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Sample records for vocal fold polyp

  1. Quantitative microlaryngoscopic measurements of vocal fold polyps, glottal gap and their relation to vocal function.

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    Uloza, Virgilijus; Kaseta, Marius; Pribuisiene, Rūta; Saferis, Viktoras; Jokūzis, Vytautas; Gelzinis, Adas; Bacauskiene, Marija

    2008-01-01

    The purpose of this study was to quantify the size of vocal fold polyps and to investigate the relationship between the glottal gap and parameters of acoustic voice analysis and phonetography. Eighty-one microlaryngoscopic images and digital recordings of voices (acoustic analysis and phonetogram) acquired from the patients with vocal fold polyps (VFPs) were employed in this study. Vocal fold (VF) images were collected during routine direct microlaryngoscopy using Moller-Wedel Universa 300 surgical microscope, 3-CCD Elmo 768 x 576-pixel color video camera and a 300 W Xenon light source. Acoustic voice analysis and phonetography were established using Dr. Speech (Tiger Electronics Inc.) software. Microlaryngoscopic images were processed by original software created by ELINTA and displayed on a monitor. The relative lengths and widths of vocal fold polyps as well as percentage area of VFP were calculated. The Pearson's correlation was applied to reveal the correlation between VFP dimensions and acoustic voice parameters. There were no statistically significant differences between the dimensions of left and right vocal folds and VFPs. Statistically significant slight to mild correlations between measured dimensions of VFP acoustic and phonetogram parameters were revealed, with HNR and phonetogram area showing the strongest correlation to the size of VFPs. The results of our study confirm that quantitative microlaryngoscopic measurements of vocal fold polyp and glottal gap dimensions may be a useful tool for objective assessment of glottic incompetence and voice impairment.

  2. The Value of Vocal Extent Measure (VEM) Assessing Phonomicrosurgical Outcomes in Vocal Fold Polyps.

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    Salmen, Tatjana; Ermakova, Tatiana; Möller, Andreas; Seipelt, Matthias; Weikert, Sebastian; Rummich, Julius; Gross, Manfred; Nawka, Tadeus; Caffier, Philipp P

    2017-01-01

    This study aimed to present vocal extent measure (VEM), demonstrate its changes with phonomicrosurgical treatment in patients with vocal fold polyps (VFPs), and to compare its performance to that of established vocal parameters. This is an individual cohort study. Microlaryngoscopic ablation was executed in 61 patients with manifestation of VFP (28 male, 33 female; 45 ± 13 years [mean ± SD]). Analysis of treatment outcome was based on pre- and postoperative voice function diagnostics and videolaryngostroboscopy. Examination instruments were: auditory-perceptual voice assessment (roughness, breathiness, and overall hoarseness [RBH]-status), voice range profile (VRP), acoustic-aerodynamic analysis, and patients' self-assessment of voice using the voice handicap index. The VEM, a parameter not yet commonly established in phoniatric diagnostics, was calculated from area and shape of the VRP to be compared with the dysphonia severity index (DSI) concerning diagnostic suitability. All polyps were completely excised. Three months postoperatively, mucosal wave propagation had recovered. All subjective and most objective acoustic and aerodynamic parameters showed highly significant improvement. The VHI-9i-score decreased from 15 ± 8 to 6 ± 7 points. The average total vocal range extended by 4 ± 5 semitones, the mean speaking pitch decreased by 1 ± 2 semitones. The DSI increased on average from 2.6 ± 2.1 to 4.0 ± 2.2, VEM from 83 ± 28 to 107 ± 21 (P VRP evaluation. This positive measure of vocal function seems to be a compelling diagnostic addition for objective quantification of vocal performance. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  3. Three-Dimensional Flow Separation Induced by a Model Vocal Fold Polyp

    Science.gov (United States)

    Stewart, Kelley C.; Erath, Byron D.; Plesniak, Michael W.

    2012-11-01

    The fluid-structure energy exchange process for normal speech has been studied extensively, but it is not well understood for pathological conditions. Polyps and nodules, which are geometric abnormalities that form on the medial surface of the vocal folds, can disrupt vocal fold dynamics and thus can have devastating consequences on a patient's ability to communicate. A recent in-vitro investigation of a model polyp in a driven vocal fold apparatus demonstrated that such a geometric abnormality considerably disrupts the glottal jet behavior and that this flow field adjustment was a likely reason for the severe degradation of the vocal quality in patients. Understanding of the formation and propagation of vortical structures from a geometric protuberance, and their subsequent impact on the aerodynamic loadings that drive vocal fold dynamic, is a critical component in advancing the treatment of this pathological condition. The present investigation concerns the three-dimensional flow separation induced by a wall-mounted prolate hemispheroid with a 2:1 aspect ratio in cross flow, i.e. a model vocal fold polyp. Unsteady three-dimensional flow separation and its impact of the wall pressure loading are examined using skin friction line visualization and wall pressure measurements. Supported by the National Science Foundation, Grant No. CBET-1236351 and GW Center for Biomimetics and Bioinspired Engineering (COBRE).

  4. Comparison of CO2 laser and conventional laryngomicrosurgery treatments of polyp and leukoplakia of the vocal fold

    Science.gov (United States)

    Zhang, Ya; Liang, Gengtian; Sun, Na; Guan, Linlin; Meng, Yang; Zhao, Xiaoyan; Liu, Li; Sun, Guangbin

    2015-01-01

    The efficacies of CO2 laser and conventional laryngeal microsurgery for vocal cord benign (vocal cord polyp) and precancerous (vocal cord leukoplakia) lesions were compared. Patients with bilateral vocal cord polyps (n = 60) and leukoplakia (n = 30) were divided randomly into two groups. One group was treated with throat microsurgical instruments and underwent routine lesion resection (conventional group) and the other with CO2 laser (laser group). For the subjective assessment, the tools GRABS and VHI were used. The objective assessment, A multi-dimensional voice program module for voice spectrum analysis was used. The laser group was slightly worse than the conventional group 1 week post-surgery by stroboscopic findings. The subjective and objective data of the two groups pre-and post-surgery showed that the voice recovery of the laser group was significantly better than that of the conventional group (P < 0.05). CO2 laser laryngeal microsurgery for vocal cord polyp and leukoplakia can improve significantly the vocal cord morphology and pronunciation quality. The procedure is especially more effective than conventional surgery in patients with vocal cord leukoplakia. PMID:26770428

  5. 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...... of the vocal fold collision is proposed, which incorporates different procedures used in contact mechanics and mathematical optimization theories. The penalty approach and the Lagrange multiplier method are investigated. The contact force solution obtained by the penalty formulation is highly dependent...

  6. [The effect of smoking and forced use of the voice to development of the vocal polyps].

    Science.gov (United States)

    Gnjatic, M; Stankovic, P; Djukić, V

    2009-01-01

    Dysphonia is often caused by polyps which are benign changes of pseudotumors. With their presence they are hampering with glotis oclusion. Laryngomicroscopy of general and endotracheal anaesthesia has been preformed on all of the patients. Microsurgical technique has been used to remove the polyps. Bioptic material was analyzed in pathophysiological laboratory of clinic of pathology in Banjaluka. All of the results were presented through tables and graphic representations. Frequency of polyps through age and sex groups, along with the examination of ethyological factors in emergence of polyps of vocal cords. Results are in accordance with the results of other authors who were involved in similar problematics. Through analysis of our data we percieve that the abuse of voice is part of ethiological factors that lead not only to emergence of vocal fold lesions but aswell as other benign changes.

  7. Vocal Fold Pathologies and Three-Dimensional Flow Separation Phenomena

    Science.gov (United States)

    Apostoli, Adam G.; Weiland, Kelley S.; Plesniak, Michael W.

    2013-11-01

    Polyps and nodules are two different pathologies, which are geometric abnormalities that form on the medial surface of the vocal folds, and have been shown to significantly disrupt a person's ability to communicate. Although the mechanism by which the vocal folds self-oscillate and the three-dimensional nature of the glottal jet has been studied, the effect of irregularities caused by pathologies is not fully understood. Examining the formation and evolution of vortical structures created by a geometric protuberance is important, not only for understanding the aerodynamic forces exerted by these structures on the vocal folds, but also in the treatment of the above-mentioned pathological conditions. Using a wall-mounted prolate hemispheroid with a 2:1 aspect ratio in cross flow, the present investigation considers three-dimensional flow separation induced by a model vocal fold polyp. Building on previous work using skin friction line visualization, both the velocity flow field and wall pressure measurements around the model polyp are presented and compared. Supported by the National Science Foundation, Grant No. CBET-1236351 and GW Center for Biomimetics and Bioinspired Engineering (COBRE).

  8. A nomenclature paradigm for benign midmembranous vocal fold lesions.

    Science.gov (United States)

    Rosen, Clark A; Gartner-Schmidt, Jackie; Hathaway, Bridget; Simpson, C Blake; Postma, Gregory N; Courey, Mark; Sataloff, Robert T

    2012-06-01

    There is a significant lack of uniform agreement regarding nomenclature for benign vocal fold lesions (BVFLs). This confusion results in difficulty for clinicians communicating with their patients and with each other. In addition, BVFL research and comparison of treatment methods are hampered by the lack of a detailed and uniform BVFL nomenclature. Clinical consensus conferences were held to develop an initial BVFL nomenclature paradigm. Perceptual video analysis was performed to validate the stroboscopy component of the paradigm. The culmination of the consensus conferences and the video-perceptual analysis was used to evaluate the BVFL nomenclature paradigm using a retrospective review of patients with BVFL. An initial BVFL nomenclature paradigm was proposed utilizing detailed definitions relating to vocal fold lesion morphology, stroboscopy, response to voice therapy and intraoperative findings. Video-perceptual analysis of stroboscopy demonstrated that the proposed binary stroboscopy system used in the BVFL nomenclature paradigm was valid and widely applicable. Retrospective review of 45 patients with BVFL followed to the conclusion of treatment demonstrated that slight modifications of the initial BVFL nomenclature paradigm were required. With the modified BVFL nomenclature paradigm, 96% of the patients fit into the predicted pattern and definitions of the BVFL nomenclature system. This study has validated a multidimensional BVFL nomenclature paradigm. This vocal fold nomenclature paradigm includes nine distinct vocal fold lesions: vocal fold nodules, vocal fold polyp, pseudocyst, vocal fold cyst (subepithelial or ligament), nonspecific vocal fold lesion, vocal fold fibrous mass (subepithelial or ligament), and reactive lesion. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  9. Some aspects of vocal fold bowing.

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    Tanaka, S; Hirano, M; Chijiwa, K

    1994-05-01

    Bowing of the vocal fold frequently occurs in patients with vocal fold paralysis (VFP), those with sulcus vocalis, and those who have had laser surgery. Additionally, there are vocal folds that present bowing with no noticeable organic lesion. For the purpose of investigating the causes and mechanisms of vocal fold bowing, consecutive fiberscopic videorecordings of 127 patients with VFP, 33 with sulcus vocalis, 33 with laser surgery, and 33 with dysphonia having no clinically noticeable organic lesion were reviewed. Sixty-nine percent of the paralyzed vocal folds had bowing, and the occurrence of bowing was significantly related to the activity of the thyroarytenoid muscle as measured by electromyography. The cricothyroid activity had no significant relationship to vocal fold bowing. All vocal folds with sulcus presented with bowing. Thirty-five percent of the vocal folds that had had laser surgery had bowing. The extent of tissue removal was closely related to the occurrence of bowing. Twelve cases with no organic lesion had vocal fold bowing. Of these 12 patients, 8 were male and 9 were older than 60 years. Some aging process in the mucosa was presumed to be the cause of the bowing in this age group of patients without clinically noticeable organic lesions. Causes of vocal fold bowing in the younger group of patients without organic lesions were not determined in this study.

  10. Classification of laryngeal disorders based on shape and vascular defects of vocal folds.

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    Irem Turkmen, H; Elif Karsligil, M; Kocak, Ismail

    2015-07-01

    Vocal fold disorders such as laryngitis, vocal nodules, and vocal polyps may cause hoarseness, breathing and swallowing difficulties due to vocal fold malfunction. Despite the fact that state of the art medical imaging techniques help physicians to obtain more detailed information, difficulty in differentiating minor anomalies of vocal folds encourages physicians to research new strategies and technologies to aid the diagnostic process. Recent studies on vocal fold disorders note the potential role of the vascular structure of vocal folds in differential diagnosis of anomalies. However, standards of clinical usage of the blood vessels have not been well established yet due to the lack of objective and comprehensive evaluation of the vascular structure. In this paper, we present a novel approach that categorizes vocal folds into healthy, nodule, polyp, sulcus vocalis, and laryngitis classes exploiting visible blood vessels on the superior surface of vocal folds and shapes of vocal fold edges by using image processing techniques and machine learning methods. We first detected the vocal folds on videolaryngostroboscopy images by using Histogram of Oriented Gradients (HOG) descriptors. Then we examined the shape of vocal fold edges in order to provide features such as size and splay portion of mass lesions. We developed a new vessel centerline extraction procedure that is specialized to the vascular structure of vocal folds. Extracted vessel centerlines were evaluated in order to get vascular features of vocal folds, such as the amount of vessels in the longitudinal and transverse form. During the last step, categorization of vocal folds was performed by a novel binary decision tree architecture, which evaluates features of the vocal fold edge shape and vascular structure. The performance of the proposed system was evaluated by using laryngeal images of 70 patients. Sensitivity of 86%, 94%, 80%, 73%, and 76% were obtained for healthy, polyp, nodule, laryngitis, and

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

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    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.

  12. Viscoelastic properties of the false vocal fold

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    Chan, Roger W.

    2004-05-01

    The biomechanical properties of vocal fold tissues have been the focus of many previous studies, as vocal fold viscoelasticity critically dictates the acoustics and biomechanics of phonation. However, not much is known about the viscoelastic response of the ventricular fold or false vocal fold. It has been shown both clinically and in computer simulations that the false vocal fold may contribute significantly to the aerodynamics and sound generation processes of human voice production, with or without flow-induced oscillation of the false fold. To better understand the potential role of the false fold in phonation, this paper reports some preliminary measurements on the linear and nonlinear viscoelastic behavior of false vocal fold tissues. Linear viscoelastic shear properties of human false fold tissue samples were measured by a high-frequency controlled-strain rheometer as a function of frequency, and passive uniaxial tensile stress-strain response of the tissue samples was measured by a muscle lever system as a function of strain and loading rate. Elastic moduli (Young's modulus and shear modulus) of the false fold tissues were calculated from the measured data. [Work supported by NIH.

  13. Improvement of a Vocal Fold Imaging System

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    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.

  14. 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…

  15. Modal locking between vocal fold and vocal tract oscillations

    CERN Document Server

    Aalto, Atte; Malinen, Jarmo; Vainio, Martti

    2012-01-01

    The human vocal folds are known to interact with the vocal tract acoustics during voiced speech production; namely a nonlinear source-filter coupling has been observed both by using models and in \\emph{in vivo} phonation. These phenomena are approached from two directions in this article. We first present a computational dynamical model of the speech apparatus that contains an explicit filter-source feedback mechanism from the vocal tract acoustics back to the vocal folds oscillations. The model was used to simulate vocal pitch glideswhere the trajectory was forced to cross the lowest vocal tract resonance, i.e., the lowest formant $F_1$. Similar patterns produced by human participants were then studied. Both the simulations and the experimental results reveal an effect when the glides cross the first formant (as may happen in \\textipa{[i]}). Conversely, this effect is not observed if there is no formant within the glide range (as is the case in \\textipa{[\\textscripta]}). The experiments show smaller effect c...

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

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    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.

  17. MARATHON DESPITE UNILATERAL VOCAL FOLD PARALYSIS

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    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

  18. Treatment of aging vocal folds: surgical approaches.

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    Seino, Yutomo; Allen, Jacqui E

    2014-12-01

    Aging may affect the voice through either physiological or pathological changes. Globally society is aging and the working lifetime is extending. Increasing numbers of elderly will present with voice issues. This review examines current thinking regarding surgical treatment of the aging voice. The mainstay of surgical treatment remains injection laryngoplasty and medialization thyroplasty. In-office injection laryngoplasty is increasingly common. Data suggest that patients with vocal fold atrophy do not achieve as much benefit from augmentation treatments as other causes of glottal incompetence. In addition the timing of injection laryngoplasty may influence the rate of subsequent medialization thyroplasty. Disease-specific treatments can provide some benefit to voice, such as deep brain stimulation in Parkinson's disease. Novel treatments including growth factor therapy are entering clinical practice and will provide new options for the clinician in future. Voice disorders affect approximately 20% of the elderly population. Causes include neurologic, malignant, iatrogenic and benign vocal fold disorders. These should be ruled out before accepting dysphonia is age-related in nature. Treatment should be specific to recognized vocal disorders but may also address physiologic changes in the glottis. Injection laryngoplasty and thyroplasty remain effective options for treating glottal incompetence but novel therapies are showing promising results.

  19. [Etiology, diagnosis, differential diagnosis and therapy of vocal fold paralysis].

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    Reiter, R; Hoffmann, T K; Rotter, N; Pickhard, A; Scheithauer, M O; Brosch, S

    2014-03-01

    Etiology of vocal fold paralysis is broad: e. g. iatrogenic/traumatic, associated with neoplasms or with systemic diseases. The cause of idiopathic paralysis is unknown. The main symptom of unilateral vocal fold paralysis is hoarseness because of a remaining glottic gap during phonation. Patients with bilateral vocal fold paralysis typically have no impairment of the voice but dyspnea. Examination of patients with an idopathic vocal fold paralysis is a CT of the vagal nerve and recurrent laryngeal nerve from skull base to neck and mediastinum. Serological tests are not obligatory. Differential diagnosis of vocal fold immobility is vocal fold paralysis/neurological causes and arthrogene causes such as arytenoid subluxation, interarytenoid adhesion and vocal fold fixation in laryngeal carcinomas. Voice therapy is a promising approach for patients with unilateral vocal fold paralysis, but not all patients benefit sufficiently. Temporary vocal fold augmentation by injection medialization results in satisfactory voice quality that is comparable with a thyroplasty. Patients with bilateral vocal fold immobility show typically dyspnea requiring immediate therapy such as temporary tracheotomy or reversible laterofixation of the paralyzed vocal chord. If the paralysis persists a definitive enlargement of the glottic airway by eg. arytenoidectomy needs to be performed.

  20. Vocal improvement after voice therapy in the treatment of benign vocal fold lesions

    OpenAIRE

    Schindler, A; MOZZANICA, F.; Ginocchio, D.; MARUZZI, P.; Atac, M.; OTTAVIANI, F.

    2012-01-01

    SUMMARY Benign vocal fold lesions are common in the general population, and have important public health implications and impact on patient quality of life. Nowadays, phonomicrosurgery is the most common treatment of these lesions. Voice therapy is generally associated in order to minimize detrimental vocal behaviours that increase the stress at the mid-membranous vocal folds. Nonetheless, the most appropriate standard of care for treating benign vocal fold lesion has not been established. Th...

  1. Idiopathic ulcerative laryngitis causing midmembranous vocal fold granuloma.

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    Sinclair, Catherine F; Sulica, Lucian

    2013-02-01

    Idiopathic ulcerative laryngitis (IUL) is characterized by bilateral midmembranous vocal fold ulceration, which follows upper respiratory infection with cough. In contrast, granuloma of the membranous vocal fold can occur rarely following microlaryngoscopy, presumably secondary to surgical violation of deep tissue planes. We report a novel case of noniatrogenic membranous vocal fold granulation developing in a patient with IUL. Although the presence of granulation implied injury to the entire microstructure of the vibratory portion of the vocal fold, the lesion resolved with conservative management without adverse sequelae.

  2. Diagnostic and therapeutic pitfalls in benign vocal fold diseases

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    Bohlender, Jörg

    2013-12-01

    Full Text Available [english] 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.

  3. In vivo measurement of vocal fold surface resistance.

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    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.

  4. The impact of intraglottal vortices on vocal fold dynamics

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    Erath, Byron; Pirnia, Alireza; Peterson, Sean

    2016-11-01

    During voiced speech a critical pressure is produced in the lungs that separates the vocal folds and creates a passage (the glottis) for airflow. As air passes through the vocal folds the resulting aerodynamic loading, coupled with the tissue properties of the vocal folds, produces self-sustained oscillations. Throughout each cycle a complex flow field develops, characterized by a plethora of viscous flow phenomena. Air passing through the glottis creates a jet, with periodically-shed vortices developing due to flow separation and the Kelvin-Helmholtz instability in the shear layer. These vortices have been hypothesized to be a crucial mechanism for producing vocal fold vibrations. In this study the effect of vortices on the vocal fold dynamics is investigated experimentally by passing a vortex ring over a flexible beam with the same non-dimensional mechanical properties as the vocal folds. Synchronized particle image velocimetry data are acquired in tandem with the beam dynamics. The resulting impact of the vortex ring loading on vocal fold dynamics is discussed in detail. This work was supported by the National Science Foundation Grant CBET #1511761.

  5. A new instrument for intraoperative assessment of individual vocal folds.

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    Heaton, James T; Kobler, James B; Hillman, Robert E; Zeitels, Steven M

    2005-07-01

    Intraoperative assessment of vocal fold vibration during phonomicrosurgery performed under general anesthesia may enhance surgical decision-making. We therefore developed and bench-tested a new device we refer to as the aerodynamic vocal fold driver (AVFD). The AVFD comprises a hand-held probe that uses airflow to drive individual vocal folds into phonatory-like vibration. This permits stroboscopic visualization of mucosal waves with simultaneous control of subglottal air pressure. In initial experiments to validate the technique, AVFD driven phonation and conventional whole-larynx phonation were compared using excised canine larynges (n = 14). Single vocal fold phonation using the AVFD and whole larynx phonation yielded similar, positive correlations between subglottal pressure and both amplitude and frequency of vibration. Experiments simulating vocal fold scar-related mucosal stiffening by subepithelial injection of fixative showed the expected elevation of phonation threshold pressures as measured with the AVFD. Likewise, unilateral tissue compression injury disrupted vocal fold vibration, and the AVFD was useful for quantifying improvement in the damaged vocal fold after repair with injection of cross-linked hyaluronic acid gel. These results show that this new instrument has the potential to provide novel and useful information for laryngeal experimentation and to improve phonosurgery.

  6. Vocal fold ion transport and mucin expression following acrolein exposure.

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    Levendoski, Elizabeth Erickson; Sivasankar, M Preeti

    2014-05-01

    The vocal fold epithelium is exposed to inhaled particulates including pollutants during breathing in everyday environments. Yet, our understanding of the effects of pollutants on vocal fold epithelial function is extremely limited. The objective of this study was to investigate the effect of the pollutant acrolein on two vocal fold epithelial mechanisms: ion transport and mucin (MUC) synthesis. These mechanisms were chosen as each plays a critical role in vocal defense and in maintaining surface hydration which is necessary for optimal voice production. Healthy, native porcine vocal folds (N = 85) were excised and exposed to an acrolein or sham challenge. A 60-min acrolein, but not sham challenge significantly reduced ion transport and inhibited cyclic adenosine monophosphate-dependent, increases in ion transport. Decreases in ion transport were associated with reduced sodium absorption. Within the same timeline, no significant acrolein-induced changes in MUC gene or protein expression were observed. These results improve our understanding of the effects of acrolein on key vocal fold epithelial functions and inform the development of future investigations that seek to elucidate the impact of a wide range of pollutant exposures on vocal fold health.

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

    DEFF Research Database (Denmark)

    Agerkvist, Finn T.; Selamtzis, Andreas

    2011-01-01

    , which is the mode that is most limited in pitch range, was tested at its pitch limit C5 (523 Hz) under normal conditions and when the singer has inhaled Helium. When inhaling Helium the acoustic impedance of the vocal tract is reduced in magnitude and the resonances are scaled upwards in frequency due...... to different density and speed of sound in Helium. The electroglottograph shows a change in waveform when the singer inhales helium. The percentage of the glottal cycle when the vocal cords are open, the so-called open quotient, increases from 40 to 55%. When inhaling helium the male singer was able reach Eb5...

  8. A Canonical Biomechanical Vocal Fold Model

    Science.gov (United States)

    Bhattacharya, Pinaki; Siegmund, Thomas H.

    2012-01-01

    Summary The present article aimed at constructing a canonical geometry of the human vocal fold (VF) from subject-specific image slice data. A computer-aided design approach automated the model construction. A subject-specific geometry available in literature, three abstractions (which successively diminished in geometric detail) derived from it, and a widely used quasi two-dimensional VF model geometry were used to create computational models. The first three natural frequencies of the models were used to characterize their mechanical response. These frequencies were determined for a representative range of tissue biomechanical properties, accounting for underlying VF histology. Compared with the subject-specific geometry model (baseline), a higher degree of abstraction was found to always correspond to a larger deviation in model frequency (up to 50% in the relevant range of tissue biomechanical properties). The model we deemed canonical was optimally abstracted, in that it significantly simplified the VF geometry compared with the baseline geometry but can be recalibrated in a consistent manner to match the baseline response. Models providing only a marginally higher degree of abstraction were found to have significant deviation in predicted frequency response. The quasi two-dimensional model presented an extreme situation: it could not be recalibrated for its frequency response to match the subject-specific model. This deficiency was attributed to complex support conditions at anterior-posterior extremities of the VFs, accentuated by further issues introduced through the tissue biomechanical properties. In creating canonical models by leveraging advances in clinical imaging techniques, the automated design procedure makes VF modeling based on subject-specific geometry more realizable. PMID:22209063

  9. Linear Classifier with Reject Option for the Detection of Vocal Fold Paralysis and Vocal Fold Edema

    Science.gov (United States)

    Kotropoulos, Constantine; Arce, Gonzalo R.

    2009-12-01

    Two distinct two-class pattern recognition problems are studied, namely, the detection of male subjects who are diagnosed with vocal fold paralysis against male subjects who are diagnosed as normal and the detection of female subjects who are suffering from vocal fold edema against female subjects who do not suffer from any voice pathology. To do so, utterances of the sustained vowel "ah" are employed from the Massachusetts Eye and Ear Infirmary database of disordered speech. Linear prediction coefficients extracted from the aforementioned utterances are used as features. The receiver operating characteristic curve of the linear classifier, that stems from the Bayes classifier when Gaussian class conditional probability density functions with equal covariance matrices are assumed, is derived. The optimal operating point of the linear classifier is specified with and without reject option. First results using utterances of the "rainbow passage" are also reported for completeness. The reject option is shown to yield statistically significant improvements in the accuracy of detecting the voice pathologies under study.

  10. A HMM-Based Method for Vocal Fold Pathology Diagnosis

    Directory of Open Access Journals (Sweden)

    Vahid Majidnezhad

    2012-11-01

    Full Text Available Acoustic analysis is a proper method in vocal fold pathology diagnosis so that it can complement and in some cases replace the other invasive, based on direct vocal fold observations methods. There are different approaches for vocal fold pathology diagnosis. This paper presents a method based on hidden markov model which classifies speeches into two classes: the normal and the pathological. Two hidden markov models are trained based on these two classes of speech and then the trained models are used to classify the dataset. The proposed method is able to classify the speeches with an accuracy of 93.75%. The results of this algorithm provide insights that can help biologists and computer scientists design high-performance system for detection of vocal fold pathology diagnosis.

  11. Correlation between vocal functions and glottal measurements in patients with unilateral vocal fold paralysis.

    Science.gov (United States)

    Inagi, K; Khidr, A A; Ford, C N; Bless, D M; Heisey, D M

    1997-06-01

    Observations and analysis of glottal characteristics are critical in choosing the best modality for surgery in patients with unilateral vocal fold paralysis (UVP). This study suggests that multiple glottal characteristics influence the vocal product in patients with UVP. In addition to the horizontal position of the paralyzed vocal fold (deviation from the midline), the glottal area, degree of bowing of the paralyzed and contralateral vocal folds, maximum separation between vocal folds, compensatory glottal maneuvers, and the vertical glottic closure plane significantly influenced the quality of the voice. Clinicians should be aware of these observations to facilitate treatment planning and assessment of the results of surgical procedures used to improve voice quality in cases of UVP.

  12. Anatomical Study Of Minor Alterations In Neonate Vocal Folds.

    OpenAIRE

    Adriano Rezende Silva; Almiro José Machado Júnior; Agrício Nubiato Crespo

    2015-01-01

    INTRODUCTION: Minor structural alterations of the vocal fold cover are frequent causes of voice abnormalities. They may be difficult to diagnose, and are expressed in different manners. Cases of intracordal cysts, sulcus vocalis, mucosal bridge, and laryngeal micro-diaphragm form the group of minor structural alterations of the vocal fold cover investigated in the present study. The etiopathogenesis and epidemiology of these alterations are poorly known. OBJECTIVE: To evaluate the existe...

  13. 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.

  14. Influence of vocal training on postoperative patients with vocal cord polyp vocal ability%嗓音训练对声带息肉患者术后发声能力的影响

    Institute of Scientific and Technical Information of China (English)

    关彩霞; 朱素月; 张小梅; 庄丽芳; 梁松好

    2015-01-01

    Objective:To investigate the influence of vocal training on postoperative patients with vocal cord polyp vocal ability. Methods:Eighty - six pa-tients,who had vocal cords polyp surgeries,were randomly divided into control group and experimental group. Regular treatment and nursing were provided to the control group. while the experimental group has additional voice training,including voice hygiene education,diaphragm breathing training,posture and movement training,and yawning training,rale training,chewing sound training,and voice training. The first and the third monthes after surgery,patients self - administratively record visual analogue scale (VAS). Results:The results showed that the throat vocal ability (VAS) between the two groups had sta-tistical significance in different time (P < 0. 05). Conclusion:Voice training can improve the resection of vocal fold polyp laryngeal vocal ability,promote the voice rehabilitation.%目的::探讨嗓音训练对声带息肉患者术后发声能力的影响。方法:选取2013年1月~2014年5月我院收治86例声带息肉术后患者为研究对象,随机等分为对照组和试验组,对照组术后予常规治疗、护理;试验组在对照组的基础上予嗓音训练,包括嗓音卫生教育、膈肌呼吸训练、姿势与运动训练、打哈欠训练、水泡音训练、嚼音训练、嗓音声学训练。术后1个月、3个月对两组患者用视觉模拟评分法行喉发声能力自主评分比较。结果:喉发声能力 VAS 评分显示,两组不同时段评分比较,差异均有统计学意义(P <0.05)。结论:嗓音训练可改善声带息肉术后喉发声能力,促进嗓音康复。

  15. Measurement of Young's modulus of vocal folds by indentation.

    Science.gov (United States)

    Chhetri, Dinesh K; Zhang, Zhaoyan; Neubauer, Juergen

    2011-01-01

    To assess the accuracy of the indentation method for stiffness measurements and to estimate the Young's modulus of the vocal fold using this technique. Basic science. Indentation tests were performed using a range of indenter diameters and indentation depths on single- and double-layer silicone rubber models with various cover-layer thicknesses with known geometry and Young's moduli. Measurements were repeated on intact vocal folds and isolated muscle and cover-layer samples from three cadaveric human larynges. Indentation on single-layer rubber models yielded Young's moduli with acceptable accuracy when the indentation depth was equal to or smaller than the indenter diameter, and both were smaller than the physical dimensions of the material sample. On two-layer models, the stiffness estimation was similarly influenced by indenter diameter and indentation depth, and acceptable accuracy was reached when indentation depth was much smaller than the height of the top cover layer. Measurements on midmembranous vocal fold tissue revealed location-dependent Young's moduli (in kPa) as follows: intact hemilarynx, 8.6 (range=5.3-13.1); isolated inferior medial surface cover, 7.5 (range=7-7.9); isolated medial surface cover, 4.8 (range=3.9-5.7); isolated superior surface cover, 2.9 (range=2.7-3.2); and isolated thyroarytenoid muscle, 2.0 (range=1.3-2.7). Indenter diameter, indentation depth, and material thickness are important parameters in the measurement of vocal fold stiffness using the indentation technique. Measurements on human larynges showed location-dependent differences in stiffness. The stiffness of the vocal folds was also found to be higher when the vocal fold structure was still attached to the laryngeal framework compared with that when the vocal fold was separated from the framework. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  16. [Management of T1a vocal fold carcinoma].

    Science.gov (United States)

    Reiter, R; Brosch, S; Smith, E; Pickhard, A

    2013-12-01

    About 2/3 of the larynx carcinomas affect the vocal chords. The main risk factor is smoking. Carcinomas in this localisation often arise from leukoplakias with dysplasia. A typical symptom is dysphonia. Arrest of vibration in microlaryngostroboscopy is a hint that a carcinoma could be present. Transoral laser cordectomy or radiotherapy show equivalent oncological results and results in quality of voice in the treatment of vocal fold carcinoma (T1a). As lymph node and distant metastasis are very rare, follow-up can concentrate on microlaryngoscopy. In case of a suspicious area on the vocal fold, biopsy of the affected tissue is needed to plan correct treatment. The prognosis of the T1 vocal chord carcinoma is quite good with a 5-year survival rate of almost 100%.

  17. Vocal improvement after voice therapy in the treatment of benign vocal fold lesions.

    Science.gov (United States)

    Schindler, A; Mozzanica, F; Ginocchio, D; Maruzzi, P; Atac, M; Ottaviani, F

    2012-10-01

    Benign vocal fold lesions are common in the general population, and have important public health implications and impact on patient quality of life. Nowadays, phonomicrosurgery is the most common treatment of these lesions. Voice therapy is generally associated in order to minimize detrimental vocal behaviours that increase the stress at the mid-membranous vocal folds. Nonetheless, the most appropriate standard of care for treating benign vocal fold lesion has not been established. The aim of this study was to analyze voice changes in a group of dysphonic patients affected by benign vocal fold lesions, evaluated with a multidimensional protocol before and after voice therapy. Sixteen consecutive patients, 12 females and 4 males, with a mean age of 49.7 years were enrolled. Each subject had 10 voice therapy sessions with an experienced speech/language pathologist for a period of 1-2 months, and was evaluated before and at the end of voice therapy with a multidimensional protocol that included self-assessment measures and videostroboscopic, perceptual, aerodynamic and acoustic ratings. Videostroboscopic examination did not reveal resolution of the initial pathology in any case. No improvement was observed in aerodynamic and perceptual ratings. A clear and significant improvement was visible on Wilcoxon signed-rank test for the mean values of Jitt%, Noise to Harmonic Ratio (NHR) and Voice Handicap Index (VHI) scores. Even if it is possible that, for benign vocal fold lesions, only a minor improvement of voice quality can be achieved after voice therapy, rehabilitation treatment still seems useful as demonstrated by improvement in self-assessment measures. If voice therapy is provided as an initial treatment to the patients with benign vocal fold lesions, this may lead to an improvement in the perceived voice quality, making surgical intervention unnecessary. This is one of the first reports on the efficacy of voice therapy in the management of benign vocal fold

  18. Influence of glycosaminoglycan identity on vocal fold fibroblast behavior.

    Science.gov (United States)

    Jimenez-Vergara, Andrea Carolina; Munoz-Pinto, Dany J; Becerra-Bayona, Silvia; Wang, Bo; Iacob, Alexandra; Hahn, Mariah S

    2011-11-01

    Poly(ethylene glycol) (PEG) hydrogels have recently begun to be studied for the treatment of scarred vocal fold lamina propria due, in part, to their tunable mechanical properties, resistance to fibroblast-mediated contraction, and ability to be polymerized in situ. However, pure PEG gels lack intrinsic biochemical signals to guide cell behavior and generally fail to mimic the frequency-dependent viscoelastic response critical to normal superficial lamina propria function. Recent results suggest that incorporation of viscoelastic bioactive substances, such as glycosaminoglycans (GAGs), into PEG networks may allow these gels to more closely approach the mechanical responses of normal vocal fold lamina propria while also stimulating desired vocal fold fibroblast behaviors. Although a number of vocal fold studies have examined the influence of hyaluronan (HA) on implant mechanics and vocal fold fibroblast responses, the effects of other GAG types have been relatively unexplored. This is significant, since recent studies have suggested that chondroitin sulfate C (CSC) and heparan sulfate (HS) are substantially altered in scarred lamina propria. The present study was therefore designed to evaluate the effects of CSC and HS incorporation on the mechanical response of PEG gels and vocal fold fibroblast behavior relative to HA. As with PEG-HA, the viscoelasticity of PEG-CSC and PEG-HS gels more closely approached that of the normal vocal fold lamina propria than pure PEG hydrogels. In addition, collagen I deposition and fibronectin production were significantly higher in CSC than in HA gels, and levels of the myofibroblast marker smooth muscle α-actin (SM α-actin) were greater in CSC and HS gels than in HA gels. Since collagen I, fibronectin, and SM α-actin are generally elevated in scarred lamina propria these results suggest that CSC and HS may be undesirable for vocal fold implants relative to HA. Investigation of various signaling intermediates indicated that

  19. Modeling of the transient responses of the vocal fold lamina propria

    OpenAIRE

    Zhang, Kai; Siegmund, Thomas; Chan, Roger W.

    2009-01-01

    The human voice is produced by flow-induced self-sustained oscillation of the vocal fold lamina propria. The mechanical properties of vocal fold tissues are important for understanding phonation, including the time-dependent and transient changes in fundamental frequency (F0). Cyclic uniaxial tensile tests were conducted on a group of specimens of the vocal fold lamina propria, including the superficial layer (vocal fold cover) (5 male, 5 female) and the deeper layers (vocal ligament) (6 male...

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

    National Research Council Canada - National Science Library

    Riede, Tobias; Titze, Ingo R

    2008-01-01

    .... 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...

  1. Multidimensional Analysis on the Effect of Vocal Function Exercises on Aged Vocal Fold Atrophy.

    Science.gov (United States)

    Kaneko, Mami; Hirano, Shigeru; Tateya, Ichiro; Kishimoto, Yo; Hiwatashi, Nao; Fujiu-Kurachi, Masako; Ito, Juichi

    2015-09-01

    Age-related voice change is characterized as weak, harsh, and breathy. These changes are caused by histologic alteration of the lamina propria of the vocal fold mucosa as well as atrophy of the thyroarytenoid muscle. Several therapeutic strategies involving laryngeal framework surgery and injection laryngoplasty have been tried, but effects have been limited. Vocal function exercises (VFE) have been used to treat age-related vocal fold atrophy although the effectiveness has been shown with limited analysis. The present study aims to determine the effectiveness of VFE for the treatment of aged atrophy using multidimensional analysis. This is a retrospective study. Sixteen patients with vocal fold atrophy aged 65-81 years underwent voice therapy using VFE. Six patients with vocal fold atrophy aged 65-85 years were involved as a historical control group. The grade, roughness, breathiness, asthenia, strain (GRBAS) scale, stroboscopic examinations, aerodynamic assessment, acoustic analysis, and Voice Handicap Index-10 (VHI-10) were performed before and after VFE. Normalized mucosal wave amplitude (NMWA), normalized glottal gap (NGG), and bowing index (BI) were measured by image analysis during stroboscopic examinations. After VFE, significant improvements were shown in GRBAS, maximum phonation time, jitter, NMWA, NGG, and VHI-10 although BI has not changed significantly. There were no significant improvements in the historical control. The data suggest that VFE produces significant improvement in subjective, objective, and patient self-evaluation and deserves further attention as a treatment for aged atrophy of the vocal fold. It was also suggested that VFE does not improve the vocal fold bowing but may improve muscular function during voicing. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  2. Impact of Vocal Tract Resonance on the Perception of Voice Quality Changes Caused by Varying Vocal Fold Stiffness

    Science.gov (United States)

    Signorello, Rosario; Zhang, Zhaoyan; Gerratt, Bruce; Kreiman, Jody

    2016-01-01

    Summary Experiments using animal and human larynx models are often conducted without a vocal tract. While it is often assumed that the absence of a vocal tract has only small effects on vocal fold vibration, it is not actually known how sound production and quality are affected. In this study, the validity of using data obtained in the absence of a vocal tract for voice perception studies was investigated. Using a two-layer self-oscillating physical model, three series of voice stimuli were created: one produced with conditions of left-right symmetric vocal fold stiffness, and two with left-right asymmetries in vocal fold body stiffness. Each series included a set of stimuli created with a physical vocal tract, and a second set created without a physical vocal tract. Stimuli were re-synthesized to equalize the mean F0 for each series and normalized for amplitude. Listeners were asked to evaluate the three series in a sort-and-rate task. Multidimensional scaling analysis was applied to examine the perceptual interaction between the voice source and the vocal tract resonances. The results showed that the presence or absence of a vocal tract can significantly affect perception of voice quality changes due to parametric changes in vocal fold properties, except when the parametric changes in vocal fold properties produced an abrupt shift in vocal fold vibratory pattern resulting in a salient quality change. PMID:27134616

  3. A new generation videokymography for routine clinical vocal fold examination

    NARCIS (Netherlands)

    Qiu, Qingjun; Schutte, Harm K.

    2006-01-01

    Objective. This study aims to introduce a new-generation videokymographic system, which provides simultaneous laryngoscopic and kymographic image, for routine clinical vocal fold examination. Study Design: The authors explored a new imaging method for diagnosis and evaluation of voice disorders. Met

  4. Anatomical study of minor alterations in neonate vocal folds.

    Science.gov (United States)

    Silva, Adriano Rezende; Machado Jr, Almiro José; Crespo, Agrício Nubiato

    2014-01-01

    Minor structural alterations of the vocal fold cover are frequent causes of voice abnormalities. They may be difficult to diagnose, and are expressed in different manners. Cases of intracordal cysts, sulcus vocalis, mucosal bridge, and laryngeal micro-diaphragm form the group of minor structural alterations of the vocal fold cover investigated in the present study. The etiopathogenesis and epidemiology of these alterations are poorly known. To evaluate the existence and anatomical characterization of minor structural alterations in the vocal folds of newborns. 56 larynxes excised from neonates of both genders were studied. They were examined fresh, or defrosted after conservation via freezing, under a microscope at magnifications of 25× and 40×. The vocal folds were inspected and palpated by two examiners, with the aim of finding minor structural alterations similar to those described classically, and other undetermined minor structural alterations. Larynges presenting abnormalities were submitted to histological examination. Six cases of abnormalities were found in different larynges: one (1.79%) compatible with a sulcus vocalis and five (8.93%) compatible with a laryngeal micro-diaphragm. No cases of cysts or mucosal bridges were found. The observed abnormalities had characteristics similar to those described in other age groups. Abnormalities similar to sulcus vocalis or micro-diaphragm may be present at birth. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  5. Restructuring the vocal fold lamina propria with endoscopic microdissection.

    Science.gov (United States)

    Bartlett, Rebecca S; Hoffman, Henry T; Dailey, Seth H; Bock, Jonathan M; Klemuk, Sarah A; Askeland, Ryan W; Ahlrichs-Hanson, Jan S; Heaford, Andrew C; Thibeault, Susan L

    2013-11-01

    The purposes of this preclinical study were to investigate histologic and rheologic outcomes of Microendoscopy of Reinke's space (MERS)-guided minithyrotomy and to assess its instrumentation. Human cadaveric and in vivo animal study. Three human cadaveric larynges were treated with MERS-guided placement of Radiesse VoiceGel and immediately evaluated histologically for biomaterial location. In the second part of this investigation, two scarred porcine larynges were treated with MERS-guided placement of HyStem-VF and rheologically evaluated 6 weeks later. Student t tests determined differences in viscoelastic properties of treated/untreated vocal folds. Sialendoscopes and microendoscopes were subjectively compared for their visualization capacity. MERS imaged the subepithelial area and vocal ligament, guiding both tissue dissection and biomaterial positioning. Sialendoscopes provided adequate visualization and feature incorporated working channels. Enhanced image clarity was created in a gas-filled rather than saline-filled environment, per rater judgment. Histological analysis revealed desirable biomaterial positioning with MERS. Per rheological analysis, viscoelastic properties of the MERS-treated porcine vocal folds compared to uninjured vocal folds 6 weeks following treatment did not statistically differ. MERS-guided laryngoplasty using sialendoscopes yielded satisfactory biomaterial positioning in the short-term and normalized rheologic tissue properties in the long-term, contributing to proof of concept for MERS in the treatment of scarring. Strengths of MERS include direct, real-time visualization of Reinke's space and an ability to manipulate surgical instruments parallel to the vocal fold edge while maintaining an intact epithelium. Future work will explore the clinical utility of MERS for addressing scarring, sulcus vocalis, and other intracordal processes. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  6. 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

    2017-09-18

    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. A numerical model with a triangular glottis, posterior glottal opening, and arytenoid posturing is proposed. Normal voice is altered by introducing various prephonatory configurations. Potential compensatory mechanisms (increased subglottal pressure, muscle activation, and supraglottal constriction) are adjusted to restore an acoustic target output through a control loop that mimics a simplified version of auditory feedback. The degree of incomplete glottal closure in both the membranous and posterior portions of the folds consistently leads to a reduction in sound pressure level, fundamental frequency, harmonic richness, and harmonics-to-noise ratio. The compensatory mechanisms lead to significantly increased vocal-fold collision forces, maximum flow-declination rate, and amplitude of unsteady flow, without significantly altering the acoustic output. Modeling provided potentially important insights into the pathophysiology of phonotraumatic vocal hyperfunction by demonstrating that compensatory mechanisms can counteract deterioration in the voice acoustic signal due to incomplete glottal closure, but this also leads to high vocal-fold collision forces (reflected in aerodynamic measures), which significantly increases the risk of developing phonotrauma.

  7. Coblation of the canine vocal fold: a histologic study.

    Science.gov (United States)

    Divi, Venu; Benninger, Michael; Kiupel, Matti; Dobbie, Allison

    2012-11-01

    Controlled ablation (coblation) is a radiofrequency bipolar method of tissue ablation, which destroys tissue at very low temperatures. It has been used in a variety of clinical settings and is most frequently used by the otolaryngologist for tonsillectomy. In this study, we have examined the effect of coblation on the canine larynx by applying coblation to the vocal fold and harvesting the larynx on postoperative days (PODs) 0, 4, and 7. Histologic examination was performed with a variety of stains to examine the healing process. Coblation injury demonstrated complete epithelialization by POD 7. No injury to the underlying vocalis muscle was seen. The inflammatory response demonstrates less inflammation than previously reported with CO(2) laser injury. Coblation is a viable method for removal of tissue from the vocal fold resulting in minimal scar formation and a controlled depth of injury. Further studies should be performed to determine clinical utility in the removal of lesions such as respiratory papillomatosis.

  8. Modal locking between vocal fold and vocal tract oscillations: Simulations in time domain

    CERN Document Server

    Aalto, Atte; Malinen, Jarmo; Aalto, Daniel; Vainio, Martti

    2015-01-01

    It is well known that during voiced speech, the human vocal folds interact with the vocal tract acoustics. The resulting source-filter coupling has been observed using mathematical and physical models as well as in in vivo phonation. We propose a computational time-domain model of the full speech apparatus that, in particular, contains a feedback mechanism from the vocal tract acoustics to the vocal fold oscillations. It is based on numerical solution of ordinary and partial differential equations defined on vocal tract geometries that have been obtained by Magnetic Resonance Imaging. The model is used to simulate rising and falling pitch glides of [a, i] in the fundamental frequency (f_0) interval [180 Hz, 360 Hz]. The interval contains the first formant F1 of [i] as well as the subformants F1/4 and F1/3 of [a]. The simulations reveal a locking pattern of the f_0-trajectory at F1 of [i] in falling and rising glides. The subformants of [a] produce perturbations in the waveforms of glottal signals but no locki...

  9. Voice rest after vocal fold surgery: current practice and evidence.

    Science.gov (United States)

    Coombs, A C; Carswell, A J; Tierney, P A

    2013-08-01

    Voice rest is commonly recommended after vocal fold surgery, but there is a lack of evidence base and no standard protocol. The aim of this study was to establish common practice regarding voice rest following vocal fold surgery. An online survey was circulated via e-mail invitation to members of the ENT UK Expert Panel between October and November 2011. The survey revealed that 86.5 per cent of respondents agreed that 'complete voice rest' means no sound production at all, but there was variability in how 'relative voice rest' was defined. There was no dominant type of voice rest routinely recommended after surgery for laryngeal papillomatosis or intermediate pathologies. There was considerable variability in the duration of voice rest recommended, with no statistically significant, most popular response (except for malignant lesions). Surgeons with less than 10 years of experience were more likely to recommend fewer days of voice rest. There is a lack of consistency in advice given to patients after vocal fold surgery, in terms of both type and length of voice rest. This may arise from an absence of robust evidence on which to base practice.

  10. Oral and vocal fold diadochokinesis in dysphonic women

    Directory of Open Access Journals (Sweden)

    Talita Louzada

    2011-12-01

    Full Text Available 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: For this study, 28 voice recordings of women from 19 to 54 years old, diagnosed with dysphonia and submitted to a voice assessment from speech pathologist and otorhinolaryngologist, were used. The control group included 30 nondysphonic women evaluated in prior research from normal adults. The analysis parameters like number and duration of emissions, as well as the regularity of the repetition of syllables "pa", "ta", "ka" and the vowels "a" and "i," were provided by the Advanced Motor Speech Profile program (MSP Model-5141, version-2.5.2 (KayPentax. The DDK sequence "pataka" was analyzed quantitatively through the Sound Forge 7.0 program, as well as manually with the audio-visual help of sound waves. Average values of oral and vocal fold DDK dysphonic and nondysphonic women were compared using the "t Student" test and were considered significant when p<0.05. Results: The findings showed no significant differences between populations; however, the coefficient of variation of period (CvP and jitter of period (JittP average of the "ka," "a" and "i" emissions, respectively, were higher in dysphonic women (CvP=10.42%, 12.79%, 12.05%; JittP=2.05%, 6.05%, 3.63% compared to the control group (CvP=8.86%; 10.95%, 11.20%; JittP=1.82%, 2.98%, 3.15%. Conclusion: Although the results do not indicate any difficulties in oral and laryngeal motor control in the dysphonic group, the largest instability in vocal fold DDK in the experimental group should be considered, and

  11. Influence of Asymmetric Stiffness on the Structural and Aerodynamic Response of Synthetic Vocal Fold Models

    OpenAIRE

    Pickup, B.A.; Thomson, S.L.

    2009-01-01

    The influence of asymmetric vocal fold stiffness on voice production was evaluated using life-sized, self-oscillating vocal fold models with an idealized geometry based on the human vocal folds. The models were fabricated using flexible, materially-linear silicone compounds with Young’s modulus values comparable to that of vocal fold tissue. The models included a two-layer design to simulate the vocal fold layered structure. The respective Young’s moduli of elasticity of the “left” and “right...

  12. Recurrent Vocal Fold Paralysis and Parsonage-Turner Syndrome

    Science.gov (United States)

    Joffily, Lucia; Vincent, Maurice Borges

    2013-01-01

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

  13. Recurrent Vocal Fold Paralysis and Parsonage-Turner Syndrome

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius Pinto

    2013-01-01

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

  14. Adapted to roar: functional morphology of tiger and lion vocal folds.

    Directory of Open Access Journals (Sweden)

    Sarah A Klemuk

    Full Text Available Vocal production requires active control of the respiratory system, larynx and vocal tract. Vocal sounds in mammals are produced by flow-induced vocal fold oscillation, which requires vocal fold tissue that can sustain the mechanical stress during phonation. Our understanding of the relationship between morphology and vocal function of vocal folds is very limited. Here we tested the hypothesis that vocal fold morphology and viscoelastic properties allow a prediction of fundamental frequency range of sounds that can be produced, and minimal lung pressure necessary to initiate phonation. We tested the hypothesis in lions and tigers who are well-known for producing low frequency and very loud roaring sounds that expose vocal folds to large stresses. In histological sections, we found that the Panthera vocal fold lamina propria consists of a lateral region with adipocytes embedded in a network of collagen and elastin fibers and hyaluronan. There is also a medial region that contains only fibrous proteins and hyaluronan but no fat cells. Young's moduli range between 10 and 2000 kPa for strains up to 60%. Shear moduli ranged between 0.1 and 2 kPa and differed between layers. Biomechanical and morphological data were used to make predictions of fundamental frequency and subglottal pressure ranges. Such predictions agreed well with measurements from natural phonation and phonation of excised larynges, respectively. We assume that fat shapes Panthera vocal folds into an advantageous geometry for phonation and it protects vocal folds. Its primary function is probably not to increase vocal fold mass as suggested previously. The large square-shaped Panthera vocal fold eases phonation onset and thereby extends the dynamic range of the voice.

  15. Adapted to roar: functional morphology of tiger and lion vocal folds.

    Science.gov (United States)

    Klemuk, Sarah A; Riede, Tobias; Walsh, Edward J; Titze, Ingo R

    2011-01-01

    Vocal production requires active control of the respiratory system, larynx and vocal tract. Vocal sounds in mammals are produced by flow-induced vocal fold oscillation, which requires vocal fold tissue that can sustain the mechanical stress during phonation. Our understanding of the relationship between morphology and vocal function of vocal folds is very limited. Here we tested the hypothesis that vocal fold morphology and viscoelastic properties allow a prediction of fundamental frequency range of sounds that can be produced, and minimal lung pressure necessary to initiate phonation. We tested the hypothesis in lions and tigers who are well-known for producing low frequency and very loud roaring sounds that expose vocal folds to large stresses. In histological sections, we found that the Panthera vocal fold lamina propria consists of a lateral region with adipocytes embedded in a network of collagen and elastin fibers and hyaluronan. There is also a medial region that contains only fibrous proteins and hyaluronan but no fat cells. Young's moduli range between 10 and 2000 kPa for strains up to 60%. Shear moduli ranged between 0.1 and 2 kPa and differed between layers. Biomechanical and morphological data were used to make predictions of fundamental frequency and subglottal pressure ranges. Such predictions agreed well with measurements from natural phonation and phonation of excised larynges, respectively. We assume that fat shapes Panthera vocal folds into an advantageous geometry for phonation and it protects vocal folds. Its primary function is probably not to increase vocal fold mass as suggested previously. The large square-shaped Panthera vocal fold eases phonation onset and thereby extends the dynamic range of the voice.

  16. Contact laser surgery in treatment of vocal fold paralysis.

    Science.gov (United States)

    Saetti, R; Silvestrini, M; Galiotto, M; Derosas, F; Narne, S

    2003-02-01

    Vocal fold paralysis is a pathological condition characterised by varying degrees of respiratory distress in relation to the degree of glottic stenosis. Dyspnoea may be present even when resting and may even require emergency tracheotomy. Frequently, the patient arrives for attention after the onset of exertional dyspnoea associated with a certain degree of dysphonia. The causes may be central or peripheral, more commonly iatrogenic following thyroid or tracheal surgery or secondary to injury. The aim of all surgical techniques used in the treatment of vocal fold paralysis is to restore a lumen sufficient to guarantee adequate breathing through the natural airway, without the patient having to permanently maintain the tracheotomy tube, while preserving acceptable phonatory quality. Between 1990 and 2001, at the Padua Hospital Unit of Endoscopic Airway Surgery, 48 patients (27 female, 21 male) were treated for respiratory distress secondary to vocal fold paralysis. At the beginning of this experience, 7 patients underwent arytenoidectomy with the Ossoff technique. In 34 cases, a modified Dennis-Kashima posterior cordectomy was performed. In 7 patients, since widening of the airway was necessary, cordectomy was extended to the false homolateral chord in 5 cases and to the arytenoid vocal process in another 2. In 9 patients, the operation was carried out with a Nd Yag (1064 nm) contact laser; the remaining 39 were treated with a GaArAl (810 nm) diode laser in use since 1995. Satisfactory results were obtained in all patients first treated by us and not already tracheotomised (35). In 23 cases (66%), results were considered "good" since no exertional dyspnoea occurred. In 12 patients (34%), the result was considered "sufficient" since there was no resting dyspnoea and normal everyday activity could be undertaken. Of the 13 patients already tracheotomised on arrival, 11 (85%) were decanulated on average 2 months after surgery. In conclusion, the present results show

  17. Modeling of the transient responses of the vocal fold lamina propria

    Science.gov (United States)

    Zhang, Kai; Siegmund, Thomas; Chan, Roger W.

    2008-01-01

    The human voice is produced by flow-induced self-sustained oscillation of the vocal fold lamina propria. The mechanical properties of vocal fold tissues are important for understanding phonation, including the time-dependent and transient changes in fundamental frequency (F0). Cyclic uniaxial tensile tests were conducted on a group of specimens of the vocal fold lamina propria, including the superficial layer (vocal fold cover) (5 male, 5 female) and the deeper layers (vocal ligament) (6 male, 6 female). Results showed that the vocal fold lamina propria, like many other soft tissues, exhibits both elastic and viscous behavior. Specifically, the transient mechanical responses of cyclic stress relaxation and creep were observed. A three-network constitutive model composed of a hyperelastic equilibrium network in parallel with two viscoplastic time-dependent networks proves effective in characterizing the cyclic stress relaxation and creep behavior. For male vocal folds at a stretch of 1.4, significantly higher peak stress was found in the vocal ligament than in the vocal fold cover. Also, the male vocal ligament was significantly stiffer than the female vocal ligament. Our findings may help explain the mechanisms of some widely observed transient phenomena in F0 regulation during phonation, such as the global declination in F0 during the production of declarative sentences, and local F0 changes such as overshoot and undershoot. PMID:19122858

  18. Fascia implantation with fibroblast growth factor on vocal fold paralysis.

    Science.gov (United States)

    Nagai, Hiromi; Nishiyama, Koichiro; Seino, Yutomo; Kimura, Yu; Tabata, Yasuhiko; Okamoto, Makito

    2013-01-01

    The purpose of this prospective study was to determine the effect of autologous transplantation of fascia into the vocal fold (ATFV) with controlled release of basic fibroblast growth factor (bFGF) on unilateral vocal fold paralysis (UVFP) in a rat model. Unilateral recurrent laryngeal nerve (RLN) section was performed on 15 rats. Ten rats received an autologous fascia implant and gelatin hydrogel with or without bFGF (1 μg) to their larynxes (fascia only, "fascia group"; bFGF + fascia, "fascia + bFGF group"), while the rest underwent RLN transection ("RLN section group"). Four months later, evaluation of the laryngeal glottal gap and histological analysis were performed. The glottal gap was significantly reduced in the fascia + bFGF group, and fat volume increased significantly relative to the RLN section. The volume of the remaining fascia in the bFGF + fascia group was significantly greater than that of the fascia group. ATFV with controlled release of bFGF may compensate for diminished laryngeal volume in UVFP by reducing resorption of the implanted fascia and increasing fat volume. Our findings suggest that this modality may represent an attractive option for treating UVFP. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Geometry of human vocal folds and glottal channel for mathematical and biomechanical modeling of voice production.

    Science.gov (United States)

    Sidlof, Petr; Svec, Jan G; Horácek, Jaromír; Veselý, Jan; Klepácek, Ivo; Havlík, Radan

    2008-01-01

    Current models of the vocal folds derive their shape from approximate information rather than from exactly measured data. The objective of this study was to obtain detailed measurements on the geometry of human vocal folds and the glottal channel in phonatory position. A non-destructive casting methodology was developed to capture the vocal fold shape from excised human larynges on both medial and superior surfaces. Two female larynges, each in two different phonatory configurations corresponding to low and high fundamental frequency of the vocal fold vibrations, were measured. A coordinate measuring machine was used to digitize the casts yielding 3D computer models of the vocal fold shape. The coronal sections were located in the models, extracted and fitted by piecewise-defined cubic functions allowing a mathematical expression of the 2D shape of the glottal channel. Left-right differences between the cross-sectional shapes of the vocal folds were found in both the larynges.

