± 8 Gy and 36 ± 6 Gy in the coplanar and non-coplanar IMRT plans, respectively. IMRT consistently reduced the doses to the other organs at risk. Conclusions: Single vocal cord irradiation with IMRT resulted in good target coverage and provided significant sparing of the critical structures. This has the potential to improve the quality-of-life outcomes after RT and maintain the same local control rates.

  20. IMRT for Image-Guided Single Vocal Cord Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Osman, Sarah O.S., E-mail: s.osman@erasmusmc.nl [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Astreinidou, Eleftheria; Boer, Hans C.J. de; Keskin-Cambay, Fatma; Breedveld, Sebastiaan; Voet, Peter; Al-Mamgani, Abrahim; Heijmen, Ben J.M.; Levendag, Peter C. [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

    2012-02-01

    Purpose: We have been developing an image-guided single vocal cord irradiation technique to treat patients with stage T1a glottic carcinoma. In the present study, we compared the dose coverage to the affected vocal cord and the dose delivered to the organs at risk using conventional, intensity-modulated radiotherapy (IMRT) coplanar, and IMRT non-coplanar techniques. Methods and Materials: For 10 patients, conventional treatment plans using two laterally opposed wedged 6-MV photon beams were calculated in XiO (Elekta-CMS treatment planning system). An in-house IMRT/beam angle optimization algorithm was used to obtain the coplanar and non-coplanar optimized beam angles. Using these angles, the IMRT plans were generated in Monaco (IMRT treatment planning system, Elekta-CMS) with the implemented Monte Carlo dose calculation algorithm. The organs at risk included the contralateral vocal cord, arytenoids, swallowing muscles, carotid arteries, and spinal cord. The prescription dose was 66 Gy in 33 fractions. Results: For the conventional plans and coplanar and non-coplanar IMRT plans, the population-averaged mean dose {+-} standard deviation to the planning target volume was 67 {+-} 1 Gy. The contralateral vocal cord dose was reduced from 66 {+-} 1 Gy in the conventional plans to 39 {+-} 8 Gy and 36 {+-} 6 Gy in the coplanar and non-coplanar IMRT plans, respectively. IMRT consistently reduced the doses to the other organs at risk. Conclusions: Single vocal cord irradiation with IMRT resulted in good target coverage and provided significant sparing of the critical structures. This has the potential to improve the quality-of-life outcomes after RT and maintain the same local control rates.

  1. [Functional dysphonia and vocal cord nodules in teachers in Navarra, Spain].

    Science.gov (United States)

    Palomino Moreno, María Prado; Hoyo Rodríguez, Asier; García López, Vega; Losantos Martínez, Juan Tomás

    2013-01-01

    To describe teachers treated for dysphonia and vocal cord nodules by the public health system in Navarra (Spain), to describe associated factors and to identify the proportion of these cases registered as occupational diseases. Cases of dysphonia occurring in persons between the age of 18 and 65 years, registered between May 2010 and June 2011, and treated in a specific unit (Speech Unit) of Otorhinolaryngology Services were identified. Information on occupation, sex and clinical diagnosis was collected. For teachers, additional information was obtained on smoking habits, teaching level and prior training in speech disorders and their prevention. Cases declared as occupational diseases were identified from the official Register of Occupational Diseases of Navarra. 135 teachers (18% of all dysphonia patients in the sample) were treated for dysphonia in the Speech Unit (87% women). Being female was 3-fold higher among teachers than other occupations (crude prevalence odds ratio = 3.5; 95% confidence interval, 95%CI, 2.1-5.9). Female teachers were also 6.5 years (95%CI, 1.7-11.4) younger than male teachers. No association was found between smoking and risk of vocal cord nodules or dysphonia. Only 20% of teachers treated had received training on speech disorders and their prevention. Nine out of 83 cases of vocal cord nodules diagnosed in professional voice users were officially declared as occupational diseases; in all cases, these were teachers. Dysphonia in teachers is a frequent reason for visiting a specialty clinic. Among these professionals, women showed a higher risk of suffering from vocal cord nodules. Most cases of vocal cord nodules in our sample were not reported as occupational diseases. Copyright belongs to the Societat Catalana de Seguretat i Medicina del Treball.

  2. Vocal cord collapse during phrenic nerve-paced respiration in congenital central hypoventilation syndrome.

    Science.gov (United States)

    Domanski, Mark C; Preciado, Diego A

    2012-01-01

    Phrenic nerve pacing can be used to treat congenital central hypoventilation syndrome (CCHS). We report how the lack of normal vocal cord tone during phrenic paced respiration can result in passive vocal cord collapse and produce obstructive symptoms. We describe a case of passive vocal cord collapse during phrenic nerve paced respiration in a patient with CCHS. As far as we know, this is the first report of this etiology of airway obstruction. The patient, a 7-year-old with CCHS and normal waking vocal cord movement, continued to require nightly continuous positive airway pressure (CPAP) despite successful utilization of phrenic nerve pacers. On direct laryngoscopy, the patient's larynx was observed while the diaphragmatic pacers were sequentially engaged. No abnormal vocal cord stimulation was witnessed during engaging of either phrenic nerve stimulator. However, the lack of normal inspiratory vocal cord abduction during phrenic nerve-paced respiration resulted in vocal cord collapse and partial obstruction due to passive adduction of the vocal cords through the Bernoulli effect. Bilateral phrenic nerve stimulation resulted in more vocal cord collapse than unilateral stimulation. The lack of vocal cord abduction on inspiration presents a limit to phrenic nerve pacers.

  3. Vocal cord dysfunction related to water-damaged buildings.

    Science.gov (United States)

    Cummings, Kristin J; Fink, Jordan N; Vasudev, Monica; Piacitelli, Chris; Kreiss, Kathleen

    2013-01-01

    Vocal cord dysfunction (VCD) is the intermittent paradoxical adduction of the vocal cords during respiration, resulting in variable upper airway obstruction. Exposure to damp indoor environments is associated with adverse respiratory health outcomes, including asthma, but its role in the development of VCD is not well described. We describe the spectrum of respiratory illness in occupants of 2 water-damaged office buildings. The National Institute for Occupational Safety and Health conducted a health hazard evaluation that included interviews with managers, a maintenance officer, a remediation specialist who had evaluated the 2 buildings, employees, and consulting physicians. In addition, medical records and reports of building evaluations were reviewed. Diagnostic evaluations for VCD had been conducted at the Asthma and Allergy Center of the Medical College of Wisconsin. Two cases of VCD were temporally related to occupancy of water-damaged buildings. The patients experienced cough, chest tightness, dyspnea, wheezing, and hoarseness when in the buildings. Spirometry was normal. Methacholine challenge did not show bronchial hyperreactivity but did elicit symptoms of VCD and inspiratory flow-volume loop truncation. Direct laryngoscopy revealed vocal cord adduction during inspiration. Coworkers developed upper and lower respiratory symptoms; their diagnoses included sinusitis and asthma, consistent with recognized effects of exposure to indoor dampness. Building evaluations provided evidence of water damage and mold growth. VCD can occur with exposure to water-damaged buildings and should be considered in exposed patients with asthma-like symptoms. Published by Elsevier Inc.

  4. DYSFUNCTION OF THE VOCAL CORDS IN CHILDREN AND ADOLESCENTS. CASE REPORT

    OpenAIRE

    Navazo-Eguía AI; Arias-Tobalina H; Suárez-Muñiz E; Mata-Franco G

    2011-01-01

    INTRODUCTIONThe vocal cord dysfunction (VCD) or laryngeal asthma is characterized by paroxysmal episodes of adduction of the vocal cords during inspiration and / or expiration, leading to episodes of dyspnea and stridor.CASE REPORT A 13 year old female with a history of exercise-related asthma is admitted to Hospital with a episode of stridor and dyspnea. Pulmonary function curve showed flattening of inspiratory and expiratory curve. Fiberoptic laryngoscopy: adducion of both vocal cords duri...

  5. Vocal cord paralysis following I-131 ablation of a postthyroidectomy remnant

    International Nuclear Information System (INIS)

    Lee, T.C.; Harbert, J.C.; Dejter, S.W.; Mariner, D.R.; VanDam, J.

    1985-01-01

    Vocal cord paralysis has been reported following I-131 therapy of thyrotoxicosis and following ablation of the whole thryoid. However, this rare complication has not previously been described following I-131 ablation of a postthyroidectomy remnant. The authors report a patient who required tracheostomy for bilateral vocal cord paralysis following I-131 ablation after near-total thyroidectomy for papillary thyroid carcinoma

  6. Left Vocal Cord Paralysis Detected by PET/CT in a Case of Lung Cancer

    Directory of Open Access Journals (Sweden)

    Ali Ozan Oner

    2015-01-01

    Full Text Available We report a patient with lung cancer. The first PET/CT imaging revealed hypermetabolic mass in the left aortopulmonary region and hypermetabolic nodule in the anterior segment of the upper lobe of the left lung. After completing chemotherapy and radiotherapy against the primary mass in the left lung, the patient underwent a second PET/CT examination for evaluation of treatment response. This test demonstrated, compared with the first PET/CT, an increase in the size and metabolic activity of the primary mass in the left lung in addition to multiple, pathologic-sized, hypermetabolic metastatic lymph nodes as well as multiple metastatic sclerotic areas in bones. These findings were interpreted as progressive disease. In addition, an asymmetrical FDG uptake was noticed at the level of right vocal cord. During follow-up, a laryngoscopy was performed, which demonstrated left vocal cord paralysis with no apparent mass. Thus, we attributed the paralytic appearance of the left vocal cord to infiltration of the left recurrent laryngeal nerve by the primary mass located in the apical region of the left lung. In conclusion, the knowledge of this pitfall is important to avoid false-positive PET results.

  7. Readability and Understandability of Online Vocal Cord Paralysis Materials.

    Science.gov (United States)

    Balakrishnan, Vini; Chandy, Zachariah; Hseih, Amy; Bui, Thanh-Lan; Verma, Sunil P

    2016-03-01

    Patients use several online resources to learn about vocal cord paralysis (VCP). The objective of this study was to assess the readability and understandability of online VCP patient education materials (PEMs), with readability assessments and the Patient Education Materials Evaluation Tool (PEMAT), respectively. The relationship between readability and understandability was then analyzed. Descriptive and correlational design. Online PEMs were identified by performing a Google search with the term "vocal cord paralysis." After scientific webpages, news articles, and information for medical professionals were excluded, 29 articles from the first 50 search results were considered. Readability analysis was performed with 6 formulas. Four individuals with different educational backgrounds conducted understandability analysis with the PEMAT. Fleiss's Kappa interrater reliability analysis determined consistency among raters. Correlation between readability and understandability was determined with Pearson's correlation test. The reading level of the reviewed articles ranged from grades 9 to 17. Understandability ranged from 29% to 82%. Correlation analysis demonstrated a strong negative correlation between materials' readability and understandability (r = -0.462, P Online PEMs pertaining to VCP are written above the recommended reading levels. Overall, materials written at lower grade levels are more understandable. However, articles of identical grade levels had varying levels of understandability. The PEMAT may provide a more critical evaluation of the quality of a PEM when compared with readability formulas. Both readability and understandability should be used to evaluate PEMs. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  8. [Vocal cord paralysis associated with tracheal intubation: incidence, risk analysis, and classification of severity].

    Science.gov (United States)

    Kikura, Mutsuhito; Suzuki, Yuji; Itagaki, Taiga; Sato, Tsunehisa; Nishino, Junko

    2015-01-01

    Vocal cord paralysis after tracheal intubation is rare. It causes severe hoarseness and aspiration, and delays recovery and discharge. Arytenoid cartilage dislocation and recurrent nerve paralysis are main causes of vocal cord paralysis. Physical stimulation of the tracheal tube as well as patient and surgical characteristics also contribute. Vocal cord paralysis occurs in 1 (0.07%) of 1,500 general surgery patients and on the left side in 70% of cases. It is associated with surgery/anesthesia time (two-fold, 3-6 hours; 15-fold, over 6 hours), age (three-fold, over 50 years), and diabetes mellitus or hypertension (two-fold). Symptoms resolve in 2-3 months. In adult cardiovascular surgery, vocal cord paralysis occurs in 1 (0.7-2%) of 50-100 cardiac surgery patients and 1 (8.6-32%) of 3-10 thoracic aortic surgery patients. In pediatric cardiac surgery, vocal cord paralysis occurs in 1 (0.1-0.5%) of 200-1,000 patients. We classified the severity of vocal cord paralysis as I, severe hoarseness; II, aspiration or dysphagia; and III, bilateral vocal cord paralysis, aspiration pneumonia, or the need for tracheal re-intubation or tracheotomy. We discuss the importance of informed consent for the patient and family.

  9. Management of unilateral true vocal cord paralysis in children.

    Science.gov (United States)

    Setlur, Jennifer; Hartnick, Christopher J

    2012-12-01

    Historically, information gained from the treatment of unilateral true vocal cord paralysis (UVCP) in adults was the same used to treat children. Today, there is a growing body of literature aimed specifically at the treatment of this condition in children. It is an area of growing interest as UVCP can significantly impact a child's quality of life. Children with UVCP may present with stridor, dysphonia, aspiration, feeding difficulties, or a combination of these symptoms. Diagnosis relies on laryngoscopy, but other adjuncts such as ultrasound and laryngeal electromyography may also be helpful in making the diagnosis and forming a treatment plan. In many instances, there is effective compensation by the contralateral vocal fold, making surgical intervention unnecessary. Children who cannot compensate for a unilateral defect may suffer from significant dysphonia that can affect their quality of life because their ability to be understood may be diminished. In these patients, treatment in the form of medialization or reinnervation of the affected recurrent laryngeal nerve may be warranted. UVCP is a well recognized problem in pediatric patients with disordered voice and feeding problems. Some patients will spontaneously recover their laryngeal function. For those who do not, a variety of reliable techniques are available for rehabilitative treatment. Improved diagnostics and a growing understanding of prognosis can help guide therapy decisions along with the goals and desires of the patient and his or her family.

  10. Lymphatic vessel density in vocal cord carcinomas assessed with LYVE-1 receptor expression

    International Nuclear Information System (INIS)

    Koskinen, Walter J.; Bono, Petri; Leivo, Ilmo; Vaheri, Antti; Aaltonen, Leena-Maija; Joensuu, Heikki

    2005-01-01

    Background and purpose: Early stage vocal cord carcinomas are usually cured by radiation therapy despite the use of portals that exclude the cervical lymph nodes. We investigated whether the lymphatic vessel density (LVD) of vocal cord carcinomas differs from that of other head and neck carcinomas. Patients and methods: Deparaffinized tissue from tumors of 60 patients diagnosed with head and neck squamous cell carcinoma (HNSCC) were immunostained for LYVE-1, a novel lymphatic vessel marker. Twenty-two had vocal cord carcinoma. Tumor blood vessel density (BVD) was assessed using immunostaining for CD31. Results: Tumor overall LVD, including both intra- and peritumoral lymph vessels, was 10-fold lower than the BVD (5 counts/mm 2 vs. 52 mm -2 , respectively). A high LVD was associated with a high BVD (P=.002), but neither was associated with the tumor size. Both tumor LVD and BVD were lower in vocal cord carcinomas than in HNSCCs arising at other sites (median, 0 vs. 7 mm -2 , P=.016; and median, 36 vs. 52 mm -2 , P=.006, respectively). Only one vocal cord carcinoma was associated with a regional metastasis at the time of the diagnosis. Among the rest of the cases tumor size was a better predictor for the presence of regional metastases than tumor BVD or LVD in a logistic regression model (odds ratio 2.2, 95% CI 1.1-4.5). Conclusion: Vocal cord carcinomas have a low lymph vessel density as compared with HNSCCs arising at other sites

  11. Spinal Cord Diseases

    Science.gov (United States)

    Your spinal cord is a bundle of nerves that runs down the middle of your back. It carries signals back ... of the spine, this can also injure the spinal cord. Other spinal cord problems include Tumors Infections such ...

  12. [Left vocal cord paralysis after patent ductus arteriosus surgery].

    Science.gov (United States)

    López Sousa, M; Pérez Feal, A; Soto, A; Fraga, J M; Couce, M L

    2015-01-01

    Patent ductus arteriosus (PDA) is a common problem in preterm newborns. Left vocal cord paralysis (LVCP) can complicate surgical closure if the recurrent nerve is damaged. A retrospective case series study was conducted on preterm babies diagnosed with PDA in our unit from 1999 to 2013. Their clinical features and treatment complications were reviewed. In those patients that received surgical treatment a telephone questionnaire on the symptoms of LVCP symptoms was completed, and laryncoscopy examination offered. A total of 88 subjects diagnosed with PDA were found, of whom 13.64% (12/88) needed surgery. These patients had a lower gestational age and birth weight. They required mechanical ventilation more frequently, and they had more complications such as, diaphragmatic paralysis, bronchopulmonary dysplasia and intraventricular hemorrhage. One third (3/9) of the surgically treated patients had LVCP, and all of them had dysphonia (100% vs. 16.7%, p=.05). LVCP is a common complication of PDA surgery. Further studies are needed to determine its risk factors and its short and long-term consequences. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  13. A rare case of a sharp foreign body on the vocal cord

    Directory of Open Access Journals (Sweden)

    Khairunnisak Misron

    2017-08-01

    Full Text Available A foreign body (FB in the upper aerodigestive tract is a common clinical problem that presents as as acute emergency. Sharp FB, such as fish bone or chicken bone, commonly lodges in the tonsil, base of tongue, vallecula or pyriform fossa. Dislodgement of a FB into the laryngopharynx is very rare and specifically onto the vocal cord is extremely uncommon. This case report illustrates a rare case of a sharp FB that was dislodged into the airway and stuck on to the right vocal cord, which was removed under local anaesthesia.

  14. Long-term study on the radiotherapy of squamous cell carcinomas confined to the vocal cord

    International Nuclear Information System (INIS)

    Legner, R.

    1983-01-01

    It was the aim of this study to compare two different methods of treating carcinomas of the vocal cord, which are ultrahard X-rays or telecobalt on the one hand and radium contact irradiation on the other hand. A clear definition of the therapeutic role of these two techniques is an urgent requirement, in particular in view of the fact that the relative advantages of a radiotherapeutic management of carcinomas of the vocal cord must in each case be carefully balanced against those of surgical intervention. (orig./MG) [de

  15. Spinal cord: motor neuron diseases.

    Science.gov (United States)

    Rezania, Kourosh; Roos, Raymond P

    2013-02-01

    Spinal cord motor neuron diseases affect lower motor neurons in the ventral horn. This article focuses on the most common spinal cord motor neuron disease, amyotrophic lateral sclerosis, which also affects upper motor neurons. Also discussed are other motor neuron diseases that only affect the lower motor neurons. Despite the identification of several genes associated with familial amyotrophic lateral sclerosis, the pathogenesis of this complex disease remains elusive. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. On-line cone beam CT image guidance for vocal cord tumor targeting

    International Nuclear Information System (INIS)

    Osman, Sarah O.S.; Boer, Hans C.J. de; Astreinidou, Eleftheria; Gangsaas, Anne; Heijmen, Ben J.M.; Levendag, Peter C.

    2009-01-01

    Background and purpose: We are developing a technique for highly focused vocal cord irradiation in early glottic carcinoma to optimally treat a target volume confined to a single cord. This technique, in contrast with the conventional methods, aims at sparing the healthy vocal cord. As such a technique requires sub-mm daily targeting accuracy to be effective, we investigate the accuracy achievable with on-line kV-cone beam CT (CBCT) corrections. Materials and methods: CBCT scans were obtained in 10 early glottic cancer patients in each treatment fraction. The grey value registration available in X-ray volume imaging (XVI) software (Elekta, Synergy) was applied to a volume of interest encompassing the thyroid cartilage. After application of the thus derived corrections, residue displacements with respect to the planning CT scan were measured at clearly identifiable relevant landmarks. The intra- and inter-observer variations were also measured. Results: While before correction the systematic displacements of the vocal cords were as large as 2.4 ± 3.3 mm (cranial-caudal population mean ± SD Σ), daily CBCT registration and correction reduced these values to less than 0.2 ± 0.5 mm in all directions. Random positioning errors (SD σ) were reduced to less than 1 mm. Correcting only for translations and not for rotations did not appreciably affect this accuracy. The residue random displacements partly stem from intra-observer variations (SD = 0.2-0.6 mm). Conclusion: The use of CBCT for daily image guidance in combination with standard mask fixation reduced systematic and random set-up errors of the vocal cords to <1 mm prior to the delivery of each fraction dose. Thus, this facilitates the high targeting precision required for a single vocal cord irradiation.

  17. Gastroesophageal reflux disease and vocal disturbances

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Coelho de Arruda Henry

    2011-06-01

    Full Text Available CONTEXT: Gastroesophageal reflux disease is a chronic disease in which gastroduodenal contents reflux into the esophagus. The clinical picture of gastroesophageal reflux disease is usually composed by heartburn and regurgitation (typical manifestations. Atypical manifestations (vocal disturbances and asthma may also be complaint. OBJECTIVE: To analyse the clinical, endoscopic, manometric and pHmetric aspects of patients suffering from gastroesophageal reflux disease associated with vocal disturbances. METHODS: Fifty patients with gastroesophageal reflux disease were studied, including 25 with vocal disturbances (group 1 - G1 and 25 without these symptoms (group 2 - G2. All patients were submitted to endoscopy, manometry and esophageal pHmetry (2 probes. The group 1 patients were submitted to videolaryngoscopy. RESULTS: Endoscopic findings: non-erosive reflux disease was observed in 95% of G1 patients and 88% of G2. Videolaryngoscopy: vocal fold congestion, asymmetry, nodules and polyps were observed in G1 patients. Manometric findings: pressure in the lower esophageal sphincter (mm Hg: 11.6 ± 5.2 in G1 and 14.0 ± 6.2 in G2 (P = 0.14; pressure in the upper esophageal sphincter (mm Hg: 58.4 ± 15.9 in G1 and 69.5 ± 30.7 in the controls. pHmetric findings: De Meester index: 34.0 ± 20.9 in G1 and 15.4 ± 9.4 in G2 (P<0.001; number of reflux episodes in distal probe: 43.0 ± 20.4 in G1 and 26.4 ± 17.2 in G2 (P = 0.003; percentage of time with esophageal pH value lower than 4 units (distal sensor: 9.0% ± 6.4% in G1 and 3.4% ± 2.1% in G2 (P<0.001; number of reflux episodes in proximal probe: 7.5 ± 10.9 in G1 and 5.3 ± 5.7 in G2 (P = 0.38; percentage of time with esophageal pH values lower than 4 units (Proximal probe: 1.2 ± 2.7 in G1 and 0.5 ± 0.7 in G2 (P = 0.21. CONCLUSIONS: 1 The clinical, endoscopic, and manometric findings observed in patients with vocal disturbance do not differ from those without these symptoms; 2 gastroesophageal

  18. Vocal cord dysfunction diagnosis may be improved by a screening check list

    Directory of Open Access Journals (Sweden)

    Lucia Helena Eduardo Pinto

    2016-04-01

    Conclusions: A finding of wheezing or stridor on auscultation of the cervical region is suggestive of vocal cord dysfunction, especially in elderly patients, and such dysfunction can be confirmed through laryngoscopy. Our VCD screening check list proved to be useful in the screening of VCD among patients with severe asthma.

  19. Anesthetic management in a child with Arnold-Chiari malformation and bilateral vocal cord paralysis.

    NARCIS (Netherlands)

    Setz, A.C.W.; Boer, H.D. de; Driessen, J.J.; Scheffer, G.J.

    2005-01-01

    We report a case of a child who was scheduled for an emergency ventriculoperitoneal shunt procedure. The patient had a type II Arnold-Chiari malformation (ACM) and associated hydrocephalus and presented with near complete respiratory obstruction from bilateral abductor vocal cord palsy. Early

  20. Outcomes of Autologous Fat Injection Laryngoplasty in Unilateral Vocal Cord Paralysis

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    Ehsan Khadivi

    2016-05-01

    Full Text Available Introduction: Unilateral vocal cord paralysis (UVCP is not an uncommon finding. Several procedures are available to manage glottal insufficiency. We conducted a clinical trial to evaluate the outcome of fat injection laryngoplasty.   Materials and Methods: Liposuctioned lower abdomen fat was injected for augmentation of paralyzed vocal cord in 20 patients with UVCP. Autologous fat was harvested with an 18G needle and a 20-ml disposable syringe using a liposuction technique. Clinical follow-up after the injection was carried out from 1 to 6–21 months   Results: Voice and glottal protective function were significantly improved after the surgery. Vocal elements were immediately improved after the surgery, and after 1 year of follow-up. Conclusion:  Fat injection laryngoplasty by liposuction is simple, safe, effective and has a low cost for patients with UVCP with aspiration and breathy voice dysphonia.

  1. Uppföljning av logopedisk behandling för patienter med träningsinducerad vocal cord dysfunction

    OpenAIRE

    Hamberg, Lena; Karlsson, Sanna

    2014-01-01

    Abstract. Several treatment options are described for patients with vocal cord dysfunction. At Karolinska University hospital, these patients are offered treatment by speech and language pathologists. The current study describes traits and treatment effects for 148 people diagnosed with exercise-induced vocal cord dysfunction at Karolinska University hospital who received treatment by speech and language pathologists in 2005-2012. Data were collected from medical records and through a questi...

  2. The Vocal Cord Dysfunction Questionnaire: Validity and Reliability of the Persian Version.

    Science.gov (United States)

    Ghaemi, Hamide; Khoddami, Seyyedeh Maryam; Soleymani, Zahra; Zandieh, Fariborz; Jalaie, Shohreh; Ahanchian, Hamid; Khadivi, Ehsan

    2017-12-25

    The aim of this study was to develop, validate, and assess the reliability of the Persian version of Vocal Cord Dysfunction Questionnaire (VCDQ P ). The study design was cross-sectional or cultural survey. Forty-four patients with vocal fold dysfunction (VFD) and 40 healthy volunteers were recruited for the study. To assess the content validity, the prefinal questions were given to 15 experts to comment on its essential. Ten patients with VFD rated the importance of VCDQ P in detecting face validity. Eighteen of the patients with VFD completed the VCDQ 1 week later for test-retest reliability. To detect absolute reliability, standard error of measurement and smallest detected change were calculated. Concurrent validity was assessed by completing the Persian Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) by 34 patients with VFD. Discriminant validity was measured from 34 participants. The VCDQ was further validated by administering the questionnaire to 40 healthy volunteers. Validation of the VCDQ as a treatment outcome tool was conducted in 18 patients with VFD using pre- and posttreatment scores. The internal consistency was confirmed (Cronbach α = 0.78). The test-retest reliability was excellent (intraclass correlation coefficient = 0.97). The standard error of measurement and smallest detected change values were acceptable (0.39 and 1.08, respectively). There was a significant correlation between the VCDQ P and the CAT total scores (P validity was significantly different. The VCDQ scores in patients with VFD before and after treatment was significantly different (P valid and reliable self-administered questionnaire in Persian-speaking population. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  3. Relation between functional dysphagia and vocal cord palsy after transhiatal oesophagectomy.

    Science.gov (United States)

    Pierie, J P; Goedegebuure, S; Schuerman, F A; Leguit, P

    2000-03-01

    To assess the incidence, natural course, and possible pathogenesis of dysphagia that is not caused by anastomotic stricture, after transhiatal oesophagectomy and gastric tube reconstruction. Prospective study. District teaching hospital, The Netherlands. 22 patients who had transhiatal oesophagectomy and gastric tube reconstruction for cancer. Incidence of dysphagia that is not caused by anastomotic stricture one week after operation, and presence of this functional dysphagia and correlation with vocal cord palsy at 4, 8, 12, and 16 weeks postoperatively. The incidence of functional dysphagia was 7 out of 22 (32%); it was self-limiting in 5 out of 7 (71%) of the cases and associated with the incidence of vocal cord palsy (p = 0.0006). Functional dysphagia after transhiatal oesophagectomy occurs frequently, but is self-limiting in most patients. Injury to branches of the recurrent laryngeal nerve is a likely cause.

  4. The successful treatment of vocal cord dysfunction with low-dose amitriptyline – including literature review

    Directory of Open Access Journals (Sweden)

    VA Varney

    2009-11-01

    Full Text Available VA Varney1, H Parnell1, J Evans1, NT Cooke1, J Lloyd2, J Bolton31Department of Respiratory Medicine, 2Department of Speech and Language Therapy, 3Department of Liaison Psychiatry, St Helier Hospital, Carshalton, Surrey, UKAbstract: Vocal cord dysfunction is an asthma mimic. Diagnosis of this condition requires a high index of suspicion if unnecessary treatments are to be avoided. We describe the findings from our case series of 62 patients (age range 18 to 90 years in whom the diagnosis was confirmed. Our findings show low-dose amitriptyline to be very effective in 90% of cases, with rapid benefit for those patients whose symptoms had been present for less than 12 months. This treatment, in conjunction with psycho-therapeutic and behavioral therapies may reduce unnecessary hospital admissions. Future studies may show whether this treatment regimen may reduce demands on the speech and language therapists.Keywords: vocal cord dysfunction, asthma, amitriptyline, wheeze, anxiety

  5. Radiation-induced cranial nerve palsy: hypoglossal nerve and vocal cord palsies

    International Nuclear Information System (INIS)

    Takimoto, Toru; Saito, Yasuo; Suzuki, Masayuki; Nishimura, Toshirou

    1991-01-01

    Cranial nerve palsies are an unexpected complication of radiotherapy for head and neck tumours. We present a case of this radiation-induced cranial palsy. An 18-year-old female with nasopharyngeal carcinoma developed a right hypoglossal nerve palsy 42 months after cancericidal doses of radiotherapy. In addition, she developed a bilateral vocal cord palsy 62 months after the therapy. Follow-up over four years has demonstrated no evidence of tumour recurrence and no sign of neurological improvement. (author)

  6. Encapsulated sensory corpuscle in the mucosa of human vocal cord: an electron microscope study.

    Science.gov (United States)

    Nagai, T

    1982-05-01

    Encapsulated sensory corpuscles of the Krause type were found in the mucosa of surgically removed human vocal cords. The corpuscles were ellipsoidal structures of about 30 to 50 micrometers and were located beneath the free edge in the mid-region along the intermembranous part. They contained a number of varicose nerve endings and lamellar cells. The lamellar cells had thin cytoplasmic lamellae which contained numerous cytoplasmic filaments and were interposed between the nerve endings. Attachment devices were frequently noted between the cytoplasmic lamellae and between the lamellae and nerve endings. Half-desmosomes were also noted along the plasma membrane of the lamellar cells. The intercellular space was filled with amorphous electron lucent material and contained a few collagen fibrils. Ladder-like filamentous structures were frequently encountered in the intercellular space. The location of the corpuscles at the free edge of the vocal cords suggests that the endings may receive the bilateral touch of the vibrating part of the cords in order to give sensory information for the control of the movement of the cords in phonation.

  7. [Treatment of bilateral vocal cord paralysis by hemi-phrenic nerve transfer].

    Science.gov (United States)

    Song, W; Li, M; Zheng, H L; Sun, L; Chen, S C; Chen, D H; Liu, F; Zhu, M H; Zhang, C Y; Wang, W

    2017-04-07

    Objective: To investigate the surgical effect of reinnervation of bilateral posterior cricoarytenoid muscles(PCA) with left hemi-phrenic nerve and endoscopic laser arytenoid resection in bilateral vocal cord fold paralysis(BVFP) and to analyze the pros and cons of the two methods. Methods: One hundred and seventeen BVFP patients who underwent reinnervation of bilateral PCA using the left hemi-phrenic nerve approach (nerve group, n =52) or laser arytenoidectomy(laser group, n =65) were enrolled in this study from Jan.2009 to Dec.2015.Vocal perception evaluation, video stroboscopy, pulmonary function test and laryngeal electromyography were preformed in all patients both preoperatively and postoperative1y.Extubution rate was calculated postoperative1y. Results: Most of the vocal function parameters in nerve group were improved postoperatively compared with preoperative parameters, albeit without a significant difference( P >0.05), while laser group showed a significant deterioration in voice quality postoperative1y( P nerve group was larger than that in laser group ( P nerve group were inhale physiological vocal cord abductions. Postoperative glottal closure showed no significant difference in nerve group ( P >0.05), while showed various increment in laser group( P nerve group and laser group respectively. In both groups, patients presented aspiration symptoms postoperatively, and rdieved soon, except 2 patients in laser group suffered repeated aspiration. Conclusions: Reinnervation of bilateral PCA muscles using left hemi-phrenic nerve can restore inspiratory vocal fold abduction to a satisfactory extent while preserving phonatory function at the preoperative level without evident morbidity, and do not affect swallowing function, greatly improving the quality of life of the patients.

  8. [When the cause of dyspnea is on larynx. Asthma of difficult control, resistant to treatment? Vocal cords dysfunction? or Both?].

    Science.gov (United States)

    Sacre Hazouri, José Antonio

    2006-01-01

    Dyspnea is a symptom whose diagnosis requires the exclusion of other diseases with which it can be confused, such as asthma and a variety of pulmonary and heart diseases. Dyspnea originated in the larynx may occur due to obstruction by a tumor or other affections in situ, interfering the airway, such as: edema by infections or inflammatory processes, a traumatism, an abnormal movement of the larynx structures, such as the inappropriate or absent of the vocal cords or the laryngospasm. Severity of larynx dyspnea may be to mild to acute, risking the life. This paper reviews the normal laryngeal function and the anatomic, obstructive, and functional disorders that can lead to dyspnea. Some suggestions are also made to determine the cause and treat these diseases.

  9. MRI in diagnosis of spinal cord diseases

    International Nuclear Information System (INIS)

    Kobayashi, Naotoshi; Ono, Yuko; Kakinoki, Yoshio; Kimura, Humiko; Ebihara, Reiko; Nagayama, Takashi; Okada, Takaharu; Watanabe, Hiromi

    1985-01-01

    64 MRI studies of 57 cases of spinal cord diseases were reviewed, and following results were obtained. (1) MRI is usefull for screening method of spinal cord diseases, as CT in cerebral diseases. (2) MRI might replaces myelography in most of spinal cord disease, and more reliable informations might be obtained by MRI than in myelography in some cases, but (3) in detection of small organic changes, some technological problems are layed regarding to the image resolution of MRI. (author)

  10. An Unusual Case of Neuralgic Amyotrophy Presenting with Bilateral Phrenic Nerve and Vocal Cord Paresis

    Directory of Open Access Journals (Sweden)

    F. Holtbernd

    2011-02-01

    Full Text Available Background: Neuralgic amyotrophy (brachial plexus neuropathy, brachial plexus neuritis, or Parsonage-Turner syndrome is an uncommon inflammatory condition typically characterized by acute and severe shoulder pain followed by paresis with muscle weakness and atrophy of the upper limb or shoulder girdle. We report an unusual clinical manifestation of neuralgic amyotrophy, namely bilateral phrenic nerve palsy with concomitant laryngeal paresis. Case Report: A 55-year-old male presented with orthopnea and aphonia after an episode of bilateral shoulder pain preceded by an upper respiratory tract infection. Spirometry, chest X-ray and videolaryngoscopy revealed bilateral and simultaneous paresis of the diaphragm and the vocal cords. Clinical examination at admission and at the 2-month follow-up did not show upper limb weakness or atrophy, except for a mild atrophy of the right supraspinatus muscle. An electromyography of the upper limb muscles and nerve conduction studies did not reveal signs of denervation. Analysis of the cerebrospinal fluid and an MRI of the neuraxis were unremarkable. After treatment with prednisolone, vocal cord function markedly improved within 8 weeks, whereas paresis of the diaphragm persisted. Conclusion: Shoulder pain followed by diaphragmatic paralysis with dyspnea and hoarseness may be a manifestation of neuralgic amyotrophy even if upper limb or shoulder girdle palsies are absent.

  11. Primary aspergillosis of vocal cord: Long-term inhalational steroid use can be the miscreant

    Directory of Open Access Journals (Sweden)

    Arpita Saha

    2015-12-01

    Full Text Available Primary laryngeal aspergillosis is extremely rare, especially in an immunocompetent host. It is commonly found as a part of systemic infection in immunocompromised patients. A case of vocal cord aspergillosis with no systemic extension in an immunocompetent patient on long-term steroid metered dose inhaler (MDI is presented here, because of its rarity. The present case is a 28-year-old asthmatic female who was on inhalational steroid for 8 years, presented with sudden onset of severe dysphonia for 5 days. Fiberoptic laryngoscopy demonstrated whitish plaque involving right vocal cord, clinically suggestive of fungal laryngitis. Microlaryngeal laser surgery was performed with stripping of the plaque. Histopathology demonstrated ulcerated hyperplastic squamous epithelium with masses of fungal hyphae, which was confirmed to be Aspergillus species on fungal culture. This rare but serious adverse effect of long-term steroid MDI use must be kept in mind while treating an asthmatic patient. We also present a brief review of literature of laryngeal aspergillosis.

  12. A systematic review of psychological interventions for adult and pediatric patients with vocal cord dysfunction.

    Science.gov (United States)

    Guglani, Loveleen; Atkinson, Sarah; Hosanagar, Avinash; Guglani, Lokesh

    2014-01-01

    Vocal cord dysfunction (VCD) or paradoxical vocal-fold motion (PVFM) is a functional disorder of the vocal cords that requires multidisciplinary treatment. Besides relaxation techniques, the use of psychological interventions can help treat the underlying psychological co-morbidities. There is currently no literature that examines the effectiveness of psychological interventions for VCD/PVFM. To review the evidence for psychological interventions used for the treatment of patients with VCD/PVFM. We searched electronic databases for English medical literature using Pubmed (Medline), PsycInfo, Cochrane Database of Systematic Reviews, Cochrane Central Registry of Controlled Trials, and Clinicaltrials.gov. The date range for our search is from June 1964 to June 2014. We included studies that reported the use of psychological interventions in both adults and children diagnosed with VCD/PVFM. We included randomized controlled trials, case-control studies, retrospective chart reviews, prospective case series, and individual case reports. Most reported studies are small case series or individual case reports that have described the use of interventions such as psychotherapy, behavioral therapy, use of anti-anxiety and anti-depressant medications, and hypnotherapy in conjunction with breathing exercises taught by speech therapists for symptomatic relief. Among the various psychological interventions that have been reported, there is no data regarding effectiveness and/or superiority of one approach over another in either adult or pediatric patients. Psychological interventions have a role to play in the management of adult and pediatric patients with VCD/PVFM. Future prospective studies using uniform approaches for treatment of associated psychopathology may help address this question.

  13. Laser arytenoidectomy in the management of bilateral vocal cord paralysis in children.

    Science.gov (United States)

    Aubry, Karine; Leboulanger, Nicolas; Harris, Robert; Genty, Erwan; Denoyelle, Françoise; Garabedian, Erea-Noël

    2010-05-01

    To analyse the efficacy of CO(2) laser arytenoidectomy in the management of bilateral vocal cord paralysis in children. Retrospective series of 17 patients who underwent laser arytenoidectomy for bilateral vocal cord between 1995 and 2008 in a tertiary care institution. All patients had bilateral laryngeal paralysis, in isolation (n=5) or associated with concomitant airway conditions (n=12). All cases had anterior prolapse of the arytenoids with partial obstruction of the airway on inspiration. 12/17 patients (70.5%) were tracheotomy-dependant, 2/17 were in-extubatable, and 3/17 had severe airway limitation, effort dyspnea and poor sleep pattern. Main outcome measures were decannulation rate for patients with tracheotomy, occurrence of aspiration and quality of voice. The mean age was 2.8 years old. 9/12 patients with tracheotomy (75%) were decannulated with a median delay of 2 months (2 days to 18 months). Both of the intubated patients were extubated with a median delay of 36h. One of the decannulated patients who re-presented with a residual dyspnea after the arytenoidectomy was improved by a further laser cordotomy. 2/17 patients (11.7%) had post-operative persistent aspirations (with pneumopathies in one case), 5/17 patients were dysphonic, 3 improved with speech therapy and 2 with intracordal lipoinjection. Laser arytenoidectomy is effective for improving the breathing in children presenting with a bilateral vocal fold paralysis associated with obstructive arytenoid prolapse. Results are good as a first-line surgery or following laryngo-tracheal surgery. Voice outcomes are satisfactory. However, aspiration is a rare complication. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  14. A Systematic Review of Psychological Interventions for Adult and Pediatric Patients with Vocal Cord Dysfunction

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    Loveleen eGuglani

    2014-08-01

    Full Text Available Background: Vocal Cord Dysfunction (VCD or Paradoxical Vocal Fold Motion (PVFM is a functional disorder of the vocal cords that requires multidisciplinary treatment. Besides relaxation techniques, the use of psychological interventions can help treat the underlying psychological co-morbidities. There is currently no literature that examines the effectiveness of psychological interventions for VCD/PVFM. Objectives: To review the evidence for psychological interventions used for the treatment of patients with VCD/PVFM. Data Sources: We searched electronic databases for English medical literature using Pubmed (Medline, PsycInfo, Cochrane Database of Systematic Reviews, Cochrane Central Registry of Controlled Trials and Clinicaltrials.gov. The date range for our search is from July 1963 to July 2013. Study Eligibility Criteria, Participants and Interventions: We included studies that reported the use of psychological interventions in both adults and children diagnosed with VCD/PVFM. We included randomized controlled trials, case-control studies, retrospective chart reviews, prospective case series, and individual case reports. Results: Most reported studies are small case series or individual case reports that have described the use of interventions such as psychotherapy, behavioral therapy, use of anti-anxiety and anti-depressant medications, and hypnotherapy in conjunction with breathing exercises taught by speech therapists for symptomatic relief. Among the various psychological interventions that have been reported, there is no data regarding effectiveness and/or superiority of one approach over another in either adult or pediatric patients. Conclusions: Psychological interventions have a role to play in the management of adult and pediatric patients with VCD/PVFM. Future prospective studies using uniform approaches for treatment of associated psychopathology may help address this question. Systematic Review Registration Number: CRD42013004873

  15. Results of primary radiation therapy in early vocal cord cancers

    International Nuclear Information System (INIS)

    Mehta, S.A.; Sarkar, S.; Mehta, M.S.; Marfatia, P.T.; Choudhary, A.J.; Mehta, A.R.

    1991-01-01

    Results of 74 patients treated by primary radiation therapy with curative intent at the Tata Memorial Hospital between January 1980 and December 1984 are reported. Thirty three (44.6%) were classified as TlaNO, twenty five (33.8%) as TlbNO, ten (13.5%) as T2NO and six(8.1%) as TisNO. The 5-year actuarial survival was 92% and disease-free survival was 85%. Thirteen patients (17.5%) failed locally, seven (53.8%) of whom were salvaged by surgery. Radiation side-effects were minimal and there were no long term complications. Anterior commissure involvement did not affect the local recurrence rates. (author). 19 refs., 1 tabs

  16. Treatment of early and moderately advanced vocal cord carcinoma with 6-MV X-rays

    International Nuclear Information System (INIS)

    Parsons, James T.; Greene, Bruce D.; Speer, Tod W.; Kirkpatrick, Steven A.; Barhorst, D. Brad; Yanckowitz, Tina

    2001-01-01

    Purpose: Whereas there are many reports regarding treatment of early vocal cord cancer with cobalt 60 or 2-4-MV X-rays, there are still few reports on the results of treatment with 6-MV X-rays. Theoretically, 6-MV X-rays result in greater underdosage of tumor at the air-tissue interface and at the anterior commissure. This paper analyzes the results of irradiation of early and moderately advanced squamous cell carcinoma of the true vocal cord treated exclusively with 6-MV X-rays in a community hospital. The literature pertinent to the issue is reviewed. Methods and Materials: Eighty-three patients with Tis, T1, T2, or T3 squamous cell carcinoma of the true vocal cord were treated with curative intent at Bethesda Memorial Hospital in Boynton Beach, Florida between April 1986 and April 1998. The dose schedules most commonly used were 63 Gy in 28 fractions (2.25 Gy per fraction once a day) for T1 tumors or 74.40 Gy in 62 fractions (1.2 Gy per fraction twice a day) for T2 and T3 tumors. All patients have minimum 2-year follow-up; 63 (76%) have 5-year minimum follow-up. Results: Local control was achieved in 6 of 6 Tis, 53 of 54 (98%) T1, 8 of 8 T2, and 6 of 6 T3 lesions. No complications were encountered. Conclusions: A recent literature review indicates that the treatment of early vocal cord cancer with 6-MV X-rays remains controversial. The dose schedules used in the present paper produced a high rate of local control, a finding that is consistent with reports of other investigators who used dose schedules similar to those used in the present series. However, several other investigators have reported significantly lower rates of local control for T1 or T2 glottic cancer treated with 6-MV X-rays when compared to results obtained with cobalt 60 or 4 MV at their own institution. The latter institutions used lower total doses and/or lower dose per fraction than those institutions reporting high rates of local control with 6 MV. Data from the literature, as well as our

  17. Clinical evaluation of nares-vocal cord distance and its correlation with various external body parameters

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    Bhuwan Sareen

    2015-01-01

    Full Text Available Background and Aims: The optimal visualisation of vocal cords during fibreoptic intubation may be utilised for the nares-vocal cord distance (NVD estimation. The present study was conducted to measure NVD and to correlate with various external body parameters. Methods: This study was conducted on 50 males and 50 females. We measured NVD and analysed its relationship with height, nares to tragus of ear distance (NED, nares to angle of mandible distance (NMD, sternal length (SL, thyro-mental distance (TMD, sterno-mental distance (SMD and arm span (AS. Results: The mean NVD of the males was 18.5 ± 1.5 cm, and that of the females was 15.9 ± 1.1 cm. The relationship between the NVD and body height (males P = 0.001, r = 0.463, females P = 0.000, r = 0.555, SL (males P = 0.000, r = 0.463, females P < 0.000, r = 0.801 or AS (males P = 0.000, r = 0.561, females P = 0.000, r = 0.499 showed a significant correlation but NED, NMD, TMD, SMD did not. After combining male and female groups, (n = 100, the correlation of NVD with external body parameters is as follows SL (r = 0.887, height (r = 0.791, AS (r = 0.769, weight (r = 0.531, SMD (r = 0.466, NED (r = 0.459, NMD (r = 0.391, TMD (r = 0.379. Conclusion: The relationship of NVD to external body parameters had strong correlation in all parameters in the combined group; whereas when gender was taken into consideration NVD correlated significantly only with SL, height and AS.

  18. Vocal cord paralysis post patent ductus arteriosus ligation surgery: risks and co-morbidities.

    Science.gov (United States)

    Rukholm, Gavin; Farrokhyar, Forough; Reid, Diane

    2012-11-01

    1. To determine the prevalence of left vocal cord paralysis (LVCP) post patent ductus arteriosus (PDA) ligation at a Tertiary Care Centre. 2. To identify risk factors associated with LVCP. 3. To identify co-morbidities associated with LVCP. 4. To determine the frequency of pre- and post-operative nasopharyngolaryngoscopic (NPL) examination in this patient population. Retrospective chart review of all infants who underwent PDA ligation surgery at a tertiary care academic hospital between July 2003 and July 2010. Data on patient age, gender, weight, method of PDA ligation, and results of NPL scoping were collected, as well as patient co-morbidities post PDA ligation. One hundred and fifteen patients underwent PDA ligation surgery. Four patients were excluded due to bilateral vocal cord paralysis. Of the remaining 111 patients, nineteen patients (17.1%) were found to have LVCP. Low birth weight was identified as a significant risk factor for LVCP (p=0.002). Gastroesophageal reflux was identified as a significant co-morbidity associated with LVCP post PDA ligation (p=0.002). Only 0.9% of patients were scoped pre-operatively, and 27.9% were scoped postoperatively. LVCP is associated with multiple morbidities. The authors strongly recommend routine post-operative scoping of all patients post PDA ligation surgery, and preoperative scoping when possible. A prospective study is warranted, in order to confirm the prevalence of LVCP as well as risk factors and associated co-morbidities. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Inducible laryngeal obstruction during exercise: moving beyond vocal cords with new insights.

    Science.gov (United States)

    Olin, James Tod; Clary, Matthew S; Deardorff, Emily H; Johnston, Kristina; Morris, Michael J; Sokoya, Mofiyinfolu; Staudenmayer, Herman; Christopher, Kent L

    2015-02-01

    Exercise as an important part of life for the health and wellness of children and adults. Inducible laryngeal obstruction (ILO) is a consensus term used to describe a group of disorders previously called vocal cord dysfunction, paradoxical vocal fold motion, and numerous other terms. Exercise-ILO can impair one's ability to exercise, can be confused with asthma, leading to unnecessary prescription of asthma controller and rescue medication, and results in increased healthcare resource utilization including (rarely) emergency care. It is characterized by episodic shortness of breath and noisy breathing that generally occurs at high work rates. The present diagnostic gold standard for all types of ILO is laryngoscopic visualization of inappropriate glottic or supraglottic movement resulting in airway narrowing during a spontaneous event or provocation challenge. A number of different behavioral techniques, including speech therapy, biofeedback, and cognitive-behavioral psychotherapy, may be appropriate to treat individual patients. A consensus nomenclature, which will allow for better characterization of patients, coupled with new diagnostic techniques, may further define the epidemiology and etiology of ILO as well as enable objective evaluation of therapeutic modalities.

  20. Carotid-Sparing Intensity-Modulated Radiotherapy for Early-Stage Squamous Cell Carcinoma of the True Vocal Cord

    International Nuclear Information System (INIS)

    Chera, Bhishamjit S.; Amdur, Robert J.; Morris, Christopher G.; Mendenhall, William M.

    2010-01-01

    Purpose: To compare radiation doses to carotid arteries among various radiotherapy techniques for treatment of early-stage squamous cell carcinoma (SCC) of the true vocal cords. Methods and Materials: Five patients were simulated using computed tomography (CT). Clinical and planning target volumes (PTV) were created for bilateral and unilateral stage T1 vocal cord cancers. Planning risk volumes for the carotid arteries and spinal cord were delineated. For each patient, three treatment plans were designed for bilateral and unilateral target volumes: opposed laterals (LATS), three-dimensional conformal radiotherapy (3DCRT), and intensity-modulated radiotherapy (IMRT), for a total of 30 plans. More than 95% of the PTV received the prescription dose (63Gy at 2.25 Gy per treatment). Results: Carotid dose was lowest with IMRT. With a bilateral vocal cord target, the median carotid dose was 10Gy with IMRT vs. 25 Gy with 3DCRT and 38 Gy with LATS (p < 0.05); with a unilateral target, the median carotid dose was 4 Gy with IMRT vs. 19 Gy with 3DCRT and 39 Gy with LATS (p < 0.05). The dosimetric tradeoff with IMRT is a small area of high dose in the PTV. The worst heterogeneity results were at a maximum point dose of 80 Gy (127%) in a unilateral target that was close to the carotid. Conclusions: There is no question that IMRT can reduce the dose to the carotid arteries in patients with early-stage vocal cord cancer. The question is whether the potential advantage of reducing the carotid dose outweighs the risk of tumor recurrence due to contouring errors and organ motion and the risk of complications from dose heterogeneity.

  1. Hypermetabolism of compensatory laryngeal muscles in unilateral vocal cord palsy: comparison study between speech and silence with normal subjects by co-registered PET-CT fusion images

    International Nuclear Information System (INIS)

    Pai, Moon Sun; Kim, Hyon Kyong; Kim, Han Su; Chung, Sung Min

    2005-01-01

    There are a few case reports on asymmetric vocal cord uptake on FDG-PET in patients with unilateral vocal cord paralysis, which could be a potential pitfall in the interpretation of FDG-PET images. We evaluated the metabolic activity of laryngeal muscles of patients with unilateral vocal cord paralysis in comparison to normal controls during both speech and silence. Eleven patients with iatrogenic unilateral vocal cord palsy(thyroidectomy 7, lung cancer = 1, others = 3) and 12 normal controls underwent FDG-PET with usual protocol. They were divided into two groups respectively; one group read books aloud for 20 minutes (phonation group) and the other kept silence (non-phonation groups) after FDG injection. Recent neck CT scan were co-registered with FDG-PET to produce PET-CT fusion images to elaborate small laryngeal muscles. In patients with unilateral vocal cord palsy, contralateral non-paralyzed vocal cord showed increased FDG uptake, more intense with phonation group (SUV =5.88, n =5) than non-phonation group (SUV =2.33, n =6) --mainly on thyroarytenoid muscle. Normal control subjects showed symmetric mildly increased FDG uptake (SUV=1.92, n=6) only in phonation group, which was significantly low against patient groups and was localized in lateral cricoarytenoid muscle. Hypermetabolism of contralateral thyroarytenoid muscle in patients with unilateral vocal cord paralysis could be encountered during FDG-PET imaging even with keeping silence. Phonation during FDG-PET study enhance FDG uptake on different laryngeal muscles between unilateral vocal cord paralysis and normal subjects

  2. Hypermetabolism of compensatory laryngeal muscles in unilateral vocal cord palsy: comparison study between speech and silence with normal subjects by co-registered PET-CT fusion images

    International Nuclear Information System (INIS)

    Pai, Moon Sun; Kim, Hyon Kyong; Kim, Han Su

    2006-01-01

    There are a few case report on asymmetric vocal cord uptake on FDG-PET in patients with unilateral vocal cord paralysis, which could be a potential pitfall in the interpretation of FDG-PET images. We evaluated the metabolic activity of laryngeal muscles of patients with unilateral vocal cord paralysis in comparison to normal controls during both speech and silence. Eleven patients with unilateral vocal cord palsy (thyroidectomy=7, lung cancer=1, other=3) and 12 normal controls underwent FDG-PET with usual protocol. They were divided into two groups respectively; one group read books aloud for 20 minutes (phonation group) and the other kept silence (non-phonation groups) after FDG injection. Recent neck CT scan were co-registered with FDG-PET to produce PET-CT fusion images to elaborate small laryngeal muscles. In patients with unilateral vocal cord palsy, contralateral non-paralyzed vocal cord showed hypermetabolism mainly on thyroarytenoid muscle, more intensely with phonation group (SUV=5.88±2.65) than with non-phonation group (SUV=2.30±0.39). Normal control subjects showed hypermetabolism (3.68± 0.96) in interarytenoid muscle and symmetric mild hypermetabolism in both lateral cricoarytenoid muscles in only phonation group. FDG-PET with fusion images using CT scan in patients with unilateral vocal cord paralysis showed hypermetabolism of contralateral non-paralyzed thyroarytedoid muscle, suggesting compensatory action during phonation. Phonation during FDG-PET study enhanced FDG uptake on different laryngeal muscles between patients with unilateral vocal cord paralysis and normal subjects

  3. Back to the drawing board-relearn the clinical skills: A root cause analysis of a missed case of bilateral vocal cord paralysis

    Directory of Open Access Journals (Sweden)

    Suruchi Ambasta

    2016-01-01

    Full Text Available Bilateral vocal cord paralysis being misdiagnosed as bronchial asthma has been reported in the literature on several occasions. Diagnosing this condition needs precise clinical acumen which could lead us to make an integrated diagnostic and treatment plan. Here, we report another missed case of bilateral vocal cord paralysis and the root cause analysis of the incident. This report emphasises the need for appropriate clinical examinations and workup during the pre-operative assessment.

  4. Assessment of vocal cord nodules: a case study in speech processing by using Hilbert-Huang Transform

    Science.gov (United States)

    Civera, M.; Filosi, C. M.; Pugno, N. M.; Silvestrini, M.; Surace, C.; Worden, K.

    2017-05-01

    Vocal cord nodules represent a pathological condition for which the growth of unnatural masses on vocal folds affects the patients. Among other effects, changes in the vocal cords’ overall mass and stiffness alter their vibratory behaviour, thus changing the vocal emission generated by them. This causes dysphonia, i.e. abnormalities in the patients’ voice, which can be analysed and inspected via audio signals. However, the evaluation of voice condition through speech processing is not a trivial task, as standard methods based on the Fourier Transform, fail to fit the non-stationary nature of vocal signals. In this study, four audio tracks, provided by a volunteer patient, whose vocal fold nodules have been surgically removed, were analysed using a relatively new technique: the Hilbert-Huang Transform (HHT) via Empirical Mode Decomposition (EMD); specifically, by using the CEEMDAN (Complete Ensemble EMD with Adaptive Noise) algorithm. This method has been applied here to speech signals, which were recorded before removal surgery and during convalescence, to investigate specific trends. Possibilities offered by the HHT are exposed, but also some limitations of decomposing the signals into so-called intrinsic mode functions (IMFs) are highlighted. The results of these preliminary studies are intended to be a basis for the development of new viable alternatives to the softwares currently used for the analysis and evaluation of pathological voice.

  5. Assessment of vocal cord nodules: a case study in speech processing by using Hilbert-Huang Transform

    International Nuclear Information System (INIS)

    Civera, M; Surace, C; Filosi, C M; Silvestrini, M; Pugno, N M; Worden, K

    2017-01-01

    Vocal cord nodules represent a pathological condition for which the growth of unnatural masses on vocal folds affects the patients. Among other effects, changes in the vocal cords’ overall mass and stiffness alter their vibratory behaviour, thus changing the vocal emission generated by them. This causes dysphonia, i.e. abnormalities in the patients’ voice, which can be analysed and inspected via audio signals. However, the evaluation of voice condition through speech processing is not a trivial task, as standard methods based on the Fourier Transform, fail to fit the non-stationary nature of vocal signals. In this study, four audio tracks, provided by a volunteer patient, whose vocal fold nodules have been surgically removed, were analysed using a relatively new technique: the Hilbert-Huang Transform (HHT) via Empirical Mode Decomposition (EMD); specifically, by using the CEEMDAN (Complete Ensemble EMD with Adaptive Noise) algorithm. This method has been applied here to speech signals, which were recorded before removal surgery and during convalescence, to investigate specific trends. Possibilities offered by the HHT are exposed, but also some limitations of decomposing the signals into so-called intrinsic mode functions (IMFs) are highlighted. The results of these preliminary studies are intended to be a basis for the development of new viable alternatives to the softwares currently used for the analysis and evaluation of pathological voice. (paper)

  6. Apoptosis and Vocal Fold Disease: Clinically Relevant Implications of Epithelial Cell Death

    Science.gov (United States)

    Novaleski, Carolyn K.; Carter, Bruce D.; Sivasankar, M. Preeti; Ridner, Sheila H.; Dietrich, Mary S.; Rousseau, Bernard

    2017-01-01

    Purpose: Vocal fold diseases affecting the epithelium have a detrimental impact on vocal function. This review article provides an overview of apoptosis, the most commonly studied type of programmed cell death. Because apoptosis can damage epithelial cells, this article examines the implications of apoptosis on diseases affecting the vocal fold…

  7. Intraoperative Mapping and Monitoring for Rootlets of the Lower Cranial Nerves Related to Vocal Cord Movement.

    Science.gov (United States)

    Wanibuchi, Masahiko; Akiyama, Yukinori; Mikami, Takeshi; Komatsu, Katsuya; Sugino, Toshiya; Suzuki, Kengo; Kanno, Aya; Ohtaki, Shunya; Noshiro, Shouhei; Mikuni, Nobuhiro

    2016-06-01

    Damage to the motor division of the lower cranial nerves that run into the jugular foramen leads to hoarseness, dysphagia, and the risk of aspiration pneumonia; therefore, its functional preservation during surgical procedures is important. Intraoperative mapping and monitoring of the motor rootlets at the cerebellomedullary cistern using endotracheal tube electrodes is a safe and effective procedure to prevent its injury. To study the location of the somatic and autonomic motor fibers of the lower cranial nerves related to vocal cord movement. Twenty-four patients with pathologies at the cerebellopontine lesion were studied. General anesthesia was maintained with fentanyl and propofol. A monopolar stimulator was used at amplitudes of 0.05 to 0.1 mA. Both acoustic and visual signals were displayed as vocalis muscle electromyographic activity using endotracheal tube surface electrodes. The average number of rootlets was 7.4 (range, 5-10); 75% of patients had 7 or 8 rootlets. As many as 6 rootlets (2-4 in most cases) were responsive in each patient. In 23 of the 24 patients, the responding rootlets congregated on the caudal side. The maximum electromyographic response was predominantly in the most caudal or second most caudal rootlet in 79%. The majority of motor fibers of the lower cranial nerves run through the caudal part of the rootlets at the cerebellomedullary cistern, and the maximal electromyographic response was elicited at the most caudal or second most caudal rootlet. EMG, electromyographic.

  8. Diagnosis of spinal cord diseases

    International Nuclear Information System (INIS)

    Halimi, P.; Sigal, R.; Doyon, D.; David, P.

    1989-01-01

    Magnetic resonance imaging (MRI) nowadays plays a predominant role in the diagnosis and evaluation of spinal canal pathologies and has reduced the other exploratory methods, including computerized tomography (CT) and myelography, to an ancillary role. These pathologies are divided into three groups: those where MRI is the only imaging method (syringomyela, tumours in the spinal canal, phakomatoses, external pachimeningitis, spinal cord injuries, myelitis); those where MRI is the initial method and is completed by other examinations (vascular malformations, dysraphism, myelopathies due to cervical osteoarthritis) and those where MRI still play a lesser role than CT (degenerative lesions of the lumbar column) [fr

  9. Acoustic analysis after radiotherapy in T1 vocal cord carcinoma: a new approach to the analysis of voice quality

    International Nuclear Information System (INIS)

    Rovirosa, Angeles; Martinez-Celdran, Eugenio; Ortega, Alicia; Ascaso, Carlos; Abellana, Rosa; Velasco, Mercedes; Bonet, Montserrat; Herrera, Carmen; Casas, Francesc; Francisco, Rosa Maria; Arenas, Meritxell; Hernandez, Victor; Sanchez-Reyes, Alberto; Leon, Concha; Traserra, Jordi; Biete, Albert

    2000-01-01

    Purpose: The study of acoustic voice parameters (fundamental frequency, jitter, shimmer, and harmonics-to-noise ratio) in extended vowel production, oral reading of a standard paragraph, spontaneous speech and a song in irradiated patients for Tis-T1 vocal cord carcinoma. Methods and Materials: Eighteen male patients irradiated for Tis-T1 vocal cord carcinoma and a control group of 31 nonirradiated subjects of the same age were included in a study of acoustic voice analysis. The control group had been rigorously selected for voice quality and the irradiated group had previous history of smoking in two-thirds of the cases and a vocal cord biopsy. Radiotherapy patients were treated with a 6MV Linac receiving a total dose of 66 Gy, 2 Gy/day, with median treatment areas of 28 cm 2 . Acoustic voice analysis was performed 1 year after radiotherapy, the voice of patients in extended vowel production, oral reading of a standard paragraph, spontaneous speech, and in a song was tape registered and analyzed by a Kay Elemetric's Computerized Speech Lab (model CSL no. 4300). Fundamental frequency, jitter, shimmer, and harmonics-to-noise ratio were obtained in each case. Mann Whitney analysis was used for statistical tests. Results: The irradiated group presented higher values of fundamental frequency, jitter, shimmer, and harmonics-to-noise ratio. Mann-Whitney analysis showed significant differences for fundamental frequency and jitter in vowel production, oral reading, spontaneous speech, and song. Shimmer only showed differences in vowel production and harmonics-to-noise ratio in oral reading and song. Conclusions: In our study only fundamental frequency and jitter showed significant increased values to the control group in all the acoustic situations. Sustained vowel production showed the worst values of the acoustic parameters in comparison with the other acoustic situations. This study seems to suggest that more work should be done in this field

  10. Significance of upper airway influence among patients of vocal cord dysfunction for its diagnosis: Role of impulse oscillometry

    Directory of Open Access Journals (Sweden)

    Hira H

    2009-01-01

    Full Text Available Background: To identify the patients of bronchial asthma (suspected or proven, not responding to optimal therapy, for the presence of vocal cord dysfunction (VCD and to compare the diagnostic ability of flow volume (FV loop and impulse oscillometry (IOS. Materials and Methods: Fifty one patients of suspected/proven bronchial asthma not responding to optimal therapy were included for the study. Each patient was subjected to both FV loop and IOS studies. Direct visualization of the vocal cords with flexible fiberoptic bronchoscope for the presence of inspiratory vocal cord adduction during quiet respiration, with speech, and while performing provocative maneuvers was carried out. All patients were subjected to simple pulmonary function tests and recording of FV loop. IOS was performed on each patient to look for the site of obstruction and upper airway influence. The observations of both FV loop and IO studies were compared. Results: Among 51 patients participated, 12 (23.53% had bronchoscopical evidence of VCD and were labeled as VCD-positive group and rest 39 were designated VCD negative. No statistically significant difference in pulmonary function test (prereversibility results between the VCD-positive and VCD-negative patients was found. Reversible airway obstruction was observed in 75% of the patients of VCD-positive group and 67.65% of the patients in the VCD-negative group. Only one patient in the VCD-positive and none in VCD-negative group had inspiratory limb flattening of FV loop. Upper airway influence was evident by IOS in 58.3% of patients in the VCD-positive group and in 15.4% of patients in the VCD-negative group. This difference was statistically significant (P < 0.005. Conclusion: VCD was a common finding in patients with symptoms suggestive of asthma and frequently coexists with asthma. IOS was found to be a useful screening test for VCD and was more sensitive than FV loop.