  20. Favorable Vocal Fold Wound Healing Induced by Platelet-Rich Plasma Injection

    OpenAIRE

    Woo, Seung Hoon; Jeong, Han-Sin; Kim, Jin Pyeong; Koh, Eun-Ha; Lee, Seon Uk; Jin, Sung Min; Kim, Dong Hoon; Sohn, Jin Hee; Lee, Sang Hyuk

    2014-01-01

    Objectives To introduce a new injection material for vocal fold diseases, which could be readily translated to clinical practice, we investigated the effectiveness of platelet-rich plasma (PRP) injection on the injured vocal fold in terms of histological recovery. Methods Blood samples were drawn from New Zealand White rabbits and PRP was isolated through centrifugation and separation of the samples. Using a CO2 laser, we made a linear wound in the 24 vocal fold sides of 12 rabbits and inject...

  1. A preliminary study of asymmetric vocal fold vibrations: modeling and "in-vitro" validation

    CERN Document Server

    Ruty, Nicolas; Pelorson, Xavier; Hirschberg, Avraham; Lopez-Arteaga, Ines

    2007-01-01

    This paper deals with some of aspects of the influence of asymmetry on vocal folds vibrations. A theoretical model of vocal fold asymmetry is presented. The influence of asymmetry is quantitatively examined in terms of oscillation frequency and pressure threshold. The theoretical model is compared to "in-vitro" experiment on a deformable replica of vocal folds. It is found that asymmetry strongly influences the oscillation subglottal pressure threshold. Moreover, the vocal fold with the highest mechanical resonance frequency imposes the oscillation fundamental frequency. The influence of geometrical asymmetry instead of purely mechanical asymmetry is shown

  2. 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…

  3. Comparison of Voice Outcome After Vocal Fold Augmentation With Fat or Calcium Hydroxylapatite

    NARCIS (Netherlands)

    Lodder, Wouter L.; Dikkers, Frederik G.

    2015-01-01

    Objectives/HypothesisTo evaluate the short-term voice outcomes of vocal fold augmentation using fat compared to calcium hydroxylapatite product Radiesse Voice (Merz Aesthetics). Study DesignRetrospective study design. MethodsSixty-six consecutive patients with vocal fold insufficiency were recruited

  4. THYROPLASTY TO IMPROVE THE VOICE IN PATIENTS WITH A UNILATERAL VOCAL FOLD PARALYSIS

    NARCIS (Netherlands)

    ROSINGH, HJ; DIKKERS, FG

    1995-01-01

    Unilateral vocal fold paralysis may cause incomplete closure of the glottis and a poor voice. Thyroplasty is a relative new operation to improve the voice by 'medialization' of the paralysed vocal fold. In our series of 29 patients 24 (83%) were satisfied and 26 (90%) had a better voice. After the o

  5. Voz e posição de prega vocal em homens com paralisia unilateral de prega vocal Voice and vocal fold position in men with unilateral vocal fold paralysis

    Directory of Open Access Journals (Sweden)

    Karine Schwarz

    2011-12-01

    Full Text Available O posicionamento da prega vocal paralisada e o grau de disfonia são fatores importantes para decidir as opções de tratamento na paralisia de prega vocal unilateral (PPVU. OBJETIVO: Verificar as características perceptivo-auditivas da voz e a posição da prega vocal paralisada, em homens, com PPVU. MATERIAIS E MÉTODOS: Estudo retrospectivo, coorte histórica, com corte transversal, com dados de 24 homens com PPVU, com média de 60,7 anos, submetidos à avaliação vocal perceptivo-auditiva da voz, por três juízas fonoaudiólogas e perceptivo-visual das imagens laríngeas, com a classificação da posição da prega vocal paralisada, por três juízes otorrinolaringologistas. RESULTADOS: A prega vocal paralisada em posição paramediana ocorreu em 45,83% dos casos; a intermediária, em 25%; a lateral, em 20,83%, e a mediana, em 4,16%; a disfonia resultante da PPVU foi caracterizada pela rouquidão, aspereza e tensão, de grau moderado; soprosidade (maior frequência do grau grave; astenia e instabilidade (maior frequência do grau leve; a posição da prega vocal paralisada influenciou significativamente o grau geral de desvio vocal. CONCLUSÃO: O grau geral de disfonia está relacionado com a posição da prega vocal paralisada; a disfonia é caracterizada pela presença de rouquidão, soprosidade, aspereza e tensão de grau moderado a grave.The paralyzed vocal fold positioning and the degree of dysphonia are important inputs when one is deciding upon treatment options for unilateral vocal fold paralysis (UVFP. OBJECTIVE: To check voice characteristics and paralyzed vocal fold position in men with UVFP. MATERIALS AND METHODS: This is a retrospective historical cross-sectional cohort study, with data from 24 men with UVFP with mean age of 60.7 years, submitted to voice assessment by three speech therapists and three ENT physicians used laryngeal images to classify the position of the paralyzed vocal fold. RESULTS: The paralyzed vocal fold

  6. Modeling and imaging of the vocal fold vibration for voice health

    DEFF Research Database (Denmark)

    Granados, Alba

    Identication of abnormalities on the vocal fold by means of dierent diagnostic methods is a key step to determine the cause or causes of a voice disorder, and subsequently give an adequate treatment. To this end, clinical investigations benet from accurate mathematical models for prediction...... modeling during asymmetric vocal fold vibration. The prediction problem is numerically addressed with a self-sustained three-dimensional nite element model of the vocal fold with position-based contact constraints. A novel contact detection mechanism is shown to successfully detect collision in asymmetric......, analysis and inference. This thesis deals with biomechanical models of the vocal fold, specially of the collision, and laryngeal videoendoscopic analysis procedures suitable for the inference of the underlying vocal fold characteristics. The rst part of this research is devoted to frictionless contact...

  7. Simulation of Vocal Folds: A Fluid-Induced Self-Oscillating Problem

    Science.gov (United States)

    Wang, Xingshi; Zhang, Lucy

    2009-11-01

    The goal of this study is to investigate the process of voice production by simulating the motion and deformation of human vocal folds. The vocal folds are oscillated by a constant lung pressure driven airflow in the throat. The system is modeled in 2-D using the immersed finite element method to simulate and study the fluid-structure interaction mechanism. From our numerical results, the glottal jets are identified. Several parameters such as the Reynolds number, Strouhal number, vocal folds stiffness, density ratio between the fluid and the structure are addressed and compared with experimental results. The frequency of the vocal folds vibration, fluid flow rate and pressure distribution are also investigated. In addition, the energy transfer between the fluid domain and the solid domain are analyzed to assist in explaining the underlying physical mechanism for this fluid-induced self-oscillating vocal folds.

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

    Directory of Open Access Journals (Sweden)

    Mioko Fukahori

    Full Text Available 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.Animal experiment using eight beagles (including three controls.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.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.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.

  9. Self-oscillating Vocal Fold Model Mechanics: Healthy, Diseased, and Aging

    Science.gov (United States)

    Hiubler, Elizabeth P.; Pollok, Lucas F. E.; Apostoli, Adam G.; Hancock, Adrienne B.; Plesniak, Michael W.

    2014-11-01

    Voice disorders have been estimated to have a substantial economic impact of 2.5 billion annually. Approximately 30% of people will suffer from a voice disorder at some point in their lives. Life-sized, self-oscillating, synthetic vocal fold (VF) models are fabricated to exhibit material properties representative of human VFs. These models are created both with and without a polyp-like structure, a pathology that has been shown to produce rich viscous flow structures not normally observed for healthy VFs during normal phonation. Pressure measurements are acquired upstream of the VFs and high-speed images are captured at varying flow rates during VF oscillation to facilitate an understanding of the characteristics of healthy and diseased VFs. The images are analyzed using a videokymography line-scan technique. Clinically-relevant parameters calculated from the volume-velocity output of a circumferentially-vented mask (Rothenberg mask) are compared to human data collected from two groups of males aged 18-30 and 60-80. This study extends the use of synthetic VF models by assessing their ability to replicate behaviors observed in human subject data to advance a means of investigating changes associated with normal, pathological, and the aging voice. Supported by the GWU Institute for Biomedical Engineering (GWIBE) and GWU Center for Biomimetics and Bioinspired Engineering (COBRE).

  10. Wavelet analysis of hemispheroid flow separation toward understanding human vocal fold pathologies

    Science.gov (United States)

    Plesniak, Daniel H.; Carr, Ian A.; Bulusu, Kartik V.; Plesniak, Michael W.

    2014-11-01

    Physiological flows observed in human vocal fold pathologies, such as polyps and nodules, can be modeled by flow over a wall-mounted protuberance. The experimental investigation of flow separation over a surface-mounted hemispheroid was performed using particle image velocimetry (PIV) and measurements of surface pressure in a low-speed wind tunnel. This study builds on the hypothesis that the signatures of vortical structures associated with flow separation are imprinted on the surface pressure distributions. Wavelet decomposition methods in one- and two-dimensions were utilized to elucidate the flow behavior. First, a complex Gaussian wavelet was used for the reconstruction of surface pressure time series from static pressure measurements acquired from ports upstream, downstream, and on the surface of the hemispheroid. This was followed by the application of a novel continuous wavelet transform algorithm (PIVlet 1.2) using a 2D-Ricker wavelet for coherent structure detection on instantaneous PIV-data. The goal of this study is to correlate phase shifts in surface pressure with Strouhal numbers associated with the vortex shedding. Ultimately, the wavelet-based analytical framework will be aimed at addressing pulsatile flows. This material is based in part upon work supported by the National Science Foundation under Grant Number CBET-1236351, and GW Center for Biomimetics and Bioinspired Engineering (COBRE).

  11. Modeling the Biomechanical Influence of Epilaryngeal Stricture on the Vocal Folds: A Low-Dimensional Model of Vocal-Ventricular Fold Coupling

    Science.gov (United States)

    Moisik, Scott R.; Esling, John H.

    2014-01-01

    Purpose: Physiological and phonetic studies suggest that, at moderate levels of epilaryngeal stricture, the ventricular folds impinge upon the vocal folds and influence their dynamical behavior, which is thought to be responsible for constricted laryngeal sounds. In this work, the authors examine this hypothesis through biomechanical modeling.…

  12. Familial congenital bilateral vocal fold paralysis: a novel gene translocation.

    Science.gov (United States)

    Hsu, Amy K; Rosow, David E; Wallerstein, Robert J; April, Max M

    2015-03-01

    True vocal fold (TVF) paralysis is a common cause of neonatal stridor and airway obstruction, though bilateral TVF paralysis is seen less frequently. Rare cases of familial congenital TVF paralysis have been described with implied genetic origin, but few genetic abnormalities have been discovered to date. The purpose of this study is to describe a novel chromosomal translocation responsible for congenital bilateral TVF immobility. The charts of three patients were retrospectively reviewed: a 35 year-old woman and her two children. The mother had bilateral TVF paralysis at birth requiring tracheotomy. Her oldest child had a similar presentation at birth and also required tracheotomy, while the younger child had laryngomalacia without TVF paralysis. Standard karyotype analysis was done using samples from all three patients and the parents of the mother, to assess whether a chromosomal abnormality was responsible. Karyotype analysis revealed the same balanced translocation between chromosomes 5 and 14, t(5;14) (p15.3, q11.2) in the mother and her two daughters. No other genetic abnormalities were identified. Neither maternal grandparent had the translocation, which appeared to be a spontaneous mutation in the mother with autosomal dominant inheritance and variable penetrance. A novel chromosomal translocation was identified that appears to be responsible for familial congenital bilateral TVF paralysis. While there are other reports of genetic abnormalities responsible for this condition, we believe this is the first describing this particular translocation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Effect of caffeine on the vocal folds: a pilot study.

    Science.gov (United States)

    Akhtar, S; Wood, G; Rubin, J S; O'Flynn, P E; Ratcliffe, P

    1999-04-01

    Caffeine is considered to be a dehydrating agent with detrimental effects on the quality of voice of persons ingesting it. This has led medical personnel dealing with voice disorders, especially in the case of professional voice users, to give advice against the use of caffeine. Yet this is an anecdotal truth as an extensive Medline literature search did not reveal any scientific evidence of caffeine being proven to have adverse effects on the vocal folds. We, therefore, initiated this pilot study to ascertain the connection between caffeine and voice quality on a laboratory basis. Two hundred and fifty mg of caffeine were provided to eight volunteers in tablet form, and blood levels along with laryngograph readings were recorded to document the changes produced. Analysing the irregularities of frequencies in a) free speech b) a reading passage and c) singing 'Happy Birthday', substantial changes were seen to authenticate the fact that caffeine does produce alterations in voice quality but these alterations have considerable intra-subject variability. A full study with wider parameters is to be performed on this subject as we consider it to be of importance in the management of voice disorders.

  14. Experimental and Theoretical Investigations of Phonation Threshold Pressure as a Function of Vocal Fold Elongation

    Science.gov (United States)

    Tao, Chao; Regner, Michael F.; Zhang, Yu; Jiang, Jack J.

    2014-01-01

    Summary The relationship between the vocal fold elongation and the phonation threshold pressure (PTP) was experimentally and theoretically investigated. The PTP values of seventeen excised canine larynges with 0% to 15% bilateral vocal fold elongations in 5% elongation steps were measured using an excised larynx phonation system. It was found that twelve larynges exhibited a monotonic relationship between PTP and elongation; in these larynges, the 0% elongation condition had the lowest PTP. Five larynges exhibited a PTP minimum at 5% elongation. To provide a theoretical explanation of these phenomena, a two-mass model was modified to simulate vibration of the elongated vocal folds. Two pairs of longitudinal springs were used to represent the longitudinal elastin in the vocal folds. This model showed that when the vocal folds were elongated, the increased longitudinal tension would increase the PTP value and the increased vocal fold length would decrease the PTP value. The antagonistic effects contributed by these two factors were found to be able to cause either a monotonic or a non-monotonic relationship between PTP and elongation, which were consistent with experimental observations. Because PTP describes the ease of phonation, this study suggests that there may exist a nonzero optimal vocal fold elongation for the greatest ease for phonation in some larynges. PMID:25530744

  15. Modal response of a computational vocal fold model with a substrate layer of adipose tissue.

    Science.gov (United States)

    Jones, Cameron L; Achuthan, Ajit; Erath, Byron D

    2015-02-01

    This study demonstrates the effect of a substrate layer of adipose tissue on the modal response of the vocal folds, and hence, on the mechanics of voice production. Modal analysis is performed on the vocal fold structure with a lateral layer of adipose tissue. A finite element model is employed, and the first six mode shapes and modal frequencies are studied. The results show significant changes in modal frequencies and substantial variation in mode shapes depending on the strain rate of the adipose tissue. These findings highlight the importance of considering adipose tissue in computational vocal fold modeling.

  16. Pediatric paradoxical vocal-fold motion: presentation and natural history.

    Science.gov (United States)

    Maturo, Stephen; Hill, Courtney; Bunting, Glenn; Baliff, Cathy; Ramakrishna, Jyoti; Scirica, Christina; Fracchia, Shannon; Donovan, Abigail; Hartnick, Christopher

    2011-12-01

    To describe (1) a cohort of children with paradoxical vocal-fold motion (PVFM) who were referred to a multidisciplinary airway center and (2) the outcomes of various treatment modalities including speech therapy, gastroesophageal reflux disease treatment, and psychiatric treatment. This was a case series with chart review of children younger than 18 years with PVFM evaluated at a tertiary care pediatric airway center over a 36-month period. Fifty-nine children with PVFM were evaluated. The cohort had a mean age of 13.64 years (range: 8-18 years) and a female-to-male ratio of 3:1. Speech therapy as an initial treatment resulted in a 63% (24 of 38) success rate after an average of 3.7 treatment sessions. Speech therapy was a more successful treatment than antireflux therapy (P = .001). Ten percent (6 of 59) of the children presented with a known psychiatric diagnosis, and 30% (18 of 59) of children in the cohort were ultimately diagnosed with a psychiatric condition. Children with inspiratory stridor at rest had a lower initial success rate with speech therapy (56%), a higher rate of underlying psychiatric disorders (75%), and a high rate of success after psychiatric treatment (100%) that required, on average, 3 sessions over a 2-month period. To our knowledge, this is the largest study to date on pediatric PVFM. The majority of children with PVFM improve with speech therapy. Children with PVFM at rest may be better treated with psychiatric therapy than speech therapy. Furthermore, children who present with symptoms at rest may have a higher likelihood of underlying psychiatric disease.

  17. Glottal jet measurements in synthetic, MRI-based human vocal fold models

    Science.gov (United States)

    Thomson, Scott; Pickup, Brian; Gollnick, Paul

    2007-11-01

    Human vocal fold vibration generates a time-varying elliptically-shaped glottal jet that produces sound in speech. Improved understanding of glottal jet dynamics can yield insight into voice production mechanisms and improve the diagnosis and treatment of voice disorders. Experiments using recently developed life-sized synthetic models of the vocal folds are presented. The fabrication process of converting MRI images to synthetic models is described. The process allows for varying the Young's modulus of the models, allowing for asymmetric conditions to be created by casting opposing vocal folds using materials of different stiffness. The models are shown to oscillate at frequencies, pressures, and flow rates typical of human speech. Phase-locked particle image velocimetry (PIV) results are presented which characterize the glottal jet, including jet direction, vortical structures, and turbulence levels. Results are shown for symmetric and asymmetric vocal fold models. The degree of material asymmetry required to cause significant asymmetry in the glottal jet is reported.

  18. A numerical strategy for finite element modeling of frictionless asymmetric vocal fold collision

    DEFF Research Database (Denmark)

    Granados, Alba; Misztal, Marek Krzysztof; Brunskog, Jonas;

    2016-01-01

    Analysis of voice pathologies may require vocal fold models that include relevant features such as vocal fold asymmetric collision. The present study numerically addresses the problem of frictionless asymmetric collision in a self-sustained three-dimensional continuum model of the vocal folds....... Theoretical background and numerical analysis of the finite-element position-based contact model are presented, along with validation. A novel contact detection mechanism capable to detect collision in asymmetric oscillations is developed. The effect of inexact contact constraint enforcement on vocal fold...... dynamics is examined by different variational methods for inequality constrained minimization problems, namely the Lagrange multiplier method and the penalty method. In contrast to the penalty solution, which is related to classical spring-like contact forces, numerical examples show that the parameter...

  19. Analysis of hyaluronic acid concentration in rat vocal folds during estral and gravidic puerperal cycles

    OpenAIRE

    Pedroso, José Eduardo de Sá [UNIFESP; Brasil,Osíris Camponês do; Martins, João Roberto Maciel [UNIFESP; Nader,Helena Bociane; Simões,Manuel de Jesus

    2009-01-01

    Hormone plays an important role in the larynx. Among other substances, vocal folds contain hyaluronic acid, which tissue concentration may vary according to hormone action. AIM: the objective of this study is to analyze hyaluronic acid concentration in the vocal folds during estral and gravidic-puerperal cycles. MATERIALS AND METHODS: Experimental study. 40 adult rats were divided into two groups. In the first group we used 20 rats to establish the concentration of hyaluronic acid during the ...

  20. Assessment of local vocal fold deformation characteristics in an in vitro static tensile test.

    Science.gov (United States)

    Dollinger, M; Berry, D A; Huttner, B; Bohr, C

    2011-08-01

    Voice quality is strongly dependent on vocal fold dynamics, which in turn are dependent on lung pressure and vocal fold biomechanics. Numerical and physical models are often used to investigate the interactions of these different subsystems. However, the utility of numerical and physical models is limited unless appropriately validated with data from physiological models. Hence a method that enables analysis of local vocal fold deformations along the entire surface is presented. In static tensile tests, forces are applied to distinctive working points being located in cover and muscle, respectively, so that specific layer properties can be investigated. The forces are directed vertically upward and are applied along or above the vocal fold edge. The resulting deformations are analyzed using multiple perspectives and three-dimensional reconstruction. Deformation characteristics of four human vocal folds were investigated. Preliminary results showed two phases of deformation: a range with a small slope for small deformations fading into a significant nonlinear deformation trend with a high slope. An increase of tissue stiffness from posterior to anterior was detected. This trend is more significant for muscle and in the mid-anterior half of the vocal fold.

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

    DEFF Research Database (Denmark)

    Wingstrand, Vibe Lindeblad; Grønhøj Larsen, Christian; 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 biomechan......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...

  2. MEASUREMENT OF YOUNG’S MODULUS OF VOCAL FOLDS BY INDENTATION

    Science.gov (United States)

    Chhetri, Dinesh K.; Zhang, Zhaoyan; Neubauer, Juergen

    2009-01-01

    Objectives To assess accuracy of the indentation method for stiffness measurements and to estimate the Young’s modulus of the vocal fold using this technique. Study Design Basic science. Methods Indentation tests were performed using a range of indenter diameters and indentation depths on single and double layer silicone rubber models with a range of cover layer thicknesses with known geometry and Young’s moduli. Measurements were repeated on intact vocal folds and isolated muscle and cover layer samples from three cadaveric human larynges. Results Indentation on single-layer rubber models yielded Young’s moduli with acceptable accuracy when the indentation depth was equal to or smaller than the indenter diameter, and both were smaller than the physical dimensions of the material sample. On two-layer models the stiffness estimation was similarly influenced by indenter diameter and indentation depth, and acceptable accuracy was reached when indentation depth was much smaller than the height of the top cover layer. Measurements on mid-membranous vocal fold tissue revealed location-dependent Young’s moduli (in kPa) as follows: intact hemilarynx 8.6 (range 5.3 – 13.1), isolated inferior medial surface cover 7.5 (range 7 – 7.9), isolated medial surface cover 4.8 (range 3.9–5.7), isolated superior surface cover 2.9 (range 2.7 – 3.2), and isolated thyroarytenoid muscle 2.0 (range 1.3 – 2.7). Conclusions Indenter diameter, indentation depth, and material thickness are important parameters in measurement of vocal fold stiffness using the indentation technique. Measurements on human larynges showed location-dependent differences in stiffness. The stiffness of the vocal folds was also found to be higher when the vocal fold structure was still attached to the laryngeal framework as compared to when the vocal fold was separated from the framework. PMID:20171829

  3. Time-resolved transglottal pressure measurements in a scaled up vocal fold model

    Science.gov (United States)

    Ringenberg, Hunter; Krane, Michael; Rogers, Dylan; Misfeldt, Mitchel; Wei, Timothy

    2016-11-01

    Experimental measurements of flow through a scaled up dynamic human vocal fold model are presented. The simplified 10x scale vocal fold model from Krane, et al. (2007) was used to examine fundamental features of vocal fold oscillatory motion. Of particular interest was the temporal variation of transglottal pressure multiplied by the volume flow rate through the glottis throughout an oscillation cycle. Experiments were dynamically scaled to examine a range of frequencies, 100 - 200 Hz, corresponding to the male and female voice. By using water as the working fluid, very high resolution, both spatial and temporal resolution, was achieved. Time resolved movies of flow through symmetrically oscillating vocal folds will be presented. Both individual realizations as well as phase-averaged data will be shown. Key features, such as randomness and development time of the Coanda effect, vortex shedding, and volume flow rate data have been presented in previous APS-DFD meetings. This talk will focus more on the relation between the flow and aeroacoustics associated with vocal fold oscillations. Supported by the NIH.

  4. A biphasic theory for the viscoelastic behaviors of vocal fold lamina propria in stress relaxation.

    Science.gov (United States)

    Zhang, Yu; Czerwonka, Lukasz; Tao, Chao; Jiang, Jack J

    2008-03-01

    In this study, a biphasic theory is applied to investigate the viscoelastic behaviors of vocal fold lamina propria during stress relaxation. The vocal fold lamina propria tissue is described as a biphasic material composed of a solid phase and an interstitial fluid phase. The biphasic theory reveals the interaction between the solid and the fluid. For the one-dimensional case, the analytical solutions of solid displacement, fluid velocity, and stress are derived. The biphasic theory predicts the stress relaxation of the vocal fold lamina propria. The quasilinear viscoelastic model as well as its higher-order elastic parameters can be derived from this biphasic theory. Furthermore, the fluid is found to support the majority of the stress at the early stage of stress relaxation; however, when the time becomes sufficiently large, the solid eventually bears all the stress. The early fluid stress support is much higher than the eventual solid support and may be important for understanding the effects of dehydration on tissue damage. By considering the solid-fluid structure of the vocal fold lamina propria, the biphasic theory allows for a more physical theory of tissue viscoelasticity than a single phase solid description and may provide a valuable physical mechanism for the observed vocal fold rheologic behaviors.

  5. Mucosal bridge and pitting of the true vocal fold: an unusual complication of cidofovir injection.

    Science.gov (United States)

    Man, Li-Xing; Statham, Melissa M; Rosen, Clark A

    2010-04-01

    We describe a unique complication of intralaryngeal cidofovir injection and present the case of a patient with recurrent respiratory papillomatosis in whom both a mucosal bridge and a pit of the true vocal fold developed after intralaryngeal cidofovir injection. A 40-year-old man presented with laryngeal papillomatosis 19 years after being treated with surgery and adjuvant radiotherapy for leiomyosarcoma of the cervical esophagus. The patient underwent 5 papillomatosis excisions combined with subepithelial injections of cidofovir to the bilateral true vocal folds at a concentration of 5 mg/mL without any complications. He subsequently received 2 higher-dose cidofovir treatments 6 weeks apart because of a poor response to the previous treatments. Two months later, there was evidence of a large mucosal bridge along the free edge of the right vocal fold and a deep pit in the lateral aspect of the same vocal fold. We conclude that repeated high-dose intralesional injection of cidofovir may result in significant morphological changes to the vocal fold, most likely due to mucosal injury.

  6. Natural and forced asymmetries in flow through a vocal fold model

    Science.gov (United States)

    Drain, Bethany; Lambert, Lori; Krane, Michael; Wei, Timothy

    2012-11-01

    Much of the complexity and richness of voice production stems from asymmetries in flow through the vocal folds. There are naturally occurring asymmetries, such as the Coanda effect (i . e . deviation of the glottal jet from the centerline as air passes through the nominally symmetric vocal folds). There are also asymmetries which arise from disease or dysfunction of the vocal folds. This study uses DPIV measurements in a dynamically scaled-up human vocal fold model to compare the flow characteristics between symmetric versus asymmetric oscillations. For this study, asymmetries were introduced by running one vocal fold out of phase with the other. Three phase lags, 0 18 and 36, were examined over a range of frequencies corresponding to the physiological frequencies of 50-200 Hz. Control volume analysis was applied and time traces of terms from the conservation of linear momentum equation were generated. This allowed analysis of how differences in the glottal jet flow manifest themselves in the fluid pressure field. In addition, further examination of the Coanda effect in the context of fluid pressure will be discussed. Supported by NIH.

  7. Quantitative analysis of vocal fold vibration during register change by high-speed digital imaging system

    Science.gov (United States)

    Kumada, Masanobu; Kobayashi, Noriko; Hirose, Hajime; Tayama, Niro; Imagawa, Hiroshi; Sakakibara, Ken-Ichi; Nito, Takaharu; Kakurai, Shin'ichi; Kumada, Chieko; Wada, Mamiko; Niimi, Seiji

    2002-05-01

    The physiological study of prosody is indispensable in terms not only of the physiological interest but also of the evaluation and treatment for pathological cases of prosody. In free talk, the changes of vocal fold vibration are found frequently and these phenomena are very important prosodic events. To analyze quantitatively the vocal fold vibration at the register change as the model of prosodic event, our high-speed digital imaging system was used at a rate of 4500 images of 256-256 pixels per second. Four healthy Japanese adults (2 males and 2 females) were served as subjects. Tasks were sustained phonation containing register changes. Two major categories (Category A and B) were found in the ways of changing of vocal fold vibrations at the register change. In Category A, changes were very smooth in terms of the vocal fold vibration. In Category B, changes were not so smooth with some additional events at the register change, such as the anterior-posterior phase difference of the vibration, the abduction of the vocal folds, or the interruption of the phonation. The number of the subtypes for Category B is thought to increase if more subjects with a wider range of variety are analyzed. For the study of prosody, our high-speed digital imaging system is a very powerful tool by which physiological information can be obtained.

  8. Performance of a reduced-order FSI model for flow-induced vocal fold vibration

    Science.gov (United States)

    Chang, Siyuan; Luo, Haoxiang; Luo's lab Team

    2016-11-01

    Vocal fold vibration during speech production involves a three-dimensional unsteady glottal jet flow and three-dimensional nonlinear tissue mechanics. A full 3D fluid-structure interaction (FSI) model is computationally expensive even though it provides most accurate information about the system. On the other hand, an efficient reduced-order FSI model is useful for fast simulation and analysis of the vocal fold dynamics, which is often needed in procedures such as optimization and parameter estimation. In this work, we study the performance of a reduced-order model as compared with the corresponding full 3D model in terms of its accuracy in predicting the vibration frequency and deformation mode. In the reduced-order model, we use a 1D flow model coupled with a 3D tissue model. Two different hyperelastic tissue behaviors are assumed. In addition, the vocal fold thickness and subglottal pressure are varied for systematic comparison. The result shows that the reduced-order model provides consistent predictions as the full 3D model across different tissue material assumptions and subglottal pressures. However, the vocal fold thickness has most effect on the model accuracy, especially when the vocal fold is thin. Supported by the NSF.

  9. Empirical Measurements of Biomechanical Anisotropy of the Human Vocal Fold Lamina Propria

    Science.gov (United States)

    Kelleher, Jordan E.; Siegmund, Thomas; Du, Mindy; Naseri, Elhum; Chan, Roger W.

    2013-01-01

    The vocal folds are known to be mechanically anisotropic due to the microstructural arrangement of fibrous proteins such as collagen and elastin in the lamina propria. Even though this has been known for many years, the biomechanical anisotropic properties have rarely been experimentally studied. We propose that an indentation procedure can be used with uniaxial tension in order to obtain an estimate of the biomechanical anisotropy within a single specimen. Experiments were performed on the lamina propria of three male and three female human vocal folds dissected from excised larynges. Two experiments were conducted: each specimen was subjected to cyclic uniaxial tensile loading in the longitudinal (i.e. anterior-posterior) direction, and then to cyclic indentation loading in the transverse (i.e. medial-lateral) direction. The indentation experiment was modeled as contact on a transversely isotropic half-space using the Barnett-Lothe tensors. The longitudinal elastic modulus EL was computed from the tensile test, and the transverse elastic modulus ET and longitudinal shear modulus GL were obtained by inverse analysis of the indentation force-displacement response. It was discovered that the average of EL/ET was 14 for the vocal ligament and 39 for the vocal fold cover specimens. Also, the average of EL/GL, a parameter important for models of phonation, was 28 for the vocal ligament and 54 for the vocal fold cover specimens. These measurements of anisotropy could contribute to more accurate models of fundamental frequency regulation and provide potentially better insights into the mechanics of vocal fold vibration. PMID:22886592

  10. Cause-effect relationship between vocal fold physiology and voice production in a three-dimensional phonation model

    OpenAIRE

    Zhang, Zhaoyan

    2016-01-01

    The goal of this study is to better understand the cause-effect relation between vocal fold physiology and the resulting vibration pattern and voice acoustics. Using a three-dimensional continuum model of phonation, the effects of changes in vocal fold stiffness, medial surface thickness in the vertical direction, resting glottal opening, and subglottal pressure on vocal fold vibration and different acoustic measures are investigated. The results show that the medial surface thickness has dom...

  11. An optical flow-based state-space model of the vocal folds

    DEFF Research Database (Denmark)

    Granados, Alba; Brunskog, Jonas

    2017-01-01

    . A linear and Gaussian nonstationary state-space model is proposed and thoroughly discussed. The evolution model is based on a self-sustained three-dimensional finite element model of the vocal folds, and the observation model involves a dense optical flow algorithm. The results show that the method is able......High-speed movies of the vocal fold vibration are valuable data to reveal vocal fold features for voice pathology diagnosis. This work presents a suitable Bayesian model and a purely theoretical discussion for further development of a framework for continuum biomechanical features estimation...... to capture different deformation patterns between the computed optical flow and the finite element deformation, controlled by the choice of the model tissue parameters....

  12. Change to earlier surgical interventions: contemporary management of unilateral vocal fold paralysis.

    Science.gov (United States)

    Costello, Declan

    2015-06-01

    The management of unilateral vocal fold paralysis has undergone significant changes in the last 2 decades. This has largely been made possible by advances in endoscope technology and new injectable materials. This article will cover the main changes in management of patients with unilateral vocal fold paralysis and summarize the recent literature in relation to early intervention in this group. Several recent studies have suggested that early vocal fold injection medialization reduces the likelihood of needing open laryngeal framework surgery in future. Early injection medialization appears to give good long-term results with few complications and minimizes the need for future laryngeal framework surgery. It should be considered in centres wherein the equipment and trained staff are available.

  13. 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.

  14. Examination of the Vocal Fold Paralysis on the Fluid Dynamics of the Glottis

    Science.gov (United States)

    Sherman, Erica; Krane, Michael; Zhang, Lucy; Wei, Timothy

    2011-11-01

    This talk is coupled to the symmetric vocal fold oscillation study presented in Halvorson, et al. In this study, one of the two symmetric vocal fold models was allowed to remain rigid while the other model was driven through a normal oscillation cycle. Again, a range of reduced frequencies were studied corresponding to physiological frequencies from 100--200 Hz. Flow measurements showing jet velocity and orientation, vortex shedding as a function of time through an oscillation cycle will be presented. Experimental data has been phase averaged to highlight characteristic differences between male and female voices. Additionally, volumetric flow rate and glottal behavior will be presented to show recurring features in phonation during an oscillation cycle. An example of differences between the paralysis case and the symmetrically oscillating vocal fold case is that the Coanda effect develops much more quickly and predictably for the paralysis case. Additional comparisons between diseased and healthy conditions will be presented and discussed. Supported by the NIH.

  15. Altered vocal fold kinematics in synthetic self-oscillating models that employ adipose tissue as a lateral boundary condition.

    Science.gov (United States)

    Saidi, Hiba; Erath, Byron D.

    2015-11-01

    The vocal folds play a major role in human communication by initiating voiced sound production. During voiced speech, the vocal folds are set into sustained vibrations. Synthetic self-oscillating vocal fold models are regularly employed to gain insight into flow-structure interactions governing the phonation process. Commonly, a fixed boundary condition is applied to the lateral, anterior, and posterior sides of the synthetic vocal fold models. However, physiological observations reveal the presence of adipose tissue on the lateral surface between the thyroid cartilage and the vocal folds. The goal of this study is to investigate the influence of including this substrate layer of adipose tissue on the dynamics of phonation. For a more realistic representation of the human vocal folds, synthetic multi-layer vocal fold models have been fabricated and tested while including a soft lateral layer representative of adipose tissue. Phonation parameters have been collected and are compared to those of the standard vocal fold models. Results show that vocal fold kinematics are affected by adding the adipose tissue layer as a new boundary condition.

  16. Airflow visualization in a model of human glottis near the self-oscillating vocal folds model

    Directory of Open Access Journals (Sweden)

    Horáček J.

    2011-06-01

    Full Text Available The contribution describes PIV (Particle Image Velocimetry measurement of airflow in the glottal region of complex physical models of the voice production that consist of 1 : 1 scaled models of the trachea, the self-oscillating vocal folds and the human vocal tract with acoustical spaces that correspond to the vowels /a:/, /u:/ and /i:/. The time-resolved PIV method was used for visualization of the airflow simultaneously with measurements of subglottal pressure, radiated acoustic pressure and vocal fold vibrations. The measurements were performed within a physiologically real range of mean airflow rate and fundamental phonation frequency. The images of the vibrating vocal folds during one oscillation period were recorded by the high-speed camera at the same time instants as the velocity fields measured by the PIV method.In the region above the models of the ventricular folds and of the epilaryngeal tube it is possible to detect large vortices with dimensions comparable with the channel cross-section and moving relatively slowly downstream. The vortices disappear in the narrower pharyngeal part of the vocal tract model where the flow is getting more uniform. The basic features of the coherent structures identified in the laryngeal cavity models in the interval of the measured airflow rates were found qualitatively similar for all three vowels investigated.

  17. [An uncommon cause for unilateral vocal fold paralisis: aortic aneurysms. Case report and literature review].

    Science.gov (United States)

    Coscarón Blanco, E; Blanco García, J L; Gómez González, J L

    2006-01-01

    Unilateral vocal fold paralysis is frequently encountered during ENT practise. It may result from many different conditions and it always should be regarded as a sign revealingan underlaying disease that can be located anywhere along the traject of the tenth cranial nerve or at the cricoarytenoidjoint being malignancies and trauma the leading causes. Etiology, glottal characteristics and compensative maneuvers, and individual factors such as comorbility or age must be considered when treatment options are proposed to the patient. A case of an uncommon etiology for unilateral vocal fold paralysis, an aortic aneurysm, is presented and considerations about the management of this condition are provided.

  18. Multidimensional effects of voice therapy in patients affected by unilateral vocal fold paralysis due to cancer.

    Science.gov (United States)

    Barcelos, Camila Barbosa; Silveira, Paula Angélica Lorenzon; Guedes, Renata Lígia Vieira; Gonçalves, Aline Nogueira; Slobodticov, Luciana Dall'Agnol Siqueira; Angelis, Elisabete Carrara-de

    2017-08-24

    Patients with unilateral vocal fold paralysis may demonstrate different degrees of voice perturbation depending on the position of the paralyzed vocal fold. Understanding the effectiveness of voice therapy in this population may be an important coefficient to define the therapeutic approach. To evaluate the voice therapy effectiveness in the short, medium and long-term in patients with unilateral vocal fold paralysis and determine the risk factors for voice rehabilitation failure. Prospective study with 61 patients affected by unilateral vocal fold paralysis enrolled. Each subject had voice therapy with an experienced speech pathologist twice a week. A multidimensional assessment protocol was used pre-treatment and in three different times after voice treatment initiation: short-term (1-3 months), medium-term (4-6 months) and long-term (12 months); it included videoendoscopy, maximum phonation time, GRBASI scale, acoustic voice analysis and the portuguese version of the voice handicap index. Multiple comparisons for GRBASI scale and VHI revealed statistically significant differences, except between medium and long term (p<0.005). The data suggest that there is vocal improvement over time with stabilization results after 6 months (medium term). From the 28 patients with permanent unilateral vocal fold paralysis, 18 (69.2%) reached complete glottal closure following vocal therapy (p=0.001). The logistic regression method indicated that the Jitter entered the final model as a risk factor for partial improvement. For every unit of increased jitter, there was an increase of 0.1% (1.001) of the chance for partial improvement, which means an increase on no full improvement chance during rehabilitation. Vocal rehabilitation improves perceptual and acoustic voice parameters and voice handicap index, besides favor glottal closure in patients with unilateral vocal fold paralysis. The results were also permanent during the period of 1 year. The Jitter value, when elevated, is

  19. Predictions of fundamental frequency changes during phonation based on a biomechanical model of the vocal fold lamina propria

    OpenAIRE

    Zhang, Kai; Siegmund, Thomas; Chan, Roger W.; Fu, Min

    2008-01-01

    This study examines the local and global changes of fundamental frequency (F0) during phonation and proposes a biomechanical model of predictions of F0 contours based on the mechanics of vibration of vocal fold lamina propria. The biomechanical model integrates the constitutive description of the tissue mechanical response with a structural model of beam vibration. The constitutive model accounts for the nonlinear and time dependent response of the vocal fold cover and the vocal ligament. The...

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

    NARCIS (Netherlands)

    DIKKERS, FG; SULTER, AM

    1994-01-01

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

  1. Localization of Label-Retaining Cells in Murine Vocal Fold Epithelium

    Science.gov (United States)

    Leydon, Ciara; Bartlett, Rebecca S.; Roenneburg, Drew A.; Thibeault, Susan L.

    2011-01-01

    Purpose: Epithelial homeostasis is critical for vocal fold health, yet little is known about the cells that support epithelial self-renewal. As a known characteristic of stem cells is that they are slow-cycling in vivo, the purpose of this prospective controlled study was to identify and quantify slow-cycling cells or putative stem cells in murine…

  2. Real-time kymographic imaging for visualizing human vocal-fold vibratory function

    NARCIS (Netherlands)

    Qiu, Qingjun; Schutte, Harm K.

    2007-01-01

    A stand-alone kymographic system for visualizing human vocal-fold vibration in real time is presented. By using a dual charge-coupled-device construction, the system not only provides kymographic images but also simultaneously presents structural images for navigating the endoscope to a desired posi

  3. Frequency Response of Synthetic Vocal Fold Models with Linear and Nonlinear Material Properties

    Science.gov (United States)

    Shaw, Stephanie M.; Thomson, Scott L.; Dromey, Christopher; Smith, Simeon

    2012-01-01

    Purpose: The purpose of this study was to create synthetic vocal fold models with nonlinear stress-strain properties and to investigate the effect of linear versus nonlinear material properties on fundamental frequency (F[subscript 0]) during anterior-posterior stretching. Method: Three materially linear and 3 materially nonlinear models were…

  4. Optical Measurements of Vocal Fold Tensile Properties: Implications for Phonatory Mechanics

    Science.gov (United States)

    Kelleher, Jordan E.; Siegmund, Thomas; Chan, Roger W.; Henslee, Erin A.

    2011-01-01

    In voice research, in vitro tensile stretch experiments of vocal fold tissues are commonly employed to determine the tissue biomechanical properties. In the standard stretch-release protocol, tissue deformation is computed from displacements applied to sutures inserted through the thyroid and arytenoid cartilages, with the cartilages assumed to be rigid. Here, a non-contact optical method was employed to determine the actual tissue deformation of vocal fold lamina propria specimens from three excised human larynges in uniaxial tensile tests. Specimen deformation was found to consist not only of deformation of the tissue itself, but also deformation of the cartilages, as well as suture alignment and tightening. Stress-stretch curves of a representative load cycle were characterized by an incompressible Ogden model. The initial longitudinal elastic modulus was found to be considerably higher if determined based on optical displacement measurements than typical values reported in the literature. The present findings could change the understanding of the mechanics underlying vocal fold vibration. Given the high longitudinal elastic modulus the lamina propria appeared to demonstrate a substantial level of anisotropy. Consequently, transverse shear could play a significant role in vocal fold vibration, and fundamental frequencies of phonation should be predicted by beam theories accounting for such effects. PMID:21497355

  5. Vocal fold hyalinosis in Urbach-Wiethe disease, a rare cause of hoarseness

    NARCIS (Netherlands)

    Honings, J.; Rossum, M.M. van; Hoogen, F.J.A. van den

    2015-01-01

    BACKGROUND: Lipoid proteinosis is an autosomal recessive disorder characterized by hyalin deposits in the skin and mucosa of the upper aerodigestive tract; currently, no treatment exists. Nearly all patients experience hoarseness and speech difficulties, due to hyalin deposition in the vocal folds a

  6. A Novel GMM-Based Feature Reduction for Vocal Fold Pathology Diagnosis

    Directory of Open Access Journals (Sweden)

    Vahid Majidnezhad

    2013-02-01

    Full Text Available Acoustic analysis is a proper method in vocal fold pathology diagnosis so that it can complement and in some cases replace the other invasive, based on direct vocal fold observation, methods. There are different approaches and algorithms for vocal fold pathology diagnosis. These algorithms usually have three stages which are Feature Extraction, Feature Reduction and Classification. While the third stage implies a choice of a variety of machine learning methods (Support Vector Machines, Gaussian Mixture Model, etc., the first and second stages play a critical role in performance and accuracy of the classification system. In this study we present initial study of feature extraction and feature reduction in the task of vocal fold pathology diagnosis. A new type of feature vector, based on wavelet packet decomposition and Mel-Frequency-Cepstral-Coefficients (MFCCs, is proposed. Also a new method for feature reduction is proposed and compared with conventional methods such as Principal Component Analysis (PCA, F-Ratio and Fisher’s discriminant ratio. Gaussian Mixture Model is used as a classifier for evaluating the performance of the proposed method. The results show the priority of the proposed method in comparison with current methods.

  7. Endoscopic laser treatment in pre-malignant and malignant vocal fold epithelial lesions.

    NARCIS (Netherlands)

    Remijn, E.E.; Marres, H.A.M.; Hoogen, F.J.A. van den

    2002-01-01

    Endoscopic laser treatment was performed in 43 patients with pre-malignant or malignant vocal fold epithelial lesions, 10 were treated with endoscopic laser surgery for dysplasia, 12 for carcinoma in situ (CIS), five for verrucous carcinoma and 16 patients for squamous cell carcinoma (SCC). Thirty-t

  8. Influence of subglottic stenosis on the flow-induced vibration of a computational vocal fold model

    Science.gov (United States)

    Smith, Simeon L.; Thomson, Scott L.

    2013-04-01

    The effect of subglottic stenosis on vocal fold vibration is investigated. An idealized stenosis is defined, parameterized, and incorporated into a two-dimensional, fully coupled finite element model of the vocal folds and laryngeal airway. Flow-induced responses of the vocal fold model to varying severities of stenosis are compared. The model vibration was not appreciably affected by stenosis severities of up to 60% occlusion. Model vibration was altered by stenosis severities of 90% or greater, evidenced by decreased superior model displacement, glottal width amplitude, and flow rate amplitude. Predictions of vibration frequency and maximum flow declination rate were also altered by high stenosis severities. The observed changes became more pronounced with increasing stenosis severity and inlet pressure, and the trends correlated well with flow resistance calculations. Flow visualization was used to characterize subglottal flow patterns in the space between the stenosis and the vocal folds. Underlying mechanisms for the observed changes, possible implications for human voice production, and suggestions for future work are discussed.

  9. Biofeedback Treatment of Paradoxical Vocal Fold Motion and Respiratory Distress in an Adolescent Girl

    Science.gov (United States)

    Warnes, Emily; Allen, Keith D.

    2005-01-01

    In this investigation, we evaluated the effectiveness of surface electromyography (EMG) biofeedback to treat paradoxical vocal fold motion in a 16-year-old girl. EMG biofeedback training occurred once per week over the course of 10 weeks. In a changing criterion design, muscle tension showed systematic changes that corresponded with changes in the…

  10. Magnetic Resonance Imaging of the Vocal Folds in Women with Congenital Adrenal Hyperplasia and Virilized Voices

    Science.gov (United States)

    Nygren, Ulrika; Isberg, Bengt; Arver, Stefan; Hertegård, Stellan; Södersten, Maria; Nordenskjöld, Agneta

    2016-01-01

    Purpose: Women with congenital adrenal hyperplasia (CAH) may develop a virilized voice due to late diagnosis or suboptimal suppression of adrenal androgens. Changes in the vocal folds due to virilization have not been studied in vivo. The purpose was to investigate if the thyroarytenoid (TA) muscle is affected by virilization and correlate…

  11. Endoscopic laser treatment in pre-malignant and malignant vocal fold epithelial lesions.

    NARCIS (Netherlands)

    Remijn, E.E.; Marres, H.A.M.; Hoogen, F.J.A. van den

    2002-01-01

    Endoscopic laser treatment was performed in 43 patients with pre-malignant or malignant vocal fold epithelial lesions, 10 were treated with endoscopic laser surgery for dysplasia, 12 for carcinoma in situ (CIS), five for verrucous carcinoma and 16 patients for squamous cell carcinoma (SCC).

  12. Combining multiobjective optimization and cluster analysis to study vocal fold functional morphology.

    Science.gov (United States)

    Palaparthi, Anil; Riede, Tobias; Titze, Ingo R

    2014-07-01

    Morphological design and the relationship between form and function have great influence on the functionality of a biological organ. However, the simultaneous investigation of morphological diversity and function is difficult in complex natural systems. We have developed a multiobjective optimization (MOO) approach in association with cluster analysis to study the form-function relation in vocal folds. An evolutionary algorithm (NSGA-II) was used to integrate MOO with an existing finite element model of the laryngeal sound source. Vocal fold morphology parameters served as decision variables and acoustic requirements (fundamental frequency, sound pressure level) as objective functions. A two-layer and a three-layer vocal fold configuration were explored to produce the targeted acoustic requirements. The mutation and crossover parameters of the NSGA-II algorithm were chosen to maximize a hypervolume indicator. The results were expressed using cluster analysis and were validated against a brute force method. Results from the MOO and the brute force approaches were comparable. The MOO approach demonstrated greater resolution in the exploration of the morphological space. In association with cluster analysis, MOO can efficiently explore vocal fold functional morphology.

  13. Influence of Embedded Fibers and an Epithelium Layer on the Glottal Closure Pattern in a Physical Vocal Fold Model

    Science.gov (United States)

    Xuan, Yue; Zhang, Zhaoyan

    2014-01-01

    Purpose: The purpose of this study was to explore the possible structural and material property features that may facilitate complete glottal closure in an otherwise isotropic physical vocal fold model. Method: Seven vocal fold models with different structural features were used in this study. An isotropic model was used as the baseline model, and…

  14. The Cystic Fibrosis Transmembrane Conductance Regulator and Chloride-Dependent Ion Fluxes of Ovine Vocal Fold Epithelium

    Science.gov (United States)

    Leydon, Ciara; Fisher, Kimberly V.; Lodewyck-Falciglia, Danielle

    2009-01-01

    Purpose: Ion-driven transepithelial water fluxes participate in maintaining superficial vocal fold hydration, which is necessary for normal voice production. The authors hypothesized that Cl[superscript -] channels are present in vocal fold epithelial cells and that transepithelial Cl[superscript -] fluxes can be manipulated pharmacologically.…

  15. New laryngoscope for quantitative high-speed imaging of human vocal folds vibration in the horizontal and vertical direction

    NARCIS (Netherlands)

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

    2008-01-01

    We report the design of a novel laser line-triangulation laryngoscope for the quantitative visualization of the three-dimensional movements of human vocal folds during phonation. This is the first successful in vivo recording of the three-dimensional movements of human vocal folds in absolute values

  16. Electroglottographic parameterization of the effects of gender, vowel and phonatory registers on vocal fold vibratory patterns: an Indian perspective.

    Science.gov (United States)

    Paul, Nilanjan; Kumar, Suman; Chatterjee, Indranil; Mukherjee, Biswarup

    2011-01-01

    In-depth study on laryngeal biomechanics and vocal fold vibratory patterns reveal that a single vibratory cycle can be divided into two major phases, the closed and open phase, which is subdivided into opening and closing phases. Studies reveal that the relative time course of abduction and adduction, which in turn is dependent on the relative relaxing and tensing of the vocal fold cover and body, to be the determining factor in production of a particular vocal register like the modal (or chest), falsetto, glottal fry registers. Studies further point out Electroglottography to be particularly suitable for the study of vocal vibratory patterns during register changes. However, to date, there has been limited study on quantitative parameterization of EGG wave form in vocal fry register. Moreover, contradictory findings abound in literature regarding effects of gender and vowel types on vocal vibratory patterns, especially during phonation at different registers. The present study endeavors to find out the effects of vowel and gender differences on the vocal fold vibratory patterns in different registers and how these would be reflected in standard EGG parameters of Contact Quotient (CQ) and Contact Index (CI), taking into consideration the Indian sociolinguistic context. Electroglottographic recordings of 10 young adults (5 males and 5 females) were taken while the subjects phonated the three vowels /a/,/i/,/u/ each in two vocal registers, modal and vocal fry. Obtained raw EGG were further normalized using the Derived EGG algorithm and theCQ and CI values were derived. Obtained data were subject to statistical analysis using the 3-way ANOVA with gender, vowel and vocal register as the three variables. Post-hoc Dunnett C multiple comparison analysis were also performed. Results reveal that CQ values are significantly higher in vocal fry than modal phonation for both males and females, indicating a relatively hyperconstricted vocal system during vocal fry. The males

  17. 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.

  18. Tracheal sounds and airflow dynamics in surgically treated unilateral vocal fold paralysis.

    Science.gov (United States)

    Saarinen, A; Rihkanen, H; Malmberg, L P; Pekkanen, L; Sovijärvi, A R

    2001-03-01

    The aim of this study was to investigate the changes in tracheal sounds and airflow dynamics in patients who underwent surgical medialization of a unilaterally paralysed vocal fold. Ten adults with unilateral vocal fold paralysis but no history of pulmonary diseases were included. Vocal fold medialization was performed by an injection of autologous fascia into the paralysed vocal fold. Recording of tracheal sounds, flow-volume spirometry and body plethysmography were carried out before and 4-14 months after the operation. The mean number of inspiratory wheezes per respiratory cycle increased from 0.02 (range 0-0.10) to 0.42 (range 0-0.86) and the mean number of expiratory wheezes per respiratory cycle from 0.03 (range 0-0.20) to 0.36 (range 0-0.89). The increment was statistically significant (P=0.03 and P=0.04, respectively). The mean expiratory sound amplitude, in terms of root mean square (RMS), increased from 31.5 dB (range 24.0-38.0) to 34.9 dB (range 25-42) (P=0.03) and the average peak inspiratory flow (PIF) decreased from 4.63 l s-1 (range 2.84-7.51) to 4.03 l s-1 (range 2.27-6.68) (P=0.01). The results indicate that when the paralysed vocal fold is brought into midline by a surgical procedure, the prevalence of inspiratory and expiratory wheezes increases and sound intensity rises. According to this preliminary data tracheal sound analysis gives additional information for the assessment of the subtle changes in the larynx.

  19. Laryngeal muscle activity in unilateral vocal fold paralysis patients using electromyography and coronal reconstructed images.

    Science.gov (United States)

    Sanuki, Tetsuji; Yumoto, Eiji; Nishimoto, Kohei; Minoda, Ryosei

    2014-04-01

    To assess laryngeal muscle activity in unilateral vocal fold paralysis (UVFP) patients using laryngeal electromyography (LEMG) and coronal images. Case series with chart review. University hospital. Twenty-one patients diagnosed with UVFP of at least 6 months in duration with paralytic dysphonia, underwent LEMG, phonatory function tests, and coronal imaging. A 4-point scale was used to grade motor unit (MU) recruitment: absent = 4+, greatly decreased = 3+, moderately decreased = 2+, and mildly decreased = 1+. Maximum phonation time (MPT) and mean flow rate (MFR) were employed. Coronal images were assessed for differences in thickness and vertical position of the vocal folds during phonation and inhalation. MU recruitment in thyroarytenoid/lateral cricoarytenoid (TA/LCA) muscle complex results were 1+ for 4 patients, 2+ for 5, 3+ for 6, and 4+ for 6. MPT was positively correlated with MU recruitment. Thinning of the affected fold was evident during phonation in 19 of the 21 subjects. The affected fold was at an equal level with the healthy fold in all 9 subjects with MU recruitment of 1+ and 2+. Eleven of 12 subjects with MU recruitments of 3+ and 4+ showed the affected fold at a higher level than the healthy fold. There was a significant difference between MU recruitment and the vertical position of the affected fold. Synkinetic reinnervation may occur in some cases with UVFP. MU recruitments of TA/LCA muscle complex in UVFP patients may be related to phonatory function and the vertical position of the affected fold.

  20. The ALE Discontinuous Galerkin Method for the Simulatio of Air Flow Through Pulsating Human Vocal Folds

    Science.gov (United States)

    Feistauer, Miloslav; Kučera, Václav; Prokopová, Jaroslav; Horáček, Jaromír

    2010-09-01

    The aim of this work is the simulation of viscous compressible flows in human vocal folds during phonation. The computational domain is a bounded subset of IR2, whose geometry mimics the shape of the human larynx. During phonation, parts of the solid impermeable walls are moving in a prescribed manner, thus simulating the opening and closing of the vocal chords. As the governing equations we take the compressible Navier-Stokes equations in ALE form. Space semidiscretization is carried out by the discontinuous Galerkin method combined with a linearized semi-implicit approach. Numerical experiments are performed with the resulting scheme.

  1. What can vortices tell us about vocal fold vibration and voice production.

    Science.gov (United States)

    Khosla, Sid; Murugappan, Shanmugam; Gutmark, Ephraim

    2008-06-01

    Much clinical research on laryngeal airflow has assumed that airflow is unidirectional. This review will summarize what additional knowledge can be obtained about vocal fold vibration and voice production by studying rotational motion, or vortices, in laryngeal airflow. Recent work suggests two types of vortices that may strongly contribute to voice quality. The first kind forms just above the vocal folds during glottal closing, and is formed by flow separation in the glottis; these flow separation vortices significantly contribute to rapid closing of the glottis, and hence, to producing loudness and high frequency harmonics in the acoustic spectrum. The second is a group of highly three-dimensional and coherent supraglottal vortices, which can produce sound by interaction with structures in the vocal tract. Present work is also described that suggests that certain laryngeal pathologies, such as asymmetric vocal fold tension, will significantly modify both types of vortices, with adverse impact on sound production: decreased rate of glottal closure, increased broadband noise, and a decreased signal to noise ratio. Recent research supports the hypothesis that glottal airflow contains certain vortical structures that significantly contribute to voice quality.

  2. 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.

  3. Functional histology of the macula flava in the human vocal fold--Part 2: Its role in the growth and development of the vocal fold.

    Science.gov (United States)

    Sato, Kiminori; Umeno, Hirohito; Nakashima, Tadashi

    2010-01-01

    This study aims to clarify the role of the maculae flavae (MFe) during growth and development of the human vocal fold mucosa (VFM). Our current results concerning the MFe in the human newborn, infant, and child VFM are summarized. Newborns already had immature MFe at the same sites as adults. They were composed of dense masses of vocal fold stellate cells (VFSCs), whereas extracellular matrix components were sparse. VFSCs in the newborn MFe had already started synthesizing extracellular matrices (EM). During infancy, the EM synthesized in the MFe appeared in the VFM to initiate the formation of the three-dimensional extracellular matrix structure of the human VFM. During childhood, MFe including VFSCs continued to synthesize EM such as collagenous, reticular, and elastic fibers, and hyaluronic acid (glycosaminoglycan), which are essential for the human VFM as a vibrating tissue. The MFe in newborns, infants and children were related to the growth and development of the human VFM. Human MFe including VFSCs were inferred to be involved in the metabolism of EM, essential for the viscoelasticity of the human VFM, and are considered to be an important structure in the growth and development of the human VFM. Copyright © 2010 S. Karger AG, Basel.

  4. Kinematic Measurements of the Vocal-Fold Displacement Waveform in Typical Children and Adult Populations: Quantification of High-Speed Endoscopic Videos

    Science.gov (United States)

    Patel, Rita; Donohue, Kevin D.; Unnikrishnan, Harikrishnan; Kryscio, Richard J.

    2015-01-01

    Purpose: This article presents a quantitative method for assessing instantaneous and average lateral vocal-fold motion from high-speed digital imaging, with a focus on developmental changes in vocal-fold kinematics during childhood. Method: Vocal-fold vibrations were analyzed for 28 children (aged 5-11 years) and 28 adults (aged 21-45 years)…

  5. A mechanical experimental setup to simulate vocal folds vibrations. Preliminary results

    CERN Document Server

    Ruty, Nicolas; Pelorson, Xavier; Lopez-Arteaga, Ines; Hirschberg, Avraham

    2005-01-01

    This paper contributes to the understanding of vocal folds oscillation during phonation. In order to test theoretical models of phonation, a new experimental set-up using a deformable vocal folds replica is presented. The replica is shown to be able to produce self sustained oscillations under controlled experimental conditions. Therefore different parameters, such as those related to elasticity, to acoustical coupling or to the subglottal pressure can be quantitatively studied. In this work we focused on the oscillation fundamental frequency and the upstream pressure in order to start (on-set threshold) either end (off-set threshold) oscillations in presence of a downstream acoustical resonator. As an example, it is shown how this data can be used in order to test the theoretical predictions of a simple one-mass model.

  6. Oscillation region of a piecewise-smooth model of the vocal folds

    OpenAIRE

    Lucero, Jorge C.; Gajo, Cristiane A.

    2006-01-01

    The two-mass model of the vocal folds is a popular representation of their dynamical structure used in phonation studies. This paper presents an analysis of a recent piecewise-smooth version of the model. This version has two equilibrium positions, and in one of them (the initial prephonatory position) the system is nondifferentiable. Standard methods of stability analysis do not apply for that position, because they require smoothness of the system. A geometrical approac...

  7. Predictions of fundamental frequency changes during phonation based on a biomechanical model of the vocal fold lamina propria

    Science.gov (United States)

    Zhang, Kai; Siegmund, Thomas; Chan, Roger W.; Fu, Min

    2009-01-01

    This study examines the local and global changes of fundamental frequency (F0) during phonation and proposes a biomechanical model of predictions of F0 contours based on the mechanics of vibration of vocal fold lamina propria. The biomechanical model integrates the constitutive description of the tissue mechanical response with a structural model of beam vibration. The constitutive model accounts for the nonlinear and time dependent response of the vocal fold cover and the vocal ligament. The structural model of the vocal fold lamina propria is based on a composite beam model with axial stress. Results show that local fluctuations such as F0 overshoots and undershoots can be characterized by the biomechanical model and might be related to the processes of stress relaxation of vocal fold tissues during length changes. The global changes of F0 declination in declarative sentence production can also be characterized by the model. Such F0 declination is partially attributed to the peak stress decay associated with stress relaxation of the vocal fold lamina propria and partially to neuromuscular control of the vocal fold length. PMID:18191379

  8. Predictions of fundamental frequency changes during phonation based on a biomechanical model of the vocal fold lamina propria.

    Science.gov (United States)

    Zhang, Kai; Siegmund, Thomas; Chan, Roger W; Fu, Min

    2009-05-01

    This study examines the local and global changes of fundamental frequency (F(0)) during phonation and proposes a biomechanical model of predictions of F(0) contours based on the mechanics of vibration of vocal fold lamina propria. The biomechanical model integrates the constitutive description of the tissue mechanical response with a structural model of beam vibration. The constitutive model accounts for the nonlinear and time-dependent response of the vocal fold cover and the vocal ligament. The structural model of the vocal fold lamina propria is based on a composite beam model with axial stress. Results show that local fluctuations such as F(0) overshoots and undershoots can be characterized by the biomechanical model and might be related to the processes of stress relaxation of vocal fold tissues during length changes. The global changes of F(0) declination in declarative sentence production can also be characterized by the model. Such F(0) declination is partially attributed to the peak stress decay associated with stress relaxation of the vocal fold lamina propria and partially to neuromuscular control of the vocal fold length.

  9. A cervid vocal fold model suggests greater glottal efficiency in calling at high frequencies.

    Directory of Open Access Journals (Sweden)

    Ingo R Titze

    Full Text Available Male Rocky Mountain elk (Cervus elaphus nelsoni produce loud and high fundamental frequency bugles during the mating season, in contrast to the male European Red Deer (Cervus elaphus scoticus who produces loud and low fundamental frequency roaring calls. A critical step in understanding vocal communication is to relate sound complexity to anatomy and physiology in a causal manner. Experimentation at the sound source, often difficult in vivo in mammals, is simulated here by a finite element model of the larynx and a wave propagation model of the vocal tract, both based on the morphology and biomechanics of the elk. The model can produce a wide range of fundamental frequencies. Low fundamental frequencies require low vocal fold strain, but large lung pressure and large glottal flow if sound intensity level is to exceed 70 dB at 10 m distance. A high-frequency bugle requires both large muscular effort (to strain the vocal ligament and high lung pressure (to overcome phonation threshold pressure, but at least 10 dB more intensity level can be achieved. Glottal efficiency, the ration of radiated sound power to aerodynamic power at the glottis, is higher in elk, suggesting an advantage of high-pitched signaling. This advantage is based on two aspects; first, the lower airflow required for aerodynamic power and, second, an acoustic radiation advantage at higher frequencies. Both signal types are used by the respective males during the mating season and probably serve as honest signals. The two signal types relate differently to physical qualities of the sender. The low-frequency sound (Red Deer call relates to overall body size via a strong relationship between acoustic parameters and the size of vocal organs and body size. The high-frequency bugle may signal muscular strength and endurance, via a 'vocalizing at the edge' mechanism, for which efficiency is critical.

  10. Towards A Simulation-Based Tool for the Treatment of Vocal Fold Paralysis

    Directory of Open Access Journals (Sweden)

    Rajat eMittal

    2011-05-01

    Full Text Available Advances in high-performance computing are enabling a new generation of software tools that employ computational modeling for surgical planning. Surgical management of laryngeal paralysis is one area where such computational tools could have a significant impact. The current paper describes a comprehensive effort to develop a software tool for planning medialization laryngoplasty where a prosthetic implant is inserted into the larynx in order to medialize the paralyzed vocal-fold. While this is one of the most common procedures used to restore voice in patients with vocal-fold paralysis, it has a relatively high revision rate, and the tool being developed is expected to improve surgical outcomes. This software tool models the biomechanics of airflow-induced vibration in the human larynx and incorporates sophisticated approaches for modeling the turbulent laryngeal flow, the complex dynamics of the vocal folds, as well as the production of voiced sound. The current paper describes the key elements of the modeling approach, presents computational results that demonstrate the utility of the approach and also describes some of the limitations and challenges.

  11. Resolution of vocal fold leukoplakia during erlotinib treatment for lung cancer.

    Science.gov (United States)

    Francis, David O; Misono, Stephanie; Somerville, Jessica; McWhorter, Andrew; Garrett, C Gaelyn

    2016-02-01

    Treatment of vocal fold leukoplakia is complicated because it is associated with a high rate of recurrence after excision and it has the potential for progression to malignancy. Authors have presented different approaches to management, one of which is directed serial excisional biopsies. Ideally, a topical or systemic agent could be administered to eradicate this troublesome condition. We present the case of a patient with an 8-year history of vocal fold leukoplakia treated with directed serial biopsies who was subsequently diagnosed with non-small-cell lung cancer and treated with erlotinib. He experienced a complete resolution after 2 months of erlotinib therapy for his lung cancer. Immunohistochemistry confirmed that his lesion exhibited a much higher than normal expression of epidermal growth factor receptor (EGFR), which supports the idea that EGFR antagonism may combat EGFR-avid leukoplakia. However, we caution that the clinical observation made herein is an association and should not be misconstrued as a recommendation regarding the safety, efficacy, or economy of using erlotinib for the treatment of vocal fold leukoplakia.

  12. Acromegaly Presenting With Bilateral Vocal Fold Immobility: Case Report and Review of the Literature.

    Science.gov (United States)

    Cooper, Timothy; Dziegielewski, Peter T; Singh, Praby; Seemann, Robert

    2016-11-01

    To present a case of bilateral vocal fold immobility (BVCI) in a patient with acromegaly and review the current literature describing this presentation. Case report and literature review. Academic tertiary care center. English language literature search of online journal databases. A 56-year-old man presented with 3 months of progressive stridor and shortness of breath. Transnasal flexible endoscopy revealed BVCI. A tracheostomy was performed to secure his airway. Further history was suggestive of acromegaly and imaging demonstrated a pituitary macroadenoma. The diagnosis of acromegaly was made. The patient was treated with octreotide followed by an endoscopic trans sphenoidal resection of the pituitary adenoma. Sixteen months after his initial presentation, a right laser arytenoidectomy was performed and the patient was subsequently decannulated. In the literature to date, 11 cases of BVCI in acromegaly have been reported. These patients often present with stridor and require a tracheostomy. With treatment of their acromegaly, these patients may regain vocal fold mobility and may be decannulated. Acromegaly with BVCI is a rare presentation. Acute management of the airway of patients with acromegaly presenting with BVCI typically requires a tracheostomy. A period of 15 months should be allowed for restoration of vocal fold mobility before airway opening procedures are considered. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  13. Frequency Response of Synthetic Vocal Fold Models with Linear and Nonlinear Material Properties

    Science.gov (United States)

    Shaw, Stephanie M.; Thomson, Scott L.; Dromey, Christopher; Smith, Simeon

    2014-01-01

    Purpose The purpose of this study was to create synthetic vocal fold models with nonlinear stress-strain properties and to investigate the effect of linear versus nonlinear material properties on fundamental frequency during anterior-posterior stretching. Method Three materially linear and three materially nonlinear models were created and stretched up to 10 mm in 1 mm increments. Phonation onset pressure (Pon) and fundamental frequency (F0) at Pon were recorded for each length. Measurements were repeated as the models were relaxed in 1 mm increments back to their resting lengths, and tensile tests were conducted to determine the stress-strain responses of linear versus nonlinear models. Results Nonlinear models demonstrated a more substantial frequency response than did linear models and a more predictable pattern of F0 increase with respect to increasing length (although range was inconsistent across models). Pon generally increased with increasing vocal fold length for nonlinear models, whereas for linear models, Pon decreased with increasing length. Conclusions Nonlinear synthetic models appear to more accurately represent the human vocal folds than linear models, especially with respect to F0 response. PMID:22271874

  14. Airway flow dynamics and voice acoustics after autologous fascia augmentation of paralyzed vocal fold.

    Science.gov (United States)

    Saarinen, A; Rihkanen, H; Lehikoinen-Söderlund, S; Sovijärvi, A R

    2000-06-01

    The aim of this study was to assess the effect of vocal fold medialization, accomplished by injection of autologous fascia, on airflow dynamics and voice acoustics. Ten patients with unilateral vocal fold paralysis were included. Flow-volume spirometry, body plethysmography, and acoustic analysis of voice were performed within 1 week before injection of autologous fascia and 4 to 14 months after operation. Medialization of the paralyzed vocal fold decreased the mean peak inspiratory flow (PIF) from 4.63 L to 4.10 L (p = .012). The acoustic characteristics of the voice improved: the values of jitter, shimmer, and mean noise-to-harmonics ratio decreased significantly (p = .006, p = .017, and p = .047, respectively), and the mean maximal phonation time almost doubled (p = .002). Changes in PIF and shimmer showed a negative correlation (r = -.857, p = .007). In conclusion, injection of autologous fascia improves voice acoustics, but induces a slight abnormal limitation on PIF. The results also suggest that improvement in voice acoustics is most prominent in subjects with the least deterioration in inspiratory airflow.

  15. Cause-effect relationship between vocal fold physiology and voice production in a three-dimensional phonation model.

    Science.gov (United States)

    Zhang, Zhaoyan

    2016-04-01

    The goal of this study is to better understand the cause-effect relation between vocal fold physiology and the resulting vibration pattern and voice acoustics. Using a three-dimensional continuum model of phonation, the effects of changes in vocal fold stiffness, medial surface thickness in the vertical direction, resting glottal opening, and subglottal pressure on vocal fold vibration and different acoustic measures are investigated. The results show that the medial surface thickness has dominant effects on the vertical phase difference between the upper and lower margins of the medial surface, closed quotient, H1-H2, and higher-order harmonics excitation. The main effects of vocal fold approximation or decreasing resting glottal opening are to lower the phonation threshold pressure, reduce noise production, and increase the fundamental frequency. Increasing subglottal pressure is primarily responsible for vocal intensity increase but also leads to significant increase in noise production and an increased fundamental frequency. Increasing AP stiffness significantly increases the fundamental frequency and slightly reduces noise production. The interaction among vocal fold thickness, stiffness, approximation, and subglottal pressure in the control of F0, vocal intensity, and voice quality is discussed.

  16. Irregular vocal fold dynamics incited by asymmetric fluid loading in a model of recurrent laryngeal nerve paralysis

    Science.gov (United States)

    Sommer, David; Erath, Byron D.; Zanartu, Matias; Peterson, Sean D.

    2011-11-01

    Voiced speech is produced by dynamic fluid-structure interactions in the larynx. Traditionally, reduced order models of speech have relied upon simplified inviscid flow solvers to prescribe the fluid loadings that drive vocal fold motion, neglecting viscous flow effects that occur naturally in voiced speech. Viscous phenomena, such as skewing of the intraglottal jet, have the most pronounced effect on voiced speech in cases of vocal fold paralysis where one vocal fold loses some, or all, muscular control. The impact of asymmetric intraglottal flow in pathological speech is captured in a reduced order two-mass model of speech by coupling a boundary-layer estimation of the asymmetric pressures with asymmetric tissue parameters that are representative of recurrent laryngeal nerve paralysis. Nonlinear analysis identifies the emergence of irregular and chaotic vocal fold dynamics at values representative of pathological speech conditions.

  17. The efficacy with self polyphonic vocal polyps soup for postoperative recovery of polyp of cord%自拟复音汤对声带息肉术后恢复的疗效探讨

    Institute of Scientific and Technical Information of China (English)

    韩丽; 李琴; 韩思伟; 罗伟国

    2014-01-01

    目的:探讨自拟复音汤对声带息肉术后恢复的临床效果。方法选择我科住院手术的声带息肉患者共80例,按照随机数字分为两组,每组40例,其中对照组术后予制酸、超声雾化、禁声等治疗,观察组则在对照组的基础上使用本研究自拟复音汤治疗,连续治疗7d后,比较两组患者治疗前后发音改善积分及临床效果。结果两组治疗前主观嗓音评价差异无统计学意义(P>0.05),治疗后观察组主观嗓音评价显著低于对照组(P<0.05),观察组痊愈率90.0%,显著高于对照组的62.5%(P<0.05)。结论自拟复音汤能更好地促进声带息肉患者术后恢复,提高临床治疗效果。%ObjectiveTo investigate the clinical effects of self polyphonic vocal polyps soup for postoperative recovery of polyp of cord.Methods 80 cases with polyp of cord were randomly divided into two groups according to the figures, 40 cases each, the control group were used acid, ultrasonic atomization, gag, the observation group were used the self polyphonic vocal polyps soup on the basis of the control group, continuous treatment for 7 days, then pronunciation improve integration and clinical, subjective voice evaluation in two groups were compared before and after treatment. ResultsSubjective voice before and after treatment had no difference (P>0.05), after treatment, the observation group with subjective voice was lower than control group (P<0.05), the observation group cure rate was 90%, it was higher than 62.5% of control group (P<0.05). Conclusion Self polyphony soup can better promote the recovery of postoperative recovery of polyp of cord, and it can improve clinical outcomes.

  18. Correlation of the Vocal Fold Vibratory Pattern to the Post-Operative Surgical Wound in the Porcine Model.

    Science.gov (United States)

    1992-02-15

    critical depth of vocal fold injury causing significant disruption of the vocal fold vibration. Materials and Methods Twelve adult, male, castrated ...near the apex of the vestibule, were away from the biopsy site. 14 Discussion Miniswine were selected for this study for several reasons. Castrated male...Nerve Stimulation on Phonation: A Glottographic Study Using in vivo Canine Model. J. Acoust. Soc. Am., 83:705-715, 1988. 10. Tanabe, M., Isshiki, N

  19. A three-dimensional model of vocal fold abduction/adduction

    Science.gov (United States)

    Hunter, Eric J.; Titze, Ingo R.; Alipour, Fariborz

    2004-04-01

    A three-dimensional biomechanical model of tissue deformation was developed to simulate dynamic vocal fold abduction and adduction. The model was made of 1721 nearly incompressible finite elements. The cricoarytenoid joint was modeled as a rocking-sliding motion, similar to two concentric cylinders. The vocal ligament and the thyroarytenoid muscle's fiber characteristics were implemented as a fiber-gel composite made of an isotropic ground substance imbedded with fibers. These fibers had contractile and/or passive nonlinear stress-strain characteristics. The verification of the model was made by comparing the range and speed of motion to published vocal fold kinematic data. The model simulated abduction to a maximum glottal angle of about 31°. Using the posterior-cricoarytenoid muscle, the model produced an angular abduction speed of 405° per second. The system mechanics seemed to favor abduction over adduction in both peak speed and response time, even when all intrinsic muscle properties were kept identical. The model also verified the notion that the vocalis and muscularis portions of the thyroarytenoid muscle play significantly different roles in posturing, with the muscularis portion having the larger effect on arytenoid movement. Other insights into the mechanisms of abduction/adduction were given.

  20. Comprehensive, Population-Based Sensitivity Analysis of a Two-Mass Vocal Fold Model.

    Directory of Open Access Journals (Sweden)

    Daniel Robertson

    Full Text Available Previous vocal fold modeling studies have generally focused on generating detailed data regarding a narrow subset of possible model configurations. These studies can be interpreted to be the investigation of a single subject under one or more vocal conditions. In this study, a broad population-based sensitivity analysis is employed to examine the behavior of a virtual population of subjects and to identify trends between virtual individuals as opposed to investigating a single subject or model instance. Four different sensitivity analysis techniques were used in accomplishing this task. Influential relationships between model input parameters and model outputs were identified, and an exploration of the model's parameter space was conducted. Results indicate that the behavior of the selected two-mass model is largely dominated by complex interactions, and that few input-output pairs have a consistent effect on the model. Results from the analysis can be used to increase the efficiency of optimization routines of reduced-order models used to investigate voice abnormalities. Results also demonstrate the types of challenges and difficulties to be expected when applying sensitivity analyses to more complex vocal fold models. Such challenges are discussed and recommendations are made for future studies.

  1. Discovery of a low frequency sound source in Mysticeti (baleen whales): anatomical establishment of a vocal fold homolog.

    Science.gov (United States)

    Reidenberg, Joy S; Laitman, Jeffrey T

    2007-06-01

    The mechanism of mysticete (baleen whale) vocalization has remained a mystery. Vocal folds (true vocal "cords"), the structures responsible for sound production in terrestrial mammals, were thought to be absent in whales. This study tests the hypothesis that the mysticete larynx possesses structures homologous to vocal folds and that they are capable of sound generation. Laryngeal anatomy was examined in 37 specimens representing 6 mysticete species. Results indicate the presence of a U-shaped fold (U-fold) in the lumen of the larynx. The U-fold is supported by arytenoid cartilages, controlled by skeletal muscles innervated by the recurrent laryngeal nerve, is adjacent to a diverticulum (laryngeal sac) covered with mucosa innervated by the superior laryngeal nerve, and contains a ligament-conditions that also define the vocal folds of terrestrial mammals and, therefore, supports homology. Unlike the vocal folds of terrestrial mammals, which are perpendicular to airflow, the mysticete U-fold is oriented parallel to airflow. U-fold adduction/abduction and elevation/depression may control airflow, and vibration of its edges may generate sounds. The walls of the laryngeal sac can expand and contract, may serve as a resonant space, and may also propagate vibrations generated by movements of the supporting arytenoid cartilages. The extensive musculature surrounding the laryngeal sac may enable rapid and forceful expulsion of air from the lumen of the sac into other respiratory spaces, or maintain a constant sac volume despite the effects of ambient pressure (e.g., changes during diving or ascent). The size and complexity of the mysticete larynx indicates an organ with multiple functions, including protection during breathing/swallowing, regulation of airflow and pressures in the respiratory spaces, and sound generation. The presence of a vocal fold homolog offers a new insight into both the mechanism of sound generation by mysticetes and the divergent evolution of

  2. Detection of the Vibration Signal from Human Vocal Folds Using a 94-GHz Millimeter-Wave Radar

    Science.gov (United States)

    Chen, Fuming; Li, Sheng; Zhang, Yang; Wang, Jianqi

    2017-01-01

    The detection of the vibration signal from human vocal folds provides essential information for studying human phonation and diagnosing voice disorders. Doppler radar technology has enabled the noncontact measurement of the human-vocal-fold vibration. However, existing systems must be placed in close proximity to the human throat and detailed information may be lost because of the low operating frequency. In this paper, a long-distance detection method, involving the use of a 94-GHz millimeter-wave radar sensor, is proposed for detecting the vibration signals from human vocal folds. An algorithm that combines empirical mode decomposition (EMD) and the auto-correlation function (ACF) method is proposed for detecting the signal. First, the EMD method is employed to suppress the noise of the radar-detected signal. Further, the ratio of the energy and entropy is used to detect voice activity in the radar-detected signal, following which, a short-time ACF is employed to extract the vibration signal of the human vocal folds from the processed signal. For validating the method and assessing the performance of the radar system, a vibration measurement sensor and microphone system are additionally employed for comparison. The experimental results obtained from the spectrograms, the vibration frequency of the vocal folds, and coherence analysis demonstrate that the proposed method can effectively detect the vibration of human vocal folds from a long detection distance. PMID:28282892

  3. Three-Dimensional Optical Reconstruction of Vocal Fold Kinematics Using High-Speed Video With a Laser Projection System.

    Science.gov (United States)

    Luegmair, Georg; Mehta, Daryush D; Kobler, James B; Döllinger, Michael

    2015-12-01

    Vocal fold kinematics and its interaction with aerodynamic characteristics play a primary role in acoustic sound production of the human voice. Investigating the temporal details of these kinematics using high-speed videoendoscopic imaging techniques has proven challenging in part due to the limitations of quantifying complex vocal fold vibratory behavior using only two spatial dimensions. Thus, we propose an optical method of reconstructing the superior vocal fold surface in three spatial dimensions using a high-speed video camera and laser projection system. Using stereo-triangulation principles, we extend the camera-laser projector method and present an efficient image processing workflow to generate the three-dimensional vocal fold surfaces during phonation captured at 4000 frames per second. Initial results are provided for airflow-driven vibration of an ex vivo vocal fold model in which at least 75% of visible laser points contributed to the reconstructed surface. The method captures the vertical motion of the vocal folds at a high accuracy to allow for the computation of three-dimensional mucosal wave features such as vibratory amplitude, velocity, and asymmetry.

  4. Quantitative measurement of the medial surface dynamics of the vocal folds using high-speed digital imaging

    Science.gov (United States)

    Doellinger, Michael; Neubauer, Juergen; Berry, David A.

    2003-10-01

    To increase our understanding of pathological and healthy voice production, the quantitative measurement of the medial surface dynamics of the vocal folds is significant, albeit rarely performed because of the inaccessibility of the vocal folds. Hence, an excised hemilarynx procedure is applied, Berry et al. recently reported such quantitative measurements along one coronal plane of the left vocal fold of a canine [J. Acoust. Soc. Am. 110, 2539-2547 (2001)]. The present work extends previous studies by capturing vibrations along the entire medial surface of the left vocal fold. The number of vertical rows of sutures used to demarcate fleshpoints was increased from one to five. An automatic algorithm for tracking vocal fold fleshpoints will be reported, along with calibration techniques, and error estimation. Preliminary results will be reported for both periodic and aperiodic vocal fold vibrations. High-speed digital imaging was performed using a Photron APX machine with a sampling frequency of 4000 Hz, a spatial resolution of 1024×512 pixels, and 256 levels of grayscale.

  5. Multimodal imaging of vocal fold scarring in a rabbit model by multiphoton microscopy

    Science.gov (United States)

    Kazarine, Alexei; Bouhabel, Sarah; Douillette, Annie H.; Kost, Karen; Li-Jessen, Nicole Y. K.; Mongeau, Luc; Wiseman, Paul W.

    2017-02-01

    Vocal fold scarring as a result of injury or disease can lead to voice disorders which can significantly affect the quality of life. During the scarring process, the normally elastic tissue of the vocal fold lamina propria is replaced by a much stiffer collagen-based fibrotic tissue, which impacts the fold's ability to vibrate. Surgical removal of this tissue is often ineffective and can result in further scarring. Injectable biomaterials, a form of tissue engineering, have been proposed as a potential solution to reduce existing scars or prevent scarring altogether. In order to properly evaluate the effectiveness of these new materials, multiphoton microscopy emerges as an effective tool due to its intrinsic multiple label free contrast mechanisms that highlight extracellular matrix elements. In this study, we evaluate the spatial distribution of collagen and elastin fibers in a rabbit model using second harmonic generation (SHG), third harmonic generation (THG) and two photon autofluorescence (TPAF) applied to unlabeled tissue sections. In comparison to traditional methods that rely on histological staining or immunohistochemistry, SHG, THG and TPAF provide a more reliable detection of these native proteins. The evaluation of collagen levels allows us to follow the extent of scarring, while the presence of elastin fibers is thought to be indicative of the level of healing of the injured fold. Using these imaging modalities, we characterize the outcome of injectable biomaterial treatments in order to direct future treatments for tissue engineering.

  6. Polydimethylsiloxane Injection Laryngoplasty for Unilateral Vocal Fold Paralysis: Long-Term Results.

    Science.gov (United States)

    Mattioli, Francesco; Bettini, Margherita; Botti, Cecilia; Busi, Giulia; Tassi, Sauro; Malagoli, Andrea; Molteni, Gabriele; Trebbi, Marco; Luppi, Maria Pia; Bergamini, Giuseppe; Presutti, Livio

    2017-07-01

    To analyze the long-term objective, perceptive, and subjective outcomes after endoscopic polydimethylsiloxane (PDMS) injection laryngoplasty in unilateral vocal fold paralysis. A retrospective study carried out between January 2008 and January 2012. Head and Neck Department, University Hospital of Modena, Modena, Italy. This was a retrospective analysis of 26 patients with unilateral vocal fold paralysis who underwent endoscopic injection of PDMS under general anesthesia. A voice evaluation protocol was performed for all patients, which included videolaryngostroboscopy, maximum phonation time, fundamental frequency, analysis of the harmonic structure of the vowel /a/ and the word /aiuole/, Grade of Dysphonia, Instability, Roughness, Breathiness, Asthenia, and Strain scale, and Voice Handicap Index. The protocol was performed before surgery, in the immediate postoperative period, and at least 3 years after surgery. The mean follow-up period was 73 months (range 39-119 months). The statistical analysis showed a significant improvement (P < 0.01) for all of the objective, perceptive, and subjective parameters by comparison between the preoperative and long-term follow-up data; moreover, no statistically significant difference was found between the postoperative and long-term follow-up data. This indicates that injection laryngoplasty with PDMS guarantees long-lasting effects over time. No complications were reported in our series. Injection laryngoplasty with PDMS can be considered to be a minimally invasive and safe technique for the treatment of unilateral vocal fold paralysis. Moreover, it allows very good and stable results to be obtained over time, avoiding repeated treatments and improving the quality of life of the patients. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  7. Evaluation of Synthetic Self-Oscillating Models of the Vocal Folds

    Science.gov (United States)

    Hubler, Elizabeth P.; Weiland, Kelley S.; Hancock, Adrienne B.; Plesniak, Michael W.

    2013-11-01

    Approximately 30% of people will suffer from a voice disorder at some point in their lives. The probability doubles for those who rely heavily on their voice, such as teachers and singers. Synthetic vocal fold (VF) models are fabricated and evaluated experimentally in a vocal tract simulator to replicate physiological conditions. Pressure measurements are acquired along the vocal tract and high-speed images are captured at varying flow rates during VF oscillation to facilitate understanding of the characteristics of healthy and damaged VFs. The images are analyzed using a videokymography line-scan technique that has been used to examine VF motion and mucosal wave dynamics in vivo. Clinically relevant parameters calculated from the volume-velocity output of a circumferentially-vented mask (Rothenberg mask) are compared to patient data. This study integrates speech science with engineering and flow physics to overcome current limitations of synthetic VF models to properly replicate normal phonation in order to advance the understanding of resulting flow features, progression of pathological conditions, and medical techniques. Supported by the GW Institute for Biomedical Engineering (GWIBE) and GW Center for Biomimetics and Bioinspired Engineering (COBRE).

  8. Viscoelastic shear properties of human vocal fold mucosa: theoretical characterization based on constitutive modeling.

    Science.gov (United States)

    Chan, R W; Titze, I R

    2000-01-01

    The viscoelastic shear properties of human vocal fold mucosa (cover) were previously measured as a function of frequency [Chan and Titze, J. Acoust. Soc. Am. 106, 2008-2021 (1999)], but data were obtained only in a frequency range of 0.01-15 Hz, an order of magnitude below typical frequencies of vocal fold oscillation (on the order of 100 Hz). This study represents an attempt to extrapolate the data to higher frequencies based on two viscoelastic theories, (1) a quasilinear viscoelastic theory widely used for the constitutive modeling of the viscoelastic properties of biological tissues [Fung, Biomechanics (Springer-Verlag, New York, 1993), pp. 277-292], and (2) a molecular (statistical network) theory commonly used for the rheological modeling of polymeric materials [Zhu et al., J. Biomech. 24, 1007-1018 (1991)]. Analytical expressions of elastic and viscous shear moduli, dynamic viscosity, and damping ratio based on the two theories with specific model parameters were applied to curve-fit the empirical data. Results showed that the theoretical predictions matched the empirical data reasonably well, allowing for parametric descriptions of the data and their extrapolations to frequencies of phonation.

  9. Novel isolation and biochemical characterization of immortalized fibroblasts for tissue engineering vocal fold lamina propria.

    Science.gov (United States)

    Chen, Xia; Thibeault, Susan L

    2009-06-01

    Tissue regeneration of the vocal fold lamina propria extracellular matrix (ECM) will be facilitated by the use of suitable vocal fold fibroblast (VFF) cell lines in appropriate model systems. Primary human VFFs (hVFFs) were steadily transduced by a retroviral vector containing human telomerase reverse transcriptase (hTERT) gene; immortalized cells grew and divided vigorously for more than 120 days. Biochemical characterization of the six transduced lines included, at different time points, expression of hTERT, telomerase activity, telomere lengths, and transcript levels of ECM constituents. Telomere lengths of the transfected lines were elongated and stable. Gene expression levels of collagen Ialpha1, collagen Ialpha2, collagen VIalpha3, elastin, and fibronectin were measured between the transduced cell clones and the primary hVFFs to verify transcription. Absence of inter- and intraspecies contamination was confirmed with DNA fingerprinting and karyotype analysis. Cell morphology, growth, and transcription expression were examined on 2D scaffolds-collagen, fibronectin, and hyaluronic acid. Immortalized hVFFs demonstrated normal attachment and spread on 2D scaffolds. Collagen Ialpha1, collagen Ialpha2, collagen VIalpha3, elastin, and fibronectin transcript expression was measured from immortalized hVFFs, for all surfaces. This is the first report of immortalization and biochemical characterization of hVFFs, providing a novel and invaluable tool for tissue regeneration applications in the larynx.

  10. Study of non-linear deformation of vocal folds in simulations of human phonation

    Science.gov (United States)

    Saurabh, Shakti; Bodony, Daniel

    2014-11-01

    Direct numerical simulation is performed on a two-dimensional compressible, viscous fluid interacting with a non-linear, viscoelastic solid as a model for the generation of the human voice. The vocal fold (VF) tissues are modeled as multi-layered with varying stiffness in each layer and using a finite-strain Standard Linear Solid (SLS) constitutive model implemented in a quadratic finite element code and coupled to a high-order compressible Navier-Stokes solver through a boundary-fitted fluid-solid interface. The large non-linear mesh deformation is handled using an elliptic/poisson smoothening technique. Supra-glottal flow shows asymmetry in the flow, which in turn has a coupling effect on the motion of the VF. The fully compressible simulations gives direct insight into the sound produced as pressure distributions and the vocal fold deformation helps study the unsteady vortical flow resulting from the fluid-structure interaction along the full phonation cycle. Supported by the National Science Foundation (CAREER Award Number 1150439).

  11. Medialization of paralyzed vocal fold does not increase respiratory resistance measured by impulse oscillometry.

    Science.gov (United States)

    Saarinen, Antti; Sovijärvi, Anssi R A; Karhumäki, Lauri; Rihkanen, Heikki

    2007-11-01

    Injection laryngoplasty restores voice in subjects with unilateral vocal fold paralysis, but knowledge of its effects on airflow dynamics is limited. Impulse oscillometry (IOS) is a non-invasive technique to investigate airway resistance. It is easily performed during normal breathing. A prospective study was conducted in order to investigate the effects of autologous fascia injection on airflow dynamics. IOS, flow-volume spirometry, acoustic analysis of voice, voice handicap index (VHI) questionnaire and subjective dyspnoea score were recorded before and 5-11 months after the operation. There was no significant change in respiratory resistance (Rres) or other variables of IOS. FEV1/FVC decreased from 0.80 to 0.77 (P = 0.02), but other variables of spirometry did not change significantly. Acoustic properties of voice (noise-to-harmonics ratio, shimmer, jitter, maximal phonation time) and VHI improved significantly. No change in dyspnoea occurred. In conclusion, medializing of a paralysed vocal fold improves voice, but does not have a clinically significant adverse effect on breathing. Flow-volume spirometry is more sensitive than IOS to changes in airflow dynamics after medialization.

  12. Viscoelasticity of hyaluronic acid-gelatin hydrogels for vocal fold tissue engineering.

    Science.gov (United States)

    Kazemirad, Siavash; Heris, Hossein K; Mongeau, Luc

    2016-02-01

    Crosslinked injectable hyaluronic acid (HA)-gelatin (Ge) hydrogels have remarkable viscoelastic and biological properties for vocal fold tissue engineering. Patient-specific tuning of the viscoelastic properties of this injectable biomaterial could improve tissue regeneration. The frequency-dependent viscoelasticity of crosslinked HA-Ge hydrogels was measured as a function of the concentration of HA, Ge, and crosslinker. Synthetic extracellular matrix hydrogels were fabricated using thiol-modified HA and Ge, and crosslinked by poly(ethylene glycol) diacrylate. A recently developed characterization method based on Rayleigh wave propagation was used to quantify the frequency-dependent viscoelastic properties of these hydrogels, including shear storage and loss moduli, over a broad frequency range; that is, from 40 to 4000 Hz. The viscoelastic properties of the hydrogels increased with frequency. The storage and loss moduli values and the rate of increase with frequency varied with the concentrations of the constituents. The range of the viscoelastic properties of the hydrogels was within that of human vocal fold tissue obtained from in vivo and ex vivo measurements. Frequency-dependent parametric relations were obtained using a linear least-squares regression. The results are useful to better fine-tune the storage and loss moduli of HA-Ge hydrogels by varying the concentrations of the constituents for use in patient-specific treatments.

  13. A bioreactor for the dynamic mechanical stimulation of vocal-fold fibroblasts based on vibro-acoustography

    Science.gov (United States)

    Chan, Roger W.; Rodriguez, Maritza

    2005-09-01

    During voice production, the vocal folds undergo airflow-induced self-sustained oscillation at a fundamental frequency of around 100-1000 Hz, with an amplitude of around 1-3 mm. The vocal-fold extracellular matrix (ECM), with appropriate tissue viscoelastic properties, is optimally tuned for such vibration. Vocal-fold fibroblasts regulate the gene expressions for key ECM proteins (e.g., collagen, fibronectin, fibromodulin, and hyaluronic acid), and these expressions are affected by the stress fields experi- enced by the fibroblasts. This study attempts to develop a bioreactor for cultivating cells under a micromechanical environment similar to that in vivo, based on the principle of vibro-acoustography. Vocal-fold fibroblasts from primary culture were grown in 3D, biodegradable scaffolds, and were excited dynamically by the radiation force generated by amplitude modulation of two confocal ultrasound beams of slightly different frequencies. Low-frequency acoustic radiation force was applied to the scaffold surface, and its vibratory response was imaged by videostroboscopy. A phantom tissue (standard viscoelastic material) with known elastic modulus was also excited and its vibratory frequency and amplitude were measured by videostroboscopy. Results showed that the bioreactor was capable of delivering mechanical stimuli to the tissue constructs in a physiological frequency range (100-1000 Hz), supporting its potential for vocal-fold tissue engineering applications. [Work supported by NIH Grant R01 DC006101.

  14. Making a diagnosis of different lesions of vocal fold mucosa by contact endoscopy: The first usage in our clinical practice

    Directory of Open Access Journals (Sweden)

    Jovanović Milan B.

    2005-01-01

    Full Text Available During laryngomicroscopy, the superficial layers of vocal fold epithelium can be examined in vivo and in situ by contact endoscopy. Methylene blue is applied initially to stain the epihelial cells of the vocal folds. When in contact with mucosal tissue, this endoscope provides 60 and 150 times magnification and clear visualization of cellular patterns of the superficial epithelial layers. For the first time in our laryngological clinical practice, we confirmed a number of previously established parametars such as regularity and arrangement of the epithelium, nucleus contour, and nucleus-cytoplasm ratio, what all enable recognition and easy evaluation of different clinical conditions such as chronic laryngitis, Reinke.s edema, papiloma dyspiasia or vocal fold carcinoma. The advantage of con- tact endoscopy in vivo and in situ allows for detailed scan and mapping of all cell changes of the whole mucosa surface. All these features definitely classify the contact endoscopy into additional diagnostic methods in laryngology.

  15. Effect of subglottic stenosis on the flow-induced vibration of a self-oscillating computational vocal fold model

    Science.gov (United States)

    Smith, Simeon L.; Thomson, Scott L.

    2010-11-01

    The subglottis plays an important role in voice production; however, in general the role of subglottal geometry in phonation is not well understood. This research focuses on studying how subglottic stenosis, or a narrowing of the airway below the vocal folds, affects the response of a self-oscillating computational vocal fold model. Methods are described for computational model development, including stenotic geometry definition from CT scan images, incorporation of the stenosis into a finite element fluid-structure interaction model, and parametric variation of the degree of stenosis severity. Results are presented for a normal (no stenosis) case and five cases of varying degrees of stenosis severity. Qualitative and quantitative comparisons of vocal fold vibratory motion and of flow behavior for the six cases are made, including characterization of flow patterns in the subglottis, glottal width and flow rate time histories, vibration frequency, and airway resistance.

  16. The unsolved chapter of vocal fold scars and how tissue engineering could help us solve the problem.

    Science.gov (United States)

    Graupp, M; Bachna-Rotter, S; Gerstenberger, C; Friedrich, G; Fröhlich-Sorger, E; Kiesler, K; Gugatschka, M

    2016-09-01

    Vocal fold scarring is a relatively small field in scar research with prerequisites found nowhere else. The deterioration of the delicate tri-layered micro-structure of the epithelium of the vocal folds leads to impaired vibration characteristics resulting in a permanent hoarse and breathy voice. Tissue engineering approaches could help to restore the pre-injury status. Despite a considerable progress in this field during the last years, routine clinical applications are not available so far. One reason might be that vocal fold fibroblasts, as the responsible cell type for fibrogenesis, have very particular properties that are only poorly characterized. Moreover, in vivo trials are costly and time consuming and a representative in vitro model does not exist so far. These particular circumstances lead to innovative in vitro strategies and concepts such as macro-molecular crowding that can also be applied in adjacent fields.

  17. Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

    Science.gov (United States)

    Laban, Mohamed; Eisa, Marwa M.

    2016-01-01

    The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P = 0.223; P = 0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB. PMID:28003825

  18. Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding.

    Science.gov (United States)

    Laban, Mohamed; Hussain, Sherif H; Hassanin, Alaa S; Khalaf, Waleed M; Etman, Mohamed K; Elsafty, Mohammed S E; Bahaa Eldin, Ahmed M; Hasanien, Ahmad S; Sakna, Noha A; Taema, Mohammed; Mostafa, Mohammed H; Eisa, Marwa M

    2016-01-01

    The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P = 0.223; P = 0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB.

  19. Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

    Directory of Open Access Journals (Sweden)

    Mohamed Laban

    2016-01-01

    Full Text Available The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS, and three-dimensional (3D Virtual Organ Computer-aided AnaLysis™ (VOCAL to detect endometrial polyps (EPs in premenopausal women with abnormal uterine bleeding (AUB. This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33% were diagnosed with EP by 2D TVUS. 50 (45.9% had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P=0.223; P=0.06. 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB.

  20. Effects of deep brain stimulation on vocal fold immobility in Parkinson's disease

    Science.gov (United States)

    Arocho-Quinones, Elsa V.; Hammer, Michael J.; Bock, Jonathan M.; Pahapill, Peter A.

    2017-01-01

    Background: Vocal fold (VF) immobility is a rare, potentially fatal complication of advanced Parkinson's disease (PD). Previous reports suggest that subthalamic nucleus deep brain stimulation (STN-DBS) may influence laryngeal function, yet the role of STN-DBS on VF immobility remains unexplored. Case Description: We report a case of a patient with advanced PD and bilateral VF immobility ultimately requiring a tracheostomy. To assess the effects of STN-DBS on vocal cord function and to correlate these effects with peripheral motor symptoms at different stimulation settings, the patient was evaluated before and after initiation of bilateral STN-DBS. Measures included direct observation of VF mobility via transnasal laryngoscopy, levodopa equivalent dose of anti-PD medication, and motor scores. High frequency (150 Hz) STN-DBS resulted in improved motor scores, reduced medication requirement, and modestly improved right VF abduction although insufficient for safe decannulation. Low frequency (60 Hz) stimulation resulted in lower motor scores, but without worsening VF abduction. Conclusions: STN-DBS may play an important role in the neuromodulation of PD-induced laryngeal dysfunction, including VF mobility. Characterization of these axial symptoms is important when programming and evaluating responsiveness to DBS. PMID:28303202

  1. The Research of the Relationship between Perceived Stress Level and Times of Vibration of Vocal Folds

    Directory of Open Access Journals (Sweden)

    Yin Zhigang

    2012-11-01

    Full Text Available Whether a syllable is perceived as stressed or not and whether the stress is strong or weak are hot issues in speech prosody research and speech recognition. A focus of the stress study is on the investigation of the acoustic factors which contribute to the perception of stress level. This study examined all possible acoustic/physiological cues to stress based on data from Annotated Chinese Speech Corpus and proposed that times of vibration of vocal folds (TVVF reflects stress level best. It is traditionally held that pitch and duration are the most important acoustic parameters to stress. But for Chinese which is a tone language and features special strong-weak pattern in prosody, these two parameters might not be the best ones to represent stress degree. This paper proposed that TVVF, reflected as the number of wave pulses of the vocalic part of a syllable, is the ideal parameter to stress level. Since number of pulses is the integral of pitch and duration (Pulse=?f(pitchdt, TVVF can embody the effect of stress on both pitch and duration. The analyses revealed that TVVF is most correlated with the grades of stress. Therefore, it can be a more effective parameter indicating stress level.

  2. Clinically silent subdural hemorrhage causes bilateral vocal fold paralysis in newborn infant.

    Science.gov (United States)

    Alshammari, Jaber; Monnier, Yan; Monnier, Philippe

    2012-10-01

    Bilateral congenital vocal fold paralysis (BVFP) may result from multiple etiologies or remain idiopathic when no real cause can be identified. If obstructive dyspnea is significant and requires urgent stabilization of the airway, then intubation is performed first and an MRI of the brain is conducted to rule out an Arnold-Chiari malformation that can benefit from a shunt procedure and thus alleviate the need for a tracheostomy. Clinically silent subdural hemorrhage without any birth trauma represents another cause of neonatal BVFP that resolves spontaneously within a month. It is of clinical relevance to recognize this potential cause of BVFP as its short duration may alleviate the need for a tracheostomy. In this article, we present such a case and review the literature to draw the otolaryngologist's attention to this possible etiology.

  3. Climate, vocal folds, and tonal languages: Connecting the physiological and geographic dots.

    Science.gov (United States)

    Everett, Caleb; Blasi, Damián E; Roberts, Seán G

    2015-02-03

    We summarize a number of findings in laryngology demonstrating that perturbations of phonation, including increased jitter and shimmer, are associated with desiccated ambient air. We predict that, given the relative imprecision of vocal fold vibration in desiccated versus humid contexts, arid and cold ecologies should be less amenable, when contrasted to warm and humid ecologies, to the development of languages with phonemic tone, especially complex tone. This prediction is supported by data from two large independently coded databases representing 3,700+ languages. Languages with complex tonality have generally not developed in very cold or otherwise desiccated climates, in accordance with the physiologically based predictions. The predicted global geographic-linguistic association is shown to operate within continents, within major language families, and across language isolates. Our results offer evidence that human sound systems are influenced by environmental factors.

  4. Feasibility of vocal fold abduction and adduction assessment using cine-MRI.

    Science.gov (United States)

    Baki, Marina Mat; Menys, Alex; Atkinson, David; Bassett, Paul; Morley, Simon; Beale, Timothy; Sandhu, Guri; Naduvilethil, Georgekutty; Stevenson, Nicola; Birchall, Martin A; Punwani, Shonit

    2017-02-01

    Determine feasibility of vocal fold (VF) abduction and adduction assessment by cine magnetic resonance imaging (cine-MRI) METHODS: Cine-MRI of the VF was performed on five healthy and nine unilateral VF paralysis (UVFP) participants using an axial gradient echo acquisition with temporal resolution of 0.7 s. VFs were continuously imaged with cine-MRI during a 10-s period of quiet respiration and phonation. Scanning was repeated twice within an individual session and then once again at a 1-week interval. Asymmetry of VF position during phonation (VF phonation asymmetry, VFPa) and respiration (VF respiration asymmetry, VFRa) was determined. Percentage reduction in total glottal area between respiration and phonation (VF abduction potential, VFAP) was derived to measure overall mobility. An un-paired t-test was used to compare differences between groups. Intra-session, inter-session and inter-reader repeatability of the quantitative metrics was evaluated using intraclass correlation coefficient (ICC). VF position asymmetry (VFPa and VFRa) was greater (p=0.012; p=0.001) and overall mobility (VFAP) was lower (p=0.008) in UVFP patients compared with healthy participants. ICC of repeatability of all metrics was good, ranged from 0.82 to 0.95 except for the inter-session VFPa (0.44). Cine-MRI is feasible for assessing VF abduction and adduction. Derived quantitative metrics have good repeatability. • Cine-MRI is used to assess vocal folds (VFs) mobility: abduction and adduction. • New quantitative metrics are derived from VF position and abduction potential. • Cine-MRI able to depict the difference between normal and abnormal VF mobility. • Cine-MRI derived quantitative metrics have good repeatability.

  5. Quantification of vocal fold motion using echography: application to recurrent nerve paralysis detection

    Science.gov (United States)

    Cohen, Mike-Ely; Lefort, Muriel; Bergeret-Cassagne, Héloïse; Hachi, Siham; Li, Ang; Russ, Gilles; Lazard, Diane; Menegaux, Fabrice; Leenhardt, Laurence; Trésallet, Christophe; Frouin, Frédérique

    2015-03-01

    Recurrent nerve paralysis (RP) is one of the most frequent complications of thyroid surgery. It reduces vocal fold mobility. Nasal endoscopy, a mini-invasive procedure, is the conventional way to detect RP. We suggest a new approach based on laryngeal ultrasound and a specific data analysis was designed to help with the automated detection of RP. Ten subjects were enrolled for this feasibility study: four controls, three patients with RP and three patients without RP according to nasal endoscopy. The ultrasound protocol was based on a ten seconds B-mode acquisition in a coronal plane during normal breathing. Image processing included three steps: 1) automated detection of two consecutive closing and opening images, corresponding to extreme positions of vocal folds in the sequence of B-mode images, using principal component analysis of the image sequence; 2) positioning of three landmarks and robust tracking of these points using a multi-pyramidal refined optical flow approach; 3) estimation of quantitative parameters indicating left and right fractions of mobility, and motion symmetry. Results provided by automated image processing were compared to those obtained by an expert. Detection of extreme images was accurate; tracking of landmarks was reliable in 80% of cases. Motion symmetry indices showed similar values for controls and patients without RP. Fraction of mobility was reduced in cases of RP. Thus, our CAD system helped in the detection of RP. Laryngeal ultrasound combined with appropriate image processing helped in the diagnosis of recurrent nerve paralysis and could be proposed as a first-line method.

  6. The relation of vocal fold lesions and voice quality to voice handicap and psychosomatic well-being

    NARCIS (Netherlands)

    Smits, R.; Marres, H.A.; Jong, F. de

    2012-01-01

    BACKGROUND: Voice disorders have a multifactorial genesis and may be present in various ways. They can cause a significant communication handicap and impaired quality of life. OBJECTIVE: To assess the effect of vocal fold lesions and voice quality on voice handicap and psychosomatic well-being. METH

  7. An In Vivo Study of Composite Microgels Based on Hyaluronic Acid and Gelatin for the Reconstruction of Surgically Injured Rat Vocal Folds

    Science.gov (United States)

    Coppoolse, Jiska M. S.; Van Kooten, T. G.; Heris, Hossein K.; Mongeau, Luc; Li, Nicole Y. K.; Thibeault, Susan L.; Pitaro, Jacob; Akinpelu, Olubunm; Daniel, Sam J.

    2014-01-01

    Purpose: The objective of this study was to investigate local injection with a hierarchically microstructured hyaluronic acid-gelatin (HA-Ge) hydrogel for the treatment of acute vocal fold injury using a rat model. Method: Vocal fold stripping was performed unilaterally in 108 Sprague-Dawley rats. A volume of 25 µl saline (placebo controls),…

  8. 3D synthetic aperture PIV measurements from artificial vibrating vocal folds

    CERN Document Server

    Daily, Jesse; Belden, Jesse; Thomson, Scott; Truscott, Tadd

    2011-01-01

    During speech, air from the lungs is forced past the vocal folds which vibrate, producing sound. A pulsatile jet of air is formed downstream of the vibrating folds which interacts with the various structures in the airway. Currently, it is postulated that the way this jet interacts with the downstream structures in the airway directly affects the quality of human speech. In order to better understand this jet, it is desirable to visualize the jet in three dimensions. We present the results of a method that reconstructs the three dimensional velocity field using Synthetic aperture PIV (SAPIV) \\cite{Belden:2010}. SAPIV uses an array of high-speed cameras to artificially create a single camera with a variable focal length. This is accomplished by overlapping the images from the array to create a "focal stack". As the images are increasingly overlapped, more distant image planes come into focus. 3D PIV is then performed on the "refocused" focal stack to reconstruct the flow field in three dimensions. SAPIV has th...

  9. Voice Outcomes of Adults Diagnosed with Pediatric Vocal Fold Nodules and Impact of Speech Therapy.

    Science.gov (United States)

    Song, Brian H; Merchant, Maqdooda; Schloegel, Luke

    2017-08-01

    Objective To evaluate the voice outcomes of adults diagnosed with vocal fold nodules (VFNs) as children and to assess the impact of speech therapy on long-term voice outcomes. Study Design Prospective cohort study. Setting Large health care system. Subjects and Methods Subjects diagnosed with VFNs as children between the years 1996 and 2008 were identified within a medical record database of a large health care system. Included subjects were 3 to 12 years old at the time of diagnosis, had a documented laryngeal examination within 90 days of diagnosis, and were ≥18 years as of December 31, 2014. Qualified subjects were contacted by telephone and administered the Vocal Handicap Index-10 (VHI-10) and a 15-item questionnaire inquiring for confounding factors. Results A total of 155 subjects were included, with a mean age of 21.4 years (range, 18-29). The male:female ratio was 2.3:1. Mean VHI-10 score for the entire cohort was 5.4. Mean VHI-10 scores did not differ between those who received speech therapy (6.1) and those who did not (4.5; P = .08). Both groups were similar with respect to confounding risk factors that can contribute to dysphonia, although the no-therapy group had a disproportionately higher number of subjects who consumed >10 alcoholic drinks per week ( P = .01). Conclusion The majority of adults with VFNs as children will achieve a close-to-normal voice quality when they reach adulthood. In our cohort, speech therapy did not appear to have an impact on the long-term voice outcomes.

  10. 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.

  11. Stomach Polyps

    Science.gov (United States)

    Diseases and Conditions Stomach polyps By Mayo Clinic Staff Stomach polyps — also called gastric polyps — are masses of cells that form on the lining inside your stomach. These polyps are rare and usually don't ...

  12. 音域图测试在声带息肉中的应用%The applications of the voice range profile in the polyp of vocal cord

    Institute of Scientific and Technical Information of China (English)

    方红雁; 李晓晓; 李劲松; 廖修富; 李忠万

    2015-01-01

    Objective To analyze the pathological voice ,normal voice range chart crowd voice characteristics through tests and analyze the differences between the two groups of test‐related parameters chart range between indicators ,so as to explore the value of the test range map in the polyp of vocal cord .Methods One hundred and twenty patients with vocal polyps according to in‐clusion and exclusion criteria were selected .Sixty cases of normal voice were randomly selected .Germany XION DIVAS system dia‐gram test mode range were recorded for both groups ,with the strongest voice of the bass were measured at different frequencies , first obtain low VRP intensity curve ,then get high‐intensity curve VRP .The maximum frequency of the vocal cord polyp group and normal control group ,the minimum frequency ,maximum intensity ,most quietly strong ,maximum phonation time ,fundamental fre‐quency perturbation and dysphonia index of the data were compared statistically .Results Compared with the control one ,the mean maximum frequency of vocal cord polyp group were lower (P= 0 .029 6) ,the average minimum frequency were significantly higher ( P= 0 .000 3) ,frequency range reduced(P= 0 .022 9) ;vocal cord polyp average loudest group was stronger(P= 0 .003 9) ,the whis‐pered strength values were significantly higher (P = 0 .000 0) ,significantly limited the average sound intensity range than normal voice group group (P= 0 .006 9) .Classification index based on objective voice disorders ,in terms of frequency ,mild voice disorders at the maximum frequency .There was no significant difference in the minimum frequency ,frequency range with a normal voice group ;and in severe voice disorders average maximum frequency lower than the normal voice group ,the smallest than normal voice frequency was significantly higher frequency range than the normal group was significantly limited .In terms of strength ,mild im‐pairment in the loudest voice is strong ,most quietly strong .There

  13. Changes of sleep-disordered breathing after laryngeal surgery in patients with bilateral vocal fold paralysis.

    Science.gov (United States)

    Li, Hsueh-Yu; Wang, Pa-Chun; Hsu, Chung-Yao; Chen, Ning-Hung; Fang, Tuan-Jen

    2005-04-01

    Snoring is the most obvious symptom of sleep-disordered breathing (SDB). Vibratory sound usually originates from the pharynx; however, in some circumstances, the narrowing of glottic structures can also cause nighttime breathing noise. This clinical study investigated the role of laryngeal obstruction in patients with SDB. Nine female patients with paralysis of bilateral vocal folds were enrolled in this study. All the patients received unilateral laser arytenoidectomy as the only treatment. Nocturnal polysomnography (PSG) was performed at baseline and 6 months after the operation. Parameters of PSG including the respiratory disturbance index (RDI) and snoring index (SI) were recorded, as well as the subjective Epworth Sleepiness Scale (ESS). Before surgery, six patients (66.6%) were identified as having obstructive sleep apnea (OSA, RDI>5). After the operation, the SI improved significantly (P=0.02). The RDI (P=0.07) and ESS (P=0.11) showed no significant improvement. The success rate of surgery in OSA patients was 66% (4/6) according to the criteria of a greater than 50% reduction of the preoperative RDI and less than 20 events per hour. The mechanism, outcomes and causes of failure are discussed in this unusual larynx-related SDB.

  14. Microarray-based characterization of differential gene expression during vocal fold wound healing in rats.

    Science.gov (United States)

    Welham, Nathan V; Ling, Changying; Dawson, John A; Kendziorski, Christina; Thibeault, Susan L; Yamashita, Masaru

    2015-03-01

    The vocal fold (VF) mucosa confers elegant biomechanical function for voice production but is susceptible to scar formation following injury. Current understanding of VF wound healing is hindered by a paucity of data and is therefore often generalized from research conducted in skin and other mucosal systems. Here, using a previously validated rat injury model, expression microarray technology and an empirical Bayes analysis approach, we generated a VF-specific transcriptome dataset to better capture the system-level complexity of wound healing in this specialized tissue. We measured differential gene expression at 3, 14 and 60 days post-injury compared to experimentally naïve controls, pursued functional enrichment analyses to refine and add greater biological definition to the previously proposed temporal phases of VF wound healing, and validated the expression and localization of a subset of previously unidentified repair- and regeneration-related genes at the protein level. Our microarray dataset is a resource for the wider research community and has the potential to stimulate new hypotheses and avenues of investigation, improve biological and mechanistic insight, and accelerate the identification of novel therapeutic targets.

  15. Feasibility of vocal fold abduction and adduction assessment using cine-MRI

    Energy Technology Data Exchange (ETDEWEB)

    Baki, Marina Mat [National University of Malaysia, Faculty of Medicine, Kuala Lumpur (Malaysia); Menys, Alex; Morley, Simon; Beale, Timothy [University College London, Centre for Medical Imaging, London (United Kingdom); Atkinson, David; Punwani, Shonit [University College London, Centre for Medical Imaging, London (United Kingdom); Royal National Throat Nose Ear Hospital, University College London Hospital NHS Trust, London (United Kingdom); Bassett, Paul [University College London, London (United Kingdom); Sandhu, Guri [Charing Cross Hospital, Imperial College Healthcare NHS Trust, London (United Kingdom); Naduvilethil, Georgekutty; Stevenson, Nicola [Royal National Throat Nose Ear Hospital, University College London Hospital NHS Trust, London (United Kingdom); Birchall, Martin A. [Royal National Throat Nose Ear Hospital, University College London Hospital NHS Trust, London (United Kingdom); University of California, Davis, Department of Otolaryngology, Davis, CA (United States); University College London, Ear Institute, London (United Kingdom)

    2017-02-15

    Determine feasibility of vocal fold (VF) abduction and adduction assessment by cine magnetic resonance imaging (cine-MRI) Cine-MRI of the VF was performed on five healthy and nine unilateral VF paralysis (UVFP) participants using an axial gradient echo acquisition with temporal resolution of 0.7 s. VFs were continuously imaged with cine-MRI during a 10-s period of quiet respiration and phonation. Scanning was repeated twice within an individual session and then once again at a 1-week interval. Asymmetry of VF position during phonation (VF phonation asymmetry, VFPa) and respiration (VF respiration asymmetry, VFRa) was determined. Percentage reduction in total glottal area between respiration and phonation (VF abduction potential, VFAP) was derived to measure overall mobility. An un-paired t-test was used to compare differences between groups. Intra-session, inter-session and inter-reader repeatability of the quantitative metrics was evaluated using intraclass correlation coefficient (ICC). VF position asymmetry (VFPa and VFRa) was greater (p=0.012; p=0.001) and overall mobility (VFAP) was lower (p=0.008) in UVFP patients compared with healthy participants. ICC of repeatability of all metrics was good, ranged from 0.82 to 0.95 except for the inter-session VFPa (0.44). Cine-MRI is feasible for assessing VF abduction and adduction. Derived quantitative metrics have good repeatability. (orig.)

  16. Microarray-based characterization of differential gene expression during vocal fold wound healing in rats

    Directory of Open Access Journals (Sweden)

    Nathan V. Welham

    2015-03-01

    Full Text Available The vocal fold (VF mucosa confers elegant biomechanical function for voice production but is susceptible to scar formation following injury. Current understanding of VF wound healing is hindered by a paucity of data and is therefore often generalized from research conducted in skin and other mucosal systems. Here, using a previously validated rat injury model, expression microarray technology and an empirical Bayes analysis approach, we generated a VF-specific transcriptome dataset to better capture the system-level complexity of wound healing in this specialized tissue. We measured differential gene expression at 3, 14 and 60 days post-injury compared to experimentally naïve controls, pursued functional enrichment analyses to refine and add greater biological definition to the previously proposed temporal phases of VF wound healing, and validated the expression and localization of a subset of previously unidentified repair- and regeneration-related genes at the protein level. Our microarray dataset is a resource for the wider research community and has the potential to stimulate new hypotheses and avenues of investigation, improve biological and mechanistic insight, and accelerate the identification of novel therapeutic targets.