  11. Composition and abundance of microbiota in the pharynx in patients with laryngeal carcinoma and vocal cord polyps.

    Science.gov (United States)

    Gong, Hongli; Wang, Boyan; Shi, Yi; Shi, Yong; Xiao, Xiyan; Cao, Pengyu; Tao, Lei; Wang, Yuezhu; Zhou, Liang

    2017-08-01

    The pharynx is an important site of microbiota colonization, but the bacterial populations at this site have been relatively unexplored by culture-independent approaches. The aim of this study was to characterize the microbiota structure of the pharynx. Pyrosequencing of 16S rRNA gene libraries was used to characterize the pharyngeal microbiota using swab samples from 68 subjects with laryngeal cancer and 28 subjects with vocal cord polyps. Overall, the major phylum was Firmicutes, with Streptococcus as the predominant genus in the pharyngeal communities. Nine core operational taxonomic units detected from Streptococcus, Fusobacterium, Prevotella, Granulicatella, and Veillonella accounted for 21.3% of the total sequences detected. However, there was no difference in bacterial communities in the pharynx from patients with laryngeal cancer and vocal cord polyps. The relative abundance of Firmicutes was inversely correlated with Fusobacteria, Proteobacteria, Actinobacteria, and Bacteroidetes. The correlation was evident at the genus level, and the relative abundance of Streptococcus was inversely associated with Fusobacterium, Leptotrichia, Neisseria, Actinomyces, and Prevotella. This study presented a profile for the overall structure of the microbiota in pharyngeal swab samples. Inverse correlations were found between Streptococcus and other bacterial communities, suggesting that potential antagonism may exist among pharyngeal microbiota.

  12. Normal width of the anterior commissure of true vocal cord in Korea adults measured by helical CT

    International Nuclear Information System (INIS)

    Lim, Woo Young; Lim, Dong Hoon; Moon, Jang Il; Ko, Yong Seok; Byeon, Joo Nam; Oh, Jae Hee

    1998-01-01

    To evaluate the mean width of anterior commissure of true vocal cord in Korean adults by measuring its dimension on spiral CT scans. We reviewed the CT scans of 53 Korean adults(age range, 23-73years; mean age 39.2 years;M:F=3D41:12) without laryngeal disorders. Soiral CT scanning was performed around the anterior commissure with 1mm slice thickness and table incrementation for 15 seconds. The anteroposterior width of the anterior commissure was measured on CT scan where the true vocal cord and arytenoid, cricoid and thyroid cartilages were all present. We determined the mean width of the anterior commissure and whether there was a relationship between age and the width of the anterior commissure. The width of the anterior commissure was between 0.9mm and 2.3mm;mean width was 1.60±0.38mm(mean±SD). Using two SDs above the mean would have defined 2.36mm as the upper limit of normal width. Statistically, no significant correlation existed between the age and the width of the anterior commissure(p>0.05). An awareuess of the normal width range of the anterior commissure in Korean adults evaluated by spiral CT enhances the possibility of early detection of invasion of the anterior commissure by glottic cancer.=20

  13. Idiopathic Parkinson's disease: vocal and quality of life analysis

    Directory of Open Access Journals (Sweden)

    Luiza Furtado e Silva

    2012-09-01

    Full Text Available OBJECTIVE: To compare voice and life quality of male patients with idiopathic Parkinson's disease, with individuals without disease (Control Group. METHODS: A cross-sectional study that evaluated the voice of individuals with Parkinson's disease, the group was composed of 27 subjects, aged from 39 to 79 years-old (average 59.96. The Control Group was matched on sex and age. Participants underwent voice recording. Perceptual evaluation was made using GRBASI scale, which considers G as the overall degree of dysphonia, R as roughness, B as breathiness, A as asthenia, S as strain and I as instability. The acoustic parameters analyzed were: fundamental frequency, jitter, shimmer, and harmonic to noise ratio (NHR. For vocal self-perception analysis, we used the Voice Related Quality of Life protocol. RESULTS: Fundamental frequency and jitter presented higher values in the Parkinson's group. NHR values were higher in the Control Group. Perceptual analysis showed a deviation ranging. The vocal disorder self-perception demonstrated a worse impact on quality of life. CONCLUSIONS: Individuals with Parkinson's disease have an altered voice quality and a negative impact on quality of life.

  14. Diagnostic and therapeutic pitfalls in benign vocal fold diseases

    Science.gov (United States)

    Bohlender, Jörg

    2013-01-01

    More than half of patients presenting with hoarseness show benign vocal fold changes. The clinician should be familiar with the anatomy, physiology and functional aspects of voice disorders and also the modern diagnostic and therapeutic possibilities in order to ensure an optimal and patient specific management. This review article focuses on the diagnostic and therapeutic limitations and difficulties of treatment of benign vocal fold tumors, the management and prevention of scarred vocal folds and the issue of unilateral vocal fold paresis. PMID:24403969

  15. Unilateral Vocal Fold Paralysis in Parkinson Disease: Case Report and Review of the Literature.

    Science.gov (United States)

    Hamdan, Abdul-Latif; Khalifee, Elie; Tabet, Georges

    2017-10-24

    The objective of this study was to report the first case of unilateral vocal fold paralysis in a patient with Parkinson disease (PD) and to review the literature. This is a case report and literature review following PubMed search using the keywords "Parkinson," "vocal fold paralysis," "vocal fold palsy," "vocal fold immobility," "vocal fold adductor palsy," "airway obstruction," and "stridor." A total of 18 subjects diagnosed with PD and vocal fold paralysis were described. In all cases, the vocal fold paralysis was bilateral and the main presenting symptoms were stridor and shortness of breath necessitating intubation and tracheostomy. This article describes the first case of PD presenting with dysphonia secondary to unilateral vocal fold paralysis (left). The management consisted of injection laryngoplasty for medialization of the paralyzed vocal fold. Patients with PD can present with unilateral vocal fold paralysis. Early treatment is advocated in view of the advent of injection laryngoplasty as a safe office procedure. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  16. Bilateral vocal cord paralysis and hypothyroidism as presenting symptoms of Williams-Beuren syndrome: a case report.

    Science.gov (United States)

    Koren, Ilana; Kessel, Ira; Rotschild, Avi; Cohen-Kerem, Raanan

    2015-09-01

    Williams-Beuren syndrome is a rare neurodevelopmental disorder caused by deletion of 1.5-1.8Mb genes on chromosome 7q11.23. The syndrome was first described as a triad of supra-valvular aortic stenosis, mental retardation, and distinctive facial features. Our patient was referred due to audible inspiratory stridor when he was seven days old. Following endoscopy he was diagnosed with bilateral vocal cord paralysis and was eventually intubated due to respiratory de-compensation followed by tracheotomy. On further workup he was diagnosed with hypothyroidism. Genetic workup supported the diagnosis of Williams-Beuren syndrome. We report here a case with an unusual clinical presentation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Transcutaneous ultrasound for evaluation of vocal fold movement in patients with thyroid disease

    International Nuclear Information System (INIS)

    Wang, Cheng-Ping; Chen, Tseng-Cheng; Yang, Tsung-Lin; Chen, Chun-Nan; Lin, Chin-Fon; Lou, Pei-Jen; Hu, Ya-Ling; Shieh, Ming-Jium; Hsieh, Fon-Jou

    2012-01-01

    Background: Preoperative evaluation of recurrent laryngeal nerve function is important in the context of thyroid surgery. Transcutaneous ultrasound may be useful to visualize vocal fold movement when evaluating thyroid disease. Methods: A 7–18 MHz linear array transducer was placed transversely on the midline of the thyroid cartilage at the anterior neck of patients with thyroid disease. The gray-scale technique was used, with the scan setting for the thyroid gland. Results: Between August 2008 and March 2010, 705 patients, including 672 patients with normal vocal fold movement and 33 patients with vocal fold paralysis were enrolled. They included 159 male and 546 female patients. Their ages ranged from 10 to 88 years. Vocal fold movement could be seen by ultrasound in 614 (87%) patients, including 589 (88%) patients with normal vocal fold movement and 25 (76%) patients with vocal fold paralysis (p = 0.06). The mean age of patients with visible and invisible vocal fold movement was 46.6 and 57.9 years old, respectively (p = 0.001). Ultrasound was able to see vocal fold movement in 533 (98%) female patients but only in 81 (51%) male patients (p = 0.001). Among the patients with vocal fold paralysis, ultrasound revealed palsied vocal folds in 17 of 18 (94%) female patients but in only 8 of 15 (53%) male patients (p = 0.01). Conclusion: Transcutaneous ultrasound represents an alternative tool to evaluate vocal fold movement for more than 85% of patients with thyroid disease, including more than 90% of female patients and about half of male patients.

  18. Dosimetric complication probability and acoustic analysis of vocal cord region in oropharyngeal carcinoma treated with voice-sparing intensity modulated radiotherapy

    International Nuclear Information System (INIS)

    Jain, S.; Gupta, T.; Agarwal, J.P.; Baccher, G.; Shrivastava, S.K.; Reenadevi; Master, J.

    2008-01-01

    Radiation to larynx has long been associated with speech and voice dysfunction. The objective is to study dosimetric parameters and complication probability of vocal cord region (VCR) and the effect of voice-sparing (VS) in the patients treated with intensity modulated radiotherapy (IMRT). The secondary objective is to describe the post-radiation acoustic voice characteristics and correlate them with the dosimetric parameters. (author)

  19. Vocal symptoms in Parkinson disease treated with levodopa. A case report.

    Science.gov (United States)

    Schley, W S; Fenton, E; Niimi, S

    1982-01-01

    This is a report of a patient with unusually severe hoarseness in the absence of vocal fold pathology demonstrating Parkinson disease as one of the neurological diseases in which vocal symptoms occur. Although it is classifiably a severe, progressive, degenerative disorder, the popularity of pharmacotherapy for Parkinson disease during the past decade has resulted in improved functionality for an undetermined course of time in most patients. The classically described deterioration of speech ad voice may develop in a variant manner difficult to distinguish as disease-related, as this case report illustrates. An explanation of the hoarseness based on dyssynchronous vocal fold motion related to the disease is suggested by the acoustic methods (spectrography, waveform analysis) used in this study, and supported by strobe light laryngoscopy. This conclusion is important because of the extremely high incidences of varying degrees of hoarseness reported in recent studies of Parkinson disease.

  20. Improvement of a Vocal Fold Imaging System

    Energy Technology Data Exchange (ETDEWEB)

    Krauter, K. G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-02-01

    Medical professionals can better serve their patients through continual update of their imaging tools. A wide range of pathologies and disease may afflict human vocal cords or, as they’re also known, vocal folds. These diseases can affect human speech hampering the ability of the patient to communicate. Vocal folds must be opened for breathing and the closed to produce speech. Currently methodologies to image markers of potential pathologies are difficult to use and often fail to detect early signs of disease. These current methodologies rely on a strobe light and slower frame rate camera in an attempt to obtain images as the vocal folds travel over the full extent of their motion.

  1. JS-X syndrome: A multiple congenital malformation with vocal cord paralysis, ear deformity, hearing loss, shoulder musculature underdevelopment, and X-linked recessive inheritance.

    Science.gov (United States)

    Hoeve, Hans L J; Brooks, Alice S; Smit, Liesbeth S

    2015-07-01

    We report on a family with a not earlier described multiple congenital malformation. Several male family members suffer from laryngeal obstruction caused by bilateral vocal cord paralysis, outer and middle ear deformity with conductive and sensorineural hearing loss, facial dysmorphisms, and underdeveloped shoulder musculature. The affected female members only have middle ear deformity and hearing loss. The pedigree is suggestive of an X-linked recessive inheritance pattern. SNP-array revealed a deletion and duplication on Xq28 in the affected family members. A possible aetiology is a neurocristopathy with most symptoms expressed in structures derived from branchial arches. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Single Vocal Cord Irradiation: Image Guided Intensity Modulated Hypofractionated Radiation Therapy for T1a Glottic Cancer: Early Clinical Results

    Energy Technology Data Exchange (ETDEWEB)

    Al-Mamgani, Abrahim, E-mail: a.almamgani@nki.nl [Department of Radiation Oncology – Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam (Netherlands); Kwa, Stefan L.S.; Tans, Lisa; Moring, Michael; Fransen, Dennie; Mehilal, Robert; Verduijn, Gerda M. [Department of Radiation Oncology – Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam (Netherlands); Baatenburg de Jong, Rob J. [Department of Otolaryngology and Head and Neck Surgery – Erasmus MC, University Medical Center Rotterdam, Rotterdam (Netherlands); Heijmen, Ben J.M.; Levendag, Peter C. [Department of Radiation Oncology – Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam (Netherlands)

    2015-10-01

    Purpose: To report, from a retrospective analysis of prospectively collected data, on the feasibility, outcome, toxicity, and voice-handicap index (VHI) of patients with T1a glottic cancer treated by a novel intensity modulated radiation therapy technique developed at our institution to treat only the involved vocal cord: single vocal cord irradiation (SVCI). Methods and Materials: Thirty patients with T1a glottic cancer were treated by means of SVCI. Dose prescription was set to 16 × 3.63 Gy (total dose 58.08 Gy). The clinical target volume was the entire vocal cord. Setup verification was done by means of an online correction protocol using cone beam computed tomography. Data for voice quality assessment were collected prospectively at baseline, end of treatment, and 4, 6, and 12 weeks and 6, 12, and 18 months after treatment using VHI questionnaires. Results: After a median follow-up of 30 months (range, 7-50 months), the 2-year local control and overall survival rates were 100% and 90% because no single local recurrence was reported and 3 patients died because of comorbidity. All patients have completed the intended treatment schedule; no treatment interruptions and no grade 3 acute toxicity were reported. Grade 2 acute dermatitis or dysphagia was reported in only 5 patients (17%). No serious late toxicity was reported; only 1 patient developed temporary grade 2 laryngeal edema, and responded to a short-course of corticosteroid. The VHI improved significantly, from 33.5 at baseline to 9.5 and 10 at 6 weeks and 18 months, respectively (P<.001). The control group, treated to the whole larynx, had comparable local control rates (92.2% vs 100%, P=.24) but more acute toxicity (66% vs 17%, P<.0001) and higher VHI scores (23.8 and 16.7 at 6 weeks and 18 months, respectively, P<.0001). Conclusion: Single vocal cord irradiation is feasible and resulted in maximal local control rate at 2 years. The deterioration in VHI scores was slight and temporary and

  3. Insights into the role of elastin in vocal fold health and disease

    Science.gov (United States)

    Moore, Jaime

    2011-01-01

    Elastic fibers are large, complex and surprisingly poorly understood extracellular matrix (ECM) macromolecules. The elastin fiber, generated from a single human gene - elastin (ELN), is a self assembling integral protein that endows critical mechanic proprieties to elastic tissues and organs such as the skin, lungs, and arteries. The biology of elastic fibers is complex because they have multiple components, a tightly regulated developmental deposition, a multi-step hierarchical assembly and unique biomechanical functions. Elastin is present in vocal folds, where it plays a pivotal role in the quality of phonation. This review article provides an overview of the genesis of elastin and its wide- ranging structure and function. Specific distribution within the vocal fold lamina propria across the lifespan in normal and pathological states and its contribution to vocal fold biomechanics will be examined. Elastin and elastin-derived molecules are increasingly investigated for their application in tissue engineering. The properties of various elastin– based materials will be discussed and their current and future applications evaluated. A new level of understanding of the biomechanical properties of vocal fold elastin composites and their molecular basis should lead to new strategies for elastic fiber repair and regeneration in aging and disease. PMID:21708449

  4. Increased vocal intensity due to the Lombard effect in speakers with Parkinson's disease: simultaneous laryngeal and respiratory strategies.

    Science.gov (United States)

    Stathopoulos, Elaine T; Huber, Jessica E; Richardson, Kelly; Kamphaus, Jennifer; DeCicco, Devan; Darling, Meghan; Fulcher, Katrina; Sussman, Joan E

    2014-01-01

    The objective of the present study was to investigate whether speakers with hypophonia, secondary to Parkinson's disease (PD), would increases their vocal intensity when speaking in a noisy environment (Lombard effect). The other objective was to examine the underlying laryngeal and respiratory strategies used to increase vocal intensity. Thirty-three participants with PD were included for study. Each participant was fitted with the SpeechVive™ device that played multi-talker babble noise into one ear during speech. Using acoustic, aerodynamic and respiratory kinematic techniques, the simultaneous laryngeal and respiratory mechanisms used to regulate vocal intensity were examined. Significant group results showed that most speakers with PD (26/33) were successful at increasing their vocal intensity when speaking in the condition of multi-talker babble noise. They were able to support their increased vocal intensity and subglottal pressure with combined strategies from both the laryngeal and respiratory mechanisms. Individual speaker analysis indicated that the particular laryngeal and respiratory interactions differed among speakers. The SpeechVive™ device elicited higher vocal intensities from patients with PD. Speakers used different combinations of laryngeal and respiratory physiologic mechanisms to increase vocal intensity, thus suggesting that disease process does not uniformly affect the speech subsystems. Readers will be able to: (1) identify speech characteristics of people with Parkinson's disease (PD), (2) identify typical respiratory strategies for increasing sound pressure level (SPL), (3) identify typical laryngeal strategies for increasing SPL, (4) define the Lombard effect. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Impairment of vocal expression of negative emotions in patients with Alzheimer's disease.

    Science.gov (United States)

    Han, Kyung-Hun; Zaytseva, Yuliya; Bao, Yan; Pöppel, Ernst; Chung, Sun Yong; Kim, Jong Woo; Kim, Hyun Taek

    2014-01-01

    Vocal expression of emotions (EE) in retrieval of events from autobiographical memory was investigated in patients in early stages of Alzheimer's disease (AD). Twenty-one AD patients and 19 controls were interviewed, and EE of the reported memories was rated by 8 independent evaluators. The AD group had lower EE of both recent and remote memory than controls, although EE in remote memories was better preserved in both groups. We observed positive correlations between EE and indicators of cognitive competence in AD patients. AD Patients are impaired in the ability to express emotions already at early stages of the disease, and EE seems to deteriorate along with the progression of cognitive impairment.

  6. Predicting onset of chronic lung disease using cord blood cytokines.

    Science.gov (United States)

    Takao, Daishi; Ibara, Satoshi; Tokuhisa, Takuya; Ishihara, Chie; Maede, Yoshinobu; Matsui, Takako; Tokumasu, Hironobu; Sato, Kyoko; Hirakawa, Eiji; Kabayama, Chika; Yamamoto, Masakatu

    2014-08-01

    Applicability of cord blood interleukin-6 (IL-6) and interleukin-8 (IL-8) as markers for early prediction of the onset of chronic lung disease (CLD) due to intrauterine infection was investigated in the present study. Eighty very low-birthweight infants with chorioamnionitis were divided into two groups: the CLD group (42 patients) and the non-CLD group (38 patients), according to the presence or absence of CLD, and the clinical background and cord blood IL-6 and IL-8 levels in each group were compared and investigated. The CLD group had significantly longer duration of mechanical ventilation and hospitalization (P CLD group. Using the receiver operating characteristic curves of CLD onset for both IL-6 and IL-8, the cut-off value of IL-6 for predicting onset of CLD was 48.0 pg/mL, and its sensitivity and specificity were 76% and 96%, respectively. The cut-off value for IL-8 was 66.0 pg/mL, and its sensitivity and specificity were 71% and 82%, respectively. The cord blood levels of both IL-6 and IL-8 were significantly higher in the CLD group, indicating that both IL-6 and IL-8 are useful predictors of onset of CLD. © 2014 Japan Pediatric Society.

  7. MRI in Lyme disease of the spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Mantienne, C.; Catalaa, I.; Sevely, A.; Cognard, C.; Manelfe, C. [Dept. of Diagnostic and Therapeutic Neuroradiology, Hopital Purpan, Toulouse (France); Albucher, J.F. [Dept. of Neurology, Hopital Purpan, Toulouse (France)

    2001-06-01

    We report a case of Lyme myelitis in a 31-year-old man, presenting with a conus medullaris syndrome. MRI demonstrated contrast enhancement on the pial surface of the lower thoracic cord and conus medullaris. Elevated blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebrospinal fluid (CSF) were found. Leptomeningitis may be the first stage of spinal infection in Lyme disease, preceding parenchymal infection leading to myelitis. Vasculitis is probably the major mechanism. MRI findings are nonspecific and the diagnosis is given by serum and CSF analyses. Early treatment with antibiotics and high doses steroids may result in complete recovery, as in this case. (orig.)

  8. MRI in Lyme disease of the spinal cord

    International Nuclear Information System (INIS)

    Mantienne, C.; Catalaa, I.; Sevely, A.; Cognard, C.; Manelfe, C.; Albucher, J.F.

    2001-01-01

    We report a case of Lyme myelitis in a 31-year-old man, presenting with a conus medullaris syndrome. MRI demonstrated contrast enhancement on the pial surface of the lower thoracic cord and conus medullaris. Elevated blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebrospinal fluid (CSF) were found. Leptomeningitis may be the first stage of spinal infection in Lyme disease, preceding parenchymal infection leading to myelitis. Vasculitis is probably the major mechanism. MRI findings are nonspecific and the diagnosis is given by serum and CSF analyses. Early treatment with antibiotics and high doses steroids may result in complete recovery, as in this case. (orig.)

  9. Role of the Internal Superior Laryngeal Nerve in the Motor Responses of Vocal Cords and the Related Voice Acoustic Changes

    Science.gov (United States)

    Seifpanahi, Sadegh; Izadi, Farzad; Jamshidi, Ali-Ashraf; Torabinezhad, Farhad; Sarrafzadeh, Javad; Mohammadi, Siavash

    2016-01-01

    Background: Repeated efforts by researchers to impose voice changes by laryngeal surface electrical stimulation (SES) have come to no avail. This present pre-experimental study employed a novel method for SES application so as to evoke the motor potential of the internal superior laryngeal nerve (ISLN) and create voice changes. Methods: Thirty-two normal individuals (22 females and 10 males) participated in this study. The subjects were selected from the students of Iran University of Medical Sciences in 2014. Two monopolar active electrodes were placed on the thyrohyoid space at the location of the ISLN entrance to the larynx and 1 dispersive electrode was positioned on the back of the neck. A current with special programmed parameters was applied to stimulate the ISLN via the active electrodes and simultaneously the resultant acoustic changes were evaluated. All the means of the acoustic parameters during SES and rest periods were compared using the paired t-test. Results: The findings indicated significant changes (P=0.00) in most of the acoustic parameters during SES presentation compared to them at rest. The mean of fundamental frequency standard deviation (SD F0) at rest was 1.54 (SD=0.55) versus 4.15 (SD=3.00) for the SES period. The other investigated parameters comprised fundamental frequency (F0), minimum F0, jitter, shimmer, harmonic-to-noise ratio (HNR), mean intensity, and minimum intensity. Conclusion: These findings demonstrated significant changes in most of the important acoustic features, suggesting that the stimulation of the ISLN via SES could induce motor changes in the vocal folds. The clinical applicability of the method utilized in the current study in patients with vocal fold paralysis requires further research. PMID:27582586

  10. Role of the Internal Superior Laryngeal Nerve in the Motor Responses of Vocal Cords and the Related Voice Acoustic Changes

    Directory of Open Access Journals (Sweden)

    Sadegh Seifpanahi

    2016-09-01

    Full Text Available Background: Repeated efforts by researchers to impose voice changes by laryngeal surface electrical stimulation (SES have come to no avail. This present pre-experimental study employed a novel method for SES application so as to evoke the motor potential of the internal superior laryngeal nerve (ISLN and create voice changes. Methods: Thirty-two normal individuals (22 females and 10 males participated in this study. The subjects were selected from the students of Iran University of Medical Sciences in 2014. Two monopolar active electrodes were placed on the thyrohyoid space at the location of the ISLN entrance to the larynx and 1 dispersive electrode was positioned on the back of the neck. A current with special programmed parameters was applied to stimulate the ISLN via the active electrodes and simultaneously the resultant acoustic changes were evaluated. All the means of the acoustic parameters during SES and rest periods were compared using the paired t-test. Results: The findings indicated significant changes (P=0.00 in most of the acoustic parameters during SES presentation compared to them at rest. The mean of fundamental frequency standard deviation (SD F0 at rest was 1.54 (SD=0.55 versus 4.15 (SD=3.00 for the SES period. The other investigated parameters comprised fundamental frequency (F0, minimum F0, jitter, shimmer, harmonic-to-noise ratio (HNR, mean intensity, and minimum intensity. Conclusion: These findings demonstrated significant changes in most of the important acoustic features, suggesting that the stimulation of the ISLN via SES could induce motor changes in the vocal folds. The clinical applicability of the method utilized in the current study in patients with vocal fold paralysis requires further research.

  11. Serial in-office laser treatment of vocal fold leukoplakia: Disease control and voice outcomes.

    Science.gov (United States)

    Koss, Shira L; Baxter, Peter; Panossian, Haig; Woo, Peak; Pitman, Michael J

    2017-07-01

    Although vocal fold (VF) leukoplakia is commonly treated with in-office laser, there is no data on its long-term effectiveness. This study hypothesizes that VF leukoplakia treated by serial in-office laser results in long-term disease control with maintenance of voice and minimal morbidity. Retrospective review (2008-2015). Forty-six patients with VF leukoplakia treated by in-office KTP (potassium titanyl phosphate) or PDL (pulsed dye laser) were included. Median follow-up from final laser treatment was 19.6 months. Main outcomes included: 1) rate of disease control, 2) percentage of disease regression using ImageJ analysis. Secondary outcomes included vocal assessment using the Voice Handicap Index-10 (VHI-10). Patients underwent a median of 2 (range: 1-6) in-office laser treatments. Time between treatments was median 7.6 months. After final treatment, 19 patients (41.3%) had no disease; two patients (4.3%) progressed to invasive cancer; overall disease regression was median 77.1% (P office treatment only); failures were 13 patients (28.3%) who required operative intervention and two patients (4%) who underwent radiation. Compared to responders, failures demonstrated significantly shorter duration between treatments (median 2.3 vs. 8.9 months, P = 0.038) and significantly less regression (median 49.3% vs. 100%, P = 0.006). Serial outpatient KTP or PDL treatment of VF leukoplakia is effective for disease control with minimal morbidity and preservation of voice quality. We suggest that patients requiring repeated in-office treatment every 6 months may benefit from earlier operative intervention; other factors associated with in-office success remain unclear. 4. Laryngoscope, 127:1644-1651, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Examining diseased states in a scaled-up vocal fold model using simultaneous temporally resolved DPIV and pressure measurements

    Science.gov (United States)

    Rogers, Dylan; Wei, Nathaniel; Ringenber, Hunter; Krane, Michael; Wei, Timothy

    2017-11-01

    This study builds on the parallel presentation of Ringenberg, et al. (APS-DFD 2017) involving simultaneous, temporally and spatially resolved flow and pressure measurements in a scaled-up vocal fold model. In this talk, data from experiments replicating characteristics of diseased vocal folds are presented. This begins with vocal folds that do not fully close and continues with asymmetric oscillations. Data are compared to symmetric, i.e. `healthy', oscillatory motions presented in the companion talk. Having pressure and flow data for individual as well as phase averaged oscillations for these diseased cases highlights the potential for aeroacoustic analysis in this complex system. Supported by NIH Grant No. 2R01 DC005642-11.

  13. Analyzing the effectiveness of vocal features in early telediagnosis of Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Betul Erdogdu Sakar

    Full Text Available The recently proposed Parkinson's Disease (PD telediagnosis systems based on detecting dysphonia achieve very high classification rates in discriminating healthy subjects from PD patients. However, in these studies the data used to construct the classification model contain the speech recordings of both early and late PD patients with different severities of speech impairments resulting in unrealistic results. In a more realistic scenario, an early telediagnosis system is expected to be used in suspicious cases by healthy subjects or early PD patients with mild speech impairment. In this paper, considering the critical importance of early diagnosis in the treatment of the disease, we evaluate the ability of vocal features in early telediagnosis of Parkinson's Disease (PD using machine learning techniques with a two-step approach. In the first step, using only patient data, we aim to determine the patient group with relatively greater severity of speech impairments using Unified Parkinson's Disease Rating Scale (UPDRS score as an index of disease progression. For this purpose, we use three supervised and two unsupervised learning techniques. In the second step, we exclude the samples of this group of patients from the dataset, create a new dataset consisting of the samples of PD patients having less severity of speech impairments and healthy subjects, and use three classifiers with various settings to address this binary classification problem. In this classification problem, the highest accuracy of 96.4% and Matthew's Correlation Coefficient of 0.77 is obtained using support vector machines with third-degree polynomial kernel showing that vocal features can be used to build a decision support system for early telediagnosis of PD.

  14. Relationship between the morphologic alterations of vocal cords from adult autopsies and the cause of death Avaliação morfológica da membrana basal das cordas vocais de adultos autopsiados e sua correlação com as causas de óbito

    Directory of Open Access Journals (Sweden)

    Ana Karina Marques Salge

    2004-01-01

    Full Text Available PURPOSE: The purpose of this study was to identify the possible alteration in the thickness of the epithelium basal membrane of the vocal cords and correlate it with the cause of death. METHOD: Larynxes collected from adult autopsies during the period of 1993 to 2001 were utilized. We used the hematoxylin-eosin and periodic acid-Schiff staining methods for the morphological and morphometric analysis. RESULTS: Sixty-six vocal cords were analysed; increased thickness was identified in 14 cases (21.2%, with equal proportions between the genders. Increased vocal-cord thickness was more frequent in patients of the white ethnicity (12 cases, 85.7%. Respiratory alterations were found in 10 (71.4% of the cases with increased vocal-cord thickness. Of the patients that were maintained with mechanical ventilation before death, 7 (18.4% had thickening of the basal membrane. Among the smokers, 9 (19.63% had basal membrane thickening. CONCLUSION: No statistically significant differences were found between the cases in which the cause of death was related to respiratory diseases as compared to non-respiratory diseases and the thickening of the basal membrane of the vocal cords. However, new studies are needed in order to verify the etiopathogenesis of this thickening.OBJETIVO: O objetivo deste trabalho foi identificar as possíveis alterações na espessura da membrana basal das cordas vocais e relacionar estas com a causa de morte. MÉTODO: Foram utilizadas laringes coletadas de adultos autopsiados, no período de 1993 até 2001. Realizamos as colorações da Hematoxilina- Eosina e Ácido Periódico de Schiff, onde foi medido o diâmetro da membrana basal. RESULTADOS: Foram analisadas 66 cordas vocais, o espessamento foi identificado em 14 casos (21,2%, sendo encontrado em proporções iguais entre os sexos, sendo freqüente em pacientes da cor branca (12 casos, 85,7%. Foram encontradas alterações respiratórias em 10 (71,4% dos casos com espessamento

  15. Impairment of vocal expression of negative emotions in patients with Alzheimer`s disease

    Directory of Open Access Journals (Sweden)

    Kyung-Hun eHan

    2014-05-01

    Full Text Available The vocal expression of emotions (EE in the retrieval of events from autobiographical memory was investigated in patients in early stages of Alzheimer’s disease (AD. 21 AD patients and 19 controls were interviewed, and EE of the reported memories was rated by 8 independent evaluators. The AD group had lower EE of both recent and remote memory than controls, although EE in remote memories was better preserved in both groups. We observed positive correlations between EE and indicators of cognitive competence in AD patients. AD Patients are impaired in their ability to express emotions at early stages of the disease, and EE seems to deteriorate along with the progression of cognitive impairment.

  16. Posterior cricoarytenoid muscle electrophysiologic changes are predictive of vocal cord paralysis with recurrent laryngeal nerve compressive injury in a canine model.

    Science.gov (United States)

    Puram, Sidharth V; Chow, Harold; Wu, Che-Wei; Heaton, James T; Kamani, Dipti; Gorti, Gautham; Chiang, Feng Yu; Dionigi, Gianlorenzo; Barczynski, Marcin; Schneider, Rick; Dralle, Henning; Lorenz, Kerstin; Randolph, Gregory W

    2016-12-01

    Injury to the recurrent laryngeal nerve (RLN) is a dreaded complication of endocrine surgery. Intraoperative neural monitoring (IONM) has been increasingly utilized to assess the functional status of the RLN. Although the posterior cricoarytenoid muscle (PCA) is innervated by the RLN as the abductor of the larynx, PCA electromyography (EMG) is infrequently recorded during IONM and PCA activity after RLN compressive injury remains poorly characterized. Single-subject prospective animal study. We employed a canine model to identify postcricoid EMG correlates of postoperative vocal cord paralysis (VCP). Postcricoid electrode recordings were obtained before and after compressive RLN injury associated with VCP. Normative postcricoid recordings revealed mean amplitude of 1288 microvolt (μV) and latency of 8.2 millisecond (ms) with maximum (1 milliamp [mA]) vagal stimulation, and mean amplitude of 1807 μV and latency of 3.5 ms with maximum (1 mA) RLN stimulation. Following injury that was associated with VCP, there was 62.1% decrement in postcricoid EMG amplitude with maximum vagal stimulation and 80% decrement with maximum RLN stimulation. Threshold stimulation of the vagus increased by 23%, and there was a corresponding 42% decrease in amplitude. For RLN stimulation, latency increased by 17.3% following injury, whereas threshold stimulation increased by 61% with 35.5% decrement in EMG amplitude. Thus, if RLN amplitude decreases by ≥ 80%, with absolute amplitude of ≤ 300 μV or less and latency increase of ≥ 10%, RLN injury is likely associated with VCP. Our results predict postoperative VCP based on postcricoid electromyographic IONM and may guide surgical decision making. NA Laryngoscope, 126:2744-2751, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Fixed cord

    International Nuclear Information System (INIS)

    Levy, L.M.; DiChiro, G.; DeSouza, B.; McCullough, D.C.; McVeigh, E.; Hefffez, D.

    1989-01-01

    Pulsatile longitudinal motion of the spinal cord was examined with MR phase imaging in healthy subjects and in cases involving cord tethering and compression. Asymptomatic patients with a low conus medullaris demonstrated normal cord motion. Clinical improvement was associated with improved cord motion after surgical untethering, provided permanent neurologic damage had not occurred. Decreased and unchanged cord motion was associated with unchanged neurologic deficits. In cases of normal cord motion and possible retethering versus syringomyelia, clinical improvement occurred after shunting only. MR imaging of pulsatile cord motion can be clinically useful in the evaluation of diseases restricting motion of the neuraxis

  18. Reduced intensity haplo plus single cord transplant compared to double cord transplant: improved engraftment and graft-versus-host disease-free, relapse-free survival

    Science.gov (United States)

    van Besien, Koen; Hari, Parameswaran; Zhang, Mei-Jie; Liu, Hong-Tao; Stock, Wendy; Godley, Lucy; Odenike, Olatoyosi; Larson, Richard; Bishop, Michael; Wickrema, Amittha; Gergis, Usama; Mayer, Sebastian; Shore, Tsiporah; Tsai, Stephanie; Rhodes, Joanna; Cushing, Melissa M.; Korman, Sandra; Artz, Andrew

    2016-01-01

    Umbilical cord blood stem cell transplants are commonly used in adults lacking HLA-identical donors. Delays in hematopoietic recovery contribute to mortality and morbidity. To hasten recovery, we used co-infusion of progenitor cells from a partially matched related donor and from an umbilical cord blood graft (haplo-cord transplant). Here we compared the outcomes of haplo-cord and double-cord transplants. A total of 97 adults underwent reduced intensity conditioning followed by haplo-cord transplant and 193 patients received reduced intensity conditioning followed by double umbilical cord blood transplantation. Patients in the haplo-cord group were more often from minority groups and had more advanced malignancy. Haplo-cord recipients received fludarabine-melphalan-anti-thymocyte globulin. Double umbilical cord blood recipients received fludarabine-cyclophosphamide and low-dose total body irradiation. In a multivariate analysis, haplo-cord had faster neutrophil (HR=1.42, P=0.007) and platelet (HR=2.54, Pdisease (HR=0.26, Pdisease (HR=0.06, Pdisease-free, relapse-free survival was superior with haplo-cord (HR 0.63, P=0.002) but not overall survival (HR=0.97, P=0.85). Haplo-cord transplantation using fludarabine-melphalan-thymoglobulin conditioning hastens hematopoietic recovery with a lower risk of relapse relative to double umbilical cord blood transplantation using the commonly used fludarabine-cyclophosphamide-low-dose total body irradiation conditioning. Graft-versus-host disease-free and relapse-free survival is significantly improved. Haplo-cord is a readily available graft source that improves outcomes and access to transplant for those lacking HLA-matched donors. Trials registered at clinicaltrials.gov identifiers 00943800 and 01810588. PMID:26869630

  19. Sensory contribution to vocal emotion deficit in Parkinson's disease after subthalamic stimulation.

    Science.gov (United States)

    Péron, Julie; Cekic, Sezen; Haegelen, Claire; Sauleau, Paul; Patel, Sona; Drapier, Dominique; Vérin, Marc; Grandjean, Didier

    2015-02-01

    Subthalamic nucleus (STN) deep brain stimulation in Parkinson's disease induces modifications in the recognition of emotion from voices (or emotional prosody). Nevertheless, the underlying mechanisms are still only poorly understood, and the role of acoustic features in these deficits has yet to be elucidated. Our aim was to identify the influence of acoustic features on changes in emotional prosody recognition following STN stimulation in Parkinson's disease. To this end, we analysed the performances of patients on vocal emotion recognition in pre-versus post-operative groups, as well as of matched controls, entering the acoustic features of the stimuli into our statistical models. Analyses revealed that the post-operative biased ratings on the Fear scale when patients listened to happy stimuli were correlated with loudness, while the biased ratings on the Sadness scale when they listened to happiness were correlated with fundamental frequency (F0). Furthermore, disturbed ratings on the Happiness scale when the post-operative patients listened to sadness were found to be correlated with F0. These results suggest that inadequate use of acoustic features following subthalamic stimulation has a significant impact on emotional prosody recognition in patients with Parkinson's disease, affecting the extraction and integration of acoustic cues during emotion perception. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Chronic Diseases: Asthma and You | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of cold air or breathing in a special chemical. Comparing your symptoms with those of conditions similar to asthma’s, such as reflux disease, vocal cord dysfunction, or sleep apnea. A chest X-ray or EKG (electrocardiogram) ...

  1. Radiation therapy for early stage (T1 - T2) sarcomatoid carcinoma of true vocal cords: outcomes and patterns of failure

    International Nuclear Information System (INIS)

    Ballo, Matthew T.; Garden, Adam S.; El-Naggar, Adel K.; Morrison, William H.; Ang, K. Kian

    1997-01-01

    Objectives/hypothesis: Sarcomatoid carcinoma of head and neck mucosal sites is a rare malignancy surrounded with much controversy. One factor consistently reported yet not well supported throughout the literature is their relative radioresistance and a general belief that surgery is the treatment of choice. Our objective was to determine if patients treated with radiation for early glottic carcinoma with this histologic diagnosis had worse outcomes than typical squamous cell carcinoma of similar stage. Materials and Methods: Twenty-eight cases of early stage sarcomatoid carcinoma of the larynx treated with definitive doses of megavoltage irradiation between 1969 and 1995 at the University of Texas M.D. Anderson Cancer Center form the cohort for this analysis. All pathologic material was reviewed to confirm the diagnosis. Follow-up ranged from 1.5 - 24 years (median, 10 years). Results: Twenty-one patients were staged T1 and 7 patients had stage T2 disease. Sixteen tumors had the more typical polypoid morphology of sarcomatoid carcinoma. All patients were treated with small laryngeal fields, median size 20 cm2, and to a median dose of 65 Gy. Four patients (14%) had local disease recurrence. All 4 patients had salvage total laryngectomies and remained free of local disease. Only one patient manifested regional and distant disease. The 10-year actuarial survival rate was 63%. Conclusions: Patients with early staged sarcomatoid carcinoma of the glottis treated with radiation had similar control rates to irradiated patients with similar volume disease with the more typical squamous cell carcinoma. We do not believe that the histologic diagnosis of sarcomatoid carcinoma by itself should influence the decision to not treat a patient with early staged glottic disease with irradiation

  2. The effect of vocal tract impedance on the vocal folds

    DEFF Research Database (Denmark)

    Agerkvist, Finn T.; Selamtzis, Andreas

    2011-01-01

    frontend is used to measure the electroglottograph signal which reflects the opening and closing pattern of the vocal folds. The measurements were carried out for all four modes (Neutral, Curbing, Overdrive and Edge) for the vowel [a] in three different pitches: C3(131 Hz), G3 (196 Hz) and C4 (262Hz......The importance of the interaction between the acoustic impedance of the vocal tract with the flow across the vocal cords is well established. In this paper we are investigating the changes in vocal tract impedance when using the different modes of phonation according to Sadolin [1], going from...... the soft levels of the Neutral mode to the high levels of the fully ‘metallic’ Edge mode. The acoustic impedance of vocal tract as seen from the mouth opening is measured via a microphone placed close to the mouth when exciting the system with a volume velocity source [2]. At the same time a Laryngograph...

  3. Family cord blood banking for sickle cell disease: a twenty-year experience in two dedicated public cord blood banks.

    Science.gov (United States)

    Rafii, Hanadi; Bernaudin, Françoise; Rouard, Helene; Vanneaux, Valérie; Ruggeri, Annalisa; Cavazzana, Marina; Gauthereau, Valerie; Stanislas, Aurélie; Benkerrou, Malika; De Montalembert, Mariane; Ferry, Christele; Girot, Robert; Arnaud, Cecile; Kamdem, Annie; Gour, Joelle; Touboul, Claudine; Cras, Audrey; Kuentz, Mathieu; Rieux, Claire; Volt, Fernanda; Cappelli, Barbara; Maio, Karina T; Paviglianiti, Annalisa; Kenzey, Chantal; Larghero, Jerome; Gluckman, Eliane

    2017-06-01

    Efforts to implement family cord blood banking have been developed in the past decades for siblings requiring stem cell transplantation for conditions such as sickle cell disease. However, public banks are faced with challenging decisions about the units to be stored, discarded, or used for other endeavors. We report here 20 years of experience in family cord blood banking for sickle cell disease in two dedicated public banks. Participants were pregnant women who had a previous child diagnosed with homozygous sickle cell disease. Participation was voluntary and free of charge. All mothers underwent mandatory serological screening. Cord blood units were collected in different hospitals, but processed and stored in two public banks. A total of 338 units were stored for 302 families. Median recipient age was six years (11 months-15 years). Median collected volume and total nucleated cell count were 91 mL (range 23-230) and 8.6×10 8 (range 0.7-75×10 8 ), respectively. Microbial contamination was observed in 3.5% (n=12), positive hepatitis B serology in 25% (n=84), and homozygous sickle cell disease in 11% (n=37) of the collections. Forty-four units were HLA-identical to the intended recipient, and 28 units were released for transplantation either alone (n=23) or in combination with the bone marrow from the same donor (n=5), reflecting a utilization rate of 8%. Engraftment rate was 96% with 100% survival. Family cord blood banking yields good quality units for sibling transplantation. More comprehensive banking based on close collaboration among banks, clinical and transplant teams is recommended to optimize the use of these units. Copyright© Ferrata Storti Foundation.

  4. Spinal cord disease in children with malignancies: Clinical cases ...

    African Journals Online (AJOL)

    Four cases of children with malignancies and spinal cord pathology are presented. Current knowledge of this ... literature review. Case presentations .... The CD4 percentage of lymphocytes was only 6.9%, raising questions about antiretroviral ...

  5. Pain and spinal cord imaging measures in children with demyelinating disease

    Directory of Open Access Journals (Sweden)

    Nadia Barakat

    2015-01-01

    Full Text Available Pain is a significant problem in diseases affecting the spinal cord, including demyelinating disease. To date, studies have examined the reliability of clinical measures for assessing and classifying the severity of spinal cord injury (SCI and also to evaluate SCI-related pain. Most of this research has focused on adult populations and patients with traumatic injuries. Little research exists regarding pediatric spinal cord demyelinating disease. One reason for this is the lack of reliable and useful approaches to measuring spinal cord changes since currently used diagnostic imaging has limited specificity for quantitative measures of demyelination. No single imaging technique demonstrates sufficiently high sensitivity or specificity to myelin, and strong correlation with clinical measures. However, recent advances in diffusion tensor imaging (DTI and magnetization transfer imaging (MTI measures are considered promising in providing increasingly useful and specific information on spinal cord damage. Findings from these quantitative imaging modalities correlate with the extent of demyelination and remyelination. These techniques may be of potential use for defining the evolution of the disease state, how it may affect specific spinal cord pathways, and contribute to the management of pediatric demyelination syndromes. Since pain is a major presenting symptom in patients with transverse myelitis, the disease is an ideal model to evaluate imaging methods to define these regional changes within the spinal cord. In this review we summarize (1 pediatric demyelinating conditions affecting the spinal cord; (2 their distinguishing features; and (3 current diagnostic and classification methods with particular focus on pain pathways. We also focus on concepts that are essential in developing strategies for the detection, monitoring, treatment and repair of pediatric myelitis.

  6. Endo-extralaryngeal Laterofixation of the Vocal Folds in Patients with Bilateral Vocal Fold Immobility.

    Science.gov (United States)

    Wiegand, Susanne; Teymoortash, Afshin; Hanschmann, Holger

    2017-01-01

    Bilateral vocal fold paralysis can result in shortness of breath and severe dyspnea which can be life-threatening. Thirty-five patients with bilateral vocal fold paralysis who underwent endo-extralaryngeal laterofixation according to Lichtenberger were retrospectively analyzed regarding etiology, symptoms, treatment and complications. In 27 patients, laterofixation of the vocal cord alone was performed. Eight patients underwent laterofixation and additional posterior chordectomy of the opposite vocal cord according to Dennis and Kashima. The time of intervention ranged from 1 day to 38 years after the onset of bilateral vocal cord immobility. The intraoperative course was uneventful in all patients. None of the patients had postoperative aspiration. Postoperative voice function was acceptable in all patients. Complications of suture laterofixation were laryngeal edema, formation of fibrin, and malposition of the suture. Laterofixation of the vocal cords according to Lichtenberger is a safe and easy method that can be used as a first-stage treatment of vocal cord paralysis. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  7. Spinal cord ischemia after simultaneous and sequential treatment of multilevel aortic disease.

    Science.gov (United States)

    Piffaretti, Gabriele; Bonardelli, Stefano; Bellosta, Raffaello; Mariscalco, Giovanni; Lomazzi, Chiara; Tolenaar, Jip L; Zanotti, Camilla; Guadrini, Cristina; Sarcina, Antonio; Castelli, Patrizio; Trimarchi, Santi

    2014-10-01

    The aim of the present study is to report a risk analysis for spinal cord injury in a recent cohort of patients with simultaneous and sequential treatment of multilevel aortic disease. We performed a multicenter study with a retrospective data analysis. Simultaneous treatment refers to descending thoracic and infrarenal aortic lesions treated during the same operation, and sequential treatment refers to separate operations. All descending replacements were managed with endovascular repair. Of 4320 patients, multilevel aortic disease was detected in 77 (1.8%). Simultaneous repair was performed in 32 patients (41.5%), and a sequential repair was performed in 45 patients (58.4%). Postoperative spinal cord injury developed in 6 patients (7.8%). At multivariable analysis, the distance of the distal aortic neck from the celiac trunk was the only independent predictor of postoperative spinal cord injury (odds ratio, 0.75; 95% confidence interval, 0.56-0.99; P=.046); open surgical repair of the abdominal aortic disease was associated with a higher risk of spinal cord injury but did not reach statistical significance (odds ratio, 0.16; 95% confidence interval, 0.02-1.06; P=.057). Actuarial survival estimates at 1, 2, and 5 years after the procedure were 80%±5%, 68%±6%, and 63%±7%, respectively. Spinal cord injury did not impair survival (P=.885). In our experience, the risk of spinal cord injury is still substantial at 8% in patients with multilevel aortic disease. The distance of the distal landing zone from the celiac trunk is a significant predictor of spinal cord ischemia. Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  8. [Evaluation of the usefulness of laryngeal vocal efficiency tests during noise load for diagnosing occupational diseases of the larynx in teachers].

    Science.gov (United States)

    Loś-Spychalska, T

    1997-01-01

    A growing incidence of the voice organ occupational diseases has recently become one of major health problems. There is a need to objective diagnostic examinations performed in teachers who apply for occupational disease certification. The aim of our study was to assess the feasibility of larynx vocal efficiency test during noise load in diagnosis of the voice organ occupational diseases in teachers.

  9. Pólipos de pregas vocais: aspectos clínicos e cirúrgicos Vocal cord polyps: clinical and surgical aspects

    Directory of Open Access Journals (Sweden)

    Suzana B. Cecatto

    2002-08-01

    Full Text Available Introdução: O pólipo de prega vocal representa uma lesão benigna comum da laringe e o seu tratamento tem diversas modalidades. O objetivo deste artigo é apresentar aspectos clínicos e cirúrgicos específicos destes pólipos. Forma de estudo: Clínico retrospectivo. Material e Método: Levantamento retrospectivo de todos os casos atendidos no ambulatório de laringe da Faculdade de Medicina do ABC durante 18 meses e análise completa de todos os dados obtidos. Discutimos ainda as possibilidades terapêuticas e os resultados relatados na literatura. Resultados: Foram atendidos 108 pacientes no período acima e o diagnóstico mais prevalente foi pólipo de prega vocal (29,62%; n = 32, sem predileção por sexo. O principal sintoma referido foi disfonia (100% e em 56,25% o tabagismo estava presente, seguido de abuso vocal (25%. Vinte seis pacientes (81,25% foram tratados por microcirurgia de laringe com laringoscópio de suspensão sob anestesia geral e fonoterapia pós-cirúrgica, além de higiene vocal e tratamento medicamentoso quando necessário. Em 95% destes houve melhora da qualidade vocal após 60 dias de pós-operatório. Conclusões: O tratamento cirúrgico do pólipo de prega vocal apresenta diversas modalidades, porém o sucesso terapêutico depende da habilidade técnica do cirurgião, dos cuidados pós-operatórios e seguimento completo fonoterápico e medicamentoso.Introduction: Vocal fold polyp is a commom benign lesion of the larynx which can be treated in various ways. This article intends to show how clinical and surgical work can be applied in the event of the vocal fold polyp. Study design: Clinical retrospective. Material and Method: A retrospective research analysing patients was carried out from February 2000 to July 2001 (18 months by the Department of Larynx at the Faculdade de Medicina do ABC. A complete analysis of the results, as well as therapeutical techiniques applied and the results referred in the medical

  10. Spinal cord stimulation therapy for gait dysfunction in advanced Parkinson's disease patients.

    Science.gov (United States)

    Samotus, Olivia; Parrent, Andrew; Jog, Mandar

    2018-02-14

    Benefits of dopaminergic therapy and deep brain stimulation are limited and unpredictable for axial symptoms in Parkinson's disease. Dorsal spinal cord stimulation may be a new therapeutic approach. The objective of this study was to investigate the therapeutic effect of spinal cord stimulation on gait including freezing of gait in advanced PD patients. Five male PD participants with significant gait disturbances and freezing of gait underwent midthoracic spinal cord stimulation. Spinal cord stimulation combinations (200-500 μs/30-130 Hz) at suprathreshold intensity were tested over a 1- to 4-month period, and the effects of spinal cord stimulation were studied 6 months after spinal cord stimulation surgery. Protokinetics Walkway measured gait parameters. Z scores per gait variable established each participant's best spinal cord stimulation setting. Timed sit-to-stand and automated freezing-of-gait detection using foot pressures were analyzed. Freezing of Gait Questionnaire (FOG-Q), UPDRS motor items, and activities-specific balance confidence scale were completed at each study visit. Spinal cord stimulation setting combinations of 300-400 μs/30-130 Hz provided gait improvements. Although on-medication/on-stimulation at 6 months, mean step length, stride velocity, and sit-to-stand improved by 38.8%, 42.3%, and 50.3%, respectively, mean UPDRS, Freezing of Gait Questionnaire, and activities-specific balance confidence scale scores improved by 33.5%, 26.8%, and 71.4%, respectively. The mean number of freezing-of-gait episodes reduced significantly from 16 presurgery to 0 at 6 months while patients were on levodopa and off stimulation. By using objective measures to detect dynamic gait characteristics, the therapeutic potential of spinal cord stimulation was optimized to each participant's characteristics. This pilot study demonstrated the safety and significant therapeutic outcome of spinal cord stimulation in advanced PD patients, and thus a larger and longer

  11. Longitudinal association between lifestyle and coronary heart disease risk factors among individuals with spinal cord injury

    NARCIS (Netherlands)

    de Groot, S.; Post, M. W.; Snoek, G. J.; Schuitemaker, M.; van der Woude, L. H.

    Objective: To investigate: (1) the course of coronary heart disease risk factors (lipid profiles and body mass index (BMI)) in the first five years after discharge from inpatient spinal cord injury (SCI) rehabilitation and (2) the association between lifestyle (physical activity, self-care related

  12. Laryngeal neuropathy of Charcot-Marie-Tooth disease: further observations and novel mutations associated with vocal fold paresis.

    Science.gov (United States)

    Benson, Brian; Sulica, Lucian; Guss, Joel; Blitzer, Andrew

    2010-02-01

    To describe and define laryngeal neuropathy in Charcot-Marie-Tooth (CMT) disease. Retrospective record review from a university laryngology practice. Four adult CMT patients presented with laryngeal symptoms. Three patients exhibited bilateral vocal fold palsy, in each case with more severe hypomobility on the left. One case exhibited an isolated left vocal fold palsy. All patients complained of hoarseness and stridor, three had dyspnea, two patients had dysphagia, and one had obstructive sleep apnea (OSA). One patient has required airway surgery to date. Genetic testing revealed known sequence alterations in one case and sequence alterations previously not associated with laryngeal dysfunction in two cases. One case was familial and two were sporadic; information is not available in a fourth. The clinical course of the cases suggests slowly progressive neuropathy that appears to be nerve length dependent. The lack of severe respiratory distress despite dense bilateral paresis is consistent with existing reports and with the reported low rate of tracheostomy in adults with laryngeal manifestations of CMT. Genetic testing does not currently inform expectations or management of laryngeal disease. Dyspnea, dysphagia, and OSA symptoms in patients with CMT require careful laryngologic evaluation.

  13. MARATHON DESPITE UNILATERAL VOCAL FOLD PARALYSIS

    Directory of Open Access Journals (Sweden)

    Matthias Echternach

    2008-06-01

    Full Text Available The principal symptoms of unilateral vocal fold paralysis are hoarseness and difficulty in swallowing. Dyspnea is comparatively rare (Laccourreye et al., 2003. The extent to which unilateral vocal fold paralysis may lead to respiratory problems at all - in contrast to bilateral vocal fold paralysis- has not yet well been determined. On the one hand, inspiration is impaired with unilateral vocal fold paralysis; on the other hand, neither the position of the vocal fold paralysis nor the degree of breathiness correlates with respiratory parameters (Cantarella et al., 2003; 2005. The question of what respiratory stress a patient with a vocal fold paresis can endure has not yet been dealt with.A 43 year-old female patient was suffering from recurrent unspecific respiratory complaints for four months after physical activity. During training for a marathon, she experienced no difficulty in breathing. These unspecific respiratory complaints occurred only after athletic activity and persisted for hours. The patient observed neither an increased coughing nor a stridor. Her voice remained unaltered during the attacks, nor were there any signs of a symptomatic gastroesophageal reflux or infectious disease. A cardio-pulmonary and a radiological examination by means of an X-ray of the thorax also revealed no pathological phenomena. As antiallergic and antiobstructive therapy remained unsuccessful, a laryngological examination was performed in order to exclude a vocal cord dysfunction.Surprisingly enough, the laryngostroboscopy showed, as an initial description, a vocal fold paralysis of the left vocal fold in median position (Figure 1. The anamnestic background for the cause was unclear. The only clue was a thoracotomy on the left side due to a pleuritis in childhood. A subsequent laryngoscopic examination had never been performed. Good mucosa waves and amplitudes were shown bilateral with complete glottal closure. Neither in the acoustic analysis, nor in the

  14. Diseases of the spine, spinal cord, and extremities

    International Nuclear Information System (INIS)

    Tanaka, H.

    1983-01-01

    This paper covers the following topics: acupuncture needle in the spinal canal of the neck; thoracic tuberculous spondylitis: cold abscess; comminuted fracture of the fifth cervical vertebra; lumbar spondylolysis; lumbar spondylosis; ossification of the posterior longitudinal ligament; disk herniation of the cervical spine: narrowing of the root tunnel; ankylosing spondylitis: narrowing of the root tunnel; ossification of the ligamentum flavum; narrow spinal canal syndrome; syringomyelia; epidural neurinoma of the cervical spine; neurofibromatosis; spinal arteriovenous malformation; atrophy of the thoracic spinal cord; osteomyelitis tuberculosa of the rib; osteomyelitis tuberculosa of the left femur; chronic osteomyelitis of the left humerus; malignant giant cell tumor of the left femur; rheumatoid arthritis of the left hip joint; arthrosis deformans of the left hip joint; and enchondroma of the left index finger: Proximal Phalanx

  15. Cord Blood

    Directory of Open Access Journals (Sweden)

    Saeed Abroun

    2014-05-01

    Full Text Available   Stem cells are naïve or master cells. This means they can transform into special 200 cell types as needed by body, and each of these cells has just one function. Stem cells are found in many parts of the human body, although some sources have richer concentrations than others. Some excellent sources of stem cells, such as bone marrow, peripheral blood, cord blood, other tissue stem cells and human embryos, which last one are controversial and their use can be illegal in some countries. Cord blood is a sample of blood taken from a newborn baby's umbilical cord. It is a rich source of stem cells, umbilical cord blood and tissue are collected from material that normally has no use following a child’s birth. Umbilical cord blood and tissue cells are rich sources of stem cells, which have been used in the treatment of over 80 diseases including leukemia, lymphoma and anemia as bone marrow stem cell potency.  The most common disease category has been leukemia. The next largest group is inherited diseases. Patients with lymphoma, myelodysplasia and severe aplastic anemia have also been successfully transplanted with cord blood. Cord blood is obtained by syringing out the placenta through the umbilical cord at the time of childbirth, after the cord has been detached from the newborn. Collecting stem cells from umbilical blood and tissue is ethical, pain-free, safe and simple. When they are needed to treat your child later in life, there will be no rejection or incompatibility issues, as the procedure will be using their own cells. In contrast, stem cells from donors do have these potential problems. By consider about cord blood potency, cord blood banks (familial or public were established. In IRAN, four cord blood banks has activity, Shariati BMT center cord blood bank, Royan familial cord blood banks, Royan public cord blood banks and Iranian Blood Transfusion Organ cord blood banks. Despite 50,000 sample which storage in these banks, but the

  16. Rat Ultrasonic Vocalizations and Behavioral Neuropharmacology: From the Screening of Drugs to the Study of Disease.

    Science.gov (United States)

    Simola, Nicola

    2015-01-01

    Several lines of evidence indicate that rats emit ultrasonic vocalizations (USVs) in response to a wide range of stimuli that are capable of producing either euphoric (positive) or dysphoric (negative) emotional states. On these bases, recordings of USVs are extensively used in preclinical studies of affect, motivation, and social behavior. Rat USVs are sensitive to the effects of certain classes of psychoactive drugs, suggesting that emission of rat USVs can have relevance not only to neurobiology, but also to neuropharmacology and psychopharmacology. This review summarizes three types of rat USVs, namely 40-kHz USVs emitted by pups, 22-kHz USVs and 50-kHz USVs emitted by young and adult animals, and relevance of these vocalizations to neuropharmacological studies. Attention will be focused on the issues of how rat USVs can be used to evaluate the pharmacological properties of different classes of drugs, and how rat USVs can be combined with other behavioral models used in neuropharmacology. The strengths and limitations of experimental paradigms based on the evaluation of rat USVs will also be discussed.

  17. An Investigation of Vocal Tract Characteristics for Acoustic Discrimination of Pathological Voices

    Directory of Open Access Journals (Sweden)

    Jung-Won Lee

    2013-01-01

    Full Text Available This paper investigates the effectiveness of measures related to vocal tract characteristics in classifying normal and pathological speech. Unlike conventional approaches that mainly focus on features related to the vocal source, vocal tract characteristics are examined to determine if interaction effects between vocal folds and the vocal tract can be used to detect pathological speech. Especially, this paper examines features related to formant frequencies to see if vocal tract characteristics are affected by the nature of the vocal fold-related pathology. To test this hypothesis, stationary fragments of vowel /aa/ produced by 223 normal subjects, 472 vocal fold polyp subjects, and 195 unilateral vocal cord paralysis subjects are analyzed. Based on the acoustic-articulatory relationships, phonation for pathological subjects is found to be associated with measures correlated with a raised tongue body or an advanced tongue root. Vocal tract-related features are also found to be statistically significant from the Kruskal-Wallis test in distinguishing normal and pathological speech. Classification results demonstrate that combining the formant measurements with vocal fold-related features results in improved performance in differentiating vocal pathologies including vocal polyps and unilateral vocal cord paralysis, which suggests that measures related to vocal tract characteristics may provide additional information in diagnosing vocal disorders.

  18. Vocal fold granulomas in six brachycephalic dogs: clinical, macroscopical and histological features.

    Science.gov (United States)

    Sarran, D; Caron, A; Billet, J P

    2018-06-05

    Vocal cord granulomas are rarely observed in brachycephalic breeds but often reported in humans as contact granulomas. Six French bulldogs were included in this retrospective descriptive study. Endoscopic laryngeal examinations were performed on all dogs under general anaesthesia. Vocal cord lesions were exclusively unilateral, exophytic, approximately 3-mm wide ulcerated mucosal nodules, arising from the vocal cord. Histopathological examination mainly revealed chronic inflammatory changes on the laryngeal epithelium which were consistent with laryngeal granulomas described in humans, except for the location: vocal cord in dogs versus vocal process in humans. In humans, granulomas result from chronic physical or chemical insult to laryngeal mucosa (chronic cough or throat clearing, vocal abuse, gastro-esophageal reflux). In brachycephalic breeds, chronic inspiratory efforts and air turbulences and gastro-esophageal reflux are suspected to result in chronic laryngeal inflammation. © 2018 British Small Animal Veterinary Association.