  17. The management of vocal fold nodules in children: a national survey of speech-language pathologists.

    Science.gov (United States)

    Signorelli, Monique E; Madill, Catherine J; McCabe, Patricia

    2011-06-01

    The purpose of this study was to determine the management options and voice therapy techniques currently being used by practicing speech-language pathologists (SLPs) to treat vocal fold nodules (VFNs) in children. The sources used by SLPs to inform and guide their clinical decisions when managing VFNs in children were also explored. Sixty-two SLPs completed a 23-item web-based survey. Data was analysed using frequency counts, content analyses, and supplementary analyses. SLPs reported using a range of management options and voice therapy techniques to treat VFNs in children. Voice therapy was reportedly the most frequently used management option across all respondents, with the majority of SLPs using a combination of indirect and direct voice therapy techniques. When selecting voice therapy techniques, the majority of SLPs reported that they did not use the limited external evidence available to guide their clinical decisions. Additionally, the majority of SLPs reported that they frequently relied on lower levels of evidence or non-evidence-based sources to guide clinical practice both in the presence and absence of higher quality evidence. Further research needs to investigate strategies to remove the barriers that impede SLPs use of external evidence when managing VFNs in children.

  18. Validation of the dyspnea index in adolescents with exercise-induced paradoxical vocal fold motion.

    Science.gov (United States)

    De Guzman, Vanessa; Ballif, Catherine L; Maurer, Rie; Hartnick, Christopher J; Raol, Nikhila

    2014-09-01

    Paradoxical vocal fold motion (PVFM) affects almost 1 million adolescents in the United States. However, to date, no disease-specific objective measure exists to assess symptom severity and response to treatment in adolescents with exercise-induced PVFM. To validate the Dyspnea Index (DI) quality-of-life instrument (previously validated for adults with breathing disorders) in children aged 12 to 18 years with exercise-induced PVFM and to determine the minimum significant DI change corresponding to patient-reported or caregiver-reported improvement or worsening of symptoms. A longitudinal study of 56 patients (age range, 12-18 years) diagnosed as having exercise-induced PVFM and their caregivers from February 1, 2013, to September 30, 2013, in an outpatient pediatric otolaryngology office practice. The DI was administered to patients and caregivers, with items modified to reflect the perspective of caregivers. Appropriate DI change was measured to reflect improvement or worsening of symptoms. Test-retest reliability was accomplished by having a subset of patients and caregivers complete the instrument twice within 2 weeks before therapy. Internal consistency was assessed by calculation of Cronbach α. Discriminant validity and convergent validity were determined by comparing DIs with assessment of global change in symptoms. The patient and caregiver mean (SD) DI changes were -12.9 (9.6) and -14.7 (9.3), respectively (P therapy.

  19. Variação da intensidade vocal: estudo da vibração das pregas vocais em seres humanos com videoquimografia Vocal intensity variation: a study of vocal folds vibration in humans with videokymography

    Directory of Open Access Journals (Sweden)

    Henry U. Koishi

    2003-08-01

    Full Text Available O aumento da resistência glótica é o principal mecanismo responsável pela elevação da intensidade vocal em baixas freqüências. Esse aumento da resistência, em situações normais, é determinado pela contração dos músculos adutores das pregas vocais que promovem o aumento da tensão e a aproximação das pregas vocais em direção à linha mediana. No entanto, essas mesmas alterações podem estar presentes em algumas doenças funcionais que envolvem a laringe, como a disfonia espasmódica em adução e a disfonia hipertônica, mesmo durante a emissão vocal em baixa intensidade. OBJETIVO: Avaliar o padrão de vibração das pregas vocais em indivíduos com vozes normais em condições distintas de intensidade vocal, na tentativa de estabelecer valores que expressem a normalidade, para as diferentes fases do ciclo vibratório, de acordo com o nível de intensidade. FORMA DE ESTUDO: Clínico prospectivo. CASUÍSTICA E MÉTODOS: Foram avaliados 58 indivíduos durante emissão vocal em intensidade habitual (suave de conversação e durante emissão vocal elevada. A análise da vibração das pregas vocais foi realizada com a videoquimografia e para a análise da intensidade vocal, foi utilizado um programa de análise acústica computadorizado. RESULTADOS: Os resultados mostraram aumento involuntário da freqüência fundamental (F0 e redução do quociente de abertura, com o aumento da intensidade. CONCLUSÃO: Foram estabelecidos os valores de intensidade sonora para a condição habitual (63,46dB e elevada (72,55dB de emissão vocal e seus respectivos valores de quociente de abertura (OQ- open quotient.The increase of glottal resistance is the main mechanism to increase vocal intensity at low fundamental frequency. This increase is due to adductory forces provoked by the contraction of intrinsic laryngeal muscles that increases tension and approximates the vocal folds to the midline. However, the same behavior can be observed in

  20. Hyperplastic epithelial lesions of the vocal folds: combined use of exfoliative cytology and laryngostroboscopy in differential diagnosis.

    Science.gov (United States)

    Gugatschka, M; Kiesler, K; Beham, A; Rechenmacher, J; Friedrich, G

    2008-07-01

    The mainstay of successful tumor therapy is early detection of neoplastic tissue. Although exfoliative cytology has proven to be a reliable tool, its importance is still underestimated. Laryngostroboscopy is the most important tool for functional investigation in laryngological and phoniatric diagnosis. Stroboscopic evaluation allows early detection of infiltrative processes of the vocal folds. Aim of our study was to demonstrate that combination of both, exfoliative cytology and stroboscopy, provides a highly sensitive and easy to perform method in differential diagnosis of epithelial hyperplastic lesions of the vocal folds. In 130 patients with varying degrees of vocal fold keratosis up to glottic cancer, preoperative layngostroboscopy was performed. Stroboscopy was classified pathological in case of reduced or abolished amplitude of vocal fold vibration and/or reduced or abolished mucosal wave propagation. Under general anaesthesia histology with corresponding cytological specimens were obtained. The latter were classified in three groups reaching from normal (I), dysplastic (II), up to malignant (III) cytology. Invasive carcinoma was diagnosed in 32 cases by histology, corresponding malignant cytology was found in 21 specimens (sensitivity: 74%). By certain combination of cytology with pathological stroboscopy, a sensitivity of more than 97% can be achieved. Combination of cytology and stroboscopy allows detection of glottic cancer with a sensitivity of 97%, in contrast to 74% as found by cytology alone. This combination can be used as preliminary or sorting procedure and gives the opportunity of early detection, as well as for follow-up examinations. For repeated biopsies can cause scars with consecutive voice impairment, this procedure is very smooth but nevertheless reliable method.

  1. Laser bonding with ICG-infused chitosan patches: preliminary experiences in suine dura mater and vocal folds

    Science.gov (United States)

    Rossi, Francesca; Matteini, Paolo; Ratto, Fulvio; Pini, Roberto; Iacoangeli, Maurizio; Giannoni, Luca; Fortuna, Damiano; Di Cicco, Emiliano; Corbara, Sylwia; Dallari, Stefano

    2014-05-01

    Laser bonding is a promising minimally invasive approach, emerging as a valid alternative to conventional suturing techniques. It shows widely demonstrated advantages in wound treatment: immediate closuring effect, minimal inflammatory response and scar formation, reduced healing time. This laser based technique can overcome the difficulties in working through narrow surgical corridors (e.g. the modern "key-hole" surgery as well as the endoscopy setting) or in thin tissues that are impossible to treat with staples and/or stitches. We recently proposed the use of chitosan matrices, stained with conventional chromophores, to be used in laser bonding of vascular tissue. In this work we propose the same procedure to perform laser bonding of vocal folds and dura mater repair. Laser bonding of vocal folds is proposed to avoid the development of adhesions (synechiae), after conventional or CO2 laser surgery. Laser bonding application in neurosurgery is proposed for the treatment of dural defects being the Cerebro Spinal Fluid leaks still a major issue. Vocal folds and dura mater were harvested from 9-months old porks and used in the experimental sessions within 4 hours after sacrifice. In vocal folds treatment, an IdocyanineGreen-infused chitosan patch was applied onto the anterior commissure, while the dura mater was previously incised and then bonded. A diode laser emitting at 810 nm, equipped with a 600 μm diameter optical fiber was used to weld the patch onto the tissue, by delivering single laser spots to induce local patch/tissue adhesion. The result is an immediate adhesion of the patch to the tissue. Standard histology was performed, in order to study the induced photothermal effect at the bonding sites. This preliminary experimental activity shows the advantages of the proposed technique in respect to standard surgery: simplification of the procedure; decreased foreign-body reaction; reduced inflammatory response; reduced operating times and better handling in

  2. Pleomorphic Rhabdomyosarcoma Arising from True Vocal Fold of Larynx: Report of a Rare Case and Literature Review

    Science.gov (United States)

    Küçüktülü, Eda; Ersöz, Şafak; Çobanoğlu, Bengü

    2016-01-01

    We present an extremely rare case of a pleomorphic rhabdomyosarcoma of the true vocal fold. The histopathological diagnosis was confirmed by immunohistochemistry. The patient was treated with radical surgery including total laryngectomy and radical neck dissection followed by postoperative radiotherapy. The clinicopathologic features of this rare malignancy are discussed together with a review of the literature. This case report and literature review highlights the more favorable prognosis of pleomorphic rhabdomyosarcoma in the larynx than in other locations. PMID:27699075

  3. Preliminary investigation of a novel technique for the quantification of the ex vivo biomechanical properties of the vocal folds.

    Science.gov (United States)

    Coelho, Paulo G; Sobieraj, Michael; Tovar, Nick; Andrews, Kenneth; Paul, Benjamin; Govil, Nandini; Jeswani, Seema; Amin, Milan R; Janal, Malvin N; Branski, Ryan C

    2014-12-01

    The human vocal fold is a complex structure made up of distinct layers that vary in cellular and extracellular matrix composition. Elucidating the mechanical properties of vocal fold tissues is critical for the study of both acoustics and biomechanics of voice production, and essential in the context of vocal fold injury and repair. Both quasistatic and dynamic behavior in the 10-300 Hz range was explored in this preliminary investigation. The resultant properties of the lamina propria were compared to that of the nearby thyroarytenoid muscle. Er, quantified via quasistatic testing of the lamina propria, was 609±138 MPa and 758±142 MPa in the muscle (p=0.001). E' of the lamina propria as determined by dynamic testing was 790±526 MPa compared to 1061±928 MPa in the muscle. Differences in E' did not achieve statistical significance via linear mixed effect modeling between the tissue types (p=0.95). In addition, frequency dependence was not significant (p=0.18). Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Flexible Fiber-Optic High-Speed Imaging of Vocal Fold Vibration: A Preliminary Report.

    Science.gov (United States)

    Woo, Peak; Baxter, Peter

    2017-03-01

    High-speed video (HSV) imaging of vocal fold vibration has been possible only through the rigid endoscope. This study reports that a fiberscope-based high-speed imaging system may allow HSV imaging of naturalistic voicing. Twenty-two subjects were recorded using a commercially available black and white high-speed camera (Photron Motion Tools, 256 × 120 pixel, 2000 frames per second, 8 second acquisition time). The camera gain is set to +6 db. The camera is coupled to a standard fiber-optic laryngoscope (Olympus ENF P-4) with a 300-W Xenon light. Image acquisition was done by asking the subject to perform repeated phonation at modal phonation. Video images were processed using commercial video editing and video noise reduction software (After effects, Magix, and Neat Video 4.1). After video processing, the video images were analyzed using digital kymography (DKG). The HSV black and white video acquired by the camera is gray and lacks contrast. By adjustment of image contrast, brightness, and gamma and using noise reduction software, the flexible laryngoscopy image can be converted to video image files suitable for DKG and waveform analysis. The increased noise still makes edge tracking for objective analysis difficult, but subjective analysis of DKG plot is possible. This is the first report of HSV acquisition in an unsedated patient using a fiberscope. Image enhancement and noise reduction can enhance the HSV to allow extraction of the digital kymogram. Further image enhancement may allow for objective analysis of the vibratory waveform. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  5. A retrospective review of the progression of pediatric vocal fold nodules.

    Science.gov (United States)

    Nardone, Heather C; Recko, Thomas; Huang, Lin; Nuss, Roger C

    2014-03-01

    To our knowledge, the rate of change in the size of pediatric vocal fold nodules (VFNs) has not been investigated. Improved understanding of the factors that affect change in VFN size may help to better guide treatment decisions and counselling of families. To characterize the rate of change in the size of pediatric VFNs over time and to identify which factors affect increased rates of improvement. Retrospective review of 67 children evaluated in a voice clinic between 2002 and 2011 with a primary diagnosis of VFNs. No treatment or behavioral modification only (n = 19) vs targeted voice therapy with or without the treatment of associated conditions (gastroesophageal reflux and allergic rhinitis) (n = 45) vs surgical intervention (n = 3). Change in VFN grade (graded according to a previously validated scale based on size) over time. Sixty-seven patients with a median (range) age of 6.0 (3.8-20.6) years were analyzed. Median (range) follow-up was 25 (1-119) months. The rate of change in VFN grade over time was significantly associated with large baseline VFN size (P therapy with or without the management of associated conditions or surgery (P = .01); the association with postpubescent age was not significant (P = .09). The rate of change in VFN grade was not significantly different at 1 and 3 years postbaseline (P = .33). Baseline VFN size, treatment, and patient age are important in predicting the rate of improvement in nodule size over time. Rate of change in VFN size is a gradual decrease that is steady over time. This information can be used to help guide treatment decisions and counsel families of children with VFNs regarding expectations for improvement. Additional study is needed to evaluate whether the same factors that influence nodule size similarly influence parental perception of voice and expert perceptual voice analysis.

  6. Comparative analysis of clinical profile: chronic cough vs paradoxical vocal fold motion

    Science.gov (United States)

    Hartley, Naomi A.; Petty, Brian E.; Johnson, Bethany; Thibeault, Susan L.

    2015-01-01

    Background Ongoing contention surrounding typical demographic and clinical attributes of chronic cough (CC) and paradoxical vocal fold motion (PVFM) impedes timely diagnosis and optimum patient care. Designed to reduce preventable patient morbidity through improved recognition and differentiation, the current study aimed to determine representative clinical profiles for CC and PVFM, with identification of distinctive attributes from the general population and risk factors associated with each diagnosis. Methods Self-reported medical questionnaires, demographic and lifestyle attributes of CC and PVFM cases from a disease-specific outcomes database were compared to US population data and published normative values. Univariate comparison and multivariate regression modelling of age, sex, alcohol intake, smoking, Reflux Symptom Index (RSI), Voice Handicap Index (VHI), and Generalized Anxiety Disorder 7-item Scale (GAD-7) determined distinguishing features between the clinical groups, including odds ratios for presenting with CC versus PVFM. Results Clinical profiles developed from 283 (128 CC, 155 PVFM) adults (18–91years) were significantly different from the general population across each demographic, lifestyle and clinical variable (all p<.01), with the exception of obesity. Age (55.39 ± 13.54 vs 45.07 ± 16.51years, p<.01) and mean RSI score (21.5 ±9.02 vs 18.1±9.08, p<.01) most reliably distinguished CC from PVFM, with those aged 60–69 years (OR=9.45) most likely to be diagnosed with CC. Conclusions Standard clinical profiles of CC and PVFM are distinct from the general population, aiding determination of relative probabilities and risk factors in the differential diagnostic process. Variations between CC and PVFM were subtle, reliably distinguished by age and relative severity of laryngopharyngeal reflux symptomatology. PMID:26507903

  7. Quantitative measurement of vocal fold vibration in male radio performers and healthy controls using high-speed videoendoscopy.

    Directory of Open Access Journals (Sweden)

    Samantha Warhurst

    Full Text Available Acoustic and perceptual studies show a number of differences between the voices of radio performers and controls. Despite this, the vocal fold kinematics underlying these differences are largely unknown. Using high-speed videoendoscopy, this study sought to determine whether the vocal vibration features of radio performers differed from those of non-performing controls.Using high-speed videoendoscopy, recordings of a mid-phonatory/i/ in 16 male radio performers (aged 25-52 years and 16 age-matched controls (aged 25-52 years were collected. Videos were extracted and analysed semi-automatically using High-Speed Video Program, obtaining measures of fundamental frequency (f0, open quotient and speed quotient. Post-hoc analyses of sound pressure level (SPL were also performed (n = 19. Pearson's correlations were calculated between SPL and both speed and open quotients.Male radio performers had a significantly higher speed quotient than their matched controls (t = 3.308, p = 0.005. No significant differences were found for f0 or open quotient. No significant correlation was found between either open or speed quotient with SPL.A higher speed quotient in male radio performers suggests that their vocal fold vibration was characterised by a higher ratio of glottal opening to closing times than controls. This result may explain findings of better voice quality, higher equivalent sound level and greater spectral tilt seen in previous research. Open quotient was not significantly different between groups, indicating that the durations of complete vocal fold closure were not different between the radio performers and controls. Further validation of these results is required to determine the aetiology of the higher speed quotient result and its implications for voice training and clinical management in performers.

  8. Coordination of respiration and swallowing: functional pattern and relevance of vocal folds closure

    Directory of Open Access Journals (Sweden)

    Milton Melciades Barbosa Costa

    2010-03-01

    Full Text Available CONTEXT: Breathing and swallowing coordination, despite the expressive number of study, remain as theme deserving further research. OBJECTIVE: To identify a coordination pattern between swallowing and the natural breathing pause that occur in association with it (swallowing apnea and also the relevance of the vocal folds closure in this process. METHODS: Sixty-six adults, male and female, including normal health people, post-laryngectomy individuals and patients with digestive complaints without dysphagia were analyzed. The respiratory air flux interruptions produced by wet requested swallows and dry, requested and spontaneous swallows, were registered using thermo and piezoelectric receptors coupled to synectics medical manometry equipment, using Polygram upper 4.21 software. The results were analyzed with the Chi-square (3×2 and (2×2 nonparametric independency test with P = 0.05. RESULTS: Swallowing apnea is a preventive breathing stop that start just before and stay present during all deglutition pharyngeal phase. It is a well coordinated phenomena that occur as pattern in association with low elastic resistance of the lung, on the expiratory final phase until inspiration initial phase. This breathing stoppage it is usually followed by a short expiraton preceding a new breathing cycle. The swallow apnea and vocal folds closure are both independents mechanisms. CONCLUSION: It is possible to suppose that in the subconscious condition, swallowing apnea is integrated under coordination of the same control mechanism that also involves the elastic resistance of the lung.CONTEXTO: Apesar do expressivo número de estudos sobre a coordenação da respiração com a deglutição, o tema permanece aberto à pesquisa. OBJETIVO: Identificar um padrão de coordenação entre a pausa respiratória e a deglutição que ocorre em associação a esta usual apneia (apneia de deglutição e estabelecer a importância do fechamento das pregas vocais que ocorre

  9. 声带竹节病的临床研究%Vocal fold bamboo nodes: diagnosis, treatment and pathology

    Institute of Scientific and Technical Information of China (English)

    吴海燕; 肖雨; 文煜冰; 高志强

    2012-01-01

    Objective To investigate the clinical features,pathology and treatment of a rarely seen laryngeal lesion,the vocal fold bamboo nodes.Methods Two patients with vocal fold bamboo nodes were retrosepectively reviewed.The clinical features,pathology and treatment were presented.Results Video laryngoscope examination showed bilaterally creamy yellow transverse bandlike deposits in the submucosa,which were the typical vocal fold bamboo nodes in patients with autoimmune disease.Immunofluorescence pathology showed IgA,C1q and IgM deposition in lamina propria.Both patients were initially treated with oral hormones and one patient subsequently underwent submucosal resection of the lesion.The resuhs of pathological and immunofluorescence investigations were reported in this paper,together with a discussion of the relevant literature.Conclusions Vocal fold bamboo node is a special laryngeal lesion in patients with autoimmune disease.The pathological results showed immune complexes in the vocal fold lamina propria.A surgical intervention can be applied if steroid drugs are not effective or the dysraphism of the vocal folds exists due to the bamboo nodes.%目的 探讨声带竹节病的临床特征、病理及治疗方法.方法 对2例声带竹节病患者的喉镜、病理和治疗等临床资料进行回顾性分析.结果 2例声嘶患者分别患有系统性红斑狼疮和未分化结缔组织综合征,声带病变表现为双侧声带中部黏膜下脂黄色条带状沉积物,激素、休声等治疗声嘶无改善.1例采用病变切除术,术后声音质量明显改善.声带切除物常规病理检查,可见Reinke间隙炎性细胞浸润,小血管增生及血管炎,结缔组织间隙可见嗜酸性均质物质沉积;免疫荧光检查证实患者声带固有层有IgA、C1q和IgM沉积.结论 声带竹节病为自身免疫病患者喉部特征性表现,病理改变为免疫复合物在声带固有层的沉积,外科干预可用于类固醇药物无效或病变导致声带闭合不全的情况.

  10. Analysis of the clinical efficacy of self-retaining laryngoscope in polyp of vocal cord operation%支撑喉内镜下声带息肉手术的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    王玲玲; 冯益进

    2012-01-01

    目的 探讨支撑喉内镜在声带息肉手术中的临床应用价值.方法支撑喉内镜下对42例声带息肉患者采用微创手术方法摘除,观察术后疗效及并发症.结果 42例均1次手术成功,无复发;3例出现软腭、舌根及咽后淤血或黏膜擦伤;2例门齿松动;无其他严重并发症发生.结论支撑喉内镜下声带息肉微创手术具有视野清晰、操作简便、精确度高、复发率低等优点,值得临床推广.%Objective To study the clinical practical value of self-retaining laryngoscope in polyp of vocal cord operations. Methods Micro-trauma surgeries were operated on 42 cases of polyp of vocal cord under self-retaining laryngoscope, and the therapeutic efficacy and complications were observed. Results All the 42 cases were successful with no recurrence. Among all the 42 cases, 3cases had congestion in soft palate, root of tongue and retropharyngeal or mucous abrasion, 2cases had loosed fore-teeth, and no other severe complications occurred. Conclusion The self-retaining laryngoscope system is valuable in polyp of vocal cord operation for its wide operative field, simple operation, high accuracy and low recurrence rate, therefore, it deserves the clinical application.

  11. The effects of the false vocal fold gaps on intralaryngeal pressure distributions and their effects on phonation

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Human phonation does not merely depend on the vibration of the vocal folds. Research by clinical and computer simulations has demonstrated that the false vocal fold (FVF) is an important laryngeal con-striction that plays a vital role during human voice production. This study explored the effects of the FVF gaps using both the three-dimensional Plexiglas model and the numerical computation methods. Twelve FVF gaps (ranging from 0.02 to 2.06 cm) were used in this study at three glottal angles (uniform and convergent/divergent 40°), two minimal glottal diameters (Dg) (0.04 cm and 0.06 cm) separately, and the constant subglottal pressure (8 cm H2O). The results suggested that (1) the intralaryngeal pressure was the lowest and the flow was the highest (least flow resistance) when the FVF gap was 1.5-2 times greater than Dg; (2) the divergent glottal angle gave lower pressure and greater flow than the conver-gent and uniform glottal angle as there were no FVF conditions; (3) the presence of the FVF decreased the effects of the glottal angle to a certain extent; and more importantly, (4) the presence of the FVF also moved the separation points downstream, straightened the glottal jet for a longer distance, decreased the overall laryngeal resistance, and reduced the energy dissipation, suggesting the significance of FVF in efficient voice production. These results may be incorporated in the phonatory models (physical or computational) for better understanding of vocal mechanics. The results might also be helpful in exploring the surgical and rehabilitative intervention of related voice problems.

  12. Quantification of acute vocal fold epithelial surface damage with increasing time and magnitude doses of vibration exposure.

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Kojima

    Full Text Available Because the vocal folds undergo repeated trauma during continuous cycles of vibration, the epithelium is routinely susceptible to damage during phonation. Excessive and prolonged vibration exposure is considered a significant predisposing factor in the development of vocal fold pathology. The purpose of the present study was to quantify the extent of epithelial surface damage following increased time and magnitude doses of vibration exposure using an in vivo rabbit phonation model. Forty-five New Zealand white breeder rabbits were randomized to nine groups and received varying phonation time-doses (30, 60, or 120 minutes and magnitude-doses (control, modal intensity phonation, or raised intensity phonation of vibration exposure. Scanning electron microscopy and transmission electron microscopy was used to quantify the degree of epithelial surface damage. Results revealed a significant reduction in microprojection density, microprojection height, and depth of the epithelial surface with increasing time and phonation magnitudes doses, signifying increased epithelial surface damage risk with excessive and prolonged vibration exposure. Destruction to the epithelial cell surface may provide significant insight into the disruption of cell function following prolonged vibration exposure. One important goal achieved in the present study was the quantification of epithelial surface damage using objective imaging criteria. These data provide an important foundation for future studies of long-term tissue recovery from excessive and prolonged vibration exposure.

  13. Characterization of extracellular matrix proteins during wound healing in the lamina propria of vocal fold in a canine model: a long-term and consecutive study.

    Science.gov (United States)

    Hu, Rong; Xu, Wen; Ling, Wei; Wang, Qi; Wu, Yan; Han, Demin

    2014-06-01

    The characterization of vocal fold wound healing can be reflected by the changes of extracellular matrix (ECM) proteins in the lamina propria. Although the expression of ECM proteins after vocal fold injury has been widely studied, such observations have lacked time continuity and integrity of marker proteins. In this study, we observed the morphology of injured vocal folds in a canine model. We used immunofluorescence staining to evaluate the expression and distribution of ECM proteins, such as collagen, elastin, hyaluronic acid, decorin and fibronectin, from 15 days to 6 months after injury. The results showed that large amounts of ECM proteins were secreted 15-40 days after injury. Collagen and fibronectin secretion increased significantly, and were disorderly deposited. The secretion of decorin and elastin increased slightly, while hyaluronic acid decreased. The 15-40 day post-injury period may be the critical intervention stage in wound healing of vocal folds. From 3 to 6 months after injury, the secretion of ECM proteins declined. However, collagen and fibronectin secretion were still significantly higher than normal with irregular arrangement, while the secretion of elastin, hyaluronic acid and decorin decreased significantly at 6 months. This led to vocal fold inelasticity and stiffness, which required effective long-term interventions to treat scar formation.

  14. The impact of vocal hyperfunction on relative fundamental frequency during voicing offset and onset.

    Science.gov (United States)

    Stepp, Cara E; Hillman, Robert E; Heaton, James T

    2010-10-01

    This study tested the hypothesis that individuals with vocal hyperfunction would show decreases in relative fundamental frequency (RFF) surrounding a voiceless consonant. This retrospective study of 2 clinical databases used speech samples from 15 control participants and women with hyperfunction-related voice disorders: 82 prior to treatment (muscle tension dysphonia, n=22; vocal fold nodules, n=30; vocal fold polyps, N=30) and 18 before and after surgical removal of vocal fold nodules or polyps. Acoustic samples were analyzed with respect to the RFF at the offset and onset of voicing surrounding a voiceless consonant. Individuals with vocal hyperfunction in a large clinical sample showed significant lowering of offset and onset RFF compared with controls. Voicing offset and onset RFFs were not significantly changed by the removal of vocal fold lesions in the surgical group. Altered offset and onset RFF in patients with hyperfunction-related voice disorders can be interpreted as a by-product of heightened levels of laryngeal muscle tension. Measurement of RFF during voice offset and onset has potential for use as a simple, noninvasive measure of vocal hyperfunction.

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

    Institute of Scientific and Technical Information of China (English)

    周舟; 葛平江; 刘倩; 刘明; 张伟

    2015-01-01

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

  16. 鼻内镜联合支撑喉镜切除声门暴露困难的声带息肉%Nasal Endoscopy Combined with Self-retaining Laryngoscopy for Vocal Cord Polyps in Difficult Laryngeal Exposure

    Institute of Scientific and Technical Information of China (English)

    赵亮; 谢洪; 周晓红; 尹金淑

    2012-01-01

    目的 探讨鼻内镜联合支撑喉镜切除声门暴露困难的声带息肉的疗效.方法 2006年6月~2009年7月支撑喉镜直接暴露声门困难26例,7例位于声带前联合处,19例位于声带前1/3处,联合使用鼻内镜,通过调整鼻内镜角度及旋转视野达到完全显露声带全程,切除声带息肉.结果 4例术后第2天发观轻度咽部擦伤,对症处理后擦伤消退.无门齿脱落、颈椎损伤、舌体损伤等严重并发症.26例随访6 ~12个月,平均9个月,23例在术后1周达到治愈标准,余3例进一步治疗后治愈.结论 鼻内镜联合支撑喉镜下手术,适用于颈部粗短、颈部活动受限、喉体较高患者,对声门暴露困难的声带息肉切除疗效满意.%Objective To investigate the efficacy of self-retaining laryngoscope combined with nasal endoscope for vocal cord polyps in difficult laryngeal exposure. Methods We selected 26 patients who had received endoscopie surgery combined with self-retaining laryngoscopy for vocal cord polyps between June 2006 and July 2009. All the cases had difficulty in exposing the laryngeal. Among the cases, 7 had the lesion at the anterior vocal commissure, and the other 19 had polyp at the anterior 1/3 of the vocal cord. Results After the operation, 4 patients showed mild pharyngeal scratches and then was cured by symptomatic treatment. No severe complications, including injuries to the incisor teeth, cervical vertebra or tongue, occurred. The patients were followed up for 6 to 12 months with a mean of 9 months, 23 of them were cured in one week after the operation, and the other 3 were cured after further treatments. Conclusions Self-retaining laryngoscopy combined with nasal endoscopy is appropriate for patients with short neck and high larynx or limited cervical movement. It is effective for difficult laryngeal exposure.

  17. Biopsy - polyps

    Science.gov (United States)

    Polyp biopsy ... are treated is the colon. How a polyp biopsy is done depends on the location: Colonoscopy or flexible sigmoidoscopy explores the large bowel Colposcopy-directed biopsy examines the vagina and cervix Esophagogastroduodenoscopy (EGD) or ...

  18. Assessment of dysphonia due to benign vocal fold lesions by acoustic and aerodynamic indices: a multivariate analysis.

    Science.gov (United States)

    Cantarella, Giovanna; Baracca, Giovanna; Pignataro, Lorenzo; Forti, Stella

    2011-04-01

    The goal was to identify acoustic and aerodynamic indices that allow the discrimination of a benign organic dysphonic voice from a normal voice. Fifty-three patients affected by dysphonia caused by vocal folds benign lesions, and a control group were subjected to maximum phonation time (MPT) measurements, GRB perceptual evaluations and acoustic/aerodynamic tests. All analyzed variables except the airflow variation coefficient were significantly different between the two groups. The unique significant factors in the discrimination between healthy and dysphonic subjects were the aerodynamic indices of MPT and Glottal efficiency index, and the acoustic index Shimmer. These results show that a combination of three parameters can discriminate a voice deviance and highlight the importance of a multidimensional assessment for objective voice evaluation.

  19. Análise do trato vocal em pacientes com nódulos, fendas e cisto de prega vocal Vocal tract analysis in patients with vocal fold nodules, clefts and cysts

    Directory of Open Access Journals (Sweden)

    Raquel Buzelin Nunes

    2009-04-01

    Full Text Available O plano supraglótico representa uma importante dimensão na produção vocal, sendo de grande relevância sua caracterização na avaliação e conduta terapêutica de indivíduos disfônicos. OBJETIVO: Verificar se determinadas configurações glóticas se relacionam com ajustes específicos de trato vocal. Avaliar por meio da nasofibrolaringoscopia a freqüência dos ajustes do trato vocal supraglótico em mulheres disfônicas com nódulos, fendas e cistos. MÉTODO: Foram avaliadas 31 mulheres disfônicas, faixa etária entre 18 e 45 anos, com alteração vocal e diagnóstico de nódulos, fenda médioposterior e cisto e realizada avaliação resumida do sistema sensório-motor e oral e exames de videolaringoestroboscopia e nasofibrolaringoscopia. Três grupos distintos foram selecionados: pacientes com nódulos bilaterais, com fenda e com cisto, com configurações glóticas semelhantes. Foi realizada, por fonoaudiólogas e otorrinolaringologistas, a análise visual do trato vocal dos exames de nasofibrolaringoscopia, verificando os parâmetros de: constrição supraglótica, mobilidade vertical da laringe, constrição faríngea e mobilidade de língua. Os dados foram descritos e tratados estatisticamente. RESULTADOS: Na análise visual não foi encontrada diferença estatística significante que separasse os grupos das alterações glóticas. CONCLUSÃO: Não houve correlação dos ajustes do trato supraglótico com determinado tipo de alteração glótica. São comportamentos individuais que geram os ajustes e justificam as diferentes qualidades vocais em pacientes com mesmo tipo de alteração laríngea.The supraglottic plan represents an important dimension in vocal production, and its characterization is very important in the evaluation and treatment approach of dysphonic individuals. AIM: to check if certain glottic configurations are related to specific adjustments in the vocal tract. To use nasal and laryngeal fibroscopy to assess

  20. Evaluation of akson therapy after vocal polyp surgery%阿克森疗法对声带息肉术后嗓音恢复的疗效探讨

    Institute of Scientific and Technical Information of China (English)

    陈闽琪; 彭文静; 陈舒华

    2014-01-01

    目的:观察阿克森疗法对声带息肉术后嗓音功能恢复的临床效果。方法经电子喉镜检查并在支撑喉镜下显微镜术后病理组织学检查结果证实为声带息肉患者60例,按随机数字表法随机将病例分为2组,治疗组在术后行常规护理的基础上加阿克森疗法进行嗓音恢复治疗;对照组在术后仅行常规护理治疗。随访1年后,有完整嗓音资料的治疗组18例,对照组20例,将对两组在3个月及1年后均行嗓音障碍指数(VHI)评估。结果治疗组和对照组在3个月和1年的有效率差异均有统计学意义(P <0.05),有效率比较差异随时间延长有正相关性。结论阿克森疗法对声带息肉术后嗓音功能恢复疗效确切并且方便,适合在声带息肉术后恢复中推广阿克森疗法以防止复发。%Objective To evaluate the therapeutic effects of vocal polyp surgery combined with akson therapy.Methods Clinical data of 60 vocal cord polyp patients undergoing surgery under self-retaining laryngoscope were randomly di-vided into treatment and control groups,in which akson therapy was applied for 3 months in the treatment group and not for the control group.The VHI testing were performed 3 months and one year after the treatment,including 18 patients of treatment group and 20 patients of control group.Results The effective rates of the treatment group were higher than those of control group 3 months and 1 year after the treatment (P <0.05).Conclusion Due to low cost and sim-plicity,akson therapy may be better choice for voice recovery after vocal polyp surgery.

  1. 中西医结合治疗声带息肉的临床研究%Clinical Research on Vocal Cord Polyp treated by Traditional Chinese Medicine and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    郑天其; 田容; 闵晓玲

    2012-01-01

    目的:观察声带息肉术后中西医结合治疗效果.方法:190例声带息肉随机分组,西医组62例,中西医结合组128例(其中中西医成药组68例,中西医辨证组60例),2月后进行疗效评定,观察治疗效果.结果:三组总有效率100%,治愈率西医组75.81%,中西医成药组89.71%,中西医辨证组93.33%.经统计学处理,三组之间有显著性差异.两两比较,西医组与中西医成药组、中西医辨证组均有显著性差异,中西医成药组与中西医辨证组之间无统计学意义.结论:中西医结合治疗声带息肉的临床疗效满意,优于单纯西医治疗效果.%Objective: To investigate the effectiveness of integrated Traditional Chinese and Western Medicine in postoperative treatment of vocal cord polyp. Methods; 190 patients with vocal cord polyp were randomly assigned into two groups, the group treated with western medicine (62 cases) and the group treated with integrated traditional Chinese combination and west-em medicine group (128 cases) , which was comprised of two subgroups, the group treated with formulary Chinese medicine (68 cases) and the group treated based on syndrome differentiation (60 cases). The treatment effectiveness of the three groups were evaluated after two months. Results; The overall response rate was 100%in all groups. The cure rate was 75. 81% in the group treated with Western Medicine, 89. 71% in the group treated based on syndrome differentiation respectively. There were significantly statistical differences among the three groups (P0.05 ). Conclusion: Combining traditional Chinese and western medicine to treat vocal chord polyp has better clinical effectiveness than western medicine alone.

  2. Finite element modeling of the vocal folds with deformable interface tracking

    DEFF Research Database (Denmark)

    Granados Corsellas, Alba; Brunskog, Jonas; Misztal, Marek Krzysztof

    2014-01-01

    Continuous and prolonged use of the sp eaking voice may lead to functional sp eech disorders that are not apparent for voice clinicians from high-sp eed imaging of the vo cal folds' vibration. However, it is hyp othesized that time dep endent tissue prop erties provide some insight into the injur...... reasons, aero dynamic driving forces are derived from Bernoulli's principle...

  3. Detecção de receptor de ácido hialurônico em prega vocal humana por método imunohistoquímico Detection of hyaluronic acid receptor in human vocal folds by immunohistochemistry

    Directory of Open Access Journals (Sweden)

    Luiz Henrique Fonseca Barbosa

    2008-04-01

    Full Text Available O receptor do ácido Hialurônico é uma glicoproteína da membrana plasmática, sendo o principal o CD44, e está expresso em vários tipos de células onde possui a função de adesão celular. OBJETIVO: Estudar a possibilidade de empregar o método imunohistoquímico para identificar a distribuição dos receptores de ácido hialurônico ao longo da prega vocal humana. MATERIAL E MÉTODOS: Foram ressecadas as pregas vocais normais de um indivíduo de 23 anos, sexo masculino, cor negra. As lâminas foram analisadas por meio de estudo histomorfométrico, comparando-se a intensidade das cores nas camadas superficial, média e profunda da lâmina própria. Nas lâminas silanizadas foi utilizado método imunohistoquímico, sendo avaliadas através de microscopia óptica com aumento 40 vezes, obtendo coloração marrom onde houve a reação com receptor para ácido hialurônico. RESULTADOS: Os achados imunohistoquímicos mostraram presença de receptores para ácido hialurônico no epitélio de cobertura da prega vocal tendo maior concentração na região central da prega vocal. CONCLUSÃO: A técnica de imunohistoquímica, utilizada para avaliar a distribuição dos receptores para ácido hialurônico na pregas vocais humanas, mostrou sua disposição em epitélio da prega vocal e predomínio no terço médio, em relação às demais regiões na prega vocal estudada.Hyaluronic acid receptor is a glycoprotein of the plasmatic membrane, and the CD44 is its representative, expressed in many cell types where it has the task of cell adhesion. AIM: the goal of the present experimental study is to investigate the possibility of using immunohistochemistry to identify the distribution of hyaluronic acid along the vocal fold. MATERIALS AND METHODS: We resected the normal vocal folds from a normal 23 year-old male black individual. The slides were analyzed by means of a histomorphometric study, comparing the color intensity in the superficial, middle and

  4. The efficacy of a novel collagen-gelatin scaffold with basic fibroblast growth factor for the treatment of vocal fold scar.

    Science.gov (United States)

    Hiwatashi, Nao; Hirano, Shigeru; Mizuta, Masanobu; Kobayashi, Toshiki; Kawai, Yoshitaka; Kanemaru, Shin-Ichi; Nakamura, Tatsuo; Ito, Juichi; Kawai, Katsuya; Suzuki, Shigehiko

    2015-06-29

    Vocal fold scar remains a therapeutic challenge. Basic fibroblast growth factor (bFGF) was reported to have regenerative effects for vocal fold scar, although it has the disadvantage of rapid absorption in vivo. A collagen-gelatin sponge (CGS) can compensate for the disadvantage by providing a sustained release system. The current study evaluated the efficacy of CGS combined with bFGF on vocal fold scar, using rat fibroblasts for an in vitro model and a canine in vivo model. We prepared fibroblasts from scarred vocal folds (sVFs) in rats and showed that bFGF accelerated cell proliferation and suppressed expression levels of cleaved caspase 3 and α-smooth muscle actin. Has 1, Has 3, Fgf2, Hgf and Vegfa mRNA levels were significantly upregulated, while Col1a1 and Col3a1 were dose-dependently downregulated, with a maximum effect at 100 ng/ml bFGF. In an in vivo assay, 6 weeks after lamina propria stripping, beagles were divided into three groups: CGS alone (CGS group); CGS with bFGF (7 µg/cm(2) ; CGS + bFGF group); or a sham-treated group. Vibratory examination revealed that the glottal gap was significantly reduced in the bFGF group and the two implanted groups, whereas the CGS + bFGF group showed higher mucosal wave amplitude. Histological examination revealed significantly restored hyaluronic acid and elastin redistribution in the CGS + bFGF group and reductions in dense collagen deposition. These results provide evidence that CGS and bFGF combination therapy may have therapeutic potential and could be a promising tool for treating vocal fold scar. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Paralisia de prega vocal em crianças: diagnóstico e conduta a partir de relato de caso Vocal fold paralysis in children: diagnostic and management from a case report

    Directory of Open Access Journals (Sweden)

    Romualdo Suzano Louzeiro Tiago

    2005-06-01

    Full Text Available A paralisia de pregas vocais representa 10% das anomalias congênitas da laringe, sendo a segunda causa mais comum de estridor laríngeo na infância. Quando considerada a paralisia de prega vocal unilateral, a principal causa é a lesão iatrogênica do nervo laríngeo recorrente esquerdo secundária à cirurgia para correção da persistência do canal arterial. Nesse trabalho fazemos uma revisão da literatura e relatamos um caso de uma criança que após a cirurgia de fechamento da persistência do canal arterial evoluiu com dificuldade respiratória e disfonia. Sugerimos o uso da fibronasofaringolaringoscopia flexível no pré e pós-operatório de crianças com indicação de cirurgia cardíaca para correção de anomalias congênitas, permitindo deste modo o diagnóstico precoce de paralisia de prega vocal e a definição de conduta o mais rápido possível.Vocal fold paralysis accounts for 10% of the larynx congenital abnormality, being the second most common cause of laryngeal stridor in childhood. As to unilateral vocal fold paralysis, the main cause is left-sided iatrogenic injury to the recurrent laryngeal nerve, secondary to surgery to correct the patent ductus arteriosus. In this study we reviewed the literature, reporting a case of a child who, after having undergone surgery to close the patent ductus arteriosus, evolved with breathing difficulty and dysphonia. We suggest that flexible fiberoptic laryngoscopy is carried out pre- and post surgery in children for whom heart surgery to correct congenital abnormalities is indicated, thus allowing for early diagnosis of vocal fold paralysis and the selection of the best management approach.

  6. Imunohistoquímica como método de estudo das fibras elásticas em prega vocal humana Immunohistochemistry as a method to study elastic fibers of human vocal fold

    Directory of Open Access Journals (Sweden)

    Hugo Valter Lisboa Ramos

    2005-08-01

    Full Text Available OBJETIVO: O objetivo deste trabalho é o de verificar a aplicabilidade do método imunohistoquímico na quantificação das diferentes formas das fibras elásticas em prega vocal humana. FORMA DE ESTUDO: coorte transversal. MATERIAL E MÉTODO: Foram seguidos os seguintes critérios de inclusão: idade entre 25 e 40 anos, gênero masculino, cor branca, morte causada por ferimento de arma de fogo, menos de doze horas de morte, ausência de intubação traqueal e de trauma na região cervical e que, por análise microscópica, não apresentassem qualquer alteração da mucosa das pregas vocais. Por estes critérios dez pregas vocais foram obtidas e selecionou-se, aleatoriamente, uma prega vocal que pertencia a um indivíduo de 28 anos. A prega vocal foi transversalmente seccionada em nove regiões e três cortes de cada fragmento foram utilizados para a realização das colorações Verhoeff e resorcina-fuchsina de Weighert e para a realização do estudo imunohistoquímico. Realizou-se quantificação colorimétrica das fibras elásticas. RESULTADO: As camadas intermediária e profunda da prega vocal apresentam valores muito superiores aos da camada superficial, nas colorações histológicas. A quantidade de tropoelastina identificada pelos anticorpos não apresentou grandes diferenças entre os valores da camada superficial e os da camada intermediária e profunda. CONCLUSÃO: A imunohistoquímica é uma técnica que identifica, em prega vocal humana, todas as formas de fibras elásticas e que também possibilita a realização de medidas objetivas.AIM: Verify the use of immunohistochemistry as a method to measure all forms of elastic fibers at human vocal folds. STUDY DESIGN: transversal cohort. MATERIAL AND METHOD: We collected vocal folds following these criterion: age between 25 and 40, Caucasian men, dead by gun shot, within 12 hours of death, without instrumentation of the larynx or suspicion of neck injury and without mucosal lesions

  7. Efeito da mitomicina C tópica na cicatrização de prega vocal em modelo suíno Topical mitomycin C effect on swine vocal folds healing

    Directory of Open Access Journals (Sweden)

    Paulo Antônio Monteiro Camargo

    2006-10-01

    Full Text Available Várias terapias adjuvantes à cirurgia vêm sendo usadas para modular o processo cicatricial nas pregas vocais, entre elas a Mitomicina tópica (MTC. OBJETIVOS: Avaliar os efeitos da MTC no processo de cicatrização de pregas vocais de suínos 30 dias após exérese de fragmento de mucosa com laser de CO2 mediante a mensuração da deposição de colágeno. FORMA DE ESTUDO: Experimental em suínos. MATERIAIS E MÉTODOS: Dois grupos de 6 suínos cada foram avaliados após exérese de fragmento de mucosa de prega vocal a laser de CO2 (grupo controle sem uso e grupo experimento com uso de MTC tópica. Após 30 dias os animais foram submetidos à eutanásia, sendo coletadas amostras das pregas vocais para análise histológica, a fim de quantificar a deposição de colágeno mediante coloração de Picrosirius Red. RESULTADOS: A média da área do colágeno total das pregas vocais do grupo controle foi de 2648,03 µm2, enquanto a média do colágeno total das pregas vocais do grupo experimento foi de 2200,30 µm2 (p = 0,0043. CONCLUSÃO: A MTC usada topicamente após a exérese de fragmento de mucosa da prega vocal a laser de CO2 em suínos, diminui, significativamente, a deposição do colágeno total.several adjuvant therapies to surgery have been used to modulate the healing process of vocal folds, including topic mitomycin (MTC. AIM: to evaluate the effect of topical MTC in the healing process of vocal folds 30 days after the exeresis of a mucosal fragment with CO2 laser in a swine model (control group without mitomycin and study group with topical MTC, with collagen deposition measurement. STUDY TYPE: prospective experimental in swine. METHODS: two groups of 6 swine each were subjected to exeresis of a mucosal fragment of the vocal fold with CO2 laser. Immediately after the procedure MTC was applied topically for three minutes on the study group. Thirty days later the animals were slaughtered and samples of the vocal folds were collected for

  8. Effects of the false vocal folds on sound generation by an unsteady glottal jet through rigid wall model of the larynx

    OpenAIRE

    Nomura, Hideyuki; Funada, Tetsuo

    2007-01-01

    In the present paper, the effects of the false vocal folds (FVFs) on sound generation induced by an unsteady glottal jet through a two-dimensional rigid wall model of the larynx are investigated by conducting numerical experiments. The glottal jets are simulated by solving the basic equations for a compressible viscous fluid based on the larynx model with and without the FVFs. The existence of the FVFs increases the amplitude of noise-like pressure fluctuation at the glottis and faraway from ...

  9. Efficacy of treating children with anterior commissure and true vocal fold respiratory papilloma with the 585-nm pulsed-dye laser.

    Science.gov (United States)

    Hartnick, Christopher J; Boseley, Mark E; Franco, Ramon A; Cunningham, Michael J; Pransky, Seth

    2007-02-01

    To report preliminary results regarding the safety and efficacy of the 585-nm pulsed-dye laser (PDL) for the treatment of juvenile-onset recurrent respiratory papillomatosis (JORRP) in the pediatric population. Prospective longitudinal cohort study. Two pediatric otolaryngology referral centers. Twenty-three pediatric patients ranging in age from 6 months to 17 years. The 585-nm PDL was used for at least 1 treatment on each of these patients to treat JORRP of the true vocal folds or anterior commissure. Complications from the use of the 585-nm PDL in the treatment of JORRP. There was no evidence of anterior commissure webbing or true vocal fold scarring in this group of 23 patients followed up for 3 months to 1 year. The 585-nm PDL seems to be a safe instrument for treatment of JORRP. There is the potential that improved voice outcomes may be apparent when compared with traditional therapies because the vocal fold epithelium seems to be unharmed when treated with this method. Furthermore, the lack of epithelial damage incurred by the 585-nm PDL should enable more aggressive surgical excision of anterior commissure disease. Further prospective longitudinal studies examining voice outcomes are needed.

  10. Investigation of the Viability, Adhesion, and Migration of Human Fibroblasts in a Hyaluronic Acid/Gelatin Microgel-Reinforced Composite Hydrogel for Vocal Fold Tissue Regeneration.

    Science.gov (United States)

    Heris, Hossein K; Daoud, Jamal; Sheibani, Sara; Vali, Hojatollah; Tabrizian, Maryam; Mongeau, Luc

    2016-01-21

    The potential use of a novel scaffold biomaterial consisting of cross-linked hyaluronic acid (HA)-gelatin (Ge) composite microgels is investigated for use in treating vocal fold injury and scarring. Cell adhesion integrins and kinematics of cell motion are investigated in 2D and 3D culture conditions, respectively. Human vocal fold fibroblast (hVFF) cells are seeded on HA-Ge microgels attached to a HA hydrogel thin film. The results show that hVFF cells establish effective adhesion to HA-Ge microgels through the ubiquitous expression of β1 integrin in the cell membrane. The microgels are then encapsulated in a 3D HA hydrogel for the study of cell migration. The cells within the HA-Ge microgel-reinforced composite hydrogel (MRCH) scaffold have an average motility speed of 0.24 ± 0.08 μm min(-1) . The recorded microscopic images reveal features that are presumably associated with lobopodial and lamellipodial cell migration modes within the MRCH scaffold. Average cell speed during lobopodial migration is greater than that during lamellipodial migration. The cells move faster in the MRCH than in the HA-Ge gel without microgels. These findings support the hypothesis that HA-Ge MRCH promotes cell adhesion and migration; thereby they constitute a promising biomaterial for vocal fold repair.

  11. Correlação entre o envelhecimento e as dimensões das pregas vocais Correlation between aging and vocal folds' dimensions

    Directory of Open Access Journals (Sweden)

    Sandrelli Virginio de Vasconcelos Miranda

    2011-06-01

    Full Text Available OBJETIVO: avaliar as dimensões das pregas vocais em ambos os sexos e correlacioná-las com o envelhecimento. MÉTODO: foram estudados 30 cadáveres (15 mulheres e 15 homens na faixa etária de 60 a 102 anos. Para isto foram seguidas quatro etapas sequenciais: 1ª História clínica do cadáver; 2ª Remoção da laringe; 3ª Dissecação da laringe; 4ª Morfometria das dimensões das pregas vocais. Trata-se de um estudo experimental. RESULTADOS: o comprimento da prega vocal masculina com média de 15,90 mm foi maior que o da feminina com 10,39 mm. A largura da prega vocal masculina foi maior com média de 2,37 mm que a feminina com 2,31 mm. A média geral da espessura também foi maior no sexo masculino com média de 2,55 mm em comparação com a feminina com 2,38 mm. Não foram encontradas diferenças estatísticas entre a idade e o comprimento, largura e espessura das pregas vocais em ambos os sexos. CONCLUSÃO: as dimensões de comprimento, largura e espessura das pregas vocais foram maiores no sexo masculino. Entretanto, não houve diferença, estatisticamente significante, entre as três dimensões das pregas vocais durante o envelhecimento em ambos os sexos.PURPOSE: to evaluate the dimensions of vocal folds in both genders and correlate them with aging. METHOD: we studied 30 cadavers (15 men and 15 women from 60 to 102 year-old. For this purpose we followed four steps: 1st History of the body; 2nd Removal of the larynx, 3rd Dissection of the larynx, 4th Morphometry for the dimensions of the vocal folds. This is an experimental study. RESULTS: the length of the vocal male with an average of 15.90 mm was higher than the female with 10.39 mm. The width of the male vocal was higher with an average of 2.37 mm to 2.31 mm with a female. The overall average thickness was also higher in males with an average of 2.55 mm compared with women with 2.38 mm. No differences were found among age and the length, width and thickness of the vocal folds in

  12. Colorectal polyps

    Science.gov (United States)

    ... risk for new polyps. Be aware that these medicines can have serious side effects if taken for a long time. Side effects include bleeding in the stomach or colon and heart disease. Talk with your provider before taking these medicines. ...

  13. Nasal polyps

    Science.gov (United States)

    ... BS, Burks AW, et al, eds. Middleton's Allergy: Principles and Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 43. Becker SS. Surgical management of polyps in the treatment of nasal airway ...

  14. Injeção de corticosteróide em patologias vocais inflamatórias crônicas, revisão da literatura Steroid injection in chronic inflammatory vocal fold disorders, literature review

    Directory of Open Access Journals (Sweden)

    Andrea Maria Campagnolo

    2008-12-01

    these situations: 1 acute inflammatory diseases, mainly when edema compromises the airways; 2 auto- immune disease with laryngeal involvement; 3 laryngeal stenosis; 4 benign lesions of the vocal folds, e.g., nodules, polyps and Reinke's edema, to reduce the inflammatory reactions before phonosurgery or in an attempt to avoid surgery; 5 In phonosurgery, aiming to reduce scarring. In this case, it could be used as a preventive measure in vocal fold scarring, or for scar treatment. CONCLUSION: Steroids may be considered an important therapeutic option in the management of many diseases, specially the inflammatory ones, associated with vocal changes.

  15. Fatores associados a patologias de pregas vocais em professores Factores asociados a patologías de cuerdas vocales en profesores Factors associated with vocal fold pathologies in teachers

    Directory of Open Access Journals (Sweden)

    Carla Lima de Souza

    2011-10-01

    édico referido de patologías de las cuerdas vocales y las independientes, características sociodemográficas, actividad profesional, organización del trabajo/relaciones interpersonales, características físicas del ambiente de trabajo, frecuencia de trastornos mentales comunes, medida por el Self-Reporting Questionnaire-20 (SRQ-20>7 y condiciones de salud general. Se aplicaron técnicas de análisis estadístico descriptivo, bivariada y regresión logística múltiple. RESULTADOS: La prevalencia de diagnóstico médico referido de patologías de las cuerdas vocales fue de 18,9%. En el análisis de regresión logística, las variables que permanecieron asociadas al diagnóstico médico de patología de las cuerdas vocales fueron: sexo femenino, trabajar como profesor por más de siete años, uso intensivo de la voz, referir más de cinco características desfavorables del ambiente físico de trabajo, una o más enfermedades del tracto respiratorio, pérdida auditiva, y presentar trastornos mentales comunes. CONCLUSIONES: La presencia de patologías de las cuerdas vocales referidas se asoció a factores que indican la necesidad de acciones de promoción de la salud vocal del profesor y modificaciones en la organización y estructura del trabajo docente.OBJECTIVE: To analyze factors associated with the prevalence of the medical diagnosis of vocal fold pathologies in teachers. METHODS: A census-based epidemiological, cross-sectional study was conducted with 4,495 public primary and secondary school teachers in the city of Salvador, Northeastern Brazil, between March and April 2006. The dependent variable was the self-reported medical diagnosis of vocal fold pathologies and the independent variables were sociodemographic characteristics; professional activity; work organization/interpersonal relationships; physical work environment characteristics; frequency of common mental disorders, measured by the Self-Reporting Questionnaire-20 (SRQ-20 >7; and general health conditions

  16. Objective assessment of vocal hyperfunction: an experimental framework and initial results.

    Science.gov (United States)

    Hillman, R E; Holmberg, E B; Perkell, J S; Walsh, M; Vaughan, C

    1989-06-01

    This report describes the experimental design and initial results of an ongoing clinical investigation of voice disorders. Its major focus is the development and use of quantitative measures to provide objective descriptions of conditions referred to as "vocal hyperfunction." The experimental design for this project is based on a descriptive theoretical framework, which holds that there are different types and stages of hyperfunctionally related voice disorders. Data consist of indirect measures derived from noninvasive aerodynamic and acoustic recordings including (a) parameters derived from inverse filtered approximations of the glottal air flow waveform; (b) estimates of transglottal pressure, average glottal air flow, glottal resistance and vocal efficiency; and (c) measures of vocal intensity and fundamental frequency. Initial results (based on comparisons among 15 voice patients and 45 normal speakers) support major assumptions that underlie the theoretical framework, and indicate that the measurement approach being utilized is capable of differentiating hyperfunctional from normal voices and hyperfunctional conditions from one another. Organic manifestations of vocal hyperfunction (nodules, polyps, contact ulcers) are accompanied by abnormally high values for the glottal waveform parameters of AC flow and maximum flow declination rate, suggesting increased potential for vocal fold trauma due to high vocal fold closure velocities and collision forces. In contrast, nonorganic manifestations of hyperfunction (functional disorders) tend to be associated with abnormally high levels of unmodulated DC flow, without high values for AC flow and maximum flow declination rate, suggesting reduced potential for vocal fold trauma. Measures also suggest different underlying mechanisms for nodules and polyps as compared to contact ulcers. Results are discussed relative to predictions based on the theoretical framework for vocal hyperfunction.

  17. Case-control survey on risk factors of benign vocal fold lesions%成人声带良性病变发病危险因素的病例对照调查

    Institute of Scientific and Technical Information of China (English)

    黄冬雁; 杨伟炎; 于萍; 何耀; 韩东一

    2008-01-01

    Objective To investigate the risk factors that may relate with benign vocal fold lesions including vocal fold nodule,vocal fold polyp,chronic laryngitis and Reinke's edema.Methods In present series,321 cases who were performed laryngoscope were invited to participate the survey.Among them 168 eases with benign vocal fold lesions composed the case group.Another 153 cases with normal larynx composed the control group.Each case were undertook the same questionnaire.Logistic regression analysis was preformed to investigate the possible risk factors.Results The result demonstrated the occurring of benign vocal fold lesions positively correlated to five factors,including occupation,work or residence environment noise,alcohol-consuming,voice-using hours per day and abuse of voice.Occupations with intensive voice-use were more vulnerable to developing these disorders.Occurring risk of occupations type Ⅱ with moderate voice-use was 1.934 times than that of occupations type Ⅰ with lesser voice-use(OR=1.934).And risk of occupations type Ⅲ with upper voice-use was 2.633 times than that of type Ⅰ.Risk raised 1.302 times with each more hour of voice use per day.OR of the following factors of voice abuse,environment noise,alcohol-consuming was 4.744,2.115 and 2.177,respectively.Conclusions The result suggested that people should abstain from alcohol,lowering the environment noise,prevent overuse and abuse of voice in order to decrease the prevalence of these disorders,which is especially important for the professional voice users,e.g.teachers or managers.The essential therapy for these disorders is to correct bad phonation habits.%目的 探讨与成人声带良性病变发病相关的危险因素.方法 采用病例对照研究设计,对168例声带良性病变(包括声带小结、声带息肉、Reinke水肿、慢性喉炎)患者及153例喉部正常者进行问卷调查.Logistic回归分析方法 进行统计学分析.结果 多因素分析显示职业、工作或居

  18. Pesquisa de estrógeno e progesterona no epitélio das pregas vocais de mulheres por imunohistoquímica Immunohistochemical searching for estrogen and progesterone receptors in women vocal fold epithelia

    Directory of Open Access Journals (Sweden)

    Oswaldo Angel Bellido Rios

    2008-08-01

    Full Text Available A laringe é extremamente sensível a mudanças endocrinológicas. A maioria das alterações da mucosa das pregas vocais é causada por modificações do conteúdo líquido das pregas vocais e das suas modificações epiteliais. O estrógeno e a progesterona interferem e modificam esse conteúdo líquido das pregas vocais. O objetivo deste trabalho é verificar a presença de receptores de estrógeno e progesterona no epitélio das pregas vocais de mulheres. MATERIAL E MÉTODO: Estudo de casos prospectivos. Foram realizados exames de imunohistoquímica para receptores de estrógeno e progesterona em 19 espécimes de epitélio de pregas vocais que não apresentavam quaisquer indícios de afecção, inclusive inflamatória. Foram descartados casos de pacientes com idade superior a 40 anos e inferior a 15 anos. RESULTADOS: Foram encontrados receptores para progesterona em 18 de 19 pacientes. Os receptores de progesterona estão localizados tanto no núcleo quanto no citoplasma e principalmente na camada basal. Não houve nenhum caso de receptores de estrógeno nas pregas vocais. CONCLUSÃO: O epitélio das pregas vocais apresenta receptores para progesterona, tanto no citoplasma quanto no núcleo. Não foram encontrados receptores para estrógeno no epitélio das pregas vocais estudadas.Larynx is extremely sensitive to endocrinologic changes. Most vocal fold mucosa alterations are caused by changes in vocal fold liquid content and its epithelial changes. Estrogen and progesterone interfere and change this liquid content in the vocal folds. Our goal with the present paper is to study the presence of estrogen and progesterone receptors on vocal fold epithelium in 19 vocal fold epithelium specimens that did not present any indication of disease, especially inflammatory disease. We discarded those cases of patients above 40 years of age and those below 15. RESULTS: we found progesterone receptors in 18 of the 19 patients. The progesterone receptors

  19. Polyp Prevention Trial

    Science.gov (United States)

    The primary objective of the Polyp Prevention Trial (PPT) is to determine whether a low fat, high fiber, high vegetable and fruit eating plan will decrease the recurrence of adenomatous polyps of the large bowel.

  20. Malignant colorectal polyps

    Institute of Scientific and Technical Information of China (English)

    Luis; Bujanda; Angel; Cosme; Ines; Gil; Juan; I; Arenas-Mirave

    2010-01-01

    Nowadays, the number of cases in which malignant colorectal polyps are removed is increasing due to colorectal cancer screening programmes. Cancerous polyps are classified into non-invasive high grade neoplasia (NHGN), when the cancer has not reached the muscularis mucosa, and malignant polyps, classed as T1, when they have invaded the submucosa. NHGN is considered cured with polypectomy, while the prognosis for malignant polyps depends on various morphological and histological factors. The prognostic facto...

  1. Survivin与PTEN在喉部鳞状细胞癌变中的表达关系初探%Analysis on expression of Survivin and PTEN in vocal cords polyps,papilloma of larynx and laryngeal squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    郭强中; 李云英

    2012-01-01

    Through exploring the differentiation on positive expressing rates between oncogene Survivin and tumor-suppresser gene PTEN(phosphatase and tensin homolog deleteted on chromosome Ten) on vocal cord polyps(VCP), adult type laryngeal papilloma (ALP) , and Laryngeal Squamous Cell Carcinoma (LSCC) , to reveal the mechanism in canceration of human laryngeal squamous cells, from benign proliferative lesion, benign tumor to malignant tumor in larynx. Method:After picking out 18 cases of VCP, 10 cases of ALP, and 18 cases of LSCC for immunohistochemical process of Survivin and PTEN with two continuous section preparations, the differentiations of positive expression rates of Survivin and PTEN in the same human laryngeal squamous cells areas among three diseases were compared. Result:The positive expressing rates of Survivin and PTEN in VCP were obviously more lower than in ALP and LSCC(P0.05). The positive expressing rates of Survivin were always higher than PTEN in VCP, ALP and LSCC evi-dently(P<0. 05). Conclusion:PTEN, expressing for competition purpose, shows a subordinative relationship with Survivin. Although they have opposite functions in determine whether the canceration of laryngeal squamous cells take place or not, Survivin is always playing the leading role and making predominant impact on development of benign proliferative lesion, benign and malignant tumor in larynx.%目的:研究声带息肉、成人型喉乳头状瘤和喉鳞状细胞癌3种疾病中Survivin和PTEN的表达特点,以了解喉鳞状细胞从增生到癌变的可能机制.方法:选取符合临床与病理诊断的声带息肉患者18例、成人型喉乳头状瘤患者10例和喉鳞状细胞癌患者18例,将每个患者的病理蜡块标本各连续切片2张,分别进行Survivin和PTEN免疫组织化学检测.比较致癌基因Survivin和抑癌基因PTEN在这3种疾病同一区域鳞状上皮细胞中的表达差异.结果:声带息肉的Survivin和PTEN阳性率均显著低于喉乳头

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

    Institute of Scientific and Technical Information of China (English)

    张武宁; 唐安洲; 徐志文; 吴铖林; 李永湘; 钟晖; 毛海燕

    2013-01-01

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

  3. Response to "Comments on 'A theoretical model of the pressure distributions arising from asymmetric intraglottal flows applied to a two-mass model of the vocal folds'" [J. Acoust. Soc. Am. 130, 389-403 (2011)].

    Science.gov (United States)

    Erath, Byron D; Peterson, Sean D; Zañartu, Matías; Wodicka, George R; Stewart, Kelley C; Plesniak, Michael W

    2013-08-01

    Hirschberg [J. Acoust. Soc. Am. 134, 9-12 (2013)] presents a commentary and criticisms of the viscous flow model presented by Erath et al. [J. Acoust. Soc. Am. 130, 389-403 (2011)] that solves for the asymmetric pressure loading on the vocal fold walls. This pressure loading arises from asymmetric flow attachment to one vocal fold wall when the glottal channel forms a divergent configuration. Hirschberg proposes an alternative model for the asymmetric loading based upon inviscid flow curvature at the glottal inlet. In this manuscript further evidence is provided in support of the model of Erath et al. and the underlying assumptions, and demonstrates that the primary criticisms presented by Hirschberg are unwarranted. The model presented by Hirschberg is compared with the model from the original paper by Erath et al., and it is shown that each model describes different and complementary aspects of divergent glottal flows.

  4. Distúrbio de voz em professores: autorreferência, avaliação perceptiva da voz e das pregas vocais Voice disorders in teachers: self-report, auditory-perceptive assessment of voice and vocal fold assessment

    Directory of Open Access Journals (Sweden)

    Maria Fabiana Bonfim de Lima-Silva

    2012-12-01

    Full Text Available OBJETIVO: Analisar a presença do distúrbio de voz em professores na concordância entre autorreferência, avaliação perceptiva da voz e das pregas vocais. MÉTODOS: Deste estudo transversal, participaram 60 professores de duas escolas públicas de ensino fundamental e médio. Após responderem questionário de autopercepção (Condição de Produção Vocal do Professor - CPV-P para caracterização da amostra e levantamento de dados sobre autorreferência ao distúrbio de voz, foram submetidos à coleta de amostra de fala e exame nasofibrolaringoscópico. Para classificar as vozes, três juízes fonoaudiólogos utilizaram à escala GRBASI e, para pregas vocais (PPVV, um otorrinolaringologista descreveu as alterações encontradas. Os dados foram analisados descritivamente, e a seguir submetidos a testes de associação. RESULTADOS: No questionário, 63,3% dos participantes referiram ter ou ter tido distúrbio de voz. Do total, 43,3% foram diagnosticados com alteração em voz e 46,7%, em prega vocal. Não houve associação entre autorreferência e avaliação da voz, nem entre autorreferência e avaliação de PPVV, com registro de concordância baixa entre as três avaliações. Porém, houve associação entre a avaliação da voz e de PPVV, com concordância intermediária entre elas. CONCLUSÃO: Há maior autorreferência a distúrbio de voz do que o constatado pela avaliação perceptiva da voz e das pregas vocais. A concordância intermediária entre as duas avaliações prediz a necessidade da realização de pelo menos uma delas por ocasião da triagem em professores.PURPOSE: To analyze the presence of voice disorders in teachers in agreement between self-report, auditory-perceptive assessment of voice quality and vocal fold assessment. METHODS: The subjects of this cross-sectional study were 60 public elementary, middle and high-school teachers. After answering a self-awareness questionnaire (Voice Production Conditions of

  5. Characterization of vocal fold regeneration after adipose-derived mesenchymal stem cells implanting%自体脂肪间充质干细胞移植促进声带修复再生的实验研究

    Institute of Scientific and Technical Information of China (English)

    胡蓉; 徐文; 范尔钟

    2010-01-01

    目的 探讨自体脂肪间充质干细胞移植入损伤声带后的生长分布及对声带固有层及其主要细胞外基质变化的影响特点.方法 对34只实验用兔(68侧声带)的53侧声带进行全麻支撑喉镜下声带锐性损伤.分离培养、鉴定及定向诱导20只实验用兔脂肪间充质干细胞.将自体脂肪间充质干细胞植入20侧损伤声带后,示踪观察脂肪间充质干细胞在声带固有层内的生长分布;同时以单纯支架(胶原或透明质酸凝胶)植入18侧受损声带(胶原10侧,透明质酸8侧)及单纯损伤15侧声带作为对照组.术后15 d~12个月时采用HE染色、Masson染色、Alcian Blue染色及免疫组化染色观察声带形态学变化及声带固有层胶原、透明质酸、纤维连接蛋白的含量及分布变化.结果 脂肪间充质干细胞呈梭形贴壁生长,具有多向分化潜能,植入损伤兔声带后持续分布于声带固有层.损伤声带在脂肪间充质于细胞植入6个月时形态接近正常,12个月时部分组织学结构类似正常;声带细胞外基质中的胶原于植入3个月内含量有增高趋势,无序分布于固有层,后逐渐减少至正常水平附近,12个月时部分分布略显不规则;透明质酸于植入40 d含量亦有增高趋势,分布于固有层各层,6个月含量减至正常水平附近,局限于固有层浅中层;纤维连接蛋白于植入后始终在固有层内散在分布,含量在40 d内有增高趋势,后逐渐减少,12个月时含量接近正常.单纯声带损伤3个月后局部开始出现瘢痕挛缩,以胶原纤维为主的大量纤维组织增生,12个月时仍紊乱分布于声带固有层各层.单纯支架植入组变化介于二者之间.结论 脂肪间充质干细胞植入兔损伤声带后具有促进声带细胞外基质分泌、合理分布及部分有序化排列的功能,具有促进声带修复再生的作用.%Objective To investigate the treatment for injured vocal folds by implanting

  6. Paradoxical Vocal Fold Movement (PVFM)

    Science.gov (United States)

    ... More Than One Language Adult Speech and Language Child Speech and Language Swallowing and Feeding Self-Help Groups Find a Professional Advertising Disclaimer Advertise with us About Us The American ...

  7. 嗓音障碍指数主观评估与发音障碍严重程度指数客观检测的相关性分析%Correlation between voice handicap index and voice acoustic analysis in patients with vocal cord polyps

    Institute of Scientific and Technical Information of China (English)

    李晓雨; 李进让

    2016-01-01

    目的:探讨声带息肉患者嗓音障碍指数(voice handicap index,VHI)量表自我评估和发音障碍严重程度指数(dysphonia severity index,DSI)客观评估的相关性。方法取104例声带息肉患者,用VHI中文版量表进行自评及DIVAS2.5声学分析软件分析DSI,按性别、侧别、形状、大小分组比较,分析VHI和DSI的相关性。结果声带息肉的大小、形状对VHI各指标差异均无统计学意义,但较大或广基底形息肉基频微扰较重;女性患者功能、生理和VHI总体评价高于男性,但DSI却低于男性;双侧息肉比单侧在生理方面影响较重,同时DSI也较重;VHI量表各指标与嗓音声学分析各参数之间无明显相关性。结论目前临床上评估嗓音障碍程度的两种主客观方法都不理想,应进一步研究更好的评价方法。%[ABSTRACT]OBJECTIVETo investigate the relationship between self-assessment of Voice Handicap Index (VHI) and objective detection of Dysphonia Severity Index (DSI) in vocal ford polyp patients.METHODSAll 104 vocal cord polyp patients assessed the Chinese version of VHI scale by themselves. The DSI was calculated by acoustic analysis of DIVAS2.5. The correlation between VHI and DSI was analyzed in Pearson test.RESULTS There was no significant difference in each index of VHI scale score by side and shape, but the Shimmer of larger or wide-base polyps was more severe. The female patients' function, physiology, and VHI total score were higher than that of male patients, but the DSI was lower than that of male patients. The physiology score was higher in bilateral vocal cord polyp patients, so as well as DSI. There was no significant correlation between each item of VHI scale score and DSI.CONCLUSIONNeither the current subjective VHI nor objective DSI in clinical assessment of voice disorders disability is ideal, further research and better evaluation methods should be further explored.

  8. Analysis of hyaluronic acid concentration in rat vocal folds during estral and gravidic puerperal cycles Análise da concentração do ácido hialurônico nas pregas vocais de ratas durante o ciclo estral e ciclo gravídico-puerperal

    OpenAIRE

    José Eduardo de Sá Pedroso; Osíris Camponês do Brasil; João Roberto Maciel Martins; Helena Bociane Nader; Manuel de Jesus Simões

    2009-01-01

    Hormone plays an important role in the larynx. Among other substances, vocal folds contain hyaluronic acid, which tissue concentration may vary according to hormone action. AIM: the objective of this study is to analyze hyaluronic acid concentration in the vocal folds during estral and gravidic-puerperal cycles. MATERIALS AND METHODS: Experimental study. 40 adult rats were divided into two groups. In the first group we used 20 rats to establish the concentration of hyaluronic acid during the ...

  9. The Application of Mucosal Suture Technology in Patients with Vocal fold Cysts%声带囊肿切除术中应用声带黏膜缝合技术的疗效分析

    Institute of Scientific and Technical Information of China (English)

    孙娜; 孙广滨; 唐海红; 方勤; 张竞飞; 董兴睿; 曹绿红; 赵晓燕; 孟洋

    2013-01-01

    Objective To explore the effects of mucosal suturing of vocal fold for the treatment of vocal-fold cysts. Methods Fourty vocal-fold cysts cases were included in this study. All patients underwent transoral micro laryngosurgery with the suspension laryngoscopy under general anesthesia,in which 20 cases underwent mucosal su turing of vocal fold,20 cases just underwent mucosal incision. All the patients underwent evaluation of vocal function included the perceptual Grade, Roughness, Breathness, Aesthenia, Strain(GRBAS) scale, the Voice Handicap In dex(VHI) questionnaire and objective voice analysis preoperation and postoperation. Results The voice of the pa tients underwent mucosal suturing recovered better than those without suturing. Conclusion Mucosal suturing of vocal fold for the treatment of vocal-fold cysts can successfully improve the voice quality.%目的 探讨声带黏膜缝合技术应用于声带囊肿切除术的疗效.方法 40例声带囊肿患者随机分为缝合组和未缝合组,每组20例,两组患者均在全麻支撑喉镜显微镜下用内侧微瓣法进行手术,缝合组辅以声带黏膜缝合技术于囊肿切除后缝合黏膜瓣,未缝合组囊肿切除后的创缘不缝合.于术前、术后1周、1月及3月时对两组患者分别行频闪喉镜、电子喉镜检查,并进行嗓音GRBAS、嗓音障碍指数(voice handicap index,VHI)主观评分及客观嗓音分析,比较两组结果.结果 术后不同时间电子喉镜检查显示缝合组创面愈合良好,声门闭合情况优于未缝合组;频闪喉镜检查显示缝合组声带黏膜波接近正常,声带振动优于未缝合组;术后主客观嗓音分析显示缝合组嗓音质量明显优于未缝合组.结论 声带囊肿切除术中应用声带黏膜缝合技术有利于术后声带形态的恢复,提高发声质量.

  10. Injeção de gordura na prega vocal: efeitos do local de injeção sobre a configuração glótica e a distribuição espacial da gordura injetada Fat injection into the vocal fold: effects of the place of injection on the configuration of the glottis and the spatial distribution of the fat

    Directory of Open Access Journals (Sweden)

    Rui Imamura

    2003-08-01

    Full Text Available A injeção intracordal de gordura tem sido utilizada para medializar a prega vocal em casos de paralisia laríngea, com resultados variáveis. A ausência de consenso entre os autores em relação a diversos aspectos técnicos, como o local de injeção, pode contribuir, em parte, para essa variação. OBJETIVO: Estudar o efeito do local de injeção em relação à distribuição espacial da gordura dentro da prega vocal e à configuração glótica após essas injeções. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Seis laringes adultas excisadas foram utilizadas. Gordura colhida por lipoaspiração foi injetada, por meio de uma seringa de pressão, no ponto médio da prega vocal em três laringes e lateralmente ao processo vocal da aritenóide em outras três. Fotografias digitais em vista cranial da glote foram obtidas antes e após as injeções. Após fixação e descalcificação, as laringes foram cortadas no plano frontal nos terços anterior, médio e posterior da prega vocal e no nível da cartilagem aritenóide, para estudar a distribuição da gordura. RESULTADOS: Somente a injeção de gordura lateralmente ao processo vocal da aritenóide permitiu o fechamento da glote posterior. A gordura tendeu a ocupar um espaço cilíndrico dentro do músculo tireoaritenóideo, ao longo do maior eixo da prega vocal, mesmo quando injetada próximo ao processo vocal. CONCLUSÕES: O local de injeção da gordura teve influência sobre a configuração glótica após a injeção, apesar da gordura tender a ocupar um espaço cilíndrico ao longo da prega vocal em ambos os grupos.Intracordal fat injection has been used for vocal fold medialization in cases of laryngeal paralysis with variable results. A lack of consensus among the authors concerning various technical aspects, such as the site of injection, may contribute, in part, to this variation. AIM: To study the effects of the place of fat injection on the spatial distribution of fat and

  11. Evaluation on the voice rehabilitation effect promoted by Akson therapy on cases following vocal cord polyp surgically removed%阿克森疗法对声带息肉术后嗓音功能恢复的主客观评估

    Institute of Scientific and Technical Information of China (English)

    陈闽琪; 陈舒华; 彭文静

    2015-01-01

    Objective To evaluate the voice rehabilitation effect promoted by Akson therapy on cases following vocal cord polyp surgically removed. Methods Sixty cases with vocal cord polyps, with their lesions removed microsurgically under self-retaining laryngoscope and diagnosed pathohistologically, were randomly divided into 2 groups following the surgery, with 30 patients in each group. Cases in treating group (TG) were given a post-operative voice rehabilitation therapy combined routine basic nursing and post-operative treatment procedures with Akson therapy for 3 months, while those in control group (CG) were only given routine treating program with basic nursing and post-operative treatment procedures. All these cases were followed up for one year after their operation. When following up period ended, they were examined to test such parameters as voice handicap index (VHI), GRBAS and maximum phonation time(MPT) for voice rehabilitation level evaluated both objectively and subjectively in a comparative way between these 2 groups. Results By the end of following up period, 18 patients in TG and 20 in CG were collected with full clinical information. As determined by both objective and subjective evaluating ways, there were significantly statistic significance in the therapeutic effect difference between TG and CG at the testing point one year following the operation, with much higher effective rate of TG than that of CG (P< 0.05). Conclusions Akson therapy is a much better voice rehabilitation therapy for voice recovery of patients following vocal cord polyp surgically removed. The voice function evaluating system, including VHI, GRBAS and MPT, can be used to assess patient's level of voice function both objectively and subjectively.%目的 评估阿克森疗法促进声带息肉术后患者嗓音功能恢复过程的效果.方法 支撑喉镜下显微手术切除声带息肉并经病理组织学确诊的患者60例,随机分为2组,每组30例. 治疗组患者术后在

  12. 声带干燥对嗓音基频微扰和振幅微扰的影响%The Influence of Vocal Fold Dehydration on Voice Acoustic Function and the Effect of Hydration Inhalation Treatment

    Institute of Scientific and Technical Information of China (English)

    李暐; 屈季宁; 周涛; 杨希林; 华杜鹃; 解为全; 邹哲飞

    2013-01-01

    目的 探讨声带干燥处理后嗓音的变化以及生理盐水雾化吸入治疗的效果.方法 对48例健康自愿者采用鼻夹阻止鼻腔吸入气体,通过面罩呼吸干燥空气行声带干燥处理,然后随机分为两组,治疗组(36例)行雾化治疗,对照组(12例)不做治疗,对两组干燥处理前后和治疗后的嗓音进行声学分析.结果 两组受试者干燥处理后基频微扰及振幅微扰均较处理前明显增高(P<0.05),噪谐比(NHR)无明显变化(P>0.05).治疗组0.9%生理盐水雾化治疗后,基频微扰及振幅微扰较治疗前和对照组明显降低(P<0.05),差异有统计学意义.结论 声带干燥可影响嗓音的稳定性,生理盐水雾化吸入是一种有效的治疗方法.%Objective To explore the influence of vocal fold dehydration on voice and the curative effect of hy dration inhalation. Methods Fourty- eight healthy volunteers were given intervention of vocal fold dehydration and were divided into two groups, thirty six volunteers received inhalation treatment and 12 were recruited as control group. The voice acoustic detection was performed before and after the process of dehydration as well as the hydra tion inhalation treatment. Results The value of acoustic jitter and shimmer showed significant increase after the process of vocal fold dehydration (P0. 05). The experiment group was given the inhalation treatment, and the value of acoustic jitter and shimmer decreased signifi cantly compared with that of before treatment. (P0. 05) ,and the value of jitter and shimmer decreased obviously compared with those of in control group. Conclusion Dryness can cause the vocal fold dehydration and have adverse effects on voice function, hydration inhalation treatment may be as a prompt and effective treatment.

  13. Paralisia unilateral de prega vocal: associação e correlação entre tempos máximos de fonação, posição e ângulo de afastamento Unilateral vocal fold paralysis: association and correlation between maximum phonation time, position and displacement angle

    Directory of Open Access Journals (Sweden)

    Luciane M. Steffen

    2004-08-01

    Full Text Available A paralisia de prega vocal (PPV decorre da lesão do nervo vago ou de seus ramos, podendo levar a alterações das funções que requerem o fechamento glótico. O tempo máximo de fonação (TMF é um teste aplicado rotineiramente em pacientes disfônicospara avaliar a eficiência glótica e freqüentemente utilizado em casos de PPV, cujos valores encontram-se diminuídos. A classificação clínica clássica da posição da prega vocal paralisada em mediana, para-mediana, intermediária e em abdução ou cadavérica tem sido objeto de controvérsias. OBJETIVO: Verificar a associação e correlação entre os TMF e posição da prega vocal paralisada (PVP, TMF e ângulo de afastamento da PVP, medir o ângulo de afastamento da linha média das diferentes posições da PVP e correlacioná-lo com a sua classificação clínica FORMA DE ESTUDO: Clínico retrospectivo. MATERIAL E MÉTODO: Foram revisados os prontuários e analisados os exames videoendoscópicos de 86 indivíduos com paralisia de prega vocal unilateral e medido o ângulo de afastamento da PVP por meio de um programa computadorizado. RESULTADOS: A associação e correlação entre os TMF em cada posição assumida pela PVP têm significância estatística somente para /z/ na posição mediana. A associação e correlação entre TMF com ângulo de afastamento da PVP guardam relação para /i/, /u/. Ao associar e correlacionar medidas de ângulo com posição observa-se significância estatística em posição de abdução. CONCLUSÕES: Neste estudo não foi possível determinar as posições assumidas pela PVP por meio dos TMF nem correlacioná-las com medidas do ângulo.Vocal fold paralysis (VFP is due to an injury of the vagus nerve or one of its branches and may cause dysfunctions in the glottic competence. The Maximum Phonation Time (MPT is a test usually applied on dysphonic patients to assess glottic efficiency, mainly in patients with VFP and a decreased phonation time. The

  14. High speed digital phonoscopy of selected extreme vocalization (Conference Presentation)

    Science.gov (United States)

    Izdebski, Krzysztof; Blanco, Matthew; Di Lorenzo, Enrico; Yan, Yuling

    2017-02-01

    We used HSDP (KayPENTAX Model 9710, NJ, USA) to capture the kinematics of vocal folds in the production of extreme vocalization used by heavy metal performers. The vibrations of the VF were captured at 4000 f/s using transoral rigid scope. Growl, scream and inhalatory phonations were recoded. Results showed that these extreme sounds are produced predominantly by supraglottic tissues rather than by the true vocal folds, which explains while these sounds do not injure the mucosa of the true vocal folds. In addition, the HSDI were processed using custom software (Vocalizer®) that clearly demonstrated the contribution of each vocal fold to the generation of the sound.

  15. Histologia da camada superficial da lâmina própria da prega vocal ao se aplicar retalho pediculado de mucosa: estudo experimental em cães Vocal fold superficial layer of lamina propria histology after the position of mucosa pediculated flap: canine experimental study

    Directory of Open Access Journals (Sweden)

    David Greco Varela

    2005-06-01

    Full Text Available Os resultados conseguidos até hoje para a correção de sulcos vocais e lesões cicatriciais não são universalmente aceitos. A Técnica do Retalho Pediculado de Mucosa de Prega Vocal consiste na colocação de um retalho de mucosa de prega vocal com pedículo anterior na camada superficial da lâmina própria, abaixo da borda livre. OBJETIVO: Descrever os achados histológicos pós-operatórios ocorridos na camada superficial da lâmina própria de cães ao se aplicar a técnica em questão, tomando-se como parâmetro a variação dos colágenos total, tipo I, tipo III e número de núcleos celulares. FORMA DE ESTUDO: experimental. MATERIAL E MÉTODO: Foram utilizados 15 cães. Numa das pregas foi realizada a intervenção e a contralateral foi deixada como controle. Cada grupo de três cães foi sacrificado em 10, 30, 90, 180 e 360 dias após a cirurgia. As colorações utilizadas foram: H.E. e Syrius Red. RESULTADOS: Os níveis de colágeno total e tipo I apresentaram uma tendência a aumento nos grupos de intervenção nos 90º e 180º dias de pós-operatório, contudo só houve significância estatística no 180º dia (pMany techniques were applied to treat patients with sulcus vocalis and scarred vocal folds. Their results were not good enough. In the Technique of Vocal Fold Pediculated Mucosa Flap, an anterior pediculated flap of vocal fold is positioned on the superficial layer of the lamina propria, below the free margin. AIM: To describe histological postoperative findings on the superficial layer of lamina propria during the application of the technique Vocal Fold Pediculated Mucosa Flap. The following parameters were compared between tested and control groups: total, type I and type III collagen and number of cellular nucleus. STUDY DESIGN: experimental. MATERIAL AND METHOD: Fifteen dogs were used. One vocal fold was submitted to the intervention and the other was left as control. Each group of three dogs was sacrificed on 10, 30

  16. Comments on "A theoretical model of the pressure field arising from asymmetric intraglottal flows applied to a two-mass model of the vocal folds" [J. Acoust. Soc. Am. 130, 389-403 (2011)].

    Science.gov (United States)

    Hirschberg, Avraham

    2013-07-01

    After demonstrating by means of an in vitro model experiment that the flow in the glottis can become asymmetric, Erath et al. [J. Acoust. Soc. Am. 130, 389-403 (2011)] propose a theory to estimate the resulting asymmetry in the lateral hydrodynamic force on the vocal folds. A wall-jet attached to one side of the divergent downstream part of the glottis is considered. The model assumes that the wall is a flat plate and that the jet separates at the glottal exit. They implement this so-called Boundary Layer Estimation of Asymmetric Pressure force model in a lumped two mass model of the vocal folds. This should allow them to study the impact of the asymmetry on voiced sound production. A critical discussion of the merits and shortcomings of the model is provided. It predicts discontinuities in the time dependency of the lateral force. It predicts this force to be independent from the glottal opening, which is not reasonable. An alternative model is proposed, which avoids these problems and predicts that there is a minimum glottal opening below which the wall-jet does not separate from the wall at the glottal exit. This is in agreement with the experimental results provided by Erath et al.

  17. Therapeutic Effect of Intracordal Injection of Adipose Tissue on Age-related Vocal Fold Atrophy%自体脂肪声带注射治疗年龄相关性声带萎缩的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王静妙; 蒋新霞; 魏俊宽; 马建刚; 李惠芹

    2013-01-01

    目的 探讨自体脂肪声带注射治疗年龄相关性声带萎缩导致声嘶的疗效.方法 对42例因年龄相关性声带萎缩而引起声嘶的患者于全麻下行自体脂肪声带注射,并分别于术前和术后1、3~6、12、18个月进行频闪喉镜检查和嗓音声学分析.结果 42例中2例无效(因手术失败,患者拒绝再次治疗),未纳入统计学分析.其余40例术前频闪喉镜检查可见声带萎缩、声门闭合不良,其中轻度声嘶者28例,中度声嘶者10例,重度声嘶者2例.术后1年,32例发声正常,频闪喉镜检查见声带振动良好,声门闭合正常;轻度声嘶者4例,中度声嘶者4例.嗓音声学分析显示术后3~6、12及18个月患者的嗓音基频微扰、振幅微扰及标准化噪声能量较术前及术后1个月明显下降(P<0.05).结论 自体脂肪声带注射治疗年龄相关性声带萎缩可改善其发声功能.%Objective To study the curative effect of autogenous fat intracordal injection for patients with vocal fold atrophy. Methods Forty-two cases of hoarseness with vocal fold atrophy were included, all patients were treated by autogenous fat injection laryngoplasty and underwent laryngostroboscopc and acoustic analysis before and after surgery. Results In this experiment, 2 cases of failed opcratin were not included. Before operation, the laryngostroboscopc examination of the 40 patients showed: vocal fold closed badly and atrophy was obscrval, 28 showed mild hoarseness and 10 showed moderate hoarseness and 2 showed severe hoarseness. One year after operation, most cases were observed with good vocal fold vibration and glottal closure, and voice acoustic analysis parameters were improved significantly. Conclusion Autogenous fat injection laryngoplasty was an effective method for the treatment of vocal fold atrophy and the long term effects were reliable.

  18. Ventricular-Fold Dynamics in Human Phonation

    Science.gov (United States)

    Bailly, Lucie; Bernardoni, Nathalie Henrich; Müller, Frank; Rohlfs, Anna-Katharina; Hess, Markus

    2014-01-01

    Purpose: In this study, the authors aimed (a) to provide a classification of the ventricular-fold dynamics during voicing, (b) to study the aerodynamic impact of these motions on vocal-fold vibrations, and (c) to assess whether ventricular-fold oscillations could be sustained by aerodynamic coupling with the vocal folds. Method: A 72-sample…

  19. The Morphology Observation of Posterior Cricoarytenoid Muscle Myofiber in Patients with Idiopathic Vocal Fold Paralysis%特发性声带麻痹患者环杓后肌肌纤维形态观察

    Institute of Scientific and Technical Information of China (English)

    马情情; 孙丽; 郑宏良; 陈世彩; 陈东辉; 张贤

    2015-01-01

    Objective To investigate the morphology change of posterior cricoarytenoid muscle myofiber in patients with idiopathic vocal fold paralysis and to provide experimental evidence for the clinical treatment of idio‐pathic vocal cord paralysis .Methods Thirty -nine cases of vocal fold paralysis patients were recruited into and di‐vided into 2 groups :idiopathic vocal cord paralysis group(n=16) ,and traumatic vocal cord paralysis group(n=23) . Both groups were further divided into 3 subgroups:0 .5~1 year(5 cases and 7 cases) ,>1~2 years(5 cases and 10 cases) ,>2 years(6 cases and 6 cases) .Part of posterior cricoarytenoid muscle(PCAM ) were acquired from all of vo‐cal cord paralysis patients .Normal human posterior cricoarytenoid muscles were treated as the control group (n=5) . They were all stained with Masson three-color staining ,the fiber crosssectional area of muscle tissue and collagen connective tissue were quantitatively analyzed with the image pro plus analysis system .Differences of two observa‐tion indexes were compared with each other among groups and subgroups .Results The number of myofibers was decreased ,but the numbers of the collagen fibers was increased with the onset time course extension ,the ratio of cross sectional area of myofibers to those of collagen fibers was progressively decreasd with increased time course of denervation and more decrease within 1 year .There was obvious difference between the control group and 0 .5~1 year ,>1~2 years ,>2 years subgroup of idiopathic vocal cord paralysis (P1~2 years subgroup and >2 years subgroup ,the trend of shrinking still existed .Com‐pared two observation indexes of traumatic vocal cord paralysis with the same period subgroup indexes of idiopathic vocal fold paralysis ,there was no significant difference about these two observation indexes (P>0 .05) .In some special cases with 10 years duration in idiopathic vocal cord paralysis group ,the posterior cricoarytenoid muscle at‐rophy fibrosis

  20. Oral Breathing Challenge in Participants with Vocal Attrition

    Science.gov (United States)

    Sivasankar, Mahalakshmi; Fisher, Kimberly V.

    2003-01-01

    Vocal folds undergo osmotic challenge by mouth breathing during singing, exercising, and loud speaking. Just 15 min of obligatory oral breathing, to dry the vocal folds, increases phonation threshold pressure (P[subscript th]) and expiratory vocal effort in healthy speakers (M. Sivasankar & K. Fisher, 2002). We questioned whether oral breathing is…

  1. [Giant esophageal fibrovascular polyp].

    Science.gov (United States)

    Palacios, Fernando; Contardo, Carlos; Guevara, Jorge; Vera, Augusto; Aguilar, Luis; Huamán, Manuel; Palomino, Américo; Yabar, Alejandro

    2003-01-01

    Fibrovascular polyps are extremely rare benign neoplasias of the esophagus, which usually originate in the lower cricoid area. They do not produce any discomfort in the patient for a long time, however it may make itself evident by the patient's regurgitation of the polyp, producing asphyxia or, more frequently, dysphagia. The case of a 58 year old male patient is presented herein, with a 9 month record of dysphagia, weight loss and intermittent melena. The barium x-ray showed a distended esophagus, with a tumor running from the upper esophageal sphincter to the cardia. The endoscopy confirmed the presence of a pediculated tumor, implanted in the cervical esophagus. Surgeons suspected the potential malignancy of the tumor and performed a transhiatal esophagectomy. The final pathologic diagnosis was giant fibrovascular esophageal polyp.

  2. Lesões organofuncionais do tipo nódulos, pólipos e edema de Reinke Organic and functional lesions: nodules, polyps and Reinke's edema

    Directory of Open Access Journals (Sweden)

    Carla Aparecida Cielo

    2011-08-01

    Full Text Available TEMA: lesões organofuncionais são formações benignas decorrentes de comportamento vocal alterado e inadequado, sendo as mais comuns: nódulos, pólipos vocais e edema de Reinke. OBJETIVO: realizar um estudo comparativo dos dados descritos na literatura sobre prega vocal normal e afecções organofuncionais do tipo nódulos, pólipos e edema de Reinke. O estudo foi realizado por meio de um levantamento bibliográfico em periódicos indexados no Science Direct, periódicos Capes, LILACS, SciELO, MedLine e Scopus e livros, no período de 1999 a 2010. CONCLUSÃO: a distribuição dos constituintes da matriz extracelular da lâmina própria lw32da mucosa, fibras elásticas, colágenas, ácido hialurônico e fibronectina, encontra-se alterada nas três afecções. Ocorre modificação das características vibratórias de amplitude, propagação da onda de mucosa e simetria do padrão vibratório devido à presença do aumento de massa nas pregas vocais, ao contrário do que se observa nas pregas vocais sem afecção. O sinal perceptivo-auditivo da qualidade vocal encontrado nas três lesões é a rouquidão, seguida da soprosidade e da aspereza (exceção do edema de Reinke, sinalizando a presença de ruído acústico à emissão, estando presente também, no edema de Reinke, o agravamento considerável da frequência fundamental. Quanto à etiologia observou-se a predominância dos usos incorretos, e quanto à incidência, nódulos e edema de Reinke predominam no sexo feminino e pólipos no sexo masculino.BACKGROUND: vocal nodules, vocal polyps and Reinke's edema are the most common benign organic lesions resulting from vocal misuse or abuse. PURPOSE: to conduct a comparative study about the normal vocal folds and the benign organic lesions, nodules, polyps and Reinke's edema. The study was performed using a literature review in indexed journals at Science Direct, Capes, LILACS, SciELO, MedLine and Scopus and books from 1999 to 2010. CONCLUSION

  3. 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.

  4. Viscous flow features in scaled-up physical models of normal and pathological vocal phonation

    Energy Technology Data Exchange (ETDEWEB)

    Erath, Byron D., E-mail: berath@purdue.ed [School of Mechanical Engineering, Purdue University, 585 Purdue Mall, West Lafayette, IN 47907 (United States); Plesniak, Michael W., E-mail: plesniak@gwu.ed [Department of Mechanical and Aerospace Engineering, George Washington University, 801 22nd Street NW, Suite 739, Washington, DC 20052 (United States)

    2010-06-15

    Unilateral vocal fold paralysis results when the recurrent laryngeal nerve, which innervates the muscles of the vocal folds becomes damaged. The loss of muscle and tension control to the damaged vocal fold renders it ineffectual. The mucosal wave disappears during phonation, and the vocal fold becomes largely immobile. The influence of unilateral vocal fold paralysis on the viscous flow development, which impacts speech quality within the glottis during phonation was investigated. Driven, scaled-up vocal fold models were employed to replicate both normal and pathological patterns of vocal fold motion. Spatial and temporal velocity fields were captured using particle image velocimetry, and laser Doppler velocimetry. Flow parameters were scaled to match the physiological values associated with human speech. Loss of motion in one vocal fold resulted in a suppression of typical glottal flow fields, including decreased spatial variability in the location of the flow separation point throughout the phonatory cycle, as well as a decrease in the vorticity magnitude.

  5. 嗓音障碍指数对声带囊肿患者术后嗓音的自我评估%Self-Assessment of Postoperative Voice with Voice Handicap Index in Patients with Vocal Fold Cysts

    Institute of Scientific and Technical Information of China (English)

    程贤宁; 刘庆伟; 陈奇志; 陈朱井

    2015-01-01

    Objective To evaluate the postoperative voice recovery with voice handicap index (VHI)in patients undergoing surgery under suspension micro-laryngoscope and fiber laryngo-scope for vocal fold cysts,and to verify the practicability of VHI.Methods Sixty patients with vocal fold cysts were treated with surgical resection under suspension micro-laryngoscope(micro-scope group,n=30)or fiber laryngoscope(fiberscope group,n=30).The postoperative voice re-covery was self-assessed by using VHI scale,including functional(F),physiological(P),emotional (E)and total(TVH)scores.Results The F,E and TVH scores significantly decreased in both groups 1 week after operation(P<0.05).The F,P,E and TVH scores significantly decreased in both groups 1 month after operation(P<0.05).Compared with microscope group,the F,P and TVH scores significantly increased in fiberscope group(P<0.05).Conclusion The VHI can sub-j ectively reflect the degree of voice disorders in patients with vocal fold cysts.Therefore,it can be used for preoperative assessment of the degree of voice disorders and postoperative evaluation of the therapeutic efficacy.%目的:探讨嗓音障碍指数(voicehandicap index,VHI)用于支撑显微喉镜和纤维喉镜治疗声带囊肿后嗓音恢复的评估,并验证 VHI的实用性。方法选取确诊为声带囊肿并接受手术切除的患者60例,其中在支撑显微喉镜下治疗30例(显微镜组),在纤维喉镜下治疗30例(纤维镜组),2组患者采用 VHI量表对手术前后的嗓音恢复进行自我评估,内容包括功能(F)、生理(P)、情感(E)及总分(TVH)评分。结果术后1周,2组 F、E、TVH 评分均较术前明显降低(P<0.05);术后1个月,2组 F、P、E、TVH 评分均较术前明显降低(P<0.05),纤维镜组 F、P、TVH评分高于显微镜组(P<0.05)。结论 VHI可主观反映患者的嗓音障碍程度,可用于治疗前对嗓音障碍程度的估计,治疗后效果评价。

  6. 声带白斑临床病理特征与咽喉反流的初步观察%Observation of clinicopathological characteristics of vocal fold leukoplakia and laryngopharyngeal reflux

    Institute of Scientific and Technical Information of China (English)

    朱虹; 徐文; 李赟; 程丽宇

    2014-01-01

    Objective To investigate the correlation between clinicopathological characteristics of vocal fold leukoplakia and laryngopharyngeal reflux ( LRP ).Methods One hundred and thirty-eight patients with vocal leukoplakia who received laryngeal microsurgeries under suspension laryngoscope were recruited in this study.Reflux symptom index ( RSI) and reflux finding score ( RFS) were measured.The clinical features , pathological characteristics were collected.Results There were 129 males and 9 females with a mean age of ( 53.4 ±11.5 ) years.The mean age of patients with severe dysplasia/carcinoma and invasive carcinoma was significantly older than that of inflammation /hyperplasia(F=6.773,P13 or RFS>7 was 54.3%, while the positive rate of RSI was 21.7%and that of RFS was 43.5%.There was no significant differences of the positive rates of RSI and RFS among different pathological types (χ2 values 3.537 and 7.619 respectively with both P >0.05 ).According to RSI evaluation, the most common reflux symptoms were hoarseness (94.9%), throat clearing (68.8%) and globus sensation ( 62.3%).The most common RFS findings were posterior commissure hypertrophy (79.7%), thick endolarygeal mucus (77.5%) and vocal fold edema (70.3%).Conclusions The vocal fold leukoplakia consisted of various pathological types including benign , dysplasia and malignancy.There was a correlation between pathological types and the extent of mucosal waves .About half of the patients with vocal fold leukoplakia existed LPR using RFS and RSI evaluation , but no significant difference of LPR positive rates were observed among different pathological types.%目的:探讨声带白斑临床病理特征与咽喉反流特征。方法2011年1月至2013年12月全身麻醉支撑喉镜下行喉显微手术的138例声带白斑患者,分析其临床及病理组织学特征,根据反流症状指数(Reflux symptom index,RSI)量表和反流体征评分(Reflux finding score,RFS)量表分析其咽

  7. Flat colon polyps: what should radiologists know?

    Energy Technology Data Exchange (ETDEWEB)

    Ignjatovic, A. [Intestinal Imaging Centre, St Mark' s Hospital, Harrow, Middlesex (United Kingdom); Burling, D., E-mail: burlingdavid@yahoo.co.u [Intestinal Imaging Centre, St Mark' s Hospital, Harrow, Middlesex (United Kingdom); Ilangovan, R.; Clark, S.K.; Taylor, S.A.; East, J.E.; Saunders, B.P. [Intestinal Imaging Centre, St Mark' s Hospital, Harrow, Middlesex (United Kingdom)

    2010-12-15

    With the recent publication of international computed tomography (CT) colonography standards, which aim to improve quality of examinations, this review informs radiologists about the significance of flat polyps (adenomas and hyperplastic polyps) in colorectal cancer pathways. We describe flat polyp classification systems and propose how flat polyps should be reported to ensure patient management strategies are based on polyp morphology as well as size. Indeed, consistency when describing flat polyps is of increasing importance given the strengthening links between CT colonography and endoscopy.

  8. Alteração de mobilidade de prega vocal unilateral: avaliação subjetiva e objetiva da voz nos momentos pré e pós-fonoterapia Unilateral vocal fold mobility alteration: objective and subjective evaluation of voice quality on prior and post speech therapy

    Directory of Open Access Journals (Sweden)

    Ana Cristina Cortes Gama

    2011-08-01

    Full Text Available OBJETIVO: avaliar de forma subjetiva e objetiva a voz de pacientes com paralisia unilateral de prega vocal nos momentos pré-tratamento e pós-tratamento. MÉTODOS: trata-se de um estudo retrospectivo por meio de revisão de prontuário, que analisou as gravações de vozes de 12 indivíduos com diagnóstico otorrinolaringológico de paralisia unilateral de prega vocal. O material de voz colhido foi a emissão sustentada da vogal /a/, seguida de fala encadeada. As vozes pré e pós-terapia foram analisadas por meio da escala GRBASI, análise espectrográfica e medida do tempo máximo de fonação (TMF. Os parâmetros para análise espectrográfica foram: forma do traçado, grau de escurecimento dos harmônicos, continuidade do traçado, presença de ruídos, presença de sub-harmônicos e harmônicos definidos. A medida do TMF da vogal /a/ representou a maior de três emissões. Os dados obtidos foram submetidos a análise descritiva de tendência central e dispersão, e ao Teste Wilcoxon. RESULTADOS: na análise perceptivo-auditiva, o parâmetro que mais se modificou no momento pós- tratamento foi o de soprosidade (B (p=0,003, seguido do grau da disfonia (G (p=0,004 e astenia (A (p=0,01, sendo que estes resultados foram estatisticamente significantes. Com relação ao espectrograma, houve melhora do traçado em 91% dos pacientes, e os parâmetros que mais se modificaram foram: aumento do número de harmônicos (32% e diminuição do ruído (24%. A medida do TMF da vogal /a/ apresentou-se significantemente maior no momento pós-fonoterapia (p=0,003%. CONCLUSÃO: pacientes com paralisia de prega vocal que foram submetidos ao tratamento fonoaudiológico apresentaram melhora dos dados perceptivo-auditivos, espectrográfico e do TMF.PURPOSE: this study aims to analyze the objective and subjective evaluation of voice quality in a unilateral vocal fold mobility alteration on prior and post speech therapy. METHODS: this is a retrospective study

  9. Estudo comparativo histológico na prega vocal após incisão com instrumental a frio e com laser de CO2 em modelo animal Comparative histology study of the vocal folds after incision with cold instruments and CO2 laser in an animal model

    Directory of Open Access Journals (Sweden)

    Fernando C. C. Santos

    2003-12-01

    Jako and Strong's works in 1972(1,2, when CO2 was first applied in the treatment of papilomatosis and early glottic malign lesions, its indications have risen, most especially in benign lesions, due to new technology developed over the last years as, for example, the reduction of microspot and the super-pulse, reducing the thermal effects on the tissues. METHODS: In this work, incisions with cold steel instruments and 1watt continuous mode and super-pulse CO2 laser were conducted on canine vocal folds. The amount of collagen deposited over the vocal folds was observed through histological exams using the Sirius Red method. RESULTS: The amount of collagen on the vocal folds was greater than the control group and statistically greater in the group of animals submitted to surgical procedures using cold instruments than procedures involving CO2. There was no statistical difference between the control group and the group submitted to incisions with cold steel instruments. CONCLUSIONS: The larynx surgery with CO2 laser, when employed in low potency, with small microspot and super-pulse, is a safe method in relation to the collagen deposit when compared with cold blade instruments.

  10. 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.

  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

    2014-07-01

    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.

  12. A study of vocal nonlinearities in humpback whale songs: from production mechanisms to acoustic analysis

    OpenAIRE

    Dorian Cazau; Olivier Adam; Thierry Aubin; Laitman, Jeffrey T.; Reidenberg, Joy S.

    2016-01-01

    International audience; Although mammalian vocalizations are predominantly harmonically structured, they can exhibit an acoustic complexity with nonlinear vocal sounds, including deterministic chaos and frequency jumps. Such sounds are normative events in mammalian vocalizations, and can be directly traceable to the nonlinear nature of vocal-fold dynamics underlying typical mammalian sound production. In this study, we give qualitative descriptions and quantitative analyses of nonlinearities ...

  13. Deep learning of contrast-coated serrated polyps for computer-aided detection in CT colonography

    Science.gov (United States)

    Näppi, Janne J.; Pickhardt, Perry; Kim, David H.; Hironaka, Toru; Yoshida, Hiroyuki

    2017-03-01

    Serrated polyps were previously believed to be benign lesions with no cancer potential. However, recent studies have revealed a novel molecular pathway where also serrated polyps can develop into colorectal cancer. CT colonography (CTC) can detect serrated polyps using the radiomic biomarker of contrast coating, but this requires expertise from the reader and current computer-aided detection (CADe) systems have not been designed to detect the contrast coating. The purpose of this study was to develop a novel CADe method that makes use of deep learning to detect serrated polyps based on their contrast-coating biomarker in CTC. In the method, volumetric shape-based features are used to detect polyp sites over soft-tissue and fecal-tagging surfaces of the colon. The detected sites are imaged using multi-angular 2D image patches. A deep convolutional neural network (DCNN) is used to review the image patches for the presence of polyps. The DCNN-based polyp-likelihood estimates are merged into an aggregate likelihood index where highest values indicate the presence of a polyp. For pilot evaluation, the proposed DCNN-CADe method was evaluated with a 10-fold cross-validation scheme using 101 colonoscopy-confirmed cases with 144 biopsy-confirmed serrated polyps from a CTC screening program, where the patients had been prepared for CTC with saline laxative and fecal tagging by barium and iodine-based diatrizoate. The average per-polyp sensitivity for serrated polyps >=6 mm in size was 93+/-7% at 0:8+/-1:8 false positives per patient on average. The detection accuracy was substantially higher that of a conventional CADe system. Our results indicate that serrated polyps can be detected automatically at high accuracy in CTC.

  14. Lysosomal exoglycosidases in nasal polyps.

    Science.gov (United States)

    Chojnowska, Sylwia; Minarowska, Alina; Knaś, Małgorzata; Niemcunowicz-Janica, Anna; Kołodziejczyk, Paweł; Zalewska-Szajda, Beata; Kępka, Alina; Minarowski, Łukasz; Waszkiewicz, Napoleon; Zwierz, Krzysztof; Szajda, Sławomir Dariusz

    2013-01-01

    Nasal polyps are smooth outgrowths assuming a shape of grapes, formed from the nasal mucosa, limiting air flow by projecting into a lumen of a nasal cavity. Up to now the surgical resection is the best method of their treatment, but etiology and pathogenesis of the nasal polyps is not yet fully established. The aim of the study was the assessment of the selected lysosomal exoglycosidases activity in the nasal polyps. In this study the activity of β-galactosidase, α-mannosidase and α-fucosidase was determined in the tissue of the nasal polyps obtained from 40 patients (10F, 30M) and control tissues derived from mucosa of lower nasal conchas obtained during mucotomy from 20 patients (10F, 10M). We observed significant lower values of GAL, FUC and tendency to decrease of MAN and GLU concentration in nasal polyps (P) in comparison to control healthy nasal mucosa (C). In nasal polyp tissue (P) no differences of GAL, MAN and FUC specific activity in comparison to control mucosa (C) were found. Our research supports bioelectrical theory of the nasal polyps pathogenesis and directs attention at research on glycoconjugates and glycosidases of the nasal mucosa extracellular matrix. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  15. 声带白斑与胃食管咽喉反流的相关分析%Relationship between vocal fold leukoplakia and gastropharyngeal reflux: analysis of 15 cases

    Institute of Scientific and Technical Information of China (English)

    倪鑫; 王晓晔; 张玉焕; 王小轶

    2008-01-01

    Objective To explore the possible relationship between vocal fold leukoplakia and gastropharyngeal reflux. Methods Fifteen patients with vocal fold leukoplakia confirmed by pathology, all males, aged ( 53 ± 14 ) ( 20 - 88 ) , underwent esophageal and laryngopharyngeal 24-hour pH monitoring before operation. The rate and characteristics of reflux were recorded. Semi-open-ended questionnaire was used to assess the symptoms. Results Nine of the 15 patients (60%) showed pathologic intra-esophageal reflux. The time of total acid reflux of the positive re intra-esophageal reflux group was 104. 6 min ± 42. 1 min, significantly longer than that of the negative group [ ( 10. 9 min ± 11.5 min ) , P = 0. 001 ] . The frequencies of intra-esophageal acid reflux of the positive group was ( 30. 1 ± 16. 2 ) times, significantly higher than that of the negative group [ ( 4. 8 ± 3.4 ) times, P = 0. 0061. The intra-esophageal acid reflux percentage of the positive group was 7.9% ± 2. 9% , significantly higher than that of the negative group ( 1.0% ± 0. 6% ), P = 0. 01 ]. and the rate in esophageal pH < 4 of total fraction time between reflux positive and negative patients( P < 0. 01 ). The scores of heartburn and acid regurgitaion of the positive group were significantly higher than those of the negative group (both P < 0. 05). Two of 15 patients ( 13.3% )had pathologic laryngopahryngeal reflux. One patient also had obstructive sleep apnea hypopnea syndrome. Conclusion The patients with vocal fold leukoplakia had more pathologic iutra-esophageal reflux compared to the normal individuals. Reflux may be a risk factor of mucosa leukoplakia.%目的 探讨声带白斑与胃食管咽喉反流可能的相关性.方法 选取2007年3月至2008年2月诊断为声带白斑,并由术后病理证实为声带角化伴或不伴不典型增生患者15例,征得患者同意后手术前行24 h咽喉及食管pH监测,统计反流率,分析反流特点、反流症状评分.结果 15例患

  16. Reinforcement of 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 reinforcing effect of maternal vocal imitation of infant vocalizations using a reversal probe BAB design. Eleven 3- to 8-month-old infants at high risk for developmental delays experienced contingent maternal vocal imitation during reinforcement conditions. Differential reinforcement of other behavior served as the control condition. The behavior of 10 infants showed evidence of a reinforcement effect. Results indicated that vocal imitations can serve to reinforce early infant vocalizations.

  17. Assessment of thyroplasty for vocal fold paralysis

    DEFF Research Database (Denmark)

    Grøntved, Ågot Møller; Faber, Christian; Jakobsen, John

    2009-01-01

    -Dimensional Voice Program. Furthermore, patients answered the Voice Handicap Index (VHI) questionnaire. RESULTS: The capacity and intensity of the voice were significantly increased with an improvement of the highest intensity of 13 dB. The capacity of the voice was increased more than 2.5 times. The voice quality...... was improved significantly as measured by the jitter percentage, shimmer percentage and voice turbulence index. The VHI was decreased by 40, from a mean preoperative value of 82. A total of 90% of patients were satisfied. CONCLUSION: Besides videostroboscopy, a phonetogram is the most important analysis...

  18. A singing voices synthesis system to characterize vocal registers using ARX-LF model

    OpenAIRE

    Motoda, Hiroki; Akagi, Masato

    2013-01-01

    This paper proposes a singing voices synthesis system to synthesize singing voices having characteristics of vocal registers, such as vocal fly, modal and falsetto. Human can sing songs naturally in wide range of frequency by training how to use vocal fold vibrations to represent vocal registers. However, even state-of-the-art singing voices synthesis systems cannot produce vocal registers appropriately. Naturalness of the synthesized singing voices using these systems is reduced in low and h...

  19. Polyp Segmentation in NBI Colonoscopy

    Science.gov (United States)

    Gross, Sebastian; Kennel, Manuel; Stehle, Thomas; Wulff, Jonas; Tischendorf, Jens; Trautwein, Christian; Aach, Til

    Endoscopic screening of the colon (colonoscopy) is performed to prevent cancer and to support therapy. During intervention colon polyps are located, inspected and, if need be, removed by the investigator. We propose a segmentation algorithm as a part of an automatic polyp classification system for colonoscopic Narrow-Band images. Our approach includes multi-scale filtering for noise reduction, suppression of small blood vessels, and enhancement of major edges. Results of the subsequent edge detection are compared to a set of elliptic templates and evaluated. We validated our algorithm on our polyp database with images acquired during routine colonoscopic examinations. The presented results show the reliable segmentation performance of our method and its robustness to image variations.

  20. Endoscopic detection and treatment of colorectal polyps

    NARCIS (Netherlands)

    Belderbos, TDG

    2017-01-01

    Colorectal cancer (CRC) is the third most commonly diagnosed malignancy and the fourth leading cause of cancer related mortality worldwide. Most colorectal cancers arise form premalignant colorectal polyps. Colorectal polyps can be roughly subdivided into hyperplastic, non-malignant polyps and

  1. Pathology and Genetics of Syndromic Gastric Polyps

    NARCIS (Netherlands)

    Brosens, Lodewijk A A; Wood, Laura D; Offerhaus, G Johan; Arnold, Christina A; Lam-Himlin, Dora; Giardiello, Francis M; Montgomery, Elizabeth A

    2016-01-01

    Gastric polyps are found in 1% to 4% of patients undergoing gastroscopy. The vast majority are sporadic, but some gastric polyps indicate an underlying syndrome. Gastric polyps can manifest in each of the gastrointestinal polyposis syndromes, including the recently described gastric adenocarcinoma a

  2. Giant Fibrovascular Polyp of the Larynx

    Directory of Open Access Journals (Sweden)

    Nascimento, Silva Bona do

    2014-05-01

    Full Text Available Introduction Fibrovascular polyps (FVPs are rare benign tumors originating in the cervical esophagus, and, rarely, in the hypopharynx. A case of FVP from the larynx has not yet been described in the literature. Objectives To discuss a unique case of FVP originating in the larynx. Resumed Report A 58-year-old woman presented with a 6-month history of progressive dysphagia. Endoscopic exams identified an elongated polypoid lesion originating from the mucosa of the epiglottis and the right pharyngoepiglottic fold. Excision of this mass under direct laryngoscopy revealed an 11.5 × 0.8-cm polypoid lesion, histologically diagnosed as an FVP. Conclusion The location of this FVP is important because, despite being a benign tumor, it carries a potentially lethal risk of upper airway obstruction.

  3. Increased Prevalence of Colorectal Polyp in Acromegaly Patients: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Ali Riza Koksal

    2014-01-01

    Full Text Available An increase in the prevalence of colorectal polyps and cancer is reported in patients with acromegaly. This trial is designed to determine whether there is an increase in the prevalence of colorectal polyps/cancer in Turkish acromegaly patients. Sixty-six patients, who were under follow-up with the diagnosis of acromegaly and underwent total colonoscopic examination, were enrolled in the study. Sixty-five age- and gender-matched patients with nonspecific complaints were selected as control. The mean age of acromegalic patients was 51.5±12.8 years of whom 27 (40.9% were females. In 20 (30.3% of the patients with acromegaly a total of 65 colorectal polyps were detected. Forty-seven (72.3% of the polyps were detected at the rectosigmoid region. In 8 (12.3% of the 65 control patients a total of 17 polyps were found. There was a statistically significant difference between the groups (P=0.018. At the logistic regression analysis we found that the risk for colon polyps increased 3.2-fold in the presence of acromegaly, irrespective of age and gender (OR: 3.191, 95% CI: 1.25–8.13. In conclusion, patients who were followed up with the diagnosis of acromegaly should be taken to the colonoscopic surveillance program and all polyps detected should be excised in order to protect them from colorectal cancer.