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

    Directory of Open Access Journals (Sweden)

    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

  20. Plastic Changes in the Spinal Cord in Motor Neuron Disease

    Directory of Open Access Journals (Sweden)

    Francesco Fornai

    2014-01-01

    Full Text Available In the present paper, we analyze the cell number within lamina X at the end stage of disease in a G93A mouse model of ALS; the effects induced by lithium; the stem-cell like phenotype of lamina X cells during ALS; the differentiation of these cells towards either a glial or neuronal phenotype. In summary we found that G93A mouse model of ALS produces an increase in lamina X cells which is further augmented by lithium administration. In the absence of lithium these nestin positive stem-like cells preferentially differentiate into glia (GFAP positive, while in the presence of lithium these cells differentiate towards a neuron-like phenotype (βIII-tubulin, NeuN, and calbindin-D28K positive. These effects of lithium are observed concomitantly with attenuation in disease progression and are reminiscent of neurogenetic effects induced by lithium in the subependymal ventricular zone of the hippocampus.

  1. Alternative allogeneic donor sources for transplantation for childhood diseases: unrelated cord blood and haploidentical family donors.

    Science.gov (United States)

    Cairo, Mitchell S; Rocha, Vanderson; Gluckman, Eliane; Hale, Gregory; Wagner, John

    2008-01-01

    Allogeneic stem cell transplantation has been demonstrated to be curative in a wide variety of pediatric malignant and nonmalignant diseases, and can be traced back over 50 years ago to the original report of Thomas et al. HLA matched sibling donors have been the gold standard for pediatric recipients requiring allogeneic donors for both nonmalignant and malignant conditions. However, only 25% of potential pediatric recipients possesses an HLA-matched sibling donor, and the frequency is even less in those with genetic nonmalignant conditions because of genetically affected other siblings within the family. Therefore, 75% to 90% of potential pediatric recipients require alternative allogeneic donor cells for treatment of their underlying conditions. Potential alternative allogeneic donor sources include unrelated cord blood donors, unrelated adult donors, and haploidentical family donors. In this article we review the experience of both unrelated cord blood donor and haploidentical family donor transplants in selected pediatric malignant and nonmalignant conditions.

  2. The Public Sphere in Emerging Infectious Disease Communication: Recipient or Active and Vocal Partner?

    Science.gov (United States)

    Gesser-Edelsburg, Anat; Shir-Raz, Yaffa; Walter, Nathan; Mordini, Emilio; Dimitriou, Dimitris; James, James J; Green, Manfred S

    2015-08-01

    Recent years have seen advances in theories and models of risk and crisis communication, with a focus on emerging epidemic infection. Nevertheless, information flow remains unilateral in many countries and does not take into account the public's polyvocality and the fact that its opinions and knowledge often "compete" with those of health authorities. This article addresses the challenges organizations face in communicating with the public sphere. Our theoretical approach is conceptualized through a framework that focuses on the public sphere and that builds upon existing guidelines and studies in the context of health and pandemics. We examine how health organizations cope with the public's transformation from recipients to an active and vocal entity, ie, how and to what extent health organizations address the public's anxiety and concerns arising in the social media during outbreaks. Although international organizations have aspired to relate to the public as a partner, this article identifies notable gaps. Organizations must involve the public throughout the crisis and conduct dialogues free of prejudices, paternalism, and preconceptions. Thereby, they can impart precise and updated information reflecting uncertainty and considering cultural differences to build trust and facilitate cooperation with the public sphere.

  3. Intraoperative handheld probe for 3D imaging of pediatric benign vocal fold lesions using optical coherence tomography (Conference Presentation)

    Science.gov (United States)

    Benboujja, Fouzi; Garcia, Jordan; Beaudette, Kathy; Strupler, Mathias; Hartnick, Christopher J.; Boudoux, Caroline

    2016-02-01

    Excessive and repetitive force applied on vocal fold tissue can induce benign vocal fold lesions. Children affected suffer from chronic hoarseness. In this instance, the vibratory ability of the folds, a complex layered microanatomy, becomes impaired. Histological findings have shown that lesions produce a remodeling of sup-epithelial vocal fold layers. However, our understanding of lesion features and development is still limited. Indeed, conventional imaging techniques do not allow a non-invasive assessment of sub-epithelial integrity of the vocal fold. Furthermore, it remains challenging to differentiate these sub-epithelial lesions (such as bilateral nodules, polyps and cysts) from a clinical perspective, as their outer surfaces are relatively similar. As treatment strategy differs for each lesion type, it is critical to efficiently differentiate sub-epithelial alterations involved in benign lesions. In this study, we developed an optical coherence tomography (OCT) based handheld probe suitable for pediatric laryngological imaging. The probe allows for rapid three-dimensional imaging of vocal fold lesions. The system is adapted to allow for high-resolution intra-operative imaging. We imaged 20 patients undergoing direct laryngoscopy during which we looked at different benign pediatric pathologies such as bilateral nodules, cysts and laryngeal papillomatosis and compared them to healthy tissue. We qualitatively and quantitatively characterized laryngeal pathologies and demonstrated the added advantage of using 3D OCT imaging for lesion discrimination and margin assessment. OCT evaluation of the integrity of the vocal cord could yield to a better pediatric management of laryngeal diseases.

  4. Bilateral arytenoidectomy with lateralisation of vocal folds: review of two cases

    OpenAIRE

    Prasad, Parmanand; Shankar, Siddharth

    2008-01-01

    We present a review of two cases of bilateral abductor palsy of vocal cords with cords in paramedian position. The aetiology was not clear. As definitive treatment, arytenoidectomy and vocal cord lateralization on both sides were done by external laryngofissure approach. Objective of this review is to emphasize upon the fact that external procedures under direct vision has still a role to play in the era of endoscopic maneuvers. It can be performed successfully even at centers having limited ...

  5. IMPAIRED MOBILITY OF VOCAL FOLDS - etiology and symptoms

    Directory of Open Access Journals (Sweden)

    Karlo Pintarić

    2015-06-01

    Full Text Available Paresis or paralysis of one or both vocal cords affects some significant aspects of a human life: breathing, swallowing and speech. The major causes for reduced mobility or even immobility are innervation damage, less often fixation of vocal cord or impaired mobility of crycoarytenoid joint. An injury of the superior or/and inferior laryngeal nerve can be a consequence of different medical procedures, tumor growth, trauma, infection, neurological disorders, radiation exposure, toxic damage, impaired circulation of the area or it is idiopathic. The symptoms are different in the case of unilateral and bilateral paresis of the vocal folds. They also depend on the cause for the impaired mobility. In the patients with unilateral vocal fold paresis, hoarseness and aspiration during swallowing are the leading symptoms. In the bilateral vocal fold paralysis, dyspnea prevails. 

  6. Imaging spinal cord atrophy in progressive myelopathies: HTLV-I-associated neurological disease (HAM/TSP) and multiple sclerosis (MS).

    Science.gov (United States)

    Azodi, Shila; Nair, Govind; Enose-Akahata, Yoshimi; Charlip, Emily; Vellucci, Ashley; Cortese, Irene; Dwyer, Jenifer; Billioux, B Jeanne; Thomas, Chevaz; Ohayon, Joan; Reich, Daniel S; Jacobson, Steven

    2017-11-01

    Previous work measures spinal cord thinning in chronic progressive myelopathies, including human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and multiple sclerosis (MS). Quantitative measurements of spinal cord atrophy are important in fully characterizing these and other spinal cord diseases. We aimed to investigate patterns of spinal cord atrophy and correlations with clinical markers. Spinal cord cross-sectional area was measured in individuals (24 healthy controls [HCs], 17 asymptomatic carriers of HTLV-1 (AC), 47 HAM/TSP, 74 relapsing-remitting MS [RRMS], 17 secondary progressive MS [SPMS], and 40 primary progressive MS [PPMS]) from C1 to T10. Clinical disability scores, viral markers, and immunological parameters were obtained for patients and correlated with representative spinal cord cross-sectional area regions at the C2 to C3, C4 to C5, and T4 to T9 levels. In 2 HAM/TSP patients, spinal cord cross-sectional area was measured over 3 years. All spinal cord regions are thinner in HAM/TSP (56 mm 2 [standard deviation, 10], 59 [10], 23 [5]) than in HC (76 [7], 83 [8], 38 [4]) and AC (71 [7], 78 [9], 36 [7]). SPMS (62 [9], 66 [9], 32 [6]) and PPMS (65 [11], 68 [10], 35 [7]) have thinner cervical cords than HC and RRMS (73 [9], 77 [10], 37 [6]). Clinical disability scores (Expanded Disability Status Scale [p = 0.009] and Instituto de Pesquisas de Cananeia [p = 0.03]) and CD8 + T-cell frequency (p = 0.04) correlate with T4 to T9 spinal cord cross-sectional area in HAM/TSP. Higher cerebrospinal fluid HTLV-1 proviral load (p = 0.01) was associated with thinner spinal cord cross-sectional area. Both HAM/TSP patients followed longitudinally showed thoracic thinning followed by cervical thinning. Group average spinal cord cross-sectional area in HAM/TSP and progressive MS show spinal cord atrophy. We further hypothesize in HAM/TSP that is possible that neuroglial loss from a thoracic inflammatory

  7. Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases

    Directory of Open Access Journals (Sweden)

    Laura Sterian Ward

    2000-09-01

    Full Text Available CONTEXT: Screening programs not only offer the opportunity to trace and treat almost all cases of congenital hypothyroidism but also mean large savings to the health system. However, carefully planned strategies are necessary to extend their benefits and reduce costs. OBJECTIVE: To determine the possible influence of maternal diseases that affect maternal-fetal placenta dynamics on primary thyroid stimulating hormone (TSH screening for congenital hypothyroidism. DESIGN: Prospective non-randomized clinical trial with at least 3 months of follow-up. SETTING: A public university referral center [CAISM/Hospital das Clínicas, Faculty of Medicine, University of Campinas, Campinas, SP]. PARTICIPANTS: 415 neonates divided into 5 groups: eighty-three infants born from cardiac mothers; 98 from mothers that had toxemia; 54 of the mothers had diabetes mellitus; 40 were HIV positive and 140 had no diseases. INTERVENTION: All newborns had cord blood samples collected on filter paper at birth. MAIN MEASUREMENTS: TSH was measured from dried blood spots using a homemade immunofluorescence assay (sensitivity in dried blood spots = 0.1 mU/L. RESULTS: There was no significant difference in the mean TSH levels among the 5 groups. Moreover, TSH levels were around 5 mU/L in 48% of the newborns, indicating that our region is severely deficient in iodine. CONCLUSIONS: Our results indicate that primary TSH screening programs using cord blood are not affected by maternal diseases. We suggest that, besides its technical advantages over heel punctures with T4 primary approaches, neonatal screening using primary cord blood TSH may also be used as a monitoring tool for evaluation and control of iodine deficiency disorders (IDD.

  8. Spinal Cord Dysfunction (SCD)

    Data.gov (United States)

    Department of Veterans Affairs — The Spinal Cord Dysfunction (SCD) module supports the maintenance of local and national registries for the tracking of patients with spinal cord injury and disease...

  9. Vocal Fold Paralysis

    Science.gov (United States)

    ... here Home » Health Info » Voice, Speech, and Language Vocal Fold Paralysis On this page: What is vocal fold ... Where can I get additional information? What is vocal fold paralysis? Structures involved in speech and voice production ...

  10. Neurogenic bowel dysfunction in patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson's disease

    Institute of Scientific and Technical Information of China (English)

    Richard A Awad

    2011-01-01

    Exciting new features have been described concerning neurogenic bowel dysfunction, including interactions between the central nervous system, the enteric nervous system, axonal injury, neuronal loss, neurotransmission of noxious and non-noxious stimuli, and the fields of gastroenterology and neurology. Patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson's disease present with serious upper and lower bowel dysfunctions characterized by constipation, incontinence, gastrointestinal motor dysfunction and altered visceral sensitivity. Spinal cord injury is associated with severe autonomic dysfunction, and bowel dysfunction is a major physical and psychological burden for these patients. An adult myelomeningocele patient commonly has multiple problems reflecting the multisystemic nature of the disease. Multiple sclerosis is a neurodegenerative disorder in which axonal injury, neuronal loss, and atrophy of the central nervous system can lead to permanent neurological damage and clinical disability. Parkinson's disease is a multisystem disorder involving dopaminergic, noradrenergic, serotoninergic and cholinergic systems, characterized by motor and non-motor symptoms. Parkinson's disease affects several neuronal structures outside the substantia nigra, among which is the enteric nervous system. Recent reports have shown that the lesions in the enteric nervous system occur in very early stages of the disease, even before the involvement of the central nervous system. This has led to the postulation that the enteric nervous system could be critical in the pathophysiology of Parkinson's disease, as it could represent the point of entry for a putative environmental factor to initiate the pathological process. This review covers the data related to the etiology, epidemiology, clinical expression, pathophysiology, genetic aspects, gastrointestinal motor dysfunction, visceral sensitivity, management, prevention and prognosis of neurogenic bowel

  11. Vocal Markers of Motor, Cognitive, and Depressive Symptoms in Parkinson’s Disease

    Science.gov (United States)

    2017-05-02

    Au WL, Tan LC (2015) Prognostic factors for early mortality in Parkinson’s disease . Parkinsonism Relat Disord 21, 226-230. [5] Leroi I, McDonald K...Pantula H, Harbishettar V (2012) Cognitive impairment in Parkinson disease : impact on quality of life, disability, and caregiver burden. J Geriatr...1271. [15] Silbergleit AK, LeWitt PA, Peterson EL, Gardner GM (2015) Quantitative Analysis of Voice in Parkinson Disease Compared to Motor

  12. Effect of gentle stroking and vocalization on behaviour, mucosal immunity and upper respiratory disease in anxious shelter cats.

    Science.gov (United States)

    Gourkow, Nadine; Hamon, Sara C; Phillips, Clive J C

    2014-11-01

    Emotional, behavioural, and health benefits of gentle stroking and vocalizations, otherwise known as gentling, have been documented for several species, but little is known about the effect of gentling on cats in stressful situations. In this study, 139 cats rated as anxious upon admission to an animal shelter were allocated to either a Gentled or Control group. Cats were gentled four times daily for 10 min over a period of 10 days, with the aid of a tool for cats that were too aggressive to handle. The cats' mood, or persistent emotional state, was rated daily for 10 d as Anxious, Frustrated or Content. Gentled cats were less likely to have negatively valenced moods (Anxious or Frustrated) than Control cats (Incidence Rate Ratio [IRR]=0.61 CI 0.42-0.88, P=0.007). Total secretory immunoglobulin A (S-IgA) was quantified from faeces by enzyme-linked immunosorbent assay. Gentled cats had increased S-IgA (6.9 ± 0.7 logeμg/g) compared to Control cats (5.9 ± 0.5 logeμg/g) (Pincrease in shedding over time in Control cats (23%, 35%, 52% on days 1, 4 and 10, respectively), but not in gentled cats (32%, 26%, 30% on days 1, 4 and 10, respectively) (P=0.001). Onset of upper respiratory disease was determined by veterinary staff based on clinical signs, in particular ocular and/or nasal discharge. Control cats were 2.4 (CI: 1.35-4.15) times more likely to develop upper respiratory disease over time than gentled cats (Pincrease production of S-IgA, and reduce the incidence of upper respiratory disease. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. A Translational Approach to Vocalization Deficits and Neural Recovery after Behavioral Treatment in Parkinson Disease

    Science.gov (United States)

    Ciucci, Michelle R.; Vinney, Lisa; Wahoske, Emerald J.; Connor, Nadine P.

    2010-01-01

    Parkinson disease is characterized by a complex neuropathological profile that primarily affects dopaminergic neural pathways in the basal ganglia, including pathways that modulate cranial sensorimotor functions such as swallowing, voice and speech. Prior work from our lab has shown that the rat model of unilateral 6-hydroxydopamine infusion to…

  14. The 3D Printing of the Paralyzed Vocal Fold: Added Value in Injection Laryngoplasty.

    Science.gov (United States)

    Hamdan, Abdul-Latif; Haddad, Ghassan; Haydar, Ali; Hamade, Ramsey

    2017-08-18

    Three-dimensional (3D) printing has had numerous applications in various disciplines, especially otolaryngology. We report the first case of a high-fidelity 3D-printed model of the vocal cords of a patient with unilateral vocal cord paralysis in need of injection laryngoplasty. A case report was carried out. A tailored 3D-printed anatomically precise models for injection laryngoplasty has the potential to enhance preoperative planning, resident teaching, and patient education. A 3D printing model of the paralyzed vocal cord has an added value in the preoperative assessment of patients undergoing injection laryngoplasty. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  15. Can family history and cord blood IgE predict sensitization and allergic diseases up to adulthood?

    DEFF Research Database (Denmark)

    Borrits Pagh Nissen, Susanne; Fomsgaard Kjær, Henrik; Høst, Arne

    2015-01-01

    with high NPV and specificity, but low PPV and sensitivity. CONCLUSION: Although family history and elevated CB-IgE were significantly associated with primarily atopic disease until 26 yr, none of these were strong predictors for subsequent sensitization and allergic symptoms from childhood until early......BACKGROUND: Long-term studies of the predictive value of family history and cord blood IgE level until adulthood are few, and their conclusions have been contradictory. METHODS: Screening of total IgE in 1617 cord blood samples was performed in a Danish birth cohort. All infants with cord blood Ig...... used. RESULTS: A total of 455 infants were included, 188 with CB-IgE ≥0.5 kU/l and 267 with CB-IgE history and elevated CB-IgE were significantly associated to allergic disease until 26 yr. Concerning any allergic...

  16. Sarcoidosis Presenting as Bilateral Vocal Fold Immobility.

    Science.gov (United States)

    Hintze, Justin M; Gnagi, Sharon H; Lott, David G

    2018-05-01

    Bilateral true vocal fold paralysis is rarely attributable to inflammatory diseases. Sarcoidosis is a rare but important etiology of bilateral true vocal fold paralysis by compressive lymphadenopathy, granulomatous infiltration, and neural involvement. We describe the first reported case of sarcoidosis presenting as bilateral vocal fold immobility caused by direct fixation by granulomatous infiltration severe enough to necessitate tracheostomy insertion. In addition, we discuss the presentation, the pathophysiology, and the treatment of this disease with a review of the literature of previously reported cases of sarcoidosis-related vocal fold immobility. Sarcoidosis should therefore be an important consideration for the otolaryngologist's differential diagnosis of true vocal fold immobility. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  17. Repairing the vibratory vocal fold.

    Science.gov (United States)

    Long, Jennifer L

    2018-01-01

    A vibratory vocal fold replacement would introduce a new treatment paradigm for structural vocal fold diseases such as scarring and lamina propria loss. This work implants a tissue-engineered replacement for vocal fold lamina propria and epithelium in rabbits and compares histology and function to injured controls and orthotopic transplants. Hypotheses were that the cell-based implant would engraft and control the wound response, reducing fibrosis and restoring vibration. Translational research. Rabbit adipose-derived mesenchymal stem cells (ASC) were embedded within a three-dimensional fibrin gel, forming the cell-based outer vocal fold replacement (COVR). Sixteen rabbits underwent unilateral resection of vocal fold epithelium and lamina propria, as well as reconstruction with one of three treatments: fibrin glue alone with healing by secondary intention, replantation of autologous resected vocal fold cover, or COVR implantation. After 4 weeks, larynges were examined histologically and with phonation. Fifteen rabbits survived. All tissues incorporated well after implantation. After 1 month, both graft types improved histology and vibration relative to injured controls. Extracellular matrix (ECM) of the replanted mucosa was disrupted, and ECM of the COVR implants remained immature. Immune reaction was evident when male cells were implanted into female rabbits. Best histologic and short-term vibratory outcomes were achieved with COVR implants containing male cells implanted into male rabbits. Vocal fold cover replacement with a stem cell-based tissue-engineered construct is feasible and beneficial in acute rabbit implantation. Wound-modifying behavior of the COVR implant is judged to be an important factor in preventing fibrosis. NA. Laryngoscope, 128:153-159, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Imaging of demyelinating and neoplastic diseases of the spinal cord; Bildgebung bei demyelinisierenden und tumoroesen Erkrankungen des Rueckenmarks

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Mang, C. [Institut fuer CT und MRT Gaenserndorf, Gaenserndorf (Austria)

    2010-12-15

    The clinical symptoms of myelopathy are variable and non-specific. Demyelinating as well as neoplastic spinal cord diseases can cause paresthesia, progressive sensomotoric deficits and bowel and bladder dysfunction. Imaging of the spine, especially with magnetic resonance imaging (MRI), is an essential component in the diagnostic assessment of myelopathy and makes a substantial contribution to achieving the correct diagnosis. Although intramedullary neoplasms are far less common than demyelinating spinal cord diseases, radiologists should be familiar with the three most common entities, astrocytoma, ependymoma and hemangioblastoma, which represent over 70% of all spinal cord neoplasms. An early diagnosis and therapy is essential with neoplastic and demyelinating spinal cord diseases to hold residual neurological deficits as low as possible. (orig.) [German] Die klinische Symptomatik von Myelopathien ist aeusserst variabel und unspezifisch. Sowohl demyelinisierende als auch tumoroese Rueckenmarkerkrankungen koennen Paraesthesien, progrediente sensomotorische Ausfaelle und eine Sphinkterdysfunktion hervorrufen. Bildgebende Untersuchungen, und hier allen voran die MRT, sind ein unerlaesslicher Bestandteil zur Abklaerung von Myelopathien und tragen wesentlich zur korrekten Diagnose bei. Intramedullaere Tumoren sind zwar weitaus seltener als demyelinisierende Rueckenmarkerkrankungen, dennoch sollte der Radiologe mit den Bildmerkmalen der 3 haeufigsten Tumorarten, dem Astrozytom, Ependymom und Haemangioblastom vertraut sein, die ueber 70% aller Rueckenmarktumoren verursachen. Eine moeglichst fruehe Diagnostik und Therapie sind bei tumoroesen und demyelinisierenden Rueckenmarkerkrankungen essenziell, um bleibende neurologische Defizite moeglichst gering zu halten. (orig.)

  19. Vocal Imitations of Non-Vocal Sounds

    Science.gov (United States)

    Houix, Olivier; Voisin, Frédéric; Misdariis, Nicolas; Susini, Patrick

    2016-01-01

    Imitative behaviors are widespread in humans, in particular whenever two persons communicate and interact. Several tokens of spoken languages (onomatopoeias, ideophones, and phonesthemes) also display different degrees of iconicity between the sound of a word and what it refers to. Thus, it probably comes at no surprise that human speakers use a lot of imitative vocalizations and gestures when they communicate about sounds, as sounds are notably difficult to describe. What is more surprising is that vocal imitations of non-vocal everyday sounds (e.g. the sound of a car passing by) are in practice very effective: listeners identify sounds better with vocal imitations than with verbal descriptions, despite the fact that vocal imitations are inaccurate reproductions of a sound created by a particular mechanical system (e.g. a car driving by) through a different system (the voice apparatus). The present study investigated the semantic representations evoked by vocal imitations of sounds by experimentally quantifying how well listeners could match sounds to category labels. The experiment used three different types of sounds: recordings of easily identifiable sounds (sounds of human actions and manufactured products), human vocal imitations, and computational “auditory sketches” (created by algorithmic computations). The results show that performance with the best vocal imitations was similar to the best auditory sketches for most categories of sounds, and even to the referent sounds themselves in some cases. More detailed analyses showed that the acoustic distance between a vocal imitation and a referent sound is not sufficient to account for such performance. Analyses suggested that instead of trying to reproduce the referent sound as accurately as vocally possible, vocal imitations focus on a few important features, which depend on each particular sound category. These results offer perspectives for understanding how human listeners store and access long

  20. Effects of Hybrid Cycle and Handcycle Exercise on Cardiovascular Disease Risk Factors in People with Spinal Cord Injury: a Randomized Controlled Trial

    NARCIS (Netherlands)

    Bakkum, A.J.T.; Paulson, T.A.W.; Bishop, N.C.; Goosey-Tolfrey, V.L.; Stolwijk-Swuste, J.M.; van Kuppevelt, D.J.; de Groot, S.; Janssen, T.W.J.

    2015-01-01

    Objective: To examine the effects of a 16-week exercise programme, using either a hybrid cycle or a handcycle, on cardiovascular disease risk factors in people with spinal cord injury. Participants: Nineteen individuals with spinal cord injury ≥ 8 years. Design: Multicentre randomized controlled

  1. Effects of Hybrid Cycle and Handcycle Exercise on Cardiovascular Disease Risk Factors in People with Spinal Cord Injury : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Bakkum, Arjan J. T.; Paulson, Thomas A. W.; Bishop, Nicolette C.; Goosey-Tolfrey, Victoria L.; Stolwijk-Swuste, Janneke M.; van Kuppevelt, Dirk J.; de Groot, Sonja; Janssen, Thomas W. J.

    Objective: To examine the effects of a 16-week exercise programme, using either a hybrid cycle or a handcycle, on cardiovascular disease risk factors in people with spinal cord injury. Participants: Nineteen individuals with spinal cord injury >= 8 years. Design: Multicentre randomized controlled

  2. Umbilical Cord Mesenchymal Stem Cell Treatment for Crohn’s Disease: A Randomized Controlled Clinical Trial

    Science.gov (United States)

    Zhang, Jian; Lv, Samei; Liu, Xiaojing; Song, Bin; Shi, Liping

    2018-01-01

    Background/Aims Stem cell therapy has been applied to treat a variety of autoimmune diseases, including Crohn’s disease (CD), but few studies have examined the use of umbilical cord mesenchymal stem cells (UC-MSCs). This trial sought to investigate the efficacy and safety of UC-MSCs for the treatment of CD. Methods Eighty-two patients who had been diagnosed with CD and had received steroid maintenance therapy for more than 6 months were included in this study. Forty-one patients were randomly selected to receive a total of four peripheral intravenous infusions of 1×106 UC-MSCs/kg, with one infusion per week. Patients were followed up for 12 months. The Crohn’s disease activity index (CDAI), Harvey-Bradshaw index (HBI), and corticosteroid dosage were assessed. Results Twelve months after treatment, the CDAI, HBI, and corticosteroid dosage had decreased by 62.5±23.2, 3.4±1.2, and 4.2±0.84 mg/day, respectively, in the UC-MSC group and by 23.6±12.4, 1.2±0.58, and 1.2±0.35 mg/day, respectively, in the control group (pUC-MSC vs control, respectively). Four patients developed a fever after cell infusion. No serious adverse events were observed. Conclusions UC-MSCs were effective in the treatment of CD and produced mild side effects. PMID:28873511

  3. Correlation between spinal cord MRI and clinical features in patients with demyelinating disease

    International Nuclear Information System (INIS)

    Papadopoulos, A.; Gatzonis, S.; Gouliamos, A.; Trakadas, S.; Kalovidouris, A.; Sgouropoulos, P.; Vlachos, L.; Papavasiliou, C.

    1994-01-01

    Localisation of spinal cord lesions by MRI was correlated with neurological symptoms and signs in 16 patients with clinical and laboratory evidence of multiple sclerosis. There was good correspondence between spinal cord lesions and motor tract signs. On the other hand, superficial or deep sensory disturbances correlated with spinal cord lesions in only about a quarter of the patients. MRI of the spinal cord appeared to explain the myelopathy in 11 patients, while in 3 there was strong clinical evidence of more extensive demyelinating lesions. In 7 of the 16 patients MRI of the brain was normal. (orig.)

  4. [Clinical analysis of vocal fold firbrous mass].

    Science.gov (United States)

    Chen, Hao; Sun, Jing Wu; Wan, Guang Lun; Hu, Yan Ming

    2018-03-01

    To explore the character of laryngoscopy finding, voice, and therapy of vocal fold fibrous mass. Clinical data, morphology, voice character, surgery and pathology of 15 cases with vocal fold fibrous mass were analyzed. The morbidity of vocal fold fibrous mass might be related to overuse of voice and laryngopharyngeal reflex. Laryngoscopy revealed shuttle line appearance, smoothness and decreased mucosal wave of vocal fold. These patients were invalid for voice training and might be improved by surgery, but recovery is slow. The morbidity of vocal fold fibrous mass might be related to overuse of voice and laryngopharyngeal reflex. Conservative treatment is ineffective for this disease, and surgery might improve. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

  5. Differentiating vocal cord dysfunction from asthma

    OpenAIRE

    Fretzayas, Andrew; Moustaki, Maria; Loukou, Ioanna; Douros, Konstantinos

    2017-01-01

    Andrew Fretzayas,1,2 Maria Moustaki,3 Ioanna Loukou,3 Konstantinos Douros4 1Third Department of Pediatrics, Athens University Medical School, “Attikon” University Hospital, Haidari, Greece; 2Athens Medical Center, Department of Pediatrics, Marousi, Greece; 3Department of Cystic Fibrosis, “Aghia Sofia”, Children’s Hospital, Athens, Greece; 4Respiratory Unit, Third Department of Pediatrics, Athens University Medical School, “Attikon&am...

  6. What Is Vocal Cord Dysfunction (VCD)?

    Science.gov (United States)

    ... can be found. VCD may be triggered by: ■■ Acid reflux (GERD) ■■ Post-nasal drip ■■ Upper respiratory infection (cold) ■■ ... VCD is triggered by post-nasal drip or acid reflux (GERD), it is important to talk to your ...

  7. Mercury in the Umbilical Cord: Implications for Risk Assessment for Minamata Disease

    DEFF Research Database (Denmark)

    Dalgård, Christine; Grandjean, Philippe; Jørgensen, Poul Jørgen

    1994-01-01

    Umbilical cord tissue was obtained from 50 births in the Faroe Islands, where high mercury intake is due to ingestion of pilot whale meat. The mercury concentration correlated significantly with the frequency of maternal whale meat dinners during pregnancy and with mercury concentrations in umbil...... mercury concentration of 4.95 nmol/g dry weight in Minamata would correspond to 668 nmol/l cord blood and 114 nmol/g maternal hair. These levels agree well with other evidence of susceptibility of the fetus to increased exposure to methylmercury....... in umbilical cord blood and in maternal hair. The results were compared with published values for mercury in umbilical cord tissue from 12 infants diagnosed with congenital methylmercury poisoning in Minamata, Japan. From the regression coefficients obtained in the Faroese samples, the median umbilical cord...

  8. Life Experience of Patients With Unilateral Vocal Fold Paralysis.

    Science.gov (United States)

    Francis, David O; Sherman, Ariel E; Hovis, Kristen L; Bonnet, Kemberlee; Schlundt, David; Garrett, C Gaelyn; Davies, Louise

    2018-05-01

    Clinicians and patients benefit when they have a clear understanding of how medical conditions influence patients' life experiences. Patients' perspectives on life with unilateral vocal fold paralysis have not been well described. To promote patient-centered care by characterizing the patient experiences of living with unilateral vocal fold paralysis. This study used mixed methods: surveys using the voice and dysphagia handicap indexes (VHI and DHI) and semistructured interviews with adults with unilateral vocal cord paralysis recruited from a tertiary voice center. Recorded interviews were transcribed, coded using a hierarchical coding system, and analyzed using an iterative inductive-deductive approach. Symptom domains of the patient experience. In 36 patients (26 [72%] were female, and the median age and interquartile range [IQR] were 63 years [48-68 years]; median interview duration, 42 minutes), median VHI and DHI scores were 96 (IQR, 77-108) and 55.5 (IQR, 35-89) at the time of interviews, respectively. Frustration, isolation, fear, and altered self-identity were primary themes permeating patients' experiences. Frustrations related to limitations in communication, employment, and the medical system. Sources of fear included a loss of control, fear of further dysfunction or permanent disability, concern for health consequences (eg, aspiration pneumonia), and/or an inability to call for help in emergency situations. These experiences were modified by the following factors: resilience, self-efficacy, perceived sense of control, and social support systems. Effects of unilateral vocal fold paralysis extend beyond impaired voice and other somatic symptoms. Awareness of the extent to which these patients experience frustration, isolation, fear, and altered self-identity is important. A patient-centered approach to optimizing unilateral vocal fold paralysis treatment is enhanced by an understanding of both the physical dimension of this condition and how patients

  9. Cytokine treatment optimises the immunotherapeutic effects of umbilical cord-derived MSC for treatment of inflammatory liver disease

    OpenAIRE

    de Witte, Samantha F. H.; Merino, Ana M.; Franquesa, Marcella; Strini, Tanja; van Zoggel, Johanna A. A.; Korevaar, Sander S.; Luk, Franka; Gargesha, Madhu; O?Flynn, Lisa; Roy, Debashish; Elliman, Steve J.; Newsome, Philip N.; Baan, Carla C.; Hoogduijn, Martin J.

    2017-01-01

    Background Mesenchymal stromal cells (MSC) possess immunomodulatory properties and low immunogenicity, both crucial properties for their development into an effective cellular immunotherapy. They have shown benefit in clinical trials targeting liver diseases; however the efficacy of MSC therapy will benefit from improvement of the immunomodulatory and immunogenic properties of MSC. Methods MSC derived from human umbilical cords (ucMSC) were treated for 3?days in vitro with various inflammator...

  10. Evaluating the prevalence of silent coronary artery disease in asymptomatic patients with spinal cord injury

    International Nuclear Information System (INIS)

    Lee, Chee-Siong; Lu, Ye-Hsu; Lee, Shuo-Tsan; Lin, Ching-Cheng; Ding, Hueisch-Jy

    2006-01-01

    To evaluate the prevalence of coronary artery disease (CAD) in patients with spinal cord injury (SCI), 47 clinically asymptomatic SCI patients received thallium-201 myocardial perfusion single photon emission computed tomography (Tl-201 SPECT) after dipyridamole administration for the diagnosis of CAD. There were 4 groups as follows; group 1: 13 patients with quadriplegia and complete SCI, group 2: 11 patients with quadriplegia and incomplete SCI, group 3: 11 patients with paraplegia and complete SCI, and group 4: 12 patients with paraplegia and incomplete SCI. There were no significant differences in sex distribution, ages, SCI duration, or CAD risk factors among the SCI patients in the 4 groups. All Tl-201 SPECT images were interpreted by the agreement of 2 experienced nuclear medicine physicians without prior knowledge of the patients' histories. A total of 30 of 47 (63.8%) SCI patients had abnormal Tl-201 SPECT findings. Among the 4 groups of SCI patients, those in groups 1 and 4 had the significantly highest and lowest prevalences of abnormal Tl-201 SPECT findings, respectively. We concluded that combined quadriplegia and complete SCI is an important CAD risk factor in SCI patients based on the objective evidence of intravenous dipyridamole cardiac stress testing with Tl-201 SPECT. (author)

  11. Spinal cord injury and Alzheimer's disease risk: a population-based, retrospective cohort study.

    Science.gov (United States)

    Yeh, Tian-Shin; Ho, Yu-Chun; Hsu, Cherng-Lan; Pan, Shin-Liang

    2018-02-01

    Propensity score-matched, retrospective cohort study. To determine the risk of developing Alzheimer's disease (AD) in patients with spinal cord injury (SCI). The present study used Taiwan's National Health Insurance Research Database. A total of 9257 patients who had ⩾2 ambulatory visits with a diagnosis of SCI in 2001 were included in the SCI group. The non-SCI group consisted of 37,028 propensity score-matched patients without a diagnosis of SCI. The cumulative incidence of AD was estimated for each of the two patient groups using the Kaplan-Meier method. Stratified Cox proportional hazard regression was then employed to assess the influence of SCI on the risk of AD. During the follow-up period, 25 subjects in the SCI group and 57 in the non-SCI group developed AD. The cumulative incidence of AD in the SCI group was higher than in the non-SCI group (P = 0.0168); and the hazard ratio of AD for the SCI group, as compared to the non-SCI group, was 1.71 (95% CI 1.06-2.76, P = 0.0273). This study suggests that patients with SCI have an increased risk of developing AD.

  12. Autologous cord blood harvesting in North Eastern Italy: ethical questions and emerging hopes for curing diabetes and celiac disease

    Directory of Open Access Journals (Sweden)

    Parco S

    2012-06-01

    Full Text Available Sergio Parco, Fulvia VascottoInstitute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, ItalyBackground: The Friuli Venezia Giulia (FVG, a region of North Eastern Italy, has passed legislation (Decree No 2324/2010 to regulate the banking of umbilical cord blood samples for personal, autologous, or family-directed use, and to implement the Agreement of the State-Regions Permanent Conference (Decree No 62/CSR/2010. This paper aims to identify the formalities and the reasons why families collect and bank their cord blood in foreign banks for both personal and private use.Methods: To this end, at the Institute for Maternal and Child Health of Trieste (the regional capital city of the FVG, Italy, which assists about 1800 pregnant women a year, 129 questionnaires, drafted from January 2010 to December 2011 and concerning the granting of authorization to export samples, were examined.Results: The collected data showed that 75% of involved families had resorted to anonymous public collection, which is available to anyone with therapeutic needs, and provided compatibility and hematologic protocols recognized by the scientific and international community (main indications: leukemia, hemoglobinopaties, and inherited hematologic and immunologic disorders. Conversely, 25.0% requested private storage at a foreign bank for personal or family-dedicated use. The principal motivation by disease was for treatment for diabetes (22.4% and celiac disease (19.7% (a multiorgan disease for which the FVG region has provided safeguards by approving a specific law granting support to families; Decree No 561/2007. For these two types of disease we found that information was received from the internet and not from general medical physicians, with a significant difference found using the χ2 test (P < 0.01.Conclusion: The indication of treating these diseases with cord blood stem cell transplantation appears to be well grounded and encouraging, and has recently

  13. Benign Lesions of The Vocal Fold

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    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

  14. Occipital neuralgia associates with high cervical spinal cord lesions in idiopathic inflammatory demyelinating disease.

    Science.gov (United States)

    Kissoon, Narayan R; Watson, James C; Boes, Christopher J; Kantarci, Orhun H

    2018-01-01

    Background The association of trigeminal neuralgia with pontine lesions has been well documented in multiple sclerosis, and we tested the hypothesis that occipital neuralgia in multiple sclerosis is associated with high cervical spinal cord lesions. Methods We retrospectively reviewed the records of 29 patients diagnosed with both occipital neuralgia and demyelinating disease by a neurologist from January 2001 to December 2014. We collected data on demographics, clinical findings, presence of C2-3 demyelinating lesions, and treatment responses. Results The patients with both occipital neuralgia and multiple sclerosis were typically female (76%) and had a later onset (age > 40) of occipital neuralgia (72%). Eighteen patients (64%) had the presence of C2-3 lesions and the majority had unilateral symptoms (83%) or episodic pain (78%). All patients with documented sensory loss (3/3) had C2-3 lesions. Most patients with progressive multiple sclerosis (6/8) had C2-3 lesions. Of the eight patients with C2-3 lesions and imaging at onset of occipital neuralgia, five (62.5%) had evidence of active demyelination. None of the patients with progressive multiple sclerosis (3/3) responded to occipital nerve blocks or high dose intravenous steroids, whereas all of the other phenotypes with long term follow-up (eight patients) had good responses. Conclusions A cervical spine MRI should be considered in all patients presenting with occipital neuralgia. In patients with multiple sclerosis, clinical features in occipital neuralgia that were predictive of the presence of a C2-3 lesion were unilateral episodic symptoms, sensory loss, later onset of occipital neuralgia, and progressive multiple sclerosis phenotype. Clinical phenotype predicted response to treatment.

  15. Artificially lengthened and constricted vocal tract in vocal training methods.

    Science.gov (United States)

    Bele, Irene Velsvik

    2005-01-01

    It is common practice in vocal training to make use of vocal exercise techniques that involve partial occlusion of the vocal tract. Various techniques are used; some of them form an occlusion within the front part of the oral cavity or at the lips. Another vocal exercise technique involves lengthening the vocal tract; for example, the method of phonation into small tubes. This essay presents some studies made on the effects of various vocal training methods that involve an artificially lengthened and constricted vocal tract. The influence of sufficient acoustic impedance on vocal fold vibration and economical voice production is presented.

  16. Spinal cord swelling and candidiasis

    International Nuclear Information System (INIS)

    Ho, K.; Gronseth, G.; Aldrich, M.; Williams, A.

    1982-01-01

    Fusiform swelling of the spinal cord was noted myelographically in a patient with Hodgkin's disease. Autopsy revealed that the swelling was cauused by Candida infection of the spinal cord. It is suggested that fungal infection be included in the differential diagnosis of spinal cord swelling in the immunsupporessed cancer patient. (orig.)

  17. Spinal cord swelling and candidiasis

    Energy Technology Data Exchange (ETDEWEB)

    Ho, K.; Gronseth, G.; Aldrich, M.; Williams, A.

    1982-11-01

    Fusiform swelling of the spinal cord was noted myelographically in a patient with Hodgkin's disease. Autopsy revealed that the swelling was caused by Candida infection of the spinal cord. It is suggested that fungal infection be included in the differential diagnosis of spinal cord swelling in the immunosuppressed cancer patient.

  18. 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

    Directory of Open Access Journals (Sweden)

    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

  19. Specific features of vocal fold paralysis in functional computed tomography

    International Nuclear Information System (INIS)

    Laskowska, K.; Mackiewicz-Nartowicz, H.; Serafin, Z.; Nawrocka, E.

    2008-01-01

    Vocal fold paralysis is usually recognized in laryngological examination, and detailed vocal fold function may be established based on laryngovideostroboscopy. Additional imaging should exclude any morphological causes of the paresis, which should be treated pharmacologically or surgically. The aim of this paper was to analyze the computed tomography (CT) images of the larynx in patients with unilateral vocal fold paralysis. CT examinations of the larynx were performed in 10 patients with clinically defined unilateral vocal fold paralysis. The examinations consisted of unenhanced acquisition and enhanced 3-phased acquisition: during free breathing, Valsalva maneuver, and phonation. The analysis included the following morphologic features of the paresis.the deepened epiglottic vallecula, the deepened piriform recess, the thickened and medially positioned aryepiglottic fold, the widened laryngeal pouch, the anteriorly positioned arytenoid cartilage, the thickened vocal fold, and the filled infraglottic space in frontal CT reconstruction. CT images were compared to laryngovideostroboscopy. The most common symptoms of vocal cord paralysis in CT were the deepened epiglottic vallecula and piriform recess, the widened laryngeal pouch with the filled infraglottic space, and the thickened aryepiglottic fold. Regarding the efficiency of the paralysis determination, the three functional techniques of CT larynx imaging used did not differ significantly, and laryngovideostroboscopy demonstrated its advantage over CT. CT of the larynx is a supplementary examination in the diagnosis of vocal fold paralysis, which may enable topographic analysis of the fold dysfunction. The knowledge of morphological CT features of the paralysis may help to prevent false-positive diagnosis of laryngeal cancer. (author)

  20. Detection of hyperphosphorylated tau protein and α-synuclein in spinal cord of patients with Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Guo YJ

    2016-02-01

    Full Text Available Yanjun Guo,1,2 Luning Wang,2 Mingwei Zhu,2 Honghong Zhang,3 Yazhuo Hu,3 Zhitao Han,3 Jia Liu,4 Weiqin Zhao,1 Dexin Wang11Department of Neurology, Beijing Friendship Hospital, Capital Medical University, 2Department of Geriatric Neurology, PLA General Hospital, 3Institute of Geriatrics, Chinese PLA General Hospital & Chinese PLA Medical Academy, 4Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of ChinaAbstract: The aim of this study was to investigate the neuropathological features of the spinal cord in patients suffering with Alzheimer’s disease (AD. Spinal cord tissue collected from three AD patients and eight controls was selected for the study. Data were collected at T2, T8, T10, L4, and S2 spinal levels. The sections were subjected to hematoxylin and eosin and Gallyas–Braak staining methods and then were immunostained with antibodies such as phosphorylated tau protein (AT8, α-synuclein, Aβ, amyloid precursor protein , ubiquitin, and TDP-43. Pathological changes exhibited by the biomarkers were detected by microscopy. Neurofibrillary tangles (NFTs were detectable in spinal anterior horn motor neurons in two of the three AD patients. AT8-positive axons or axon-like structures and AT8 expression in glial cells were detected in all three AD cases. Hyperphosphorylation of tau protein was detected in spinal anterior horn cells, glial cells, and axons, and its severity was associated with NFTs in the brain tissue. α-Synuclein-positive Lewy bodies and scattered Lewy-like neuritis were detected in the medial horn of the thoracic spinal cord and ventral sacral gray matter, respectively, in one patient who had AD with Lewy bodies. Neither amyloid deposition nor amyloid precursor protein and TDP-43 expression was detected in the spinal cord of AD patients. Spinal cord of AD patients was observed to contain phosphorylated tau protein and α-synuclein immunoreactive structures, which may play a

  1. An Exploratory Human Laboratory Experiment Evaluating Vaporized Cannabis in the Treatment of Neuropathic Pain From Spinal Cord Injury and Disease.

    Science.gov (United States)

    Wilsey, Barth; Marcotte, Thomas D; Deutsch, Reena; Zhao, Holly; Prasad, Hannah; Phan, Amy

    2016-09-01

    Using 8-hour human laboratory experiments, we evaluated the analgesic efficacy of vaporized cannabis in patients with neuropathic pain related to injury or disease of the spinal cord, most of whom were experiencing pain despite traditional treatment. After obtaining baseline data, 42 participants underwent a standardized procedure for inhaling 4 puffs of vaporized cannabis containing either placebo, 2.9%, or 6.7% delta 9-THC on 3 separate occasions. A second dosing occurred 3 hours later; participants chose to inhale 4 to 8 puffs. This flexible dosing was used to attempt to reduce the placebo effect. Using an 11-point numerical pain intensity rating scale as the primary outcome, a mixed effects linear regression model showed a significant analgesic response for vaporized cannabis. When subjective and psychoactive side effects (eg, good drug effect, feeling high, etc) were added as covariates to the model, the reduction in pain intensity remained significant above and beyond any effect of these measures (all P analgesic potency, the lower dose appears to offer the best risk-benefit ratio in patients with neuropathic pain associated with injury or disease of the spinal cord. A crossover, randomized, placebo-controlled human laboratory experiment involving administration of vaporized cannabis was performed in patients with neuropathic pain related to spinal cord injury and disease. This study supports consideration of future research that would include longer duration studies over weeks to months to evaluate the efficacy of medicinal cannabis in patients with central neuropathic pain. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  2. Aspectos respiratorios, posturais e vocais da Doença de Parkinson: considerações teóricas Respiratory, posture and vocals features in Parkinson's Disease: theoretical considerations

    Directory of Open Access Journals (Sweden)

    Fernanda Vargas Ferreira

    2011-06-01

    Full Text Available TEMA: manifestações respiratórias, posturais e vocais, associadas aos estágios da Doença de Parkinson (DP e suas possíveis inter-relações. OBJETIVO: revisar a literatura, a fim de descrever as características respiratórias, posturais e vocais associadas aos estágios na DP e suas possíveis inter-relações. CONCLUSÃO: Na DP, a etiologia das manifestações respiratórias é multifatorial, sendo obstrutivas; restritivas; relacionadas à bradicinesia, à rigidez e às alterações posturais; fraqueza da musculatura; anormalidades na musculatura laríngea; interferência da medicação antiparkisoniana. A postura em flexão altera a dinâmica corporal, interferindo nas funções estomatognáticas e na relação tóraco-abdominal. As alterações vocais podem estar presentes desde os estágios iniciais com diminuição dos tempos máximos de fonação e da intensidade vocal; adução glótica incompleta; fendas glóticas; tremor e instabilidade fonatória; perturbações de frequência e de intensidade; e qualidade vocal alterada. Os déficits na força muscular respiratória se refletem no menor suporte respiratório à emissão vocal e, por consequência, na diminuição da intensidade vocal e dos tempos máximos de fonação. Do mesmo modo, a postura em flexão gera desvantagem biomecânica à atividade respiratória, com menor expansão e redução dos volumes pulmonares, e déficit na excursão diafragmática. Os distúrbios respiratórios, posturais e/ou vocais, à medida que a DP evolui, de acordo com os seus estágios, tendem ao maior comprometimento, apresentando efeitos na comunicação verbal e não-verbal.BACKGROUND: respiratory, postural and vocal manifestations, associated to stages in Parkinson's Disease and their possible interrelations. PURPOSE: to review the literature in order to describe breathing, posture and voice characteristics associated with stages in PD and their possible interrelations. CONCLUSION: Etiology of

  3. Coronary heart disease risk indicators, aerobic power, and physical activity in men with spinal cord injuries

    NARCIS (Netherlands)

    Janssen, T W; van Oers, C A; van Kamp, G J; TenVoorde, B J; van der Woude, L H; Hollander, A P

    OBJECTIVE: To compare the lipid and (apo-)lipoprotein profile and blood pressure of men with long-standing spinal cord injuries (SCI) to those of an age-matched able-bodied (AB) population, and to assess the most important determinants of this profile and blood pressure. DESIGN: A cross-sectional

  4. Reinforcement of Infant Vocalizations through Contingent Vocal Imitation

    Science.gov (United States)

    Pelaez, Martha; Virues-Ortega, Javier; Gewirtz, Jacob L.

    2011-01-01

    Maternal vocal imitation of infant vocalizations is highly prevalent during face-to-face interactions of infants and their caregivers. Although maternal vocal imitation has been associated with later verbal development, its potentially reinforcing effect on infant vocalizations has not been explored experimentally. This study examined the…

  5. Cord-Blood Banking

    Science.gov (United States)

    ... cord blood mainly because of the promise that stem cell research holds for the future. Most of us would have little use for stem cells now, but research into using them to treat diseases is ongoing — ...

  6. Morphology of nerve endings in vocal fold of human newborn.

    Science.gov (United States)

    Gonçalves da Silva Leite, Janaina; Costa Cavalcante, Maria Luzete; Fechine-Jamacaru, Francisco Vagnaldo; de Lima Pompeu, Margarida Maria; Leite, José Alberto Dias; Nascimento Coelho, Dulce Maria; Rabelo de Freitas, Marcos

    2016-10-01

    Sensory receptors are distributed throughout the oral cavity, pharynx, and larynx. Laryngeal sensitivity is crucial for maintaining safe swallowing, thus avoiding silent aspiration. Morphologic description of different receptor types present in larynx vary because of the study of many different species, from mouse to humans. The most commonly sensory structures described in laryngeal mucosa are free nerve endings, taste buds, muscle spindles, glomerular and corpuscular receptors. This study aimed at describing the morphology and the distribution of nerve endings in premature newborn glottic region. Transversal serial frozen sections of the whole vocal folds of three newborns were analyzed using an immuno-histochemical process with a pan-neuronal marker anti-protein gene product 9.5 (PGP 9.5). Imaging was done using a confocal laser microscope. Nerve fiber density in vocal cord was calculated using panoramic images in software Morphometric Analysis System v1.0. Some sensory structures, i.e. glomerular endings and intraepithelial free nerve endings were found in the vocal cord mucosa. Muscle spindles, complex nerve endings (Meissner-like, spherical, rectangular and growing) spiral-wharves nerve structures were identified in larynx intrinsic muscles. Nervous total mean density in vocal cord was similar in the three newborns, although they had different gestational age. The mean nerve fiber density was higher in the posterior region than anterior region of vocal cord. The present results demonstrate the occurrence of different morphotypes of sensory corpuscles and nerve endings premature newborn glottic region and provide information on their sensory systems. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Efeitos da inalação passiva da fumaça de cigarro sobre as pregas vocais de ratos Effects of passive smoke inhalation on the vocal cords of rats

    Directory of Open Access Journals (Sweden)

    Josilene Luciene Duarte

    2006-04-01

    Full Text Available Poucos estudos demonstram as reações patológicas devidas à inalação de fumaça pelas vias aéreas de ratos. OBJETIVO: Estudar e analisar os possíveis efeitos histopatologicos produzidos pela inalação crônica de fumaça de cigarro nas pregas vocais de ratos. DESENHO DE ESTUDO: Experimental. MATERIAL E MÉTODOS: 36 ratos masculinos (Rattus norvergicus Wistar, de 60 dias de idade, foram mantidos em gaiolas e expostos à inalação da fumaça produzida por 10 cigarros, 3 vezes ao dia, 7 dias por semana, para períodos de 25, 50 e 75 dias, e os controles respectivos. Os animais foram sacrificados e as suas laringes dissecadas e submetidas a análise histológica com coloração de Hematoxilina e Eosina e analisados através de microscopia simples. RESULTADOS: Os ratos expostos ao cigarro exibiram menor (p Few studies have demonstrated the pathologic reactions yielded by smoke inhalation on the airway in rats. AIM: The aim of this study was to analyze the possible histopathological effects produced by chronic cigarette smoke inhalation on the vocal folds of rats. STUDY DESIGN: Experimental. MATERIAL AND METHOD: 36 male rats (Rattus norvergicus Wistar strain, aged 60 days, were kept in cages and exposed to inhalation of the smoke produced by 10 cigarettes lit 3 times a day, 7 days a week, for periods of 25, 50 and 75 days, and their respective controls. Thereafter the animals were killed and their larynxes were dissected and submitted to histological processing for achievement of histological sections, which were stained with Hematoxylin and Eosin and analyzed by light microscopy. RESULTS: The rats exposed to smoke displayed smaller (p< 0,05 body mass than the control group. There was hyperplasia and squamous metaplasia in the free edge of the vocal fold and squamous hyperplasia on the middle portion of the vocal fold in all 3 study periods. Moreover, the 50-day group revealed keratinizing metaplasia in this area. Morphological alterations in

  8. An Exploratory Human Laboratory Experiment Evaluating Vaporized Cannabis in the Treatment of Neuropathic Pain from Spinal Cord Injury and Disease

    Science.gov (United States)

    Wilsey, Barth; Marcotte, Thomas D.; Deutsch, Reena; Zhao, Holly; Prasad, Hannah; Phan, Amy

    2016-01-01

    Using eight hour human laboratory experiments, we evaluated the analgesic efficacy of vaporized cannabis in patients with neuropathic pain related to injury or disease of the spinal cord, the majority of whom were experiencing pain despite traditional treatment. After obtaining baseline data, 42 participants underwent a standardized procedure for inhaling 4 puffs of vaporized cannabis containing either placebo, 2.9%, or 6.7% delta-9-tetrahydrocannabinol on three separate occasions. A second dosing occurred 3 hours later; participants chose to inhale 4 to 8 puffs. This flexible dosing was utilized to attempt to reduce the placebo effect. Using an 11-point numerical pain intensity rating scale as the primary outcome, a mixed effects linear regression model demonstrated a significant analgesic response for vaporized cannabis. When subjective and psychoactive side effects (e.g., good drug effect, feeling high, etc.) were added as covariates to the model, the reduction in pain intensity remained significant above and beyond any effect of these measures (all p<0.0004). Psychoactive and subjective effects were dose dependent. Measurement of neuropsychological performance proved challenging because of various disabilities in the population studied. As the two active doses did not significantly differ from each other in terms of analgesic potency, the lower dose appears to offer the best risk-benefit ratio in patients with neuropathic pain associated with injury or disease of the spinal cord. PMID:27286745

  9. Life satisfaction in patients with and without spinal cord ischemia after advanced endovascular therapy for extensive aortic disease at mid-term follow-up.

    Science.gov (United States)

    Mehmedagic, Irma; Santén, Stefan; Jörgensen, Sophie; Acosta, Stefan

    2016-11-11

    Advanced endovascular aortic repair can be used to treat patients with extensive and complex aortic disease who are at risk of spinal cord ischaemia. The aim of this study was to compare whether life satisfaction differs between patients with and without spinal cord ischaemia at mid-term follow-up. Nested case-control study. Among patients undergoing advanced endovascular aortic repair between 2009 and 2012, 18 patients with spinal cord ischaemia and 33 without were interviewed at home. The Life Satisfaction Questionnaire (LiSat-11) and the Satisfaction With Life Scale (SWLS) were used. LiSat-11 found that patients with spinal cord ischaemia were more dissatisfied with their activities of daily living than were patients without spinal cord ischaemia (p=0.012). Both groups had similar, very low, scores in the sexual life domain; median 2.0 (interquartile range (IQR) 1.5-3.0) and 3.0 (IQR 2.0-4.0), respectively. There was no difference in SWLS between the groups. This study cohort of patients who underwent advanced endovascular aortic repair was rather homo-genous in their rating of life satisfaction and there was little difference between mid-term survivors who had spinal cord ischaemia and those who did not.

  10. Amino-Terminal proB-Type Natriuretic Peptide Levels in the Umbilical Cord Blood of Neonates Differ According to the Type of Prenatally Diagnosed Congenital Heart Disease.

    Science.gov (United States)

    Bae, Jin Young; Cha, Hyun-Hwa; Seong, Won Joon

    2015-12-01

    The aim of this study was to investigate differences in amino-terminal proB-type natriuretic peptide (NT-proBNP) levels in the cord blood of neonates according to the type of congenital heart disease (CHD) and to evaluate the usefulness of NT-proBNP as a prognostic marker. We included 76 neonates with prenatally diagnosed CHD and 45 controls without CHD. Neonates were classified into five groups based on echocardiographic findings. The levels of NT-proBNP in the cord blood were examined and analyzed according to the neonatal outcomes. The levels of NT-proBNP were significantly elevated in the cord blood of neonates with CHD compared with that in the cord blood of controls. The levels of NT-proBNP in the group with right ventricular outflow tract obstruction without a ventricular septal defect were significantly increased compared to that in the other groups. The neonates that required acute surgical correction had higher levels of NT-proBNP in the cord blood, though they were not statistically significant. Meanwhile, NT-proBNP levels in the cord blood of neonates with functional single ventricle were significantly higher than that in the cord blood of those with functional biventricles. Significant differences in the levels of NT-proBNP between survivors and nonsurvivors were observed within 1 year of birth. In this study, we found that the levels of NT-proBNP in the cord blood of neonates with CHD were higher than the levels in controls. This finding was striking in the group with right ventricular outflow tract obstruction, and it was associated with surgery for functional single ventricle and 1-year survival.

  11. Risk factors for the appearance of minimal pathologic lesions on vocal folds in vocal professionals

    Directory of Open Access Journals (Sweden)

    Stojanović Jasmina

    2012-01-01

    Full Text Available Background/Aim. An excessive use or misuse of voice by vocal professionals may result in symptoms such are husky voice, hoarse voice, total loss of voice, or even organic changes taking place on vocal folds - minimal pathological lesions - MAPLs. The purpose of this study was to identify the type of MAPLs which affects vocal professionals, as well as to identify the risk factors that bring about these changes. Methods. There were 94 vocal professionals who were examined altogether, out of whom 46 were affected by MAPLs, whereas 48 of them were diagnosed with no MAPLs, so that they served as the control group. All these patients were clinically examined (anamnesis, clinical examination, bacteoriological examination of nose and pharynx, radiography of paranasal cavities, allergological processing, phoniatric examination, endo-video-stroboscopic examination, as well as gastroenterologic examination, and finally endocrinological and pulmological analyses. Results. The changes that occurred most often were identified as nodules (50%; n = 23/46 and polyps (24%; n = 11/46. Risk factors causing MAPLs in vocal professionals were as follows: age, which reduced the risk by 23.9% [OR 0.861 (0.786-0.942] whereas the years of career increase the risk [OR 1.114 (1.000-1.241], as well as the presence of a chronic respiratory disease [OR 7.310 (1.712- 31.218], and the presence of gastro-oesophageal reflux disease [OR 4.542 (1.263-16.334]. The following factors did not contribute to development of MAPLs in vocal professionals: sex, a place of residence, irritation, smoking, endocrinologic disease and the presence of poly-sinusitis. Conclusion. It is necessary to introduce comprehensive procedures for prevention of MAPLs, particularly in high-risk groups. Identification of the risk factors for MAPLs and prevention of their influence on vocal professionals (given that their income depends on their vocal ability is of the highest importance.

  12. Fixed cord in spinal stenosis

    International Nuclear Information System (INIS)

    Levy, L.M.; Wang, H.; Francomano, C.; Hurko, O.; Carson, B.; Heffez, D.S.; DiChiro, G.; Bryan, R.N.

    1990-01-01

    This paper evaluates patients with cervical spinal canal compromise due to congenital anomalies (achondroplasia, Chiari malformation) and degenerative diseases using MR cord motion and cerebrospinal fluid (CSF) flow studies. Pulsatile longitudinal motion of the cervical cord was determined by means of cardiac-gated velocity phase contrast methods, including cine. Pathology included dwarfism (n = 15), Chiari malformation (n = 10), spondylosis (n = 10), and acute cord compression (n = 9). Symptomatic cases of congenital cervical stenosis had decreased cord motion, although CSF flow was not always significantly compromised. Postoperative cases demonstrated good cord and CSF motion, unless compression or obstruction was present

  13. Association of depression and pain interference with disease-management self-efficacy in community-dwelling individuals with spinal cord injury.

    Science.gov (United States)

    Pang, Marco Y C; Eng, Janice J; Lin, Kwan-Hwa; Tang, Pei-Fang; Hung, Chihya; Wang, Yen-Ho

    2009-11-01

    To determine factors influencing disease-management self-efficacy in individuals with spinal cord injury. A cross-sectional study. Forty-nine community-dwelling individuals with chronic spinal cord injury (mean age 44 years) participated in the study. Each subject was evaluated for disease-management self-efficacy (Self-efficacy for Managing Chronic Disease), depression (10-item Center for Epidemiologic Studies Depression Scale), pain interference (Pain Interference Scale), and availability of support (Interpersonal Support Evaluation List short form). Multiple regression analysis was performed to determine the relative contributions of these factors to disease-management self-efficacy. The mean disease-management self-efficacy score was 6.5 out of 10 (standard deviation 1.6). Bivariate correlation analysis showed that higher self-efficacy was significantly correlated with longer time since injury (r = 0.367, p = 0.010), better social support (r = 0.434, p = 0.002), lower pain interference (r = -0.589, p management self-efficacy (F 4,44=10.249, R2=0.482, pmanagement self-efficacy is suboptimal in many community-living people with spinal cord injury. This research suggests that rehabilitation of patients with spinal cord injury should include self-efficacy-enhancing strategies. Alleviation of depressive symptoms and pain self-management may be important for improving disease-management self-efficacy in this population, but this requires further study.

  14. Recurrence of vocal fold leukoplakia after carbon dioxide laser therapy.

    Science.gov (United States)

    Chen, Min; Chen, Jian; Cheng, Lei; Wu, Haitao

    2017-09-01

    This work aims to analyze the recurrence of vocal fold leukoplakia after carbon dioxide (CO 2 ) laser resection. In this retrospective study, all patients undergoing CO 2 laser resection of vocal fold leukoplakia were followed up for at least 2 years. Recurrence was diagnosed as any presence of leukoplakia in the vocal cord subsequent to previous successful complete resection. A total of 326 patients with complete resection of vocal fold leukoplakia and follow-up subsequent surveillance laryngoscopy were studied. The recurrence rate, the recurrence time, and risk factors were evaluated. Of these, 52 (16.0%) patients experienced recurrence with a mean follow-up time of 50.5 ± 15.4 months. The mean time to recurrence was 16.2 ± 14.1 months. Univariate analysis showed that the size of lesion (P vocal fold leukoplakia, long-term follow-up is required after CO 2 laser resection. In conclusion, the size of lesion combined with the pathological grade are important risk factors that predict vocal fold leukoplakia recurrence.

  15. Autoimmune Demyelinating Polyneuropathy as a Manifestation of Chronic Graft-versus-Host Disease after Adult Cord Blood Transplantation in a Patient with Chronic Lymphocytic Leukemia

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    Fredrick Hogan

    2014-01-01

    Full Text Available Immune mediated demyelinating disease after allogeneic stem cell transplantation is a rare entity with unclear etiology. Acute inflammatory demyelinating polyneuropathy (AIDP has been reported after related and adult unrelated allogeneic stem cell transplantation but no such case has been reported after unrelated cord blood transplantation. We hereby present the first case of AIDP after double umbilical cord blood transplantation (DUCBT. A 55-year-old man with chronic lymphocytic leukemia (CLL received a cord blood transplant for relapsed refractory disease with high risk cytogenetics. On day 221, patient presented with skin rash, tingling in both lower extremites, and ascending paralysis that progressed rapidly over the course of 2 days. The workup resulted in a diagnosis of AIDP and administration of intravenous immunoglobulins plus steroids was initiated. Motor and sensory powers were fully recovered and his chronic GVHD was managed for several months with single agent sirolimus.

  16. Autoshaping Infant Vocalizations

    OpenAIRE

    Myers, Alexander McNaughton

    1981-01-01

    A series of five experiments was conducted to determine whether operant or respondent factors controlled the emission of a particular vocalization ( "Q" ) by human infants 16 to 18 months old. Experiment 1 consisted of a pilot investigation of the effects of an autoshaping procedure on three infants' vocal behavior. All three subjects demonstrated increased emission of the target sound during the CR period. Experiments 2 through 4 attempted to replicate the findings of Experiment 1 under cont...

  17. Eletromiografia laríngea e análise vocal em pacientes com Mal de Parkinson: estudo comparativo Laryngeal electromyography and acoustic voice analysis in Parkinson's disease: a comparative study

    Directory of Open Access Journals (Sweden)

    Ana Paula Zarzur

    2010-02-01

    Full Text Available A doença ou Mal de Parkinson se deve à deficiência dopaminérgica nos núcleos da base que geram alterações motoras. Comprometimento da comunicação verbal ocorre em 70 a 90% dos doentes. Existem poucas referências da aplicação da eletromiografia no estudo dos músculos laríngeos em pacientes com a doença de Parkinson. OBJETIVOS: Definir o padrão contrátil da musculatura intrínseca da laringe e sua correlação com a análise acústica vocal nos parkinsonianos. CASUÍSTICA E MÉTODO: Estudo prospectivo onde 26 adultos com o diagnóstico de Mal de Parkinson foram submetidos à eletromiografia laríngea e análise acústica vocal. Foram coletados potenciais de ação, tanto em repouso vocal quanto em fonação. Para a análise acústica da voz foram utilizados os programas VOXMETRIA® e GRAM 5.1.6®. RESULTADOS: O padrão eletromiográfico predominante no grupo estudo foi o de hipercontratibilidade (ou recrutamento aumentado durante repouso vocal que ocorreu em 73% dos indivíduos, sem que houvesse registro eletromiográfico de tremor. Quanto às características vocais, detectou-se a presença de tremor vocal no traçado do espectrograma (VOXMETRIA E GRAM e na avaliação perceptivo-auditiva em 69,5 % e 61 % dos sujeitos, respectivamente. CONCLUSÃO: O tremor vocal foi a característica acústica predominante no grupo estudado, sem que houvesse correlação eletromiográfica.Parkinson's disease (PD involves a progressive depletion of dopamine in the basal ganglia leading to motor alterations. Oral communication impairment occurs in 75% to 90% of patients and has been poorly studied. AIM: to asses laryngeal electromyography (LEMG patterns and correlate them to vocal analysis in patients with Parkinson's disease. MATERIALS AND METHODS: This is a prospective study. Twenty six adults with PD underwent laryngeal electromyography. Rest and phonation potentials were analyzed. VOXMETRIA® and GRAM 5.1.6. ® were used in acoustic analysis

  18. Multiple intracerebroventricular injections of human umbilical cord mesenchymal stem cells delay motor neurons loss but not disease progression of SOD1G93A mice.

    Science.gov (United States)

    Sironi, Francesca; Vallarola, Antonio; Violatto, Martina Bruna; Talamini, Laura; Freschi, Mattia; De Gioia, Roberta; Capelli, Chiara; Agostini, Azzurra; Moscatelli, Davide; Tortarolo, Massimo; Bigini, Paolo; Introna, Martino; Bendotti, Caterina

    2017-12-01

    Stem cell therapy is considered a promising approach in the treatment of amyotrophic lateral sclerosis (ALS) and mesenchymal stem cells (MSCs) seem to be the most effective in ALS animal models. The umbilical cord (UC) is a source of highly proliferating fetal MSCs, more easily collectable than other MSCs. Recently we demonstrated that human (h) UC-MSCs, double labeled with fluorescent nanoparticles and Hoechst-33258 and transplanted intracerebroventricularly (ICV) into SOD1G93A transgenic mice, partially migrated into the spinal cord after a single injection. This prompted us to assess the effect of repeated ICV injections of hUC-MSCs on disease progression in SOD1G93A mice. Although no transplanted cells migrated to the spinal cord, a partial but significant protection of motor neurons (MNs) was found in the lumbar spinal cord of hUC-MSCs-treated SOD1G93A mice, accompanied by a shift from a pro-inflammatory (IL-6, IL-1β) to anti-inflammatory (IL-4, IL-10) and neuroprotective (IGF-1) environment in the lumbar spinal cord, probably linked to the activation of p-Akt survival pathway in both motor neurons and reactive astrocytes. However, this treatment neither prevented the muscle denervation nor delayed the disease progression of mice, emphasizing the growing evidence that protecting the motor neuron perikarya is not sufficient to delay the ALS progression. Copyright © 2017. Published by Elsevier B.V.

  19. Impacto vocal de professores Teachers' vocal impact

    Directory of Open Access Journals (Sweden)

    Adriana Ricarte

    2011-08-01

    Full Text Available OBJETIVO: analisar o impacto vocal nas atividades diárias em professores do ensino médio. Correlacionar os achado da auto-percepção do problema vocal com os aspectos: efeitos no trabalho, na comunicação diária, na comunicação social e na sua emoção. MÉTODOS: a amostra foi constituída por 107 professores, sendo 86 com queixa e 21 sem queixa, selecionados em escolas da rede particular de ensino de Maceió-AL. Cada professor respondeu individualmente o protocolo Perfil Participação em Atividades Vocais na presença da pesquisadora, assinalando suas respostas em uma escala visual que varia de 0 a 10. O protocolo é composto por 28 questões com a presença integrada em cinco aspectos englobados para avaliar a qualidade de vida e o resultado de tratamentos vocais. O protocolo oferece, ainda, dois escores adicionais: pontuação de limitação nas atividades (PLA e de restrição de participação (PRP. RESULTADOS: na comparação dos grupos com e sem queixa vocal foram verificados que todos os resultados foram estatisticamente significantes (pPURPOSE: to analyze the vocal impact in the daily activities on high-school teachers. Correlate the finding of the auto-perception on the vocal problem with the following aspects: effects in the work, daily communication, social communication and, its emotion METHODS: the sample consisted of 107 teachers, 86 with and 21 with no complaint, selected from private teaching schools in Maceió-AL. Each teacher answered individually the Protocol for Voice Activity Participation Profile in the presence of the researcher, noting their responses on a visual scale ranging from 0 to 10. The protocol is composed of 28 questions with the presence integrated in five aspects to evaluate the quality of life and the result of vocal treatments. The protocol offers, still, two additional scores: punctuation of limitation in the activities (PLA and restriction of participation (PRP. RESULTS: comparing the groups with

  20. Morphometric Study of Vocal Folds in Indian Cadavers

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    Rawal J.D.

    2015-06-01

    Full Text Available Introduction: -The larynx is an air passage and a sphincteric device used in respiration and phonation. The larynx, from inside outwards has a framework of mucosa surrounded by fibro-elastic membrane which in turn is surrounded by cartilages and then a layer of muscles. Vocal folds are intrinsic ligament of larynx covered by mucosal folds. Larynx generates sound through rhythmic opening and closing of the vocal folds. The perceived pitch of human voice mainly depends upon fundamental frequency of sound generated by larynx. Aim: - The aim of present study is to measure various dimensions of vocal folds in Indian cadavers. Material & Methods: - 50 larynx were obtained from embalmed cadavers, of which 10 larynx were of females. Vocal cords were dissected from the larynx and morphometric analysis was done. Results and Conclusions: - The average total length of the vocal folds was found to be 16.11 mm. ± 2.62 mm. in male and 14.10 mm. ± 1.54 mm. in female cadavers. The average width of the vocal folds was found to be 4.38 mm. ± 0.74 mm. in male and 3.60 mm. ± 0.64 mm. in female cadavers. The average total length of the membranous part of the vocal folds was found to be 11.90 mm. ± 1.86 mm. in male and 10.45 mm. ± 1.81 mm. in female cadavers. The average ratio of the length of the membranous and the cartilaginous parts of the vocal folds was calculated to be 3.10 ± 0.96in male and 2.85 ± 0.73in female cadavers.

  1. Involvement of the Interosseous and Lumbrical Muscle-Tendon Units in the Lateral and Spiral Cords in Dupuytren's Disease of the Middle Fingers.

    Science.gov (United States)

    Thoma, Achilleas; Karpinski, Marta

    2017-07-01

    The nature of intrinsic muscle involvement in Dupuytren's disease of the middle fingers (long and ring) remains poorly characterized. Over the years, the authors have observed that both the spiral and lateral digital cords in the middle fingers receive contribution from intrinsic muscle-tendon units. This report describes the anatomical characteristics and frequency of intrinsic muscle-tendon unit involvement in Dupuytren's disease of the middle fingers. Intrinsic muscle involvement in the middle digits was recorded in the operative reports of patients undergoing Dupuytren's surgery between October of 2013 and February of 2016. The anatomical variations of diseased fascia were delineated and classified. Of the 113 digits with Dupuytren's contracture operated on during this period, 52 involved the middle fingers (12 long and 40 ring fingers). Intrinsic muscles were found to be involved in the contracture of 14 of these digits. Two unique contracture patterns were identified: type I contracture, which involves a lateral digital cord originating from intrinsic muscle-tendon units and contracting only the proximal interphalangeal joint; and type II contracture, which involves a spiral cord receiving contribution from intrinsic muscle-tendon units and contracting both the metacarpophalangeal and proximal interphalangeal joints. The frequency of type I and type II contractures was 6 percent and 12 percent, respectively. Intrinsic hand muscles may contribute to Dupuytren's disease in the middle digits, and the authors suggest resecting cords as close as possible to their musculotendinous origin to improve postoperative outcomes.

  2. Comparison of CT and MR in 400 patients with suspected disease of the brain and cervical spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, W.G. Jr.; Waluch, V.; Yadley, R.A.; Wycoff, R.R.

    1984-09-01

    Magnetic resonance imaging (MR) (0.35T) and computed tomography (CT) were compared in 400 consecutive patients with suspected disease of the brain and cervical spinal cord. Of 325 positive diagnoses, MR detected abnormality while CT was normal in 93; MR was more specific in 68; MR and CT gave equivalent information in 129; CT was more specific in 32; and CT was positive while MR was normal in 3. MR was superior to CT in detection of multiple sclerosis, subcortical arteriosclerotic encephalopathy, posterior fossa infarcts and tumors, small extra-axial fluid collections, and cervical syringomyelia. CT was preferable in evaluation of meningiomas and separation of tumor from edema. CT takes less time and may be preferable in patients with acute trauma as well as very young or elderly individuals. Thus the two studies should be considered complementary.

  3. Comparison of CT and MR in 400 patients with suspected disease of the brain and cervical spinal cord

    International Nuclear Information System (INIS)

    Bradley, W.G. Jr.; Waluch, V.; Yadley, R.A.; Wycoff, R.R.

    1984-01-01

    Magnetic resonance imaging (MR) (0.35T) and computed tomography (CT) were compared in 400 consecutive patients with suspected disease of the brain and cervical spinal cord. Of 325 positive diagnoses, MR detected abnormality while CT was normal in 93; MR was more specific in 68; MR and CT gave equivalent information in 129; CT was more specific in 32; and CT was positive while MR was normal in 3. MR was superior to CT in detection of multiple sclerosis, subcortical arteriosclerotic encephalopathy, posterior fossa infarcts and tumors, small extra-axial fluid collections, and cervical syringomyelia. CT was preferable in evaluation of meningiomas and separation of tumor from edema. CT takes less time and may be preferable in patients with acute trauma as well as very young or elderly individuals. Thus the two studies should be considered complementary

  4. Epstein-Barr Virus-positive T-cell Lymphoproliferative Disease Following Umbilical Cord Blood Transplantation for Acute Myeloid Leukemia.

    Science.gov (United States)

    Yui, Shunsuke; Yamaguchi, Hiroki; Imadome, Ken-ichi; Arai, Ayako; Takahashi, Mikiko; Ohashi, Ryuji; Tamai, Hayato; Moriya, Keiichi; Nakayama, Kazutaka; Shimizu, Akira; Inokuchi, Koiti

    2016-01-01

    We report a case of the extremely rare condition Epstein-Barr virus (EBV)-positive T-cell lymphoproliferative disease (LPD) which occurred after umbilical cord blood transplantation. A 25-year-old Japanese man underwent cord blood transplantation from a male human leukocyte antigen 4/6-matched donor due to acute myeloid leukemia with trisomy 8. Bone marrow examination on day 30 showed chimerism with at least 90% donor cells and complete hematological response. Chronic symptoms of graft-versus-host disease appeared only on the skin and were successfully treated with cyclosporine alone. Three years later, however, the patient experienced repeated cold-like symptoms and was hospitalized with liver dysfunction. A high fever developed and was followed by significant edema of the right side of the face. The EBV DNA copy number in whole peripheral blood was 2×10(4)/mL. Liver biopsy showed invasion of EBV-infected CD8-positive T cells. Southern blotting analysis of the whole peripheral blood showed that the T-cell receptor Cβ1 rearrangement was positive. On the basis of these results, EBV-positive T-cell LPD was diagnosed and treated with prednisolone, cyclosporine, and etoposide, followed by cyclophosphamide, doxorubicin, vincristine, and prednisone. However, the patient died of cardiac function failure, pneumonia, and pulmonary hemorrhage, all of unidentified cause. Most cases of EBV-related LPD after hematopoietic stem cell transplantation consist of EBV-positive B-cell LPD, and, to our knowledge, de novo EBV-positive T-cell LPD subsequent to transplantation has not been previously reported.

  5. Angyomatous vocal polypus: a complete spontaneous regression

    Directory of Open Access Journals (Sweden)

    Edmir Américo Lourenço

    Full Text Available The authors describe a male patient who had malignant lymphoma seven years ago which remitted with chemotherapy.Two years ago he developed dysphonia. An unilateral, pediculate smooth red lesion on the right vocal fold was later discovered. Even without benefit of medicamentosus treatment, the patient refused surgery. In a reevaluation using rigid telescopy of the larynx two years later, the lesion had disappeared, completely and spontaneously. As there are no existing publications on this topic, this case report is an alert that surgery should be recommended with extreme caution in this type of vocal disease.

  6. Human Umbilical Cord Blood Stem Cells: Rational for Use as a Neuroprotectant in Ischemic Brain Disease

    Directory of Open Access Journals (Sweden)

    Hadar Arien-Zakay

    2010-09-01

    Full Text Available The use of stem cells for reparative medicine was first proposed more than three decades ago. Hematopoietic stem cells from bone marrow, peripheral blood and human umbilical cord blood (CB have gained major use for treatment of hematological indications. CB, however, is also a source of cells capable of differentiating into various non-hematopoietic cell types, including neural cells. Several animal model reports have shown that CB cells may be used for treatment of neurological injuries. This review summarizes the information available on the origin of CB-derived neuronal cells and the mechanisms proposed to explain their action. The potential use of stem/progenitor cells for treatment of ischemic brain injuries is discussed. Issues that remain to be resolved at the present stage of preclinical trials are addressed.

  7. Nonlinear dynamic mechanism of vocal tremor from voice analysis and model simulations

    Science.gov (United States)

    Zhang, Yu; Jiang, Jack J.

    2008-09-01

    Nonlinear dynamic analysis and model simulations are used to study the nonlinear dynamic characteristics of vocal folds with vocal tremor, which can typically be characterized by low-frequency modulation and aperiodicity. Tremor voices from patients with disorders such as paresis, Parkinson's disease, hyperfunction, and adductor spasmodic dysphonia show low-dimensional characteristics, differing from random noise. Correlation dimension analysis statistically distinguishes tremor voices from normal voices. Furthermore, a nonlinear tremor model is proposed to study the vibrations of the vocal folds with vocal tremor. Fractal dimensions and positive Lyapunov exponents demonstrate the evidence of chaos in the tremor model, where amplitude and frequency play important roles in governing vocal fold dynamics. Nonlinear dynamic voice analysis and vocal fold modeling may provide a useful set of tools for understanding the dynamic mechanism of vocal tremor in patients with laryngeal diseases.

  8. High-speed Imaging of Vocal Fold Vibration Onset Delay: Normal Versus Abnormal.

    Science.gov (United States)

    Woo, Peak

    2017-05-01

    Vocal fold vibration onset delay (VFVOD) is heard frequently in spasmodic dysphonia and in muscle tension dysphonia. VFVOD changes due to other vocal pathologies have not been investigated. VFVOD during sustained vowel production was estimated with high-speed video in 10 normal and 40 pathologic subjects (scars, vocal fold paralysis, vocal fold nodules, and polyps). Analysis of high-speed video was done using digital kymography. VFVOD can be divided into two portions. Pre-phonation delay (PPD) is the duration when the vocal folds are nearly approximated to the time of first observed oscillation. Steady state delay (SSD) is the time when vocal folds are observed to come into oscillation until steady state of oscillation is observed. Normal subjects have almost zero PPD with vocal fold oscillation observed before full vocal fold adduction. Pathologic cases showed prolonged PPD because of (1) false cord adduction, (2) prolonged true vocal fold adduction, and (3) delay to onset of vocal fold vibration. Normal subjects have SSD of three to five cycles before steady state. Pathologic states result in increased SSD. Causes for increased SSD include (1) slow ramping up to steady state, (2) partial vibration of vocal folds, and (3) diplophonia with alternating beats before achieving steady state. There are significant differences between normal and pathology groups in both PPD and SSD. VFVOD is elevated in pathologic states. This can be due to increase in PPD or SSD. VFVOD is an under-recognized phenomenon that may contribute to complaints of vocal fatigue and dysphonia. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  9. Absence of Association between Cord Specific Antibody Levels and Severe Respiratory Syncytial Virus (RSV) Disease in Early Infants: A Case Control Study from Coastal Kenya.

    Science.gov (United States)

    Nyiro, Joyce Uchi; Sande, Charles Jumba; Mutunga, Martin; Kiyuka, Patience Kerubo; Munywoki, Patrick Kioo; Scott, John Anthony G; Nokes, David James

    2016-01-01

    The target group for severe respiratory syncytial virus (RSV) disease prevention is infants under 6 months of age. Vaccine boosting of antibody titres in pregnant mothers could protect these young infants from severe respiratory syncytial virus (RSV) associated disease. Quantifying protective levels of RSV-specific maternal antibody at birth would inform vaccine development. A case control study nested in a birth cohort (2002-07) was conducted in Kilifi, Kenya; where 30 hospitalised cases of RSV-associated severe disease were matched to 60 controls. Participants had a cord blood and 2 subsequent 3-monthly blood samples assayed for RSV-specific neutralising antibody by the plaque reduction neutralisation test (PRNT). Two sample paired t test and conditional logistic regression were used in analyses of log2PRNT titres. The mean RSV log2PRNT titre at birth for cases and controls were not significantly different (P = 0.4) and remained so on age-stratification. Cord blood PRNT titres showed considerable overlap between cases and controls. The odds of RSV disease decreased with increase in log2PRNT cord blood titre. There was a 30% reduction in RSV disease per unit increase in log2PRNT titre (disease. Cord antibody levels show wide variation with considerable overlap between cases and controls. It is likely that, there are additional factors to specific PRNT antibody levels which determine susceptibility to severe RSV disease. In addition, higher levels of neutralizing antibody beyond the normal range may be required for protection; which it is hoped can be achieved by a maternal RSV vaccine.

  10. Learn About Neuromuscular Disease

    Science.gov (United States)

    ... cause weakness and degeneration of the skeletal muscles. Becker muscular dystrophy (BMD) Congenital muscular dystrophies (CMD) Bethlem CMD Fukuyama ... Hyperkalemic periodic paralysis Hypokalemic periodic paralysis Myotonia ... muscular dystrophy Vocal cord and pharyngeal distal myopathy Welander distal ...

  11. Vocal Fold Collision Modeling

    DEFF Research Database (Denmark)

    Granados, Alba; Brunskog, Jonas; Misztal, M. K.

    2015-01-01

    When vocal folds vibrate at normal speaking frequencies, collisions occurs. The numerics and formulations behind a position-based continuum model of contact is an active field of research in the contact mechanics community. In this paper, a frictionless three-dimensional finite element model...

  12. Spinal cord swelling as a myelographic indicator of prognosis: a retrospective study in dogs with intervertebral disc disease and loss of deep pain perception

    International Nuclear Information System (INIS)

    Duval, J.; Dewey, C.; Roberts, R.; Aron, D.

    1996-01-01

    The association of myelographic spinal cord swelling with neurological outcome was examined in 46 dogs with intervertebral disc disease and absence of deep pain perception (DPP). Spinal cord swelling was measured by calculating a ratio of the length of the loss of the myelographic dye column to the length of the second lumbar vertebra (L2). A positive neurological outcome was defined as return of voluntary motor function. A cut-off value for swelling:L2 of 5.0 was established by the creation of a receiver operator characteristic curve. Using a swelling:L2 ratio of 5.0 as a cutoff for indication of neurological recovery yielded a sensitivity of 74% and a specificity of 61%. Overall neurological recovery rate was 43%. Dogs with spinal cord swelling:L2 ratios less than 5.0 had a recovery rate of 61%, whereas dogs with a ratio greater than or equal to 5.0 had a recovery rate of 26%. Evaluation of these data by chi square analysis confirmed that a ratio less than 5.0 was associated with a positive outcome, and a ratio greater than or equal to 5.0 was associated with a negative outcome, (P < .05). Although other factors, such as duration of neurological signs, affect neurological outcome in dogs with no DPP, evaluation of myelographic spinal cord swelling can assist in establishing a prognosis

  13. Interleukin-6, interleukin-8, and soluble tumor necrosis factor receptor-I in the cord blood as predictors of chronic lung disease in premature infants.

    Science.gov (United States)

    An, Hiromi; Nishimaki, Shigeru; Ohyama, Makiko; Haruki, Atsushi; Naruto, Takuya; Kobayashi, Naoki; Sugai, Toshiyuki; Kobayashi, Yoshinori; Mori, Masaaki; Seki, Kazuo; Yokota, Shumpei

    2004-11-01

    In order to predict the late-development of chronic lung disease of prematurity (CLD), cytokines in the cord blood were assessed in this study. Eighteen premature infants with CLD were enrolled. Cord blood plasma levels of cytokines of these infants and 12 control infants without CLD were measured including interleukin (IL)-1beta, IL-2, IL-4, IL-6, IL-8, IL-10, interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, soluble TNF receptor-I, and soluble IL-6 receptor using a cytometric bead array and an enzyme-linked immunosorbent assay. The cord blood IL-6, IL-8, and sTNFR-I levels were significantly elevated in CLD infants compared with those in control (P < .05). IL-1beta, IL-2, IL-4, IL-10, and IFN-gamma were undetectable in both groups. CLD infants with maternal chorioamnionitis had higher IL-6 than those without chorioamnionitis (P < .01). In CLD infants, IL-6 was higher in the infants who required prolonged oxygen therapy (P < .05). Elevated inflammatory cytokines in the cord blood are associated with the progression to CLD.

  14. Cardiovascular disease risk factors in persons with paraplegia: the Stockholm spinal cord injury study.

    Science.gov (United States)

    Wahman, Kerstin; Nash, Mark S; Westgren, Ninni; Lewis, John E; Seiger, Ake; Levi, Richard

    2010-03-01

    To examine cardiovascular disease risk factors and risk clusters in Swedish persons with traumatic wheelchair-dependent paraplegia. Prospective examination. A total of 135 individuals aged 18-79 years with chronic (>or= 1 year) post-traumatic paraplegia. Cardiovascular disease risk factors; dyslipidemia, impaired fasting glucose, hypertension, overweight, smoking, and medication usage for dyslipidemia, hypertension, and diabetes mellitus, were analyzed according to authoritative guidelines. Stepwise regression tested the effects of age, gender, and injury characteristics on cardiovascular disease risks. High-prevalence risk factors were dyslipidemia (83.1%), hypertension (39.3%), and overweight (42.2%) with pervasive clustering of these risks. Being older was related to increased cardiovascular disease risk, except for dyslipidemia. Hypertension was more common in low-level paraplegia. Prevalence of impaired fasting glucose was lower than previously reported after paraplegia. A high percentage of persons being prescribed drug treatment for dyslipidemia and hypertension failed to reach authoritative targets for cardiovascular disease risk reduction. Swedish persons with paraplegia are at high risk for dyslipidemia, hypertension, and overweight. Impaired fasting glucose was not as common as reported in some previous studies. Pharmacotherapy for dyslipidemia and hypertension often failed to achieve recommended targets. Population-based screening and therapeutic countermeasures to these cardiovascular disease risks are indicated.

  15. Radiation-related vocal fold palsy in patients with head and neck carcinoma.

    Science.gov (United States)

    Jaruchinda, Pariyanan; Jindavijak, Somjin; Singhavarach, Natchavadee

    2012-05-01

    Recurrent laryngeal nerve damage is a rare complication after receiving conventional radiotherapy for treatment of head and neck cancers and will always be underestimated. The purpose of the present study was to focus on the prevalence of vocal cord paralysis after irradiation and the natural history in those patients. All patients who received more than 60 Gy radiation dose of convention radiotherapy for treatment of head and neck carcinoma from Phramongkutklao Hospital and Nation Cancer Institute of Thailand were recruited in the present study duringfollow-up period between May 2006-December 2007. The subjects had to have good mobility of bilateral vocal cords with no recurrence or persistent tumor before the enrollment. Baseline characteristic and the associated symptoms of the recurrent laryngeal nerve paralysis were recorded. Laryngeal examinations were done byfiberoptic laryngoscope and in suspicious cases; stroboscope and/or laryngeal electromyography were also performed. The vocal fold paralysis was diagnosed by reviewing recorded VDO by 2 laryngologist who were not involved in the present study. 70 patients; 51 male and 19female were recruited. 5 patients (7.14%) were diagnosed to have vocal cord paralysis and 2 patients (2.86%) were found to have vocal cord paresis confirmed by electromyography. Most of them were the patients with nasopharyngeal cancers (6/7) with the only one had oropharyngeal cancer (1/7). All of the paralysis/paresis was unilateral lesion; 4 on the left and 3 on the right side. The duration from the patients completed radiotherapy to the time of the diagnosis of vocal cord palsy was 14-35 months. The measure of agreement or Kappa value with 95% CI was 0.818 +/- 0.245. Associated symptoms of vocal cord palsy are hoarseness (100%), dysphagia (28.6%) and aspiration (28.6%). A significant number of vocal fold palsy may occur in patients with head and neck carcinoma after receiving conventional radiotherapy. Subcutaneous fibrosis or

  16. Spinal cord injury and Parkinson's disease: a population-based, propensity score-matched, longitudinal follow-up study.

    Science.gov (United States)

    Yeh, T-S; Huang, Y-P; Wang, H-I; Pan, S-L

    2016-12-01

    To investigate whether patients with spinal cord injury (SCI) are at an increased risk of developing Parkinson's disease (PD). A population-based, propensity score-matched, longitudinal follow-up cohort study. The study was conducted using the National Health Insurance (NHI) Research Database. A total of 10 125 patients with at least 2 ambulatory visits with a diagnosis of SCI in 2001 were enrolled in the SCI group. The non-SCI group comprised 10 125 propensity score-matched patients without SCI. The propensity scores were computed using a logistic regression model that included age, sex, comorbidities and socioeconomic status. The PD-free survival rates of the two groups were estimated using the Kaplan-Meier method. Stratified Cox proportional hazard regression was used to estimate the effect of SCI on subsequent occurrence of PD. During the 3-year follow-up period, 99 subjects in the SCI group and 59 in the non-SCI group developed PD. The hazard ratio of PD for the SCI group compared with the non-SCI group was 1.65 (95% confidence interval 1.16-2.33, P=0.0049). The PD-free survival rate for the SCI group was lower than that for the non-SCI group (P=0.0017). This study shows that SCI is associated with a subsequent increased risk of PD. Further studies are needed to elucidate the mechanism underlying this association.

  17. Vocal evaluation in teachers with or without symptoms.

    Science.gov (United States)

    Tavares, Elaine L M; Martins, Regina H G

    2007-07-01

    The aim of this study was to perform voice evaluation in teachers with and without vocal symptoms, identifying etiologic factors of dysphonia, voice symptoms, vocal qualities, and laryngeal lesions. Eighty teachers were divided into two groups: GI (without or sporadic symptoms, 40) and GII (with frequent vocal symptoms, 40). They answered a specific questionnaire, and were subject to a perceptual vocal assessment (maximum phonation time, glottal attack, resonance, coordination of breathing and voicing, pitch, and loudness), GIRBAS scale, and to videolaryngoscopy. Females were predominant in both groups, and the age range was from 36 to 50 years. Elementary teachers predominated, working in classes with 31-40 students. Voice symptoms and alterations in the perceptual vocal analysis and in the GIRBAS scale were more frequent in GII. In 46 teachers (GI-16; GII-30), videolaryngoscopy exams were abnormal with the vocal nodules being the most frequent lesions. These results indicate that a teacher's voice is compromised, and requires more attention including control of environmental factors and associated diseases, preventive vocal hygiene, periodic laryngeal examinations, and access to adequate specialist treatment.

  18. Cervical osteophytes presenting as unilateral vocal fold paralysis and dysphagia.

    Science.gov (United States)

    Yoskovitch, A; Kantor, S

    2001-05-01

    Any process involving either the vagus nerve, its recurrent laryngeal branch or the external branch of the superior laryngeal nerve may cause paralysis of the vocal fold. The most common cause is neoplasm. Clinically, the patients often present with a hoarse, breathy voice as well as symptoms of aspiration. The following represents a unique case of unilateral vocal fold paralysis and dysphagia caused by a degenerative disease of the cervical spine, resluting in extrinsic compression of the recurrent laryngeal nerve.

  19. Spinal cord stimulation for the treatment of abnormal posture and gait disorder in patients with Parkinson's disease.

    Science.gov (United States)

    Agari, Takashi; Date, Isao

    2012-01-01

    Patients with advanced Parkinson's disease (PD) often present with axial symptoms, including abnormal posture, postural instability, and gait disorder. Although spinal cord stimulation (SCS) is effective for pain, little is known about the effect of SCS on motor function in PD patients. The present study investigated the effect of SCS on posture and gait in 15 PD patients, 5 men and 10 women aged 63-79 years (mean 71.1 years), with low back pain and leg pain who received SCS. A visual analog scale (VAS) was used for pain evaluation pre- and postoperatively. The Unified Parkinson's Disease Rating Scale, Timed Up and Go tests, and Timed 10-Meter Walk tests were used to evaluate motor function and activities of daily living of patients. Preoperative mean VAS score was 8.9 (range 7.8-10), which showed significant postoperative improvement at 3 months to mean VAS score of 2.0 (range 0-3.3). The improvements in VAS scores persisted at 12 months after surgery with mean VAS score of 2.3 (range 0-4). Posture and postural stability motor subscores were improved at 3 months after SCS, and gait had significantly improved at 3 months and 1 year after surgery. Timed 10-Meter Walk tests also demonstrated that patient gait was significantly improved at 3 months and 12 months after surgery. Most advanced stage PD patients suffer considerable pain that causes abnormal posture and gait disturbance. SCS is expected to lead to both amelioration of pain and improvement of motor function in such patients.

  20. Vocal therapy of hyperkinetic dysphonia

    OpenAIRE

    Mumović Gordana; Veselinović Mila; Arbutina Tanja; Škrbić Renata

    2014-01-01

    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...

  1. Vocal fold injection medialization laryngoplasty.

    Science.gov (United States)

    Modi, Vikash K

    2012-01-01

    Unilateral vocal fold paralysis (UVFP) can cause glottic insufficiency that can result in hoarseness, chronic cough, dysphagia, and/or aspiration. In rare circumstances, UVFP can cause airway obstruction necessitating a tracheostomy. The treatment options for UVFP include observation, speech therapy, vocal fold injection medialization laryngoplasty, thyroplasty, and laryngeal reinnervation. In this chapter, the author will discuss the technique of vocal fold injection for medialization of a UVFP. Copyright © 2012 S. Karger AG, Basel.

  2. Spinal Cord Stimulation

    DEFF Research Database (Denmark)

    Meier, Kaare

    2014-01-01

    Spinal cord stimulation (SCS) is a surgical treatment for chronic neuropathic pain that is refractory to other treatment. Originally described by Shealy et al. in 1967(1), it is used to treat a range of conditions such as complex regional pain syndrome (CRPS I)(2), angina pectoris(3), radicular...... pain after failed back surgery syndrome (FBSS)(4), pain due to peripheral nerve injury, stump pain(5), peripheral vascular disease(6) and diabetic neuropathy(7,8); whereas phantom pain(9), postherpetic neuralgia(10), chronic visceral pain(11), and pain after partial spinal cord injury(12) remain more...

  3. A Case of Adult-Onset Alexander Disease Featuring Severe Atrophy of the Medulla Oblongata and Upper Cervical Cord on Magnetic Resonance Imaging

    Science.gov (United States)

    Yonezu, Tadahiro; Ito, Shoichi; Kanai, Kazuaki; Masuda, Saeko; Shibuya, Kazumoto; Kuwabara, Satoshi

    2012-01-01

    Adult-onset Alexander disease (AOAD) has been increasingly recognized since the identification of the glial fibrillary acidic protein gene mutation in 2001. We report on a 56-year-old man who was genetically confirmed as AOAD with the glial fibrillary acidic protein mutation of p.M74T. He developed spastic tetraparesis, sensory disturbances in four limbs, and mild cognitive impairment without apparent dysarthria and dysphagia. The case was characterized by severe atrophy of the medulla oblongata and upper cervical cord with intramedullary signal intensity changes on magnetic resonance imaging. While AOAD is diverse in clinical presentation, the peculiar magnetic resonance imaging findings of marked atrophy of the medulla oblongata and cervical cord are thought to be highly suggestive of the diagnosis of AOAD. PMID:23185175

  4. Coronary artery disease and hypertension in a non-selected spinal cord injury patient population.

    Science.gov (United States)

    Aidinoff, E; Bluvshtein, V; Bierman, U; Gelernter, I; Front, L; Catz, A

    2017-03-01

    Retrospective observational comparative study. The objectives of this study were to assess the atherosclerosis diseases and risk factors prevalence after spinal cored injury (SCI). Loewenstein Rehabilitation Hospital, Israel. Data of 154 traumatic and non-traumatic SCI patients were retrospectively collected. Coronary artery disease (CAD), myocardial infarction (MI), hypertension (HT) and risk factors for atherosclerotic diseases were examined after SCI for prevalence and effects, and compared with published corresponding data of the general population. CAD, MI and HT were found in 11.7, 6.7 and 29.2% of 120 patients, aged 53.4±11.1 years, 83.3% males, who survived until the end of the follow-up. Corresponding values for the general population, adjusted for age, gender and years of education, are 8.5, 6.6 and 24.9% in Israel, and 10.2% for CAD and 40.3% for HT, in US. Body mass index>30 increased the odds of acquiring CAD (P=0.016). Hypercholesterolemia and older age at injury increased the hazard for HT (P=0.044; P=0.019, respectively). A steady partner decreased the risk of CAD (P=0.029). HT was more prevalent at T 4 -T 6 than above T 4 (52 vs 23.3%, P=0.02). Patients with SCI below T 6 had a higher rate of diabetes mellitus, hypercholesterolemia, and past smoking, and fewer years of education than those with SCI above T 7 (P=0.016; P=0.032; P=0.034; P=0.014, respectively). The prevalence of CAD, HT and some of their risk factors after SCI is generally, but not consistently and not statistically significant, slightly higher than in the corresponding general population. The challenge is to reduce the prevalence of atherosclerotic morbidity after SCI below that in the general population.

  5. Vocal fold immobility: a longitudinal analysis of etiology over 20 years.

    Science.gov (United States)

    Rosenthal, Laura H Swibel; Benninger, Michael S; Deeb, Robert H

    2007-10-01

    To determine the current etiology of vocal fold immobility, identify changing trends over the last 20 years, and compare results to historical reports. The present study is a retrospective analysis of all patients seen within a tertiary care institution between 1996 and 2005 with vocal fold immobility. The results were combined with a previous study of patients within the same institution from 1985 through 1995. Results were compared to the literature. The medical records of all patients assigned a primary or additional diagnostic code for vocal cord paralysis were obtained from the electronic database. Eight hundred twenty-seven patients were available for analysis (435 from the most recent cohort), which is substantially larger than any reported series to date. Vocal fold immobility was most commonly associated with a surgical procedure (37%). Nonthyroid surgeries (66%), such as anterior cervical approaches to the spine and carotid endarterectomies, have surpassed thyroid surgery (33%) as the most common iatrogenic causes. These data represent a change from historical figures in which extralaryngeal malignancies were considered the major cause of unilateral immobility. Thyroidectomy continues to cause the majority (80%) of iatrogenic bilateral vocal fold immobility and 30% of all bilateral immobility. This 20-year longitudinal assessment revealed that the etiology of unilateral vocal fold immobility has changed such that there has been a shift from extralaryngeal malignancies to nonthyroid surgical procedures as the major cause. Thyroid surgery remains the most common cause of bilateral vocal fold immobility.

  6. A Morphological Analyzer for Vocalized or Not Vocalized Arabic Language

    Science.gov (United States)

    El Amine Abderrahim, Med; Breksi Reguig, Fethi

    This research has been to show the realization of a morphological analyzer of the Arabic language (vocalized or not vocalized). This analyzer is based upon our object model for the Arabic Natural Language Processing (NLP) and can be exploited by NLP applications such as translation machine, orthographical correction and the search for information.

  7. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal ... Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal ...

  8. Spinal Cord Injury 101

    Medline Plus

    Full Text Available menu Understanding Spinal Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal Cord Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal ...

  9. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal ... Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal ...

  10. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal ... Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal ...

  11. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Animated Spinal Cord Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal ... Animated Spinal Cord Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal ...

  12. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ...

  13. Collagen Content Limits Optical Coherence Tomography Image Depth in Porcine Vocal Fold Tissue.

    Science.gov (United States)

    Garcia, Jordan A; Benboujja, Fouzi; Beaudette, Kathy; Rogers, Derek; Maurer, Rie; Boudoux, Caroline; Hartnick, Christopher J

    2016-11-01

    Vocal fold scarring, a condition defined by increased collagen content, is challenging to treat without a method of noninvasively assessing vocal fold structure in vivo. The goal of this study was to observe the effects of vocal fold collagen content on optical coherence tomography imaging to develop a quantifiable marker of disease. Excised specimen study. Massachusetts Eye and Ear Infirmary. Porcine vocal folds were injected with collagenase to remove collagen from the lamina propria. Optical coherence tomography imaging was performed preinjection and at 0, 45, 90, and 180 minutes postinjection. Mean pixel intensity (or image brightness) was extracted from images of collagenase- and control-treated hemilarynges. Texture analysis of the lamina propria at each injection site was performed to extract image contrast. Two-factor repeated measure analysis of variance and t tests were used to determine statistical significance. Picrosirius red staining was performed to confirm collagenase activity. Mean pixel intensity was higher at injection sites of collagenase-treated vocal folds than control vocal folds (P Fold change in image contrast was significantly increased in collagenase-treated vocal folds than control vocal folds (P = .002). Picrosirius red staining in control specimens revealed collagen fibrils most prominent in the subepithelium and above the thyroarytenoid muscle. Specimens treated with collagenase exhibited a loss of these structures. Collagen removal from vocal fold tissue increases image brightness of underlying structures. This inverse relationship may be useful in treating vocal fold scarring in patients. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  14. Increased cardiovascular disease risk in Swedish persons with paraplegia: The Stockholm spinal cord injury study.

    Science.gov (United States)

    Wahman, Kerstin; Nash, Mark S; Lewis, John E; Seiger, Ake; Levi, Richard

    2010-05-01

    Comparison of prevalence of cardiovascular disease risks in persons with chronic traumatic paraplegia with those in the general population. Cross-sectional comparative study. A total of 135 individuals, age range 18-79 years, with chronic (> or = 1 year) traumatic paraplegia. The prevalences of diabetes mellitus, dyslipidaemia, hypertension, overweight, and smoking, were assessed in the study population and were compared with an age- and gender-matched sample of the general population in the region under study. History of myocardial infarction and medication for dyslipidaemia, hypertension, and diabetes mellitus were also recorded. chi2 tests were used to compare the paraplegic cohort with the general population sample. Significantly more persons with paraplegia reported a history of myocardial infarction (5.9%) than those in the comparison group (0.7%). The prevalences of diabetes mellitus (5.9%), dyslipidaemia (11.1%), and hypertension (14.1%) were also significantly higher in the paraplegic group, as were drug treatment for these disorders. Persons with paraplegia report increased prevalences of diabetes mellitus, hypertension, and dyslipidaemia, in particular, compared with the general population. Population-based screening and therapeutic counter-measures for these conditions may therefore be particularly indicated for this patient group.

  15. Cytokine treatment optimises the immunotherapeutic effects of umbilical cord-derived MSC for treatment of inflammatory liver disease.

    Science.gov (United States)

    de Witte, Samantha F H; Merino, Ana M; Franquesa, Marcella; Strini, Tanja; van Zoggel, Johanna A A; Korevaar, Sander S; Luk, Franka; Gargesha, Madhu; O'Flynn, Lisa; Roy, Debashish; Elliman, Steve J; Newsome, Philip N; Baan, Carla C; Hoogduijn, Martin J

    2017-06-08

    Mesenchymal stromal cells (MSC) possess immunomodulatory properties and low immunogenicity, both crucial properties for their development into an effective cellular immunotherapy. They have shown benefit in clinical trials targeting liver diseases; however the efficacy of MSC therapy will benefit from improvement of the immunomodulatory and immunogenic properties of MSC. MSC derived from human umbilical cords (ucMSC) were treated for 3 days in vitro with various inflammatory factors, interleukins, vitamins and serum deprivation. Their immunogenicity and immunomodulatory capacity were examined by gene-expression analysis, surface-marker expressions, IDO activity, PGE 2 secretion and inhibition of T cell proliferation and IFNγ production. Furthermore, their activation of NK cell cytotoxicity was investigated via CD107a expression on NK cells. The immunomodulatory capacity, biodistribution and survival of pre-treated ucMSC were investigated in a CCl 4 -induced liver disease mouse model. In addition, capacity of pre-treated MSC to ameliorate liver inflammation was examined in an ex vivo liver inflammation co-culture model. IFN-γ and a multiple cytokine cocktail (MC) consisting of IFN-γ, TGFβ and retinoic acid upregulated the expression of immunomodulatory factor PD-L1 and IDO activity. Subsequently, both treatments enhanced the capacity of ucMSC to inhibit CD4 and CD8 T cell proliferation and IFN-γ production. The susceptibility of ucMSC for NK cell lysis was decreased by IFN-β, TGFβ and MC treatment. In vivo, no immunomodulation was observed by the ucMSC. Four hours after intravenous infusion in mice with CCl 4 -induced inflammatory liver injury, the majority of ucMSC were trapped in the lungs. Rapid clearance of ucMSC(VitB 6 ), ucMSC(Starv + VitB 6 ) and ucMSC(MC) and altered bio-distribution of ucMSC(TGFβ) compared to untreated ucMSC was observed. In the ex vivo co-culture system with inflammatory liver slices ucMSC(MC) showed significantly enhanced

  16. Força muscular respiratória, postura corporal, intensidade vocal e tempos máximos de fonação na Doença de Parkinson Respiratory muscle strength, body posture, vocal intensity and maximum phonation times in Parkinson Disease

    Directory of Open Access Journals (Sweden)

    Fernanda Vargas Ferreira

    2012-04-01

    Full Text Available TEMA: Verificar os achados de força muscular respiratória (FMR, postura corporal (PC, intensidade vocal (IV e tempos máximos de fonação (TMF, em indivíduos com Doença de Parkinson (DP e casos de controle, conforme o sexo, o estágio da DP e o nível de atividade física (AF. PROCEDIMENTOS: três homens e duas mulheres com DP, entre 36 e 63 anos (casos de estudo - CE, e cinco indivíduos sem doenças neurológicas, pareados em idade, sexo e nível de AF (casos de controle - CC. Avaliadas a FMR, PC, IV e TMF. RESULTADOS: homens: diminuição mais acentuada dos TMF, IV e FMR nos parkinsonianos, mais alterações posturais nos idosos; mulheres com e sem DP: alterações posturais similares, relação positiva entre estágio, nível de AF e as demais medidas. CONCLUSÕES: Verificou-se nas parkinsonianas, prejuízo na IV e nos parkinsonianos déficits nos TMF, IV e FMR. Sugerem-se novos estudos sob um viés interdisciplinar.PURPOSE: To check the findings on respiratory muscular strength (RMS, body posture (BP, vocal intensity (VI and maximum phonation time (MPT, in patients with Parkinson Disease (PD and control cases, according to gender, Parkinson Disease stage (PD and the level of physical activity (PA. METHODS: three men and two women with PD, between 36 and 63 year old (study cases - SC, and five subjects without neurologic diseases, of the same age, gender and PA level (control cases - CC. We evaluated RMS, BP, VI and MPT. RESULTS: men: a more pronounced decrease of MPT, VI, RMS in Parkinson patients, plus postural alterations in the elderly; women: similar postural alterations, positive relation between stages, PA level and the other measures. CONCLUSIONS: We observed in women with PD, impaired VI; in men with PD deficits in MPT, VI, RMS. We suggest further studies under an interdisciplinary bias.

  17. Time course of recovery of idiopathic vocal fold paralysis.

    Science.gov (United States)

    Husain, Solomon; Sadoughi, Babak; Mor, Niv; Levin, Ariana M; Sulica, Lucian

    2018-01-01

    To clarify the time course of recovery in patients with idiopathic vocal fold paralysis. Retrospective chart review. Medical records for all patients with idiopathic vocal fold paralysis over a 10-year period were reviewed to obtain demographic and clinical information, including onset of disease and recovery of vocal function. Stroboscopic exams of patients who recovered voice were reviewed blindly to assess return of vocal fold motion. Thirty-eight of 55 patients (69%) recovered vocal function. Time course of recovery could be assessed in 34 patients who did not undergo injection augmentation. The mean time to recovery was 152.8 ± 109.3 days (left, 179.8 ± 111.3 days; right, 105.3 ± 93.7 days; P = .088). Two-thirds of patients recovered within 6 months. Probability of recovery declined over time. Five of 22 patients who recovered voice had return of vocal fold motion; 17 did not. The mean time to recovery did not differ between these groups (return of motion, 127.4 ± 132.3 days; no return of motion, 160.1 ± 105.1 days; P = .290). Sixty-nine percent of patients with idiopathic vocal fold paralysis recovered vocal function, two-thirds doing so within 6 months of onset. Age, gender, laterality, use of injection augmentation did not influence recovery rate. Declining probability of recovery over time leads us to consider framework surgery after 6 months in patients with idiopathic paralysis. 4. Laryngoscope, 128:148-152, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Do Talkativeness and Vocal Loudness Correlate With Laryngeal Pathology? A Study of the Vocal Overdoer/Underdoer Continuum.

    Science.gov (United States)

    Bastian, Robert W; Thomas, James P

    2016-09-01

    Assess the correlation between self-rating scales of talkativeness and loudness with various types of voice disorders. This is a retrospective study. A total of 974 patients were analyzed. The cohort study included 430 consecutive patients presenting to the senior author with voice complaints from December 1995 to December 1998. The case-control study added 544 consecutive patients referred to the same examiner from January 1988 to December 1998 for vocal fold examination before thyroid, parathyroid, and carotid surgery. Patient responses on seven-point Likert self-rating scales of talkativeness and loudness were compared with laryngeal disease. Mucosal lesions clearly associated with vibratory trauma are strongly associated with a high self-rating of talkativeness. Laryngeal deconditioning disorders were associated with a low self-rating of talkativeness. Use of a simple self-rating scale of vocal loudness and talkativeness during history taking can reliably orient the examiner to the types of voice disorders likely to be diagnosed subsequently during vocal capability testing and visual laryngeal examination. The high degree of talkativeness and loudness seen in vocal overdoers correlates well with mucosal disorders such as nodules, polyps, capillary ectasia, epidermoid inclusion cysts, and hemorrhage. A lower degree of talkativeness correlates with muscle deconditioning disorders such as vocal fold bowing, atrophy, presbyphonia, and vocal fatigue syndrome. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  19. Comparative study in swines' vocal cords healing after excision of fragment with CO2 laser with mitomycin and 5-fluorouracil postoperative topical application Estudo comparado da cicatrização da prega vocal de suínos após exérese de fragmento com laser de CO2 e aplicação tópica pós-operatória de mitomicina e 5-fluorouracil

    Directory of Open Access Journals (Sweden)

    Eduardo Baptistella

    2009-02-01

    Full Text Available PURPOSE: To evaluate the deposition of collagen fibers at pig's vocal folds after topical use of mitomycin or 5-fluorouracil, when partial exeresis of mucosa layer had been promoted by CO2 laser. METHODS: There were used 18 Larger white pigs which were anesthetized and submitted to mucosa fragment's exeresis, bilaterally, at its free border. The animals were divided into 3 groups, each one with 6 animals: control group, without topical drug application; mitomycin group; and 5-fluorouracil group. After 30 days, the animals were subjected to euthanasia, and samples of the vocal folds were collected and stained by picrosirius red technique with polarization for quantification of total collagen deposition. RESULTS: In control group, the mean rate of right vocal fold's collagen deposition at submucosa consisted in a 3428.66 micrometers area. There was found an area whose size had, in average, 2196.36 micrometers, in mitomycin group, and 2269.19 micrometers, in 5-fluorouracil group. CONCLUSION: Mitomycin and 5-fluorouracil had promoted beneficial change in vocal fold's cicatrization with less collagen deposition, but there was no significant statistically difference when they were compared between themselves.OBJETIVO: Avaliar a deposição das fibras de colágeno total em pregas vocais suínas após o uso tópico de mitomicina ou 5-fluorouracil nas exéreses parciais de mucosa com laser de CO2. MÉTODOS: Foram utilizados 18 porcos da raça Larger white anestesiados e submetidos à exérese de fragmento de mucosa de borda livre da prega vocal direita e prega vocal esquerda. Os animais foram divididos em 3 grupos com 6 animais cada: grupo controle, sem aplicação de medicação tópica; grupo mitomicina, com uso tópico dessa substância; grupo 5-fluorouracil, uso tópico. Após 30 dias do experimento os animais foram submetidos à eutanásia, coletadas amostras das pregas vocais e coradas pela técnica do picrosirius red com polarização para a

  20. Cord Blood Chimerism And Relapse After Haplo-Cord Transplantation

    Science.gov (United States)

    van Besien, Koen; Koshy, Nebu; Gergis, Usama; Mayer, Sebastian; Cushing, Melissa; Rennert, Hannah; Slotky, Ronit; Mark, Tomer; Pearse, Roger; Rossi, Adriana; Phillips, Adrienne; Vasovic, Liljana; Ferrante, Rosanna; Hsu, Michael; Shore, Tsiporah

    2018-01-01

    Haplo-cord stem cell transplantation combines the infusion of CD34 selected hematopoietic progenitors from a haplo-identical donor with an umbilical cord blood graft from an unrelated donor and allows faster count recovery, with low rates of disease recurrence and chronic GVHD. But the contribution of the umbilical cord blood graft to long-term transplant outcome remains unclear. We analyzed 39 recipients of haplo-cord transplants with AML and MDS, engrafted and in remission at 2 months. Median age was 66 (18-72) and all had intermediate, high, or very high risk disease. Less than 20% UCB chimerism in the CD33 lineage was associated with an increased rate of disease recurrence (54% vs 11% Pdisease recurrence (46% vs 12%, P=0.007) Persistent haplo-chimerism in the CD3 lineage was associated with an increased rate of disease recurrence (40% vs 15%, P=0.009) Chimerism did not predict for treatment related mortality. The cumulative incidence of acute GVHD by day 100 was 43%. The cumulative incidence of moderate/severe chronic GVHD was only 5%. Engraftment of the umbilical cord blood grafts provides powerful GVL effects which protect against disease recurrence and is associated with low risk of chronic GVHD. Engraftment of CD34 selected haplo-identical cells can lead to rapid development of circulating T-cells, but when these cells dominate, GVL-effects are limited and rates of disease recurrence are high. PMID:27333804

  1. Nutrition education for cardiovascular disease prevention in individuals with spinal cord injuries: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Lieberman, Jesse A; McClelland, Jacquelyn W; Goff, David C; Racine, Elizabeth; Dulin, Michael F; Bauman, William A; Niemeier, Janet; Hirsch, Mark A; Norton, H James; Moore, Charity G

    2017-12-04

    Individuals with chronic spinal cord injuries (SCIs) have an increased prevalence of cardiovascular disease (CVD) and associated risk factors compared with age-matched control subjects. Exercise has been shown to improve selected CVD risk factors in individuals with SCI, but using nutrition education as an intervention has not been evaluated in this population. This paper describes our research plan for evaluating the effect of nutrition education on individuals with SCI. In the present study, called Eat Smart, Live Better, we are using a randomized controlled design to test an intervention adapted from an existing evidence-based program that showed a positive effect on nutrition knowledge and behavior of older adults from the general population. There will be an inpatient group (n = 100) and a community group (n = 100). The aims of our study are to compare the intervention and control groups for (1) changes in nutritional behavior, nutritional knowledge, and dietary quality by participants in the program; (2) levels of adiposity and metabolic CVD risk factors at 12-month follow-up; and (3) differential effects among individuals with SCI in the acute rehabilitation setting and those living in the community. This is a randomized controlled trial of nutrition education. The treatment groups receive six nutrition education sessions. The control groups receive the one "standard of care" nutrition lecture that is required by the Commission on Accreditation of Rehabilitation Facilities. Treatment groups include both an inpatient group, comprising patients who have been admitted to an acute rehabilitation facility because of their recent SCI, and an outpatient group, consisting of community-dwelling adults who are at least 1 year after their SCI. A total of 200 participants will be randomized 1:1 to the intervention or control group, stratified by location (acute rehabilitation facility or community dwelling). To our knowledge, this will be the first reported

  2. Vocal therapy of hyperkinetic dysphonia

    Directory of Open Access Journals (Sweden)

    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.

  3. Cord Blood Banking for Potential Future Transplantation.

    Science.gov (United States)

    Shearer, William T; Lubin, Bertram H; Cairo, Mitchell S; Notarangelo, Luigi D

    2017-11-01

    This policy statement is intended to provide information to guide pediatricians, obstetricians, and other medical specialists and health care providers in responding to parents' questions about cord blood donation and banking as well as the types (public versus private) and quality of cord blood banks. Cord blood is an excellent source of stem cells for hematopoietic stem cell transplantation in children with some fatal diseases. Cord blood transplantation offers another method of definitive therapy for infants, children, and adults with certain hematologic malignancies, hemoglobinopathies, severe forms of T-lymphocyte and other immunodeficiencies, and metabolic diseases. The development of universal screening for severe immunodeficiency assay in a growing number of states is likely to increase the number of cord blood transplants. Both public and private cord blood banks worldwide hold hundreds of thousands of cord blood units designated for the treatment of fatal or debilitating illnesses. The procurement, characterization, and cryopreservation of cord blood is free for families who choose public banking. However, the family cost for private banking is significant and not covered by insurance, and the unit may never be used. Quality-assessment reviews by several national and international accrediting bodies show private cord blood banks to be underused for treatment, less regulated for quality control, and more expensive for the family than public cord blood banks. There is an unquestionable need to study the use of cord blood banking to make new and important alternative means of reconstituting the hematopoietic blood system in patients with malignancies and blood disorders and possibly regenerating tissue systems in the future. Recommendations regarding appropriate ethical and operational standards (including informed consent policies, financial disclosures, and conflict-of-interest policies) are provided for physicians, institutions, and organizations that

  4. IMPAIRED MOBILITY OF VOCAL FOLDS – DIAGNOSTIC PROCEDURES AND TREATMENT, part 2

    Directory of Open Access Journals (Sweden)

    Karlo Pintarić

    2015-09-01

    Full Text Available Paresis or paralysis of one or both vocal cords affects phonation, swallowing and breathing. The major cause for reduced mobility or even immobility is innervation damage, less often mechanical disorder.The main procedures in the diagnostics of disordered vocal fold mobility are indirect laryngoscopy and videoendostroboscopy. Different imaging techniques (especially computerized tomography are of great value in searching for a cause of the impaired mobility.In unilateral vocal fold immobility, the treatment is focused on the improvement of voice quality and the prevention of aspiration during swallowing. In bilateral paralysis, it is crucial to find a balance between effective breathing and sufficient voice quality. The treatment of unilateral paralysis is started with voice therapy and swallowing rehabilitation. If these procedures are not enough surgical treatment for the medialization of the paralyzed vocal fold is applied. In the case of breathing difficulties in bilateral vocal fold immobility there is a possibility of surgical lateralization of one or both folds or a surgical excision of a part or the entire vocal fold. Surgical reinnervation, functional electrostimulation of certain laryngeal muscles and gene therapy are developing treatment modalities.

  5. Chondrometaplasia of the vocal cord in an adult male

    Directory of Open Access Journals (Sweden)

    Hamoud Al Arouj

    2018-01-01

    Conclusion: The patient didn’t have history of laryngeal trauma. Subacute and progressive onset of clinical symptoms and histological and radiological findings helps to distinguish the chondrometaplastic nature from true laryngeal cartilaginous tumours, such as chondroma and low grade chondrosarcoma.

  6. Endolaryngeal Surgery of Bilateral Vocal Cord Abductor Paralysis

    African Journals Online (AJOL)

    1971-12-04

    Dec 4, 1971 ... S. L. SELLARS, M.A., F.R.C.S., Senior Lecturer, Department ot Otolaryngology, Medical School,. University ot Cape Town. SUMMARY. The treatment of bilateral recurrent laryngeal nerve palsy is discussed and the method of endolaryngeal arytenoidectomy and cordopexy is described in detail. Two.

  7. Cord Blood and Transplants

    Science.gov (United States)

    ... donate their baby’s umbilical cord blood to a public cord blood bank. We have more than 249,000 cord blood ... stored as a cord blood unit at a public cord blood bank for future use. It can then be listed ...

  8. A valuable animal model of spinal cord injury to study motor dysfunctions, comorbid conditions, and aging associated diseases.

    Science.gov (United States)

    Rouleau, Pascal; Guertin, Pierre A

    2013-01-01

    Most animal models of contused, compressed or transected spinal cord injury (SCI) require a laminectomy to be performed. However, despite advantages and disadvantages associated with each of these models, the laminectomy itself is generally associated with significant problems including longer surgery and anaesthesia (related post-operative complications), neuropathic pain, spinal instabilities, deformities, lordosis, and biomechanical problems, etc. This review provides an overview of findings obtained mainly from our laboratory that are associated with the development and characterization of a novel murine model of spinal cord transection that does not require a laminectomy. A number of studies successfully conducted with this model provided strong evidence that it constitutes a simple, reliable and reproducible transection model of complete paraplegia which is particularly useful for studies on large cohorts of wild-type or mutant animals - e.g., drug screening studies in vivo or studies aimed at characterizing neuronal and non-neuronal adaptive changes post-trauma. It is highly suitable also for studies aimed at identifying and developing new pharmacological treatments against aging associated comorbid problems and specific SCI-related dysfunctions (e.g., stereotyped motor behaviours such as locomotion, sexual response, defecation and micturition) largely related with 'command centers' located in lumbosacral areas of the spinal cord.

  9. Vocal therapy of hyperkinetic dysphonia.

    Science.gov (United States)

    Mumović, Gordana; Veselinović, Mila; Arbutina, Tanja; Škrbić, Renata

    2014-01-01

    Hyperkinetic (hyperfunctional) dysphonia is a common pathology. The disorder is often found in vocal professionals faced with high vocal requirements. 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. 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. The subjective acoustic analysis revealed a significant (pvocal 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 FO and jitter %. In children, the acoustic parameters SD FO, jitter % and NNE (normal noise energy) were significantly improved (p=0.003-0.03). Pathological voice qualities were also improved in adults and children (pVocal therapy effectively improves the voice in hyperkinetic dysphonia with prenodular lesions and soft nodules in both adults and children, affectinq diverse acoustic parameters.

  10. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... spinal cord injury? play_arrow What kind of surgery is common after a spinal cord injury? play_ ... How soon after a spinal cord injury should surgery be performed? play_arrow Is it common to ...

  11. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... L Sarah Harrison, OT Anne Bryden, OT The Role of the Social Worker after Spinal Cord Injury ... a spinal cord injury important? play_arrow What role does “compression” play in a spinal cord injury? ...

  12. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Cord Injury Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, ... Children with Spinal Cord Injury Patricia Mucia, RN Family Life After Pediatric Spinal Injury Dawn Sheaffer, MSW ...

  13. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury ... Jennifer Piatt, PhD David Chen, MD Read Bio Medical Director, Spinal Cord Injury Rehabilitation Program, Rehabilitation Institute ...

  14. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury 101 ... arrow What is the “Spinal Cord Injury Model Systems” program? play_arrow What are the most promising ...

  15. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury 101 Adult Injuries Spinal Cord Injury 101 David ...

  16. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury 101 Adult Injuries Spinal Cord Injury 101 ...

  17. Animal Models of Speech and Vocal Communication Deficits Associated With Psychiatric Disorders.

    Science.gov (United States)

    Konopka, Genevieve; Roberts, Todd F

    2016-01-01

    Disruptions in speech, language, and vocal communication are hallmarks of several neuropsychiatric disorders, most notably autism spectrum disorders. Historically, the use of animal models to dissect molecular pathways and connect them to behavioral endophenotypes in cognitive disorders has proven to be an effective approach for developing and testing disease-relevant therapeutics. The unique aspects of human language compared with vocal behaviors in other animals make such an approach potentially more challenging. However, the study of vocal learning in species with analogous brain circuits to humans may provide entry points for understanding this human-specific phenotype and diseases. We review animal models of vocal learning and vocal communication and specifically link phenotypes of psychiatric disorders to relevant model systems. Evolutionary constraints in the organization of neural circuits and synaptic plasticity result in similarities in the brain mechanisms for vocal learning and vocal communication. Comparative approaches and careful consideration of the behavioral limitations among different animal models can provide critical avenues for dissecting the molecular pathways underlying cognitive disorders that disrupt speech, language, and vocal communication. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  18. Spinal cord contusion.

    Science.gov (United States)

    Ju, Gong; Wang, Jian; Wang, Yazhou; Zhao, Xianghui

    2014-04-15

    Spinal cord injury is a major cause of disability with devastating neurological outcomes and limited therapeutic opportunities, even though there are thousands of publications on spinal cord injury annually. There are two major types of spinal cord injury, transaction of the spinal cord and spinal cord contusion. Both can theoretically be treated, but there is no well documented treatment in human being. As for spinal cord contusion, we have developed an operation with fabulous result.