  4. 成人声带良性病变患者嗓音多维分析的重测信度评价%The Reliability of Multi Dimensional Parameters in Adult with Vocal Folds' Benign Lesions

    Institute of Scientific and Technical Information of China (English)

    张华蓉; 黄永望

    2013-01-01

    Objective To study the test-rctcst reliability of multi - dimensional paramctcrs(F0,jitter, Shim, NHR)by observing the changes of the acoustic parameters of voice samples from dysphonia adult. Methods A total of 105 patients with the benign lesions of vocal fold and 60 subjects with normal voice were included. All 105 patients were divided into group A(56 cases) and group B(49 cases) randomly,group was normal control group. All subjects voices were recorded by the Multi - Dimensional Voice Program ( MDVP ) of CSL model 4500. The voice of the patients in group A and group C were recorded once and then a second time in 5 minutes later. The voices of the patients in B were recorded two more times in 5 minutes later . The test-rctcst reliability of acoustic parameters was evaluated by intraclass correlation coeff icicnt ( ICC). ICC exceeded 0. 4 was considered as "good" consistency to measure the results of this study. Results The test-rctcst reliability of the following parameters were shown, respectively as follows: group A: F0>0. 4 , Jittcr>0. 4 ,Shim>0. 4 , NHR0. 4. Conclusion The study showed a highest intra - subject stability of frequency fundamental parameters. The voice should be evaluated by objective voice analysis from 2 samplings.%目的 研究声带良性病变患者的多维嗓音声学分析(MDVP)中基频(F0)、基频微扰(jitter)、振幅微扰(shim)、噪谐比(NHR)的重测信度.方法 成人声带良性病变患者105例,随机分为两组,甲组56例,乙组49例;选取健康成年人60名作为正常对照组(丙组).用计算机语音工作站(CSL 4500型)录声样,甲组及丙组发/a:/音1次,5分钟后,以同样的方式再发音1次;乙组受试者发/a:/音2次,5分钟后,以同样的方式再发音2次.用MDVP软件对各组嗓音的F0、jitt、shim、NHR等指标进行分析,以组内相关系数(ICC) 检验声学指标的重测信度.结果甲组F0、jitt、shim一致性良好(ICC>0.4),NHR的一致性差(ICC<0.4);乙组F0

  5. Regulation of glottal closure and airflow in a three-dimensional phonation model: implications for vocal intensity control.

    Science.gov (United States)

    Zhang, Zhaoyan

    2015-02-01

    Maintaining a small glottal opening across a large range of voice conditions is critical to normal voice production. This study investigated the effectiveness of vocal fold approximation and stiffening in regulating glottal opening and airflow during phonation, using a three-dimensional numerical model of phonation. The results showed that with increasing subglottal pressure the vocal folds were gradually pushed open, leading to increased mean glottal opening and flow rate. A small glottal opening and a mean glottal flow rate typical of human phonation can be maintained against increasing subglottal pressure by proportionally increasing the degree of vocal fold approximation for low to medium subglottal pressures and vocal fold stiffening at high subglottal pressures. Although sound intensity was primarily determined by the subglottal pressure, the results suggest that, to maintain small glottal opening as the sound intensity increases, one has to simultaneously tighten vocal fold approximation and/or stiffen the vocal folds, resulting in increased glottal resistance, vocal efficiency, and fundamental frequency.

  6. Techniques for Vocal Health.

    Science.gov (United States)

    Wiest, Lori

    1997-01-01

    Outlines a series of simple yet effective practices, techniques, and tips for improving the singing voice and minimizing stress on the vocal chords. Describes the four components for producing vocal sound: respiration, phonation, resonation, and articulation. Provides exercises for each and lists symptoms of sickness and vocal strain. (MJP)

  7. The effects of physiological adjustments on the perceptual and acoustical characteristics of simulated laryngeal vocal tremor

    OpenAIRE

    Rosemary A Lester; Story, Brad H.

    2015-01-01

    The purpose of this study was to determine if adjustments to the voice source [i.e., fundamental frequency (F0), degree of vocal fold adduction] or vocal tract filter (i.e., vocal tract shape for vowels) reduce the perception of simulated laryngeal vocal tremor and to determine if listener perception could be explained by characteristics of the acoustical modulations. This research was carried out using a computational model of speech production that allowed for precise control and manipulati...

  8. Giant Hyperplastic Polyp in the Stomach

    Directory of Open Access Journals (Sweden)

    Fazilet Uğur DUMAN

    2010-09-01

    Full Text Available Hyperplastic polyps, which account for nearly 75% of all gastric polyps, are generally small (<1 cm, single, sessile, polyps and located in antrum. They are usually asymptomatic. A 77-year-old man was admitted to hospital due to severe fatigue as a consequence of irondeficiency anemia. The upper gastrointestinal endoscopy which was done to discover an etiological factor revealed a papillomatous mass 6 cm in diameter that had a malignant endoscopic appearance. Numerous macroscopic sections were taken since larger gastric polyps (especially those greater than 2 cm in diameter have a greater risk of malignancy development. No dysplasia was detected on histological and immunohistochemical evaluation and it was therefore diagnosed as a giant hyperplastic polyp in the stomach. The large size of the polyp in the presented case led us to emphasize the importance of searching for dysplasia in such cases.

  9. Inappropriate colonoscopic surveillance of hyperplastic polyps.

    LENUS (Irish Health Repository)

    Keane, R A

    2011-11-15

    Colonoscopic surveillance of hyperplastic polyps alone is controversial and may be inappropriate. The colonoscopy surveillance register at a university teaching hospital was audited to determine the extent of such hyperplastic polyp surveillance. The surveillance endoscopy records were reviewed, those patients with hyperplastic polyps were identified, their clinical records were examined and contact was made with each patient. Of the 483 patients undergoing surveillance for colonic polyps 113 (23%) had hyperplastic polyps alone on last colonoscopy. 104 patients remained after exclusion of those under appropriate surveillance. 87 of the 104 patients (84%) were successfully contacted. 37 patients (8%) were under appropriate colonoscopic surveillance for a significant family history of colorectal carcinoma. 50 (10%) patients with hyperplastic polyps alone and no other clinical indication for colonoscopic surveillance were booked for follow up colonoscopy. This represents not only a budgetary but more importantly a clinical opportunity cost the removal of which could liberate valuable colonoscopy time for more appropriate indications.

  10. Incidência de lesões laríngeas não neoplásicas em pacientes com queixas vocais Incidence of non-neoplasic lesion in patients with vocal complains

    Directory of Open Access Journals (Sweden)

    Erich Christiano Madruga de Melo

    2001-01-01

    usually reports on microsurgical findings during laryngeal direct intervention. Aim: The goal of the present study was to evaluate the incidence of non-neoplasic benign lesions, in patients with vocal complains, seen at the "Hospital do Servidor Público do Estado de São Paulo - Francisco Morato de Oliveira", during a one year period, from March 1999 to March 2000. Study design: Retrospective no randomized. Material and method: The parameters considered for the analysis were sex, age, type of lesion (isolated or in association with other findings, type of glottic closure and presence of suggestive signs of GER. 1093 videolaryngoscopic examinations, from patients with vocal complains, without stroboscopy, were considered for the analysis, being 131 examinations from male patients and 962 from female patients, age distribution from 4 to 80 years-old, mean age of 42.5 years. Results: 13 different laryngeal pathologies were identified: vocal fold cyst 24%; Reinke’s edema 10%; vocal fold sulcus 10%; vocal fold nodules 8%; nodular lesion 8%; polyps 7%; vasculodysgenesy 4%; vocal fold paralysis 3%; laryngitis 3%; leukoplaquia 2%; granulomma 2%; anterior microweb 1%; mucosal bridge <1%. Normal evaluation was achieved by 18% of patients. This study also describes the distribution of the 1093 cases according to age, sex and other studied parameters.

  11. Computer-aided polyp detection on CT colonography: Comparison of three systems in a high-risk human population

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hee Sun [Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Kim, Se Hyung, E-mail: shkim@radcom.snu.ac.k [Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Kim, Jong Hyo [Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Interdisciplinary Program in Radiation Applied Life Science, Seoul National University College of Medicine (Korea, Republic of); Lee, June-Goo [Interdisciplinary Program in Radiation Applied Life Science, Seoul National University College of Medicine (Korea, Republic of); Kim, Sang Gyun [Department of Internal Medicine, Seoul National University Hospital (Korea, Republic of); Lee, Jeong Min; Lee, Jae Young; Han, Joon Koo; Choi, Byung Ihn [Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of)

    2010-08-15

    Purpose: To compare the detection performances of two commercial and one academic computer-aided diagnosis (CAD) systems for polyp detection on CT colonography (CTC) in a high-risk human population and to assess their detection characteristics. Materials and methods: This retrospective study had institutional review board approval, but informed consent was waived. Sixty-eight patients who were suspected of having colonic polyps and scheduled for colonoscopic polyp removal were included. After CTC was performed using a 64-row MDCT, two commercial (PEV, CAR) and one academic (Hessian matrix-based) CAD systems were applied to each CTC dataset. Colonoscopy using the segmental unblinded technique was performed as a standard of reference. Per-polyp and per-patient sensitivities were calculated and compared for each CAD system. The mean number of false-positives (FPs) and false-negatives (FNs) was computed and the causes of all FPs and FNs were analyzed. Results: A total of 151 polyps in 61 patients were detected (77 polyps <6 mm, 48 6-9.9 mm, 26 {>=} 10 mm). Per-polyp sensitivity for PEV, CAR, and Hessian matrix-based CAD were: 71.6%, 78.4%, and 83.8% for polyps {>=}6 mm, and 88.5%, 96.2%, and 96.2% for polyps {>=}10 mm. Per-patient sensitivity for polyps {>=}6 mm was 80.4%, 89.1%, and 93.5%, and 87%, 95.7%, and 95.7% for polyps {>=}10 mm, respectively. Per-polyp and per-patient sensitivities were not significantly different among the three CAD systems regardless of size threshold. Mean number of FPs was 6.9 for PEV, 7.3 for CAR, and 14 for Hessian matrix-based CAD. The most common cause of FPs were feces, followed by extracolonic findings, prominent folds and ileocecal valve, and rectal tube. The distribution of the causes of FPs was significantly different among the three systems. Conclusion: Sensitivity of the three CAD systems for polyp detection was comparable regardless of the polyp size threshold; however, the number of FPs was higher in the Hessian matrix

  12. 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.

  13. Vocal-tract filtering by lingual articulation in a parrot.

    Science.gov (United States)

    Beckers, Gabriël J L; Nelson, Brian S; Suthers, Roderick A

    2004-09-07

    Human speech and bird vocalization are complex communicative behaviors with notable similarities in development and underlying mechanisms. However, there is an important difference between humans and birds in the way vocal complexity is generally produced. Human speech originates from independent modulatory actions of a sound source, e.g., the vibrating vocal folds, and an acoustic filter, formed by the resonances of the vocal tract (formants). Modulation in bird vocalization, in contrast, is thought to originate predominantly from the sound source, whereas the role of the resonance filter is only subsidiary in emphasizing the complex time-frequency patterns of the source (e.g., but see ). However, it has been suggested that, analogous to human speech production, tongue movements observed in parrot vocalizations modulate formant characteristics independently from the vocal source. As yet, direct evidence of such a causal relationship is lacking. In five Monk parakeets, Myiopsitta monachus, we replaced the vocal source, the syrinx, with a small speaker that generated a broad-band sound, and we measured the effects of tongue placement on the sound emitted from the beak. The results show that tongue movements cause significant frequency changes in two formants and cause amplitude changes in all four formants present between 0.5 and 10 kHz. We suggest that lingual articulation may thus in part explain the well-known ability of parrots to mimic human speech, and, even more intriguingly, may also underlie a speech-like formant system in natural parrot vocalizations.

  14. Appendiceal Hyperplastic Polyp: Case Report

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    Faten Limaiem

    2015-02-01

    Full Text Available Serrated lesions morphologically analogous to those seen in the colorectum are found in the appendix. Appendiceal hyperplastic polyps are very rare, and their true incidence is unknown. A 52-year-old male previously healthy patient with no particular past medical history, presented with a 24-h history of abdominal pain localized to the right lower quadrant. On physical examination, he was tender to palpation in the lower right quadrant. As acute appendicitis was highly suspected, laparoscopic appendectomy was performed. Histological examination of the surgical specimen showed acute inflammation of the appendiceal wall. The crypts were focally elongated but relatively straight with serrations that were visible mainly near the luminal end of the crypts. Columnar cells with or without apical mucous vacuoles alternated with large goblet cells. The crypt bases were not serrated and were lined by regular cells with small nuclei. The muscularis mucosa was intact. The postoperative course was uneventful, and the patient was discharged on postoperative day 1. The final pathological diagnosis was acute appendicitis associated with hyperplastic polyp. Hyperplastic lesions of the appendix are often incidental findings although they can be associated with acute appendicitis. They are significantly associated with adenocarcinoma elsewhere in the large intestine and the finding of mucosal hyperplasia in an appendectomy is an indication for further investigations to exclude colorectal neoplasia. [J Interdiscipl Histopathol 2015; 3(1.000: 36-38

  15. Confocal Endomicroscopy of Colorectal Polyps

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    Vivian M. Ussui

    2012-01-01

    Full Text Available Confocal laser endomicroscopy (CLE is one of several novel methods that provide real-time, high-resolution imaging at a micron scale via endoscopes. CLE has the potential to be a disruptive technology in that it can change the current algorithms that depend on biopsy to perform surveillance of high-risk conditions. Furthermore, it allows on-table decision making that has the potential to guide therapy in real time and reduce the need for repeated procedures. CLE and related technologies are often termed “virtual biopsy” as they simulate the images seen in traditional histology. However, the imaging of living tissue allows more than just pragmatic convenience; it also allows imaging of living tissue such as active capillary circulation, cellular death, and vascular and endothelial translocation, thus extending beyond what is capable in traditional biopsy. Immediate potential applications of CLE are to guide biopsy sampling in Barrett's esophagus and inflammatory bowel disease surveillance, evaluation of colorectal polyps, and intraductal imaging of the pancreas and bile duct. Data on these applications is rapidly emerging, and more is needed to clearly demonstrate the optimal applications of CLE. In this paper, we will focus on the role of CLE as applied to colorectal polyps detected during colonoscopy.

  16. Combining heterogeneous features for colonic polyp detection in CTC based on semi-definite programming

    Science.gov (United States)

    Wang, Shijun; Yao, Jianhua; Petrick, Nicholas A.; Summers, Ronald M.

    2009-02-01

    Colon cancer is the second leading cause of cancer-related deaths in the United States. Computed tomographic colonography (CTC) combined with a computer aided detection system provides a feasible combination for improving colonic polyps detection and increasing the use of CTC for colon cancer screening. To distinguish true polyps from false positives, various features extracted from polyp candidates have been proposed. Most of these features try to capture the shape information of polyp candidates or neighborhood knowledge about the surrounding structures (fold, colon wall, etc.). In this paper, we propose a new set of shape descriptors for polyp candidates based on statistical curvature information. These features, called histogram of curvature features, are rotation, translation and scale invariant and can be treated as complementing our existing feature set. Then in order to make full use of the traditional features (defined as group A) and the new features (group B) which are highly heterogeneous, we employed a multiple kernel learning method based on semi-definite programming to identify an optimized classification kernel based on the combined set of features. We did leave-one-patient-out test on a CTC dataset which contained scans from 50 patients (with 90 6-9mm polyp detections). Experimental results show that a support vector machine (SVM) based on the combined feature set and the semi-definite optimization kernel achieved higher FROC performance compared to SVMs using the two groups of features separately. At a false positive per patient rate of 7, the sensitivity on 6-9mm polyps using the combined features improved from 0.78 (Group A) and 0.73 (Group B) to 0.82 (p<=0.01).

  17. 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…

  18. Miss rate of colorectal neoplastic polyps and risk factors for missed polyps in consecutive colonoscopies.

    Science.gov (United States)

    Kim, Nam Hee; Jung, Yoon Suk; Jeong, Woo Shin; Yang, Hyo-Joon; Park, Soo-Kyung; Choi, Kyuyong; Park, Dong Il

    2017-07-01

    Colonoscopic polypectomy is the best diagnostic and therapeutic tool to detect and prevent colorectal neoplasms. However, previous studies have reported that 17% to 28% of colorectal polyps are missed during colonoscopy. We investigated the miss rate of neoplastic polyps and the factors associated with missed polyps from quality-adjusted consecutive colonoscopies. We reviewed the medical records of patients who were found to have colorectal polyps at a medical examination center of the Kangbuk Samsung Hospital between March 2012 and February 2013. Patients who were referred to a single tertiary academic medical center and underwent colonoscopic polypectomy on the same day were enrolled in our study. The odds ratios (ORs) associated with polyp-related and patient-related factors were evaluated using logistic regression analyses. A total of 463 patients and 1,294 neoplastic polyps were analyzed. The miss rates for adenomas, advanced adenomas, and carcinomas were 24.1% (312/1,294), 1.2% (15/1,294), and 0% (0/1,294), respectively. Flat/sessile-shaped adenomas (adjusted OR, 3.62; 95% confidence interval [CI], 2.40-5.46) and smaller adenomas (adjusted OR, 5.63; 95% CI, 2.84- 11.15 for ≤5 mm; adjusted OR, 3.18; 95% CI, 1.60-6.30 for 6-9 mm, respectively) were more frequently missed than pedunculated/sub-pedunculated adenomas and larger adenomas. In patients with 2 or more polyps compared with only one detected (adjusted OR, 2.37; 95% CI, 1.55-3.61 for 2-4 polyps; adjusted OR, 11.52; 95% CI, 4.61-28.79 for ≥5 polyps, respectively) during the first endoscopy, the risk of missing an additional polyp was significantly higher. One-quarter of neoplastic polyps was missed during colonoscopy. We encourage endoscopists to detect smaller and flat or sessile polyps by using the optimal withdrawal technique.

  19. Extreme Folding

    Science.gov (United States)

    Demaine, Erik

    2012-02-01

    Our understanding of the mathematics and algorithms behind paper folding, and geometric folding in general, has increased dramatically over the past several years. These developments have found a surprisingly broad range of applications. In the art of origami, it has helped spur the technical origami revolution. In engineering and science, it has helped solve problems in areas such as manufacturing, robotics, graphics, and protein folding. On the recreational side, it has led to new kinds of folding puzzles and magic. I will give an overview of the mathematics and algorithms of folding, with a focus on new mathematics and sculpture.

  20. A study of vocal nonlinearities in humpback whale songs: from production mechanisms to acoustic analysis

    Science.gov (United States)

    Cazau, Dorian; Adam, Olivier; Aubin, Thierry; Laitman, Jeffrey T.; Reidenberg, Joy S.

    2016-01-01

    Although mammalian vocalizations are predominantly harmonically structured, they can exhibit an acoustic complexity with nonlinear vocal sounds, including deterministic chaos and frequency jumps. Such sounds are normative events in mammalian vocalizations, and can be directly traceable to the nonlinear nature of vocal-fold dynamics underlying typical mammalian sound production. In this study, we give qualitative descriptions and quantitative analyses of nonlinearities in the song repertoire of humpback whales from the Ste Marie channel (Madagascar) to provide more insight into the potential communication functions and underlying production mechanisms of these features. A low-dimensional biomechanical modeling of the whale’s U-fold (vocal folds homolog) is used to relate specific vocal mechanisms to nonlinear vocal features. Recordings of living humpback whales were searched for occurrences of vocal nonlinearities (instabilities). Temporal distributions of nonlinearities were assessed within sound units, and between different songs. The anatomical production sources of vocal nonlinearities and the communication context of their occurrences in recordings are discussed. Our results show that vocal nonlinearities may be a communication strategy that conveys information about the whale’s body size and physical fitness, and thus may be an important component of humpback whale songs. PMID:27721476

  1. A study of vocal nonlinearities in humpback whale songs: from production mechanisms to acoustic analysis

    Science.gov (United States)

    Cazau, Dorian; Adam, Olivier; Aubin, Thierry; Laitman, Jeffrey T.; Reidenberg, Joy S.

    2016-10-01

    Although mammalian vocalizations are predominantly harmonically structured, they can exhibit an acoustic complexity with nonlinear vocal sounds, including deterministic chaos and frequency jumps. Such sounds are normative events in mammalian vocalizations, and can be directly traceable to the nonlinear nature of vocal-fold dynamics underlying typical mammalian sound production. In this study, we give qualitative descriptions and quantitative analyses of nonlinearities in the song repertoire of humpback whales from the Ste Marie channel (Madagascar) to provide more insight into the potential communication functions and underlying production mechanisms of these features. A low-dimensional biomechanical modeling of the whale’s U-fold (vocal folds homolog) is used to relate specific vocal mechanisms to nonlinear vocal features. Recordings of living humpback whales were searched for occurrences of vocal nonlinearities (instabilities). Temporal distributions of nonlinearities were assessed within sound units, and between different songs. The anatomical production sources of vocal nonlinearities and the communication context of their occurrences in recordings are discussed. Our results show that vocal nonlinearities may be a communication strategy that conveys information about the whale’s body size and physical fitness, and thus may be an important component of humpback whale songs.

  2. Vocal cord hemangioma in an adult

    Directory of Open Access Journals (Sweden)

    Muzaffer Kanlıkama

    2011-09-01

    Full Text Available Hemangioma is one of the most common benign tumors in the head and neck region. Laryngeal hemangiomas are benign vascular tumors of unknown etiology that arise from subglottic region with stridor in infants. This type also known as congenital laryngeal hemangioma, is the more common. Congenital hemangiomas occur usually in subglottic region and more frequent in girls. Laryngeal hemangioma in adults is a very rare condition and main symptom is hoarseness and breathing difficulties. Adult hemangiomas can be seen in different locations such as the epiglottis, aryepiglottic folds, arytenoids and false and true vocal cords. They are more often of cavernous form and cause hoarseness. In this report we present an adult patient with hemangioma of the left vocal fold and review the literature. Diagnostic investigation revealed a pink-purple mass which was extended from the anterior comissure to the posterior part of true vocal cord and false vocal cord, filling the ventricule and extending to supraglottic region. Direct laryngoscopy was performed, but the lesion was not excised because of its widespread extension in the larynx. J Clin Exp Invest 2010; 2(3: 323-326.

  3. Vocal cord hemangioma in an adult

    Directory of Open Access Journals (Sweden)

    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

  4. THE VOCALIZATION MECHANISM OF THE FLORIDA MANATEE (TRICHECHUS MANATUS LATIROSTRIS

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    Charles J. Grossman

    2014-01-01

    Full Text Available The mechanism by which Florida manatees produce vocalizations is unknown. Anatomically, the laryngeal region in manatees lacks clearly defined vocal folds. Initially we developed a method to visualize the entire manatee upper respiratory system. We then forced air through fresh necropsied manatee larynxes and generated artificial vocalizations which closely duplicated the normal vocalizations produced by live manatees, both in fundamental frequency and structure of harmonics. Here we report that sound is generated in the larynx when air vibrates bilateral strips of tissue embedded in the lateral laryngeal walls which are in close approximation anteriorly but which diverge posteriorly. We propose that these strips of tissue are the modified vocal folds containing ligaments and we support this through histological stained sections and because they are connected anteriorly to the posterior side of the thyroid cartilage and posteriorly with the arytenoidal cartilages. We also suggest that these vocalizations are then modified within the resonance cavities in the frontal area of the head and the air used to generate these vocalizations also causes a transient deformation of this region before being conserved and returned to the lungs.

  5. Measurement of vocal doses in virtual classrooms

    DEFF Research Database (Denmark)

    Bottalico, Pasquale; Pelegrin Garcia, David

    2010-01-01

    different acoustical conditions, that combined different kind of background noise and virtual classroom acoustics. Readings from the vocal fold vibrations were registered with an Ambulatory Phonation Monitor device. The speech signal from the talker in the center of the facility was picked up with a head......This work shows the results of a preliminary study about the determination of the optimal acoustical conditions for speakers in small classrooms. An experiment was carried out in a laboratory facility with 22 untrained talkers, who read a text passage from “Goldilocks” during two minutes under 13...... with an artificial head (corresponding to the mouth-ears path) placed at the talker position while simulating the classrooms. Time histories of the vocal fold vibration readings, with the trend of the fundamental frequency and an estimation of the sound pressure level, sampled every 50 ms, were obtained. From...

  6. Clinical classification and treatment of leukokeratosis of the vocal cords

    Institute of Scientific and Technical Information of China (English)

    MA Li-jing; WANG Jun; XIAO Yang; YE Jing-ying; XU Wen; YANG Qing-wen

    2013-01-01

    Background Leukokeretosis of the vocal cords is a clinical descriptive diagnosis,which includes a group of squamous intraepithelial lesions of the vocal cord mucosa.We investigated the clinical classification and treatment efficacy of leukokeratosis of the vocal cords.Methods We conducted a retrospective analysis of the medical history,laryngoscopic examinations,morphological features under a surgical microscope,and pathology results of 360 cases of leukokeratosis of the vocal cords to examine correlations among treatment modalities,therapeutic effects,and clinical features.Results All cases were divided into four types based on symptoms,examination results,and treatment efficacies as follows:21 patients had type Ⅰ inflammatory leukoplakia and their vocal cord morphology and voice quality recovered after conservative therapies; 76 patients had type Ⅱ frictional polyps and received CO2 laser submucosal cordectomy;68 patients had type Ⅲ sulcus vocalis and received mucosal slicing with dredging; and 195 cases had type Ⅳ simple leukokeratosis and received partial subligamental cordectomy with CO2 lasers or transmuscular cordectomy.Our treatment achieved a surgical cure rate of 90.9% (308/339),with a recurrence rate of 9.1% (31/339) and malignant transformation rate of 6.5% (22/339).All cancerous transformations occurred in type Ⅳ patients.Conclusion Choosing conservative or CO2 laser surgery based on the morphological characteristics of squamous epithelial lesions of keratinized vocal cord mucosa can maximally protect voice quality,reduce complications,and improve the cure rate.

  7. Analysis of hyaluronic acid concentration in rat vocal folds during estral and gravidic puerperal cycles Análise da concentração do ácido hialurônico nas pregas vocais de ratas durante o ciclo estral e ciclo gravídico-puerperal

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    José Eduardo de Sá Pedroso

    2009-10-01

    Full Text Available Hormone plays an important role in the larynx. Among other substances, vocal folds contain hyaluronic acid, which tissue concentration may vary according to hormone action. AIM: the objective of this study is to analyze hyaluronic acid concentration in the vocal folds during estral and gravidic-puerperal cycles. MATERIALS AND METHODS: Experimental study. 40 adult rats were divided into two groups. In the first group we used 20 rats to establish the concentration of hyaluronic acid during the estral cycle and in the second group, 20 animals were submitted to the same procedure but during the gravidic-puerperal cycle. RESULTS: Variations in hyaluronic acid concentration was not observed during the estral cycle. In the gravidic puerperal cycle group, an increase in hyaluronic acid concentration was observed in the puerperal subgroup. Comparing the two groups of estral and gravidic-puerperal cycles, no difference was observed. CONCLUSIONS: In comparing all subgroups of estral and gravidic-puerperal cycles, an increase in hyaluronic acid concentration was noticed only in the puerperal phase.Os hormônios exercem importante influência sobre a laringe. A prega vocal contém, entre outras substâncias, o ácido hialurônico, cuja concentração nos tecidos pode variar com a ação dos hormônios. OBJETIVO: O objetivo deste trabalho é analisar comparativamente a concentração do ácido hialurônico nas pregas vocais de ratas durante o ciclo estral e ciclo gravídico-puerperal. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Foram utilizadas 40 ratas adultas, divididas em dois grupos, no primeiro grupo utilizamos 20 ratas para determinação da concentração do ácido hialurônico no ciclo estral, no segundo grupo, também de 20 animais, foi realizado o mesmo experimento no ciclo gravídico-puerperal. RESULTADOS: No grupo do ciclo estral não observou-se variação da concentração do ácido hialurônico. No grupo do ciclo grav

  8. Impacto vocal de professores Teachers' vocal impact

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    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

  9. Active contours for localizing polyps in colonoscopic NBI image data

    Science.gov (United States)

    Breier, Matthias; Gross, Sebastian; Behrens, Alexander; Stehle, Thomas; Aach, Til

    2011-03-01

    Colon cancer is the third most common type of cancer in the United States of America. Every year about 140,000 people are newly diagnosed with colon cancer. Early detection is crucial for a successful therapy. The standard screening procedure is called colonoscopy. Using this endoscopic examination physicians can find colon polyps and remove them if necessary. Adenomatous colon polyps are deemed a preliminary stage of colon cancer. The removal of a polyp, though, can lead to complications like severe bleedings or colon perforation. Thus, only polyps diagnosed as adenomatous should be removed. To decide whether a polyp is adenomatous the polyp's surface structure including vascular patterns has to be inspected. Narrow-Band imaging (NBI) is a new tool to improve visibility of vascular patterns of the polyps. The first step for an automatic polyp classification system is the localization of the polyp. We investigate active contours for the localization of colon polyps in NBI image data. The shape of polyps, though roughly approximated by an elliptic form, is highly variable. Active contours offer the flexibility to adapt to polyp variation well. To avoid clustering of contour polygon points we propose the application of active rays. The quality of the results was evaluated based on manually segmented polyps as ground truth data. The results were compared to a template matching approach and to the Generalized Hough Transform. Active contours are superior to the Hough transform and perform equally well as the template matching approach.

  10. A Rare Complication of Hyperplastic Gastric Polyp

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    Suresh Kumar Nayudu

    2013-01-01

    Full Text Available Hyperplastic gastric polyps are incidentally diagnosed during upper gastrointestinal endoscopy. They are known to cause gastric outlet obstruction and chronic blood loss leading to iron deficiency anemia. However, hyperplastic gastric polyp presenting as acute severe upper gastrointestinal bleeding is very rare. To the best of our knowledge, there have been two cases of hyperplastic gastric polyps presenting as acute gastrointestinal bleeding in the medical literature. We present a case of a 56-year-old African American woman who was admitted to our hospital with symptomatic anemia and sepsis. The patient developed acute upper gastrointestinal bleeding during her hospital stay. She underwent emergent endoscopy, but bleeding could not be controlled. She underwent emergent laparotomy and wedge resection to control the bleeding. Biopsy of surgical specimen was reported as hyperplastic gastric polyp. We recommend that physicians should be aware of this rare serious complication of hyperplastic gastric polyps as endoscopic polypectomy has diagnostic and therapeutic benefits in preventing future complications including bleeding.

  11. Recurrent giant fibrovascular polyp of the esophagus

    Institute of Scientific and Technical Information of China (English)

    Ser Yee Lee; Weng Hoong Chan; Ranjiv Sivanandan; Dennis Teck Hock Lim; Wai Keong Wong

    2009-01-01

    Giant fibrovascular polyps of the esophagus and hypopharynx are rare benign esophageal tumors. They arise most commonly in the upper esophagus and may, rarely, originate in the hypopharynx. They can vary significantly in size. Even though they are benign, they may be lethal due to either bleeding or, rarely, asphyxiation if a large polyp is regurgitated. Patients commonly present with dysphagia or hematemesis. The polyps may not be well visualized on endoscopy and imaging plays a vital role in aiding diagnosis as well as providing important information for preoperative planning, such as the location of the pedicle, the vascularity of the polyp and the tissue elements of the mass. They can also be recurrent in rare cases, especially if the resection margins of the base are involved. We review the recent literature and report a case of a 61-year-old man with a recurrent giant esophageal fibrovascular polyp with illustrative contrast barium swallow, CT and intra-operative images, who required several surgeries via a combination of endoscopic, trans-oral, trans-cervical, trans-thoracic and trans-abdominal approaches.

  12. Computer assisted optical biopsy for colorectal polyps

    Science.gov (United States)

    Navarro-Avila, Fernando J.; Saint-Hill-Febles, Yadira; Renner, Janis; Klare, Peter; von Delius, Stefan; Navab, Nassir; Mateus, Diana

    2017-03-01

    We propose a method for computer-assisted optical biopsy for colorectal polyps, with the final goal of assisting the medical expert during the colonoscopy. In particular, we target the problem of automatic classification of polyp images in two classes: adenomatous vs non-adenoma. Our approach is based on recent advancements in convolutional neural networks (CNN) for image representation. In the paper, we describe and compare four different methodologies to address the binary classification task: a baseline with classical features and a Random Forest classifier, two methods based on features obtained from a pre-trained network, and finally, the end-to-end training of a CNN. With the pre-trained network, we show the feasibility of transferring a feature extraction mechanism trained on millions of natural images, to the task of classifying adenomatous polyps. We then demonstrate further performance improvements when training the CNN for our specific classification task. In our study, 776 polyp images were acquired and histologically analyzed after polyp resection. We report a performance increase of the CNN-based approaches with respect to both, the conventional engineered features and to a state-of-the-art method based on videos and 3D shape features.

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

    Directory of Open Access Journals (Sweden)

    Ido Filho, Jorge Massaaki

    2014-01-01

    Full Text Available Introduction: Dysphonia is the main symptom of lesions that affect the vocal tract. Many of those lesions may require surgical treatment. Polyps are one of the most common forms of vocal cord lesions and the most prevalent indication for laryngeal microsurgery. There are different types of polyps, and their different characteristics can indicate different prognosis and treatments. Aim: To conduct a comparative study of polypoid lesions (angiomatous and gelatinous in patients undergoing laryngeal microsurgery via an electronic protocol. Method: We prospectively evaluated 93 patients diagnosed with vocal fold polyps; the polyps were classified as angiomatous or gelatinous. Results: In total, 93 patients undergoing laryngeal microsurgery were diagnosed with vocal fold polyps. Of these, 63 (64.74% had angiomatous and 30 (32.26% gelatinous polyps. Most patients with angiomatous polyps were men; their polyps were frequently of medium size, positioned in the middle third of the vocal fold, and accompanied by minimal structural alterations (MSA. In contrast, the majority of patients with gelatinous polyps were women; their polyps were smaller, positioned in the middle and posterior third of the vocal fold, and were not accompanied by MSA. Both types of polyps were more frequently located on the right vocal fold. Conclusion: Angiomatous polyps were more frequently encountered than gelatinous polyps. In addition, correlations between polyp type and sex, polyp size, position, location, and the presence of MSA were observed. Different surgical techniques were used, but the postoperative results were similar and satisfactory after speech therapy.

  14. Fibrovascular polyp of the hypopharynx and esophagus

    Institute of Scientific and Technical Information of China (English)

    WANG Jun; HAN De-min; NI Xin; MA Li-jing; YE Jing-ying; XIAO Yang

    2011-01-01

    Fibrovascular polyp of the hypopharynx and esophagus, a rare, benign, intraluminal and submucosal tumor, is most commonly originated from the proximal esophagus. We discussed four cases with regurgitation, respiratory symptom or the feeling of a mass in the throat. All the patients were examined with laryngoscope under general anesthesia. A transverse cervical incision was performed in one patient and the polyps were excised under laryngoscope with CO2 laser in the other three patients. All the lesions were removed successfully. Diagnostic and therapeutic principles involved in these cases are presented and discussed. The recognition of fibrovascular polyp of the hypopharynx and esophagus as a potential cause of regurgitation is paramount. Surgical excision is recommended because of the satisfactory outcome.

  15. Exploring the anatomical encoding of voice with a mathematical model of the vocal system.

    Science.gov (United States)

    Assaneo, M Florencia; Sitt, Jacobo; Varoquaux, Gael; Sigman, Mariano; Cohen, Laurent; Trevisan, Marcos A

    2016-11-01

    The faculty of language depends on the interplay between the production and perception of speech sounds. A relevant open question is whether the dimensions that organize voice perception in the brain are acoustical or depend on properties of the vocal system that produced it. One of the main empirical difficulties in answering this question is to generate sounds that vary along a continuum according to the anatomical properties the vocal apparatus that produced them. Here we use a mathematical model that offers the unique possibility of synthesizing vocal sounds by controlling a small set of anatomically based parameters. In a first stage the quality of the synthetic voice was evaluated. Using specific time traces for sub-glottal pressure and tension of the vocal folds, the synthetic voices generated perceptual responses, which are indistinguishable from those of real speech. The synthesizer was then used to investigate how the auditory cortex responds to the perception of voice depending on the anatomy of the vocal apparatus. Our fMRI results show that sounds are perceived as human vocalizations when produced by a vocal system that follows a simple relationship between the size of the vocal folds and the vocal tract. We found that these anatomical parameters encode the perceptual vocal identity (male, female, child) and show that the brain areas that respond to human speech also encode vocal identity. On the basis of these results, we propose that this low-dimensional model of the vocal system is capable of generating realistic voices and represents a novel tool to explore the voice perception with a precise control of the anatomical variables that generate speech. Furthermore, the model provides an explanation of how auditory cortices encode voices in terms of the anatomical parameters of the vocal system.

  16. Vocal coordination and vocal imitation: a role for mirror neurons?

    Science.gov (United States)

    Newman, John D

    2014-04-01

    Some birds and mammals have vocal communication systems in which coordination between individuals is important. Examples would include duetting or antiphonal calling in some birds and mammals, rapid exchanges of the same vocalization, and vocal exchanges between paired individuals and other nearby pairs. Mirror neurons may play a role in such systems but become functional only after experience.

  17. Appendiceal Adenocarcinoma Presenting as a Rectal Polyp

    Directory of Open Access Journals (Sweden)

    Erin Fitzgerald

    2016-02-01

    Full Text Available Appendiceal adenocarcinoma typically presents as an incidentally noted appendiceal mass, or with symptoms of right lower quadrant pain that can mimic appendicitis, but local involvement of adjacent organs is uncommon, particularly as the presenting sign. We report on a case of a primary appendiceal cancer initially diagnosed as a rectal polyp based on its appearance in the rectal lumen. The management of the patient was in keeping with standard practice for a rectal polyp, and the diagnosis of appendiceal adenocarcinoma was made intraoperatively. The operative strategy had to be adjusted due to this unexpected finding. Although there are published cases of appendiceal adenocarcinoma inducing intussusception and thus mimicking a cecal polyp, there are no reports in the literature describing invasion of the appendix through the rectal wall and thus mimicking a rectal polyp. The patient is a 75-year-old female who presented with spontaneous hematochezia and, on colonoscopy, was noted to have a rectal polyp that appeared to be located within a diverticulum. When endoscopic mucosal resection was not successful, she was referred to colorectal surgery for a low anterior resection. Preoperative imaging was notable for an enlarged appendix adjacent to the rectum. Intraoperatively, the appendix was found to be densely adherent to the right lateral rectal wall. An en bloc resection of the distal sigmoid colon, proximal rectum and appendix was performed, with pathology demonstrating appendiceal adenocarcinoma that invaded through the rectal wall. The prognosis in this type of malignancy weighs heavily on whether or not perforation and spread throughout the peritoneal cavity have occurred. In this unusual presentation, an en bloc resection is required for a complete resection and to minimize the risk of peritoneal spread. Unusual appearing polyps do not always originate from the bowel wall. Abnormal radiographic findings adjacent to an area of

  18. Gallbladder polyps: ultrasonographic and histopathological findings correlation

    Directory of Open Access Journals (Sweden)

    F. Rodriguez

    2014-11-01

    Full Text Available Gallbladder polyp is an increasingly common diagnosis, primarily as an abdominal ultrasound finding requested by another cause. Studies report a prevalence between 4% and 5.6%. The importance of an accurate diagnosis is related to the possibility of developing a malignancy desease. The objectvie is to correlate ultrasound and histopathologic findings in gallbladder polyp patients operated at the Hospital San Juan de Dios de La Serena. We reviewed retrospectively the medical records of patients undergoing cholecystectomy for gallbladder polyp from January 2000 to December 2010. a total of 40 patients underwent cholecystectomy for gallbladder polyp. 16 only had its tab clinic with abdominal ultrasonography report and the pathology report. 13 of them (81% were female. The mean age was 46 + / - 12 years. The reason for the ultrasonography was in 9 patients (56% abdominal pain in 3 patients (19%, a finding in asymptomatic patients, in one patient (6% biliary colic, none had jaundice, and in 3 patients (19% the cause was different. According to Abdominal ultrasound, the number of polyps was 1.1 + / - 0.3 per patient, and the average size was 5.8 + / - 1.8 mm. Histopathological examination showed the presence of polyps colesterolínicos in 11 of the 16 patients (69%. In the series described the abdominal ultrasonography showed a PPV = 0.68 for the diagnosis of gallbladder polyp. According to the report histopathological cholesterolosis diagnosed chronic cholecystitis in six cases (37.5%, chronic cholecystitis in six cases (37.5%, cholesterolosis in three cases (18.75% and cholelithiasis in one case (6 , 25%. Not demonstrated the presence of adenomas or foci of carcinoma in situ. In conclusion the described series does not allow to extrapolated or compare conclusions with other national and international series due to the small number of patients studied. There is a substantial sub-register of the pathology because the majority of patients undergoing

  19. Vocal Characteristics and Laryngoscopic Findings in Future Musical Theater Performers.

    Science.gov (United States)

    D'haeseleer, Evelien; Claeys, Sofie; Meerschman, Iris; Bettens, Kim; Degeest, Sofie; Dijckmans, Caroline; De Smet, Joke; Luyten, Anke; Van Lierde, Kristiane

    2017-07-01

    Musical theater performers are a special group of elite vocal performers with a high vocal load as they combine singing, acting, and physical performance. As they are absolutely depending on their voice quality and vocal capacities for their studies and their future profession, an optimal voice production is very important. The purpose of this study was to determine the voice quality of musical theater students. The voice quality of seven students was then reevaluated 1 year after the first assessment. Observational study. Thirty-one musical students (7 men and 24 women) with a mean age of 20 years participated in the study. To determine the voice quality, objective (aerodynamic measurements, voice range profile, acoustic analysis, and Dysphonia Severity Index) and subjective (videolaryngostroboscopy, Voice Handicap Indexes, and questionnaires regarding voice symptoms and risk factors) voice measurements were performed. The median Dysphonia Severity Index in male and female musical students was respectively 5.3 and 5.7, both corresponding with an overall good voice quality. The questionnaires revealed the presence of vocal fatigue, dryness of the throat, vocal tract discomfort, and harmful vocal habits in the majority of students. In 45% of the subjects, videolaryngostroboscopic evaluation of the vocal folds showed an organic lesion. The majority of these lesions are inflammatory lesions (26%). In 68% of the subjects, a certain degree of supraglottic constriction was observed. Despite the overall good voice quality, videolaryngostroboscopy showed a high presence of vocal fold lesions and supraglottic constriction during phonation. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  20. Vocal tract dynamics in an adult stutterer

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    Lesley Wolk

    1981-08-01

    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.

  1. 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.

  2. Sleep-disordered breathing as a delayed complication of iatrogenic vocal cord trauma.

    Science.gov (United States)

    Faiz, Saadia A; Bashoura, Lara; Kodali, Lavanya; Hessel, Amy C; Evans, Scott E; Balachandran, Diwakar D

    2016-06-01

    A case of a 55-year-old woman with iatrogenic vocal cord trauma and sleep-related symptoms is reported. In particular, this case highlights sleep-disordered breathing as a delayed complication after iatrogenic vocal cord trauma. The patient developed acute stridor from a contralateral vocal cord hematoma following vocal fold injection for right vocal cord paralysis. Acute respiratory symptoms resolved with oxygen, steroids, and nebulized therapy, but nocturnal symptoms persisted and polysomnography revealed sleep-related hypoventilation and mild obstructive sleep apnea. Positive pressure therapy was successfully used to ameliorate her symptoms and treat sleep-disordered breathing until her hematoma resolved. In addition to the typically acute respiratory symptoms that may result from vocal cord dysfunction, sleep-disordered breathing may also present as a significant subacute or chronic problem. Management of the acute respiratory symptoms is relatively well established, but clinicians should be alert for more subtle nocturnal symptoms that may require further study with polysomnography.

  3. Matching colonic polyps using correlation optimized warping

    Science.gov (United States)

    Wang, Shijun; Yao, Jianhua; Petrick, Nicholas; Summers, Ronald M.

    2010-03-01

    Computed tomographic colonography (CTC) combined with a computer aided detection system has the potential for improving colonic polyp detection and increasing the use of CTC for colon cancer screening. In the clinical use of CTC, a true colonic polyp will be confirmed with high confidence if a radiologist can find it on both the supine and prone scans. To assist radiologists in CTC reading, we propose a new method for matching polyp findings on the supine and prone scans. The method performs a colon registration using four automatically identified anatomical salient points and correlation optimized warping (COW) of colon centerline features. We first exclude false positive detections using prediction information from a support vector machine (SVM) classifier committee to reduce initial false positive pairs. Then each remaining CAD detection is mapped to the other scan using COW technique applied to the distance along the centerline in each colon. In the last step, a new SVM classifier is applied to the candidate pair dataset to find true polyp pairs between supine and prone scans. Experimental results show that our method can improve the sensitivity to 0.87 at 4 false positive pairs per patient compared with 0.72 for a competing method that uses the normalized distance along the colon centerline (p<0.01).

  4. Fiber as Protective Factor for Colon Polyps

    Science.gov (United States)

    Tantamango, Yessenia M.; Knutsen, Synnove F.; Sabate, Joan

    2010-01-01

    Background: Colorectal cancer (CRC) is the third leading cause of death in the United States. The change in incidence patterns observed in populations previously considered at low risk for CRC suggests that environmental factors, including those related to diet, contribute to the etiology of this disease. It has been documented that the majority of colorectal cancers arise in adenomatous polyps. Although most colon polyps are harmless, some turn cancerous over time and as many as 30% to 40% of middle-aged and older adults may have one or more colon polyps. It is estimated that as much as one third to one half of colon cancer risk, and one fourth to one third of distal colon adenoma risk, might be avoidable by modification of dietary and life-style habits. Factors that have shown the most consistent protective effect against adenomas in epidemiologic studies include, among others, dietary fiber contained in fruits, vegetables, and grains. Because colonic polyps are so common in the industrialized world, prevention should play an important role. Methods: This is a cohort study to compare the association between fiber intake from fruits, vegetables, and grains, and the risk of physician-diagnosed colon polyps among 2,818 non-Hispanic white cohort members who had undergone colonoscopy. Subjects participated in two cohort studies, the Adventist Health Study-1 (AHS-1) in 1976 and again in the Adventist Health Study-2 (AHS-2) in 2002–2005. Dietary information was obtained from the self-administered questionnaire from the AHS-1, while outcome was assessed from the AHS-2. Logistic regression analysis was used to estimate the period risk of incident cases of polyps with adjustment for age, gender, BMI, physical activity, and alcohol and meat intake. Results: A total of 441 incident cases of colon polyps were identified. After adjusting for age, sex, BMI, physical activity, alcohol and meat, total fiber intake was inversely associated with the risk of colon polyps (RR for

  5. Frequency of Thyroid Nodules among Patients with Colonic Polyps

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    Cevdet Duran

    2012-01-01

    Full Text Available Aim. Colonic polyps and thyroid nodules are common diseases and their frequency increases with age. In the literature, there is no study investigating the coexistence of colonic polyps and thyroid nodules. Therefore, this study was designed to investigate thyroid nodule prevalence in patients with colonic polyps. Material and Methods. Sixty-six patients with colonic polyps and 146 patients without colonic polyps enrolled into the study. Age and sex matched control group was composed from patients without colonic polyps. Colonoscopic examinations, thyroid ultrasonographies were performed in all patients, and TSH were measured. Results. Male/female ratio in polyp and control groups were 40/26 versus 68/78, respectively (P=0.058. Mean ages were similar in both groups (53.3±11.4 versus, 51.8±11.4, P=0.373. Thyroid nodule was detected in 44 (66.7% patients with polyps and in 61 (41.8% controls (P=0.001. Patients with adenomatous polyps had 5 or more thyroid nodules compared to patients with hyperplastic polyps (P=0.03. Thyroid nodules were more prevalent among patients aged 50 or older compared to 50 years or less (P=0.023. Conclusion. Thyroid nodules were detected more common in patients with colonic polyps. Further studies are needed to clarify this coexistence.

  6. Vocal nodules and edema may be due to vibration-induced rises in capillary pressure.

    Science.gov (United States)

    Czerwonka, Lukasz; Jiang, Jack J; Tao, Chao

    2008-04-01

    Vocal fold vibration may physically raise intravascular pressure to levels high enough to damage capillaries and result in leakage of erythrocytes. This type of injury is commonly seen in benign vocal fold lesions and is not well explained. Theoretical, retrospective. The relationship of intravascular pressure to vibration frequency and amplitude is derived and confirmed with a physical blood vessel model, then applied to published human measurements to estimate human intravascular pressures. Vocal fold intravascular pressure is predicted to have a quadratic dependence on both frequency and amplitude. During speaking, the pressure may rise to over 20 cmH2O, and may reach levels far higher for screaming and singing. Such pressure magnitudes are known to trigger inflammatory cascades and can lead to fluid leakage. They also have the potential for pharmacologic control with beta-agonists. Intravascular pressure likely rises significantly during vocal fold vibration and may lead to the type of injury seen in benign vocal fold lesions. The results support voice therapy aimed at reducing vibratory amplitude. More vibratory amplitude measurements need to be performed in a wider range of subjects before the full range of human vocal fold vascular pressures can be estimated.

  7. Prevalence of advanced colonic polyps in asymptomatic Chinese

    Institute of Scientific and Technical Information of China (English)

    Hui-Hsiung Liu; Meng-Chen Wu; Yeh Peng; Ming-Shiang Wu

    2005-01-01

    AIM: To investigate the prevalence of advanced polyps in asymptomatic Chinese and to determine the risk of proximal advanced colonic polyps in subjects with and without polyps in the distal colon.METHODS: Data were collected prospectively during colonoscopic examinations performed in 5 973 subjects as part of health evaluation at our unit from December 1997 to December 2003. Polyps were considered advanced, if they were larger than 10 mm or were tubovillous, villous or malignant. Proximal colon was defined as the splenic flexure and more proximal portions of the colon.RESULTS: Colon polyps were detected in 971 (16.3%)subjects (613 males and 358 females) with their mean age being 56.6±10.7 years. Advanced polyps were noted in 199 (3.3%) individuals. Subjects were sub-classified according to the location of polyps into three groups: distal (569, 58.6%), proximal (284, 29.2%), and combined proximal and distal (118, 12.2%) groups. Subjects with advanced polyps in these three groups were 95 (9.8%),56 (5.8%), and 48 (4.9%) respectively. In the 48 subjects with advanced combined polyps, 13 advanced polyps were distributed at the distal colon, 17 at the proximal colon,and 18 at both. Eighteen colon cancers including 12 at sigmoid and 6 at ascending colon were confirmed by final pathology. The relative risk for advanced proximal polyp according to distal findings was 3.1 (95%CI: 1.3-7.4) for hyperplastic polyp, 2.7 (95%CI: 1.4-5.3) for tubular polyp and 13.5 (95%CI: 5.1-35.4) for advanced polyp as compared to that for no polyp. However, 56 (28.2%) of 199 subjects with advanced polyps had no index polyps at the distal colon and might go undetected under sigmoidoscopic screening.CONCLUSION: Although distal lesions can predict the risk of advanced proximal polyps, a substantial portion of Chinese with advanced proximal polyps is not associated with any distal sentinel lesions. These data have implications for screening policy of colon cancers in Taiwanese Chinese.

  8. Vocal tract resonances in speech, singing, and playing musical instruments.

    Science.gov (United States)

    Wolfe, Joe; Garnier, Maëva; Smith, John

    2009-01-01

    IN BOTH THE VOICE AND MUSICAL WIND INSTRUMENTS, A VALVE (VOCAL FOLDS, LIPS, OR REED) LIES BETWEEN AN UPSTREAM AND DOWNSTREAM DUCT: trachea and vocal tract for the voice; vocal tract and bore for the instrument. Examining the structural similarities and functional differences gives insight into their operation and the duct-valve interactions. In speech and singing, vocal tract resonances usually determine the spectral envelope and usually have a smaller influence on the operating frequency. The resonances are important not only for the phonemic information they produce, but also because of their contribution to voice timbre, loudness, and efficiency. The role of the tract resonances is usually different in brass and some woodwind instruments, where they modify and to some extent compete or collaborate with resonances of the instrument to control the vibration of a reed or the player's lips, andor the spectrum of air flow into the instrument. We give a brief overview of oscillator mechanisms and vocal tract acoustics. We discuss recent and current research on how the acoustical resonances of the vocal tract are involved in singing and the playing of musical wind instruments. Finally, we compare techniques used in determining tract resonances and suggest some future developments.

  9. A subharmonic vibratory pattern in normal vocal folds

    NARCIS (Netherlands)

    Svec, JG; Schutte, HK; Miller, DG

    1996-01-01

    This study observes in detail an F-0/2 (sounding an octave below an original tone) subharmonic vibratory pattern produced in a normal larynx. Simultaneous electroglottographic and photoglottographic measurements reveal two different open phases within a subharmonic cycle-the first shorter with a sim

  10. Endoscopic banding ligation can effectively resect hyperplastic Polyps of stomach

    Institute of Scientific and Technical Information of China (English)

    Ching-Chu Lo; Wen-Chi Chen; E-Ming Wang; Kwok-Hung Lai; Ping-I Hsu; Gin-Ho Lo; Hui-Hwa Tseng; Hui-Chun Chen; Ping-Ning Hsu; Chiun-Ku Lin; Hoi-Hung Chan; Wei-Lun Tsai

    2003-01-01

    AIM: Bleeding and perforation are the major and serious complications associated with endoscopic polypectomy. To develop a safe and effective method to resect hyperplastic polyps of the stomach, we employed rubber bands to strangulate hyperplastic polyps and to determine the possibility of inducing avascular necrosis in these lesions.METHODS: Forty-seven patients with 72 hyperplastic polyps were treated with endoscopic banding ligation (EBL). On 14 days after endoscopic ligation, follow-up endoscopies were performed to assess the outcomes of the strangulated polyps.RESULTS: After being strangulated by the rubber bands,all of the polyps immediately became congested (100 %),and then developed cyanotic changes (100 %) approximately 4 minutes later. On follow-up endoscopy 2 weeks later, all the polyps except one had dropped off. The only one residual polyp shrank with a rubber band in its base, and it also dropped off spontaneously during subsequent follow-up.No complications occurred during or following the ligation procedures.CONCLUSION: Gastric polyps develop avascular necrosis following ligation by rubber bands. Employing suction equipment, EBL can easily capture sessile polyps. It is an easy, safe and effective method to eradicate hyperplastic polyps of the stomach.

  11. Are gastric hyperplastic polyps an additional manifestation in celiac disease?

    Science.gov (United States)

    Dore, Maria Pina; Pes, Giovanni Mario; Rocchi, Chiara; Loria, Maria Francesca; Soro, Sara; Bassotti, Gabrio

    2017-01-01

    Abstract Gastric polyps are frequently reported in patients undergoing upper endoscopic procedures. In this retrospective study, the association between hyperplastic polyps and celiac disease in Northern Sardinia was estimated. Age, gender, body mass index, and medications taken in the 2 preceding months, including proton-pump inhibitors (PPIs), H2 receptor blockers (anti-H2), Helicobacter pylori status, endoscopic findings, and histology from charts of patients undergoing esophago-gastro-duodenoscopy were reviewed. Polyps were classified as hyperplastic, fundic gland, inflammatory, and adenomatous. 3.7% (423/11379) patients had celiac disease. Prevalence of gastric polyps was 4.2% (3.8% among celiac vs 4.2% nonceliac patients). Inflammatory polyp was the most common histotype (55.8% and 56.2%) followed by fundic gland polyps (31.4% and 43.7%), hyperplastic (8.7% and 0%), and adenomas, in celiac and nonceliac patients, respectively. Fundic gland polyps were more common in PPI users (odds ratio: 4.06) than in nonusers (2.65, P = 0.001) among celiac and nonceliac patients. Age older than 50, female gender, esophago-gastro-duodenoscopy year, and PPI use were associated with the presence of polyps, whereas active H pylori infection was not. Gastric polyps were common in Sardinian patients undergoing esophago-gastro-duodenoscopy. However, the previously reported association between hyperplastic polyps and celiac disease was not confirmed in our study. PMID:28151870

  12. Jumbo biopsy is useful for the diagnosis of colonic prolapsing mucosal polyps with diverticulosis

    Institute of Scientific and Technical Information of China (English)

    Shingo Kato; Kazutoshi Hashiguchi; Ryuichi Yamamoto; Mitsuru Seo; Takashi Matsuura; Kazuro Itoh; Akinori Iwashita; Soichiro Miura

    2006-01-01

    We report here a case of multiple prolapsing mucosal polyps with diverticulosis in the sigmoid colon. A 52-yearold man was admitted to our hospital because of bloody diarrhea. Colonoscopy and barium enema showed multiple diverticula, markedly thickened mucosal folds and polypoid lesions with mucus on the top of them in the sigmoid colon. Endoscopic ultrasonography showed thickening of the mucosal and submucosal layers.Several endoscopic biopsy specimens were taken from the polypoid lesions. Histological examination revealed only chronic inflammatory cell infiltration. In order to obtain a definite diagnosis, we performed endoscopic jumbo biopsy for the polypoid lesions after obtaining informed consent. Histological examination revealed marked lymphocyte infiltration, hemosiderin deposits and fibromuscular obliteration in the lamina propria, features similar to those of mucosal prolapsing syndrome. After anti-diarrhetic treatment, clinical findings were improved.Thus, jumbo biopsy is useful for diagnosis and treatment of prolapsing mucosal polyps.

  13. Efeito imediato de técnicas vocais em mulheres sem queixa vocal Immediate effect of vocal techniques in women without vocal complaint

    Directory of Open Access Journals (Sweden)

    Eliane Cristina Pereira

    2011-10-01

    Full Text Available OBJETIVO: verificar o efeito imediato das técnicas vocais vibração, som nasal e sobrearticulação na voz e na laringe de mulheres sem queixas vocais. MÉTODO: participaram da pesquisa 32 sujeitos do sexo feminino, com idades entre 20 e 45 anos, sem queixas vocais, com qualidade vocal avaliada entre normal e alteração de grau leve Os sujeitos foram submetidos à análise perceptivo-auditiva pela escala visual analógica da vogal /ε/ e fala espontânea, análise acústica e laringoestroboscopia antes e após a realização das técnicas. RESULTADOS: a análise perceptivo-auditiva revelou melhora significante dos parâmetros impressão global da voz, rouquidão e estabilidade na vogal /ε/ e articulação na fala espontânea. A análise acústica evidenciou melhora significante do jitter e shimmer. A laringoestroboscopia evidenciou significante melhora no fechamento glótico e melhora na movimentação muco-ondulatória das pregas vocais. CONCLUSÃO: as técnicas vocais estudadas são capazes de proporcionar melhora imediata significante da qualidade vocal e da configuração laríngea.PURPOSE: to check the immediate effect of vocal techniques: vibration, nasal sound and overarticulation. METHOD: 32 female subjects with normal to mild dysphonia took part in the study, with ages from 20 to 45 years. Subjects were submitted to perceptual analysis and laryngostroboscopic exams before and after the use of vocal techniques. RESULTS: subjects' vocal classification in perceptual analysis after accomplishing the vocal techniques showed significant improvement on parameters voice global impression, hoarseness and stability; and, in spontaneous speech, one showed a significant improvement on the parameter articulation. The acoustic analysis evidenced significant improvement of the jitter and shimmer. Laryngostroboscopic examination evidenced a significant increase in the glottic closing and an increase in the mucondulatory movement of the vocal folds

  14. The effects of physiological adjustments on the perceptual and acoustical characteristics of simulated laryngeal vocal tremor.

    Science.gov (United States)

    Lester, Rosemary A; Story, Brad H

    2015-08-01

    The purpose of this study was to determine if adjustments to the voice source [i.e., fundamental frequency (F0), degree of vocal fold adduction] or vocal tract filter (i.e., vocal tract shape for vowels) reduce the perception of simulated laryngeal vocal tremor and to determine if listener perception could be explained by characteristics of the acoustical modulations. This research was carried out using a computational model of speech production that allowed for precise control and manipulation of the glottal and vocal tract configurations. Forty-two healthy adults participated in a perceptual study involving pair-comparisons of the magnitude of "shakiness" with simulated samples of laryngeal vocal tremor. Results revealed that listeners perceived a higher magnitude of voice modulation when simulated samples had a higher mean F0, greater degree of vocal fold adduction, and vocal tract shape for /i/ vs /ɑ/. However, the effect of F0 was significant only when glottal noise was not present in the acoustic signal. Acoustical analyses were performed with the simulated samples to determine the features that affected listeners' judgments. Based on regression analyses, listeners' judgments were predicted to some extent by modulation information present in both low and high frequency bands.