  19. Anatomical study of the final common pathway for vocalization in the cat

    Science.gov (United States)

    Holstege, Gert

    1989-01-01

    Results are presented of an anatomical study of the neuronal pathways in the cat, via which the periaqueductal gray (PAG) produces excitation of motoneurons involved in vocalization. It is shown that a specific cell group in the lateral part of the caudal PAG and in the tegmentum just lateral to it projects bilaterally to the nucleus retroambiguus (NRA) in the caudal medulla oblongata. Neurons in the NRA in turn project, via a contralateral pathway through the ventral funiculus of the spinal cord, to the motoneuronal cell groups innervating intercostal and abdominal muscles. In the brainstem, the NRA neurons project to the motoneuronal cell groups innervating mouth-opening and perioral muscles as well as to motoneurons innervating the pharynx, soft palate, and tongue. These results indicate that the projections from PAG via NRA to vocalization motoneurons form the final common pathway in vocalization.

  20. Involuntary expiratory phonation as a dose-related consequence of L-dopa therapy in a patient with Parkinson's disease.

    Science.gov (United States)

    Ishii, Kosuke; Kumada, Masanobu; Ueki, Akira; Yamamoto, Masanori; Hirose, Hajime

    2003-12-01

    We report a case of involuntary phonation caused by abnormal vocal cord movements during expiration in a patient with Parkinson's disease. A 60-year-old woman had been treated for parkinsonism at the outpatient clinic of the Department of Neurology since August 1999. She began to groan involuntarily in the daytime in September 2001. She could not eat well while groaning. Stridor was not noted during sleep at night. Endoscopic examination of the larynx revealed insufficient abduction of the bilateral vocal cords, although the glottis was not so small as to cause stridor during inspiration. During expiration, however, the vocal cords adducted, resulting in the involuntary production of voice. Electromyography showed an increase in the activity of the thyroarytenoid and lateral cricoarytenoid muscles. This muscle activity was further enhanced during inspiration. The involuntary phonation disappeared when the patient's dose of L-dopa was decreased, although she had a decrease in her systemic mobility as well. When the dose of L-dopa was increased to the therapeutic level, involuntary phonation recurred, and her voluntary systemic activity improved. In the present case, it was considered that excessive dopaminergic denervation occurred in the nerve innervating the laryngeal adductors. Involuntary voice appeared to be produced by hypertonus of the laryngeal adductors because of a lowering in the threshold level for L-dopa, even though the drug was administered at the usual dose.

  1. Increasing specialty care access through use of an innovative home telehealth-based spinal cord injury disease management protocol (SCI DMP).

    Science.gov (United States)

    Woo, Christine; Seton, Jacinta M; Washington, Monique; Tomlinson, Suk C; Phrasavath, Douangmala; Farrell, Karen R; Goldstein, Barry

    2016-01-01

    A spinal cord injury disease management protocol (SCI DMP) was developed to address the unique medical, physical, functional, and psychosocial needs of those living with spinal cord injuries and disorders (SCI/D). The SCI DMP was piloted to evaluate DMP clinical content and to identify issues for broader implementation across the Veterans Affairs (VA) SCI System of Care. Thirty-three patients with SCI/D from four VA SCI centers participated in a 6-month pilot. Patients received customized SCI DMP questions through a data messaging device (DMD). Nurse home telehealth care coordinators (HTCC) monitored responses and addressed clinical alerts daily. One site administered the Duke Severity of Illness (DUSOI) Checklist and Short Form-8 (SF-8™) to evaluate the changes in comorbidity severity and health-related quality of life while on the SCI DMP. Patients remained enrolled an average of 116 days, with a mean response rate of 56%. The average distance between patient's home and their VA SCI center was 59 miles. Feedback on SCI DMP content and the DMD included requests for additional clinical topics, changes in administration frequency, and adapting the DMD for functional impairments. Improvement in clinical outcomes was seen in a subset of patients enrolled on the SCI DMP. SCI HTCCs and patients reported that the program was most beneficial for newly injured patients recently discharged from acute rehabilitation that live far from specialty SCI care facilities. SCI DMP content changes and broader implementation strategies are currently being evaluated based on lessons learned from the pilot.

  2. Identification of the hot-spot areas for sickle cell disease using cord blood screening at a district hospital: an Indian perspective.

    Science.gov (United States)

    Dixit, Sujata; Sahu, Pushpansu; Kar, Shantanu Kumar; Negi, Sapna

    2015-10-01

    Sickle cell disease (SCD), a genetic disorder often reported late, can be identified early in life, and hot-spot areas may be identified to conduct genetic epidemiology studies. This study was undertaken to estimate prevalence and to identify hot spot area for SCD in Kalahandi district, by screening cord blood of neonates delivered at the district hospital as first-hand information. Kalahandi District Hospital selected for the study is predominated by tribal population with higher prevalence of SCD as compared to other parts of Odisha. Cord blood screening of SCD was carried out on 761 newborn samples of which 13 were screened to be homozygous for SCD. Information on area of parent's residence was also collected. Madanpur Rampur area was found to be with the highest prevalence of SCD (10.52 %) and the gene distribution did not follow Hardy-Weinberg Equation indicating un-natural selection. The approach of conducting neonatal screening in a district hospital for identification of SCD is feasible and appropriate for prioritizing area for the implementation of large-scale screening and planning control measures thereof.

  3. Voice Disorders in Occupations with Vocal Load in Slovenia.

    Science.gov (United States)

    Boltežar, Lučka; Šereg Bahar, Maja

    2014-12-01

    The aim of this paper is to compare the prevalence of voice disorders and the risk factors for them in different occupations with a vocal load in Slovenia. A meta-analysis of six different Slovenian studies involving teachers, physicians, salespeople, catholic priests, nurses and speech-and-language therapists (SLTs) was performed. In all six studies, similar questions about the prevalence of voice disorders and the causes for them were included. The comparison of the six studies showed that more than 82% of the 2347 included subjects had voice problems at some time during their career. The teachers were the most affected by voice problems. The prevalent cause of voice problems was the vocal load in teachers and salespeople and respiratory-tract infections in all the other occupational groups. When the occupational groups were compared, it was stated that the teachers had more voice problems and showed less care for their voices than the priests. The physicians had more voice problems and showed better consideration of vocal hygiene rules than the SLTs. The majority of all the included subjects did not receive instructions about voice care during education. In order to decrease the prevalence of voice disorders in vocal professionals, a screening program is recommended before the beginning of their studies. Regular courses on voice care and proper vocal technique should be obligatory for all professional voice users during their career. The inclusion of dysphonia in the list of occupational diseases should be considered in Slovenia as it is in some European countries.

  4. Bilateral Vocal Fold Medialization: A Treatment for Abductor Spasmodic Dysphonia.

    Science.gov (United States)

    Dewan, Karuna; Berke, Gerald S

    2017-11-10

    Abductor spasmodic dysphonia, a difficult-to-treat laryngologic condition, is characterized by spasms causing the vocal folds to remain abducted despite efforts to adduct them during phonation. Traditional treatment for abductor spasmodic dysphonia-botulinum toxin injection into the posterior cricoarytenoid muscle-can be both technically challenging and uncomfortable. Due to the difficulty of needle placement, it is often unsuccessful. The purpose of this investigation is to present a previously undescribed treatment for abductor spasmodic dysphonia-bilateral vocal fold medialization. A retrospective case review of all cases of abductor spasmodic dysphonia treated in a tertiary care laryngology practice with bilateral vocal fold medialization over a 10-year period was performed. The Voice Handicap Index and the Voice-Related Quality of Life surveys were utilized to assess patient satisfaction with voice outcome. Six patients with abductor spasmodic dysphonia treated with bilateral vocal fold medialization were identified. Disease severity ranged from mild to severe. All six patients reported statistically significant improvement in nearly all Voice Handicap Index and Voice-Related Quality of Life parameters. They reported fewer voice breaks and greater ease of communication. Results were noted immediately and symptoms continue to be well controlled for many years following medialization. Bilateral vocal fold medialization is a safe and effective treatment for abductor spasmodic dysphonia. It is performed under local anesthesia and provides phonation improvement in the short and long term. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  5. Intraoperative Recurrent Laryngeal Nerve Monitoring in a Patient with Contralateral Vocal Fold Palsy

    Directory of Open Access Journals (Sweden)

    Bub-Se Na

    2017-10-01

    Full Text Available Recurrent laryngeal nerve injury can develop following cervical or thoracic surgery; however, few reports have described intraoperative recurrent laryngeal nerve monitoring. Consensus regarding the use of this technique during thoracic surgery is lacking. We used intraoperative recurrent laryngeal nerve monitoring in a patient with contralateral vocal cord paralysis who was scheduled for completion pneumonectomy. This case serves as an example of intraoperative recurrent laryngeal nerve monitoring during thoracic surgery and supports this indication for its use.

  6. Transplantation of human umbilical cord blood-derived mononuclear cells induces recovery of motor dysfunction in a rat model of Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Chen C

    2016-04-01

    Full Text Available Chao Chen,1,* Jing Duan,1,* Aifang Shen,2,* Wei Wang,1 Hao Song,1 Yanming Liu,1 Xianjie Lu,1 Xiaobing Wang,2 Zhiqing You,1 Zhongchao Han,3,4 Fabin Han1 1Center for Stem Cells and Regenerative Medicine, The Liaocheng People's Hospital, Affiliated Liaocheng Hospital, Taishan Medical University, Shandong, People's Republic of China; 2Department of Gynecology and Obstetrics, The Liaocheng People's Hospital, Affiliated Liaocheng Hospital, Taishan Medical University, Shandong, People's Republic of China; 3The State Key Laboratory of Experimental Hematology, Institute of Hematology and Hospital of Blood Diseases, Chinese Academy of Medical Sciences, Peking Union of Medical College, Tianjin, People's Republic of China; 4National Engineering Research Center of Cell Products, AmCellGene Co. Ltd., TEDA, Tianjin, People's Republic of China*These authors contributed equally to this workAbstract: Human umbilical cord blood-derived mononuclear cells (hUCB-MNCs were reported to have neurorestorative capacity for neurological disorders such as stroke and traumatic brain injury. This study was performed to explore if hUCB-MNC transplantation plays any therapeutic effects for Parkinson's disease (PD in a 6-OHDA-lesioned rat model of PD. hUCB-MNCs were isolated from umbilical cord blood and administered to the striatum of the 6-OHDA-lesioned rats. The apomorphine-induced locomotive turning-overs were measured to evaluate the improvement of motor dysfunctions of the rats after administration of hUCB-MNCs. We observed that transplanted hUCB-MNCs significantly improve the motor deficits of the PD rats and that grafted hUCB-MNCs integrated to the host brains and differentiated to neurons and dopamine neurons in vivo after 16 weeks of transplantation. Our study provided evidence that transplanted hUCB-MNCs play therapeutic effects in a rat PD model by differentiating to neurons and dopamine neurons. Keywords: hUCB-MNCs, Parkinson's disease, transplantation

  7. Comparison between carbondioxide laser and cold instruments in treatment of vocal nodule

    International Nuclear Information System (INIS)

    Kundi, N.A.; Qayyum, A.; Ahmed, B.; Raza, M.

    2013-01-01

    Background: Vocal cord nodules are one of the most frequent disorders in both children and adults who use their voice excessively. Main symptom with which patient presents is hoarseness of voice. The treatment in early stages is voice therapy. Various methods are used for its treatment e.g. surgical removal with cold instruments and carbon dioxide laser ablation. Response to the treatment is measured by improvement in voice quality. Objective: To compare the results of Carbon dioxide laser and cold instruments in the treatment of vocal nodule. Study Design: Quasi-experimental study. Place and Duration of Study: This study was conducted at Otolaryngology Department Combined Military Hospital Rawalpindi. Patients and Methods: In this study 50 patients undergoing treatment of vocal cord nodule were included, 25 patients were treated by surgical removal with cold instruments and 25 patients were treated with carbon dioxide laser ablation. The main comparative outcomes were measured by patients' perception of voice quality (worse, same, improved) one week post operatively. Results: Improvement in voice quality with carbon dioxide laser was found to be clinically superior. Voice quality was significantly improved as compared to cold surgical instruments. Conclusion: Carbon dioxide laser causes early improvement in quality of voice as compared to cold instruments in the treatment of vocal nodules. (author)

  8. Vocal Fold Vibration Following Surgical Intervention in Three Vocal Pathologies: A Preliminary Study.

    Science.gov (United States)

    Chen, Wenli; Woo, Peak; Murry, Thomas

    2017-09-01

    High-speed videoendoscopy captures the cycle-to-cycle vibratory motion of each individual vocal fold in normal and severely disordered phonation. Therefore, it provides a direct method to examine the specific vibratory changes following vocal fold surgery. The purpose of this study was to examine the vocal fold vibratory pattern changes in the surgically treated pathologic vocal fold and the contralateral vocal fold in three vocal pathologies: vocal polyp (n = 3), paresis or paralysis (n = 3), and scar (n = 3). Digital kymography was used to extract high-speed kymographic vocal fold images at the mid-membranous region of the vocal fold. Spectral analysis was subsequently applied to the digital kymography to quantify the cycle-to-cycle movements of each vocal fold, expressed as a spectrum. Surgical modification resulted in significantly improved spectral power of the treated pathologic vocal fold. Furthermore, the contralateral vocal fold also presented with improved spectral power irrespective of vocal pathology. In comparison with normal vocal fold spectrum, postsurgical vocal fold vibrations continued to demonstrate decreased vibratory amplitude in both vocal folds. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  9. University Vocal Training and Vocal Health of Music Educators and Music Therapists

    Science.gov (United States)

    Baker, Vicki D.; Cohen, Nicki

    2017-01-01

    The purpose of this study was to describe the university vocal training and vocal health of music educators and music therapists. The participants (N = 426), music educators (n = 351) and music therapists (n = 75), completed a survey addressing demographics, vocal training, voice usage, and vocal health. Both groups reported singing at least 50%…

  10. Mesenchymal Stem Cell Therapy for the Treatment of Vocal Fold Scarring

    DEFF Research Database (Denmark)

    Wingstrand, Vibe Lindeblad; Larsen, Christian Grønhøj; Jensen, David H

    2016-01-01

    OBJECTIVES: Therapy with mesenchymal stem cells exhibits potential for the development of novel interventions for many diseases and injuries. The use of mesenchymal stem cells in regenerative therapy for vocal fold scarring exhibited promising results to reduce stiffness and enhance...... the biomechanical properties of injured vocal folds. This study evaluated the biomechanical effects of mesenchymal stem cell therapy for the treatment of vocal fold scarring. DATA SOURCES: PubMed, Embase, the Cochrane Library and Google Scholar were searched. METHODS: Controlled studies that assessed...... the biomechanical effects of mesenchymal stem cell therapy for the treatment of vocal fold scarring were included. Primary outcomes were viscoelastic properties and mucosal wave amplitude. RESULTS: Seven preclinical animal studies (n = 152 single vocal folds) were eligible for inclusion. Evaluation of viscoelastic...

  11. Spontaneous herniation of the thoracic spinal cord : a case report

    International Nuclear Information System (INIS)

    Jin, Sung Chan; Lee, Seong Ro; Park, Dong Woo; Joo, Kyung Bin

    2001-01-01

    Spontaneous herniation of the spinal cord is a rare disease entity in which spinal cord substance is herniated through a previously uninjured and/or untouched dural. It is a cause of myelopathy that is treatable but difficult to diagnose. We report the CT and MR findings of a case of spontaneous thoracic spinal cord through a dural defect

  12. The vocal monotony of monogamy

    Science.gov (United States)

    Thomas, Jeanette

    2003-04-01

    There are four phocids in waters around Antarctica: Weddell, leopard, crabeater, and Ross seals. These four species provide a unique opportunity to examine underwater vocal behavior in species sharing the same ecosystem. Some species live in pack ice, others in factice, but all are restricted to the Antarctic or sub-Antarctic islands. All breed and produce vocalizations under water. Social systems range from polygyny in large breeding colonies, to serial monogamy, to solitary species. The type of mating system influences the number of underwater vocalizations in the repertoire, with monogamous seals producing only a single call, polygynous species producing up to 35 calls, and solitary species an intermediate number of about 10 calls. Breeding occurs during the austral spring and each species carves-out an acoustic niche for communicating, with species using different frequency ranges, temporal patterns, and amplitude changes to convey their species-specific calls and presumably reduce acoustic competition. Some species exhibit geographic variations in their vocalizations around the continent, which may reflect discrete breeding populations. Some seals become silent during a vulnerable time of predation by killer whales, perhaps to avoid detection. Overall, vocalizations of these seals exhibit adaptive characteristics that reflect the co-evolution among species in the same ecosystem.

  13. Vocal Fold Epithelial Barrier in Health and Injury A Research Review

    Science.gov (United States)

    Levendoski, Elizabeth Erickson; Leydon, Ciara; Thibeault, Susan L.

    2015-01-01

    Purpose Vocal fold epithelium is composed of layers of individual epithelial cells joined by junctional complexes constituting a unique interface with the external environment. This barrier provides structural stability to the vocal folds and protects underlying connective tissue from injury while being nearly continuously exposed to potentially hazardous insults including environmental or systemic-based irritants such as pollutants and reflux, surgical procedures, and vibratory trauma. Small disruptions in the epithelial barrier may have a large impact on susceptibility to injury and overall vocal health. The purpose of this article is to provide a broad-based review of our current knowledge of the vocal fold epithelial barrier. Methods A comprehensive review of the literature was conducted. Details of the structure of the vocal fold epithelial barrier are presented and evaluated in the context of function in injury and pathology. The importance of the epithelial-associated vocal fold mucus barrier is also introduced. Results/Conclusions Information presented in this review is valuable for clinicians and researchers as it highlights the importance of this understudied portion of the vocal folds to overall vocal health and disease. Prevention and treatment of injury to the epithelial barrier is a significant area awaiting further investigation. PMID:24686981

  14. Vocal fold paralysis secondary to phonotrauma.

    Science.gov (United States)

    Klein, Travis A L; Gaziano, Joy E; Ridley, Marion B

    2014-01-01

    A unique case of acute onset vocal fold paralysis secondary to phonotrauma is presented. The cause was forceful vocalization by a drill instructor on a firearm range. Imaging studies revealed extensive intralaryngeal and retropharyngeal hemorrhage. Laryngoscopy showed a complete left vocal fold paralysis. Relative voice rest was recommended, and the patient regained normal vocal fold mobility and function after approximately 12 weeks. Copyright © 2014 The Voice Foundation. All rights reserved.

  15. Regeneration of Vocal Fold Mucosa Using Tissue-Engineered Structures with Oral Mucosal Cells

    Science.gov (United States)

    Fukahori, Mioko; Chitose, Shun-ichi; Sato, Kiminori; Sueyoshi, Shintaro; Kurita, Takashi; Umeno, Hirohito; Monden, Yu; Yamakawa, Ryoji

    2016-01-01

    Objectives Scarred vocal folds result in irregular vibrations during phonation due to stiffness of the vocal fold mucosa. To date, a completely satisfactory corrective procedure has yet to be achieved. We hypothesize that a potential treatment option for this disease is to replace scarred vocal folds with organotypic mucosa. The purpose of this study is to regenerate vocal fold mucosa using a tissue-engineered structure with autologous oral mucosal cells. Study Design Animal experiment using eight beagles (including three controls). Methods A 3 mm by 3 mm specimen of canine oral mucosa was surgically excised and divided into epithelial and subepithelial tissues. Epithelial cells and fibroblasts were isolated and cultured separately. The proliferated epithelial cells were co-cultured on oriented collagen gels containing the proliferated fibroblasts for an additional two weeks. The organotypic cultured tissues were transplanted to the mucosa-deficient vocal folds. Two months after transplantation, vocal fold vibrations and morphological characteristics were observed. Results A tissue-engineered vocal fold mucosa, consisting of stratified epithelium and lamina propria, was successfully fabricated to closely resemble the normal layered vocal fold mucosa. Laryngeal stroboscopy revealed regular but slightly small mucosal waves at the transplanted site. Immunohistochemically, stratified epithelium expressed cytokeratin, and the distributed cells in the lamina propria expressed vimentin. Elastic Van Gieson staining revealed a decreased number of elastic fibers in the lamina propria of the transplanted site. Conclusion The fabricated mucosa with autologous oral mucosal cells successfully restored the vocal fold mucosa. This reconstruction technique could offer substantial clinical advantages for treating intractable diseases such as scarring of the vocal folds. PMID:26730600

  16. An Investigation of Extinction-Induced Vocalizations

    Science.gov (United States)

    Valentino, Amber L.; Shillingsburg, M. Alice; Call, Nathan A.; Burton, Britney; Bowen, Crystal N.

    2011-01-01

    Children with autism have significant communication delays. Although some children develop vocalizations through shaping and differential reinforcement, others rarely exhibit vocalizations, and alternative methods are targeted in intervention. However, vocal language often remains a goal for caregivers and clinicians. Thus, strategies to increase…

  17. Family-directed umbilical cord blood banking.

    Science.gov (United States)

    Gluckman, Eliane; Ruggeri, Annalisa; Rocha, Vanderson; Baudoux, Etienne; Boo, Michael; Kurtzberg, Joanne; Welte, Kathy; Navarrete, Cristina; van Walraven, Suzanna M

    2011-11-01

    Umbilical cord blood transplantation from HLA-identical siblings provides good results in children. These results support targeted efforts to bank family cord blood units that can be used for a sibling diagnosed with a disease which can be cured by allogeneic hematopoietic stem cell transplantation or for research that investigates the use of allogeneic or autologous cord blood cells. Over 500 patients transplanted with related cord blood units have been reported to the Eurocord registry with a 4-year overall survival of 91% for patients with non-malignant diseases and 56% for patients with malignant diseases. Main hematologic indications in children are leukemia, hemoglobinopathies or inherited hematologic, immunological or metabolic disorders. However, family-directed cord blood banking is not widely promoted; many cord blood units used in sibling transplantation have been obtained from private banks that do not meet the necessary criteria required to store these units. Marketing by private banks who predominantly store autologous cord blood units has created public confusion. There are very few current validated indications for autologous storage but some new indications might appear in the future. Little effort is devoted to provide unbiased information and to educate the public as to the distinction between the different types of banking, economic models and standards involved in such programs. In order to provide a better service for families in need, directed-family cord blood banking activities should be encouraged and closely monitored with common standards, and better information on current and future indications should be made available.

  18. Caracterização vocal de pacientes com hipertireoidismo e hipotireoidismo Vocal characterization of patients with hyperthyroidism and hypothyroidism

    Directory of Open Access Journals (Sweden)

    Roberta Werlang Isolan-Cury

    2007-06-01

    : Twenty non-smoking women with ages between 18 and 55 years from the Endocrinology Ambulatory of the institution were evaluated after clinical and lab diagnosis for hyperthyroidism or hypothyroidism. The parameters investigated were: period bearing the disease, vocal complaint, maximum phonation time /a/, /s/, and /z/, fundamental frequency (F0, glottal noise (GNE. The aspects evaluated in the auditory-perceptive analysis were: pneumo-phono-articulatory coordination (coordinated or uncoordinated, pitch, loudness, vocal attack, resonance, speech speed and vocal quality, that could be classified as one or two of the following: neutral, hoarse, whispered, coarse, or tense, and degree: light, moderate or severe. Data were statistically analyzed through the EPI-INFO 6.04b software, Fisher qualitative method, considering a significance level of 0.05. RESULTS: The auditory-perceptive analysis showed that seven patients with hypothyroidism and nine with hyperthyroidism presented changes in vocal quality. Eight subjects from both groups presented pneumo-phono-articulatory incoordination. Eight subjects from group A and six from group B referred vocal complaints, such as hoarseness and thick voice, respectively. In the acoustic analysis, nine subjects presented change in glottal noise. CONCLUSION: The results showed great incidence of vocal changes on the studied groups (both hyper and hypothyroidism groups, which evidences the relation between dysphonia and thyroidal dysfunctions.

  19. Torakal Ventral Cord Herniation

    Directory of Open Access Journals (Sweden)

    Sermin Tok

    2015-11-01

    Full Text Available  Ventral cord herniation is a rare cause of focal myelopathy due to herniation of the thoracic cord through a dural defect.It is also known by a variety of other terms such as spontaneous thoracic cord herniation or idiopathic spinal cord herniation.The key feature is focal distortion and rotation of the cord with no CSF seen between it and the ventral theca.

  20. Evidence for a periaqueductal gray-nucleus retroambiguus spinal cord pathway in the rat

    NARCIS (Netherlands)

    Holstege, G.; Kerstens, Lenka; Moes, M.C.; Horst, V.G.J.M. van der

    1997-01-01

    The nucleus retroambiguus in the cat has been shown to receive strong projections from the periaqueductal gray and to send fibres to distinct motoneuronal cell groups in brainstem and spinal cord. The nucleus retroambiguus plays a role in the production of vocalization and possibly copulatory

  1. Risk factors in iatrogenic spinal cord injury.

    Science.gov (United States)

    Montalva-Iborra, A; Alcanyis-Alberola, M; Grao-Castellote, C; Torralba-Collados, F; Giner-Pascual, M

    2017-09-01

    In the last years, there has been a change in the aetiology of spinal cord injury. There has been an increase in the number of elderly patients with spinal cord injuries caused by diseases or medical procedures. The aim of this study is to investigate the frequency of the occurrence of iatrogenic spinal cord injury in our unit. The secondary aim is to study what variables can be associated with a higher risk of iatrogenesis. A retrospective, descriptive, observational study of patients with acute spinal cord injury admitted from June 2009 to May 2014 was conducted. The information collected included the patient age, aetiology, neurological level and grade of injury when admitted and when discharged, cardiovascular risk factors, a previous history of depression and any prior treatment with anticoagulant or antiplatelet drugs. We applied a logistic regression. The grade of statistical significance was established as Pinjury was the thoracic level (48%). The main aetiology of spinal cord injury caused by iatrogenesis was surgery for degenerative spine disease, in patients under the age of 30 were treated with intrathecal chemotherapy. Iatrogenic spinal cord injury is a frequent complication. A statistically significant association between a patient history of depression and iatrogenic spinal cord injury was found as well as with anticoagulant and antiplatelet drug use prior to iatrogenic spinal cord injury.

  2. Vocal plasticity in a reptile.

    Science.gov (United States)

    Brumm, Henrik; Zollinger, Sue Anne

    2017-05-31

    Sophisticated vocal communication systems of birds and mammals, including human speech, are characterized by a high degree of plasticity in which signals are individually adjusted in response to changes in the environment. Here, we present, to our knowledge, the first evidence for vocal plasticity in a reptile. Like birds and mammals, tokay geckos ( Gekko gecko ) increased the duration of brief call notes in the presence of broadcast noise compared to quiet conditions, a behaviour that facilitates signal detection by receivers. By contrast, they did not adjust the amplitudes of their call syllables in noise (the Lombard effect), which is in line with the hypothesis that the Lombard effect has evolved independently in birds and mammals. However, the geckos used a different strategy to increase signal-to-noise ratios: instead of increasing the amplitude of a given call type when exposed to noise, the subjects produced more high-amplitude syllable types from their repertoire. Our findings demonstrate that reptile vocalizations are much more flexible than previously thought, including elaborate vocal plasticity that is also important for the complex signalling systems of birds and mammals. We suggest that signal detection constraints are one of the major forces driving the evolution of animal communication systems across different taxa. © 2017 The Author(s).

  3. Depth-kymography of vocal fold vibrations : part II. Simulations and direct comparisons with 3D profile measurements

    NARCIS (Netherlands)

    de Mul, Frits F. M.; George, Nibu A.; Qiu, Qingjun; Rakhorst, Gerhard; Schutte, Harm K.

    2009-01-01

    We report novel direct quantitative comparisons between 3D profiling measurements and simulations of human vocal fold vibrations. Until now, in human vocal folds research, only imaging in a horizontal plane was possible. However, for the investigation of several diseases, depth information is

  4. Sex differences in DNA methylation of the cord blood are related to sex-bias psychiatric diseases

    Science.gov (United States)

    Maschietto, Mariana; Bastos, Laura Caroline; Tahira, Ana Carolina; Bastos, Elen Pereira; Euclydes, Veronica Luiza Vale; Brentani, Alexandra; Fink, Günther; de Baumont, Angelica; Felipe-Silva, Aloísio; Francisco, Rossana Pulcineli Vieira; Gouveia, Gisele; Grisi, Sandra Josefina Ferraz Ellero; Escobar, Ana Maria Ulhoa; Moreira-Filho, Carlos Alberto; Polanczyk, Guilherme Vanoni; Miguel, Euripedes Constantino; Brentani, Helena

    2017-03-01

    Sex differences in the prevalence of psychiatric disorders are well documented, with exposure to stress during gestation differentially impacting females and males. We explored sex-specific DNA methylation in the cord blood of 39 females and 32 males born at term and with appropriate weight at birth regarding their potential connection to psychiatric outcomes. Mothers were interviewed to gather information about environmental factors (gestational exposure) that could interfere with the methylation profiles in the newborns. Bisulphite converted DNA was hybridized to Illumina HumanMethylation450 BeadChips. Excluding XYS probes, there were 2,332 differentially methylated CpG sites (DMSs) between sexes, which were enriched within brain modules of co-methylated CpGs during brain development and also differentially methylated in the brains of boys and girls. Genes associated with the DMSs were enriched for neurodevelopmental disorders, particularly for CpG sites found differentially methylated in brain tissue between patients with schizophrenia and controls. Moreover, the DMS had an overlap of 890 (38%) CpG sites with a cohort submitted to toxic exposition during gestation. This study supports the evidences that sex differences in DNA methylation of autosomes act as a primary driver of sex differences that are found in psychiatric outcomes.

  5. Clinical Use and Patentability of Cord Blood

    Science.gov (United States)

    Cavusoglu, Turker; Kilic, Kubilay Dogan; Yigitturk, Gurkan; Tomruk, Canberk; Turgut, Mehmet; Uyanikgil, Yigit

    2018-03-14

    The blood in the umbilical cord that provides the connection between mother and fetus during pregnancy is called cord blood. The blood of umbilical cord which is usually got rid of following birth, is a very rich stem cell source. Cord blood collection gives no harm to the mother and baby. Besides, its allogeneic and au-tologous usage, the most important disadvantage is that the number of cells is insufficient in adults. Today, it is predominantly used for therapeutic purposes for many diseases. The aim of this review is giving a detailed information about groups of stem cells in cord blood and determining the point of clinical use. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  6. Predictive value of cord blood bilirubins for hyperbilirubinemia in neonates at risk for maternal-fetal blood group incompatibility and hemolytic disease of the newborn

    Science.gov (United States)

    Calkins, Kara L.; Roy, Devika; Molchan, Lauren; Bradley, Lyndsey; Grogan, Tristan; Elashoff, David; Walker, Valencia P.

    2015-01-01

    Objective To determine the predictive ability of cord blood bilirubin (CBB) for hyperbilirubinemia in a population at risk for maternal-fetal blood group incompatibility and hemolytic disease of the newborn. Study Design This is a single center retrospective case-control study. Cases received phototherapy; controls did not. Cases were matched 1:3 to controls by gender and treating physician. Inclusion criteria included: ≥ 35 weeks gestation, CBB, and one or more total serum bilirubin (TSB) concentrations. The primary outcome was CBB. Secondary outcomes were a TSB > 75th percentile, length of stay, and neonatal intensive care unit admission. The prognostic ability of CBB for phototherapy and TSB > 75th percentile was assessed using area under the receiver operating characteristic (ROC) curve. Logistic regression analyses were performed to determine predictors for phototherapy and TSB > 75th percentile. Result When compared to controls (n=142), cases (n=54) were more likely to have a positive Coombs’ test (82% vs. 41%, p 75th percentile (85% vs. 21%, p75th percentile was 0.87±0.03 (phemolytic disease of the newborn. PMID:26518407

  7. Predictive value of cord blood bilirubin for hyperbilirubinemia in neonates at risk for maternal-fetal blood group incompatibility and hemolytic disease of the newborn.

    Science.gov (United States)

    Calkins, K; Roy, D; Molchan, L; Bradley, L; Grogan, T; Elashoff, D; Walker, V

    2015-01-01

    To determine the predictive ability of cord blood bilirubin (CBB) for hyperbilirubinemia in a population at risk for maternal-fetal blood group incompatibility and hemolytic disease of the newborn. This is a single center retrospective case-control study. Cases received phototherapy; controls did not. Cases were matched 1:3 to controls by gender and treating physician. Inclusion criteria included: ≥35 weeks gestation, CBB, and one or more total serum bilirubin (TSB) concentrations. The primary outcome was CBB. Secondary outcomes were a TSB >75th percentile, length of stay, and neonatal intensive care unit admission. The prognostic ability of CBB for phototherapy and TSB >75th percentile was assessed using area under the receiver operating characteristic (ROC) curve. Logistic regression analyses were performed to determine predictors for phototherapy and TSB >75th percentile. When compared to controls (n = 142), cases (n = 54) were more likely to have a positive Coombs' test (82% vs. 41% , p 75th percentile (85% vs. 21% , p 75th percentile was 0.87 ± 0.03 (p hemolytic disease of the newborn.

  8. Radiology findings in adult patients with vocal fold paralysis

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, S. [Helsinki Medical Imaging Centre, University of Helsinki, Haartmaninkatu, Helsinki (Finland)]. E-mail: s.robinson@dzu.at; Pitkaeranta, A. [Department of Otorhinolaryngology, Haartmaninkatu, Helsinki (Finland)

    2006-10-15

    Aim: To compile imaging findings in patients with vocal fold paralysis. Materials and methods: A retrospective analysis of the medical charts of 100 consecutive patients, admitted to our department with vocal fold paralysis was undertaken. After laryngoscopy, patients were referred for radiological work-up depending on their clinical history and clinical findings. Ultrasound of the neck and/or contrast-enhanced spiral computed tomography (CT) of the neck and mediastinum was performed, extending to include the whole chest if necessary. In one patient, CT of the brain and in two patients, magnetic resonance angiography was undertaken. Analysis of the clinical and radiological data was performed to assess the most frequent causes for vocal fold paralysis. Results: In 66% of patients, the paralysis was related to previous surgery. Thirty-four percent of cases were labelled idiopathic after clinical examination. After imaging and follow-up, only 8% remained unexplained. Nine patients suffered from neoplasms, four from vascular disease, and 12 from infections. One patient developed encephalomyelitis disseminata on follow-up. Conclusion: Thorough radiological work-up helps to reduce the amount of idiopathic cases of vocal fold paralysis and guides appropriate therapy.

  9. Radiology findings in adult patients with vocal fold paralysis

    International Nuclear Information System (INIS)

    Robinson, S.; Pitkaeranta, A.

    2006-01-01

    Aim: To compile imaging findings in patients with vocal fold paralysis. Materials and methods: A retrospective analysis of the medical charts of 100 consecutive patients, admitted to our department with vocal fold paralysis was undertaken. After laryngoscopy, patients were referred for radiological work-up depending on their clinical history and clinical findings. Ultrasound of the neck and/or contrast-enhanced spiral computed tomography (CT) of the neck and mediastinum was performed, extending to include the whole chest if necessary. In one patient, CT of the brain and in two patients, magnetic resonance angiography was undertaken. Analysis of the clinical and radiological data was performed to assess the most frequent causes for vocal fold paralysis. Results: In 66% of patients, the paralysis was related to previous surgery. Thirty-four percent of cases were labelled idiopathic after clinical examination. After imaging and follow-up, only 8% remained unexplained. Nine patients suffered from neoplasms, four from vascular disease, and 12 from infections. One patient developed encephalomyelitis disseminata on follow-up. Conclusion: Thorough radiological work-up helps to reduce the amount of idiopathic cases of vocal fold paralysis and guides appropriate therapy

  10. Functional assessment of the ex vivo vocal folds through biomechanical testing: A review

    Science.gov (United States)

    Dion, Gregory R.; Jeswani, Seema; Roof, Scott; Fritz, Mark; Coelho, Paulo; Sobieraj, Michael; Amin, Milan R.; Branski, Ryan C.

    2016-01-01

    The human vocal folds are complex structures made up of distinct layers that vary in cellular and extracellular composition. The mechanical properties of vocal fold tissue are fundamental to the study of both the acoustics and biomechanics of voice production. To date, quantitative methods have been applied to characterize the vocal fold tissue in both normal and pathologic conditions. This review describes, summarizes, and discusses the most commonly employed methods for vocal fold biomechanical testing. Force-elongation, torsional parallel plate rheometry, simple-shear parallel plate rheometry, linear skin rheometry, and indentation are the most frequently employed biomechanical tests for vocal fold tissues and each provide material properties data that can be used to compare native tissue verses diseased for treated tissue. Force-elongation testing is clinically useful, as it allows for functional unit testing, while rheometry provides physiologically relevant shear data, and nanoindentation permits micrometer scale testing across different areas of the vocal fold as well as whole organ testing. Thoughtful selection of the testing technique during experimental design to evaluate a hypothesis is important to optimizing biomechanical testing of vocal fold tissues. PMID:27127075

  11. Combined cord blood and bone marrow transplantation from the same human leucocyte antigen-identical sibling donor for children with malignant and non-malignant diseases.

    Science.gov (United States)

    Tucunduva, Luciana; Volt, Fernanda; Cunha, Renato; Locatelli, Franco; Zecca, Marco; Yesilipek, Akif; Caniglia, Maurizio; Güngör, Tayfun; Aksoylar, Serap; Fagioli, Franca; Bertrand, Yves; Addari, Maria Carmen; de la Fuente, Josu; Winiarski, Jacek; Biondi, Andrea; Sengeloev, Henrik; Badell, Isabel; Mellgren, Karin; de Heredia, Cristina Díaz; Sedlacek, Petr; Vora, Ajay; Rocha, Vanderson; Ruggeri, Annalisa; Gluckman, Eliane

    2015-04-01

    Umbilical cord blood (UCB) from an human leucocyte antigen (HLA)-identical sibling can be used for transplantation of patients with malignant and non-malignant diseases. However, the low cellular content of most UCB units represents a limitation to this approach. An option to increase cell dose is to harvest bone marrow (BM) cells from the same donor and infuse them along with the UCB. We studied 156 children who received such a combined graft between 1992 and 2011. Median age was 7 years and 78% of patients (n = 122) were transplanted for non-malignant diseases, mainly haemoglobinopathies. Acute leukaemia (n = 26) was the most frequent malignant diagnosis. Most patients (91%) received myeloablative conditioning. Median donor age was 1·7 years, median infused nucleated cell dose was 24·4 × 10(7) /kg and median follow-up was 41 months. Sixty-days neutrophil recovery occurred in 96% of patients at a median of 17 d. The probabilities of grade-II-IV acute and chronic graft-versus-host disease (GVHD) were 19% and 10%, respectively. Four-year overall survival was 90% (68% malignant; 97% non-malignant diseases) with 3% probability of death. In conclusion, combined UCB and BM transplantation from an HLA-identical sibling donor is an effective treatment for children with malignant and non-malignant disorders with high overall survival and low incidence of GVHD. © 2014 John Wiley & Sons Ltd.

  12. Comportamento vocal de cantores populares Vocal behavior of popular singers

    Directory of Open Access Journals (Sweden)

    Valquíria Zimmer

    2012-04-01

    Full Text Available OBJETIVO: investigar aspectos do histórico, hábitos e comportamentos vocais de cantores populares, conforme o sexo e as categorias profissional e amador. MÉTODO: entrevista com 47 cantores, 25 homens e 22 mulheres. RESULTADOS: significância estatística nos seguintes achados: MASCULINO - microfone nos ensaios, ausência de problemas vocais diagnosticados, ausência de orientações sobre higiene vocal, dor ou desconforto após cantar, ausência de alergias e problemas respiratórios; FEMININO - aulas de canto e conhecimento sobre postura; AMADOR - não cantar dançando, não imitar vozes, ausência de avaliação otorrinolaringológica, ausência de problemas vocais diagnosticados, ausência de terapia fonoaudiológica, ausência de orientações de anatomofisiologia vocal e não utilização de álcool nos ensaios; PROFISSIONAL - rouquidão, conhecimento sobre articulação, álcool durante os shows, "garganta suja" ou pigarro, dor após cantar. CONCLUSÕES: a comparação entre os sexos evidenciou que os homens utilizavam microfone no ensaio, não apresentavam problemas alérgicos ou respiratórios, nem problemas vocais diagnosticados, mas apresentavam sensação de dor ou desconforto após o canto e não possuíam noções sobre higiene vocal; e que as mulheres realizavam aulas de canto e possuíam orientações de postura. A comparação entre amadores e profissionais mostrou que os amadores não cantavam dançando, não imitavam vozes, não utilizavam álcool nos ensaios, e não apresentavam problemas vocais diagnosticados, mas não possuíam avaliação otorrinolaringológica, não realizavam terapia fonoaudiológica, e não possuíam conhecimento sobre anatomofisiologia vocal; e os profissionais apresentavam queixa de rouquidão, de "garganta suja" ou pigarro e de dor após cantar, e usavam álcool durante os shows, apesar de possuir conhecimento sobre articulação.PURPOSE: to investigate aspects of vocal history, vocal habits and

  13. Cardiometabolic Syndrome in People With Spinal Cord Injury/Disease: Guideline-Derived and Nonguideline Risk Components in a Pooled Sample.

    Science.gov (United States)

    Nash, Mark S; Tractenberg, Rochelle E; Mendez, Armando J; David, Maya; Ljungberg, Inger H; Tinsley, Emily A; Burns-Drecq, Patricia A; Betancourt, Luisa F; Groah, Suzanne L

    2016-10-01

    To assess cardiometabolic syndrome (CMS) risk definitions in spinal cord injury/disease (SCI/D). Cross-sectional analysis of a pooled sample. Two SCI/D academic medical and rehabilitation centers. Baseline data from subjects in 7 clinical studies were pooled; not all variables were collected in all studies; therefore, participant numbers varied from 119 to 389. The pooled sample included men (79%) and women (21%) with SCI/D >1 year at spinal cord levels spanning C3-T2 (American Spinal Injury Association Impairment Scale [AIS] grades A-D). Not applicable. We computed the prevalence of CMS using the American Heart Association/National Heart, Lung, and Blood Institute guideline (CMS diagnosis as sum of risks ≥3 method) for the following risk components: overweight/obesity, insulin resistance, hypertension, and dyslipidemia. We compared this prevalence with the risk calculated from 2 routinely used nonguideline CMS risk assessments: (1) key cut scores identifying insulin resistance derived from the homeostatic model 2 (HOMA2) method or quantitative insulin sensitivity check index (QUICKI), and (2) a cardioendocrine risk ratio based on an inflammation (C-reactive protein [CRP])-adjusted total cholesterol/high-density lipoprotein cholesterol ratio. After adjustment for multiple comparisons, injury level and AIS grade were unrelated to CMS or risk factors. Of the participants, 13% and 32.1% had CMS when using the sum of risks or HOMA2/QUICKI model, respectively. Overweight/obesity and (pre)hypertension were highly prevalent (83% and 62.1%, respectively), with risk for overweight/obesity being significantly associated with CMS diagnosis (sum of risks, χ(2)=10.105; adjusted P=.008). Insulin resistance was significantly associated with CMS when using the HOMA2/QUICKI model (χ(2)2=21.23, adjusted P<.001). Of the subjects, 76.4% were at moderate to high risk from elevated CRP, which was significantly associated with CMS determination (both methods; sum of risks, χ(2

  14. Modeling vocalization with ECoG cortical activity recorded during vocal production in the macaque monkey.

    Science.gov (United States)

    Fukushima, Makoto; Saunders, Richard C; Fujii, Naotaka; Averbeck, Bruno B; Mishkin, Mortimer

    2014-01-01

    Vocal production is an example of controlled motor behavior with high temporal precision. Previous studies have decoded auditory evoked cortical activity while monkeys listened to vocalization sounds. On the other hand, there have been few attempts at decoding motor cortical activity during vocal production. Here we recorded cortical activity during vocal production in the macaque with a chronically implanted electrocorticographic (ECoG) electrode array. The array detected robust activity in motor cortex during vocal production. We used a nonlinear dynamical model of the vocal organ to reduce the dimensionality of `Coo' calls produced by the monkey. We then used linear regression to evaluate the information in motor cortical activity for this reduced representation of calls. This simple linear model accounted for circa 65% of the variance in the reduced sound representations, supporting the feasibility of using the dynamical model of the vocal organ for decoding motor cortical activity during vocal production.

  15. Spinal Cord Injury 101

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    Full Text Available ... About Media Donate Spinal Cord Injury Medical Expert Videos ... Home Kim Eberhardt Muir, MS Coping with a New Injury Robin Dorman, PsyD Sex and Fertility After Spinal Cord Injury Diane M. ...

  16. Spinal Cord Injury 101

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    Full Text Available ... of Spinal Cord Injury Rehabilitation Kristine Cichowski, MS Occupational Therapy after Spinal Cord Injury Katie Powell, OT ... does not provide medical advice, recommend or endorse health care products or services, or control the information ...

  17. Spinal Cord Injury 101

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    Full Text Available ... Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal Experiences ...

  18. Spinal Cord Injury 101

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    Full Text Available ... of spinal cord injuries? play_arrow What does stem-cell research on animals tell us? play_arrow When can we expect stem-cell treatments to become available for spinal cord injuries? ...

  19. Spinal Cord Injury 101

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    Full Text Available ... spinal cord injuries? play_arrow What does stem-cell research on animals tell us? play_arrow When can we expect stem-cell treatments to become available for spinal cord injuries? ...

  20. Spinal Cord Injury 101

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    Full Text Available ... Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal Experiences by Topic Resources ... Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal Experiences by Topic Resources ...

  1. Spinal Cord Injury 101

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    Full Text Available ... play_arrow What are the chances of regaining feeling and mobility after a spinal cord injury? play_arrow How long does it usually take for feeling and movement to return after a spinal cord ...

  2. Spinal Cord Injury 101

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    Full Text Available ... RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation ... Rogers, PT Recreational Therapy after Spinal Cord Injury Jennifer Piatt, PhD David Chen, MD Read Bio Medical ...

  3. Spinal Cord Injury 101

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    Full Text Available ... Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC Understanding Spinal Cord Injury About Us Expert Videos Contact Us Personal Experience Videos Blog Videos By Topic Media Resources Donate to support families facing spinal cord ...

  4. Tethered Spinal Cord Syndrome

    Science.gov (United States)

    ... cord over time and may be exacerbated during sports or pregnancy, or may be due to narrowing of the ... cord over time and may be exacerbated during sports or pregnancy, or may be due to narrowing of the ...

  5. Spinal cord stimulation

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007560.htm Spinal cord stimulation To use the sharing features on this page, please enable JavaScript. Spinal cord stimulation is a treatment for pain that uses ...

  6. Spinal Cord Injury 101

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    Full Text Available ... Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children with Spinal Cord Injury Patricia Mucia, RN Family Life After Pediatric Spinal Injury Dawn Sheaffer, MSW Rehabilitation ...

  7. Spinal Cord Injury 101

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    Full Text Available ... Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from Hospital to ... a spinal cord injury? play_arrow Why are high-dose steroids often used right after an injury? ...

  8. Vocal cysts: clinical, endoscopic, and surgical aspects.

    Science.gov (United States)

    Martins, Regina Helena Garcia; Santana, Marcela Ferreira; Tavares, Elaine Lara Mendes

    2011-01-01

    Vocal cysts are benign laryngeal lesions, which affect children and adults. They can be classified as epidermic or mucous-retention cyst. The objective was to study the clinical, endoscopic, and surgical aspects of vocal cysts. We reviewed the medical charts of 72 patients with vocal cysts, considering age, gender, occupation, time of vocal symptoms, nasosinusal and gastroesophageal symptoms, vocal abuse, tabagism, alcoholism, associated lesions, treatment, and histological details. Of the 72 cases, 46 were adults (36 females and 10 male) and 26 were children (eight girls and 18 boys). As far as occupation is concerned, there was a higher incidence of students and teachers. All the patients had symptoms of chronic hoarseness. Nasosinusal (27.77%) and gastroesophageal (32%) symptoms were not relevant. Vocal abuse was reported by 45.83%, smoking by 18%, and alcoholism by 8.4% of the patients. Unilateral cysts were seen in 93% of the cases, 22 patients had associated lesions, such as bridge, sulcus vocalis, and microweb. Surgical treatment was performed in 46 cases. Histological analysis of the epidermic cysts revealed a cavity with caseous content, covered by stratified squamous epithelium, often keratinized. Mucous cysts presented mucous content, and the walls were coated by a cylindrical ciliated epithelium. Vocal cysts are benign vocal fold lesions that affect children and adults, being often associated with vocal overuse, which frequently affects people who use their voices professionally. Vocal symptoms are chronic in course, often times since childhood, and the treatment of choice is surgical removal. A careful examination of the vocal folds is necessary during surgery, because other laryngeal lesions may be associated with vocal cysts. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  9. Vocal competition in male Xenopus laevis frogs

    OpenAIRE

    Tobias, Martha L.; Corke, Anna; Korsh, Jeremy; Yin, David; Kelley, Darcy B.

    2010-01-01

    Male Xenopus laevis frogs produce underwater advertisement calls that attract gravid females and suppress calling by male competitors. Here we explore whether groups of males establish vocal ranks and whether auditory cues alone suffice for vocal suppression. Tests of male–male pairs within assigned groups reveal linear vocal dominance relations, in which each male has a defined rank. Both the duration over which males interact, as well as the number of competitive opportunities, affect linea...

  10. Spinal Cord Injury 101

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    Full Text Available ... the spinal cord work? play_arrow Why is the level of a spinal cord injury important? play_arrow What role does “compression” play in a spinal cord injury? play_arrow Why are high-dose steroids often used right after an injury? play_arrow What is meant ...

  11. Spinal Cord Injury 101

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    Full Text Available ... arrow What is the “Spinal Cord Injury Model Systems” program? play_arrow What are the most promising new treatments for spinal cord injuries? play_arrow What are the latest developments in the use of electrical stimulation for spinal cord injuries? play_arrow ...

  12. Spinal Cord Injuries

    Science.gov (United States)

    ... forth between your body and your brain. A spinal cord injury disrupts the signals. Spinal cord injuries usually begin with a blow that fractures or ... down on the nerve parts that carry signals. Spinal cord injuries can be complete or incomplete. With a complete ...

  13. Spinal Cord Injury 101

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    Full Text Available ... injury? play_arrow How does the spinal cord work? play_arrow Why is the level of a spinal cord injury important? play_arrow What role does “compression” play in a spinal cord injury? play_arrow Why are high-dose steroids often used right after an injury? play_arrow What is meant ...

  14. Spinal Cord Injury 101

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    Full Text Available ... Abuse and Spinal Cord Injury Allen Heinemann, PhD How Peer Counseling Works Julie Gassaway, MS, RN Pediatric Injuries Pediatric Spinal ... What is a spinal cord injury? play_arrow How does the spinal cord work? play_arrow Why is the level of a ...

  15. Cytokine treatment optimises the immunotherapeutic effects of umbilical cord-derived MSC for treatment of inflammatory liver disease

    NARCIS (Netherlands)

    S.F. De Witte (Samantha Fh); A. Merino (Ana); M. Franquesa (Marcella); T. Strini (Tanja); J.A.A. van Zoggel (Hanneke); S.S. Korevaar (Sander); F. Luk (Franka); M. Gargesha (Madhusudhana); O'Flynn, L. (Lisa); D. Roy (Debashish); Elliman, S.J. (Steve J.); Newsome, P.N. (Philip N.); C.C. Baan (Carla); M.J. Hoogduijn (Martin)

    2017-01-01

    textabstractBackground: Mesenchymal stromal cells (MSC) possess immunomodulatory properties and low immunogenicity, both crucial properties for their development into an effective cellular immunotherapy. They have shown benefit in clinical trials targeting liver diseases; however the efficacy of MSC

  16. Vocalization Subsystem Responses to a Temporarily Induced Unilateral Vocal Fold Paralysis

    Science.gov (United States)

    Croake, Daniel J.; Andreatta, Richard D.; Stemple, Joseph C.

    2018-01-01

    Purpose: The purpose of this study is to quantify the interactions of the 3 vocalization subsystems of respiration, phonation, and resonance before, during, and after a perturbation to the larynx (temporarily induced unilateral vocal fold paralysis) in 10 vocally healthy participants. Using dynamic systems theory as a guide, we hypothesized that…

  17. Vocal Noise Cancellation From Respiratory Sounds

    National Research Council Canada - National Science Library

    Moussavi, Zahra

    2001-01-01

    Although background noise cancellation for speech or electrocardiographic recording is well established, however when the background noise contains vocal noises and the main signal is a breath sound...

  18. Quantification of Porcine Vocal Fold Geometry.

    Science.gov (United States)

    Stevens, Kimberly A; Thomson, Scott L; Jetté, Marie E; Thibeault, Susan L

    2016-07-01

    The aim of this study was to quantify porcine vocal fold medial surface geometry and three-dimensional geometric distortion induced by freezing the larynx, especially in the region of the vocal folds. The medial surface geometries of five excised porcine larynges were quantified and reported. Five porcine larynges were imaged in a micro-CT scanner, frozen, and rescanned. Segmentations and three-dimensional reconstructions were used to quantify and characterize geometric features. Comparisons were made with geometry data previously obtained using canine and human vocal folds as well as geometries of selected synthetic vocal fold models. Freezing induced an overall expansion of approximately 5% in the transverse plane and comparable levels of nonuniform distortion in sagittal and coronal planes. The medial surface of the porcine vocal folds was found to compare reasonably well with other geometries, although the compared geometries exhibited a notable discrepancy with one set of published human female vocal fold geometry. Porcine vocal folds are qualitatively geometrically similar to data available for canine and human vocal folds, as well as commonly used models. Freezing of tissue in the larynx causes distortion of around 5%. The data can provide direction in estimating uncertainty due to bulk distortion of tissue caused by freezing, as well as quantitative geometric data that can be directly used in developing vocal fold models. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  19. Vocal Fold Vibratory Changes Following Surgical Intervention.

    Science.gov (United States)

    Chen, Wenli; Woo, Peak; Murry, Thomas

    2016-03-01

    High-speed videoendoscopy (HSV) captures direct cycle-to-cycle visualization of vocal fold movement in real time. This ultrafast recording rate is capable of visualizing the vibratory motion of the vocal folds in severely disordered phonation and provides a direct method for examining vibratory changes after vocal fold surgery. The purpose of this study was to examine the vibratory motion before and after surgical intervention. HSV was captured from two subjects with identifiable midvocal fold benign lesions and six subjects with highly aperiodic vocal fold vibration before and after phonosurgery. Digital kymography (DKG) was used to extract high-speed kymographic vocal fold images sampled at the midmembranous, anterior 1/3, and posterior 1/3 region. Spectral analysis was subsequently applied to the DKG to quantify the cycle-to-cycle movements of the left and the right vocal fold, expressed as a spectrum. Before intervention, the vibratory spectrum consisted of decreased and flat-like spectral peaks with robust power asymmetry. After intervention, increases in spectral power and decreases in power symmetry were noted. Spectral power increases were most remarkable in the midmembranous region of the vocal fold. Surgical modification resulted in improved lateral excursion of the vocal folds, vibratory function, and perceptual measures of Voice Handicap Index-10. These changes in vibratory behavior trended toward normal vocal fold vibration. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  20. Simplified spinal cord phantom for evaluation of SQUID magnetospinography

    International Nuclear Information System (INIS)

    Adachi, Y; Oyama, D; Uehara, G; Somchai, N; Kawabata, S

    2014-01-01

    Spinal cord functional imaging by magnetospinography (MSG) is a noninvasive diagnostic method for spinal cord diseases. However, the accuracy and spatial resolution of lesion localization by MSG have barely been evaluated in detail so far. We developed a simplified spinal cord phantom for MSG evaluation. The spinal cord phantom is composed of a cylindrical vessel filled with saline water, which acts as a model of a neck. A set of modeled vertebrae is arranged in the cylindrical vessel, which has a neural current model made from catheter electrodes. The neural current model emulates the current distribution around the activated site along the axon of the spinal cord nerve. Our MSG system was used to observe the magnetic field from the phantom; a quadrupole-like pattern of the magnetic field distribution, which is a typical distribution pattern for spinal cord magnetic fields, was successfully reproduced by the phantom. Hence, the developed spinal cord phantom can be used to evaluate MSG source analysis methods.

  1. Evaluation of Dying Vocal Fold Epithelial Cells by Ultrastructural Features and TUNEL Method

    Science.gov (United States)

    Novaleski, Carolyn K.; Mizuta, Masanobu; Rousseau, Bernard

    2016-01-01

    Cell death is a regulated mechanism of eliminating cells to maintain tissue homeostasis. This study described two methodological procedures for evaluating cell death in the epithelium of immobilized, approximated, and vibrated vocal folds from 12 New Zealand white breeder rabbits. The gold standard technique of transmission electron microscopy evaluated high-quality ultrastructural criteria of cell death and a common immunohistochemical marker, terminal deoxynucleotidyl transferase dUTP nick end labeling method, to confirm cell death signaling. Results revealed that ultrastructural characteristics of apoptotic cell death, specifically condensed chromatin and apoptotic bodies, were observed after vocal fold vibration and approximation. Although episodes of necrotic cell death were rare, few enlarged cell nuclei were present after vibration and approximation. The vocal fold expresses an immunohistochemical marker for apoptosis along the apical surface of the epithelium. This study provides a solid foundation for future investigations regarding the role of cell death in vocal fold health and disease. PMID:27537846

  2. Independent exercise for glottal incompetence to improve vocal problems and prevent aspiration pneumonia in the elderly: a randomized controlled trial.

    Science.gov (United States)

    Fujimaki, Yoko; Tsunoda, Koichi; Kobayashi, Rika; Tonghyo, Chong; Tanaka, Fujinobu; Kuroda, Hiroyuki; Numata, Tsutomu; Ishii, Toyota; Kuroda, Reiko; Masuda, Sawako; Hashimoto, Sho; Misawa, Hayato; Shindo, Naoko; Mori, Takahiro; Mori, Hiroko; Uchiyama, Naoki; Kamei, Yuichirou; Tanaka, Masashi; Hamaya, Hironobu; Funatsuki, Shingo; Usui, Satoko; Ito, Ikuno; Hamada, Kohei; Shindo, Akihito; Tokumaru, Yutaka; Morita, Yoko; Ueha, Rumi; Nito, Takaharu; Kikuta, Shu; Sekimoto, Sotaro; Kondo, Kenji; Sakamoto, Takashi; Itoh, Kenji; Yamasoba, Tatsuya; Matsumoto, Sumio

    2017-08-01

    To evaluate the effect of a self-controlled vocal exercise in elderly people with glottal closure insufficiency. Parallel-arm, individual randomized controlled trial. Patients who visited one of 10 medical centers under the National Hospital Organization group in Japan for the first time, aged 60 years or older, complaining of aspiration or hoarseness, and endoscopically confirmed to have glottal closure insufficiency owing to vocal cord atrophy, were enrolled in this study. They were randomly assigned to an intervention or a control group. The patients of the intervention group were given guidance and a DVD about a self-controlled vocal exercise. The maximum phonation time which is a measure of glottal closure was evaluated, and the number of patients who developed pneumonia during the six months was compared between the two groups. Of the 543 patients enrolled in this trial, 259 were allocated into the intervention group and 284 into the control; 60 of the intervention group and 75 of the control were not able to continue the trial. A total of 199 patients (age 73.9 ±7.25 years) in the intervention group and 209 (73.3 ±6.68 years) in the control completed the six-month trial. Intervention of the self-controlled vocal exercise extended the maximum phonation time significantly ( p < 0.001). There were two hospitalizations for pneumonia in the intervention group and 18 in the control group, representing a significant difference ( p < 0.001). The self-controlled vocal exercise allowed patients to achieve vocal cord adduction and improve glottal closure insufficiency, which reduced the rate of hospitalization for pneumonia significantly. gov Identifier-UMIN000015567.

  3. Difficulty Systematized Evaluation of Vocal Folds Exposure in Microsurgery of the Larynx

    Directory of Open Access Journals (Sweden)

    Ballin, Annelyse Cristine

    2010-09-01

    Full Text Available Introduction: Several studies addressing preoperative factors that predict difficulty of endotracheal intubation graduated by anesthesiologists, for the scale of the Cormack-Lehane. These parameters were evaluated for the difficulty of location of the laryngoscope in microsurgery of the larynx. There is not a standard scale of difficulty targeted to surgeons of the larynx. Objective: Create a standard scale of difficulty leasing the laryngoscope during microsurgery of the larynx, with a focus on exposure of the vocal folds (vocal cords to evaluate which clinical parameters predict difficulty of exposure of their vocal folds and verify the improvement of laryngeal exposure with the hanger of the laryngoscope. Method: A prospective randomized study, 57 patients undergoing laryngeal microsurgery. The preoperative parameters were evaluated: three epidemiological data, two of history and 13 physical examination. Intraoperatively: the anesthesiologist evaluated the Cormack-Lehane score and the surgeon evaluated according to the proposed scale, before and after placement of the hanger. Results and Conclusion: Several parameters showed sensitivity, specificity, positive predictive value for high inadequate exposure of the larynx. But only distance hiomentual <6.05 cm (p = 0.003 and 2 classes of Cormack-Lehane (p = 0.04 with statistical significance and high sensitivity of 100% and 81% respectively. The use of the hanger of laryngoscope laryngeal exposure improved significantly (p = 0.04. The proposed scale standardizes the visualization and grades the difficulty of exposure of their vocal folds, facilitating comparisons between studies and communication between otolaryngologists.

  4. Acute contained ruptured aortic aneurysm presenting as left vocal fold immobility.

    Science.gov (United States)

    Gnagi, Sharon H; Howard, Brittany E; Hoxworth, Joseph M; Lott, David G

    2015-01-01

    Objective. To recognize intrathoracic abnormalities, including expansion or rupture of aortic aneurysms, as a source of acute onset vocal fold immobility. Methods. A case report and review of the literature. Results. An 85-year-old female with prior history of an aortic aneurysm presented to a tertiary care facility with sudden onset hoarseness. On laryngoscopy, the left vocal fold was immobile in the paramedian position. A CT scan obtained that day revealed a new, large hematoma surrounding the upper descending aortic stent graft consistent with an acute contained ruptured aortic aneurysm. She was referred to the emergency department for evaluation and treatment by vascular surgery. She was counseled regarding surgical options and ultimately decided not to pursue further treatment. Her vocal fold immobility was subsequently treated via office-based injection medialization two weeks after presentation and again 5 months after the initial injection which dramatically improved her voice. Follow-up CT scan at 8 months demonstrated a reduction of the hematoma. The left vocal cord remains immobile to date. Conclusion. Ortner's syndrome, or cardiovocal syndrome, is hoarseness secondary to left recurrent laryngeal nerve palsy caused by cardiovascular pathology. It is a rare condition and, while typically presenting gradually, may also present with acute symptomatology.

  5. Acute Contained Ruptured Aortic Aneurysm Presenting as Left Vocal Fold Immobility

    Directory of Open Access Journals (Sweden)

    Sharon H. Gnagi

    2015-01-01

    Full Text Available Objective. To recognize intrathoracic abnormalities, including expansion or rupture of aortic aneurysms, as a source of acute onset vocal fold immobility. Methods. A case report and review of the literature. Results. An 85-year-old female with prior history of an aortic aneurysm presented to a tertiary care facility with sudden onset hoarseness. On laryngoscopy, the left vocal fold was immobile in the paramedian position. A CT scan obtained that day revealed a new, large hematoma surrounding the upper descending aortic stent graft consistent with an acute contained ruptured aortic aneurysm. She was referred to the emergency department for evaluation and treatment by vascular surgery. She was counseled regarding surgical options and ultimately decided not to pursue further treatment. Her vocal fold immobility was subsequently treated via office-based injection medialization two weeks after presentation and again 5 months after the initial injection which dramatically improved her voice. Follow-up CT scan at 8 months demonstrated a reduction of the hematoma. The left vocal cord remains immobile to date. Conclusion. Ortner’s syndrome, or cardiovocal syndrome, is hoarseness secondary to left recurrent laryngeal nerve palsy caused by cardiovascular pathology. It is a rare condition and, while typically presenting gradually, may also present with acute symptomatology.

  6. Vocal Fold Hyperplastic Lesions: an Evaluation of Surgical Outcome with Videolaryngostroboscopy

    Directory of Open Access Journals (Sweden)

    Melek Kezban Gürbüz

    2013-06-01

    Full Text Available Background: Vocal fold hyperplastic lesions are premalignant lesions that can be treated effectively by removal of the lesions surgically. Aims: The aim of this study was to discuss the success of surgery in patients with vocal fold hyperplastic lesions in terms of preserving vibratory function by comparing the preoperative and postoperative videolaryngostroboscopy findings. Study Design: The medical charts and videolaryngostroboscopic recordings of patients diagnosed with hyperplastic lesions on the vocal folds were reviewed retrospectively. Methods: Twenty seven patients with unilateral lesions who underwent type1 subepithelial cordectomy were enrolled in the study. The videolaryngostroboscopic recordings were evaluated by three raters who were not the operating surgeon and who were blinded to the histology of patients. To evaluate the videolaryngostroboscopic findings, a form, which is a modification of criteria described by Hirano and Bless, was used. Preoperative and 6th month postoperative videolaryngostroboscopic recordings were compared with each other and with recordings of the control group, which included 50 healthy volunteers. Results: All videolaryngostroboscopic findings, except false cord vibration, were significantly improved after surgery. Conclusion: The principle of vocal fold surgery in patients with benign lesions is to preserve the vibratory tissue. This principle also applies to patients with hyperplastic lesions that are premalignant. The hydrodissection technique may be beneficial for this purpose.

  7. One-Year Mortality of Patients with Chronic Kidney Disease After Spinal Cord Injury: A 14-Year Population-Based Study.

    Science.gov (United States)

    Yu, Shou-Chun; Kuo, Jinn-Rung; Shiue, Yow-Ling; Yu, Zong-Xing; Ho, Chung-Han; Wu, Chia-Chun; Wang, Jhi-Joung; Chu, Chin-Chen; Lim, Sher-Wei

    2017-09-01

    Chronic kidney disease (CKD) has become a global public health burden because of its increasing incidence, high risk of progression to end-stage renal disease (ESRD), and poor prognosis. We aimed to investigate the 1-year mortality of patients with spinal cord injury (SCI) with CKD and ESRD, and compare it with that of patients with SCI without CKD by reviewing a large Taiwanese population data set. In this 14-year retrospective cohort study, the study group (SCI with CKD group, n = 3315) and comparison group (SCI without CKD group, n = 6630) were matched at a 1:2 ratio with propensity score matching by age, sex, comorbidities, length of intensive care unit stay, and length of stay. The 1-year mortality and the relative risks of mortality were calculated. Mortality stratified by age, sex, and comorbidities was also analyzed. The SCI with CKD group had a significantly shorter survival period (10.13 vs. 10.97 months), higher 1-year mortality (17.65% vs. 8.54%), and higher risk of mortality than did the comparison group (adjusted hazard ratio, 2.25). Furthermore, patients with CKD with ESRD had a 7.71-fold higher risk of mortality than did patients with SCI without CKD for ages <50 years. The presence of comorbidities was a risk factor for mortality among patients with SCI CKD or ESRD in contrast to patients with SCI without CKD. Patients with SCI with CKD, especially those with ESRD, have a higher risk of mortality than do patients who do not have CKD. Therefore, patients with CKD should have carefully monitoring for the development of 1-year mortality after SCI, especially for ESRD. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Spinal cord toxoplasmosis in AIDS

    International Nuclear Information System (INIS)

    Carteret, M.; Petit, E.; Granat, O.; Marichez, M.; Gilquin, J.

    1995-01-01

    Toxoplasmosis is the most common brain parasitic infection in acquired immunodeficiency syndrome (AIDS). Spinal cord localizations are still rare (2 cases with cerebral involvement, 2 cases without). A case of both spinal cord and cerebral involvement is reported. Magnetic resonance imaging (MR imaging) was performed because of sensory level (L 1). A focal conus medullaris enlargement was seen, iso intense on T 1 weighted images. This lesion was hyperintense on T 2 weighted sequence, and was homogeneously enhanced after Gadolinium on T 1 weighted images. A medullary oedema was noted. A toxoplasmosis treatment was initiated, without cortico therapy. MR imaging performed one month later (D 30), while important clinical improvements were seen, pointed out normal thickness of conus medullaris, without enhancement after Gadolinium. Disease lesions in AIDS with focal spinal cord processes are reviewed, and diagnostic work-up is discussed. Spinal cord single lesion, associated or not with brain involvements should be treated as a toxoplasmic infection, with MR imaging follow up. This work up should avoid medullary biopsy, still required in case of treatment failure. Cerebral involvements, with multiples lesions can mask medullary localization. (authors). 8 refs., 2 figs

  9. Therapeutic approaches for spinal cord injury

    Directory of Open Access Journals (Sweden)

    Alexandre Fogaça Cristante

    2012-10-01

    Full Text Available This study reviews the literature concerning possible therapeutic approaches for spinal cord injury. Spinal cord injury is a disabling and irreversible condition that has high economic and social costs. There are both primary and secondary mechanisms of damage to the spinal cord. The primary lesion is the mechanical injury itself. The secondary lesion results from one or more biochemical and cellular processes that are triggered by the primary lesion. The frustration of health professionals in treating a severe spinal cord injury was described in 1700 BC in an Egyptian surgical papyrus that was translated by Edwin Smith; the papyrus reported spinal fractures as a ''disease that should not be treated.'' Over the last biological or pharmacological treatment method. Science is unraveling the mechanisms of cell protection and neuroregeneration, but clinically, we only provide supportive care for patients with spinal cord injuries. By combining these treatments, researchers attempt to enhance the functional recovery of patients with spinal cord injuries. Advances in the last decade have allowed us to encourage the development of experimental studies in the field of spinal cord regeneration. The combination of several therapeutic strategies should, at minimum, allow for partial functional recoveries for these patients, which could improve their quality of life.

  10. VOCAL SEGMENT CLASSIFICATION IN POPULAR MUSIC

    DEFF Research Database (Denmark)

    Feng, Ling; Nielsen, Andreas Brinch; Hansen, Lars Kai

    2008-01-01

    This paper explores the vocal and non-vocal music classification problem within popular songs. A newly built labeled database covering 147 popular songs is announced. It is designed for classifying signals from 1sec time windows. Features are selected for this particular task, in order to capture...

  11. Final Syllable Lengthening (FSL) in Infant Vocalizations.

    Science.gov (United States)

    Nathani, Suneeti; Oller, D. Kimbrough; Cobo-Lewis, Alan B.

    2003-01-01

    Sought to verify research findings that suggest there may be a U-shaped developmental trajectory for final syllable lengthening (FSL). Attempted to determine whether vocal maturity and deafness influence FSL . Eight normally hearing infants and eight deaf infants were examined at three levels of prelinguistic vocal development. (Author/VWL)

  12. Vocal communication in an avian hybrid zone

    NARCIS (Netherlands)

    Hartog, Paula Maria den

    2008-01-01

    Avian vocalizations function in mate attraction and territorial defence. Vocalizations can act as behavioural barriers and play an important role in speciation processes. Hybrid zones illustrate behavioural barriers are not always impermeable and provide a natural laboratory to examine the role of

  13. Reinke Edema: Watch For Vocal Fold Cysts.

    Science.gov (United States)

    Tüzüner, Arzu; Demirci, Sule; Yavanoglu, Ahmet; Kurkcuoglu, Melih; Arslan, Necmi

    2015-06-01

    Reinke edema is one of the common cause of dysphonia middle-aged population, and severe thickening of vocal folds require surgical treatment. Smoking plays a major role on etiology. Vocal fold cysts are also benign lesions and vocal trauma blamed for acquired cysts. We would like to present 3 cases with vocal fold cyst related with Reinke edema. First case had a subepidermal epidermoid cyst with Reinke edema, which could be easily observed before surgery during laryngostroboscopy. Second case had a mucous retention cyst into the edematous Reinke tissue, which was detected during surgical intervention, and third case had a epidermoid cyst that occurred 2 months after before microlaryngeal operation regarding Reinke edema reduction. These 3 cases revealed that surgical management of Reinke edema needs a careful dissection and close follow-up after surgery for presence of vocal fold cysts.

  14. Auditory-vocal mirroring in songbirds.

    Science.gov (United States)

    Mooney, Richard

    2014-01-01

    Mirror neurons are theorized to serve as a neural substrate for spoken language in humans, but the existence and functions of auditory-vocal mirror neurons in the human brain remain largely matters of speculation. Songbirds resemble humans in their capacity for vocal learning and depend on their learned songs to facilitate courtship and individual recognition. Recent neurophysiological studies have detected putative auditory-vocal mirror neurons in a sensorimotor region of the songbird's brain that plays an important role in expressive and receptive aspects of vocal communication. This review discusses the auditory and motor-related properties of these cells, considers their potential role on song learning and communication in relation to classical studies of birdsong, and points to the circuit and developmental mechanisms that may give rise to auditory-vocal mirroring in the songbird's brain.

  15. Auditory–vocal mirroring in songbirds

    Science.gov (United States)

    Mooney, Richard

    2014-01-01

    Mirror neurons are theorized to serve as a neural substrate for spoken language in humans, but the existence and functions of auditory–vocal mirror neurons in the human brain remain largely matters of speculation. Songbirds resemble humans in their capacity for vocal learning and depend on their learned songs to facilitate courtship and individual recognition. Recent neurophysiological studies have detected putative auditory–vocal mirror neurons in a sensorimotor region of the songbird's brain that plays an important role in expressive and receptive aspects of vocal communication. This review discusses the auditory and motor-related properties of these cells, considers their potential role on song learning and communication in relation to classical studies of birdsong, and points to the circuit and developmental mechanisms that may give rise to auditory–vocal mirroring in the songbird's brain. PMID:24778375

  16. Microvascular lesions of the true vocal fold.

    Science.gov (United States)

    Postma, G N; Courey, M S; Ossoff, R H

    1998-06-01

    Microvascular lesions, also called varices or capillary ectasias, in contrast to vocal fold polyps with telangiectatic vessels, are relatively small lesions arising from the microcirculation of the vocal fold. Varices are most commonly seen in female professional vocalists and may be secondary to repetitive trauma, hormonal variations, or repeated inflammation. Microvascular lesions may either be asymptomatic or cause frank dysphonia by interrupting the normal vibratory pattern, mass, or closure of the vocal folds. They may also lead to vocal fold hemorrhage, scarring, or polyp formation. Laryngovideostroboscopy is the key in determining the functional significance of vocal fold varices. Management of patients with a varix includes medical therapy, speech therapy, and occasionally surgical vaporization. Indications for surgery are recurrent hemorrhage, enlargement of the varix, development of a mass in conjunction with the varix or hemorrhage, and unacceptable dysphonia after maximal medical and speech therapy due to a functionally significant varix.

  17. Bedside screen for oral cavity structure, salivary flow, and vocal production over the 14days following endotracheal extubation.

    Science.gov (United States)

    Chen, Cheryl Chia-Hui; Wu, Kuo-Hsiang; Ku, Shih-Chi; Chan, Ding-Cheng; Lee, Jang-Jaer; Wang, Tyng-Guey; Hsiao, Tzu-Yu

    2018-06-01

    To describe the sequelae of oral endotracheal intubation by evaluating prevalence rates of structural injury, hyposalivation, and impaired vocal production over 14days following extubation. Consecutive adults (≥20years, N=114) with prolonged (≥48h) endotracheal intubation were enrolled from medical intensive care units at a university hospital. Participants were assessed by trained nurses at 2, 7, and 14days after extubation, using a standardized bedside screening protocol. Within 48-hour postextubation, structural injuries were common, with 51% having restricted mouth opening. Unstimulated salivary flow was reduced in 43%. For vocal production, 51% had inadequate breathing support for phonation, dysphonia was common (94% had hoarseness and 36% showed reduced efficiency of vocal fold closure), and >40% had impaired articulatory precision. By 14days postextubation, recovery was noted in most conditions, but reduced efficiency of vocal fold closure persisted. Restricted mouth opening (39%) and reduced salivary flow (34%) remained highly prevalent. After extubation, restricted mouth opening, reduced salivary flow, and dysphonia were common and prolonged in recovery. Reduced efficiency of vocal cord closure persisted at 14days postextubation. The extent and duration of these sequelae remind clinicians to screen for them up to 2weeks after extubation. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. A Cystine-Rich Whey Supplement (Immunocal® Delays Disease Onset and Prevents Spinal Cord Glutathione Depletion in the hSOD1G93A Mouse Model of Amyotrophic Lateral Sclerosis

    Directory of Open Access Journals (Sweden)

    Erika K. Ross

    2014-12-01

    Full Text Available Depletion of the endogenous antioxidant, glutathione (GSH, underlies progression of the devastating neurodegenerative disease, amyotrophic lateral sclerosis (ALS. Thus, strategies aimed at elevating GSH may yield new therapeutics for ALS. Here, we investigated the effects of a unique non-denatured whey protein supplement, Immunocal®, in the transgenic Gly position 93 to Ala (G93A mutant hSOD1 (hSOD1G93A mouse model of ALS. Immunocal® is rich in the GSH precursor, cystine, and is therefore capable of bolstering GSH content. Transgenic hSOD1G93A mice receiving Immunocal® displayed a significant delay in disease onset compared to untreated hSOD1G93A controls. Additionally, Immunocal® treatment significantly decreased the rate of decline in grip strength and prevented disease-associated reductions in whole blood and spinal cord tissue GSH levels in end-stage hSOD1G93A mice. However, Immunocal® did not extend survival, likely due to its inability to preserve the mitochondrial GSH pool in spinal cord. Combination treatment with Immunocal® and the anti-glutamatergic compound, riluzole, delayed disease onset and extended survival in hSOD1G93A mice. These findings demonstrate that sustaining tissue GSH with Immunocal® only modestly delays disease onset and slows the loss of skeletal muscle strength in hSOD1G93A mice. Moreover, the inability of Immunocal® to rescue mitochondrial GSH in spinal cord provides a possible mechanism for its lack of effect on survival and is a limiting factor in the potential utility of this supplement as a therapeutic for ALS.

  19. Detecting Laryngopharyngeal Reflux by Immunohistochemistry of Pepsin in the Biopsies of Vocal Fold Leukoplakia.

    Science.gov (United States)

    Gong, Xia; Wang, Xiao-Yun; Yang, Li; Sun, Ming-Jun; Du, Jun; Zhang, Wei

    2018-05-01

    Laryngopharyngeal reflux (LPR) may contribute to the development of laryngeal diseases including vocal fold leukoplakia. Clinical methods of determining LPR are limited. Pepsin, as an exogenous protein, is considered as a biomarker of LPR. The aim of the current study was, therefore, to detect pepsin by immunohistochemistry in the biopsies from patients with vocal fold leukoplakia, and by which, to determine the potential association of LPR and vocal leukoplakia. A total of 26 biopsies from patients with vocal fold leukoplakia were examined in comparison with 20 vocal fold biopsies from control subjects. We found that 2 out of 26 patients (7.7%) were strongly positive, 4 of the 26 (15.4%) patients were positive, 11 of the 26 (42.3%) patients were weakly positive, and 9 of the 26 (34.6%) were negative staining for pepsin. In contrast, only 4 of the 20 (20.0%) control subjects were weakly positive and the rest (16; 80.0%) were negative staining for pepsin. There was significant difference between the two groups in terms of positivity of pepsin staining (χ 2  = 24.181, P vocal fold leukoplakia. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  20. Vocal fold nodules in school age children: attention deficit hyperactivity disorder as a potential risk factor.

    Science.gov (United States)

    D'Alatri, Lucia; Petrelli, Livia; Calò, Lea; Picciotti, Pasqualina Maria; Marchese, Maria Raffaella; Bussu, Francesco

    2015-05-01

    To evaluate the presence of symptoms of inattention and hyperactivity/impulsivity in a population of school age children affected by vocal fold nodules. Parents and teachers of 18 children with vocal fold nodules (10 males, eight females; aged between 6 and 12 years) and 20 matched controls without dysphonia and/or vocal fold diseases (11 males, nine females; aged between 6 and 12 years) completed Attention-Deficit/Hyperactivity Disorder (ADHD) rating scale for parents (SDAG [Scala per i Disturbi di Attenzione/Iperattività per Genitori]) and teachers (SDAI [Scala per i Disturbi di Attenzione/Iperattività per Insegnanti) rating scales containing in two subscales items that specifically evaluate the symptoms of ADHD according to the DSM-IV. All children were subjected to videolaryngoscopy. The group with vocal fold nodules scored significantly higher than the controls; the difference between the two groups was statistically significant for both the subscales of both questionnaires (SDAG and SDAI) (P ADHD was formulated. ADHD is a possible risk factor for the development of vocal fold nodules in childhood. SDAG and SDAI rating scales may supplement the diagnostic assessment of children with vocal fold nodules. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  1. NR4A1 is an endogenous inhibitor of vocal fold fibrosis.

    Science.gov (United States)

    Hiwatashi, Nao; Bing, Renjie; Kraja, Iv; Branski, Ryan C

    2017-09-01

    NR4A1 was recently identified as an endogenous inhibitor of transforming growth factor (TGF)-β-induced fibrosis, and the role of this nuclear receptor has not been elucidated in tissue health or the response to injury in the vocal folds. Given the clinical implications of vocal fold fibrosis, we investigated NR4A1 expression during vocal fold wound healing in vivo and the regulatory roles of NR4A1 on vocal fold fibroblasts (VFFs) in vitro with the ultimate goal of developing targeted therapies for this challenging patient population. In vivo and in vitro. In vivo, the temporal pattern of NR4A1 mRNA expression was quantified following rat vocal fold injury. In vitro, the role of NR4A1 on TGF-β1-mediated transcription of genes underlying fibrosis as well as myofibroblast differentiation and collagen gel contraction was quantified in our human VFF line. Small interfering RNA was employed to alter NR4A1 expression to further elucidate this complex system. Nr4a1 mRNA increased 1 day after injury and peaked at 7 days. Knockdown of NR4A1 resulted in upregulation of COL1A1 and TGF-β1, with TGF-β1 stimulation (both P vocal fold health or disease. Upregulation of TGF-β following vocal fold injury was concurrent with increased NR4A1 expression. These data provide a foundation for the development of therapeutic strategies given persistent TGF-β signaling in vocal fold fibrosis. N/A Laryngoscope, 127:E317-E323, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  2. Arm crank ergometry improves cardiovascular disease risk factors and community mobility independent of body composition in high motor complete spinal cord injury.

    Science.gov (United States)

    Bresnahan, James J; Farkas, Gary J; Clasey, Jody L; Yates, James W; Gater, David R

    2018-01-15

    Evaluate the effect of aerobic exercise using arm crank ergometry (ACE) in high motor complete (ISNCSCI A/B) spinal cord injury (SCI) as primarily related to cardiovascular disease (CVD) risk factors and functional mobility and secondarily to body composition and metabolic profiles. Longitudinal interventional study at an academic medical center. Ten previously untrained participants (M8/F2, Age 36.7 y ± 10.1, BMI 24.5 ± 6.0) with high motor complete SCI (C7-T5) underwent ACE exercise training 30 minutes/day × 3 days/week for 10 weeks at 70% VO 2Peak . Primary outcome measures were pre- and post-intervention changes in markers of cardiovascular fitness (graded exercise testing (GXT): VO 2 , VO 2Peak , respiratory quotient [RQ], GXT time, peak power, and energy expenditure [EE]) and community mobility (time to traverse a 100ft-5° ramp, and 12-minute WC propulsion test). Secondary outcome measures were changes in body composition and metabolic profiles (fasting and area under the curve for glucose and insulin, homeostasis model assessment [HOMA] for %β-cell activity [%β], %insulin sensitivity [%S], and insulin resistance [IR], and Matsuda Index [ISI Matsuda ]). Resting VO 2 , relative VO 2Peak , absolute VO 2Peak , peak power, RQ, 12-minute WC propulsion, fasting insulin, fasting G:I ratio, HOMA-%S, and HOMA-IR all significantly improved following intervention (P 0.05). Ten weeks of ACE at 70% VO 2Peak in high motor complete SCI improves aerobic capacity, community mobility, and metabolic profiles independent of changes in body composition.

  3. Low testosterone and non-alcoholic fatty liver disease: Evidence for their independent association in men with chronic spinal cord injury.

    Science.gov (United States)

    Barbonetti, Arcangelo; Caterina Vassallo, Maria Rosaria; Cotugno, Michele; Felzani, Giorgio; Francavilla, Sandro; Francavilla, Felice

    2016-07-01

    Non-alcoholic fatty liver disease (NAFLD) has been claimed as a liver phenotype of metabolic syndrome, which in turn is associated with male hypogonadism. We assessed whether an independent association between NAFLD and androgen deficiency could be revealed in men with chronic spinal cord injury (SCI), who exhibit a high prevalence of biochemical androgen deficiency and a combination of risk factors for metabolic syndrome. Fifty-five consecutive men with chronic SCI admitted to a rehabilitation program underwent clinical/biochemical evaluations and liver ultrasonography. NAFLD was diagnosed in 27 patients (49.1%). Men with NAFLD were older and exhibited significantly higher body mass index, Homeostatic model assessment of insulin resistance, triglycerides and gamma-glutamyl transpeptidase values, lower total and free testosterone levels and they were engaged in a significantly poorer weekly leisure time physical activity (LTPA). At the multiple logistic regression analysis, only total and free testosterone levels exhibited a significant independent association with NAFLD. The risk of having NAFLD increased indeed of 1% for each decrement of 1 ng/dL of total testosterone and of 3% for each decrement of 1 pg/mL of free testosterone, after adjustment for confounders. In men with total testosterone < 300 ng/dL (36.4%) the prevalence of NAFLD reached 85%: they had a risk of having NAFLD significantly higher (∼12-fold) than those with total testosterone ≥ 300 ng/dL, after adjustment for confounders. The evidence of an independent association between NAFLD and low testosterone is strongly reinforced by its demonstration in men with chronic SCI, in spite of the many confounders peculiar to this population.

  4. Directed midbrain and spinal cord neurogenesis from pluripotent stem cells to model development and disease in a dish.

    Science.gov (United States)

    Allodi, Ilary; Hedlund, Eva

    2014-01-01

    Induction of specific neuronal fates is restricted in time and space in the developing CNS through integration of extrinsic morphogen signals and intrinsic determinants. Morphogens impose regional characteristics on neural progenitors and establish distinct progenitor domains. Such domains are defined by unique expression patterns of fate determining transcription factors. These processes of neuronal fate specification can be recapitulated in vitro using pluripotent stem cells. In this review, we focus on the generation of dopamine neurons and motor neurons, which are induced at ventral positions of the neural tube through Sonic hedgehog (Shh) signaling, and defined at anteroposterior positions by fibroblast growth factor (Fgf) 8, Wnt1, and retinoic acid (RA). In vitro utilization of these morphogenic signals typically results in the generation of multiple neuronal cell types, which are defined at the intersection of these signals. If the purpose of in vitro neurogenesis is to generate one cell type only, further lineage restriction can be accomplished by forced expression of specific transcription factors in a permissive environment. Alternatively, cell-sorting strategies allow for selection of neuronal progenitors or mature neurons. However, modeling development, disease and prospective therapies in a dish could benefit from structured heterogeneity, where desired neurons are appropriately synaptically connected and thus better reflect the three-dimensional structure of that region. By modulating the extrinsic environment to direct sequential generation of neural progenitors within a domain, followed by self-organization and synaptic establishment, a reductionist model of that brain region could be created. Here we review recent advances in neuronal fate induction in vitro, with a focus on the interplay between cell intrinsic and extrinsic factors, and discuss the implications for studying development and disease in a dish.

  5. The Health Economics of the spinal cord injury or disease among veterans of war: A systematic review.

    Science.gov (United States)

    Furlan, Julio C; Gulasingam, Sivakumar; Craven, B Catharine

    2017-11-01

    Information on health-care utilization and the economic burden of disease are essential to understanding service demands, service accessibility, and practice patterns. This information may also be used to enhance the quality of care through altered resource allocation. Thus, a systematic review of literature on the economic impact of caring for SCI/D veterans would be of great value. To systematically review and critically appraise the literature on the economics of the management of veterans with SCI/D. Medline, EMBASE and PsycINFO databases were searched for articles on economic impact of management of SCI/D veterans, published from 1946 to September/2016. The STROBE statement was used to determine publication quality. The search identified 1,573 publications of which 13 articles fulfilled the inclusion/exclusion criteria with 12 articles focused on costs of management of SCI/D veterans; and, one cost-effectiveness analysis. Overall, the health care costs for the management of SCI/D veterans are substantial ($30,770 to $62,563 in 2016 USD per year) and, generally, greater than the costs of caring for patients with other chronic diseases. The most significant determinants of the higher total health-care costs are cervical level injury, complete injury, time period (i.e. first year post-injury and end-of-life year), and presence of pressure ulcers. There is growing evidence for the economic burden of SCI/D and its determinants among veterans, whereas there is a paucity of comparative studies on interventions including cost-effectiveness analyses. Further investigations are needed to fulfill significant knowledge gaps on the economics of caring for veterans with SCI/D.

  6. The Risk of Vocal Fold Atrophy after Serial Corticosteroid Injections of the Vocal Fold.

    Science.gov (United States)

    Shi, Lucy L; Giraldez-Rodriguez, Laureano A; Johns, Michael M

    2016-11-01

    The aim of this study was to illustrate the risk of vocal fold atrophy in patients who receive serial subepithelial steroid injections for vocal fold scar. This study is a retrospective case report of two patients who underwent a series of weekly subepithelial infusions of 10 mg/mL dexamethasone for benign vocal fold lesion. Shortly after the procedures, both patients developed a weak and breathy voice. The first patient was a 53-year-old man with radiation-induced vocal fold stiffness. Six injections were performed unilaterally, and 1 week later, he developed unilateral vocal fold atrophy with new glottal insufficiency. The second patient was a 67-year-old woman with severe vocal fold inflammation related to laryngitis and calcinosis, Raynaud's phenomenon, esophagean dysmotility, sclerodactyly, and telangiectasia (CREST) syndrome. Five injections were performed bilaterally, and 1 week later, she developed bilateral vocal fold atrophy with a large midline glottal gap during phonation. In both cases, the steroid-induced vocal atrophy resolved spontaneously after 4 months. Serial subepithelial steroid infusions of the vocal folds, although safe in the majority of patients, carry the risk of causing temporary vocal fold atrophy when given at short intervals. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  7. A Rat Excised Larynx Model of Vocal Fold Scar

    Science.gov (United States)

    Welham, Nathan V.; Montequin, Douglas W.; Tateya, Ichiro; Tateya, Tomoko; Choi, Seong Hee; Bless, Diane M.

    2009-01-01

    Purpose: To develop and evaluate a rat excised larynx model for the measurement of acoustic, aerodynamic, and vocal fold vibratory changes resulting from vocal fold scar. Method: Twenty-four 4-month-old male Sprague-Dawley rats were assigned to 1 of 4 experimental groups: chronic vocal fold scar, chronic vocal fold scar treated with 100-ng basic…

  8. Spinal cord involvement in Balo's concentric sclerosis

    NARCIS (Netherlands)

    Kreft, Karim L.; Mellema, S. Jouke; Hintzen, Rogier Q.

    2009-01-01

    We present a patient with a history of myelitis, who had a steroid refractory attack of CNS inflammatory demyelinating disease that developed into cerebral concentric sclerosis of Balo after plasma exchange. The acute inflammatory disease involved the spinal cord, a phenomenon rarely demonstrated.

  9. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC Understanding Spinal Cord Injury About ... Your email address * This iframe contains the logic required to ...

  10. Gestures, vocalizations, and memory in language origins.

    Science.gov (United States)

    Aboitiz, Francisco

    2012-01-01

    THIS ARTICLE DISCUSSES THE POSSIBLE HOMOLOGIES BETWEEN THE HUMAN LANGUAGE NETWORKS AND COMPARABLE AUDITORY PROJECTION SYSTEMS IN THE MACAQUE BRAIN, IN AN ATTEMPT TO RECONCILE TWO EXISTING VIEWS ON LANGUAGE EVOLUTION: one that emphasizes hand control and gestures, and the other that emphasizes auditory-vocal mechanisms. The capacity for language is based on relatively well defined neural substrates whose rudiments have been traced in the non-human primate brain. At its core, this circuit constitutes an auditory-vocal sensorimotor circuit with two main components, a "ventral pathway" connecting anterior auditory regions with anterior ventrolateral prefrontal areas, and a "dorsal pathway" connecting auditory areas with parietal areas and with posterior ventrolateral prefrontal areas via the arcuate fasciculus and the superior longitudinal fasciculus. In humans, the dorsal circuit is especially important for phonological processing and phonological working memory, capacities that are critical for language acquisition and for complex syntax processing. In the macaque, the homolog of the dorsal circuit overlaps with an inferior parietal-premotor network for hand and gesture selection that is under voluntary control, while vocalizations are largely fixed and involuntary. The recruitment of the dorsal component for vocalization behavior in the human lineage, together with a direct cortical control of the subcortical vocalizing system, are proposed to represent a fundamental innovation in human evolution, generating an inflection point that permitted the explosion of vocal language and human communication. In this context, vocal communication and gesturing have a common history in primate communication.

  11. Vocal ontogeny in neotropical singing mice (Scotinomys.

    Directory of Open Access Journals (Sweden)

    Polly Campbell

    Full Text Available Isolation calls produced by dependent young are a fundamental form of communication. For species in which vocal signals remain important to adult communication, the function and social context of vocal behavior changes dramatically with the onset of sexual maturity. The ontogenetic relationship between these distinct forms of acoustic communication is surprisingly under-studied. We conducted a detailed analysis of vocal development in sister species of Neotropical singing mice, Scotinomys teguina and S. xerampelinus. Adult singing mice are remarkable for their advertisement songs, rapidly articulated trills used in long-distance communication; the vocal behavior of pups was previously undescribed. We recorded 30 S. teguina and 15 S. xerampelinus pups daily, from birth to weaning; 23 S. teguina and 11 S. xerampelinus were recorded until sexual maturity. Like other rodent species with poikilothermic young, singing mice were highly vocal during the first weeks of life and stopped vocalizing before weaning. Production of first advertisement songs coincided with the onset of sexual maturity after a silent period of ≧2 weeks. Species differences in vocal behavior emerged early in ontogeny and notes that comprise adult song were produced from birth. However, the organization and relative abundance of distinct note types was very different between pups and adults. Notably, the structure, note repetition rate, and intra-individual repeatability of pup vocalizations did not become more adult-like with age; the highly stereotyped structure of adult song appeared de novo in the first songs of young adults. We conclude that, while the basic elements of adult song are available from birth, distinct selection pressures during maternal dependency, dispersal, and territorial establishment favor major shifts in the structure and prevalence of acoustic signals. This study provides insight into how an evolutionarily conserved form of acoustic signaling provides

  12. Coping strategies in teachers with vocal complaint.

    Science.gov (United States)

    Zambon, Fabiana; Moreti, Felipe; Behlau, Mara

    2014-05-01

    To understand the coping strategies used by teachers with vocal complaints, compare the differences between those who seek and those who do not seek voice therapy, and investigate the relationships among coping and voice perceptual analysis, coping and signs and symptoms of voice, and coping and participation restrictions and limitations in vocal activities. Cross-sectional nonrandomized prospective study with control group. Ninety female teachers participated in the study, of similar ages, divided into three groups: group 1 (G1) comprised 30 teachers with vocal complaints who sought voice therapy, group 2 (G2) comprised 30 teachers with vocal complaints who never sought voice therapy, and group 3 (G3) comprised 30 teachers without vocal complaints. The following analysis were conducted: identification and characterization questionnaire, addressing personal and occupational description, recording speech material for voice perceptual analysis, Voice Signs and Symptoms Questionnaire, Voice Activity and Participation Profile (VAPP), and Voice Disability Coping Questionnaire (VDCQ)-Brazilian Version. In relation to the voice perceptual analysis, there was statistically significant difference between the groups with vocal complaint (G1+G2), which had showed voices with mild-to-moderate deviation, and the group without vocal complaint (G1), which showed voices within the normal variability of voice quality (mean for G1 = 49.9, G2 = 43.7, and G3 = 32.3, P Teachers with vocal complaints who looked for voice therapy use more coping strategies. Moreover, they present a tendency to use more problem-focused coping strategies. Voice symptoms prompt the teachers into seeking treatment; however, they are not correlated with the coping itself. In general, the higher the perception of limitation and restriction of participating in vocal activities, the greater the use of coping strategies. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  13. Cord blood transplantation: can we make it better?

    Directory of Open Access Journals (Sweden)

    Leland eMetheny

    2013-09-01

    Full Text Available Umbilical cord blood is an established source of hematopoietic stem cells for transplantation. It enjoys several advantages over bone marrow or peripheral blood, including increased tolerance for Human Leukocyte Antigen mismatches, decreased incidence of graft-versus-host disease, and easy availability. Unrelated cord blood does have limitations, however, especially in the treatment of adults. In the 24 years since the first umbilical cord blood transplant was performed, significant progress has been made, but delayed hematopoietic engraftment and increased treatment related mortality remain obstacles to widespread use. Here we summarize the latest results of unrelated cord blood transplants, and review strategies under investigation to improve clinical outcomes.

  14. Positive therapy of andrographolide in vocal fold leukoplakia.

    Science.gov (United States)

    Xu, Jue; Xue, Tao; Bao, Ying; Wang, Dong-Hai; Ma, Bing-Liang; Yin, Chen-Yi; Yang, Guang-Hui; Ren, Gang; Lan, Long-Jiang; Wang, Jian-Qiu; Zhang, Xiao-Lan; Zhao, Yu-Qin

    2014-01-01

    Vocal fold leukoplakia is a premalignant precursor of squamous cell carcinoma. Although many efforts have been contributed to therapy of this disease, none exhibits a satisfactory result. The aims of this study were to investigate the effectiveness and feasibility of andrographolide therapy in vocal fold leukoplakia and to explore the preliminary mechanism underlying. Forty-one eligible patients were enrolled in the study. The patients were treated for 10-minute exposures of 5 ml (25mg/ml) andrographolide injection aerosols twice a day, and 2 weeks was considered as one treatment course. Electronic laryngoscope was used to observe the condition of vocal fold leukoplakia during the treatment. Every patient received one or two treatment courses, and the follow-up was carried out for 12 months. Toxic reactions of treatments were evaluated on the basis of the standards of the United States MD Anderson Cancer Center. Moreover, laryngeal carcinoma cell line Hep2 was applied to explore the mechanism of effect of andrographolide. Anti-proliferative effect on Hep2, cell nuclear morphology, express of mitogen-activated protein kinases (MAPK) and pro-apoptotic protein were detected after andrographolide treatment. We found that andrographolide exhibited significant curative effects on treatments, which were accompanied by thinning of the lesion of leukoplakia, reduction in the whitish surface area, and return of pink or red epithelium. A complete response up to 85% was observed, and no toxic side effect events occurred during the study. No patient with a complete response had a recurrence in the follow-up. Moreover, cellular experiments in Hep2 indicated that andrographolide activated MAPK pathway and caspase cascade, and finally induced apoptosis in laryngeal carcinoma cell. The advantages of andrographolide are connected with minimally invasive and localized character of the treatment and no damage of collagenous tissue structures, which are more convenient and less painful

  15. 45 Gy - tolerance dose spinal cord - dogma or the facts?

    International Nuclear Information System (INIS)

    Maciejewski, B.; Hliniak, A.; Danczak-Ginalska, Z.; Meder, M.; Skolyszewski, J.; Reinfuss, M.; Korzeniowski, S.; Peszynski, J.; Jassem, J.

    1993-01-01

    Dose of 45 Gy as a tolerance dose for spinal cord was questioned based on review of clinical data. Some data show that for conventional fractionation with the dose per fraction of less than 2.0 Gy spinal cord tolerance dose may arise up to 50-55 Gy. This was the base for round-table discussion and the importance of clinical and physical risk factors of postirradiation spinal cord injury was discussed and previous diseases of spinal cord, size of dose per fraction and length of irradiated spinal cord were pointed out as high risk factors. It was concluded that from clinical point of view there is no reason and on need to verify and to increase tolerance dose for spinal cord. (author)

  16. Symptomatic epidural lipomatosis of the spinal cord in a child: MR demonstration of spinal cord injury

    Energy Technology Data Exchange (ETDEWEB)

    Munoz, Alberto [Department of Radiology, Section of Neuroradiology, 505 Parnassus Av, L-371, University of California-San Francisco, CA 94143-0628 (United States); Servicio de Radiodiagnostico, Seccion de Neurorradiologia, Hospital Universitario ' ' 12 de Octubre' ' , 28040 Madrid (Spain); Barkovich, James A. [Department of Radiology, Section of Neuroradiology, 505 Parnassus Av, L-371, University of California-San Francisco, CA 94143-0628 (United States); Mateos, Fernando; Simon, Rogelio [Seccion de Neurpediatria, Servicio de Neurologia, Hospital Universitario ' ' 12 de Octubre' ' , 28041 Madrid (Spain)

    2002-12-01

    We report a case of symptomatic epidural lipomatosis in an 8-year-old girl with Cushing's syndrome secondary to longstanding high-dose steroid therapy for Crohn's disease. MR imaging of the spine revealed massive diffuse epidural fat compressing the entire spinal cord with T2 prolongation in the central gray matter of the cord suggesting ischemic myelopathy. This finding has not been previously demonstrated on imaging. A proposed mechanism underlying these findings is discussed. (orig.)

  17. Symptomatic epidural lipomatosis of the spinal cord in a child: MR demonstration of spinal cord injury

    International Nuclear Information System (INIS)

    Munoz, Alberto; Barkovich, James A.; Mateos, Fernando; Simon, Rogelio

    2002-01-01

    We report a case of symptomatic epidural lipomatosis in an 8-year-old girl with Cushing's syndrome secondary to longstanding high-dose steroid therapy for Crohn's disease. MR imaging of the spine revealed massive diffuse epidural fat compressing the entire spinal cord with T2 prolongation in the central gray matter of the cord suggesting ischemic myelopathy. This finding has not been previously demonstrated on imaging. A proposed mechanism underlying these findings is discussed. (orig.)

  18. Neuroimaging for spine and spinal cord surgery

    Energy Technology Data Exchange (ETDEWEB)

    Koyanagi, Izumi [Hokkaido Neurosurgical Memorial Hospital (Japan); Iwasaki, Yoshinobu; Hida, Kazutoshi

    2001-01-01

    Recent advances in neuroimaging of the spine and spinal cord are described based upon our clinical experiences with spinal disorders. Preoperative neuroradiological examinations, including magnetic resonance (MR) imaging and computerized tomography (CT) with three-dimensional reconstruction (3D-CT), were retrospectively analyzed in patients with cervical spondylosis or ossification of the posterior longitudinal ligament (130 cases), spinal trauma (43 cases) and intramedullary spinal cord tumors (92 cases). CT scan and 3D-CT were useful in elucidating the spine pathology associated with degenerative and traumatic spine diseases. Visualization of the deformity of the spine or fracture-dislocation of the spinal column with 3D-CT helped to determine the correct surgical treatment. MR imaging was most important in the diagnosis of both spine and spinal cord abnormalities. The axial MR images of the spinal cord were essential in understanding the laterality of the spinal cord compression in spinal column disorders and in determining surgical approaches to the intramedullary lesions. Although non-invasive diagnostic modalities such as MR imaging and CT scans are adequate for deciding which surgical treatment to use in the majority of spine and spinal cord disorders, conventional myelography is still needed in the diagnosis of nerve root compression in some cases of cervical spondylosis. (author)

  19. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... spinal cord injuries? play_arrow What is “Braingate” research? play_arrow How would stem-cell therapies work ... cord injuries? play_arrow What does stem-cell research on animals tell us? play_arrow When can ...

  20. Spinal Cord Injury 101

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    Full Text Available ... Cord Injury Allen Heinemann, PhD How Peer Counseling Works Julie Gassaway, MS, RN Pediatric Injuries Pediatric Spinal ... injury? play_arrow How does the spinal cord work? play_arrow Why is the level of a ...

  1. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... arrow What are the latest developments in the use of electrical stimulation for spinal cord injuries? play_arrow What is “Braingate” research? play_arrow How would stem-cell therapies work in the treatment of spinal cord ...

  2. Spinal Cord Injury 101

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    Full Text Available ... Spinal Cord Injury Guy W. Fried, MD Substance Abuse and Spinal Cord Injury Allen Heinemann, PhD How ... arrow Why are high-dose steroids often used right after an injury? play_arrow What is meant ...

  3. Cord blood is the optimal graft source for the treatment of pediatric patients with lysosomal storage diseases : Clinical outcomes and future directions

    NARCIS (Netherlands)

    Aldenhoven, Mieke; Kurtzberg, Joanne

    Initially used as an alternative hematopoietic stem cell source for patients without a human leukocyte antigen-matched bone marrow or peripheral blood stem cell donor, unrelated cord blood (UCB) is now the preferred donor source when hematopoietic stem cell transplantation (HSCT) is used to treat

  4. Spinal cord magnetic resonance imaging in suspected multiple sclerosis

    International Nuclear Information System (INIS)

    Lycklama a Nijeholt, G.J.; Bergers, E.; Castelijns, J.A.; Barkhof, F.; Uitdehaag, B.M.J.; Polman, C.H.

    2000-01-01

    We examined the value of spinal cord magnetic resonance imaging (MRI) in the diagnostic work-up of multiple sclerosis (MS). Forty patients suspected of having MS were examined within 24 months after the start of symptoms. Disability was assessed, and symptoms were categorized as either brain or spinal cord. Work-up further included cerebrospinal fluid analysis and standard proton-density, T2-, and T1-weighted gadolinium-enhanced brain and spinal cord MRI. Patients were categorized as either clinically definite MS (n = 13), laboratory-supported definite MS (n = 14), or clinically probable MS (n = 4); four patients had clinically probable MS, and in nine MS was suspected. Spinal cord abnormalities were found in 35 of 40 patients (87.5 %), consisting of focal lesions in 31, only diffuse abnormalities in two, and both in two. Asymptomatic spinal cord lesions occurred in six patients. All patients with diffuse spinal cord abnormality had clear spinal cord symptoms and a primary progressive disease course. In clinically definite MS, the inclusion of spinal imaging increased the sensitivity of MRI to 100 %. Seven patients without a definite diagnosis had clinically isolated syndromes involving the spinal cord. Brain MRI was inconclusive, while all had focal spinal cord lesions which explained symptoms and ruled out other causes. Two other patients had atypical brain abnormalities suggesting ischemic/vascular disease. No spinal cord abnormalities were found, and during follow-up MS was ruled out. Spinal cord abnormalities are common in suspected MS, and may occur asymptomatic. Although diagnostic classification is seldom changed, spinal cord imaging increases diagnostic sensitivity of MRI in patients with suspected MS. In addition, patients with primary progressive MS may possibly be earlier diagnosed. Finally, differentiation with atypical lesions may be improved. (orig.)

  5. Real-Time Vocal Tract Modelling

    Directory of Open Access Journals (Sweden)

    K. Benkrid

    2008-03-01

    Full Text Available To date, most speech synthesis techniques have relied upon the representation of the vocal tract by some form of filter, a typical example being linear predictive coding (LPC. This paper describes the development of a physiologically realistic model of the vocal tract using the well-established technique of transmission line modelling (TLM. This technique is based on the principle of wave scattering at transmission line segment boundaries and may be used in one, two, or three dimensions. This work uses this technique to model the vocal tract using a one-dimensional transmission line. A six-port scattering node is applied in the region separating the pharyngeal, oral, and the nasal parts of the vocal tract.

  6. Vascular lesions of the vocal fold.

    Science.gov (United States)

    Gökcan, Kürşat Mustafa; Dursun, Gürsel

    2009-04-01

    The aim of the study was to present symptoms, laryngological findings, clinical course, management modalities, and consequences of vascular lesions of vocal fold. This study examined 162 patients, the majority professional voice users, with vascular lesions regarding their presenting symptoms, laryngological findings, clinical courses and treatment results. The most common complaint was sudden hoarseness with hemorrhagic polyp. Microlaryngoscopic surgery was performed in 108 cases and the main indication of surgery was the presence of vocal fold mass or development of vocal polyp during clinical course. Cold microsurgery was utilized for removal of vocal fold masses and feeding vessels cauterized using low power, pulsed CO(2) laser. Acoustic analysis of patients revealed a significant improvement of jitter, shimmer and harmonics/noise ratio values after treatment. Depending on our clinical findings, we propose treatment algorithm where voice rest and behavioral therapy is the integral part and indications of surgery are individualized for each patient.

  7. Optogenetics of the Spinal Cord: Use of Channelrhodopsin Proteins for Interrogation of Spinal Cord Circuits.

    Science.gov (United States)

    Rahman, Habibur; Nam, Youngpyo; Kim, Jae-Hong; Lee, Won-Ha; Suk, Kyoungho

    2017-12-29

    Spinal cord circuits play a key role in receiving and transmitting somatosensory information from the body and the brain. They also contribute to the timing and coordination of complex patterns of movement. Under disease conditions, such as spinal cord injury and neuropathic pain, spinal cord circuits receive pain signals from peripheral nerves, and are involved in pain development via neurotransmitters and inflammatory mediators released from neurons and glial cells. Despite the importance of spinal cord circuits in sensory and motor functions, many questions remain regarding the relationship between activation of specific cells and behavioral responses. Optogenetics offers the possibility of understanding the complex cellular activity and mechanisms of spinal cord circuits, as well as having therapeutic potential for addressing spinal cord-related disorders. In this review, we discuss recent findings in optogenetic research employing the channelrhodopsin protein to assess the function of specific neurons and glia in spinal cord circuits ex vivo and in vivo. We also explore the possibilities and challenges of employing optogenetics technology in future therapeutic strategies for the treatment of spinal disorders. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  8. Expression of tenascin-C in a rat vocal fold injury model and its regulation of fibroblasts.

    Science.gov (United States)

    Li, Juan; Liu, Yiqiong; Wang, Yiming; Xu, Wen

    2018-03-23

    Tenascin-C (Tnc) is an extracellular matrix (ECM) glycoprotein that plays a vital role in wound healing and fibrotic disease. Tnc is highly upregulated soon after vocal fold injury, but its function in the vocal fold has not yet been defined. In this study, we investigated Tnc expression in a rat vocal fold injury model in vivo and its roles in fibroblasts in vitro. In vivo and in vitro. Tnc mRNA and protein expression levels were quantified on days 3, 7, 14, 28, and 56 after vocal fold injury in Sprague-Dawley rats. In vitro, immunocytochemistry, Western blot, and quantitative real-time polymerase chain reaction (qRT-PCR) analyses were performed in primary rat vocal fold fibroblasts following Tnc or transforming growth factor (TGF)-β1 stimulation to investigate the phenotypic effects. Tnc mRNA and protein expression was upregulated dramatically on days 3 and 7 after injury, and significant differences were observed by qRT-PCR (P vocal fold fibroblasts. Following incubation with Tnc for 72 hours, α-smooth muscle actin, collagen I, and fibronectin expression was significantly upregulated (P vocal fold fibroblast migration, transdifferentiation, and ECM protein synthesis in vitro. Tnc was induced by TGF-β1 in a SMAD3-dependent manner. Transient expression of Tnc is likely to promote regeneration, but its potential role in fibrosis requires further study. NA Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Nuclear magnetic imaging for MTRA. Spinal canal and spinal cord

    International Nuclear Information System (INIS)

    Fritzsch, Dominik; Hoffmann, Karl-Titus

    2011-01-01

    The booklet covers the following topics: (1) Clinical indications for NMR imaging of spinal cord and spinal canal; (2) Methodic requirements: magnets and coils, image processing, contrast media: (3) Examination technology: examination conditions, sequences, examination protocols; (4) Disease pattern and indications: diseases of the myelin, the spinal nerves and the spinal canal (infections, tumors, injuries, ischemia and bleedings, malformations); diseases of the spinal cord and the intervertebral disks (degenerative changes, infections, injuries, tumors, malformations).

  10. MR imaging findings in subacute combined degeneration of the spinal cord: a case report

    International Nuclear Information System (INIS)

    Kim, Ki Jun; Lee, Jae Hee; Lee, Sung Yong; Chung, Sung Woo

    2000-01-01

    Vitamin B12 deficiency can cause neurologic complications in the spinal cord, brain, and optic and peripheral nerves. Subacute combined degeneration is a rare disease of demyelinating lesions of the spinal cord, affecting mainly the posterior and lateral columns of the thoracic cord. We report the MR imaging findings of a case of subacute combined degeneration of the spinal cord in a patient with vitamin B12 deficiency and mega loblastic anemia. (author)

  11. Spinal Cord Diseases - Multiple Languages

    Science.gov (United States)

    ... Information Translations Russian (Русский) Expand Section Myelogram - Русский (Russian) Bilingual ... Health Information Translations Characters not displaying correctly on this page? See language display issues . Return to the MedlinePlus Health Information ...

  12. Vocal health fitness to different music styles

    Directory of Open Access Journals (Sweden)

    Maria Cláudia Mendes Caminha Muniz

    2010-09-01

    Full Text Available Objective: To present genres and styles currently running on western music scene, focusing on the practice of singing voice. Methods: An observational and documental study for which were selected sound sources presenting musical genres and styles that are part of the experience of the researchers, which were analyzed considering origins, formative elements and vocal features. Alongside we carried out a review of literature grounded in databases research and free review of websites and classical books of the area. Results: The selected styles (Rock and Roll, Heavy Metal, Trash Metal, Grunge, Gothic Metal, Rap, Funk, Blues, R&B – Rhythm and Blues, Soul, Gospel, MPB, Samba, Forro, Sertanejo, Bossa Nova, Opera and Chamber Music were described, pointing the reasons for the speech therapist to be informed about them and about singing voice aspects. His guidance may minimize possible vocal damage caused by each style, since each of them carries its own patterns to which the interpreter must submit. Conclusions: We conclude that the singer will use a specific vocal pattern that resembles the musical style he intends to sing, regardless of any harm it may or may not cause to vocal health. When choosing a musical style, it is important that the singer has the knowledge and understanding of how the use of his vocal apparatus will cause or not cause injury to his voice. Also be aware that the technique in singing is necessary for vocal longevity.

  13. Vocal fold hemorrhage: factors predicting recurrence.

    Science.gov (United States)

    Lennon, Christen J; Murry, Thomas; Sulica, Lucian

    2014-01-01

    Vocal fold hemorrhage is an acute phonotraumatic injury treated with voice rest; recurrence is a generally accepted indication for surgical intervention. This study aims to identify factors predictive of recurrence based on outcomes of a large clinical series. Retrospective cohort. Retrospective review of cases of vocal fold hemorrhage presenting to a university laryngology service. Demographic information was compiled. Videostroboscopic exams were evaluated for hemorrhage extent, presence of varix, mucosal lesion, and/or vocal fold paresis. Vocal fold hemorrhage recurrence was the main outcome measure. Follow-up telephone survey was used to complement clinical data. Forty-seven instances of vocal fold hemorrhage were evaluated (25M:22F; 32 professional voice users). Twelve of the 47 (26%) patients experienced recurrence. Only the presence of varix demonstrated significant association with recurrence (P = 0.0089) on multivariate logistic regression. Vocal fold hemorrhage recurred in approximately 26% of patients. Varix was a predictor of recurrence, with 48% of those with varix experiencing recurrence. Monitoring, behavioral management and/or surgical intervention may be indicated to treat patients with such characteristics. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  14. [Is subtotal bilateral thyroidectomy still indicated in patients with Grave's disease?].

    Science.gov (United States)

    Bilosi, M; Binquet, C; Goudet, P; Lalanne-Mistrih, M L; Brun, J M; Cougard, P

    2002-02-01

    To evaluate the morbidity and the functional results of subtotal bilateral thyroidectomy in patients (TST) with Graves' disease. A retrospective study was performed in 128 patients. They were 23 males and 105 females with a median age of 34 years (range: 14-68). Weight of remnant tissue was between 4 and 5 g. Thyroid functional status was evaluated, at 3 months and after a follow-up period ranged from 1 to 5 years, by measurement of serum concentration of free T4 and/or free T3 and TSH. They were no post-operative death. Surgical complications were 2 vocal cord palsies and 17 hypocalcemia (inf. to 2 mmol/L). After a median follow-up of 2 years, they were no longer any cases of vocal cord dysfunction and no case of permanent hypoparathyroidism. Functional results were established in 118 patients: 46 patients had clinical hypothyroidism (39%), 64 patients had latent hypothyroidism or euthyroidism (54.2%), and 8 had recurrent hyperthyroidism (6.8%). These results suggest that TST with a remnant mass inferior to 5 g provides a low level of recurrent hyperthyroidism and allows to give no drug therapy to half patients. In our opinion, TST is still indicated in Graves' disease.

  15. Percutaneous injection laryngoplasty in the management of acute vocal fold paralysis.

    Science.gov (United States)

    Damrose, Edward J

    2010-08-01

    To evaluate the clinical outcome of patients with acute vocal fold paralysis treated with bovine collagen via percutaneous injection laryngoplasty under simple topical anesthesia. Retrospective case series. The charts of 38 consecutive patients with acute unilateral vocal fold paralysis who underwent percutaneous injection laryngoplasty under simple topical anesthesia were reviewed. Symptoms and laryngeal function were assessed pre- and postinjection using the Glottal Function Index (GFI), GRBAS Dysphonia Scale, Functional Outcome Swallowing Scale (FOSS), and maximum phonation time (MPT). Mean GFI, GRBAS, FOSS, and MPT improved from 13.71 to 7.68, 7.24 to 3.95, 3.70 to 2.20, and 12.87 to 16.45, respectively (P dysphagia and aspiration, injection was successful in restoring oral alimentation in only three patients, with the four failures occurring in patients with multiple cranial neuropathies. Percutaneous injection laryngoplasty is a viable option for immediate rehabilitation of acute vocal fold paralysis, and can be performed in the inpatient setting. With dysphagia and aspiration secondary to multiple cranial nerve palsies, medialization of the paralyzed cord alone may be insufficient to restore safe oral alimentation.

  16. Umbilical Cord Blood: Counselling, Collection, and Banking.

    Science.gov (United States)

    Armson, B Anthony; Allan, David S; Casper, Robert F

    2015-09-01

    bone marrow or peripheral stem cell transplantation to treat malignant and non-malignant conditions in children and adults. There is minimal harm to the mother or newborn provided that priority is given to maternal/newborn safety during childbirth management. Recipients of umbilical cord stem cells may experience graft-versus-host disease, transfer of infection or genetic abnormalities, or therapeutic failure. The financial burden on the health system for public cord blood banking and on families for private cord blood banking is considerable. Recommendations 1. Health care professionals should be well-informed about cord blood collection and storage and about factors that influence the volume, quality, and ability to collect a cord blood unit. (III-A) 2. Health care professionals caring for women and families who choose private umbilical cord blood banking must disclose any financial interests or potential conflicts of interest. (III-A) 3. Pregnant women should be provided with unbiased information about umbilical cord blood banking options, including the benefits and limitations of public and private banks. (III-A) 4. Health care professionals should obtain consent from mothers for the collection of umbilical cord blood prior to the onset of active labour, ideally during the third trimester, with ample time to address any questions. (III-A) 5. Health care professionals must be trained in standardized procedures (ex utero and in utero techniques) for cord blood collection to ensure the sterility and quality of the collected unit. (II-2A) 6. Umbilical cord blood should be collected with the goal of maximizing the content of hematopoietic progenitors through the volume collected. The decision to bank the unit will depend upon specific measures of graft potency. (II-2A) 7. Umbilical cord blood collection must not adversely affect the health of the mother or newborn. Cord blood collection should not interfere with delayed cord clamping. (III-E) 8. Health care

  17. Cost-effectiveness of private umbilical cord blood banking.

    Science.gov (United States)

    Kaimal, Anjali J; Smith, Catherine C; Laros, Russell K; Caughey, Aaron B; Cheng, Yvonne W

    2009-10-01

    To investigate the cost-effectiveness of private umbilical cord blood banking. A decision-analytic model was designed comparing private umbilical cord blood banking with no umbilical cord blood banking. Baseline assumptions included a cost of $3,620 for umbilical cord blood banking and storage for 20 years, a 0.04% chance of requiring an autologous stem cell transplant, a 0.07% chance of a sibling requiring an allogenic stem cell transplant, and a 50% reduction in risk of graft-versus-host disease if a sibling uses banked umbilical cord blood. Private cord blood banking is not cost-effective because it cost an additional $1,374,246 per life-year gained. In sensitivity analysis, if the cost of umbilical cord blood banking is less than $262 or the likelihood of a child needing a stem cell transplant is greater than 1 in 110, private umbilical cord blood banking becomes cost-effective. Currently, private umbilical cord blood banking is cost-effective only for children with a very high likelihood of needing a stem cell transplant. Patients considering private blood banking should be informed of the remote likelihood that a unit will be used for a child or another family member. III.

  18. Dysphonia and vocal fold telangiectasia in hereditary hemorrhagic telangiectasia.

    Science.gov (United States)

    Chang, Joseph; Yung, Katherine C

    2014-11-01

    This case report is the first documentation of dysphonia and vocal fold telangiectasia as a complication of hereditary hemorrhagic telangiectasia (HHT). Case report of a 40-year-old man with HHT presenting with 2 years of worsening hoarseness. Hoarseness corresponded with a period of anticoagulation. Endoscopy revealed vocal fold scarring, vocal fold telangiectasias, and plica ventricular is suggestive of previous submucosal vocal fold hemorrhage and subsequent counterproductive compensation with ventricular phonation. Hereditary hemorrhagic telangiectasia may present as dysphonia with vocal fold telangiectasias and place patients at risk of vocal fold hemorrhage. © The Author(s) 2014.

  19. Trauma: Spinal Cord Injury.

    Science.gov (United States)

    Eckert, Matthew J; Martin, Matthew J

    2017-10-01

    Injuries to the spinal column and spinal cord frequently occur after high-energy mechanisms of injury, or with lower-energy mechanisms, in select patient populations like the elderly. A focused yet complete neurologic examination during the initial evaluation will guide subsequent diagnostic procedures and early supportive measures to help prevent further injury. For patients with injury to bone and/or ligaments, the initial focus should be spinal immobilization and prevention of inducing injury to the spinal cord. Spinal cord injury is associated with numerous life-threatening complications during the acute and long-term phases of care that all acute care surgeons must recognize. Published by Elsevier Inc.

  20. Avian vocal mimicry: a unified conceptual framework.

    Science.gov (United States)

    Dalziell, Anastasia H; Welbergen, Justin A; Igic, Branislav; Magrath, Robert D

    2015-05-01

    Mimicry is a classical example of adaptive signal design. Here, we review the current state of research into vocal mimicry in birds. Avian vocal mimicry is a conspicuous and often spectacular form of animal communication, occurring in many distantly related species. However, the proximate and ultimate causes of vocal mimicry are poorly understood. In the first part of this review, we argue that progress has been impeded by conceptual confusion over what constitutes vocal mimicry. We propose a modified version of Vane-Wright's (1980) widely used definition of mimicry. According to our definition, a vocalisation is mimetic if the behaviour of the receiver changes after perceiving the acoustic resemblance between the mimic and the model, and the behavioural change confers a selective advantage on the mimic. Mimicry is therefore specifically a functional concept where the resemblance between heterospecific sounds is a target of selection. It is distinct from other forms of vocal resemblance including those that are the result of chance or common ancestry, and those that have emerged as a by-product of other processes such as ecological convergence and selection for large song-type repertoires. Thus, our definition provides a general and functionally coherent framework for determining what constitutes vocal mimicry, and takes account of the diversity of vocalisations that incorporate heterospecific sounds. In the second part we assess and revise hypotheses for the evolution of avian vocal mimicry in the light of our new definition. Most of the current evidence is anecdotal, but the diverse contexts and acoustic structures of putative vocal mimicry suggest that mimicry has multiple functions across and within species. There is strong experimental evidence that vocal mimicry can be deceptive, and can facilitate parasitic interactions. There is also increasing support for the use of vocal mimicry in predator defence, although the mechanisms are unclear. Less progress has

  1. Evaluation of 18F-fluorodeoxyglucose accumulation in the larynx of unilateral vocal fold paralysis cases

    International Nuclear Information System (INIS)

    Nimura, Yoshitsugu; Hayashi, Ibuki; Higashikawa, Masahiko; Okamura, Terue; Nakai, Ken; Ichihara, Kengo

    2011-01-01

    Fluorodeoxyglucose-positron emission tomography (FDG-PET) is employed to decide the treatment strategy for malignant tumors clinically. Meanwhile, glucose metabolism is enhanced in the exercise of muscles. Because vocal folds always conduct glucose metabolism by phonation and swallowing, physiological accumulation of FDG may be found in the normal larynx. In this study we examined FDG accumulation in the larynx of patients with unilateral vocal fold paralysis established by endoscope. FDG-PET/CT was taken one hour after the FDG administration (early image) and again two hours later (delayed image). All patients had no chance to utter after the FDG administration. In 25 of the 28 patients with unilateral vocal fold paralysis, standardized uptake value (SUV) max was higher, by visual inspection, in the normal side of the larynx than in the paralyzed side. None of the 3 patients in whom no accumulation was seen on the non-paralyzed side had malignant disease. In both images, SUV max of the normal side was significantly higher than paralyzed side (p<0.01). In the delayed images, accumulation of FDG was significantly higher than that in the early images (p<0.01). We believe that strong FDG accumulation in the normal side of the larynx of patients with unilateral vocal fold paralysis may owe to high glucose metabolism of the vocal muscles from muscle hyperkinesis. We conclude that unilateral accumulation in the larynx suggests not only cancer of that same side of the larynx but also paralysis of the other side. (author)

  2. Outcomes of surgical treatment of thyroid disease in children

    Directory of Open Access Journals (Sweden)

    Olga S. Rogova

    2017-01-01

    Full Text Available Background. In recent years there has been a tendency of increase in the proportion of nodular goiter and Graves’ disease in thyroid pathology in children, which necessitates a choice of rational tactics for treatment of these diseases. At present there is no optimal method of treatment for thyroid gland pathology, but one of the methods is surgery. Thyroid surgery due to the determination of the indications and choice of the optimal volume of the surgical intervention continues to be under debate as postoperative complications of surgical treatment of thyroid diseases in children are possible.Aim: to study the outcomes of surgical treatment for thyroid pathology in children, depending on the volume of operation.Materials and methods. This article presents the results of a survey of 77 children operated on in the period of 2002–2016 for Graves’ disease, single-node goiter, and multinodular goiter. The examination included the determination of the levels of ionized calcium and TSH, FT4, FT3 in the blood serum, the evaluation of the functional state of the pituitary-thyroid system, thyroid ultrasound examination, and examination by an otolaryngologist.Results. The incidence of adverse outcomes of surgical treatment in children with nodular goiter was 27%. Adverse outcomes were observed equally often after organ-preserving operations and after thyroidectomy, but they were of different structure. The frequency of postoperative complications after thyroidectomy performed on the nodular goiter was 27%. Complications presented as postsurgical hypoparathyroidism and vocal cord paresis. In children with nodular goiter, after thyroidectomy hypoparathyroidism occurred more frequently than paresis of the vocal folds. Symptomatic hypocalcemia was observed more frequently than the asymptomatic variant, and in most cases hypoparathyrodism was transient. Among children with a single-node goiter who underwent organ-preserving surgery on the thyroid gland

  3. Vocal fold elasticity of the Rocky Mountain elk (Cervus elaphus nelsoni) – producing high fundamental frequency vocalization with a very long vocal fold

    OpenAIRE

    Riede, Tobias; Titze, Ingo R.