  15. Antrochoanal polyp derived from periapical granuloma

    Institute of Scientific and Technical Information of China (English)

    LIN Zhi-hong; LIN Min; TENG Yao-shu

    2008-01-01

    @@ Aatrochoanal polyp (ACP) is an infrequent, benign polypoid lesion that stems from the edematous mucosa of the maxillary sinus, grows from the natural or accessory ostium to the middle meatus, and protrudes toward the choana and nasopharynx.1 Although the exact causes of ACP are still unknown, chronic sinusitis, allergy,and lower respiratory tract infections are often related to ACP.2 Our report is an ACP arising from a secondary infection of the pefiapical granuloma in the maxillary sinus.

  16. Portal hypertensive duodenal polyp: A case report

    Institute of Scientific and Technical Information of China (English)

    Jean-David Zeitoun; Ariane Chryssostalis; Benoit Terris; Frederic Prat; Marianne Gaudric; Stanislas Chaussade

    2007-01-01

    Abnormalities of gastric mucosa in patients with portal hypertension are well documented. Manifestations of portal hypertension in small bowel and colon are less common. Colonic polypoid lesions microscopically consisting of a normal mucosa, with dilatation of submucosal vessels, have been described. We here report the first case of portal hypertensive duodenal polyp, responsible for gastro-intestinal bleeding.Endoscopic treatment turned out to be successful.

  17. 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...

  18. Inverted Lymphoglandular Polyp in Descending Colon

    Directory of Open Access Journals (Sweden)

    Shengmei Zhou

    2015-01-01

    Full Text Available A 47-year-old male with a history of left colon cancer, status post left colon resection for 12 years, presented with rectal bleeding. Colonoscopic examination revealed an 8 mm sessile polyp in the proximal descending colon. Microscopic examination showed that the surface of this polyp was covered with a layer of normal colonic mucosa with focal surface erosion. In the submucosal layer, an intimate admixture of multiple cystically dilated glands and prominent lymphoid aggregates with germinal centers was seen. The glands were lined by columnar epithelium. Immunohistochemical staining showed the glands were positive for CK20 and CDX2 and negative for CK7, with a low proliferative index, mostly consistent with reactive colonic glands. The patient remained asymptomatic after one-year follow-up. A review of the literature shows very rare descriptions of similar lesions, but none fits exactly this pattern. We would designate this inverted lymphoglandular polyp and present this case to raise the awareness of recognizing this unusual histological entity.

  19. CP-Miner : A hybrid Approach for Colorectal Polyp Detection

    Directory of Open Access Journals (Sweden)

    Ms. M. Vanitha,

    2010-05-01

    Full Text Available Computed Tomography Colonography (CTC is the new generation technique for detecting colorectal polyps using volumetric CT data combined with Computer Aided Detection (CAD system. The aim of this paper is to detail the implementation of a fully integrated CP-Minersystem that is able to identify the polyps in the CT data. The CP-Miner system has a multistage implementation whose main system components are: 1. Interpolation, 2. Automatic Colon Segmentation,3.Feature extraction, 4.Polyp Detection. The proposed system has the aim to reduce the number of false positives than the existing system. The developed system provides 100% sensitivity for polyps greater than 6mm, provides 83.33% sensitivity for polyps within 3 to 6mm, 69.23% sensitivity for polyps less than 3mm. The overall sensitivityof the CP-Miner system is 84.18%.

  20. Acute Gastric Bleeding Due to Giant Hyperplastic Polyp

    Directory of Open Access Journals (Sweden)

    Bulent Aksel

    2013-04-01

    Full Text Available Hyperplastic gastric polyps account for the majority of benign gastric polyps. The vast majority of these lesions are small, asymptomatic and found incidentally on radiologic or endoscopic examination. Giant hyperplastic gastric polyps are uncommon and most of them are asymptomatic. We report a case of a 66-year-old woman who admitted because of acute gastric bleeding. The gastrin levels were within normal ranges. Esophagogastroduodenoscopy showed 12 cm pedunculated and multiple lobulated hyperplastic polyps arising from antrum with signs of diffuse oozing. The patient is treated by subtotal gastrectomy with Roux-Y gastrojejunostomy. Histological examination showed the presence of ulcers and regeneration findings with the contemporary occurrence of hyperplastic polyp. Giant hyperplastic gastric polyp should be kept in mind in the differential diagnosis of acute upper gastrointestinal bleeding.

  1. High-performance computer aided detection system for polyp detection in CT colonography with fluid and fecal tagging

    Science.gov (United States)

    Liu, Jiamin; Wang, Shijun; Kabadi, Suraj; Summers, Ronald M.

    2009-02-01

    CT colonography (CTC) is a feasible and minimally invasive method for the detection of colorectal polyps and cancer screening. Computer-aided detection (CAD) of polyps has improved consistency and sensitivity of virtual colonoscopy interpretation and reduced interpretation burden. A CAD system typically consists of four stages: (1) image preprocessing including colon segmentation; (2) initial detection generation; (3) feature selection; and (4) detection classification. In our experience, three existing problems limit the performance of our current CAD system. First, highdensity orally administered contrast agents in fecal-tagging CTC have scatter effects on neighboring tissues. The scattering manifests itself as an artificial elevation in the observed CT attenuation values of the neighboring tissues. This pseudo-enhancement phenomenon presents a problem for the application of computer-aided polyp detection, especially when polyps are submerged in the contrast agents. Second, general kernel approach for surface curvature computation in the second stage of our CAD system could yield erroneous results for thin structures such as small (6-9 mm) polyps and for touching structures such as polyps that lie on haustral folds. Those erroneous curvatures will reduce the sensitivity of polyp detection. The third problem is that more than 150 features are selected from each polyp candidate in the third stage of our CAD system. These high dimensional features make it difficult to learn a good decision boundary for detection classification and reduce the accuracy of predictions. Therefore, an improved CAD system for polyp detection in CTC data is proposed by introducing three new techniques. First, a scale-based scatter correction algorithm is applied to reduce pseudo-enhancement effects in the image pre-processing stage. Second, a cubic spline interpolation method is utilized to accurately estimate curvatures for initial detection generation. Third, a new dimensionality

  2. CP-Miner : A hybrid Approach for Colorectal Polyp Detection

    OpenAIRE

    Ms. M. Vanitha,; Prof. P. Tamije Selvy; Dr. V.Palanisamy,; Prof. AR.Sivakumaran

    2010-01-01

    Computed Tomography Colonography (CTC) is the new generation technique for detecting colorectal polyps using volumetric CT data combined with Computer Aided Detection (CAD) system. The aim of this paper is to detail the implementation of a fully integrated CP-Minersystem that is able to identify the polyps in the CT data. The CP-Miner system has a multistage implementation whose main system components are: 1. Interpolation, 2. Automatic Colon Segmentation,3.Feature extraction, 4.Polyp Detecti...

  3. 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.

  4. Finite element modelling of vocal tract changes after voice therapy

    Directory of Open Access Journals (Sweden)

    Vampola T.

    2011-06-01

    Full Text Available Two 3D finite element (FE models were constructed, based on CT measurements of a subject phonating on [a:] before and after phonation into a tube. Acoustic analysis was performed by exciting the models with acoustic flow velocity at the vocal folds. The generated acoustic pressure of the response was computed in front of the mouth and inside the vocal tract for both FE models. Average amplitudes of the pressure oscillations inside the vocal tract and in front of the mouth were compared to display the cost-efficiency of sound energy transfer at different formant frequencies. The formants F1–F3 correspond to classical vibration modes also solvable by 1D vocal tract model. However, for higher formants, there occur more complicated transversal modes which require 3D modelling. A special attention is given to the higher frequency range (above 3.5 Hz where transversal modes exist between piriform sinuses and valleculae. Comparison of the pressure oscillation inside and outside the vocal tract showed that formants differ in their efficiency, F4 (at about 3.5 kHz, i.e. at the speaker’s or singer’s formant region being the most effective. The higher formants created a clear formant cluster around 4 kHz after the vocal exercise with the tube. Since the human ear is most sensitive to frequencies between 2 and 4 kHz concentration of sound energy in this frequency region (F4–F5 is effective for communication. The results suggest that exercising using phonation into tubes help in improving the vocal economy.

  5. LASER SCANNING CYTOMETRIC DNA ANALYSES AND EXPRE- SSION OF P53 PROTEIN,KI67 AND BCL-X IN EARLY AND ADVANCED CARCINOMAS OF THE VOCAL CORD

    Institute of Scientific and Technical Information of China (English)

    林梅绥; 金嘉平; 陈颖; 花井淳

    2003-01-01

    Objective To study DNA ploidy and genetic changes in the different stages of neoplastic growth in the vocal cord, as well as their biological behavior, for further recognition of the lesions of carcinoma in situ and early carcinoma. Methods 18 tumor lesions of the vocal cord were DNA analyzed by laser scanning cytometry and followed up, and 62 lesions were immunohistochemically investigated for p53, Ki67 and Bcl-X, and with main observation on carcinomas in situ (CISs) and early microinvasive carcinomas (EMICs) which were compared with invasive carcinomas and polyps. Results DNA analysis showed that almost all the CISs and EMICs were diploidy, while 90% invasive carcinomas were aneuploidy. Follow-up data displayed that no one died of the tumor in CIS and EMIC, as well as in the patients with diploidy tumor, and all the patients died of the tumors were with anueploidy tumor. Immunohistochemically, 86% of CIS and EMIC and 91% of invasive carcinoma expressed p53 protein, and the positivities for Ki67 in them were respectively 29% and 27%, which were very significantly different from those of polyps of the vocal cord(P<0. 001). In contrast, expression of Bcl-X were decreasing from benign to malignant lesions, and it was lowest in the invasive carcinomas, significantly different from that of polyp(P=0. 002). Conclusion The present study showed that there were differences of DNA ploidy and genetic expressions among benign lesions, CISs and EMICs, and invasive carcinomas of the vocal cord, indicating that they might be different in biological entities. CIS of the vocal cord could be considered as a borderline lesion, and is better to receive conservative treatment. Moreover, p53 protein determination combined with Ki67 would be helpful in diagnosis of the carcinomas of the vocal cord.

  6. Effect of Vocal Fry on Voice and on Velopharyngeal Sphincter

    Directory of Open Access Journals (Sweden)

    Elias, Vanessa Santos

    2016-01-01

    Full Text Available Introduction It is known that the basal sound promotes shortening and adduction of the vocal folds and leaves the mucosa looser. However there are few studies that address the supralaryngeal physiological findings obtained using the technique. Objective To check the effectiveness of using vocal fry on the voice and velopharingeal port closure of five adult subjects, whose cleft palate has been corrected with surgery. Methods Case study with five subjects who underwent otolaryngology examination by means of nasopharyngoscopy for imaging and measurement of the region of velopharyngeal port closure before and after using the vocal fry technique for three minutes. During the exam, the subjects sustained the isolated vowel /a:/ in their usual pitch and loudness. The emission of the vowel /a:/ was also used for perceptual analysis and spectrographic evaluation of their voices. Results Four subjects had an improvement in the region of velopharyngeal port closure; the results of the spectrographic evaluation were indicative of decreased hypernasality, and the results of the auditory-perceptual analysis suggested improved overall vocal quality, adequacy of loudness, decreased hypernasality, improvement of type of voice and decreased hoarseness. Conclusion This study showed a positive effect of vocal fry on voice and greater velopharyngeal port closure.

  7. Different Vocal Parameters Predict Perceptions of Dominance and Attractiveness.

    Science.gov (United States)

    Hodges-Simeon, Carolyn R; Gaulin, Steven J C; Puts, David A

    2010-12-01

    Low mean fundamental frequency (F(0)) in men's voices has been found to positively influence perceptions of dominance by men and attractiveness by women using standardized speech. Using natural speech obtained during an ecologically valid social interaction, we examined relationships between multiple vocal parameters and dominance and attractiveness judgments. Male voices from an unscripted dating game were judged by men for physical and social dominance and by women in fertile and non-fertile menstrual cycle phases for desirability in short-term and long-term relationships. Five vocal parameters were analyzed: mean F(0) (an acoustic correlate of vocal fold size), F(0) variation, intensity (loudness), utterance duration, and formant dispersion (D(f), an acoustic correlate of vocal tract length). Parallel but separate ratings of speech transcripts served as controls for content. Multiple regression analyses were used to examine the independent contributions of each of the predictors. Physical dominance was predicted by low F(0) variation and physically dominant word content. Social dominance was predicted only by socially dominant word content. Ratings of attractiveness by women were predicted by low mean F(0), low D(f), high intensity, and attractive word content across cycle phase and mating context. Low D(f) was perceived as attractive by fertile-phase women only. We hypothesize that competitors and potential mates may attend more strongly to different components of men's voices because of the different types of information these vocal parameters provide.

  8. 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.

  9. Computational acoustic modeling of cetacean vocalizations

    Science.gov (United States)

    Gurevich, Michael Dixon

    A framework for computational acoustic modeling of hypothetical vocal production mechanisms in cetaceans is presented. As a specific example, a model of a proposed source in the larynx of odontocetes is developed. Whales and dolphins generate a broad range of vocal sounds, but the exact mechanisms they use are not conclusively understood. In the fifty years since it has become widely accepted that whales can and do make sound, how they do so has remained particularly confounding. Cetaceans' highly divergent respiratory anatomy, along with the difficulty of internal observation during vocalization have contributed to this uncertainty. A variety of acoustical, morphological, ethological and physiological evidence has led to conflicting and often disputed theories of the locations and mechanisms of cetaceans' sound sources. Computational acoustic modeling has been used to create real-time parametric models of musical instruments and the human voice. These techniques can be applied to cetacean vocalizations to help better understand the nature and function of these sounds. Extensive studies of odontocete laryngeal morphology have revealed vocal folds that are consistently similar to a known but poorly understood acoustic source, the ribbon reed. A parametric computational model of the ribbon reed is developed, based on simplified geometrical, mechanical and fluid models drawn from the human voice literature. The physical parameters of the ribbon reed model are then adapted to those of the odontocete larynx. With reasonable estimates of real physical parameters, both the ribbon reed and odontocete larynx models produce sounds that are perceptually similar to their real-world counterparts, and both respond realistically under varying control conditions. Comparisons of acoustic features of the real-world and synthetic systems show a number of consistencies. While this does not on its own prove that either model is conclusively an accurate description of the source, it

  10. The clinical utility of vocal dosimetry for assessing voice rest.

    Science.gov (United States)

    Misono, Stephanie; Banks, Kathryn; Gaillard, Philippe; Goding, George S; Yueh, Bevan

    2015-01-01

    Voice rest is frequently recommended following surgical disruption of vocal fold epithelium, but patients report variable adherence to voice rest recommendations. The objective of this study was to assess the clinical utility of an ambulatory vocal dosimeter for measuring adherence to voice rest recommendations. Outcomes research. Part 1: To determine the utility of the dosimeter in nonclinical use, the relationship between self-reported voice use and dosimeter measurements was examined in normal subjects (n = 11) who prospectively logged voice use while wearing the dosimeter. Part 2: To determine clinical utility of the dosimeter, patients undergoing vocal fold surgery for which postoperative voice rest was recommended (n = 11) wore a dosimeter for 2 days prior to and 2 days after surgery. Phonation percent and sound level were compared at baseline and during voice rest. The dosimeter performed as hypothesized with both normal subjects and patients. A moderate correlation (r = 0.62) was noted between self-reported voice use and dosimeter measurements in normal subjects. In patients on voice rest, a statistically and clinically significant decrease was observed in measured voice use, both in phonation time (P = .002) and intensity of phonation (P = .004). Ambulatory vocal dosimetry may have clinical utility for assessing adherence to voice rest recommendations. This information will be useful for the design of future studies on voice rest. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Classification of colon polyps in NBI endoscopy using vascularization features

    Science.gov (United States)

    Stehle, Thomas; Auer, Roland; Gross, Sebastian; Behrens, Alexander; Wulff, Jonas; Aach, Til; Winograd, Ron; Trautwein, Christian; Tischendorf, Jens

    2009-02-01

    The evolution of colon cancer starts with colon polyps. There are two different types of colon polyps, namely hyperplasias and adenomas. Hyperplasias are benign polyps which are known not to evolve into cancer and, therefore, do not need to be removed. By contrast, adenomas have a strong tendency to become malignant. Therefore, they have to be removed immediately via polypectomy. For this reason, a method to differentiate reliably adenomas from hyperplasias during a preventive medical endoscopy of the colon (colonoscopy) is highly desirable. A recent study has shown that it is possible to distinguish both types of polyps visually by means of their vascularization. Adenomas exhibit a large amount of blood vessel capillaries on their surface whereas hyperplasias show only few of them. In this paper, we show the feasibility of computer-based classification of colon polyps using vascularization features. The proposed classification algorithm consists of several steps: For the critical part of vessel segmentation, we implemented and compared two segmentation algorithms. After a skeletonization of the detected blood vessel candidates, we used the results as seed points for the Fast Marching algorithm which is used to segment the whole vessel lumen. Subsequently, features are computed from this segmentation which are then used to classify the polyps. In leave-one-out tests on our polyp database (56 polyps), we achieve a correct classification rate of approximately 90%.

  12. Transanal endoscopic microsurgery for giant polyps of the rectum

    DEFF Research Database (Denmark)

    Levic, K; Bulut, O; Hesselfeldt, P

    2014-01-01

    BACKGROUND: The potential for malignancy in rectal polyps increases with the size of the polyp, and unexpected malignancy is reported in up to 39 % of large rectal adenomas. Transanal endoscopic microsurgery (TEM) offers the possibility of an en bloc full-thickness excision for lesions in the rec...

  13. Relation between obesity and adenomatous polyps of the large bowel.

    Science.gov (United States)

    Sato, Yumi; Nozaki, Ryoichi; Yamada, Kazutaka; Takano, Masahiro; Haruma, Ken

    2009-07-01

    We compared the prevalence of colorectal adenoma (polyps) in men and women and examined the role of body mass index (BMI) on polyp risk according to patient age and gender. The risk of developing colorectal polyps was studied in 15 380 subjects (7155 men and 8225 women) who underwent colonoscopy for the first time from April 1998 to March 2006 at our 'Human Dry Dock', which is the check-up service provided in Japan. Eligible subjects were 20-86 years old (mean age +/- SD, 47.3 +/- 8.5) and were free of invasive cancer, hyperplastic polyps and familial polyposis. Polyps were found in 1590 subjects (1062 men and 528 women). The odds ratio (OR) of detection of polyps in relation to obesity was determined in all cases by multivariate logistic regression analysis after making an adjustment for gender and age. The OR of polyp detection in obese subjects (BMI >or= 25) versus non-obese subjects (BMI < 25, OR = 1) was 1.34 (P < 0.001) in men and 1.13 (P = 0.26) in women. As the BMI increased in increments of one, the OR in men increased significantly to 1.01 (P < 0.001), whereas the OR in women was unchanged at 1.00 (P = 0.23), which was without significance. We conclude that obesity in men is a risk factor for the development of polyps. These results must be confirmed by additional epidemiological studies.

  14. Influences of laryngeal afferent inputs on intralaryngeal muscle activity during vocalization in the cat.

    Science.gov (United States)

    Shiba, K; Yoshida, K; Nakajima, Y; Konno, A

    1997-01-01

    The present study was undertaken to elucidate the possible role of the laryngeal afferent inputs in the regulation of intralaryngeal muscle activity during vocalization. We studied the influences of airflow and/or pressure applied to the larynx on intralaryngeal muscle activity during vocalization in ketamine-anesthetized cats. Vocalization was induced by airflow applied to the upper airway, which was isolated from the lower airway, during pontine call site stimulation. When the upper airway was open to the atmosphere through the nostrils and mouth, the airflow increased not only the vocal fold adductor and tensor activities but also the duration of these activities. The adductor and tensor activities were increased suddenly at a critical subglottic pressure level equivalent to the subglottic pressure threshold for vocalization. These effects were significantly reduced by sectioning of the internal branch of the superior laryngeal nerve or by lidocaine application to the laryngeal mucosa. Sustained pressure applied to the isolated upper airway, when the mouth and nostrils were occluded, did not affect adductor or tensor activities. These results indicate that the afferent inputs evoked by vocal fold stretching or vibration play an important role in the motor control of intralaryngeal and respiratory muscles during vocalization.

  15. "King archie, who was quite grouchy" - a vocal dysphonia health education project

    OpenAIRE

    Maria Rosário Dias; Cátia da Silva Pedrosa

    2013-01-01

    PURPOSE: one major cause of dysphonia can be linked to the presence of vocal folds nodules - a condition commonly seen in children due to vocal misuse and/or vocal abuse. The present health education project, also directed to parents and educators, aims at making children (the project's chief target-population) aware of how to make a correct use of their voice. METHOD: the target population includes parents, educators and children from both sexes and aged between five and eight years old. RES...

  16. Juvenile Polyps in Denmark From 1995 to 2014

    DEFF Research Database (Denmark)

    Jelsig, Anne Marie; Ousager, Lilian Bomme; Brusgaard, Klaus;

    2016-01-01

    BACKGROUND: Juvenile polyps in the large bowel are rare but the most common type of polyp in children. The prevalence and incidence are unknown, and few studies exist on the occurrence in adults. They are considered not to harbor any malignant potential unless they are part of the hereditary...... juvenile polyposis syndrome. OBJECTIVE: We aimed to study the demographics of juvenile polyps in Denmark in a 20-year period from 1995 to 2015 in both adults and children. This is the first report on the occurrence, anatomic localization, and reoccurrence of these polyps in a whole population. DESIGN: Data...... from all of the patients who had been diagnosed with 1 or more juvenile polyp from January 1, 1995, until December 31, 2014, were obtained. SETTINGS: The study was conducted based on patients registered in the nationwide pathological register in Denmark, the Danish Pathology Data Bank. PATIENTS: We...

  17. Polyp Detection and Segmentation from Video Capsule Endoscopy: A Review

    Directory of Open Access Journals (Sweden)

    V. B. Surya Prasath

    2016-12-01

    Full Text Available Video capsule endoscopy (VCE is used widely nowadays for visualizing the gastrointestinal (GI tract. Capsule endoscopy exams are prescribed usually as an additional monitoring mechanism and can help in identifying polyps, bleeding, etc. To analyze the large scale video data produced by VCE exams, automatic image processing, computer vision, and learning algorithms are required. Recently, automatic polyp detection algorithms have been proposed with various degrees of success. Though polyp detection in colonoscopy and other traditional endoscopy procedure based images is becoming a mature field, due to its unique imaging characteristics, detecting polyps automatically in VCE is a hard problem. We review different polyp detection approaches for VCE imagery and provide systematic analysis with challenges faced by standard image processing and computer vision methods.

  18. Prevalence and incidence of hyperplastic polyps and adenomas in familial colorectal cancer: correlation between the two types of colon polyps

    OpenAIRE

    Liljegren, A.; Lindblom, A; Rotstein, S; Nilsson, B; Rubio, C; Jaramillo, E

    2003-01-01

    Background and aims: Colorectal adenomas are recognised as precursors of colorectal carcinomas. The significance of hyperplastic (metaplastic) colorectal polyps is unknown. The relationship between hyperplastic polyps and adenomas, and the prevalence and incidence of these lesions were evaluated in individuals predisposed to familial colorectal cancer.

  19. 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.

  20. Contribution of the supraglottic larynx to the vocal product: imaging and acoustic analysis

    Science.gov (United States)

    Gracco, L. Carol

    1996-04-01

    Horizontal supraglottic laryngectomy is a surgical procedure to remove a mass lesion located in the region of the pharynx superior to the true vocal folds. In contrast to full or partial laryngectomy, patients who undergo horizontal supraglottic laryngectomy often present with little or nor involvement to the true vocal folds. This population provides an opportunity to examine the acoustic consequences of altering the pharynx while sparing the laryngeal sound source. Acoustic and magnetic resonance imaging (MRI) data were acquired in a group of four patients before and after supraglottic laryngectomy. Acoustic measures included the identification of vocal tract resonances and the fundamental frequency of the vocal fold vibration. 3D reconstruction of the pharyngeal portion of each subjects' vocal tract were made from MRIs taken during phonation and volume measures were obtained. These measures reveal a variable, but often dramatic difference in the surgically-altered area of the pharynx and changes in the formant frequencies of the vowel/i/post surgically. In some cases the presence of the tumor created a deviation from the expected formant values pre-operatively with post-operative values approaching normal. Patients who also underwent radiation treatment post surgically tended to have greater constriction in the pharyngeal area of the vocal tract.

  1. Physiologically driven avian vocal synthesizer

    Science.gov (United States)

    Sitt, Jacobo D.; Arneodo, Ezequiel M.; Goller, Franz; Mindlin, Gabriel B.

    2010-03-01

    In this work, we build an electronic syrinx, i.e., a programmable electronic device capable of integrating biomechanical model equations for the avian vocal organ in order to synthesize song. This vocal prosthesis is controlled by the bird’s neural instructions to respiratory and the syringeal motor systems, thus opening great potential for studying motor control and its modification by sensory feedback mechanisms. Furthermore, a well-functioning subject-controlled vocal prosthesis can lay the foundation for similar devices in humans and thus provide directly health-related data and procedures.

  2. Haustral fold segmentation with curvature-guided level set evolution.

    Science.gov (United States)

    Zhu, Hongbin; Barish, Matthew; Pickhardt, Perry; Liang, Zhengrong

    2013-02-01

    Human colon has complex structures mostly because of the haustral folds. The folds are thin flat protrusions on the colon wall, which complicate the shape analysis for computer-aided detection (CAD) of colonic polyps. Fold segmentation may help reduce the structural complexity, and the folds can serve as an anatomic reference for computed tomographic colonography (CTC). Therefore, in this study, based on a model of the haustral fold boundaries, we developed a level-set approach to automatically segment the fold surfaces. To evaluate the developed fold segmentation algorithm, we first established the ground truth of haustral fold boundaries by experts' drawing on 15 patient CTC datasets without severe under/over colon distention from two medical centers. The segmentation algorithm successfully detected 92.7% of the folds in the ground truth. In addition to the sensitivity measure, we further developed a merit of segmented-area ratio (SAR), i.e., the ratio between the area of the intersection and union of the expert-drawn folds and the area of the automatically segmented folds, to measure the segmentation accuracy. The segmentation algorithm reached an average value of SAR = 86.2%, showing a good match with the ground truth on the fold surfaces. We believe the automatically segmented fold surfaces have the potential to benefit many postprocedures in CTC, such as CAD, taenia coli extraction, supine-prone registration, etc.

  3. Colon polyps: epidemiology, risk factors, diagnostic criteria and courses of treatment

    Directory of Open Access Journals (Sweden)

    Lapteva Е.А.

    2013-06-01

    Full Text Available Article focuses on the intestinal polyps. Intestinal polyps are considered to be obligatory precancerous diseases of the colon. Risk factors, epidemiology, clinical manifestations and diagnostic methods of polyps have been analyzed. The courses of treatment of colon polyps have been revealed.

  4. Vocal Improvisation for Elementary Students.

    Science.gov (United States)

    Thompson, Keith P.

    1980-01-01

    The author describes the three-phase process of musical creativity (exploratory, invention, organizational), identifying activities in each of the creative phases. Included are vocal impression, picture sounds, chord tones, and name improvisation. Selected readings and recordings are included. (KC)

  5. Role of high definition colonoscopy in colorectal adenomaatous polyp detection

    Institute of Scientific and Technical Information of China (English)

    Tolga Erim; John M Rivas; Evelio Velis; Fernando Castro

    2011-01-01

    AIM: To investigate the rates of polyp detection in a mixed risk population using standard definition (SDC) vs high definition colonoscopes (HDC). METHODS: This was a retrospective cohort comparative study of 3 colonoscopists who each consecutively performed 150 SDC (307, 200 pixel) and 150 HDC (792, 576 pixels) in a community teaching hospital.RESULTS: A total of 900 colonoscopies were evaluated (mean age 56, 46.8% men), 450 with each resolution. Polyps of any type were detected in 46.0% of patients using SDC and 43.3% with HDC (P = 0.42). There was no significant difference between the overall number of polyps, HDC (397) and SDC (410), detected among all patients examined, (P = 0.73). One or more adenomatous polyps were detected in 24.2% of patients with HDC and 24.9% of patients with SDC colonoscopy (P = 0.82). There was no significant difference between HDC (M = 0.41) and SDC (M = 0.42) regarding adenomatous polyp (P = 0.88) or advanced adenoma (P = 0.56) detection rate among all patients examined.CONCLUSION: HDC did not improve yield of adenomatous polyp, advanced adenoma or overall polyp detection in a population of individuals with mixed risk for colorectal cancer.

  6. Effects of proton pump inhibitors on pediatric inflammatory esophagogastric polyps.

    Science.gov (United States)

    Choi, Kyong Eun; Kim, Mi Jin; Lee, Ji Hyuk; Lee, Jong Seung; Lee, Jee Hyun; Choe, Yon Ho

    2012-01-01

    The aim of this study was to investigate the effects of proton pump inhibitors on symptomatic inflammatory esophagogastric polyps (IEPs) in a pediatric cohort and to determine the optimal duration of treatment. The 11 patients with IEPs were managed with lansoprazole. Follow-up endoscopies were performed at 2 and 6 months after the start of medication. Medication was discontinued when the clinical symptoms completely resolved and the polyp size was reduced by more than 50% compared to the initial size. The initial polyp size was 13.7 ± 3.3 mm. After 2 months of medication, the polyp size was reduced to 8.0 ± 5.8 mm. At 6 months, the polyp size was 4.7 ± 2.2 mm. The mean duration of medication was 4.8 ± 2.1 months. The duration of medication and the change in the polyp size appeared to have a linear correlation (p IEPs. About 5 months of lansoprazole was adequate to treat IEPs in children. The optimal duration for complete resolution of the polyp might be more than 7 months. Copyright © 2012 S. Karger AG, Basel.

  7. The fluoroscopic barium enema in colonic polyp detection.

    Science.gov (United States)

    Teefey, S A; Carlson, H C

    1983-12-01

    The results of 1,500 barium enema studies done by vigorous manual palpation under fluoroscopy were reviewed to determine the adequacy of this technique in detecting polyps above the proctoscopic level. Of the 1,500 patients examined, 103 (7%) were diagnosed radiographically as having a total of 149 polyps. Polyps were found at proctoscopy in about 10% of the 1,500 patients. Colonoscopy or surgery was performed on 35 of the 103 patients. Of the 52 polyps discovered during these procedures, only three were missed at fluoroscopic barium enema study, a false-negative rate of 6%. Fourteen patients whose barium enemas initially were reported as negative for polyps or neoplasia had colonoscopy. Two of the 14 patients had positive findings, for a true-negative rate of 86%. If the detection rate of 7% found at barium enema, taking into account an overlap of 10%, is combined with the rate of 7.5% found at proctoscopy, a frequency of about 14% emerges in detecting polyps in the rectum and in the colon. Thus, the fluoroscopic barium enema when combined with proctoscopy is a sensitive method in the detection of colorectal polyps. In addition, it has the advantage of rapid execution and relatively low cost.

  8. Prolapsing Gastric Polyp Causing Intermittent Gastric Outlet Obstruction.

    Science.gov (United States)

    Kosai, Nik Ritza; Gendeh, Hardip Singh; Norfaezan, Abdul Rashid; Razman, Jamin; Sutton, Paul Anthony; Das, Srijit

    2015-06-01

    Gastric polyps are often an incidental finding on upper gastrointestinal endoscopy, with an incidence up to 5%. The majority of gastric polyps are asymptomatic, occurring secondary to inflammation. Prior reviews discussed Helicobacter pylori (H pylori)-associated singular gastric polyposis; however, we present a rare and unusual case of recurrent multiple benign gastric polyposis post H pylori eradication resulting in intermittent gastric outlet obstruction. A 70-year-old independent male, Chinese in ethnicity, with a background of diabetes mellitus, hypertension, and a simple renal cyst presented with a combination of melena, anemia, and intermittent vomiting of partially digested food after meals. Initial gastroscopy was positive for H pylori; thus he was treated with H pylori eradication and proton pump inhibitors. Serial gastroscopy demonstrated multiple sessile gastric antral polyps, the largest measuring 4 cm. Histopathologic examination confirmed a benign hyperplastic lesion. Computed tomography identified a pyloric mass with absent surrounding infiltration or metastasis. A distal gastrectomy was performed, whereby multiple small pyloric polyps were found, the largest prolapsing into the pyloric opening, thus explaining the intermittent nature of gastric outlet obstruction. Such polyps often develop from gastric ulcers and, if left untreated, may undergo neoplasia to form malignant cells. A distal gastrectomy was an effective choice of treatment, taking into account the polyp size, quantity, and potential for malignancy as opposed to an endoscopic approach, which may not guarantee a complete removal of safer margins and depth. Therefore, surgical excision is favorable for multiple large gastric polyps with risk of malignancy.

  9. Pólipos endometriais Endometrial polyps

    Directory of Open Access Journals (Sweden)

    Antonio Alberto Nogueira

    2005-05-01

    Full Text Available Os pólipos endometriais são lesões benignas, com baixo potencial de malignização. No período reprodutivo seu diagnóstico é obtido nas pacientes sintomáticas, com sangramento uterino anormal ou infertilidade. Na pós-menopausa em sua maioria são assintomáticos, podendo estar associados a sangramento anormal em torno de um terço dos casos. São mais freqüentes na pós-menopausa e os fatores de risco para câncer de endométrio não têm sido associados da mesma maneira, como de risco para pólipos endometriais, embora sejam hormônio-dependentes, como nas pacientes usuárias do tamoxifeno, por exemplo. Seu diagnóstico definitivo é realizado pelo exame histológico com amostra obtida de maneira mais eficiente por biópsia dirigida por meio da histeroscopia, assim como seu tratamento mais efetivo é a ressecção histeroscópica. Pólipos podem apresentar recorrência após tratamento. A polipectomia é altamente satisfatória na pós-menopausa, tem menor taxa de sucesso em mulheres sintomáticas no período reprodutivo e melhora as taxas de fertilidade em mulheres inférteis.Endometrial polyps are benign lesions, with a low potential of malignancy. In the reproductive period their diagnosis is established in symptomatic patients with abnormal uterine bleeding or infertility. Postmenopausal women are mostly asymptomatic but in approximately one third of the cases there is an association with abnormal bleeding. They are more frequent after the menopause and risk factors of cancer of the endometrium have not been associated in the same way as risk for endometrial polyps, although they are hormone-dependent as in patients in use of tamoxifen, for instance. Their definitive diagnosis is established by hysteroscopy-guided biopsy and their most effective treatment is hysteroscopic resection. Polyps may recur after treatment. Polypectomy is highly satisfactory after the menopause, is less successful in symptomatic women in the reproductive

  10. 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 (pdysphonia 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 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 (pdysphonia with prenodular lesions and soft nodules in both adults and children, affectinq diverse acoustic parameters.

  11. Positive predictive value for polyps detected at screening CT colonography

    Energy Technology Data Exchange (ETDEWEB)

    Pickhardt, Perry J.; Wise, Steven M.; Kim, David H. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States)

    2010-07-15

    To determine the positive predictive value (PPV) for polyps detected at CT colonography (CTC). Assessment of 739 colorectal lesions {>=}6 mm detected prospectively at CTC screening in 479 patients was performed. By-polyp PPV was analyzed according to small (6-9 mm) versus large ({>=}10 mm) size; morphology (sessile/pedunculated/flat); diagnostic confidence level (3 = most confident, 1 = least confident); and histology. By-patient PPV was analyzed at various polyp size thresholds. By-polyp PPV for CTC-detected lesions {>=}6 mm, 6-9 mm, and {>=}10 mm was 91.6% (677/739), 90.1% (410/451), and 92.7% (267/288), respectively (p = 0.4). By-polyp PPV according to sessile, pedunculated, flat, and mass-like morphology was 92.5% (441/477), 96.5% (139/144), 77.7% (73/94), and 97.6% (40/41), respectively (p < 0.0001 for flat versus polypoid morphology). By-polyp PPV according to diagnostic confidence level was 94.7% (554/585) for highest (= level 3), 83.5% (106/127) for intermediate (= level 2), and 63.0% (17/27) for lowest (= level 1) confidence (p < 0.0001 for levels-2/3 versus level-1). By-patient PPV at 6-mm, 8-mm, 10-mm, and 30-mm polyp size thresholds was 92.3% (442/479), 93.0% (306/329), 93.1% (228/245), and 97.4% (38/39), respectively. The overall per-polyp and per-patient PPV for lesions {>=}6 mm was 92% for CTC screening. Increased diagnostic confidence and polypoid (non-flat) morphology correlated with a higher PPV, whereas small versus large polyp size had very little effect. (orig.)

  12. Associations between dietary fiber and colorectal polyp risk differ by polyp type and smoking status.

    Science.gov (United States)

    Fu, Zhenming; Shrubsole, Martha J; Smalley, Walter E; Ness, Reid M; Zheng, Wei

    2014-05-01

    The association of dietary fiber intake with colorectal cancer risk is established. However, the association may differ between cigarette smokers and nonsmokers. We evaluated this hypothesis in a large colonoscopy-based case-control study. Dietary fiber intakes were estimated by self-administered food frequency questionnaire. Unconditional logistic regression analysis was used to estimate ORs and 95% CIs with adjustment for potential confounders. Analysis also was stratified by cigarette smoking and sex. High dietary fiber intake was associated with reduced risk of colorectal polyps (P-trend = 0.003). This association was found to be stronger among cigarette smokers (P-trend = 0.006) than nonsmokers (P-trend = 0.21), although the test for multiplicative interaction was not statistically significant (P = 0.11). This pattern of association was more evident for high-risk adenomatous polyps (ADs), defined as advanced or multiple ADs (P-interaction smoking and dietary fiber intake = 0.09). Among cigarette smokers who smoked ≥23 y, a 38% reduced risk of high-risk ADs was found to be associated with high intake of dietary fiber compared with those in the lowest quartile fiber intake group (P-trend = 0.004). No inverse association with dietary fiber intake was observed for low-risk ADs, defined as single nonadvanced ADs. Cigarette smoking may modify the association of dietary fiber intake with the risk of colorectal polyps, especially high-risk ADs, a well-established precursor of colorectal cancer.

  13. Associations between Dietary Fiber and Colorectal Polyp Risk Differ by Polyp Type and Smoking Status12

    Science.gov (United States)

    Fu, Zhenming; Shrubsole, Martha J.; Smalley, Walter E.; Ness, Reid M.; Zheng, Wei

    2014-01-01

    The association of dietary fiber intake with colorectal cancer risk is established. However, the association may differ between cigarette smokers and nonsmokers. We evaluated this hypothesis in a large colonoscopy-based case-control study. Dietary fiber intakes were estimated by self-administered food frequency questionnaire. Unconditional logistic regression analysis was used to estimate ORs and 95% CIs with adjustment for potential confounders. Analysis also was stratified by cigarette smoking and sex. High dietary fiber intake was associated with reduced risk of colorectal polyps (P-trend = 0.003). This association was found to be stronger among cigarette smokers (P-trend = 0.006) than nonsmokers (P-trend = 0.21), although the test for multiplicative interaction was not statistically significant (P = 0.11). This pattern of association was more evident for high-risk adenomatous polyps (ADs), defined as advanced or multiple ADs (P-interaction smoking and dietary fiber intake = 0.09). Among cigarette smokers who smoked ≥23 y, a 38% reduced risk of high-risk ADs was found to be associated with high intake of dietary fiber compared with those in the lowest quartile fiber intake group (P-trend = 0.004). No inverse association with dietary fiber intake was observed for low-risk ADs, defined as single nonadvanced ADs. Cigarette smoking may modify the association of dietary fiber intake with the risk of colorectal polyps, especially high-risk ADs, a well-established precursor of colorectal cancer. PMID:24572038

  14. Effect of fundamental frequency at voice onset on vocal attack time.

    Science.gov (United States)

    Watson, Ben C; Baken, R J; Roark, Rick M; Reid, Stephanie; Ribeiro, Melissa; Tsai, Weilyn

    2013-05-01

    To examine vocal attack time (VAT) values associated with the production of low, mid, and high rates of vocal fold vibration in normal speakers. Sound pressure (SP) and electroglottographic (EGG) recordings were obtained for eight female and five male subjects while producing multiple tokens of the sustained vowels /ɑ/, /i/, and /u/ at comfortable loudness and at mid, low (-3 semitones), and high (+6 semitones) rates of vocal fold vibration. Generalized sinusoidal models of the SP and EGG signals were computed to compare rates of amplitude change. VAT was computed from the time lag of the cross-correlation function. Adjusted mean VAT for the high frequency condition was smaller than the adjusted mean VAT values for the low- and mid-frequency conditions. There was no significant difference between the mid and low frequency conditions. Findings reveal an association of the VAT measure with increases in vocal fold tension associated with the production of high rates of vocal fold vibration. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  15. Evaluation of metal clips combining with microwave therapy in treatinglarge, pedicellated gastrointestinal polyps

    Institute of Scientific and Technical Information of China (English)

    Kang Nian Zhou; Qiu Ju Feng

    2000-01-01

    AIM To evluate the curative effect of metal clips combining with microwave in treating large, pedicellatedgastrointestinal polyps by endoscopy.METHODS Ten patients with pedicellated gastrointestinal polyps were treated with metal clips (OlympusMD-850) combining with microwave by endoscopy. Among them, gastric polyps were found in 6 cases (6polyps), colonic polyps in 4 cases(4 polyps), 9 polyps were 1.5 cm - 2 cm in size, the other one was morethan 2 cm, the diameter of pedicel was 1 cm to 1.5 cm. All patients were repeatedly examined withendoscopy to observe the curative effect at 5 to 10 days and one month after treatment.RESULTS All the 10 polyps were eradicated, 2- 4 metal clips were placed in one polyp, the succeedingcurative rate was 100%. No hemorrhage, perforation and other complications occurred.CONCLUSION The curative effect of metal clips combining with microwave in treating large, pedicellatedgastrointestinal polyps by endoscopy is reliable and safe.

  16. Improving Polyp Detection Algorithms for CT Colonography: Pareto Front Approach.

    Science.gov (United States)

    Huang, Adam; Li, Jiang; Summers, Ronald M; Petrick, Nicholas; Hara, Amy K

    2010-03-21

    We investigated a Pareto front approach to improving polyp detection algorithms for CT colonography (CTC). A dataset of 56 CTC colon surfaces with 87 proven positive detections of 53 polyps sized 4 to 60 mm was used to evaluate the performance of a one-step and a two-step curvature-based region growing algorithm. The algorithmic performance was statistically evaluated and compared based on the Pareto optimal solutions from 20 experiments by evolutionary algorithms. The false positive rate was lower (pPareto optimization process can effectively help in fine-tuning and redesigning polyp detection algorithms.

  17. Colonoscopic polyp detection using convolutional neural networks

    Science.gov (United States)

    Park, Sun Young; Sargent, Dusty

    2016-03-01

    Computer aided diagnosis (CAD) systems for medical image analysis rely on accurate and efficient feature extraction methods. Regardless of which type of classifier is used, the results will be limited if the input features are not diagnostically relevant and do not properly discriminate between the different classes of images. Thus, a large amount of research has been dedicated to creating feature sets that capture the salient features that physicians are able to observe in the images. Successful feature extraction reduces the semantic gap between the physician's interpretation and the computer representation of images, and helps to reduce the variability in diagnosis between physicians. Due to the complexity of many medical image classification tasks, feature extraction for each problem often requires domainspecific knowledge and a carefully constructed feature set for the specific type of images being classified. In this paper, we describe a method for automatic diagnostic feature extraction from colonoscopy images that may have general application and require a lower level of domain-specific knowledge. The work in this paper expands on our previous CAD algorithm for detecting polyps in colonoscopy video. In that work, we applied an eigenimage model to extract features representing polyps, normal tissue, diverticula, etc. from colonoscopy videos taken from various viewing angles and imaging conditions. Classification was performed using a conditional random field (CRF) model that accounted for the spatial and temporal adjacency relationships present in colonoscopy video. In this paper, we replace the eigenimage feature descriptor with features extracted from a convolutional neural network (CNN) trained to recognize the same image types in colonoscopy video. The CNN-derived features show greater invariance to viewing angles and image quality factors when compared to the eigenimage model. The CNN features are used as input to the CRF classifier as before. We report

  18. Measurement of vocal doses in virtual classrooms

    DEFF Research Database (Denmark)

    Bottalico, Pasquale; Pelegrin Garcia, David

    2010-01-01

    This work shows the results of a preliminary study about the determination of the optimal acoustical conditions for speakers in small classrooms. An experiment was carried out in a laboratory facility with 22 untrained talkers, who read a text passage from “Goldilocks” during two minutes under 13...... different acoustical conditions, that combined different kind of background noise and virtual classroom acoustics. Readings from the vocal fold vibrations were registered with an Ambulatory Phonation Monitor device. The speech signal from the talker in the center of the facility was picked up with a head......-worn microphone, convolved in real time with the impulse response of the chosen classroom, and reproduced through 29 loudspeakers placed around the subject. In particular, two different primary school classrooms were selected, with very low and very high reverberation time and, for each of them, two speaker...

  19. Vocal dose in teachers: correlation with dysphonia.

    Science.gov (United States)

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

    2016-04-01

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

  20. Vocal power and pressure-flow relationships in excised tiger larynges.

    Science.gov (United States)

    Titze, Ingo R; Fitch, W Tecumseh; Hunter, Eric J; Alipour, Fariborz; Montequin, Douglas; Armstrong, Douglas L; McGee, Joann; Walsh, Edward J

    2010-11-15

    Despite the functional importance of loud, low-pitched vocalizations in big cats of the genus Panthera, little is known about the physics and physiology of the mechanisms producing such calls. We investigated laryngeal sound production in the laboratory using an excised-larynx setup combined with sound-level measurements and pressure-flow instrumentation. The larynges of five tigers (three Siberian or Amur, one generic non-pedigreed tiger with Bengal ancestry and one Sumatran), which had died of natural causes, were provided by Omaha's Henry Doorly Zoo over a five-year period. Anatomical investigation indicated the presence of both a rigid cartilaginous plate in the arytenoid portion of the glottis, and a vocal fold fused with a ventricular fold. Both of these features have been confusingly termed 'vocal pads' in the previous literature. We successfully induced phonation in all of these larynges. Our results showed that aerodynamic power in the glottis was of the order of 1.0 W for all specimens, acoustic power radiated (without a vocal tract) was of the order of 0.1 mW, and fundamental frequency ranged between 20 and 100 Hz when a lung pressure in the range of 0-2.0 kPa was applied. The mean glottal airflow increased to the order of 1.0 l s(-1) per 1.0 kPa of pressure, which is predictable from scaling human and canine larynges by glottal length and vibrational amplitude. Phonation threshold pressure was remarkably low, on the order of 0.3 kPa, which is lower than for human and canine larynges phonated without a vocal tract. Our results indicate that a vocal fold length approximately three times greater than that of humans is predictive of the low fundamental frequency, and the extraordinarily flat and broad medial surface of the vocal folds is predictive of the low phonation threshold pressure.

  1. Human acoustics: From vocal chords to inner ear

    Science.gov (United States)

    Lamar, Michael Drew

    2005-11-01

    Part I covers the vocal chords, more accurately known as the vocal folds (VF). Modeling efforts are split into two areas: the VF tissue and the airflow. There are multiple existing models of the VF, with varying ranges of complexity for both the tissue and the airflow. In our model, the tissue is based on a recent two-mass model of Bogaert's [5], while the airflow is quasi-one-dimensional and is derived from the two-dimensional compressible Navier-Stokes equations. Our model is more accurate than Bernoulli's law (quasi-steady approximation), yet less complex than the full Navier-Stokes system. The model is shown to reproduce important transient behaviour intrinsic in vocal fold motion, such as pressure peaks before and after vocal fold closure. Part II concerns the inner ear, or cochlea. Again the modeling effort is split into two areas: the cochlear tissue and the cochlear fluid. We model the cochlear fluid with the well known two-dimensional box model of the cochlea, derived from the three-dimensional compressible Navier-Stokes equations. The cochlear tissue structure is where the complexity takes place. We start with Neely and Kim's [25] linear active model for the cochlear structure and modify their active gain parameter into a nonlinear nonlocal functional. The nonlinearity forces us to work in the time domain, which is prone to dispersive instabilities if one uses a frequency domain middle ear model. The middle ear's role as a transient absorber is discussed and its time domain formulation is shown to reduce the dispersive instability. We perform simulations on the full system and show that the model recovers many important nonlinear phenomena, such as suppression and difference tones. A spectrogram based on the cochlear response is created and compared with the spectrogram of the input waveform. In both Part I and Part II, the emphasis is on time dependent modeling and numerical implementation.

  2. A bond graph approach to modeling the anuran vocal production system.

    Science.gov (United States)

    Kime, Nicole M; Ryan, Michael J; Wilson, Preston S

    2013-06-01

    Air-driven vocal production systems such as those found in mammals, birds, and anurans (frogs and toads) combine pneumatic and mechanical elements in species-specific ways to produce a diversity of communication signals. This study uses bond graphs to model a generalized anuran vocal production system. Bond graphs allow an incremental approach to modeling dynamic physical systems involving different domains. Anurans provide an example of how signal diversity results from variation in the structure and behavior of vocal system elements. This paper first proposes a bond graph model of the integrated anuran vocal system as a framework for future study. It then presents a simulated submodel of the anuran sound source that produces sustained oscillations in vocal fold displacement and air flow through the larynx. The modeling approach illustrated here should prove of general applicability to other biological sound production systems, and will allow researchers to study the biomechanics of vocal production as well as the functional congruence and evolution of groups of traits within integrated vocal systems.

  3. Hamartomatous polyps - a clinical and molecular genetic study

    DEFF Research Database (Denmark)

    Jelsig, Anne Marie

    2016-01-01

    are typically removed concurrently with endoscopy when located in the colon, rectum, or stomach, whereas polyps in the small bowel are removed during push-enteroscopy, device-assisted enteroscopy, or by surgery. HPs can be classified as juvenile polyps or Peutz-Jeghers polyps based on their histopathological......% fulfilled to diagnostic criteria of JPS. The majority of patients had a single juvenile polyp. Paper II: In this paper we conducted a review of the HPS based on the current literature. Paper III: We investigated the hypothesis that patients with one or few HPs may have a HPS based on genetic screening. We...... reported previously none could be classified as definitely pathogenic or likely pathogenic according to our variant classification scheme and thus we concluded that genetic screening of patients with one or few JPs are not indicated. Paper IV: In Paper IV we investigated one of the ethical aspects of next...

  4. Uterine prolapse complicated with a giant cervical polyp.

    Science.gov (United States)

    Massinde, Anthony Naju; Mpogoro, Filbert; Rumanyika, Richard Nyerere; Magoma, Moke

    2012-01-01

    Uterine prolapse with giant cervical polyp is a rare combination. Although uterine prolapse is common among elderly and menopausal women, giant cervical polyps are commonly encountered in young reproductive-age adults. A 55-year-old, para 7, Tanzanian woman, 7 months postmenopausal, presented with history of a protruding vaginal mass for 3 months. She also had a third-degree uterine prolapse with the cervix beyond the hymen and a huge, ulcerated, round mass on the anterior lip of the cervix. The mass had a large stalk, bled easily on touch, and measured approximately 6 × 6 cm in its largest diameter. The external cervical os and posterior cervical lip were identified and appeared normal. Transvaginal hysterectomy was performed with unremarkable recovery. Giant cervical polyp associated with uterine prolapse, although rare, can occur in menopausal women. Transvaginal hysterectomy as was done in this patient may be all that is required in benign polyps.

  5. Antral hyperplastic polyp causing intermittent gastric outlet obstruction: Case report

    Directory of Open Access Journals (Sweden)

    Kurtkaya-Yapicier Ozlem

    2003-06-01

    Full Text Available Abstract Background Hyperplastic polyps are the most common polypoid lesions of the stomach. Rarely, they cause gastric outlet obstruction by prolapsing through the pyloric channel, when they arise in the prepyloric antrum. Case presentation A 62-year-old woman presented with intermittent nausea and vomiting of 4 months duration. Upper gastrointestinal endoscopy revealed a 30 mm prepyloric sessile polyp causing intermittent gastric outlet obstruction. Following submucosal injection of diluted adrenaline solution, the polyp was removed with a snare. Multiple biopsies were taken from the greater curvature of the antrum and the corpus. Rapid urease test for Helicobacter pylori yielded a negative result. Histopathologic examination showed a hyperplastic polyp without any evidence of malignancy. Biopsies of the antrum and the corpus revealed gastritis with neither atrophic changes nor Helicobacter pylori infection. Follow-up endoscopy after a 12-week course of proton pomp inhibitor therapy showed a complete healing without any remnant tissue at the polypectomy site. The patient has been symptom-free during 8 months of follow-up. Conclusions Symptomatic gastric polyps should be removed preferentially when they are detected at the initial diagnostic endoscopy. Polypectomy not only provides tissue to determine the exact histopathologic type of the polyp, but also achieves radical treatment.

  6. [Predictive significance of tissue eosinophilia for nasal polyp recurrence].

    Science.gov (United States)

    Wang, C S; Lou, H F; Meng, Y F; Piao, Y S; Zhang, L

    2016-04-07

    To evaluate the association between clinical parameters, especially tissue eosinophilia, and chronic sinusitis with nasal polyps (CRSwNP) recurrence. To identify optimal criteria of tissue eosinophilia as a predictor for recurrence. Two hundred and forty-eight CRSwNP patients were enrolled in this study. The demographic and clinical features were compared between recurrence and no recurrence groups. Mucosal specimens were assessed for the presence of tissue inflammatory cells. Factors associated with polyp recurrence were analyzed by Logistic regression analysis and optimal cutoff point of the predictor for nasal polyp recurrence was determined by receiver operating characteristic curve. SPSS 19.0 software was used to analyze the data. The recurrence rate was 55.6%(138/248 patients) in this cohort. Tissue and peripheral eosinophilia, comorbid asthma, olfactory score and Lund-Mackay score were significantly correlated with polyp recurrence(all Peosinophilia provides valuable information regarding to polyp recurrence. Tissue eosinophil proportion equal to or over 27% may be regarded as the prognostic criterion for nasal polyp recurrence.

  7. Where are the polyps? Molecular identification, distribution and population differentiation of Aurelia aurita jellyfish polyps in the southern North Sea area

    NARCIS (Netherlands)

    Walraven, van L.; Driessen, F.; Bleijswijk, van J.; Bol, A.; Luttikhuizen, P.; Coolen, J.W.P.; Bos, Oscar; Gittenberger, A.; Schrieken, N.; Langenberg, V.T.; Veer, van der H.W.

    2016-01-01

    For many species of metagenic jellyfish the location of the benthic polyps is unknown. To gain insight in the distribution, species composition and population structure of scyphozoan jellyfish polyps in the southern North Sea area, polyp samples were collected from natural and artificial substrates

  8. 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%…

  9. 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.

  10. Significance of histologic criteria for the management of patients with malignant colorectal polyps and polypectomy.

    Science.gov (United States)

    Netzer, P; Binek, J; Hammer, B; Lange, J; Schmassmann, A

    1997-09-01

    The management of invasive cancer in colorectal polyps (malignant polyps) is controversial, particularly with regard to the different sets of histologic criteria for deciding whether malignant colorectal polyps should be treated by polypectomy alone or be followed by surgical resection. We report on the outcome of patients in accordance with the histologic assessment of their malignant polyps. Malignant polyps were defined as having favourable histology (free margin, grade I or II, and no angiolymphatic invasion) or unfavorable histology (no free margin, grade III, or angiolymphatic invasion). Malignant polyps with favourable histology were treated by endoscopic polypectomy alone, whereas further therapy was recommended for malignant polyps with unfavourable histology. Residual cancer in a resection specimen and local or metastatic recurrence during the follow-up period (mean, 60 months; range, 12 - 120) were defined as adverse outcome. Thirty-seven malignant polyps were detected in 35 (0.5%) of 6605 patients. Five of these 35 patients were treated by primary bowel resection and analysed separately. In the other 30 patients the following unfavourable histologic signs were detected in 20 (62.5%) of 32 malignant polyps; no free margin in 16, grade III in 1, and angiolymphatic invasion in 3 polyps. Twelve polyps with favourable histology had no adverse outcome; in contrast, 5 of 20 polyps with unfavourable histology had an average outcome (P < 0.05). Locally excised malignant polyps without unfavourable histologic signs may not need further surgical treatment; for all other malignant polyps an ensuing bowel resection is recommended.

  11. [Clinical classification and management of squamous intraepithelial lesions of the vocal cord].

    Science.gov (United States)

    Ma, Li-jing; Wang, Jun; Ye, Jing-ying; Xu, Wen; Yang, Qing-wen

    2012-08-01

    To discuss the clinical classification of the squamous intraepithelial lesions (SILs) of vocal cord and their outcomes after different therapeutic procedures. Three hundred and forty-three patients with the SILs of vocal cord were enrolled. Based on the history of the diseases, macroscopic appearance by video rhino aryngoscopic, stroboscopic and microlaryngoscopic examination, and pathological findings, the correlation of clinical features, treatment modalities and treatment effect of the vocal cord SILs were discussed. According to the morphological characteristics, 343 patients were divided into four types. TypeI, leukoplakia combined with inflammation (n = 19); type II, leukoplakia combined with polyps by friction (n = 72); type III, leukoplakia combined with sulcus vocalis (n = 64); type IV, keratosis (n = 188). Patients with type I lesions were treated by medications. The vocal cord configuration and the voice of the patients in type I returned to normal after treatment. Patients with type II, III, IV lesions were treated by CO(2) laser. Type II were treated by subepithelial cordectomy, type III by mucosa slicing with dredging, type IV by sub ligament cordectomy or trans muscular cordectomy. The cure rate of patients with type II, III, IV lesions was 90.7% (294/324) after single surgery, the recurrent rate was 9.3% (30/324). Twenty-one patients (11.2%), all in type IV, developed carcinogenesis. Eight cases were diagnosed in the first surgery and 13 cases in the second. Among the 13 cases diagnosed in the second surgery, 2 cases had partial laryngectomy for the third surgery. Since the squamous intraepithelial lesions of vocal cord manifested differently, conservative treatment or CO(2) laser surgery should be used. In this way, a less invasive procedure, better recovery of the voice and less complication could be expected.