    2008-01-01

    The vocal folds of male Rocky Mountain elk (Cervus elaphus nelsoni) are about 3 cm long. If fundamental frequency were to be predicted by a simple vibrating string formula, as is often done for the human larynx, such long vocal folds would bear enormous stress to produce the species-specific mating call with an average fundamental frequency of 1 kHz. Predictions would be closer to 50 Hz. Vocal fold histology revealed the presence of a large vocal ligament between the vocal fold epithelium and...

  4. Elaborate Mimetic Vocal Displays by Female Superb Lyrebirds

    Directory of Open Access Journals (Sweden)

    Anastasia H Dalziell

    2016-04-01

    Full Text Available Some of the most striking vocalizations in birds are made by males that incorporate vocal mimicry in their sexual displays. Mimetic vocalization in females is largely undescribed, but it is unclear whether this is because of a lack of selection for vocal mimicry in females, or whether the phenomenon has simply been overlooked. These issues are thrown into sharp relief in the superb lyrebird, Menura novaehollandiae, a basal oscine passerine with a lek-like mating system and female uniparental care. The spectacular mimetic song display produced by courting male lyrebirds is a textbook example of a sexually selected trait, but the vocalizations of female lyrebirds are largely unknown. Here, we provide the first analysis of the structure and context of the vocalizations of female lyrebirds. Female lyrebirds were completely silent during courtship; however, females regularly produced sophisticated vocal displays incorporating both lyrebird-specific vocalizations and imitations of sounds within their environment. The structure of female vocalizations varied significantly with context. While foraging, females mostly produced a complex lyrebird-specific song, whereas they gave lyrebird-specific alarm calls most often during nest defense. Within their vocal displays females also included a variety of mimetic vocalizations, including imitations of the calls of dangerous predators, and of alarm calls and song of harmless heterospecifics. Females gave more mimetic vocalizations during nest defense than while foraging, and the types of sounds they imitated varied between these contexts, suggesting that mimetic vocalizations have more than one function. These results are inconsistent with previous portrayals of vocalizations by female lyrebirds as rare, functionless by-products of sexual selection on males. Instead, our results support the hypotheses that complex female vocalizations play a role in nest defense and mediate female-female competition for

  5. Stuttering: A novel bullfrog vocalization

    Science.gov (United States)

    Simmons, Andrea; Suggs, Dianne

    2004-05-01

    The advertisement call of male bullfrogs (Rana catesbeiana) consists of a series of individual croaks, each of which contains multiple harmonics with a missing or attenuated fundamental frequency of approximately 100 Hz. The envelope of individual croaks has typically been represented in the literature as smooth and unmodulated. From an analysis of 5251 advertisement calls from 17 different choruses over two mating seasons, we show that males add an extra modulation (around 4 Hz) to the envelope of individual croaks, following specific rules. We term these extra modulations stutters. Neither single croak calls nor the first croak in multiple croak calls contains stutters. When stuttering begins, it does so with a croak containing a single stutter, and the number of stutters increases linearly (plus or minus 1 stutter, up to 4 stutters) with the number of croaks. This pattern is stable across individual males (N=10). Playback experiments reveal that vocal responses to stuttered and nonstuttered calls vary with proximity to the stimulus. Close males respond with nonstuttered calls, while far males respond with stuttered calls. The data suggest that nonstuttered calls are used for aggressive or territorial purposes, while stuttered calls are used to attract females.

  6. Classifications of Vocalic Segments from Articulatory Kinematics: Healthy Controls and Speakers with Dysarthria

    Science.gov (United States)

    Yunusova, Yana; Weismer, Gary G.; Lindstrom, Mary J.

    2011-01-01

    Purpose: In this study, the authors classified vocalic segments produced by control speakers (C) and speakers with dysarthria due to amyotrophic lateral sclerosis (ALS) or Parkinson's disease (PD); classification was based on movement measures. The researchers asked the following questions: (a) Can vowels be classified on the basis of selected…

  7. Intraoperative imaging of pediatric vocal fold lesions using optical coherence tomography

    Science.gov (United States)

    Benboujja, Fouzi; Garcia, Jordan A.; Beaudette, Kathy; Strupler, Mathias; Hartnick, Christopher J.; Boudoux, Caroline

    2016-01-01

    Optical coherence tomography (OCT) has been previously identified as a promising tool for exploring laryngeal pathologies in adults. Here, we present an OCT handheld probe dedicated to imaging the unique geometry involved in pediatric laryngoscopy. A vertical cavity surface emitting laser-based wavelength-swept OCT system operating at 60 frames per second was coupled to the probe to acquire three-dimensional (3-D) volumes in vivo. In order to evaluate the performance of the proposed probe and system, we imaged pediatric vocal fold lesions of patients going under direct laryngoscopy. Through this in vivo study, we extracted OCT features characterizing each pediatric vocal fold lesion, which shows a great potential for noninvasive laryngeal lesion discrimination. We believe OCT vocal fold examination in 3-D will result in improved knowledge of the pediatric anatomy and could aid in managing pediatric laryngeal diseases.

  8. The value of contrast media in spinal cord abnormalities

    International Nuclear Information System (INIS)

    Matsumasa Takahashi

    1995-01-01

    The contents are intramedullary tumors, inflammatry lesions, demyelinating diseases - multiple sclerosis (MS), radiation myelitis, acute disseminated encephalomyelitis (ADEM); vascular lesions - spinal cord infarct, arteriovenous malformation, cavernous haemangioma (24 refs.)

  9. The value of contrast media in spinal cord abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Matsumasa [Kumamoto Univ. (Japan). School of Medicine

    1996-12-31

    The contents are intramedullary tumors, inflammatry lesions, demyelinating diseases - multiple sclerosis (MS), radiation myelitis, acute disseminated encephalomyelitis (ADEM); vascular lesions - spinal cord infarct, arteriovenous malformation, cavernous haemangioma (24 refs.).

  10. Spinal Cord Injury 101

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    Full Text Available ... Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC Understanding Spinal Cord Injury About Us Expert ... Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC close close

  11. Spinal Cord Injury 101

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    Full Text Available ... Life in a Wheelchair Lisa Rosen, MS Spasticity, Physical Therapy-Lokomat T. George Hornby, PhD, PT Empowering ... Rogers, SW Marguerite David, MSW Kathy Hulse, MSW Physical Therapy after Spinal Cord Injury Laura Wehrli, PT ...

  12. Spinal Cord Injury 101

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    Full Text Available ... How Peer Counseling Works Julie Gassaway, MS, RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children ...

  13. Spinal Cord Injury 101

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    Full Text Available ... com is an informational and support website for families facing spinal cord injuries. The website does not provide medical advice, recommend or endorse health care products or ...

  14. Spinal Cord Injury 101

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    Full Text Available ... OT Anne Bryden, OT The Role of the Social Worker after Spinal Cord Injury Patti Rogers, SW Marguerite ... play_arrow What are the latest developments in the use of electrical stimulation for spinal ...

  15. Spinal Cord Injury 101

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    Full Text Available ... Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, PsyD Understanding SCI Rehabilitation Donald Peck Leslie, MD Adjusting to Social Life in a Wheelchair Lisa Rosen, MS Spasticity, ...

  16. Spinal Cord Injury 101

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    Full Text Available ... with SCI Personal Experiences by Topic Resources Peer Counseling Blog About Media Donate close search Understanding Spinal ... with SCI Personal Experiences by Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical ...

  17. Spinal Cord Injury 101

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    Full Text Available ... does not provide medical advice, recommend or endorse health care products or services, or control the information ... With Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC Understanding Spinal Cord Injury About Us ...

  18. Parachute Cord Tension Sensor

    Data.gov (United States)

    National Aeronautics and Space Administration — To design and fabricate a light weight (few oz), very small (~2 inch length) parachute cord tension sensor demonstrator device.A major challenge for the CPAS (The...

  19. Spinal Cord Injury 101

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    Full Text Available ... Resources Peer Counseling Blog About Media Donate close search Understanding Spinal Cord Injury What is a Spinal ... health care products or services, or control the information found on external websites. The Hill Foundation is ...

  20. Spinal Cord Injury 101

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    Full Text Available ... Anne Bryden, OT The Role of the Social Worker after Spinal Cord Injury Patti Rogers, SW Marguerite ... arrow Why are high-dose steroids often used right after an injury? play_arrow What is meant ...

  1. Spinal Cord Injury 101

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    Full Text Available ... Living with SCI Personal Experiences by Topic Resources Peer Counseling Blog About Media Donate close search Understanding ... Living with SCI Personal Experiences by Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury ...

  2. Spinal Cord Injury 101

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    Full Text Available ... Injury Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, PsyD ... Rehabilitation Donald Peck Leslie, MD Adjusting to Social Life in a Wheelchair Lisa Rosen, MS Spasticity, Physical ...

  3. Spinal Cord Injury 101

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  4. Spinal Cord Injury 101

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    Full Text Available ... Anne Bryden, OT The Role of the Social Worker after Spinal Cord Injury Patti Rogers, SW Marguerite ... or endorse health care products or services, or control the information found on external websites. The Hill ...

  5. Spinal Cord Injury 101

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    ... With Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC Understanding Spinal Cord Injury About Us Expert ... With Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC close close

  6. Spinal Cord Injury 101

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  7. Spinal Cord Injury 101

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  8. Spinal Cord Injury 101

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  9. Spinal Cord Injury 101

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    Full Text Available ... SCI Rehabilitation Donald Peck Leslie, MD Adjusting to Social Life in a Wheelchair Lisa Rosen, MS Spasticity, ... OT Anne Bryden, OT The Role of the Social Worker after Spinal Cord Injury Patti Rogers, SW ...

  10. Spinal Cord Injury 101

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    Full Text Available ... Living with SCI Personal Experiences by Topic Resources Peer ... Adult Injuries Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from Hospital to ...

  11. Spinal Cord Injury 101

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  13. Vocal fold submucosal infusion technique in phonomicrosurgery.

    Science.gov (United States)

    Kass, E S; Hillman, R E; Zeitels, S M

    1996-05-01

    Phonomicrosurgery is optimized by maximally preserving the vocal fold's layered microstructure (laminae propriae). The technique of submucosal infusion of saline and epinephrine into the superficial lamina propria (SLP) was examined to delineate how, when, and why it was helpful toward this surgical goal. A retrospective review revealed that the submucosal infusion technique was used to enhance the surgery in 75 of 152 vocal fold procedures that were performed over the last 2 years. The vocal fold epithelium was noted to be adherent to the vocal ligament in 29 of the 75 cases: 19 from previous surgical scarring, 4 from cancer, 3 from sulcus vocalis, 2 from chronic hemorrhage, and 1 from radiotherapy. The submucosal infusion technique was most helpful when the vocal fold epithelium required resection and/or when extensive dissection in the SLP was necessary. The infusion enhanced the surgery by vasoconstriction of the microvasculature in the SLP, which improved visualization during cold-instrument tangential dissection. Improved visualization facilitated maximal preservation of the SLP, which is necessary for optimal pliability of the overlying epithelium. The infusion also improved the placement of incisions at the perimeter of benign, premalignant, and malignant lesions, and thereby helped preserve epithelium uninvolved by the disorder.

  14. Phonosurgery of vocal fold polyps, cysts and nodules is beneficial

    DEFF Research Database (Denmark)

    Jensen, Jane Bjerg; Rasmussen, Niels

    2013-01-01

    This study reports our experience with microscopic phonosurgery (PS) of benign lesions of the vocal folds.......This study reports our experience with microscopic phonosurgery (PS) of benign lesions of the vocal folds....

  15. Oral and vocal fold diadochokinesis in dysphonic women

    OpenAIRE

    Louzada,Talita; Beraldinelle,Roberta; Berretin-Felix,Giédre; Brasolotto,Alcione Ghedini

    2011-01-01

    The evaluation of oral and vocal fold diadochokinesis (DDK) in individuals with voice disorders may contribute to the understanding of factors that affect the balanced vocal production. Scientific studies that make use of this assessment tool support the knowledge advance of this area, reflecting the development of more appropriate therapeutic planning. Objective: To compare the results of oral and vocal fold DDK in dysphonic women and in women without vocal disorders. Material and methods: F...

  16. Malignant spinal cord compression in cancer patients may be mimicked by a primary spinal cord tumour.

    Science.gov (United States)

    Mohammadianpanah, M; Vasei, M; Mosalaei, A; Omidvari, S; Ahmadloo, N

    2006-12-01

    Although it is quite rare, second primary neoplasms in cancer patients may present with the signs and symptoms of malignant spinal cord compression. Primary spinal cord tumours in the cancer patients may be deceptive and considered as the recurrent first cancer. Therefore, it should be precisely differentiated and appropriately managed. We report such a case of intramedullary ependymoma of the cervical spinal cord mimicking metatstatic recurrent lymphoma and causing cord compression. A 50-year-old man developed intramedullary ependymoma of the cervical spinal cord 1.5 years following chemoradiation for Waldeyer's ring lymphoma. He presented with a 2-month history of neck pain, progressive upper- and lower-extremity numbness and weakness, and bowel and bladder dysfunction. Magnetic resonance imaging revealed an intramedullary expansive lesion extending from C4 to C6 levels of the cervical spinal cord. The clinical and radiological findings were suggestive of malignant process. A comprehensive investigation failed to detect another site of disease. He underwent operation, and the tumour was subtotally resected. The patient's neurological deficits improved subsequently. The development of the intramedullary ependymoma following treating lymphoma has not been reported. We describe the clinical, radiological and pathological findings of this case and review the literature.

  17. Vocal Hygiene Habits and Vocal Handicap Among Conservatory Students of Classical Singing.

    Science.gov (United States)

    Achey, Meredith A; He, Mike Z; Akst, Lee M

    2016-03-01

    This study sought to assess classical singing students' compliance with vocal hygiene practices identified in the literature and to explore the relationship between self-reported vocal hygiene practice and self-reported singing voice handicap in this population. The primary hypothesis was that increased attention to commonly recommended vocal hygiene practices would correlate with reduced singing voice handicap. This is a cross-sectional, survey-based study. An anonymous survey assessing demographics, attention to 11 common vocal hygiene recommendations in both performance and nonperformance periods, and the Singing Voice Handicap Index 10 (SVHI-10) was distributed to classical singing teachers to be administered to their students at two major schools of music. Of the 215 surveys distributed, 108 were returned (50.2%), of which 4 were incomplete and discarded from analysis. Conservatory students of classical singing reported a moderate degree of vocal handicap (mean SVHI-10, 12; range, 0-29). Singers reported considering all 11 vocal hygiene factors more frequently when preparing for performances than when not preparing for performances. Of these, significant correlations with increased handicap were identified for consideration of stress reduction in nonperformance (P = 0.01) and performance periods (P = 0.02) and with decreased handicap for consideration of singing voice use in performance periods alone (P = 0.02). Conservatory students of classical singing report more assiduous attention to vocal hygiene practices when preparing for performances and report moderate degrees of vocal handicap overall. These students may have elevated risk for dysphonia and voice disorders which is not effectively addressed through common vocal hygiene recommendations alone. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  18. Vocal Health Education and Medical Resources for Graduate-Level Vocal Performance Students.

    Science.gov (United States)

    Latham, Katherine; Messing, Barbara; Bidlack, Melissa; Merritt, Samantha; Zhou, Xian; Akst, Lee M

    2017-03-01

    Most agree that education about vocal health and physiology can help singers avoid the development of vocal disorders. However, little is known about how this kind of education is provided to singers as part of their formal training. This study describes the amount of instruction in these topics provided through graduate-level curricula, who provides this instruction, and the kinds of affiliations such graduate singing programs have with medical professionals. This is an online survey of music schools with graduate singing programs. Survey questions addressed demographics of the programs, general attitudes about vocal health instruction for singers, the amount of vocal health instruction provided and by whom it was taught, perceived barriers to including more vocal health instruction, and any affiliations the voice program might have with medical personnel. Eighty-one survey responses were received. Instruction on vocal health was provided in 95% of the schools. In 55% of the schools, none of this instruction was given by a medical professional. Limited time in the curriculum, lack of financial support, and lack of availability of medical professional were the most frequently reported barriers to providing more instruction. When programs offered more hours of instruction, they were more likely to have some of that instruction given by a medical professional (P = 0.008) and to assess the amount of instruction provided positively (P = 0.001). There are several perceived barriers to incorporating vocal health education into graduate singing programs. Opportunity exists for more collaboration between vocal pedagogues and medical professionals in the education of singers about vocal health. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  19. The role of vocal individuality in conservation

    DEFF Research Database (Denmark)

    Terry, Andrew Mark Ryder; Peake, Thomas More; McGregor, Peter Kenneth

    2005-01-01

    Identifying the individuals within a population can generate information on life history parameters, generate input data for conservation models, and highlight behavioural traits that may affect management decisions and error or bias within census methods. Individual animals can be discriminated...... by features of their vocalisations. This vocal individuality can be utilised as an alternative marking technique in situations where the marks are difficult to detect or animals are sensitive to disturbance. Vocal individuality can also be used in cases were the capture and handling of an animal is either...... and techniques for using this to count and monitor populations over time. We present case studies in birds where vocal individuality has been applied to conservation and we discuss its role in mammals....

  20. Phonetic characteristics of vocalizations during pain

    DEFF Research Database (Denmark)

    Niebuhr, Oliver; Lautenbacher, Stefan; Salinas-Ranneberg, Melissa

    2017-01-01

    ” (central vowel, sounding like a darker “e” as in hesitations like “ehm”)—as experimental approximations to natural vocalizations. Methods: In 50 students vowel production and self-report ratings were assessed during painful and nonpainful heat stimulation (hot water immersion) as well as during baseline......Introduction and Objectives: There have, yet, been only few attempts to phonetically characterize the vocalizations of pain, although there is wide agreement that moaning, groaning, or other nonverbal utterance can be indicative of pain. We studied the production of vowels “u,” “a,” “i”, and “schwa...... pain. Furthermore, changes from nonpainful to painful stimulations in these parameters also significantly predicted concurrent changes in pain ratings. Conclusion: Vocalization characteristics of pain seem to be best described by an increase in pitch and in loudness. Future studies using more specific...

  1. A Framework for Automated Marmoset Vocalization Detection And Classification

    Science.gov (United States)

    2016-09-08

    for studying the origins and neural basis of human language. Vocalizations belonging to the same species, or Conspecific Vocalizations (CVs), are...applications including automatic speech recognition [17], speech enhancement [18], voice activity detection [19], hyper-nasality detection [20], and emotion ...vocalizations. The feature sets chosen have the desirable property of capturing characteristics of the signals that are useful in both identifying and

  2. The Development and Validation of the Vocalic Sensitivity Test.

    Science.gov (United States)

    Villaume, William A.; Brown, Mary Helen

    1999-01-01

    Notes that presbycusis, hearing loss associated with aging, may be marked by a second dimension of hearing loss, a loss in vocalic sensitivity. Reports on the development of the Vocalic Sensitivity Test, which controls for the verbal elements in speech while also allowing for the vocalics to exercise their normal metacommunicative function of…

  3. Nomenclature proposal to describe vocal fold motion impairment

    NARCIS (Netherlands)

    Rosen, Clark A.; Mau, Ted; Remacle, Marc; Hess, Markus; Eckel, Hans E.; Young, VyVy N.; Hantzakos, Anastasios; Yung, Katherine C.; Dikkers, Frederik G.

    2016-01-01

    The terms used to describe vocal fold motion impairment are confusing and not standardized. This results in a failure to communicate accurately and to major limitations of interpreting research studies involving vocal fold impairment. We propose standard nomenclature for reporting vocal fold

  4. Nomenclature proposal to describe vocal fold motion impairment

    NARCIS (Netherlands)

    Rosen, Clark A.; Mau, Ted; Remacle, Marc; Hess, Markus; Eckel, Hans E.; Young, VyVy N.; Hantzakos, Anastasios; Yung, Katherine C.; Dikkers, Frederik G.

    The terms used to describe vocal fold motion impairment are confusing and not standardized. This results in a failure to communicate accurately and to major limitations of interpreting research studies involving vocal fold impairment. We propose standard nomenclature for reporting vocal fold

  5. Stem cells of umbilical blood cord – therapeutic use

    Directory of Open Access Journals (Sweden)

    Beata Bielec

    2015-07-01

    Full Text Available For many years, the transplantation of hematopoietic stem cells has been used to treat some diseases of the hematopoietic system. For a very long time, only bone marrow was used as a source of hematopoietic stem cells for this method of treatment. However, to comply with allogeneic bone marrow transplantation, an antigenically compatible donor is necessary. Transplantations from unrelated donors are associated with increased risk of a graft-versus-host reaction, transplant rejection and, consequently, increased mortality. Many years ago, it was found that umbilical cord blood as well as bone marrow and peripheral blood contains hematopoietic stem cells and mesenchymal cells able to differentiate into different cell types and that the umbilical cord blood can be a source of stem cells for transplantation. Following this discovery, numerous attempts were made for its potential use in the treatment of hematologic diseases, metabolic diseases as well as regenerative medicine. Umbilical cord blood stem cells exhibit intermediate characteristics between embryonic and adult stem cells. They are distinguished from the latter by telomere length, telomerase activity, and lower risk of accumulation of DNA mutations or chromosomal aberrations. The only transplantation limitation appears to be the amount of cord blood collected, which on average is sufficient for transplantation in a 40-50 kg child. Collection of cord blood is a simple, short-lasting treatment, not causing any danger for a newborn or the mother. Umbilical cord blood is obtained during labor, and then frozen and stored at cord blood banks all over the world.

  6. ETIOLOGICAL FACTORS FOR VOCAL FOLD POLYP FORMATION

    Directory of Open Access Journals (Sweden)

    DAŠA GLUVAJIĆ

    2016-05-01

    Full Text Available Background: Vocal fold polyp is one of the most common causes for hoarseness. Many different etiological factors contribute to vocal fold polyp formation. The aim of the study was to find out whether the etiological factors for polyp formation have changed in the last 30 years.Methods: Eighty-one patients with unilateral vocal fold polyp were included in the study. A control group was composed of 50 volunteers without voice problems who matched the patients by age and gender. The data about etiological factors and the findings of phoniatric examination were obtained from the patients' medical documentation and from the questionnaires for the control group. The incidence of etiological factors was compared between the two groups. The program SPSS, Version 18 was used for statistical analysis.Results: The most frequent etiological factors were occupational voice load, GER, allergy and smoking. In 79% of patients 2 – 6 contemporary acting risk factors were found. Occupational voice load (p=0,018 and GER (p=0,004 were significantly more frequent in the patients than in the controls. The other factors did not significantly influence the polyp formation.Conclusions: There are several factors involved simultaneously in the formation of vocal fold polyps both nowadays and 30 years ago. Some of the most common factors remain the same (voice load, smoking, others are new (GER, allergy, which is probably due to the different lifestyle and working conditions than 30 years ago. Occupational voice load and GER were significantly more frequently present in the patients with polyp than in the control group. Regarding the given results it is important to instruct workers with professional vocal load about etiological factors for vocal fold polyp formation.

  7. Assessment of thyroplasty for vocal fold paralysis

    DEFF Research Database (Denmark)

    Grøntved, Ågot Møller; Faber, Christian; Jakobsen, John

    2009-01-01

    INTRODUCTION: Thyroplasty with silicone rubber implantation is a surgical procedure for treatment of patients with vocal fold paralysis. The aim of the present study was to evaluate the outcome of the operation and to monitor which of the analyses were the more beneficial. MATERIAL AND METHODS...... because it offers a quantitative measure of the voice capacity and intensity, which are the major problems experienced by patients with vocal fold paralysis. Used together, these tools are highly instrumental in guiding the patient's choice of surgery or no surgery. Udgivelsesdato: 2009-Jan-12...

  8. The Importance of Vocal Parameters Correlation

    Directory of Open Access Journals (Sweden)

    Valentin Ghisa

    2016-06-01

    Full Text Available To analyze communication we need to study the main parameters that describe the vocal sounds from the point of view of information content transfer efficiency. In this paper we analyze the physical quality of the “on air" information transfer, according to the audio streaming parameters and from the particular phonetic nature of the human factor. Applying this statistical analysis we aim to identify and record the correlation level of the acoustical parameters with the vocal ones and the impact which the presence of this cross-correlation can have on communication structures’ improvement.

  9. [Biofeedback in young singer vocal training].

    Science.gov (United States)

    Ciochină, Paula; Ciochină, Al D; Burlui, Ada; Zaharia, D

    2007-01-01

    Biofeedback therapy is a learning process that is based on "operant conditioning" techniques. To estimate the significance of biofeedback to an accurate and faster control of singing voice emission. Significantly, it was discovered that professional singers active in performing of both classical and music theatre repertoire with regard to the visual-kinesthetic effect of melodic contour in musical notation as it affect vocal timbre. The results of the study also indicate that the development of new technology for youth singer vocal training, may be useful to these singers.

  10. Depth-kymography of vocal fold vibrations: part II. Simulations and direct comparisons with 3D profile measurements

    Energy Technology Data Exchange (ETDEWEB)

    Mul, Frits F M de; George, Nibu A; Qiu Qingjun; Rakhorst, Gerhard; Schutte, Harm K [Department of Biomedical Engineering BMSA, Faculty of Medicine, University Medical Center Groningen UMCG, University of Groningen, PO Box 196, 9700 AD Groningen (Netherlands)], E-mail: ffm@demul.net

    2009-07-07

    We report novel direct quantitative comparisons between 3D profiling measurements and simulations of human vocal fold vibrations. Until now, in human vocal folds research, only imaging in a horizontal plane was possible. However, for the investigation of several diseases, depth information is needed, especially when the two folds act differently, e.g. in the case of tumour growth. Recently, with our novel depth-kymographic laryngoscope, we obtained calibrated data about the horizontal and vertical positions of the visible surface of the vibrating vocal folds. In order to find relations with physical parameters such as elasticity and damping constants, we numerically simulated the horizontal and vertical positions and movements of the human vocal folds while vibrating and investigated the effect of varying several parameters on the characteristics of the phonation: the masses and their dimensions, the respective forces and pressures, and the details of the vocal tract compartments. Direct one-to-one comparison with measured 3D positions presents-for the first time-a direct means of validation of these calculations. This may start a new field in vocal folds research.

  11. Depth-kymography of vocal fold vibrations: part II. Simulations and direct comparisons with 3D profile measurements

    International Nuclear Information System (INIS)

    Mul, Frits F M de; George, Nibu A; Qiu Qingjun; Rakhorst, Gerhard; Schutte, Harm K

    2009-01-01

    We report novel direct quantitative comparisons between 3D profiling measurements and simulations of human vocal fold vibrations. Until now, in human vocal folds research, only imaging in a horizontal plane was possible. However, for the investigation of several diseases, depth information is needed, especially when the two folds act differently, e.g. in the case of tumour growth. Recently, with our novel depth-kymographic laryngoscope, we obtained calibrated data about the horizontal and vertical positions of the visible surface of the vibrating vocal folds. In order to find relations with physical parameters such as elasticity and damping constants, we numerically simulated the horizontal and vertical positions and movements of the human vocal folds while vibrating and investigated the effect of varying several parameters on the characteristics of the phonation: the masses and their dimensions, the respective forces and pressures, and the details of the vocal tract compartments. Direct one-to-one comparison with measured 3D positions presents-for the first time-a direct means of validation of these calculations. This may start a new field in vocal folds research.

  12. Pregnancy Complications: Umbilical Cord Abnormalities

    Science.gov (United States)

    ... Umbilical cord abnormalities Umbilical cord abnormalities Now playing: E-mail to a friend Please fill in all fields. ... blood supply) to the baby. The two arteries transport waste from the baby to the placenta (where ...

  13. Vocalization in Dementia: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Arkady Yusupov

    2014-04-01

    Full Text Available Background: Vocalizations are part of the spectrum of the ‘negative' behavioral and psychological symptoms of dementia (BPSD. We describe a patient with moderate-stage mixed dementia of Alzheimer's disease and cerebrovascular disease and a left orbitofrontal lesion exhibiting vocalization. The use of ‘redirection' has been demonstrated to be an effective nonpharmacological means of controlling BPSD, while reducing caregiver distress. Case Report: A 78-year-old right-handed African-American female presented with complaints of worsening memory and BPSD, causing significant caregiver distress. Throughout the evaluation, she constantly vocalized her son's name and made a continuous grunting noise, correlating with increased anxiety/agitation. We utilized a redirection technique, which achieved the immediate reduction of the vocalization symptoms. Caregiver psychoeducation was provided allowing them to use the redirection technique at home. Conclusions: In patients with dementia exhibiting negative symptoms of BPSD, using nonpharmacologic techniques (i.e. redirection may be indicated. Psychotropic medications rarely address negative BPSD symptoms, while simultaneously decreasing patient's quality of life. Nonpharmacologic approaches are beneficial as first-line therapy for negative BPSD.

  14. Functional results after external vocal fold medialization thyroplasty with the titanium vocal fold medialization implant.

    Science.gov (United States)

    Schneider, Berit; Denk, Doris-Maria; Bigenzahn, Wolfgang

    2003-04-01

    A persistent insufficiency of glottal closure is mostly a consequence of a unilateral vocal fold movement impairment. It can also be caused by vocal fold atrophy or scarring processes with regular bilateral respiratory vocal fold function. Because of consequential voice, breathing, and swallowing impairments, a functional surgical treatment is required. The goal of the study was to outline the functional results after medialization thyroplasty with the titanium vocal fold medialization implant according to Friedrich. In the period of 1999 to 2001, an external vocal fold medialization using the titanium implant was performed on 28 patients (12 women and 16 men). The patients were in the age range of 19 to 84 years. Twenty-two patients had a paralysis of the left-side vocal fold, and six patients, of the right-side vocal fold. Detailed functional examinations were executed on all patients before and after the surgery: perceptive voice sound analysis according to the "roughness, breathiness, and hoarseness" method, judgment of the s/z ratio and voice dysfunction index, voice range profile measurements, videostroboscopy, and pulmonary function tests. In case of dysphagia/aspiration, videofluoroscopy of swallowing was also performed. The respective data were statistically analyzed (paired t test, Wilcoxon-test). All patients reported on improvement of voice, swallowing, and breathing functions postoperatively. Videostroboscopy revealed an almost complete glottal closure after surgery in all of the patients. All voice-related parameters showed a significant improvement. An increase of the laryngeal resistance by the medialization procedure could be excluded by analysis of the pulmonary function test. The results confirm the external medialization of the vocal folds as an adequate method in the therapy of voice, swallowing, and breathing impairment attributable to an insufficient glottal closure. The titanium implant offers, apart from good tissue tolerability, the

  15. Vocal Tract and Glottal Function During and After Vocal Exercising With Resonance Tube and Straw

    Czech Academy of Sciences Publication Activity Database

    Guzman, M.; Laukkanen, A. M.; Krupa, P.; Horáček, Jaromír; Švec, J.G.; Geneid, A.

    2013-01-01

    Roč. 27, č. 4 (2013), "523.e19"-"523.e34" ISSN 0892-1997 R&D Projects: GA ČR GAP101/12/1306 Institutional support: RVO:61388998 Keywords : vocal exercises * resonance tube * vocal tract impedance * computerized tomography * singer’s/speaker’s formant cluster Subject RIV: BI - Acoustics Impact factor: 0.944, year: 2013 http://www.sciencedirect.com/science/journal/08921997

  16. Vocal Fold Injection: Review of Indications, Techniques, and Materials for Augmentation

    OpenAIRE

    Mallur, Pavan S.; Rosen, Clark A.

    2010-01-01

    Vocal fold injection is a procedure that has over a 100 year history but was rarely done as short as 20 years ago. A renaissance has occurred with respect to vocal fold injection due to new technologies (visualization and materials) and new injection approaches. Awake, un-sedated vocal fold injection offers many distinct advantages for the treatment of glottal insufficiency (vocal fold paralysis, vocal fold paresis, vocal fold atrophy and vocal fold scar). A review of materials available and ...

  17. Iconicity can ground the creation of vocal symbols.

    Science.gov (United States)

    Perlman, Marcus; Dale, Rick; Lupyan, Gary

    2015-08-01

    Studies of gestural communication systems find that they originate from spontaneously created iconic gestures. Yet, we know little about how people create vocal communication systems, and many have suggested that vocalizations do not afford iconicity beyond trivial instances of onomatopoeia. It is unknown whether people can generate vocal communication systems through a process of iconic creation similar to gestural systems. Here, we examine the creation and development of a rudimentary vocal symbol system in a laboratory setting. Pairs of participants generated novel vocalizations for 18 different meanings in an iterative 'vocal' charades communication game. The communicators quickly converged on stable vocalizations, and naive listeners could correctly infer their meanings in subsequent playback experiments. People's ability to guess the meanings of these novel vocalizations was predicted by how close the vocalization was to an iconic 'meaning template' we derived from the production data. These results strongly suggest that the meaningfulness of these vocalizations derived from iconicity. Our findings illuminate a mechanism by which iconicity can ground the creation of vocal symbols, analogous to the function of iconicity in gestural communication systems.

  18. Female presence and estrous state influence mouse ultrasonic courtship vocalizations.

    Directory of Open Access Journals (Sweden)

    Jessica L Hanson

    Full Text Available The laboratory mouse is an emerging model for context-dependent vocal signaling and reception. Mouse ultrasonic vocalizations are robustly produced in social contexts. In adults, male vocalization during courtship has become a model of interest for signal-receiver interactions. These vocalizations can be grouped into syllable types that are consistently produced by different subspecies and strains of mice. Vocalizations are unique to individuals, vary across development, and depend on social housing conditions. The behavioral significance of different syllable types, including the contexts in which different vocalizations are made and the responses listeners have to different types of vocalizations, is not well understood. We examined the effect of female presence and estrous state on male vocalizations by exploring the use of syllable types and the parameters of syllables during courtship. We also explored correlations between vocalizations and other behaviors. These experimental manipulations produced four main findings: 1 vocalizations varied among males, 2 the production of USVs and an increase in the use of a specific syllable type were temporally related to mounting behavior, 3 the frequency (kHz, bandwidth, and duration of syllables produced by males were influenced by the estrous phase of female partners, and 4 syllable types changed when females were removed. These findings show that mouse ultrasonic courtship vocalizations are sensitive to changes in female phase and presence, further demonstrating the context-sensitivity of these calls.

  19. Predicting Achievable Fundamental Frequency Ranges in Vocalization Across Species.

    Directory of Open Access Journals (Sweden)

    Ingo Titze

    2016-06-01

    Full Text Available Vocal folds are used as sound sources in various species, but it is unknown how vocal fold morphologies are optimized for different acoustic objectives. Here we identify two main variables affecting range of vocal fold vibration frequency, namely vocal fold elongation and tissue fiber stress. A simple vibrating string model is used to predict fundamental frequency ranges across species of different vocal fold sizes. While average fundamental frequency is predominantly determined by vocal fold length (larynx size, range of fundamental frequency is facilitated by (1 laryngeal muscles that control elongation and by (2 nonlinearity in tissue fiber tension. One adaptation that would increase fundamental frequency range is greater freedom in joint rotation or gliding of two cartilages (thyroid and cricoid, so that vocal fold length change is maximized. Alternatively, tissue layers can develop to bear a disproportionate fiber tension (i.e., a ligament with high density collagen fibers, increasing the fundamental frequency range and thereby vocal versatility. The range of fundamental frequency across species is thus not simply one-dimensional, but can be conceptualized as the dependent variable in a multi-dimensional morphospace. In humans, this could allow for variations that could be clinically important for voice therapy and vocal fold repair. Alternative solutions could also have importance in vocal training for singing and other highly-skilled vocalizations.

  20. Glass ionomer application for vocal fold augmentation: Histopathological analysis on rabbit vocal fold.

    Science.gov (United States)

    Demirci, Sule; Tuzuner, Arzu; Callıoglu, Elif Ersoy; Yumusak, Nihat; Arslan, Necmi; Baltacı, Bülent

    2016-04-01

    The aim of this study was to investigate the use of glass ionomer cement (GIC) as an injection material for vocal fold augmentation and to evaluate the biocompatibility of the material. Ten adult New Zealand rabbits were used. Under general anesthesia, 0.1-cc GIC was injected to one vocal fold and the augmentation of vocal fold was observed. No injection was applied to the opposite side, which was accepted as the control group. The animals were sacrificed after 3 months and the laryngeal specimens were histopathologically evaluated. The injected and the noninjected control vocal folds were analyzed. The GIC particles were observed in histological sections on the injected side, and no foreign body giant cells, granulomatous inflammation, necrosis, or marked chronic inflammation were detected around the glass ionomer particles. Mild inflammatory reactions were noticed in only two specimens. The noninjected sides of vocal folds were completely normal. The findings of this study suggest that GIC is biocompatible and may be further investigated as an alternative injection material for augmentation of the vocal fold. Further studies are required to examine the viscoelastic properties of GIC and the long-term effects in experimental studies. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  1. Production, Usage, and Comprehension in Animal Vocalizations

    Science.gov (United States)

    Seyfarth, Robert M.; Cheney, Dorothy L.

    2010-01-01

    In this review, we place equal emphasis on production, usage, and comprehension because these components of communication may exhibit different developmental trajectories and be affected by different neural mechanisms. In the animal kingdom generally, learned, flexible vocal production is rare, appearing in only a few orders of birds and few…

  2. Hemispheric processing of vocal emblem sounds.

    Science.gov (United States)

    Neumann-Werth, Yael; Levy, Erika S; Obler, Loraine K

    2013-01-01

    Vocal emblems, such as shh and brr, are speech sounds that have linguistic and nonlinguistic features; thus, it is unclear how they are processed in the brain. Five adult dextral individuals with left-brain damage and moderate-severe Wernicke's aphasia, five adult dextral individuals with right-brain damage, and five Controls participated in two tasks: (1) matching vocal emblems to photographs ('picture task') and (2) matching vocal emblems to verbal translations ('phrase task'). Cross-group statistical analyses on items on which the Controls performed at ceiling revealed lower accuracy by the group with left-brain damage (than by Controls) on both tasks, and lower accuracy by the group with right-brain damage (than by Controls) on the picture task. Additionally, the group with left-brain damage performed significantly less accurately than the group with right-brain damage on the phrase task only. Findings suggest that comprehension of vocal emblems recruits more left- than right-hemisphere processing.

  3. Functional flexibility in wild bonobo vocal behaviour

    Directory of Open Access Journals (Sweden)

    Zanna Clay

    2015-08-01

    Full Text Available A shared principle in the evolution of language and the development of speech is the emergence of functional flexibility, the capacity of vocal signals to express a range of emotional states independently of context and biological function. Functional flexibility has recently been demonstrated in the vocalisations of pre-linguistic human infants, which has been contrasted to the functionally fixed vocal behaviour of non-human primates. Here, we revisited the presumed chasm in functional flexibility between human and non-human primate vocal behaviour, with a study on our closest living primate relatives, the bonobo (Pan paniscus. We found that wild bonobos use a specific call type (the “peep” across a range of contexts that cover the full valence range (positive-neutral-negative in much of their daily activities, including feeding, travel, rest, aggression, alarm, nesting and grooming. Peeps were produced in functionally flexible ways in some contexts, but not others. Crucially, calls did not vary acoustically between neutral and positive contexts, suggesting that recipients take pragmatic information into account to make inferences about call meaning. In comparison, peeps during negative contexts were acoustically distinct. Our data suggest that the capacity for functional flexibility has evolutionary roots that predate the evolution of human speech. We interpret this evidence as an example of an evolutionary early transition away from fixed vocal signalling towards functional flexibility.

  4. Vocal behaviour of Orange River Francolin Scleroptila ...

    African Journals Online (AJOL)

    Fieldwork to study the vocal behaviour of Orange River Francolin Scleroptilia levaillantoides was conducted on a farm in the Heidelberg district, Gauteng province, South Africa, during August 2009 to March 2011. Orange River Francolins possess a basic repertoire of seven calls and one mechanical sound. From 83 ...

  5. Modelling vocal anatomy's significant effect on speech

    NARCIS (Netherlands)

    de Boer, B.

    2010-01-01

    This paper investigates the effect of larynx position on the articulatory abilities of a humanlike vocal tract. Previous work has investigated models that were built to resemble the anatomy of existing species or fossil ancestors. This has led to conflicting conclusions about the relation between

  6. Targeted transtracheal stimulation for vocal fold closure.

    Science.gov (United States)

    Hadley, Aaron J; Thompson, Paul; Kolb, Ilya; Hahn, Elizabeth C; Tyler, Dustin J

    2014-06-01

    Paralysis of the structures in the head and neck due to stroke or other neurological disorder often causes dysphagia (difficulty in swallowing). Patients with dysphagia have a significantly higher incidence of aspiration pneumonia and death. The recurrent laryngeal nerve (RLN), which innervates the intrinsic laryngeal muscles that control the vocal folds, travels superiorly in parallel to the trachea in the tracheoesophageal groove. This study tests the hypothesis that functional electrical stimulation (FES) applied via transtracheal electrodes can produce controlled vocal fold adduction. Bipolar electrodes were placed at 15° intervals around the interior mucosal surface of the canine trachea, and current was applied to the tissue while electromyography (EMG) from the intrinsic laryngeal muscles and vocal fold movement visualization via laryngoscopy were recorded. The lowest EMG thresholds were found at an average location of 100° to the left of the ventral midsagittal line and 128° to the right. A rotatable pair of bipolar electrodes spaced 230° apart were able to stimulate bilaterally both RLNs in every subject. Laryngoscopy showed complete glottal closure with transtracheal stimulation in six of the eight subjects, and this closure was maintained under simultaneous FES-induced laryngeal elevation. Transtracheal stimulation is an effective tool for minimally invasive application of FES to induce vocal fold adduction, providing an alternative mechanism to study airway protection.

  7. Path Models of Vocal Emotion Communication.

    Directory of Open Access Journals (Sweden)

    Tanja Bänziger

    Full Text Available We propose to use a comprehensive path model of vocal emotion communication, encompassing encoding, transmission, and decoding processes, to empirically model data sets on emotion expression and recognition. The utility of the approach is demonstrated for two data sets from two different cultures and languages, based on corpora of vocal emotion enactment by professional actors and emotion inference by naïve listeners. Lens model equations, hierarchical regression, and multivariate path analysis are used to compare the relative contributions of objectively measured acoustic cues in the enacted expressions and subjective voice cues as perceived by listeners to the variance in emotion inference from vocal expressions for four emotion families (fear, anger, happiness, and sadness. While the results confirm the central role of arousal in vocal emotion communication, the utility of applying an extended path modeling framework is demonstrated by the identification of unique combinations of distal cues and proximal percepts carrying information about specific emotion families, independent of arousal. The statistical models generated show that more sophisticated acoustic parameters need to be developed to explain the distal underpinnings of subjective voice quality percepts that account for much of the variance in emotion inference, in particular voice instability and roughness. The general approach advocated here, as well as the specific results, open up new research strategies for work in psychology (specifically emotion and social perception research and engineering and computer science (specifically research and development in the domain of affective computing, particularly on automatic emotion detection and synthetic emotion expression in avatars.

  8. Enhanced Processing of Vocal Melodies in Childhood

    Science.gov (United States)

    Weiss, Michael W.; Schellenberg, E. Glenn; Trehub, Sandra E.; Dawber, Emily J.

    2015-01-01

    Music cognition is typically studied with instrumental stimuli. Adults remember melodies better, however, when they are presented in a biologically significant timbre (i.e., the human voice) than in various instrumental timbres (Weiss, Trehub, & Schellenberg, 2012). We examined the impact of vocal timbre on children's processing of melodies.…

  9. Phonetic characteristics of vocalizations during pain

    NARCIS (Netherlands)

    Lautenbacher, Stefan; Salinas-Ranneberg, Melissa; Niebuhr, Oliver; Kunz, Miriam

    2017-01-01

    INTRODUCTION AND OBJECTIVES: There have, yet, been only few attempts to phonetically characterize the vocalizations of pain, although there is wide agreement that moaning, groaning, or other nonverbal utterance can be indicative of pain. We studied the production of vowels "u," "a," "i", and "schwa"

  10. Music Education Intervention Improves Vocal Emotion Recognition

    Science.gov (United States)

    Mualem, Orit; Lavidor, Michal

    2015-01-01

    The current study is an interdisciplinary examination of the interplay among music, language, and emotions. It consisted of two experiments designed to investigate the relationship between musical abilities and vocal emotional recognition. In experiment 1 (N = 24), we compared the influence of two short-term intervention programs--music and…

  11. Umbilical cord blood as an alternative source of reduced-intensity hematopoietic stem cell transplantation for chronic Epstein-Barr virus-associated T or natural killer cell lymphoproliferative diseases.

    Science.gov (United States)

    Sawada, Akihisa; Inoue, Masami; Koyama-Sato, Maho; Kondo, Osamu; Yamada, Kayo; Shimizu, Mariko; Isaka, Kanako; Kimoto, Tomiko; Kikuchi, Hiroaki; Tokimasa, Sadao; Yasui, Masahiro; Kawa, Keisei

    2014-02-01

    Chronic Epstein-Barr virus-associated T/natural killer cell lymphoproliferative diseases represented by chronic active Epstein-Barr virus infection are lethal but are curable with several courses of chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT). Recently, we reported that reduced-intensity conditioning (RIC) provided better outcomes than myeloablative conditioning because RIC was less toxic. However, it was unclear whether cord blood transplantation (CBT) works in the context of RIC. We retrospectively analyzed 17 patients who underwent RIC followed by bone marrow transplantation (RIC-BMT) and 15 patients who underwent RIC followed by CBT (RIC-CBT). The representative regimen was fludarabine and melphalan based. The overall survival rates with RIC-BMT and RIC-CBT were 92.9% ± 6.9% and 93.3% ± 6.4%, respectively (P = .87). One patient died of lung graft-versus-host disease after RIC-BMT, and 1 patient died of multiple viral infections after RIC-CBT. Although cytotoxic chemotherapy was also immunosuppressive and might contribute to better donor cell engraftment after RIC-HSCT, the rate of engraftment failure after RIC-CBT was still higher than that after RIC-BMT (not significant); however, patients who had experienced graft failure were successfully rescued with a second HSCT. Unrelated cord blood can be an alternative source for RIC-HSCT if a patient has no family donor. Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  12. A case of bilateral vocal fold mucosal bridges, bilateral trans-vocal fold type III sulci vocales, and an intracordal polyp.

    Science.gov (United States)

    Tan, Melin; Pitman, Michael J

    2011-07-01

    We present a patient with a novel finding of bilateral mucosal bridges, bilateral type III trans-vocal fold sulci vocales, and a vocal fold polyp. Although sulci and mucosal bridges occur in the vocal folds, it is rare to find multiples of these lesions in a single patient, and it is even more uncommon when they occur in conjunction with a vocal fold polyp. To our knowledge, this is the first description of a vocal fold polyp in combination with multiple vocal fold bridges and multiple type III sulci vocales in a single patient. To describe and visually present the diagnosis and treatment of a patient with an intracordal polyp, bilateral mucosal bridges, as well as bilateral type III trans-vocal fold sulci vocales. Presentation of a set of high definition intraoperative photos displaying the extent of the vocal fold lesions and the resection of the intracordal polyp. This patient presented with only 6 months of significant dysphonia. It was felt that the recent change in voice was because of the polyp and not the bridges or sulci vocales. Considering the patient's presentation and the possible morbidity of resection of mucosal bridges and sulci, only the polyp was excised. Postoperatively, the patient's voice returned to his acceptable mild baseline dysphonia, and the benefit has persisted 6 months postoperatively. The combination of bilateral mucosal bridges, bilateral type III sulcus vocalis, and an intracordal polyp in one patient is rare if not novel. Treatment of the polyp alone returned the patient's voice to his lifelong baseline of mild dysphonia. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  13. Catecholaminergic contributions to vocal communication signals.

    Science.gov (United States)

    Matheson, Laura E; Sakata, Jon T

    2015-05-01

    Social context affects behavioral displays across a variety of species. For example, social context acutely influences the acoustic and temporal structure of vocal communication signals such as speech and birdsong. Despite the prevalence and importance of such social influences, little is known about the neural mechanisms underlying the social modulation of communication. Catecholamines are implicated in the regulation of social behavior and motor control, but the degree to which catecholamines influence vocal communication signals remains largely unknown. Using a songbird, the Bengalese finch, we examined the extent to which the social context in which song is produced affected immediate early gene expression (EGR-1) in catecholamine-synthesising neurons in the midbrain. Further, we assessed the degree to which administration of amphetamine, which increases catecholamine concentrations in the brain, mimicked the effect of social context on vocal signals. We found that significantly more catecholaminergic neurons in the ventral tegmental area and substantia nigra (but not the central grey, locus coeruleus or subcoeruleus) expressed EGR-1 in birds that were exposed to females and produced courtship song than in birds that produced non-courtship song in isolation. Furthermore, we found that amphetamine administration mimicked the effects of social context and caused many aspects of non-courtship song to resemble courtship song. Specifically, amphetamine increased the stereotypy of syllable structure and sequencing, the repetition of vocal elements and the degree of sequence completions. Taken together, these data highlight the conserved role of catecholamines in vocal communication across species, including songbirds and humans. © 2015 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  14. Laryngeal ultrasound and pediatric vocal fold nodules.

    Science.gov (United States)

    Ongkasuwan, Julina; Devore, Danielle; Hollas, Sarah; Jones, Jeremy; Tran, Brandon

    2017-03-01

    The term vocal fold nodules refers to bilateral thickening of the membranous folds with minimal impairment of the vibratory properties of the mucosa. Nodules are thought to be related to repetitive mechanical stress, associated with voice use patterns. Diagnosis is typically made in the office via either rigid or flexible laryngeal stroboscopy. Depending on the individual child, obtaining an optimal view of the larynx can be difficult if not impossible. Recent advances in high-frequency ultrasonography allows for transcervical examination of laryngeal structures. The goal of this project was to determine if laryngeal ultrasound (LUS) can be used to identify vocal fold nodules in dysphonic children. Prospective case-control study in which the patient acted as his or her own control. Forty-six pediatric patients were recruited for participation in this study; the mean age was 4.8 years. Twenty-three did not have any vocal fold lesions and 23 had a diagnosis of vocal fold nodules on laryngeal stroboscopy. Recorded LUSs were reviewed by two pediatric radiologists who were blinded to the nodule status. There was substantial inter-rater agreement (κ = 0.70, 95% confidence interval [CI]: 0.50-0.89) between the two radiologists regarding the presence of nodules. There was also substantial agreement (κ = 0.87, 95% CI: 0.72-1) between LUS and laryngeal stroboscopy. Sensitivity of LUS was 100% (95% CI: 85%-100%) and specificity was 87% (95% CI: 66%-97%). LUS can be used to identify vocal fold nodules in children with substantial agreement with laryngeal stroboscopy. 3b Laryngoscope, 127:676-678, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  15. Gd-DTPA MR imaging enhancement of spinal cord tumors

    International Nuclear Information System (INIS)

    Dillon, W.P.; Bolla, K.; Mark, A.S.; Tsudura, J.S.; Norman, D.; Newton, T.H.

    1987-01-01

    Nineteen patients with suspected spinal cord tumors were imaged with T1- and T2-weighted sequences before and after the administration of Gd-DTPA (0.1 mmol/kg). Eleven of the 19 patients had spinal cord tumors (three unproven). Eight of 11 patients had intramedullary tumors (four astrocytomas, two ependymomas) and two had extra-medullary tumors (one meningioma, one metastatic melanoma). Other lesions studied include idiopathic syringomyelia (two), spinal arteriovenous malformation (AVM) (one), posttraumatic arachnoiditis (one), and cord infarct (one). All of the tumors enhanced after the administration of Gd-DTPA. Spinal cord enhancement was also noted in association with a spinal cord AVM, a suspected cord infarct, and in the patient with severe arachnoiditis. No enhancement was present in patients with idiopathic or posttraumatic syringomyelia or in the three normal patients. In six of the patients, enhancement was critical in confirming disease that was questionable on the precontrast MR images. Gadolinium enhancement allowed differentiation of tumor from postoperative changes in two patients with spinal cord tumors. Enhanced images localized the lesion more accurately than precontrast MR images in eight patients. In four patients a lesion could only be detected after the administration of contrast. The postcontrast images better defined the margin of tumor from surrounding edema, operative scarring, and cord cavitation. The AVM case had enhancement of slowly flowing veins with Gd-DTPA posterior to an ischemic cord segment. Gd-DTPA enhancement is extremely useful in the detection and therapeutic assessment of spinal cord tumors; however, enhancement is not specific for tumors and should be interpreted in light of the clinical setting

  16. Spinal cord stimulation therapy for localized central pain

    International Nuclear Information System (INIS)

    Hirato, Masafumi; Takahashi, Akio; Watanabe, Katsushige; Kazama, Ken; Yoshimoto, Yuhei

    2008-01-01

    We studied the pathophysiology of localized central pain and the surgical result of spinal cord stimulation. There were 10 cases; 7 males and 3 females from 24 to 77 years old. Pain was caused by peripheral nerve injury in one case, spinal cord injury in two cases and cerebrovascular disease (CVD) (thalamic pain) in 7 cases. All cases were treated by epidural spinal cord stimulation and followed from 0.8 to 8.8 years. Sufficient pain relief was achieved in one case of peripheral nerve and spinal cord injury and in 4 cases of CVD. Moderate pain control was achieved in 2 cases of CVD. In one each case of spinal cord injury and of CVD, pain control was ineffective. In cases with thalamic pain, we studied the correlation between the surgical result of spinal cord stimulation and the clinical features, MRI, fluoro-deoxyglucose (FDG)-positron emission tomography (PET), and somatosensory evoked potentials (SEP) findings before operation. MRI revealed a small to moderate sized lesion on the thalamus or putamen in each case. PET also showed decreased accumulation of FDG on the affected thalamus. In all cases without one fair responder to spinal cord stimulation, we could recognize definite SEP originating in the sensory cortex ipsilateral side to the CVD lesion during contralateral median or posterior tibial nerve stimulation. In the good responders, we could recognize SEP originating in the sensory cortex of the lesion side with less delayed latency or decreased amplitude than in the moderate responders. In this group, test stimulation with low voltage on the spinal cord evoked a sensory effect (paresthesia) over the painful part of the body. Spinal cord stimulation proved to be an effective treatment for localized central pain. In cases with localized central pain after CVD, we could expect to ameliorate the intractable pain in those cases in which SEP or spinal cord test stimulation revealed that the thalamo-cortical system was preserved. (author)

  17. Ischemic spinal cord infarction in children without vertebral fracture

    OpenAIRE

    Nance, Jessica R.; Golomb, Meredith R.

    2007-01-01

    Spinal cord infarction in children is a rare condition which is becoming more widely recognized. There are few reports in the pediatric literature characterizing etiology, diagnosis, treament and prognosis. The risk factors for pediatric ischemic spinal cord infarction include obstruction of blood flow associated with cardiovascular compromise or malformation, iatrogenic or traumatic vascular inujury, cerebellar herniation, thrombotic or embolic disease, infection, and vasculitis. In many chi...

  18. Private Cord Blood Banking: Experiences And Views Of Pediatric Hematopoietic Cell Transplantation Physicians

    Science.gov (United States)

    Thornley, Ian; Eapen, Mary; Sung, Lillian; Lee, Stephanie J.; Davies, Stella M.; Joffe, Steven

    2011-01-01

    Objective Private cord blood banks are for-profit companies that facilitate storage of umbilical cord blood for personal or family use. Pediatric hematopoietic cell transplantation (HCT) physicians are currently best situated to use cord blood therapeutically. We sought to describe the experiences and views of these physicians regarding private cord blood banking. Participants and Methods Emailed cross-sectional survey of pediatric HCT physicians in the United States and Canada. 93/152 potentially eligible physicians (93/130 confirmed survey recipients) from 57 centers responded. Questions addressed the number of transplants performed using privately banked cord blood, willingness to use banked autologous cord blood in specific clinical settings, and recommendations to parents regarding private cord blood banking. Results Respondents reported having performed 9 autologous and 41 allogeneic transplants using privately banked cord blood. In 36/40 allogeneic cases for which data were available, the cord blood had been collected because of a known indication in the recipient. Few respondents would choose autologous cord blood over alternative stem cell sources for treatment of acute lymphoblastic leukemia in second remission. In contrast, 55% would choose autologous cord blood to treat high-risk neuroblastoma, or to treat severe aplastic anemia in the absence of an available sibling donor. No respondent would recommend private cord blood banking for a newborn with one healthy sibling when both parents were of Northern European descent; 11% would recommend banking when parents were of different minority ethnicities. Conclusions Few transplants have been performed using cord blood stored in the absence of a known indication in the recipient. Willingness to use banked autologous cord blood varies depending on disease and availability of alternative stem cell sources. Few pediatric HCT physicians endorse private cord blood banking in the absence of an identified recipient

  19. Perfil vocal do guia de turismo Vocal profile of tourism guide

    Directory of Open Access Journals (Sweden)

    Elisângela Barros Soares

    2006-12-01

    Full Text Available OBJETIVO: caracterizar o perfil vocal dos guias de turismo, bem como gênero e idade. MÉTODOS: participaram desse estudo 23 guias de turismo, de ambos os gêneros, com idade entre 25 a 64 anos, participantes do Sindicato de Guias de Turismo do Estado de Pernambuco, que compareceram às reuniões trimestrais no período da coleta. Trata-se de um estudo de caráter descritivo, observacional e transversal. Para coleta foi realizada avaliação perceptivo-auditiva GRBAS. RESULTADOS: observou-se que a maioria dos guias apresentou loudness adequada, pitch normal e voz alterada. Além disso, as médias dos tempos máximos de fonação das vogais e das fricativas encontravam-se reduzidas e ataque vocal isocrônico. A ressonância, na maioria dos guias, estava equilibrada, mas houve uma incidência de ressonância laringo-faringea. A articulação foi precisa, com tipo e modo respiratório misto e nasal, respectivamente. Quanto à escala GRBAS as alterações apareceram de forma leve no G (grau de alteração vocal em 68%. CONCLUSÃO: na amostra estudada, a maioria era do gênero feminino com média de idade de 46 anos, e perfil vocal caracterizado por tempo máximo de fonação reduzidos, relação s/z adequado, ataque vocal isocrônico, pitch normal, loudness adequado, qualidade vocal alterada, com presença de rouquidão, soprosidade, tensão. A ressonância da maioria estava equilibrada e a articulação precisa, com tipo e modo respiratório misto e nasal, respectivamente. Quanto à escala GRBAS, as alterações apareceram de forma leve no grau de alteração vocal (G em 68% e tensão (S em 78% dos sujeitos.PURPOSE: to characterize the vocal profile of tourism guides, as well as gender and age. METHODS: 23 guides took part in this study, of both genders, with age between 25 to 64 years, partakers of the Union of Tourism Guides of the State of Pernambuco, who appeared to the quarterly meetings in the period of the collection. It is a descriptive

  20. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Home Kim Eberhardt Muir, MS Coping with a New Injury Robin Dorman, PsyD Sex and Fertility After ... program? play_arrow What are the most promising new treatments for spinal cord injuries? play_arrow What ...

  1. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... What is “Braingate” research? play_arrow How would stem-cell therapies work in the treatment of spinal cord injuries? play_arrow What does stem-cell research on animals tell us? play_arrow When ...

  2. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... is “Braingate” research? play_arrow How would stem-cell therapies work in the treatment of spinal cord injuries? play_arrow What does stem-cell research on animals tell us? play_arrow When ...

  3. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Braingate” research? play_arrow How would stem-cell therapies work in the treatment of spinal cord injuries? play_arrow What does stem-cell research on animals tell us? play_arrow When can we expect ...

  4. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Anne Bryden, OT The Role of the Social Worker after Spinal Cord Injury Patti Rogers, SW Marguerite David, ... injuries. The website does not provide medical advice, recommend or endorse health care products or services, or control the information ...

  5. Anterior spinal cord syndrome of unknown etiology

    OpenAIRE

    Klakeel, Merrine; Thompson, Justin; Srinivasan, Rajashree; McDonald, Frank

    2015-01-01

    A spinal cord injury encompasses a physical insult to the spinal cord. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior spinal artery. We present the cases of two 13-year-old boys with anterior spinal cord syndrome, along with a review of the anatomy and vasculature of the spinal cord and an explanation of how a lesion in the cord corresponds to anterior spinal cord syndrome.

  6. The loss-of-function disease-mutation G301R in the Na+/K+-ATPase α2 isoform decreases lesion volume and improves functional outcome after acute spinal cord injury in mice.

    Science.gov (United States)

    Ellman, Ditte Gry; Isaksen, Toke Jost; Lund, Minna Christiansen; Dursun, Safinaz; Wirenfeldt, Martin; Jørgensen, Louise Helskov; Lykke-Hartmann, Karin; Lambertsen, Kate Lykke

    2017-09-08

    The Na + /K + -ATPases are transmembrane ion pumps important for maintenance of ion gradients across the plasma membrane that serve to support multiple cellular functions, such as membrane potentials, regulation of cellular volume and pH, and co-transport of signaling transmitters in all animal cells. The α 2 Na + /K + -ATPase subunit isoform is predominantly expressed in astrocytes, which us the sharp Na + -gradient maintained by the sodium pump necessary for astroglial metabolism. Prolonged ischemia induces an elevation of [Na + ] i , decreased ATP levels and intracellular pH owing to anaerobic metabolism and lactate accumulation. During ischemia, Na + /K + -ATPase-related functions will naturally increase the energy demand of the Na + /K + -ATPase ion pump. However, the role of the α 2 Na + /K + -ATPase in contusion injury to the spinal cord remains unknown. We used mice heterozygous mice for the loss-of-function disease-mutation G301R in the Atp1a2 gene (α 2 +/G301R ) to study the effect of reduced α 2 Na + /K + -ATPase expression in a moderate contusion spinal cord injury (SCI) model. We found that α 2 +/G301R mice display significantly improved functional recovery and decreased lesion volume compared to littermate controls (α 2 +/+ ) 7 days after SCI. The protein level of the α 1 isoform was significantly increased, in contrast to the α 3 isoform that significantly decreased 3 days after SCI in both α 2 +/G301R and α 2 +/+ mice. The level of the α 2 isoform was significantly decreased in α 2 +/G301R mice both under naïve conditions and 3 days after SCI compared to α 2 +/+ mice. We found no differences in astroglial aquaporin 4 levels and no changes in the expression of chemokines (CCL2, CCL5 and CXCL1) and cytokines (TNF, IL-6, IL-1β, IL-10 and IL-5) between genotypes, just as no apparent differences were observed in location and activation of CD45 and F4/80 positive microglia and infiltrating leukocytes. Our proof of concept study

  7. Is laughter a better vocal change detector than a growl?

    Science.gov (United States)

    Pinheiro, Ana P; Barros, Carla; Vasconcelos, Margarida; Obermeier, Christian; Kotz, Sonja A

    2017-07-01

    The capacity to predict what should happen next and to minimize any discrepancy between an expected and an actual sensory input (prediction error) is a central aspect of perception. Particularly in vocal communication, the effective prediction of an auditory input that informs the listener about the emotionality of a speaker is critical. What is currently unknown is how the perceived valence of an emotional vocalization affects the capacity to predict and detect a change in the auditory input. This question was probed in a combined event-related potential (ERP) and time-frequency analysis approach. Specifically, we examined the brain response to standards (Repetition Positivity) and to deviants (Mismatch Negativity - MMN), as well as the anticipatory response to the vocal sounds (pre-stimulus beta oscillatory power). Short neutral, happy (laughter), and angry (growls) vocalizations were presented both as standard and deviant stimuli in a passive oddball listening task while participants watched a silent movie and were instructed to ignore the vocalizations. MMN amplitude was increased for happy compared to neutral and angry vocalizations. The Repetition Positivity was enhanced for happy standard vocalizations. Induced pre-stimulus upper beta power was increased for happy vocalizations, and predicted the modulation of the standard Repetition Positivity. These findings indicate enhanced sensory prediction for positive vocalizations such as laughter. Together, the results suggest that positive vocalizations are more effective predictors in social communication than angry and neutral ones, possibly due to their high social significance. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Vocal quality in university teachers: a pilot study.

    Science.gov (United States)

    D'haeseleer, E; Claeys, S; Wuyts, F; Van Lierde, K M

    2009-01-01

    The main purpose of this study was to determine the vocal quality of 20 male and 9 female university teachers using a multi-parameter approach. Secondly, the effect of an academic lecture on the voice profiles of the university teachers was measured. All groups underwent subjective voice evaluations (perceptual evaluation, Voice Handicap Index, anamnesis of vocal complaints and vocal abuse) and objective voice evaluations (aerodynamic and acoustic parameters, vocal performance, and the Dysphonia Severity Index). The same voice assessment was performed after an academic lecture with a mean length of one and a half hours. The mean DSI score was + 2.2 for the male teachers and + 4.0 for the female teachers. The mean VHI score was 13. Perceptually, all voice parameters were rated as normal. The questionnaire revealed a relatively high amount of vocal abuse. No changes in the objective vocal parameters were found after the lecture. Perceptually, however, the voices of the university teachers were significantly less instable after the lecture. Although no negative changes in objective vocal quality were observed, 48% of the university teachers experienced subjective vocal changes. The authors concluded that university teachers are professional voice users with good vocal quality who suffer no handicapping effect from possible voice disorders. No important changes in the vocal profile after a teaching activity of one and a half hours were found, despite the high prevalence of voice complaints.

  9. Vocal fold paresis - a debilitating and underdiagnosed condition.

    Science.gov (United States)

    Harris, G; O'Meara, C; Pemberton, C; Rough, J; Darveniza, P; Tisch, S; Cole, I

    2017-07-01

    To review the clinical signs of vocal fold paresis on laryngeal videostroboscopy, to quantify its impact on patients' quality of life and to confirm the benefit of laryngeal electromyography in its diagnosis. Twenty-nine vocal fold paresis patients were referred for laryngeal electromyography. Voice Handicap Index 10 results were compared to 43 patients diagnosed with vocal fold paralysis. Laryngeal videostroboscopy analysis was conducted to determine side of paresis. Blinded laryngeal electromyography confirmed vocal fold paresis in 92.6 per cent of cases, with vocal fold lag being the most common diagnostic sign. The laryngology team accurately predicted side of paresis in 76 per cent of cases. Total Voice Handicap Index 10 responses were not significantly different between vocal fold paralysis and vocal fold paresis groups (26.08 ± 0.21 and 22.93 ± 0.17, respectively). Vocal fold paresis has a significant impact on quality of life. This study shows that laryngeal electromyography is an important diagnostic tool. Patients with persisting dysphonia and apparently normal vocal fold movement, who fail to respond to appropriate speech therapy, should be investigated for a diagnosis of vocal fold paresis.

  10. Quantitative electromyographic characteristics of idiopathic unilateral vocal fold paralysis.

    Science.gov (United States)

    Chang, Wei-Han; Fang, Tuan-Jen; Li, Hsueh-Yu; Jaw, Fu-Shan; Wong, Alice M K; Pei, Yu-Cheng

    2016-11-01

    Unilateral vocal fold paralysis with no preceding causes is diagnosed as idiopathic unilateral vocal fold paralysis. However, comprehensive guidelines for evaluating the defining characteristics of idiopathic unilateral vocal fold paralysis are still lacking. In the present study, we hypothesized that idiopathic unilateral vocal fold paralysis may have different clinical and neurologic characteristics from unilateral vocal fold paralysis caused by surgical trauma. Retrospective, case series study. Patients with unilateral vocal fold paralysis were evaluated using quantitative laryngeal electromyography, videolaryngostroboscopy, voice acoustic analysis, the Voice Outcome Survey, and the Short Form-36 Health Survey quality-of-life questionnaire. Patients with idiopathic and iatrogenic vocal fold paralysis were compared. A total of 124 patients were recruited. Of those, 17 with no definite identified causes after evaluation and follow-up were assigned to the idiopathic group. The remaining 107 patients with surgery-induced vocal fold paralysis were assigned to the iatrogenic group. Patients in the idiopathic group had higher recruitment of the thyroarytenoid-lateral cricoarytenoid muscle complex and better quality of life compared with the iatrogenic group. Idiopathic unilateral vocal fold paralysis has a distinct clinical presentation, with relatively minor denervation changes in the involved laryngeal muscles, and less impact on quality of life compared with iatrogenic vocal fold paralysis. 4. Laryngoscope, 126:E362-E368, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Improvement of Vocal Pathologies Diagnosis Using High-Speed Videolaryngoscopy

    Science.gov (United States)

    Tsuji, Domingos Hiroshi; Hachiya, Adriana; Dajer, Maria Eugenia; Ishikawa, Camila Cristina; Takahashi, Marystella Tomoe; Montagnoli, Arlindo Neto

    2014-01-01

    Introduction The study of the dynamic properties of vocal fold vibration is important for understanding the vocal production mechanism and the impact of organic and functional changes. The advent of high-speed videolaryngoscopy (HSV) has provided the possibility of seeing the real cycle of vocal fold vibration in detail through high sampling rate of successive frames and adequate spatial resolution. Objective To describe the technique, advantages, and limitations of using HSV and digital videokymography in the diagnosis of vocal pathologies. Methods We used HSV and digital videokymography to evaluate one normophonic individual and four patients with vocal fold pathologies (nodules, unilateral paralysis of the left vocal fold, intracordal cyst, and adductor spasmodic dysphonia). The vocal fold vibration parameters (glottic closure, vibrational symmetry, periodicity, mucosal wave, amplitude, and glottal cycle phases) were assessed. Results Differences in the vocal vibration parameters were observed and correlated with the pathophysiology. Conclusion HSV is the latest diagnostic tool in visual examination of vocal behavior and has considerable potential to refine our knowledge regarding the vocal fold vibration and voice production, as well as regarding the impact of pathologic conditions have on the mechanism of phonation. PMID:25992109

  12. Improvement of Vocal Pathologies Diagnosis Using High-Speed Videolaryngoscopy

    Directory of Open Access Journals (Sweden)

    Tsuji, Domingos Hiroshi

    2014-04-01

    Full Text Available Introduction The study of the dynamic properties of vocal fold vibration is important for understanding the vocal production mechanism and the impact of organic and functional changes. The advent of high-speed videolaryngoscopy (HSV has provided the possibility of seeing the real cycle of vocal fold vibration in detail through high sampling rate of successive frames and adequate spatial resolution. Objective To describe the technique, advantages, and limitations of using HSV and digital videokymography in the diagnosis of vocal pathologies. Methods We used HSV and digital videokymography to evaluate one normophonic individual and four patients with vocal fold pathologies (nodules, unilateral paralysis of the left vocal fold, intracordal cyst, and adductor spasmodic dysphonia. The vocal fold vibration parameters (glottic closure, vibrational symmetry, periodicity, mucosal wave, amplitude, and glottal cycle phases were assessed. Results Differences in the vocal vibration parameters were observed and correlated with the pathophysiology. Conclusion HSV is the latest diagnostic tool in visual examination of vocal behavior and has considerable potential to refine our knowledge regarding the vocal fold vibration and voice production, as well as regarding the impact of pathologic conditions have on the mechanism of phonation.

  13. Responses of primate frontal cortex neurons during natural vocal communication.

    Science.gov (United States)

    Miller, Cory T; Thomas, A Wren; Nummela, Samuel U; de la Mothe, Lisa A

    2015-08-01

    The role of primate frontal cortex in vocal communication and its significance in language evolution have a controversial history. While evidence indicates that vocalization processing occurs in ventrolateral prefrontal cortex neurons, vocal-motor activity has been conjectured to be primarily subcortical and suggestive of a distinctly different neural architecture from humans. Direct evidence of neural activity during natural vocal communication is limited, as previous studies were performed in chair-restrained animals. Here we recorded the activity of single neurons across multiple regions of prefrontal and premotor cortex while freely moving marmosets engaged in a natural vocal behavior known as antiphonal calling. Our aim was to test whether neurons in marmoset frontal cortex exhibited responses during vocal-signal processing and/or vocal-motor production in the context of active, natural communication. We observed motor-related changes in single neuron activity during vocal production, but relatively weak sensory responses for vocalization processing during this natural behavior. Vocal-motor responses occurred both prior to and during call production and were typically coupled to the timing of each vocalization pulse. Despite the relatively weak sensory responses a population classifier was able to distinguish between neural activity that occurred during presentations of vocalization stimuli that elicited an antiphonal response and those that did not. These findings are suggestive of the role that nonhuman primate frontal cortex neurons play in natural communication and provide an important foundation for more explicit tests of the functional contributions of these neocortical areas during vocal behaviors. Copyright © 2015 the American Physiological Society.

  14. Current obstetrical practice and umbilical cord prolapse.

    Science.gov (United States)

    Usta, I M; Mercer, B M; Sibai, B M

    1999-01-01

    The aim of this study was to assess the contribution of current obstetrical practice to the occurrence and complications of umbilical cord prolapse. Maternal and neonatal charts of 87 pregnancies complicated by true umbilical cord prolapse during a 5-year period were reviewed. Twin gestation and noncephalic presentations were common features (14 and 41%, respectively). Eighty-nine percent (77) of infants were delivered by cesarean section of which 29% were classical and 88% were primary. The mean gestational age at delivery was 34.0 +/- 6.0 weeks, and the mean birth weight was 2318 +/- 1159 g. Obstetrical intervention preceded 41 (47%) cases (the obstetrical intervention group): amniotomy (9), scalp electrode application (4), intrauterine pressure catheter insertion (6), attempted external cephalic version (7), expectant management of preterm premature rupture of membranes (14), manual rotation of the fetal head (1), and amnioreduction (1). There were 11 perinatal deaths. Thirty-three percent of the infants (32) had a 5-min Apgar score < 7 and 34% had a cord pH < 7.20. Neonatal seizures, intracerebral hemorrhage, necrotizing enterocolitis, hyaline membrane disease, persistent fetal circulation, sepsis, assisted ventilation, and perinatal mortality were comparable in the "obstetrical intervention" and "no-intervention" groups. Most of the neonatal complications occurred in infants < 32 weeks' gestation. We conclude that obstetrical intervention contributes to 47% of umbilical cord prolapse cases; however, it does not increase the associated perinatal morbidity and mortality.

  15. Doença de Creutzfeldt-Jakob: a propósito de um caso com comprometimento medular Creutzfeldt-Jakob disease: case report with spinal cord involvement

    Directory of Open Access Journals (Sweden)

    Marlos Fábio Alves de Azevedo

    2001-12-01

    Full Text Available A doença de Creutzfeldt-Jakob (DCJ é a encefalopatia espongiforme subaguda transmissível mais frequente nos seres humanos. Aproximadamente 85% dos casos pertencem à forma esporádica da doença. Os outros 15% consistem na forma genética e iatrogênica. Relatamos o caso de uma paciente com a forma esporádica da doença de Creutzfeldt-Jakob, com comprometimento medular e apresentação clínica caracterizada por síndrome demencial e cerebelar, miofasciculação com arreflexia difusa e crises convulsivas do tipo tônico-clônico generalizada. É rara a associação das duas últimas manifestações clínicas. O caso foi considerado como provável DCJ até confirmação por autópsia e imunohistoquímica. Concluímos que se deve sempre pensar na DCJ em pacientes que apresentam demência rapidamente progressiva e, na ausência de sinais piramidais ou extrapiramidais, pensar em acometimento periférico e/ou medular.Creutzfeldt-Jakob disease (CJD is the most common subacute transmissible spongiform encephalopathy. Approximately 85% of the cases are sporadic. The remaining 15% consist of genetic and iatrogenic forms. We report a sporadic form of CJD with spinal cord involvement and a clinical manifestation characterized by dementia and cerebellar syndrome, myofasciculation with absent reflexes and seizures. The two last manifestations are rare. The clinical hypothesis was probable CJD which was confirmed with autopsy and immunohistochemistry. We conclude that CJD should always be suspected when rapidly progressive dementia occurs and the absence of pyramidal or extrapyramidal signs suggest a spinal cord and/or peripheral nerve involvement.

  16. Ischemic Tolerance of the Brain and Spinal Cord: A Review.

    Science.gov (United States)

    Yunoki, Masatoshi; Kanda, Takahiro; Suzuki, Kenta; Uneda, Atsuhito; Hirashita, Koji; Yoshino, Kimihiro

    2017-11-15

    Ischemic tolerance is an endogenous neuroprotective phenomenon induced by sublethal ischemia. Ischemic preconditioning (IPC), the first discovered form of ischemic tolerance, is widely seen in many species and in various organs including the brain and the spinal cord. Ischemic tolerance of the spinal cord is less familiar among neurosurgeons, although it has been reported from the viewpoint of preventing ischemic spinal cord injury during aortic surgery. It is important for neurosurgeons to have opportunities to see patients with spinal cord ischemia, and to understand ischemic tolerance of the spinal cord as well as the brain. IPC has a strong neuroprotective effect in animal models of ischemia; however, clinical application of IPC for ischemic brain and spinal diseases is difficult because they cannot be predicted. In addition, one drawback of preconditioning stimuli is that they are also capable of producing injury with only minor changes to their intensity or duration. Numerous methods to induce ischemic tolerance have been discovered that vary in their timing and the site at which short-term ischemia occurs. These methods include ischemic postconditioning (IPoC), remote ischemic preconditioning (RIPC), remote ischemic perconditioning (RIPerC) and remote ischemic postconditioning (RIPoC), which has had a great impact on clinical approaches to treatment of ischemic brain and spinal cord injury. Especially RIPerC and RIPoC to induce spinal cord tolerance are considered clinically useful, however the evidence supporting these methods is currently insufficient; further experimental or clinical research in this area is thus necessary.

  17. Desvantagem vocal em cantores de igreja Vocal handicap of church singers

    Directory of Open Access Journals (Sweden)

    Tatiane Prestes

    2012-10-01

    Full Text Available OBJETIVO: avaliar a desvantagem vocal de cantores amadores de coros de igreja. MÉTODO: participaram 42 cantores de coros amadores de igrejas, sendo 20 homens e 22 mulheres, com idades entre 18 e 59 anos. Todos responderam a um questionário contendo perguntas sobre autopercepção vocal e práticas de canto, e ao protocolo Índice de Desvantagem para o Canto Moderno (IDCM, composto por 30 questões referentes às subescalas incapacidade, desvantagem e defeito. Foi realizada triagem perceptivo-auditiva para classificação das vozes em adaptadas ou alteradas e mensuração dos graus De alteração. RESULTADOS: a pontuação total média obtida no IDCM foi 23 pontos. Os maiores escores foram obtidos na subescala "defeito" (10,9, seguido por "incapacidade" (7,6 e "desvantagem" (4,5, com diferença entre elas (p= 0,001. Cantores que nunca realizaram aula de canto apresentaram maiores escores no domínio "desvantagem" (p=0,003. À medida que o escore total do IDCM aumentou, a nota atribuída pelo cantor em relação à própria voz diminuiu (p= 0,046. Participantes com qualidade vocal alterada apresentaram maiores escores nas subescalas incapacidade e desvantagem e no domínio total do IDCM quando comparados aos que apresentavam qualidade vocal adaptada (p=0,012, p=0,049 e p=0,015, respectivamente. Além disso, quanto maior o grau de alteração vocal, maiores foram os escores referentes à subescala incapacidade (p=0,022. CONCLUSÃO: cantores de igreja apresentam desvantagem vocal importante. Quando apresentam alterações vocais, esta desvantagem é ainda maior. Quanto maior o grau de alteração vocal, maiores as limitações referentes à voz cantada. Aulas de canto parecem minimizar a desvantagem vocal nessa população.PURPOSE: to evaluate the vocal handicap of amateur singers of church choirs. METHOD: we interviewed 42 amateur singers from church choirs, 20 men, and 22 women, between 18 and 59 year old. Everybody answered a questionnaire

  18. Effect of Vocal Fold Medialization on Dysphagia in Patients with Unilateral Vocal Fold Immobility.

    Science.gov (United States)

    Cates, Daniel J; Venkatesan, Naren N; Strong, Brandon; Kuhn, Maggie A; Belafsky, Peter C

    2016-09-01

    The effect of vocal fold medialization (VFM) on vocal improvement in persons with unilateral vocal fold immobility (UVFI) is well established. The effect of VFM on the symptom of dysphagia is uncertain. The purpose of this study is to evaluate dysphagia symptoms in patients with UVFI pre- and post-VFM. Case series with chart review. Academic tertiary care medical center. The charts of 44 persons with UVFI who underwent VFM between June 1, 2013, and December 31, 2014, were abstracted from a prospectively maintained database at the University of California, Davis, Voice and Swallowing Center. Patient demographics, indications, and type of surgical procedure were recorded. Self-reported swallowing impairment was assessed with the validated 10-item Eating Assessment Tool (EAT-10) before and after surgery. A paired samples t test was used to compare pre- and postmedialization EAT-10 scores. Forty-four patients met criteria and underwent either vocal fold injection (73%) or thyroplasty (27%). Etiologies of vocal fold paralysis were iatrogenic (55%), idiopathic (29%), benign or malignant neoplastic (9%), traumatic (5%), or related to the late effects of radiation (2%). EAT-10 (mean ± SD) scores improved from 12.2 ± 11.1 to 7.7 ± 7.2 after medialization (P dysphagia and report significant improvement in swallowing symptoms following VFM. The symptomatic improvement appears to be durable over time. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  19. The Vocal Tract Organ: A New Musical Instrument Using 3-D Printed Vocal Tracts.

    Science.gov (United States)

    Howard, David M

    2017-10-27

    The advent and now increasingly widespread availability of 3-D printers is transforming our understanding of the natural world by enabling observations to be made in a tangible manner. This paper describes the use of 3-D printed models of the vocal tract for different vowels that are used to create an acoustic output when stimulated with an appropriate sound source in a new musical instrument: the Vocal Tract Organ. The shape of each printed vocal tract is recovered from magnetic resonance imaging. It sits atop a loudspeaker to which is provided an acoustic L-F model larynx input signal that is controlled by the notes played on a musical instrument digital interface device such as a keyboard. The larynx input is subject to vibrato with extent and frequency adjustable as desired within the ranges usually found for human singing. Polyphonic inputs for choral singing textures can be applied via a single loudspeaker and vocal tract, invoking the approximation of linearity in the voice production system, thereby making multiple vowel stops a possibility while keeping the complexity of the instrument in reasonable check. The Vocal Tract Organ offers a much more human and natural sounding result than the traditional Vox Humana stops found in larger pipe organs, offering the possibility of enhancing pipe organs of the future as well as becoming the basis for a "multi-vowel" chamber organ in its own right. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  20. Vocal caricatures reveal signatures of speaker identity

    Science.gov (United States)

    López, Sabrina; Riera, Pablo; Assaneo, María Florencia; Eguía, Manuel; Sigman, Mariano; Trevisan, Marcos A.

    2013-12-01

    What are the features that impersonators select to elicit a speaker's identity? We built a voice database of public figures (targets) and imitations produced by professional impersonators. They produced one imitation based on their memory of the target (caricature) and another one after listening to the target audio (replica). A set of naive participants then judged identity and similarity of pairs of voices. Identity was better evoked by the caricatures and replicas were perceived to be closer to the targets in terms of voice similarity. We used this data to map relevant acoustic dimensions for each task. Our results indicate that speaker identity is mainly associated with vocal tract features, while perception of voice similarity is related to vocal folds parameters. We therefore show the way in which acoustic caricatures emphasize identity features at the cost of loosing similarity, which allows drawing an analogy with caricatures in the visual space.

  1. Vocal tract dynamics in an adult stutterer

    Directory of Open Access Journals (Sweden)

    Lesley Wolk

    1981-11-01

    Full Text Available The present study was motivated by the clinical observation of "laryngeal spasms" during dysfluency in an adult female  stutterer. The flexible fiberoptic nasolaryngoscope was employed in an attempt to assess this phenomenon objectively. Findings from fiberscopic and spectrographic investigations provided evidence for a disturbance in laryngeal behaviour, and in turn served to determine the nature of the treatment programme. Asymmetry of the vocal folds  and partial abductory laryngeal behaviour, reflecting  a conflict between adductory and abductory forces, characterized the dysfluency  in this patient. A subjective evaluation after treatment revealed a reduction in both severity and frequency of stuttering behaviour. Furthermore, fiberscopic examination carried out after treatment revealed an absence of the laryngeal disturbances noted previously. Results are considered in terms of vocal tract dynamics in stuttering and its clinical applicability.

  2. Effect of Performance Time of the Semi-Occluded Vocal Tract Exercises in Dysphonic Children.

    Science.gov (United States)

    Ramos, Lorena de Almeida; Gama, Ana Cristina Côrtes

    2017-05-01

    This study aimed to verify the effects of execution time on auditory-perceptual and acoustic responses in children with dysphonia completing straw phonation exercises. A randomized, prospective, comparative intra-subject study design was used. Twenty-seven children, ranging from 5 to 10 years of age, diagnosed with vocal cord nodules or cysts, were enrolled in the study. All subjects included in the Experimental Group were also included in the Control Group which involved complete voice rest. Sustained vowels (/a/e/ε/e/) counting from 1 to 10 were recorded before the exercises (m0) and then again after the first (m1), third (m3), fifth (m5), and seventh (m7) minutes of straw phonation exercises. The recordings were randomized and presented to five speech therapists, who evaluated vocal quality based on the Grade Roughness Breathiness Asthenia/Strain Instability scale. For acoustic analysis, fundamental frequency, jitter, shimmer, glottal to noise excitation ratio, and noise parameters were analyzed. Reduced roughness, breathiness, and noise measurements as well as increased glottal to noise excitation ratio were observed in the Experimental Group after 3 minutes of exercise. Reduced grade of dysphonia and breathiness were noted after 5 minutes. The ideal duration of straw phonation in children with dysphonia is from 3 to 5 minutes. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  3. Botulinum toxin in the treatment of vocal fold nodules.

    Science.gov (United States)

    Allen, Jacqui E; Belafsky, Peter C

    2009-12-01

    Promising new techniques in the management of vocal fold nodules have been developed in the past 2 years. Simultaneously, the therapeutic use of botulinum toxin has rapidly expanded. This review explores the use of botulinum toxin in treatment of vocal nodules and summarizes current therapeutic concepts. New microsurgical instruments and techniques, refinements in laser technology, radiosurgical excision and steroid intralesional injections are all promising new techniques in the management of vocal nodules. Botulinum toxin-induced 'voice rest' is a new technique we have employed in patients with recalcitrant nodules. Successful resolution of nodules is possible with this technique, without the risk of vocal fold scarring inherent in dissection/excision techniques. Botulinum toxin usage is exponentially increasing, and large-scale, long-term studies demonstrate its safety profile. Targeted vocal fold temporary paralysis induced by botulinum toxin injection is a new, well tolerated and efficacious treatment in patients with persistent vocal fold nodules.

  4. The voice conveys specific emotions: evidence from vocal burst displays.

    Science.gov (United States)

    Simon-Thomas, Emiliana R; Keltner, Dacher J; Sauter, Disa; Sinicropi-Yao, Lara; Abramson, Anna

    2009-12-01

    Studies of emotion signaling inform claims about the taxonomic structure, evolutionary origins, and physiological correlates of emotions. Emotion vocalization research has tended to focus on a limited set of emotions: anger, disgust, fear, sadness, surprise, happiness, and for the voice, also tenderness. Here, we examine how well brief vocal bursts can communicate 22 different emotions: 9 negative (Study 1) and 13 positive (Study 2), and whether prototypical vocal bursts convey emotions more reliably than heterogeneous vocal bursts (Study 3). Results show that vocal bursts communicate emotions like anger, fear, and sadness, as well as seldom-studied states like awe, compassion, interest, and embarrassment. Ancillary analyses reveal family-wise patterns of vocal burst expression. Errors in classification were more common within emotion families (e.g., 'self-conscious,' 'pro-social') than between emotion families. The three studies reported highlight the voice as a rich modality for emotion display that can inform fundamental constructs about emotion.

  5. In-Office Excision En Masse of a Vocal Process Granuloma Using the Potassium-Titanyl-Phosphate Laser.

    Science.gov (United States)

    Mascarella, Marco A; Young, Jonathan

    2016-01-01

    In-office laryngeal surgery is taking on a more commonplace role in the treatment of laryngeal disorders. The potassium-titanyl-phosphate (KTP) laser has been a resourceful adjunct to the management of patients with mucosal lesions of the vocal cords. However, a paucity of data exists for its use in postintubation granulomas treated in-office. A 43-year-old female presented with voice hoarseness and found to have a large obstructing postintubation granuloma which was treated by in-office KTP laser and en masse excision. We report the successful case of a patient receiving in-office treatment for a large vocal process granuloma using the KTP laser with en masse excision. The combined use of the KTP laser and forceps in-office can be valuable to the surgical management of vocal process granulomas, given their numerous recurrences. New avenues in office-based surgical management of laryngeal disorders can offer accessibility and decreased morbidity to patients. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  6. Hierarchical Diagnosis of Vocal Fold Disorders

    Science.gov (United States)

    Nikkhah-Bahrami, Mansour; Ahmadi-Noubari, Hossein; Seyed Aghazadeh, Babak; Khadivi Heris, Hossein

    This paper explores the use of hierarchical structure for diagnosis of vocal fold disorders. The hierarchical structure is initially used to train different second-level classifiers. At the first level normal and pathological signals have been distinguished. Next, pathological signals have been classified into neurogenic and organic vocal fold disorders. At the final level, vocal fold nodules have been distinguished from polyps in organic disorders category. For feature selection at each level of hierarchy, the reconstructed signal at each wavelet packet decomposition sub-band in 5 levels of decomposition with mother wavelet of (db10) is used to extract the nonlinear features of self-similarity and approximate entropy. Also, wavelet packet coefficients are used to measure energy and Shannon entropy features at different spectral sub-bands. Davies-Bouldin criterion has been employed to find the most discriminant features. Finally, support vector machines have been adopted as classifiers at each level of hierarchy resulting in the diagnosis accuracy of 92%.

  7. A validated battery of vocal emotional expressions

    Directory of Open Access Journals (Sweden)

    Pierre Maurage

    2007-11-01

    Full Text Available For a long time, the exploration of emotions focused on facial expression, and vocal expression of emotion has only recently received interest. However, no validated battery of emotional vocal expressions has been published and made available to the researchers’ community. This paper aims at validating and proposing such material. 20 actors (10 men recorded sounds (words and interjections expressing six basic emotions (anger, disgust, fear, happiness, neutral and sadness. These stimuli were then submitted to a double validation phase: (1 preselection by experts; (2 quantitative and qualitative validation by 70 participants. 195 stimuli were selected for the final battery, each one depicting a precise emotion. The ratings provide a complete measure of intensity and specificity for each stimulus. This paper provides, to our knowledge, the first validated, freely available and highly standardized battery of emotional vocal expressions (words and intonations. This battery could constitute an interesting tool for the exploration of prosody processing among normal and pathological populations, in neuropsychology as well as psychiatry. Further works are nevertheless needed to complement the present material.

  8. Acoustic vocal tract model of one-year-old children

    OpenAIRE

    Vojnović, Milan; Bogavac, Ivana; Dobrijević, Ljiljana

    2014-01-01

    The physical shape of vocal tract and its formant (resonant) frequencies are directly related. The study of this functional connectivity is essential in speech therapy practice with children. Most of the perceived children’s speech anomalies can be explained on a physical level: malfunctioning movement of articulation organs. The current problem is that there is no enough data on the anatomical shape of children’s vocal tract to create its acoustic model. Classical techniques for vocal tract...

  9. Current Understanding and Future Directions for Vocal Fold Mechanobiology

    Science.gov (United States)

    Li, Nicole Y.K.; Heris, Hossein K.; Mongeau, Luc

    2013-01-01

    The vocal folds, which are located in the larynx, are the main organ of voice production for human communication. The vocal folds are under continuous biomechanical stress similar to other mechanically active organs, such as the heart, lungs, tendons and muscles. During speech and singing, the vocal folds oscillate at frequencies ranging from 20 Hz to 3 kHz with amplitudes of a few millimeters. The biomechanical stress associated with accumulated phonation is believed to alter vocal fold cell activity and tissue structure in many ways. Excessive phonatory stress can damage tissue structure and induce a cell-mediated inflammatory response, resulting in a pathological vocal fold lesion. On the other hand, phonatory stress is one major factor in the maturation of the vocal folds into a specialized tri-layer structure. One specific form of vocal fold oscillation, which involves low impact and large amplitude excursion, is prescribed therapeutically for patients with mild vocal fold injuries. Although biomechanical forces affect vocal fold physiology and pathology, there is little understanding of how mechanical forces regulate these processes at the cellular and molecular level. Research into vocal fold mechanobiology has burgeoned over the past several years. Vocal fold bioreactors are being developed in several laboratories to provide a biomimic environment that allows the systematic manipulation of physical and biological factors on the cells of interest in vitro. Computer models have been used to simulate the integrated response of cells and proteins as a function of phonation stress. The purpose of this paper is to review current research on the mechanobiology of the vocal folds as it relates to growth, pathogenesis and treatment as well as to propose specific research directions that will advance our understanding of this subject. PMID:24812638

  10. The voice conveys specific emotions: Evidence from vocal burst displays

    OpenAIRE

    Simon-Thomas, E.; Keltner, D.; Sauter, D.; Sinicropi-Yao, L.; Abramson, A.

    2009-01-01

    Studies of emotion signaling inform claims about the taxonomic structure, evolutionary origins, and physiological correlates of emotions. Emotion vocalization research has tended to focus on a limited set of emotions: anger, disgust, fear, sadness, surprise, happiness, and for the voice, also tenderness. Here, we examine how well brief vocal bursts can communicate 22 different emotions: 9 negative (Study 1) and 13 positive (Study 2), and whether prototypical vocal bursts convey emotions more ...

  11. Acute spinal cord injuries

    International Nuclear Information System (INIS)

    Takahashi, M.; Izunaga, H.; Sato, R.; Shinzato, I.; Korogi, Y.; Yamashita, Y.

    1991-01-01

    This paper reports on sequential MR images and neurologic findings that were correlated in 40 acute spinal cord injuries. Within 1 week after injury, frequent initial MR changes appeared isointense on both T1- and T2-weighted images and isointense on T1- and hyperintense on T2-weighted images. After 2 months, hypointensity appeared on T1-weighted images and hyperintensity persisted or appeared on T2-weighted images. Clinical improvements were observed in patients with isointensity on both T1- and T2-weighted images at the initial examination. A larger area of hyperintensity on subsequent T2-weighted images was correlated with no neurologic improvement. MR findings were good indicators of the spinal cord injury

  12. International Spinal Cord Injury

    DEFF Research Database (Denmark)

    Dvorak, M F; Itshayek, E; Fehlings, M G

    2015-01-01

    STUDY DESIGN: Survey of expert opinion, feedback and final consensus. OBJECTIVE: To describe the development and the variables included in the International Spinal Cord Injury (SCI) Spinal Interventions and Surgical Procedures Basic Data set. SETTING: International working group. METHODS......: A committee of experts was established to select and define data elements. The data set was then disseminated to the appropriate committees and organizations for comments. All suggested revisions were considered and both the International Spinal Cord Society and the American Spinal Injury Association endorsed...... spinal intervention and procedure is coded (variables 1 through 7) and the spinal segment level is described (variables 8 and 9). Sample clinical cases were developed to illustrate how to complete it. CONCLUSION: The International SCI Spinal Interventions and Surgical Procedures Basic Data Set...

  13. Acute exposure to vibration is an apoptosis-inducing stimulus in the vocal fold epithelium.

    Science.gov (United States)

    Novaleski, Carolyn K; Kimball, Emily E; Mizuta, Masanobu; Rousseau, Bernard

    2016-10-01

    Clinical voice disorders pose significant communication-related challenges to patients. The purpose of this study was to quantify the rate of apoptosis and tumor necrosis factor-alpha (TNF-α) signaling in vocal fold epithelial cells in response to increasing time-doses and cycle-doses of vibration. 20 New Zealand white breeder rabbits were randomized to three groups of time-doses of vibration exposure (30, 60, 120min) or a control group (120min of vocal fold adduction and abduction). Estimated cycle-doses of vocal fold vibration were extrapolated based on mean fundamental frequency. Laryngeal tissue specimens were evaluated for apoptosis and gene transcript and protein levels of TNF-α. Results revealed that terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining was significantly higher after 120min of vibration compared to the control. Transmission electron microscopy (TEM) revealed no significant effect of time-dose on the mean area of epithelial cell nuclei. Extrapolated cycle-doses of vibration exposure were closely related to experimental time-dose conditions, although no significant correlations were observed with TUNEL staining or mean area of epithelial cell nuclei. TUNEL staining was positively correlated with TNF-α protein expression. Our findings suggest that apoptosis can be induced in the vocal fold epithelium after 120min of modal intensity phonation. In contrast, shorter durations of vibration exposure do not result in apoptosis signaling. However, morphological features of apoptosis are not observed using TEM. Future studies are necessary to examine the contribution of abnormal apoptosis to vocal fold diseases. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. A retrospective study of long-term treatment outcomes for reduced vocal intensity in hypokinetic dysarthria

    Directory of Open Access Journals (Sweden)

    Christopher R. Watts

    2016-02-01

    Full Text Available Abstract Background Reduced vocal intensity is a core impairment of hypokinetic dysarthria in Parkinson’s disease (PD. Speech treatments have been developed to rehabilitate the vocal subsystems underlying this impairment. Intensive treatment programs requiring high-intensity voice and speech exercises with clinician-guided prompting and feedback have been established as effective for improving vocal function. Less is known, however, regarding long-term outcomes of clinical benefit in speakers with PD who receive these treatments. Methods A retrospective cohort design was utilized. Data from 78 patient files across a three year period were analyzed. All patients received a structured, intensive program of voice therapy focusing on speaking intent and loudness. The dependent variable for all analyses was vocal intensity in decibels (dBSPL. Vocal intensity during sustained vowel production, reading, and novel conversational speech was compared at pre-treatment, post-treatment, six month follow-up, and twelve month follow-up periods. Results Statistically significant increases in vocal intensity were found at post-treatment, 6 months, and 12 month follow-up periods with intensity gains ranging from 5 to 17 dB depending on speaking condition and measurement period. Significant treatment effects were found in all three speaking conditions. Effect sizes for all outcome measures were large, suggesting a strong degree of practical significance. Conclusions Significant increases in vocal intensity measured at 6 and 12 moth follow-up periods suggested that the sample of patients maintained treatment benefit for up to a year. These findings are supported by outcome studies reporting treatment outcomes within a few months post-treatment, in addition to prior studies that have reported long-term outcome results. The positive treatment outcomes experienced by the PD cohort in this study are consistent with treatment responses subsequent to other treatment

  15. Defects in ultrasonic vocalization of cadherin-6 knockout mice.

    Directory of Open Access Journals (Sweden)

    Ryoko Nakagawa

    Full Text Available BACKGROUND: Although some molecules have been identified as responsible for human language disorders, there is still little information about what molecular mechanisms establish the faculty of human language. Since mice, like songbirds, produce complex ultrasonic vocalizations for intraspecific communication in several social contexts, they can be good mammalian models for studying the molecular basis of human language. Having found that cadherins are involved in the vocal development of the Bengalese finch, a songbird, we expected cadherins to also be involved in mouse vocalizations. METHODOLOGY/PRINCIPAL FINDINGS: To examine whether similar molecular mechanisms underlie the vocalizations of songbirds and mammals, we categorized behavioral deficits including vocalization in cadherin-6 knockout mice. Comparing the ultrasonic vocalizations of cadherin-6 knockout mice with those of wild-type controls, we found that the peak frequency and variations of syllables were differed between the mutant and wild-type mice in both pup-isolation and adult-courtship contexts. Vocalizations during male-male aggression behavior, in contrast, did not differ between mutant and wild-type mice. Open-field tests revealed differences in locomotors activity in both heterozygote and homozygote animals and no difference in anxiety behavior. CONCLUSIONS/SIGNIFICANCE: Our results suggest that cadherin-6 plays essential roles in locomotor activity and ultrasonic vocalization. These findings also support the idea that different species share some of the molecular mechanisms underlying vocal behavior.

  16. Sex Hormone Receptor Expression in the Human Vocal Fold Subunits.

    Science.gov (United States)

    Kirgezen, Tolga; Sunter, Ahmet Volkan; Yigit, Ozgur; Huq, Gulben Erdem

    2017-07-01

    The study aimed to evaluate the existence of sex hormone receptors in the subunits of vocal fold. This is a cadaver study. The androgen, estrogen, and progesterone receptors were examined in the epithelium (EP), superficial layer of the lamina propria (SLP), vocal ligament (VL), and macula flava (MF) of the vocal folds from 42 human cadavers (21 male, 21 female) by immunohistochemical methods. Their staining ratios were scored and statistically compared. The androgen receptor score was significantly higher for the MF than for the EP and SLP (P vocal fold, mostly in the MF and VLs. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  17. The influence of thyroarytenoid and cricothyroid muscle activation on vocal fold stiffness and eigenfrequencies

    OpenAIRE

    Yin, Jun; Zhang, Zhaoyan

    2013-01-01

    The influence of the thyroarytenoid (TA) and cricothyroid (CT) muscle activation on vocal fold stiffness and eigenfrequencies was investigated in a muscularly controlled continuum model of the vocal folds. Unlike the general understanding that vocal fold fundamental frequency was determined by vocal fold tension, this study showed that vocal fold eigenfrequencies were primarily determined by vocal fold stiffness. This study further showed that, with reference to the resting state of zero stra...

  18. [Allogenic hematopoietic stem cell transplantation with unrelated cord blood: report of three cases from the Chilean cord blood bank].

    Science.gov (United States)

    Barriga, Francisco; Wietstruck, Angélica; Rojas, Nicolás; Bertin, Pablo; Pizarro, Isabel; Carmona, Amanda; Guilof, Alejandro; Rojas, Iván; Oyarzún, Enrique

    2013-08-01

    Public cord blood banks are a source of hematopoietic stem cells for patients with hematological diseases who lack a family donor and need allogeneic transplantation. In June 2007 we started a cord blood bank with units donated in three maternity wards in Santiago, Chile. We report the first three transplants done with cord blood units form this bank. Cord blood units were obtained by intrauterine collection at delivery. They were depleted of plasma and red cells and frozen in liquid nitrogen. Tests for total nucleated cells, CD34 cell content, viral serology, bacterial cultures and HLA A, B and DRB1 were done. Six hundred cord blood units were stored by March 2012. Three patients received allogeneic transplant with cord blood from our bank, two with high risk lymphoblastic leukemia and one with severe congenital anemia. They received conditioning regimens according to their disease and usual supportive care for unrelated donor transplantation until full hematopoietic and immune reconstitution was achieved. The three patients had early engraftment of neutrophils and platelets. The child corrected his anemia and the leukemia patients remain in complete remission. The post-transplant course was complicated with Epstein Barr virus, cytomegalovirus and BK virus infection. Two patients are fully functional 24 and 33 months after transplant, the third is still receiving immunosuppression.

  19. Behcet's Disease

    Science.gov (United States)

    ... organs and affect the central nervous system, causing memory loss and impaired speech, balance, and movement. The effects of the disease may include blindness, stroke, swelling of the spinal cord, and intestinal ...

  20. The influence of thyroarytenoid and cricothyroid muscle activation on vocal fold stiffness and eigenfrequencies

    Science.gov (United States)

    Yin, Jun; Zhang, Zhaoyan

    2013-01-01

    The influence of the thyroarytenoid (TA) and cricothyroid (CT) muscle activation on vocal fold stiffness and eigenfrequencies was investigated in a muscularly controlled continuum model of the vocal folds. Unlike the general understanding that vocal fold fundamental frequency was determined by vocal fold tension, this study showed that vocal fold eigenfrequencies were primarily determined by vocal fold stiffness. This study further showed that, with reference to the resting state of zero strain, vocal fold stiffness in both body and cover layers increased with either vocal fold elongation or shortening. As a result, whether vocal fold eigenfrequencies increased or decreased with CT/TA activation depended on how the CT/TA interaction influenced vocal fold deformation. For conditions of strong CT activation and thus an elongated vocal fold, increasing TA contraction reduced the degree of vocal fold elongation and thus reduced vocal fold eigenfrequencies. For conditions of no CT activation and thus a resting or slightly shortened vocal fold, increasing TA contraction increased the degree of vocal fold shortening and thus increased vocal fold eigenfrequencies. In the transition region of a slightly elongated vocal fold, increasing TA contraction first decreased and then increased vocal fold eigenfrequencies. PMID:23654401

  1. Gender Differences in the Reporting of Vocal Fatigue in Teachers as Quantified by the Vocal Fatigue Index.

    Science.gov (United States)

    Hunter, Eric J; Banks, Russell E

    2017-12-01

    Occupational voice users report higher instances of vocal health problems. Women, who are more likely than men to report voice problems, are the largest members of some occupational voice users, such as teachers. While a common complaint among this population is vocal fatigue, it has been difficult to quantify. Therefore, the goal of this study is to quantify vocal fatigue generally in school teachers and investigate any related gender differences. Six hundred forty (518 female, 122 male) teachers were surveyed using an online questionnaire consisting in part of the Vocal Fatigue Index (VFI), an index specifically designed to quantify vocal fatigue. Compared to vocally healthy adults, the teachers surveyed were 3 times as likely to report vocal tiredness or vocal avoidance and over 3 times as likely to report physical voice discomfort. Additionally, female teachers were more likely to have scores approaching those with dysphonia. The VFI quantified elevated levels of vocal fatigue in teachers, with a significant prevalence of symptoms reported among females compared to males. Further, because the VFI indicated elevated complaints (between normal and dysphonic) in a population likely to be elevated, the VFI might be used to identify early indications of voice problems and/or track recovery.

  2. Hyperbaric oxygen therapy of spinal cord injury

    Directory of Open Access Journals (Sweden)

    Nitesh P Patel

    2017-01-01

    Full Text Available Spinal cord injury (SCI is a complex disease process that involves both primary and secondary mechanisms of injury and can leave patients with devastating functional impairment as well as psychological debilitation. While no curative treatment is available for spinal cord injury, current therapeutic approaches focus on reducing the secondary injury that follows SCI. Hyperbaric oxygen (HBO therapy has shown promising neuroprotective effects in several experimental studies, but the limited number of clinical reports have shown mixed findings. This review will provide an overview of the potential mechanisms by which HBO therapy may exert neuroprotection, provide a summary of the clinical application of HBO therapy in patients with SCI, and discuss avenues for future studies.

  3. Postmortem diffusion MRI of the entire human spinal cord at microscopic resolution

    Directory of Open Access Journals (Sweden)

    Evan Calabrese

    Full Text Available The human spinal cord is a central nervous system structure that plays an important role in normal motor and sensory function, and can be affected by many debilitating neurologic diseases. Due to its clinical importance, the spinal cord is frequently the subject of imaging research. Common methods for visualizing spinal cord anatomy and pathology include histology and magnetic resonance imaging (MRI, both of which have unique benefits and drawbacks. Postmortem microscopic resolution MRI of fixed specimens, sometimes referred to as magnetic resonance microscopy (MRM, combines many of the benefits inherent to both techniques. However, the elongated shape of the human spinal cord, along with hardware and scan time limitations, have restricted previous microscopic resolution MRI studies (both in vivo and ex vivo to small sections of the cord. Here we present the first MRM dataset of the entire postmortem human spinal cord. These data include 50 μm isotropic resolution anatomic image data and 100 μm isotropic resolution diffusion data, made possible by a 280 h long multi-segment acquisition and automated image segment composition. We demonstrate the use of these data for spinal cord lesion detection, automated volumetric gray matter segmentation, and quantitative spinal cord morphometry including estimates of cross sectional dimensions and gray matter fraction throughout the length of the cord. Keywords: Spinal cord, Magnetic resonance microscopy, Tractography, Human, Gray matter

  4. Incidence of vocal fold immobility in patients with dysphagia.

    Science.gov (United States)

    Leder, Steven B; Ross, Douglas A

    2005-01-01

    This study prospectively investigated the incidence of vocal fold immobility, unilateral and bilateral, and its influence on aspiration status in a referred population of 1452 patients for a dysphagia evaluation from a large, urban, tertiary-care, teaching hospital. Main outcome measures included overall incidence of vocal fold immobility and aspiration status, with specific emphasis on age, etiology, and side of vocal fold immobility, i.e., right, left, or bilateral. Overall incidence of vocal fold immobility was 5.6% (81 of 1452 patients), including 47 males (mean age 55.7 yr) and 34 females (mean age 59.7 yr). In the subgroup of patients with vocal fold immobility, 31% (25 of 81) exhibited unilateral right, 60% (49 of 81) unilateral left, and 9% (7 of 81) bilateral impairment. Overall incidence of aspiration was found to be 29% (426 of 1452) of all patients referred for a swallow evaluation. Aspiration was observed in 44% (36 of 81) of patients presenting with vocal fold immobility, i.e., 44% (11 of 25) unilateral right, 43% (21 of 49) unilateral left, and 57% (4 of 7) bilateral vocal fold immobility. Left vocal fold immobility occurred most frequently due to surgical trauma. A liquid bolus was aspirated more often than a puree bolus. Side of vocal fold immobility and age were not factors that increased incidence of aspiration. In conclusion, vocal fold immobility, with an incidence of 5.6%, is not an uncommon finding in patients referred for a dysphagia evaluation in the acute-care setting, and vocal fold immobility, when present, was associated with a 15% increased incidence of aspiration when compared with a population already being evaluated for dysphagia.

  5. In vivo measurement of vocal fold surface resistance.

    Science.gov (United States)

    Mizuta, Masanobu; Kurita, Takashi; Dillon, Neal P; Kimball, Emily E; Garrett, C Gaelyn; Sivasankar, M Preeti; Webster, Robert J; Rousseau, Bernard

    2017-10-01

    A custom-designed probe was developed to measure vocal fold surface resistance in vivo. The purpose of this study was to demonstrate proof of concept of using vocal fold surface resistance as a proxy of functional tissue integrity after acute phonotrauma using an animal model. Prospective animal study. New Zealand White breeder rabbits received 120 minutes of airflow without vocal fold approximation (control) or 120 minutes of raised intensity phonation (experimental). The probe was inserted via laryngoscope and placed on the left vocal fold under endoscopic visualization. Vocal fold surface resistance of the middle one-third of the vocal fold was measured after 0 (baseline), 60, and 120 minutes of phonation. After the phonation procedure, the larynx was harvested and prepared for transmission electron microscopy. In the control group, vocal fold surface resistance values remained stable across time points. In the experimental group, surface resistance (X% ± Y% relative to baseline) was significantly decreased after 120 minutes of raised intensity phonation. This was associated with structural changes using transmission electron microscopy, which revealed damage to the vocal fold epithelium after phonotrauma, including disruption of the epithelium and basement membrane, dilated paracellular spaces, and alterations to epithelial microprojections. In contrast, control vocal fold specimens showed well-preserved stratified squamous epithelia. These data demonstrate the feasibility of measuring vocal fold surface resistance in vivo as a means of evaluating functional vocal fold epithelial barrier integrity. Device prototypes are in development for additional testing, validation, and for clinical applications in laryngology. NA Laryngoscope, 127:E364-E370, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  6. Umbilical cord blood for unrelated bone marrow replacement; Asia bank and Japan cord blood bank network update.

    Science.gov (United States)

    Mugishima, Hideo; Takahashi, Tuneo; Nagamura, Tokiko; Asano, Sigetaka; Saito, Hidehiko

    2002-08-01

    Cord blood offers many advantages including a high concentration of hematopoietic stem cells, a large number of potential donors, and ease of harvest. Furthermore, since there is no risk for either the mother or baby, few people refuse to donate. There is thought to be a low risk for virus contamination and also probably a low incidence and severity of GVHD. Cord blood can be obtained quickly without the assistance of a coordinator and one or 2 locus-mismatched HLA is usually acceptable. In Japan, there are 10 cord blood banks supported by the government. Between 1996 and June 2002, 9,500 units were registered with the Japan cord blood bank network (JCBBN). 630 units were delivered and most of these were transplanted. The status of registered cord blood units worldwide is shown. 59,081 units have been registered by NETCORD. The Japan cord blood bank network accounts for 13% of these units. I will discuss the Tokyo cord blood tank (TCBB). The bank at Tokyo, to which we belong, is one of the largest banks in Japan. We helped to establish Asia CORD in 2000 and have held annual conferences and meetings in Tokyo to exchange information. So far, China, Korea, Taiwan, Thailand, Viet Nam and Japan have participated. We accepted three trainees from the Ho Chi Minh City Blood Transfusion and Hematology Center for training in cord blood transplantation in May 2001. In January 2002, a patient with ALL received cord blood and was successfully engrafted at Ho Chi Minh City Blood Transfusion and Hematology Center. We present here the clinical outcome of these patients through Tokyo cord blood bank and Japan cord blood bank network. First, the number of CB units stored and registered at JCBBN and TCBB has increased rapidly over the past two years. Second, the survival rate of acute leukemia patients in release was significantly lower than that in patients in CR. Third, the engraftment rate in patients with metabolic disease (50%) was lower than that in patients with leukemia

  7. Diagnosis and surgical treatment of terminal syringomyelia within spinal cord combined with tethered cord syndrome

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    Jing-cheng XIE

    2016-04-01

    Full Text Available Objective To summarize the clinical manifestations, imaging characteristics and experience of surgical treatment of spinal cord terminal syringomyelia with tethered cord syndrome (TCS.  Methods and Results Clinical data of 10 patients with spinal cord syringomyelia combined with TCS surgically treated under microscope from January 1999 to March 2014 in our hospital were retrospectively analyzed. There were 3 males and 7 females with average age of 15.06 years old (ranged from 2 to 35 years old. The course of disease ranged from 3 months to 20 years (average 42.17 months. Among those patients, one patient presented hydromyelia, 8 patients suffered from meningeal cyst within the sacral canal, and one patient were concurrent with sacral dermal sinus. The weakness of lower extremities, especially distal limbs, was the main clinical manifestation. Five patients were accompanied with bowel and bladder dysfunction and 5 patients with sensory disturbance below the level of syringomyelia, especially hypesthesia. Preoperative MRI showed conus medullaris disappeared at the end of spinal cord, and there was fluid signal in the lower spinal cord with hypo-intensity signal in T1WI and hyper-intensity signal in T2WI without enhancement. All patients underwent surgical procedures. Under microscope, filum terminale was cut off, drainage was performed, meningeal cyst within the sacral canal was removed, and tethered cord was released. The success rate of operations was 100%. The duration of surgery ranged from 1.52 to 3.07 h (average 2.15 h, with average intraoperative blood loss 220 ml (ranged from 100 to 410 ml. The tethering filum had been totally resected and histological examination showed typical filum tissue in all cases. No operative complication was found. Visual Analogue Scale (VAS score was decreased, and the lower limbs weakness as well as bowel and bladder dysfunction was gradually relieved after operation. The period of follow-up was ranged from 6

  8. Is early cord clamping, delayed cord clamping or cord milking best?

    Science.gov (United States)

    Vatansever, Binay; Demirel, Gamze; Ciler Eren, Elif; Erel, Ozcan; Neselioglu, Salim; Karavar, Hande Nur; Gundogdu, Semra; Ulfer, Gozde; Bahadir, Selcen; Tastekin, Ayhan

    2018-04-01

    To compare the antioxidant status of three cord clamping procedures (early clamping, delayed clamping and milking) by analyzing the thiol-disulfide balance. This randomized controlled study enrolled 189 term infants who were divided into three groups according to the cord clamping procedure: early clamping, delayed clamping and milking. Blood samples were collected from the umbilical arteries immediately after clamping, and the thiol/disulfide homeostasis was analyzed. The native and total thiol levels were significantly (p total thiol ratio was significantly (p = .026) lower in the delayed cord clamping and milking groups compared with the early clamping groups. Early cord clamping causes the production of more disulfide bonds and lower thiol levels, indicating that oxidation reactions are increased in the early cord clamping procedure compared with the delayed cord clamping and milking procedures. The oxidant capacity is greater with early cord clamping than with delayed clamping or cord milking. Delayed cord clamping or milking are beneficial in neonatal care, and we suggest that they be performed routinely in all deliveries.

  9. Low frequency mechanical resonance of the vocal tract in vocal exercises that apply tubes

    Czech Academy of Sciences Publication Activity Database

    Horáček, Jaromír; Radolf, Vojtěch; Laukkanen, A. M.

    2017-01-01

    Roč. 37, August (2017), s. 39-49 ISSN 1746-8094 R&D Projects: GA ČR(CZ) GA16-01246S Institutional support: RVO:61388998 Keywords : biomechanics of voice * vocal tract acoustics * phonation into tubes * water resistance voice therapy * bubbling frequency * formant frequencies Subject RIV: BI - Acoustics OBOR OECD: Acoustics Impact factor: 2.214, year: 2016

  10. Precise auditory-vocal mirroring in neurons for learned vocal communication.

    Science.gov (United States)

    Prather, J F; Peters, S; Nowicki, S; Mooney, R

    2008-01-17

    Brain mechanisms for communication must establish a correspondence between sensory and motor codes used to represent the signal. One idea is that this correspondence is established at the level of single neurons that are active when the individual performs a particular gesture or observes a similar gesture performed by another individual. Although neurons that display a precise auditory-vocal correspondence could facilitate vocal communication, they have yet to be identified. Here we report that a certain class of neurons in the swamp sparrow forebrain displays a precise auditory-vocal correspondence. We show that these neurons respond in a temporally precise fashion to auditory presentation of certain note sequences in this songbird's repertoire and to similar note sequences in other birds' songs. These neurons display nearly identical patterns of activity when the bird sings the same sequence, and disrupting auditory feedback does not alter this singing-related activity, indicating it is motor in nature. Furthermore, these neurons innervate striatal structures important for song learning, raising the possibility that singing-related activity in these cells is compared to auditory feedback to guide vocal learning.

  11. Modeling the Pathophysiology of Phonotraumatic Vocal Hyperfunction with a Triangular Glottal Model of the Vocal Folds

    Science.gov (United States)

    Galindo, Gabriel E.; Peterson, Sean D.; Erath, Byron D.; Castro, Christian; Hillman, Robert E.; Zañartu, Matías

    2017-01-01

    Purpose: Our goal was to test prevailing assumptions about the underlying biomechanical and aeroacoustic mechanisms associated with phonotraumatic lesions of the vocal folds using a numerical lumped-element model of voice production. Method: A numerical model with a triangular glottis, posterior glottal opening, and arytenoid posturing is…

  12. Characteristics of Vocal Fold Vibrations in Vocally Healthy Subjects: Analysis with Multi-Line Kymography

    Science.gov (United States)

    Yamauchi, Akihito; Imagawa, Hiroshi; Sakakibara, Ken-Ichi; Yokonishi, Hisayuki; Nito, Takaharu; Yamasoba, Tatsuya; Tayama, Niro

    2014-01-01

    Purpose: In this study, the authors aimed to analyze longitudinal data from high-speed digital images in normative subjects using multi-line kymography. Method: Vocally healthy subjects were divided into young (9 men and 17 women; M[subscript age] = 27 years) and older groups (8 men and 12 women; M[subscript age] = 73 years). From high-speed…

  13. Chitotriosidase (CHIT1) is increased in microglia and macrophages in spinal cord of amyotrophic lateral sclerosis and cerebrospinal fluid levels correlate with disease severity and progression.

    Science.gov (United States)

    Steinacker, Petra; Verde, Federico; Fang, Lubin; Feneberg, Emily; Oeckl, Patrick; Roeber, Sigrun; Anderl-Straub, Sarah; Danek, Adrian; Diehl-Schmid, Janine; Fassbender, Klaus; Fliessbach, Klaus; Foerstl, Hans; Giese, Armin; Jahn, Holger; Kassubek, Jan; Kornhuber, Johannes; Landwehrmeyer, G Bernhard; Lauer, Martin; Pinkhardt, Elmar Hans; Prudlo, Johannes; Rosenbohm, Angela; Schneider, Anja; Schroeter, Matthias L; Tumani, Hayrettin; von Arnim, Christine A F; Weishaupt, Jochen; Weydt, Patrick; Ludolph, Albert C; Yilmazer Hanke, Deniz; Otto, Markus

    2018-03-01

    Neurochemical markers of amyotrophic lateral sclerosis (ALS) that reflect underlying disease mechanisms might help in diagnosis, staging and prediction of outcome. We aimed at determining the origin and differential diagnostic and prognostic potential of the putative marker of microglial activation chitotriosidase (CHIT1). Altogether 316 patients were included, comprising patients with sporadic ALS, ALS mimics (disease controls (DCo)), frontotemporal lobar degeneration (FTLD), Creutzfeldt-Jakob disease (CJD), Alzheimer's disease (AD), Parkinson's disease (PD) and healthy controls (Con). CHIT1 and neurofilament levels were determined in cerebrospinal fluid (CSF) and blood and analysed with regard to diagnostic sensitivity and specificity and prognostic performance. Additionally, postmortem tissue was analysed for CHIT1 expression. In ALS, CHIT1 CSF levels were higher compared with Con (pdifferential diagnosis and prediction of disease progression in ALS and, therefore, seems suitable as a supplemental marker for patient stratification in therapeutic trials. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Prevalence and correlates of auditory vocal hallucinations in middle childhood

    NARCIS (Netherlands)

    Bartels-Velthuis, A.A.; Jenner, J.A.; van de Willige, G.; van Os, J.; Wiersma, D.

    Background Hearing voices occurs in middle childhood, but little is known about prevalence, aetiology and immediate consequences. Aims To investigate prevalence, developmental risk factors and behavioural correlates of auditory vocal hallucinations in 7- and 8-year-olds. Method Auditory vocal

  15. The Effect of Vocalization on Melodic Memory Conservation.

    Science.gov (United States)

    Pembrook, Randall G.

    1987-01-01

    Reports on a study which reinforces prior findings on melodic memory that show a majority of students do not sing accurately enough after only one hearing of a melody to benefit from vocalization memory techniques. Questions whether vocalization can be a memory reinforcer in melodies that are shorter and simpler than those used in this research.…

  16. The Infant Monitor of Vocal Production: Simple Beginnings

    Science.gov (United States)

    Moore, Robyn Cantle

    2014-01-01

    The Infant Monitor of vocal Production (IMP) was conceived as an educational strategy to help parents understand the nature and pace of their baby's vocal development following neonatal diagnosis and amplification for hearing loss. The potential for other clinical applications emerged with use. The instrument presents as a series of…

  17. Assessing vocal performance in complex birdsong: a novel approach.

    Science.gov (United States)

    Geberzahn, Nicole; Aubin, Thierry

    2014-08-06

    Vocal performance refers to the ability to produce vocal signals close to physical limits. Such motor skills can be used by conspecifics to assess a signaller's competitive potential. For example it is difficult for birds to produce repeated syllables both rapidly and with a broad frequency bandwidth. Deviation from an upper-bound regression of frequency bandwidth on trill rate has been widely used to assess vocal performance. This approach is, however, only applicable to simple trilled songs, and even then may be affected by differences in syllable complexity. Using skylarks (Alauda arvensis) as a birdsong model with a very complex song structure, we detected another performance trade-off: minimum gap duration between syllables was longer when the frequency ratio between the end of one syllable and the start of the next syllable (inter-syllable frequency shift) was large. This allowed us to apply a novel measure of vocal performance ¿ vocal gap deviation: the deviation from a lower-bound regression of gap duration on inter-syllable frequency shift. We show that skylarks increase vocal performance in an aggressive context suggesting that this trait might serve as a signal for competitive potential. We suggest using vocal gap deviation in future studies to assess vocal performance in songbird species with complex structure.

  18. The vocal load of Reform Jewish cantors in the USA.

    Science.gov (United States)

    Hapner, Edie; Gilman, Marina

    2012-03-01

    Jewish cantors comprise a subset of vocal professionals that is not well understood by vocal health professionals. This study aimed to document the vocal demands, vocal training, reported incidence of voice problems, and treatment-seeking behavior of Reform Jewish cantors. The study used a prospective observational design to anonymously query Reform Jewish cantors using a 35-item multiple-choice survey distributed online. Demographic information, medical history, vocal music training, cantorial duties, history of voice problems, and treatment-seeking behavior were addressed. Results indicated that many of the commonly associated risk factors for developing voice disorders were present in this population, including high vocal demands, reduced vocal downtime, allergies, and acid reflux. Greater than 65% of the respondents reported having had a voice problem that interfered with their ability to perform their duties at some time during their careers. Reform Jewish cantors are a population of occupational voice users who may be currently unidentified and underserved by vocal health professionals. The results of the survey suggest that Reform Jewish cantors are occupational voice users and are at high risk for developing voice disorders. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  19. The Relations of Mothers' Controlling Vocalizations to Children's Intrinsic Motivation.

    Science.gov (United States)

    Deci, Edward L.; And Others

    1993-01-01

    Coded maternal vocalizations during videotaped play sessions of mothers and their six- or seven-year-old children. Children's intrinsic motivation was assessed by observing children's play when they were alone in a room. Found a negative relationship between maternal controlling vocalizations and children's intrinsic motivation. (MM)

  20. The effect of surface electrical stimulation on vocal fold position.

    Science.gov (United States)

    Humbert, Ianessa A; Poletto, Christopher J; Saxon, Keith G; Kearney, Pamela R; Ludlow, Christy L

    2008-01-01

    Closure of the true and false vocal folds is a normal part of airway protection during swallowing. Individuals with reduced or delayed true vocal fold closure can be at risk for aspiration and may benefit from intervention to ameliorate the problem. Surface electrical stimulation is currently used during therapy for dysphagia, despite limited knowledge of its physiological effects. Prospective single effects study. The immediate physiological effect of surface stimulation on true vocal fold angle was examined at rest in 27 healthy adults using 10 different electrode placements on the submental and neck regions. Fiberoptic nasolaryngoscopic recordings during passive inspiration were used to measure change in true vocal fold angle with stimulation. Vocal fold angles changed only to a small extent during two electrode placements (P vocal fold abduction was 2.4 degrees; while horizontal placements of electrodes in the submental region produced a mean adduction of 2.8 degrees (P = .03). Surface electrical stimulation to the submental and neck regions does not produce immediate true vocal fold adduction adequate for airway protection during swallowing, and one position may produce a slight increase in true vocal fold opening.