  12. 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…

  13. Risk Factors for Self-Reported Colon Polyps

    Science.gov (United States)

    Kahn, Henry S; Tatham, Lilith M; Thun, Michael J; Heath, Clark W

    1998-01-01

    OBJECTIVE Investigate risk factors for colon polyp using multivariate analyses. DESIGN In a group responding to a 1992 mail survey, we assessed the association between physician-diagnosed colon polyp and possible risk factors reported primarily 10 years earlier. SETTING Survey respondents within the Cancer Prevention Study II. PARTICIPANTS Respondents, 72,868 men and 81,356 women, who reported no polyp diagnosis when questioned in 1982 at ages 40 to 64 years. MEASUREMENTS AND MAIN RESULTS The characteristics of 7,504 men (10.3%) and 5,111 women (6.3%) reporting a first colon polyp were compared with those of participants who did not report a polyp. After adjustments for age, family history of colorectal cancer, and other potential risk factors, polyp occurrence was associated with 1982 histories of smoking, former smoking, alcohol use of at least two drinks per day (odds ratios [ORs] from 1.5 to 1.1; all p < .005), and a body mass index ≥ 28 kg/m 2(men's OR 1.06; 95% confidence interval [CI] 1.00, 1.13; women's OR 1.08; 95% CI 0.99, 1.17). Polyps were also associated with a diagnosis of gallbladder disease or gallstone at any time and with gallbladder surgery up to 1982 (OR from 2.7 to 1.3; all p < .001). Polyp occurrence was inversely associated with 1982 histories of high exercise level (men's OR 0.83; 95% CI 0.76, 0.91; women's OR 0.90; 95% CI 0.78, 1.03), frequent aspirin use in women (OR 0.85; 95% CI 0.77, 0.95), and high parity in women (OR 0.84; 95% CI 0.75, 0.94). Among participants lacking a clinically normal gallbladder, the polyp risks associated with smoking and high body mass index were reduced (p < .04 for interactions). CONCLUSIONS Despite the limitations and potential biases in these self-reported data, the risk factors described here may be useful for identifying persons at modestly increased risk of having a colon polyp. The effect-modifying role of gallbladder status deserves further investigation. PMID:9613885

  14. Cetacean vocal learning and communication.

    Science.gov (United States)

    Janik, Vincent M

    2014-10-01

    The cetaceans are one of the few mammalian clades capable of vocal production learning. Evidence for this comes from synchronous changes in song patterns of baleen whales and experimental work on toothed whales in captivity. While baleen whales like many vocal learners use this skill in song displays that are involved in sexual selection, toothed whales use learned signals in individual recognition and the negotiation of social relationships. Experimental studies demonstrated that dolphins can use learned signals referentially. Studies on wild dolphins demonstrated how this skill appears to be useful in their own communication system, making them an interesting subject for comparative communication studies.

  15. [Vocal cord dysfunction. An important differential diagnosis to bronchial asthma].

    Science.gov (United States)

    Kothe, C; Schade, G; Fleischer, S; Hess, M

    2004-03-01

    Vocal cord dysfunction (VCD) is described as a functional disorder of the vocal folds which leads to an intermittent, inspiratory 'paradoxical' glottal closure. We report on three women with frequent repetitive shortness of breath attacks caused by VCD. This was diagnosed by transnasal videofiberendoscopy, with glottal closure being seen during inspiration. Because of the different etiologies, one of the patients was treated with breathing and speech therapy, another received Omeprazol for laryngopharyngeal reflux, and the third was treated by intralaryngeal botulinum toxin injections. All three patients showed a reduction in attacks. Clinically, VCD seems to mimic asthma. However, with a thorough patient history and diagnostics, especially with transnasal laryngoscopy during a (triggered) attack, a precise diagnosis seems possible.

  16. How low can you go? Physical production mechanism of elephant infrasonic vocalizations.

    Science.gov (United States)

    Herbst, Christian T; Stoeger, Angela S; Frey, Roland; Lohscheller, Jörg; Titze, Ingo R; Gumpenberger, Michaela; Fitch, W Tecumseh

    2012-08-03

    Elephants can communicate using sounds below the range of human hearing ("infrasounds" below 20 hertz). It is commonly speculated that these vocalizations are produced in the larynx, either by neurally controlled muscle twitching (as in cat purring) or by flow-induced self-sustained vibrations of the vocal folds (as in human speech and song). We used direct high-speed video observations of an excised elephant larynx to demonstrate flow-induced self-sustained vocal fold vibration in the absence of any neural signals, thus excluding the need for any "purring" mechanism. The observed physical principles of voice production apply to a wide variety of mammals, extending across a remarkably large range of fundamental frequencies and body sizes, spanning more than five orders of magnitude.

  17. Endometrial Intraepithelial Neoplasia (EIN In An Endometrial Polyp

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    Devic Ana

    2015-12-01

    Full Text Available Endometrial intraepithelial neoplasia (EIN is a monoclonal neoplastic cell proliferation of the endometrium associated with a significantly increased risk of endometrioid endometrial adenocarcinoma. We herein present the case of a 58-year-old female patient who underwent a hysterectomy with bilateral salpingo-oophorectomy because of the existence of endometrial intraepithelial neoplasia in an endometrial polyp. The patient had irregular uterine bleeding, which lasted 10 days. An endometrial polyp was diagnosed by ultrasound examination. The polyp was located in the isthmus of the uterus, on the back wall, and measured 32 mm × 25 mm. The patient underwent fractional dilation and curettage, and the specimens were subjected to a histopathological examination. The histopathological findings were EIN, endometrioid type, a focus of which was found within the endometrial polyps, as well as the endometrial polyp and proliferative endometrium. The endocervical tissue was normal. Given the age of the patient and the histopathological findings, she underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The final histopathological findings were EIN, endometrioid type with a focus found within the endometrial polyp; endometrial polyp; simple hyperplasia; chronic inflammation of the uterine cervix; hyperkeratosis of the cervical squamous epithelium; and cervicitis chronica. There was also hydrosalpinx of the left fallopian tube, and cystic follicles in the left ovary. There was no significant morphological change in the right ovary or fallopian tube. The surgical and postoperative course were normal. The patient was sent home on the fifth postoperative day in good general condition. A check-up performed one month after surgery showed normal findings.

  18. Factors Influencing the Recurrence Potential of Benign Endometrial Polyps after Hysteroscopic Polypectomy.

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    Jehn-Hsiahn Yang

    Full Text Available An endometrial polyp is a frequently encountered gynecologic disease with abnormal uterine bleeding and infertility being the two common presenting problems, and hysteroscopic polypectomy is an effective method to remove them. The postoperative polyp recurrence might result in reappearance of abnormal uterine bleeding or infertility, whereas factors influencing the postoperative recurrence potential have limited data.This case-series report included 168 premenopausal women who suffered from endometrial polyps and underwent hysteroscopic polypectomy. All of them were awaiting a future pregnancy. Office hysteroscopy was done before and after hysteroscopic polypectomy, in which preoperative hysteroscopy examined the number, type, and location of endometrial polyps, and postoperative hysteroscopy checked the polyp recurrence. Surgical indications, either infertility or the presentation of abnormal uterine bleeding, and follow-up duration were recorded.Seventy-three out of 168 (43% women had polyp recurrence after hysteroscopic polypectomy. Multivariate logistic regression analysis revealed that more endometrial polyps (P = 0.015 and longer duration of follow-up (P = 0.004 were significantly associated with an increased risk of postoperative polyp recurrence. The type of endometrial polyps was not correlated with polyp recurrence potential, whereas pedunculated type endometrial polyps were closely related to the presentation of abnormal uterine bleeding (P = 0.001.A higher number of endometrial polyps and longer follow-up duration are associated with a greater potential of polyp recurrence after hysteroscopic polypectomy.

  19. US characteristics for the prediction of neoplasm in gallbladder polyps 10 mm or larger

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Sil; Lee, Jeong Kyong; Kim, Yookyung; Lee, Sang Min [Ewha Womans University, Department of Radiology and Medical Research Institute, School of Medicine, Seoul (Korea, Republic of)

    2016-04-15

    To evaluate the characteristics of gallbladder polyps 10 mm or larger to predict a neoplasm in US examinations. Fifty-three patients with gallbladder polyps ≥ 10 mm with follow-up images or pathologic diagnosis were included in the retrospective study. All images and reports were reviewed to determine the imaging characteristics of gallbladder polyps. Univariate and multivariate analyses were used to evaluate predictors for a neoplastic polyp. A neoplastic polyp was verified in 12 of 53 patients and the mean size was 13.9 mm. The univariate analysis revealed that adjacent gallbladder wall thickening, larger size (≥15 mm), older age (≥57 years), absence of hyperechoic foci in a polyp, CT visibility, sessile shape, a solitary polyp, and an irregular surface were significant predictors for a neoplastic polyp. In the multivariate analysis, larger size (≥15 mm) was a significant predictor for a neoplastic polyp. A polyp size ≥15 mm was the strongest predictor for a neoplastic polyp with US. The hyperechoic foci in a polyp and CT visibility would be useful indicators for the differentiation of a neoplastic polyp, in addition to the established predictors. (orig.)

  20. Vocal Health for Physical Educators

    Science.gov (United States)

    Trout, Josh; McColl, Douglas

    2007-01-01

    Evidence suggests that teachers are often at risk for vocal disease and are more likely to change occupations because of their voice problems compared to non-teachers. Physical educators are especially at risk for voice problems due to the intense daily demands of voice projection. Chronic abuse can cause swelling and inflammation of the…

  1. Laryngeal biomechanics and vocal communication in the squirrel monkey (Saimiri boliviensis)

    Science.gov (United States)

    Brown, Charles H.; Alipour, Fariborz; Berry, David A.; Montequin, Douglas

    2003-04-01

    The larynges of eight squirrel monkeys were harvested, dissected, mounted on a pseudotracheal tube, and phonated using compressed air. Patterns of vocal fold oscillation were compared with sound spectrograms of calls recorded from monkeys in our colony. Four different regimes of vocal fold activation were identified. Regime 1 resembled typical human vowel production, with regular vocal-fold vibration, a prominent fundamental frequency, and an accompanying series of harmonic overtones. This regime is likely to give rise to squirrel monkey ``cackles,'' as well as a variety of other harmonically structured calls. In regime 2, the pattern of vibrations exhibited the presence of two or more unrelated frequencies (biphonation). This regime of glottal activity resembled the biphonation observed in many exemplars of ``twitter'' and ``kecker'' calls. The vocal folds oscillated continuously in regime 3, but produced glottal pulses whose amplitudes waxed and waned rhythmically. This phenomenon resulted in the percept of a series of discrete pulses, and may give rise to ``errs,'' ``churrs,'' and other calls composed of a rapid sequence of acoustic elements. In regime 4, the period of each oscillation was quasi-irregular. Shrieks and other broadband calls or call elements that lack an apparent fundamental frequency may be produced in this manner.

  2. Increased prevalence of gallbladder polyps in acromegaly.

    Science.gov (United States)

    Annamalai, Anand K; Gayton, Emma L; Webb, Alison; Halsall, David J; Rice, Caiomhe; Ibram, Ferda; Chaudhry, Afzal N; Simpson, Helen L; Berman, Laurence; Gurnell, Mark

    2011-07-01

    Several studies have suggested an increased prevalence of benign and malignant tumors in acromegaly, particularly colonic neoplasms. The gallbladder's epithelial similarity to the colon raises the possibility that gallbladder polyps (GBP) may occur more frequently in acromegaly. Thirty-one patients with newly diagnosed acromegaly (14 females, 17 males; mean age 54.7 yr, range 27-76 yr) were referred to our center between 2004 and 2008. All had pituitary adenomas and were treated with somatostatin analogs prior to transsphenoidal surgery. Biliary ultrasonography was performed at the time of referral. In a retrospective case-cohort study, we compared the prevalence of GBP in these scans with those of 13,234 consecutive patients (age range 20-80 yr) presenting at the hospital for abdominal/biliary ultrasound during the same time interval. Associations between GH and IGF-I levels and GBP in acromegaly were also examined. There was a higher prevalence of GBP in patients with acromegaly compared with controls (29.03 vs 4.62%, P = 0.000008); relative risk was 6.29 (95% confidence interval 3.61-10.96). Eight of nine patients with acromegaly and GBP were older than 50 yr of age. GH levels were higher in those with GBP (median 30.8 μg/liter, interquartile range 10.9-39.1) than those without (8.2 μg/liter, interquartile range 6.0-16.0), but IGF-I levels were comparable. This is the first study to demonstrate an increased prevalence of GBP in patients with newly diagnosed acromegaly. Further studies are required to determine whether these patients are at increased risk of developing gallbladder carcinoma and to define the role, if any, of biliary ultrasound surveillance.

  3. Uni- and bidirectional wide angle CT colonography: effect on missed areas, surface visualization, viewing time and polyp conspicuity

    Energy Technology Data Exchange (ETDEWEB)

    East, James E.; Saunders, Brian P. [St. Mark' s Hospital, Wolfson Unit for Endoscopy, London (United Kingdom); Boone, Darren; Halligan, Steve; Taylor, Stuart A. [University College Hospital, Department of Specialist Radiology, London (United Kingdom); Burling, David [St. Mark' s Hospital, Department of Intestinal Imaging, London (United Kingdom)

    2008-09-15

    The effect of field of view on mucosal visualisation and reader efficiency during three-dimensional endoluminal CT colonography (CTC) was investigated. Twenty CTC datasets were reviewed at standard 90-degree and ''wide'' 140-degree viewing angles using customised viewing software (V3D colon; Viatronix), which listed number and size of missed mucosal areas (''missed regions tool'') and percentage mucosal visualisation. We compared: (1) unidirectional and bidirectional flythrough using 140- versus 90-degree viewing angles; (2) reader analysis time comparing unidirectional 140-degree flythrough versus bidirectional 90-degree flythrough; (3) paired image snapshots of 12 polyps taken at each field of view were reviewed to assess conspicuity. All patients underwent conventional colonoscopy. Bidirectional 140-degree review reduced the numbers of missed areas by between eight- and 40-fold depending on size category, including those >1,000 mm{sup 2}, compared with standard 90-degree bidirectional flythrough (P<0.001). Combined prone-supine unidirectional 140-degree flythrough and missed area review was 3.8 min faster than 90-degree bidirectional review (9.3 versus 5.5 min, P< 0.0001) for the same surface visualisation. When viewed as pairs, polyps were rated more conspicuous with a 90-degree field of view, P=0.03. Wide-angle (140-degree) CTC can reduce both numbers of missed areas and review times. However, this may be at the expense of polyp conspicuity. (orig.)

  4. Decomposition of vocal cycle length perturbations into vocal jitter and vocal microtremor, and comparison of their size in normophonic speakers.

    Science.gov (United States)

    Schoentgen, J

    2003-06-01

    A statistical method that enables raw vocal cycle length perturbations to be decomposed into perturbations ascribed to vocal jitter and vocal tremor is presented, together with a comparison of the size of jitter and tremor. The method is based on a time series model that splits the vocal cycle length perturbations into uncorrelated cycle-to-cycle perturbations ascribed to vocal jitter and supra-cycle perturbations ascribed to vocal tremor. The corpus was composed of 114 vocal cycle length time series for sustained vowels [a], [i], and [u] produced by 22 male and 16 female normophonic speakers. The results were the following. First, 100 out of 114 time series were decomposed successfully by means of the time series model. Second, vocal perturbations ascribed to tremor were significantly larger than perturbations ascribed to jitter. Third, the correlation between vocal jitter and vocal tremor was moderate, but statistically significant. Fourth, small but statistically significant differences were observed among the three vowel timbres in the relative jitter and the arithmetic difference of jitter and tremor. Fifth, the differences between male and female speakers were not statistically significant in the relative raw perturbations, the relative jitter, or the modulation level owing to tremor.

  5. A Rare Case of Solitary Peutz Jeghers Type Hamartomatous Duodenal Polyp with Dysplasia!

    Science.gov (United States)

    Rathi, Chetan Devendra; Solanke, Dattatray Balasaheb; Kabra, Nikita Lalitkumar; Ingle, Meghraj Ananda; Sawant, Prabha Dilip

    2016-07-01

    Solitary Peutz Jeghers (SPJ) type hamartomatous polyp is a rare and separate entity from classic Peutz Jeghers syndrome (PJS). A hamartomatous polyp without associated mucocutaneous pigmentations, any other gastrointestinal polyp or a family history of PJS is diagnosed as a SPJ type polyp. We described a case of 22-year-old young man in whom solitary duodenal polyp was incidentally detected and resected. Histopathological examination revealed PJ type hamartomatous polyp with foci of adenomatous and moderate dysplastic change. Very few cases of solitary duodenal PJ type hamartomatous polyps with malignant transformation have been reported. They can be treated with endoscopic or surgical resection. Endoscopic ultrasound can give an idea about the depth of involvement. This is a rare case of duodenal solitary PJ polyp with dysplasia in a young patient.

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

    Science.gov (United States)

    Martins, Regina Helena Garcia; Tavares, Elaine Lara Mendes; Ranalli, Paula Ferreira; Branco, Anete; Pessin, Adriana Bueno Benito

    2014-01-01

    Psychogenic dysphonia is a functional disorder with variable clinical manifestations. To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series. The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings. 28 patients (26 women and 2 men) were assessed. Their occupations included: housekeeper (n=17), teacher (n=4), salesclerk (n=4), nurse (n=1), retired (n=1), and psychologist (n=1). Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms. In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Regina Helena Garcia Martins

    2014-12-01

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

  8. Placental polyp: a rare cause of iron deficiency anemia

    Directory of Open Access Journals (Sweden)

    Fernando Peixoto Ferraz de Campos

    2011-12-01

    Full Text Available Placental polyps are defined as pedunculated or polypoid fragments of placentaor ovular membranes retained for an indefinite period of time into the uterus afterabortion or child birth. An important cause of retention is placental accretism, anabnormal adherence of the placenta into the uterine wall. Chronic cases are rarelyreported in the literature. In these cases, the placental retention in the immediatepostpartum is not followed by heavy bleeding what makes the diagnosischallenging. We report a rare case of iron-deficiency anemia in a multiparous29-year-old female patient two years after the last delivery. She sought medicalcare with clinical symptoms of anemia and recent menses alterations. Therewas no history of abortion. On gynecological examination, there was a twofoldenlarged uterus, and the pelvic ultrasound revealed an image compatible with anendometrial polyp. She underwent open hysterectomy because of uncontrollablebleeding followed by hypotension after curettage. The histolopathologicexamination revealed a partially hyalinized and necrotic placental polyp.

  9. Regulation of polyp-to-jellyfish transition in Aurelia aurita.

    Science.gov (United States)

    Fuchs, Björn; Wang, Wei; Graspeuntner, Simon; Li, Yizhu; Insua, Santiago; Herbst, Eva-Maria; Dirksen, Philipp; Böhm, Anna-Marei; Hemmrich, Georg; Sommer, Felix; Domazet-Lošo, Tomislav; Klostermeier, Ulrich C; Anton-Erxleben, Friederike; Rosenstiel, Philip; Bosch, Thomas C G; Khalturin, Konstantin

    2014-02-03

    The life cycle of scyphozoan cnidarians alternates between sessile asexual polyps and pelagic medusa. Transition from one life form to another is triggered by environmental signals, but the molecular cascades involved in the drastic morphological and physiological changes remain unknown. We show in the moon jelly Aurelia aurita that the molecular machinery controlling transition of the sessile polyp into a free-swimming jellyfish consists of two parts. One is conserved and relies on retinoic acid signaling. The second, novel part is based on secreted proteins that are strongly upregulated prior to metamorphosis in response to the seasonal temperature changes. One of these proteins functions as a temperature-sensitive "timer" and encodes the precursor of the strobilation hormone of Aurelia. Our findings uncover the molecule framework controlling the polyp-to-jellyfish transition in a basal metazoan and provide insights into the evolution of complex life cycles in the animal kingdom. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Atypical presentation of pseudomembranous colitis localized in adenomatous polyps.

    Science.gov (United States)

    Hernández-Rocha, Cristian; Barra-Carrasco, Jonathan; Guzmán, Ana María; Paredes-Sabja, Daniel; Lezcano, Gabriel; Zoroquiaín, Pablo; Alvarez-Lobos, Manuel

    2013-01-14

    The most frequent cause of pseudomembranous colitis is Clostridium difficile (C. difficile) infection. This type of colitis is characterized by an endoscopic pattern of numerous small, yellowish or whitish plaques diffusely distributed, which typically compromises the rectum extending to proximal colon. Occasionally, the pseudomembranes compromise only the transverse or right colon, but their exclusive localization over polyps has not been reported. In this case report we have described a patient with symptoms compatible with C. difficile infection and positive for C. difficile toxigenic culture. Colonoscopy examination showed two small polyps with a whitish surface, and histopathological analysis confirmed them to be pseudomembranes over tubular adenomas. The rest of the colonic mucosa was normal and no other cause was demonstrated. We suggest that this particular distribution might be due to a higher affinity for dysplastic cells such as adenomatous polyps of colon by C. difficile and/or its toxins.

  11. Fibroepithelial Polyp of the Tonsil: Report of a Rare Case.

    Science.gov (United States)

    Telugu, Ramesh Babu; Ashish, Gaurav

    2015-12-01

    Pedunculated polyps of the palatine tonsil are rare benign tumours of tonsil. Most of the cases have been reported in adults with varying presenting symptoms. We report a 12-year-old male child who presented with 6 months history of difficulty in swallowing. There was no history of breathing difficulty, change in voice or history of trauma. Clinical examination revealed a 2x1 cm small pedunculated polyp arising from the superior pole of right tonsil which was excised under general anaesthesia. Left tonsil was normal. A diagnosis of fibroepithelial polyp of right palatine tonsil was made based on histopathological findings. An unusual presentation of a rare condition in a paediatric patient has been discussed along with the clinical and histopathological features of this lesion.

  12. Analysis of thermal damage in vocal cords for the prevention of collateral laser treatment effects

    Science.gov (United States)

    Fanjul Vélez, Félix; Luis Arce-Diego, José; del Barrio Fernández, Ángela; Borragán Torre, Alfonso

    2007-05-01

    The importance of vocal cords for the interaction with the world around is obviously known. Vocal cords disorders can be divided mainly into three categories: difficulty of movement of one or both vocal folds, lesion formation on them, and difficulty or lack of mucosal wave movement. In this last case, a laser heating treatment can be useful in order to improve tissue vibration. However, thermal damage should be considered to adjust laser parameters and so to prevent irreversible harmful effects to the patient. in this work, an analysis of thermal damage in vocal folds is proposed. Firstly thermo-optical laser-tissue interaction is studied, by means of a RTT (Radiation Transfer Theory) model solved with a Monte Carlo approach for the optical propagation of radiation, and a bio-heat equation, with a finite difference numerical method based solution, taking into account blood perfusion and boundary effects, for the thermal distribution. The spatial-temporal temperature distributions are obtained for two widely used lasers, Nd:YAG (1064 nm) and KTP (532 nm). From these data, an Arrhenius thermal damage analysis allows a prediction of possible laser treatment harmful effects on vocal cords that could cause scar formation or tissue burn. Different source powers and exposition times are considered, in such a way that an approximation of adequate wavelength, power and duration is achieved, in order to implement an efficient and safe laser treatment.

  13. A Giant Pedunculated Urothelial Polyp Mimicking Bladder Mass in a Child: A Rare Case

    Directory of Open Access Journals (Sweden)

    Mehmet Kaba

    2014-01-01

    Full Text Available Ureteral fibroepithelial polyps are rarely seen benign tumors with mesodermal origin. These polyps can involve kidney, pelvis, ureter, bladder, and urethra. The most common symptoms are hematuria and flank pain. The choice of treatment is either endoscopic or surgical resection of polyp by sparing kidney. Here, we presented a pediatric case with giant, fibroepithelial polyp that mimics bladder tumor, originating from middle segment of the ureter.

  14. Covering folded shapes

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    Oswin Aichholzer

    2014-05-01

    Full Text Available Can folding a piece of paper flat make it larger? We explore whether a shape S must be scaled to cover a flat-folded copy of itself. We consider both single folds and arbitrary folds (continuous piecewise isometries \\(S\\to\\mathbb{R}^2\\. The underlying problem is motivated by computational origami, and is related to other covering and fixturing problems, such as Lebesgue's universal cover problem and force closure grasps. In addition to considering special shapes (squares, equilateral triangles, polygons and disks, we give upper and lower bounds on scale factors for single folds of convex objects and arbitrary folds of simply connected objects.

  15. Automatic colonic polyp detection using multi-objective evolutionary techniques

    Science.gov (United States)

    Li, Jiang; Huang, Adam; Yao, Jianhua; Bitter, Ingmar; Petrick, Nicholas; Summers, Ronald M.; Pickhardt, Perry J.; Choi, J. Richard

    2006-03-01

    Colonic polyps appear like elliptical protrusions on the inner wall of the colon. Curvature based features for colonic polyp detection have proved to be successful in several computer-aided diagnostic CT colonography (CTC) systems. Some simple thresholds are set for those features for creating initial polyp candidates, sophisticated classification scheme are then applied on these polyp candidates to reduce false positives. There are two objective functions, the number of missed polyps and false positive rate, that need to be minimized when setting those thresholds. These two objectives conflict and it is usually difficult to optimize them both by a gradient search. In this paper, we utilized a multiobjective evolutionary method, the Strength Pareto Evolutionary Algorithm (SPEA2), to optimize those thresholds. SPEA2 incorporates the concept of Pareto dominance and applies genetic techniques to evolve individual solutions to the Pareto front. The SPEA2 algorithm was applied to colon CT images from 27 patients each having a prone and a supine scan. There are 40 colonoscopically confirmed polyps resulting in 72 positive detections in CTC reading. The results obtained by SPEA2 were compared with those obtained by our old system, where an appropriate value was set for each of those thresholds by a histogram examination method. If we keep the sensitivity the same as that of our old system, the SPEA2 algorithm reduced false positive rate by 76.4% from average false positive 55.6 to 13.3 per data set. If the false positive rate is kept the same for both systems, SPEA2 increased the sensitivity by 13.1% from 53 to 61 among 72 ground truth detections.

  16. Accuracy for optical diagnosis of colorectal polyps in clinical practice

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    Javier Sola-Vera

    2015-05-01

    Full Text Available Background: Optical diagnostic involves predicting polyp histopathology from its endoscopic characteristics. It is only recommended for diminutive polyps (≤ 5 mm and for predictions made with high confidence. Objectives: To evaluate the accuracy of optical imaging in clinical practice and to assess if optical diagnosis is useful for predicting future colonoscopy surveillance intervals without waiting for histopathological analysis. Methods: consecutive > 18 years patients were enrolled in this prospective study. Colonoscopies were performed by five expert endoscopists who previously participated in an ex-vivo training. Colonoscopes CF-H180AL and CF-Q180AL were used together with Exera II (Olympus Medical System, Tokyo, Japan processors. Each polyp was characterized in real time using white light and Narrow Band Imaging. Accuracy of optical diagnosis (S, E, NPV, PPV and correlation between surveillance interval based on optical diagnosis and histopathological analysis were calculated. Results: 311 colon polyps < 10 mm (216 diminutive in 195 patients were analyzed. Accuracy of optical diagnostics for predictions made with high confidence: Diminutive polyps (sensitivity 0.59, specificity 0.92, NPV 0.48; polyps < 10 mm (sensitivity 0.73, specificity 0.88, NPV 0.50. An optical diagnosis based surveillance recommendation was given to 90 patients. Concordance with histopathology based recommendation was 92.2% according to the European guideline and 93.3% according to the ESGE guideline. Conclusions: Optical diagnostics can be used to predict future surveillance intervals immediately after colonoscopy. However, in this study, based on clinical practice, the accuracy of optical imaging is below the recommended standards.

  17. Could Eosinophilia predict clinical severity in nasal polyps?

    Science.gov (United States)

    Aslan, Figen; Altun, Eren; Paksoy, Serpil; Turan, Gulay

    2017-01-01

    Although nasal polyps are one of the most frequent diseases, their etiopathogenesis remains unclear.Since eosinophils are the main inflammatory cells in the substantial proportion of nasal polyp tissues, they are considered potentially responsible for the etiopathogenesis and prognosis of the disease. Aim of this study was to investigate the relation between mucosal and peripheral eosinophilia and their relation with disease severity in nasal polyps. The study included 53 patients with nasal polyps who underwent endoscopic sinus surgery. Preoperative Lund-MacKay computed tomography (CT) scores and the Lund-Kennedy endoscopic scores of the patients were recorded. Nasal polyp tissues were stained with hematoxylin and eosin, eosinophil counts were performed using high-power field (HPF, 400×) under the light microscope, and the patients were grouped as those with high mucosal eosinophil count and those with low mucosal eosinophil count. The mean Lund-MacKay CT score and the mean Lund-Kennedy endoscopic score were higher in the patients with high mucosal eosinophil count than in those with low mucosal eosinophil count. Likewise, the mean Lund-MacKay CT score and the mean Lund-Kennedy endoscopic scores were significantly higher in the patients with high peripheral eosinophil count than in those with low peripheral eosinophil count (p < 0.05 for both). Moreover, the mean peripheral eosinophil count was significantly higher in the patients with high mucosal eosinophil count than in those with low mucosal eosinophil count (p < 0.05). Mucosal and peripheral eosinophilia can be used as a marker to predict disease severity in nasal polyps.

  18. Teacher's voice: vocal tract discomfort symptoms, vocal intensity and noise in the classroom.

    Science.gov (United States)

    Mendes, Amanda Louize Félix; Lucena, Brunna Thaís Luckwu de; De Araújo, Aline Menezes Guedes Dias; Melo, Luciana Pimentel Fernandes de; Lopes, Leonardo Wanderley; Silva, Maria Fabiana Bonfim de Lima

    2016-04-01

    To identify a possible correlation between teachers vocal intensity and the noise in the classroom, as well as between vocal intensity and the symptoms of vocal tract discomfort before and after classes. 27 Elementary School I teachers participated in the study. We used the questionnaires "Vocal Production Condition of the Teacher" and "Vocal Tract Discomfort Scale - VTD" which were applied before and after the class. A properly calibrated noise meter was used for measuring noise in the classroom and the teachers' vocal intensity. There was a moderate positive correlation between vocal intensity and noise and also a significant difference between the VTD scale and the teachers with and without vocal complaint before and after classes. When compared separately on both occasions, there was an increase in the group's scores for both groups and with and without complaints. We found association of the vocal tract symptoms before and after classes, frequency of burning, itching, sore throat and sensitive throat were observed. The intensity of symptoms was significant for sore throat, itching and feeling of lump in the throat. We observed significant values of vocal intensity and frequency and intensity of symptoms for sensitive throat and lump in the throat before the class, and sore throat and lump in the throat after the. The increase in teacher's vocal intensity correlates to high noise levels in the classroom. The evidence suggests correlation between vocal intensity and discomfort of the vocal tract, with most of the symptoms reported in greater frequency and intensity after the class.

  19. Giant sporadic fundic gland polyp: Endoscopic and endosonographic features and management

    Institute of Scientific and Technical Information of China (English)

    Ihab I El Hajj; Mohamad Hawchar; Assaad Soweid; Karim Maasd; Ayman Tawil; Kassem A Barada

    2008-01-01

    Fundic gland polyps are the most common gastric polyps. They are usually small in size, sporadic and asymptomatic. We present a case of giant fundic gland polyp. Our case is particular because of the clinical presentation, the endoscopic and endosonographic documented findings, and the treatment otpions followed.

  20. Watchful waiting versus colorectal resection after polypectomy for malignant colorectal polyps

    DEFF Research Database (Denmark)

    Levic, Katarina; Kjær, Monica; Bulut, Orhan;

    2015-01-01

    INTRODUCTION: Unexpected malignancy in removed colorectal polyps is reported in up to 9% of cases. The introduction of screening for colorectal cancer will inevitably increase the number of removed colorectal polyps and therefore also the incidence of malignant polyps. The treatment strategy is e...

  1. Syndromic Gastric Polyps : At the Crossroads of Genetic and Environmental Cancer Predisposition

    NARCIS (Netherlands)

    Brosens, Lodewijk A A; Giardiello, Francis M; Offerhaus, G Johan; Montgomery, Elizabeth A

    2016-01-01

    Gastric polyps occur in 1-4 % of patients undergoing gastroscopy. Although most are sporadic, some gastric polyps are part of an underlying hereditary syndrome. Gastric polyps can be seen in each of the well-known gastrointestinal polyposis syndromes, but also in Lynch syndrome and in several rare n

  2. Where are the polyps? Molecular identification, distribution and population differentiation of

    NARCIS (Netherlands)

    van Walraven, L.; Driessen, F.; van Bleijswijk, J.; Bol, A.; Luttikhuizen, P.C.; Coolen, J.; Bos, O.G.; Gittenberger, A.; Schrieken, N.; Langenberg, V.T.; van der Veer, H.W.

    2016-01-01

    For many species of metagenic jellyfish the location of the benthic polyps is unknown. To gain insight in the distribution, species composition and population structure of scyphozoan jellyfish polyps in the southern North Sea area, polyp samples were collected from natural and artificial substrates

  3. Where are the polyps? Molecular identification, distribution and population differentiation of

    NARCIS (Netherlands)

    van Walraven, L.; Driessen, F.; van Bleijswijk, J.; Bol, A.; Luttikhuizen, P.C.; Coolen, J.; Bos, O.G.; Gittenberger, A.; Schrieken, N.; Langenberg, V.T.; van der Veer, H.W.

    2016-01-01

    For many species of metagenic jellyfish the location of the benthic polyps is unknown. To gain insight in the distribution, species composition and population structure of scyphozoan jellyfish polyps in the southern North Sea area, polyp samples were collected from natural and artificial substrates

  4. Irukandji jellyfish polyps exhibit tolerance to interacting climate change stressors.

    Science.gov (United States)

    Klein, Shannon G; Pitt, Kylie A; Rathjen, Kristen A; Seymour, Jamie E

    2014-01-01

    Increasing ocean temperatures and strengthening boundary currents have caused the poleward migration of many marine species. Cubozoan jellyfish known to cause Irukandji syndrome have historically been confined to tropical waters but may be expanding into subtropical regions. Here, we examine the interactive effects of warming and acidification on the population dynamics of polyps of an Irukandji jellyfish, Alatina nr mordens, and the formation of statoliths in newly metamorphosed medusae, to determine if this jellyfish could tolerate future conditions predicted for southeast Queensland (SEQ), Australia. Two experiments, examining the orthogonal factors of temperature and pH, were undertaken. Experiment 1 mimicked the current, ca. 2050 and ca. 2100 summer temperature and pH conditions predicted for SEQ using A1F1 scenarios (temperature: 25, 27, 29 °C; pH: 7.9, 7.8, 7.6) and Experiment 2 mimicked current and future winter conditions (18 and 22 °C, pH 7.9, 7.8, 7.6). All polyps in Experiment 1 survived and budded. Fewer polyps budded in the lower pH treatments; however, patterns varied slightly among temperature treatments. Statoliths at pH 7.6 were 24% narrower than those at pH 7.8 and 7.9. Most polyps survived the winter conditions mimicked by Experiment 2 but only polyps in the 22 °C, pH 7.9 treatment increased significantly. The current absence of A. nr mordens medusae in SEQ, despite the polyps' ability to tolerate the current temperature and pH conditions, suggests that ecological, rather than abiotic factors currently limit their distribution. Observations that budding was lower under low pH treatments suggest that rates of asexual reproduction will likely be much slower in the future. We consider that A. nr mordens polyps are likely to tolerate future conditions but are unlikely to thrive in the long term. However, if polyps can overcome potential ecological boundaries and acidification proceeds slowly A. nr mordens could expand polewards in the short

  5. Inflammatory polyps in idiopathic inflammation of the colon

    Energy Technology Data Exchange (ETDEWEB)

    Winter, J.; Schupp, R.R.; Friedrich, M.

    1983-02-01

    The article discusses the morphology and clinical importance of inflammatory polyps. It is shown via an analysis of the authors' own patients that no importance can be attached to such lesions in the differential diagnosis of indiopathic inflammations of the colon: 52,7% of the patients with Crohn's colitis (n = 112) as well as 43.3% of the patients with Colitis ulcerosa (n = 67) showed inflammatory polyps of the colon in the course of their disease. The article discusses the difficulty of radiological differentiation against adenomas or premalignant dysplasias of chronically inflamed mucosa.

  6. VOCALS-UK: An overview of UK VOCALS science (Invited)

    Science.gov (United States)

    Coe, H.; Vocals-Uk Science Team

    2010-12-01

    This paper will highlight a variety of process studies, observationally led studies and modelling studies, both completed and in progress, conducted by groups in the United Kingdom, working in collaboration with international partners on the VAMOS Ocean-Cloud-Atmosphere Land Study Regional Experiment (VOCALS-REx). The VOCALS field experiment was conducted out of Arica, Chile, between October and November, 2008. The study aims to better understand the nature and variability of interactions between the ocean, atmosphere and steep topography, as well as local and long-range transport of pollutants and aerosol, in the context of their role in controlling the climate of the South East Pacific - an important region in terms of the global energy budget and which is currently poorly characterised in global climate models. Specific highlights will include a statistical representation of the SEP marine boundary layer during VOCALS-Rex to inform future modelling; an analysis of the synoptic and large-scale dynamical influences on cloud in the SEP; results from improved Met Office Unified Model forecast runs which examine aerosol-cloud interactions with a comparison to results from WRF-CHEM; and large eddy modelling of simulated gravity waves and their potential to induce open cellular convection (create pockets of open cells). In addition, early results from a number of further studies will be presented.

  7. 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

  8. Origami - Folded Plate Structures

    OpenAIRE

    Buri, Hans Ulrich

    2010-01-01

    This research investigates new methods of designing folded plate structures that can be built with cross-laminated timber panels. Folded plate structures are attractive to both architects and engineers for their structural, spatial, and plastic qualities. Thin surfaces can be stiffened by a series of folds, and thus not only cover space, but also act as load bearing elements. The variation of light and shadow along the folded faces emphasizes the plas...

  9. The Folded t Distribution

    OpenAIRE

    Psarakis, Stelios; Panaretos, John

    1990-01-01

    Measurements are frequently recorder without their algebraic sign. As a consequence the underlying distribution of measurements is replaced by a distribution of absolute measurements. When the underlying distribution is t the resulting distribution is called the “folded-t distribution”. Here we study this distribution, we find the relationship between the folded-t distribution and a special case of the folded normal distribution and we derive relationships of the folded-t distribution to othe...

  10. MODELS OF PROTEIN FOLDING

    Directory of Open Access Journals (Sweden)

    Unnati Ahluwalia

    2012-12-01

    Full Text Available In an attempt to explore the understanding of protein folding mechanism, various models have been proposed in the literature. Advances in recent experimental and computational techniques rationalized our understanding on some of the fundamental features of the protein folding pathways. The goal of this review is to revisit the various models and outline the essential aspects of the folding reaction.

  11. Acoustic detection of manatee vocalizations

    Science.gov (United States)

    Niezrecki, Christopher; Phillips, Richard; Meyer, Michael; Beusse, Diedrich O.

    2003-09-01

    The West Indian manatee (trichechus manatus latirostris) has become endangered partly because of a growing number of collisions with boats. A system to warn boaters of the presence of manatees, that can signal to boaters that manatees are present in the immediate vicinity, could potentially reduce these boat collisions. In order to identify the presence of manatees, acoustic methods are employed. Within this paper, three different detection algorithms are used to detect the calls of the West Indian manatee. The detection systems are tested in the laboratory using simulated manatee vocalizations from an audio compact disk. The detection method that provides the best overall performance is able to correctly identify ~96% of the manatee vocalizations. However, the system also results in a false alarm rate of ~16%. The results of this work may ultimately lead to the development of a manatee warning system that can warn boaters of the presence of manatees.

  12. Recording vocalizations with Bluetooth technology.

    Science.gov (United States)

    Gaona-González, Andrés; Santillán-Doherty, Ana María; Arenas-Rosas, Rita Virginia; Muñoz-Delgado, Jairo; Aguillón-Pantaleón, Miguel Angel; Ordoñez-Gómez, José Domingo; Márquez-Arias, Alejandra

    2011-06-01

    We propose a method for capturing vocalizations that is designed to avoid some of the limiting factors found in traditional bioacoustical methods, such as the impossibility of obtaining continuous long-term registers or analyzing amplitude due to the continuous change of distance between the subject and the position of the recording system. Using Bluetooth technology, vocalizations are captured and transmitted wirelessly into a receiving system without affecting the quality of the signal. The recordings of the proposed system were compared to those obtained as a reference, which were based on the coding of the signal with the so-called pulse-code modulation technique in WAV audio format without any compressing process. The evaluation showed p < .05 for the measured quantitative and qualitative parameters. We also describe how the transmitting system is encapsulated and fixed on the animal and a way to video record a spider monkey's behavior simultaneously with the audio recordings.

  13. Ultrasonic vocalizations emitted by flying squirrels.

    Directory of Open Access Journals (Sweden)

    Meghan N Murrant

    Full Text Available Anecdotal reports of ultrasound use by flying squirrels have existed for decades, yet there has been little detailed analysis of their vocalizations. Here we demonstrate that two species of flying squirrel emit ultrasonic vocalizations. We recorded vocalizations from northern (Glaucomys sabrinus and southern (G. volans flying squirrels calling in both the laboratory and at a field site in central Ontario, Canada. We demonstrate that flying squirrels produce ultrasonic emissions through recorded bursts of broadband noise and time-frequency structured frequency modulated (FM vocalizations, some of which were purely ultrasonic. Squirrels emitted three types of ultrasonic calls in laboratory recordings and one type in the field. The variety of signals that were recorded suggest that flying squirrels may use ultrasonic vocalizations to transfer information. Thus, vocalizations may be an important, although still poorly understood, aspect of flying squirrel social biology.

  14. Universal vocal signals of emotion

    OpenAIRE

    Sauter, D.; Eisner, F.; Ekman, P.; Scott, S.

    2009-01-01

    Emotional signals allow for the sharing of important information with conspecifics, for example to warn them of danger. Humans use a range of different cues to communicate to others how they feel, including facial, vocal, and gestural signals. Although much is known about facial expressions of emotion, less research has focused on affect in the voice. We compare British listeners to individuals from remote Namibian villages who have had no exposure to Western culture, and examine recognition ...

  15. Vocal attractiveness increases by averaging.

    Science.gov (United States)

    Bruckert, Laetitia; Bestelmeyer, Patricia; Latinus, Marianne; Rouger, Julien; Charest, Ian; Rousselet, Guillaume A; Kawahara, Hideki; Belin, Pascal

    2010-01-26

    Vocal attractiveness has a profound influence on listeners-a bias known as the "what sounds beautiful is good" vocal attractiveness stereotype [1]-with tangible impact on a voice owner's success at mating, job applications, and/or elections. The prevailing view holds that attractive voices are those that signal desirable attributes in a potential mate [2-4]-e.g., lower pitch in male voices. However, this account does not explain our preferences in more general social contexts in which voices of both genders are evaluated. Here we show that averaging voices via auditory morphing [5] results in more attractive voices, irrespective of the speaker's or listener's gender. Moreover, we show that this phenomenon is largely explained by two independent by-products of averaging: a smoother voice texture (reduced aperiodicities) and a greater similarity in pitch and timbre with the average of all voices (reduced "distance to mean"). These results provide the first evidence for a phenomenon of vocal attractiveness increases by averaging, analogous to a well-established effect of facial averaging [6, 7]. They highlight prototype-based coding [8] as a central feature of voice perception, emphasizing the similarity in the mechanisms of face and voice perception.

  16. Aesthetic and Culture Origin of Vocal Art

    Institute of Scientific and Technical Information of China (English)

    张延春

    2010-01-01

    As one of the most commonly and widely adopted art forms, vocal art has been closely related with national culture and the aesthetics trend. Traditional Chinese vocal art rooted from China' s long history and distinctive culture. On the contrary, Italian bel canto stems from the prospect of Italian Opera Art during the Renaissance period. This essay discusses the differences between East and West vocal art, from its aesthetic and culture origin.

  17. Vocal Assessment Before, After, and the Day After Opera Performance.

    Science.gov (United States)

    McHenry, Monica; Evans, Joseph; Powitzky, Eric

    2016-03-01

    To explore aerodynamic, acoustic, and laryngeal changes surrounding opera performance. Prospective preperformance, postperformance, and day after performance. The laryngeal and vocal function of five male and five female classically trained singers was assessed immediately before, immediately after, and 1 day after an actual operatic performance. Phonatory threshold pressure was obtained. In addition, during a full-voice singing task, aerodynamic and acoustic measures included estimated subglottal pressure, airflow during voicing, laryngeal resistance, and sound pressure level (SPL). Expert listeners in the audience judged performers' voice quality at the beginning and the end of the performance. Laryngeal visualization was performed immediately before performance and the day after performance. Laryngeal stroboscopy revealed allergy symptoms with no change in vocal fold edges for all men. Women were less impacted by allergies. For all singers, perceptual judgments of expert listeners in the audience corresponded well with laryngeal findings. The men whose voices were perceived to be balanced and strong across the performance demonstrated increased airflow and reduced laryngeal resistance after performance. The two women who did not sing in church the morning after the performance demonstrated increased airflow and reduced laryngeal resistance. The two men who did sing in church the morning after the performance demonstrated noticeably reduced SPL and increased laryngeal resistance the day after performance. It appears most useful to describe the complexity of vocal performance with a variety of acoustic, aerodynamic, and perceptual measures. The findings further suggest that vocal rest the day after performance may facilitate recovery. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  18. Endometrial polyps and associated factors in Danish women aged 36-74 years

    DEFF Research Database (Denmark)

    Dreisler, Eva; Sorensen, Soren Stampe; Lose, Gunnar

    2008-01-01

    , the following was positively associated with endometrial polyps: current use of hormone therapy (odds ratio, 2.81; 95% CI, 1.29-6.13) and being overweight (body mass index > 25 kg/m(2)) (odds ratio, 2.06; 95% CI, 1.12-3.79) (postmenopausal women). Negatively associated was use of oral contraceptive pills (odds...... women were positively associated, whereas the use of oral contraceptive pills was negatively associated with endometrial polyps. Hypertension and cervical polyps were not associated with endometrial polyps. Endometrial polyps were infrequently related to premalignant and malignant disease....

  19. The natural course of endometrial polyps: could they vanish when left untreated?

    Science.gov (United States)

    Haimov-Kochman, Ronit; Deri-Hasid, Revital; Hamani, Yaron; Voss, Ernst

    2009-08-01

    To report the occurrence of spontaneous regression of three endometrial polyps detected by hysteroscopy. Case series. A uterine imaging unit in an academic medical center. Three patients diagnosed as having an endometrial polyp of 5-8 mm on hysteroscopy. Patient deferral of the surgical procedure for several months. Presence of a uterine polyp in the next hysteroscopy. The polyps disappeared spontaneously. Deferral of hysteroscopic polypectomy for a few months in asymptomatic women in the hope of spontaneous regression of the polyps may be justified.

  20. Inflammatory fibroid polyp occurring in the transverse colon diagnosed by endoscopic biopsy

    Institute of Scientific and Technical Information of China (English)

    Shoji Hirasaki; Minoru Matsubara; Fusao Ikeda; Hideaki Taniguchi; Seiyuu Suzuki

    2007-01-01

    A case of an inflammatory fibroid polyp occurring in the transverse colon and diagnosed by endoscopic biopsy is reported. The patient was an 82-year-old man who visited our hospital for further evaluation of occult blood in stool. The Colonoscopy revealed a small,red, and peduncular polyp, about 6 mm in diameter,in the transverse colon. Histological examination of the biopsy specimen obtained from the polyp revealed proliferation of fibroblasts and infiltration of inflammatory cells such as plasma cells and eosinophils. This polyp was diagnosed as an inflammatory fibroid polyp, which can appear in many different locations throughout gastrointestinal tract, though still rare in the transverse colon.

  1. Automated classification of colon polyps in endoscopic image data

    Science.gov (United States)

    Gross, Sebastian; Palm, Stephan; Tischendorf, Jens J. W.; Behrens, Alexander; Trautwein, Christian; Aach, Til

    2012-03-01

    Colon cancer is the third most commonly diagnosed type of cancer in the US. In recent years, however, early diagnosis and treatment have caused a significant rise in the five year survival rate. Preventive screening is often performed by colonoscopy (endoscopic inspection of the colon mucosa). Narrow Band Imaging (NBI) is a novel diagnostic approach highlighting blood vessel structures on polyps which are an indicator for future cancer risk. In this paper, we review our automated inter- and intra-observer independent system for the automated classification of polyps into hyperplasias and adenomas based on vessel structures to further improve the classification performance. To surpass the performance limitations we derive a novel vessel segmentation approach, extract 22 features to describe complex vessel topologies, and apply three feature selection strategies. Tests are conducted on 286 NBI images with diagnostically important and challenging polyps (10mm or smaller) taken from our representative polyp database. Evaluations are based on ground truth data determined by histopathological analysis. Feature selection by Simulated Annealing yields the best result with a prediction accuracy of 96.2% (sensitivity: 97.6%, specificity: 94.2%) using eight features. Future development aims at implementing a demonstrator platform to begin clinical trials at University Hospital Aachen.

  2. Computer Aided Detection of Polyps in CT Colonography

    NARCIS (Netherlands)

    Van Ravesteijn, V.F.

    2013-01-01

    CT colonography (CTC) is a minimally invasive method for detection of colorectal polyps and colon cancer. Limitations of CTC related to the efficiency as well as the sensitivity of radiologists. Additionally, the patient's preparation was considered burdensome and the X-ray radiation that is inheren

  3. Thermal and Osmotic Tolerance of 'Irukandji' Polyps: Cubozoa; Carukia barnesi.

    Directory of Open Access Journals (Sweden)

    Robert Courtney

    Full Text Available This research explores the thermal and osmotic tolerance of the polyp stage of the Irukandji jellyfish Carukia barnesi, which provides new insights into potential polyp habitat suitability. The research also targets temperature, salinity, feeding frequency, and combinations thereof, as cues for synchronous medusae production. Primary findings revealed 100% survivorship in osmotic treatments between 19 and 46‰, with the highest proliferation at 26‰. As salinity levels of 26‰ do not occur within the waters of the Great Barrier Reef or Coral Sea, we conclude that the polyp stage of C. barnesi is probably found in estuarine environments, where these lower salinity conditions commonly occur, in comparison to the medusa stage, which is oceanic. Population stability was achieved at temperatures between 18 and 31°C, with an optimum temperature of 22.9°C. We surmise that C. barnesi polyps may be restricted to warmer estuarine areas where water temperatures do not drop below 18°C. Asexual reproduction was also positively correlated with feeding frequency. Temperature, salinity, feeding frequency, and combinations thereof did not induce medusae production, suggesting that this species may use a different cue, possibly photoperiod, to initiate medusae production.

  4. Glycoprotein expression by adenomatous polyps of the colon

    Science.gov (United States)

    Roney, Celeste A.; Xie, Jianwu; Xu, Biying; Jabour, Paul; Griffiths, Gary; Summers, Ronald M.

    2008-03-01

    Colon cancer is the second leading cause of cancer related deaths in the United States. Specificity in diagnostic imaging for detecting colorectal adenomas, which have a propensity towards malignancy, is desired. Adenomatous polyp specimens of the colon were obtained from the mouse model of colorectal cancer called adenomatous polyposis coli-multiple intestinal neoplasia (APC Min). Histological evaluation, by the legume protein Ulex europaeus agglutinin I (UEA-1), determined expression of the glycoprotein α-L-fucose. FITC-labelled UEA-1 confirmed overexpression of the glycoprotein by the polyps on fluorescence microscopy in 17/17 cases, of which 13/17 included paraffin-fixed mouse polyp specimens. In addition, FITC-UEA-1 ex vivo multispectral optical imaging of 4/17 colonic specimens displayed over-expression of the glycoprotein by the polyps, as compared to non-neoplastic mucosa. Here, we report the surface expression of α-L-fucosyl terminal residues by neoplastic mucosal cells of APC specimens of the mouse. Glycoprotein expression was validated by the carbohydrate binding protein UEA-1. Future applications of this method are the development of agents used to diagnose cancers by biomedical imaging modalities, including computed tomographic colonography (CTC). UEA-1 targeting to colonic adenomas may provide a new avenue for the diagnosis of colorectal carcinoma by CT imaging.

  5. European Position Paper on Rhinosinusitis and Nasal Polyps 2012.

    Science.gov (United States)

    Fokkens, Wytske J; Lund, Valerie J; Mullol, Joachim; Bachert, Claus; Alobid, Isam; Baroody, Fuad; Cohen, Noam; Cervin, Anders; Douglas, Richard; Gevaert, Philippe; Georgalas, Christos; Goossens, Herman; Harvey, Richard; Hellings, Peter; Hopkins, Claire; Jones, Nick; Joos, Guy; Kalogjera, Livije; Kern, Bob; Kowalski, Marek; Price, David; Riechelmann, Herbert; Schlosser, Rodney; Senior, Brent; Thomas, Mike; Toskala, Elina; Voegels, Richard; Wang, De Yun; Wormald, Peter John

    2012-03-01

    The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007.The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps and chronic rhinosinusitis with nasal polyps are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed.

  6. Case Report of Nasal Polyp Treated by Acupuncture

    Institute of Scientific and Technical Information of China (English)

    蒋传义

    2007-01-01

    @@ A Patient, female, student, nineteen years old.She was diagnosed with rhinitis and nasal polyps at the age of 17, and was treated with many methods,but the disease was not cured. The patient and her parents were fearful of surgical treatment, so she came for acupuncture therapy.

  7. Aragonite precipitation by "proto-polyps" in coral cell cultures.

    Directory of Open Access Journals (Sweden)

    Tali Mass

    Full Text Available The mechanisms of coral calcification at the molecular, cellular and tissue levels are poorly understood. In this study, we examine calcium carbonate precipitation using novel coral tissue cultures that aggregate to form "proto-polyps". Our goal is to establish an experimental system in which calcification is facilitated at the cellular level, while simultaneously allowing in vitro manipulations of the calcifying fluid. This novel coral culturing technique enables us to study the mechanisms of biomineralization and their implications for geochemical proxies. Viable cell cultures of the hermatypic, zooxanthellate coral, Stylophora pistillata, have been maintained for 6 to 8 weeks. Using an enriched seawater medium with aragonite saturation state similar to open ocean surface waters (Ω(arag~4, the primary cell cultures assemble into "proto-polyps" which form an extracellular organic matrix (ECM and precipitate aragonite crystals. These extracellular aragonite crystals, about 10 µm in length, are formed on the external face of the proto-polyps and are identified by their distinctive elongated crystallography and X-ray diffraction pattern. The precipitation of aragonite is independent of photosynthesis by the zooxanthellae, and does not occur in control experiments lacking coral cells or when the coral cells are poisoned with sodium azide. Our results demonstrate that proto-polyps, aggregated from primary coral tissue culture, function (from a biomineralization perspective similarly to whole corals. This approach provides a novel tool for investigating the biophysical mechanism of calcification in these organisms.

  8. Considerações sobre modificações vocais e laríngeas ocasionadas pelo som basal em mulheres sem queixa vocal Considerations regarding vocal and laryngeal modifications caused by vocal fry in women without voice complaints

    Directory of Open Access Journals (Sweden)

    Débora Meurer Brum

    2010-01-01

    vowel /a/ and the videostroboscopic examination of the larynx. Both laryngeal and vocal data found prior to and after the vocal fry technique were submitted to acoustic, auditory-perceptive, and videostroboscopic analyses. The acoustic analysis was generated by the Multi Speech program. Analyses showed the following effects of the vocal fry: increase of the vibration of the vocal folds mucosa; alteration or maintenance of voice type and pitch; decrease or maintenance of measures related to jitter and shimmer, as well as the index that suggests glottic noise; decrease of the soft phonation index; maintenance or alteration of the vocal quality and resonance focus, with laryngopharyngeal prevalence; decrease of the fundamental frequency; and increase of frequency and width variations. The study allowed the conclusion that vocal fry had a positive effect on the vibration of the vocal folds mucosa as well as on voice noise, and a negative effect on voice resonance and stability.

  9. Association between Obesity, Serum Lipids, and Colorectal Polyps in Old Chinese People

    Directory of Open Access Journals (Sweden)

    Wen Yang

    2013-01-01

    Full Text Available Background. Colorectal cancer mostly arises from the polyps of colon. The aim of our study was to examine the association of body mass index (BMI and serum lipids with the colorectal polyps in old Chinese people. Methods. The risk of developing colorectal polyps was studied in 244 subjects (212 men and 32 women, 74.63 ± 11.63 years old who underwent colonoscopy for the first time from January 2008 to July 2012 at the Navy General Hospital, Beijing, China. According to the results of colonoscopy, all the subjects were divided into 112 normal control, 38 right colorectal polyps, 53 left colorectal polyps, and 41 both right and left colorectal polyps groups. The total plasma cholesterol, plasma triglyceride, plasma creatinine concentration, blood urinary nitrogen, and fasting glucose were determined using a multichannel analyzer. Results. There were significant differences among normal control, right colorectal polyps, left colorectal polyps, and both right and left polyps groups, which were the BMI, total cholesterol, triglycerides, creatinine, and urinary nitrogen. In binary logistic regression analysis, there were two risk factors associated with the occurrence of colorectal polyps, which included BMI and systolic blood pressure. Conclusions. Colorectal polyps were significantly associated with increased BMI, total cholesterol, and triglycerides levels.

  10. [Vocal care: question of prevention and health].

    Science.gov (United States)

    Guimarães, Valeriana de Castro; Viana, Maria Aparecida do Divino Espírito Santo Reis; Barbosa, Maria Alves; Paiva, Maria Luiza de Faria; Tavares, João Antonio Gomes; Camargo, Leandro Azevedo de

    2010-09-01

    Planned by Brazilian doctors, the National Week of the Voice (Semana Nacional da Voz) conquered the world due to the huge reached success. This study has the objective to demonstrate the results reached during the 9th National Week of the Voice (9ª Semana Nacional da Voz) that took place in the Hospital das Clínicas of the Federal University of Goiás. During the event, 125 patients had been selected by the phonoaudiology team and manually filled a questionnaire elaborated for the campaign in the validity of possible pharyngolaryngeal alterations. The patients had been examined by the otorhinolaryngologist using indirect laryngoscopy and, when necessary, submitted to videolaryngoscopy. After medical evaluation, it was observed that 52 people (41.6%) had presented alterations in the speech organs or in proximal regions, in one patient paralysis of left vocal fold was detected and one patient presented tumoral injury. Considering all the patients attended, only one presented malignant neoplasm (squamous cell carcinoma), confirmed later by biopsy.

  11. Quantification of the vocal folds’ dynamic displacements

    Science.gov (United States)

    del Socorro Hernández-Montes, María; Muñoz, Silvino; De La Torre, Manuel; Flores, Mauricio; Pérez, Carlos; Mendoza-Santoyo, Fernando

    2016-05-01

    Fast dynamic data acquisition techniques are required to investigate the motional behavior of the vocal folds (VFs) when they are subjected to a steady air-flow through the trachea. High-speed digital holographic interferometry (DHI) is a non-invasive full-field-of-view technique that has proved its usefulness to study rapid and non-repetitive object movements. Hence it is an ideal technique used here to measure VF displacements and vibration patterns at 2000 fps. Analyses from a set of 200 displacement images showed that VFs’ vibration cycles are established along their width (y) and length (x). Furthermore, the maximum deformation for the right and left VFs’ area may be quantified from these images, which in itself represents an important result in the characterization of this structure. At a controlled air pressure, VF displacements fall within the range ~100-1740 nm, with a calculated precision and accuracy that yields a variation coefficient of 1.91%. High-speed acquisition of full-field images of VFs and their displacement quantification are on their own significant data in the study of their functional and physiological behavior since voice quality and production depend on how they vibrate, i.e. their displacement amplitude and frequency. Additionally, the use of high speed DHI avoids prolonged examinations and represents a significant scientific and technological alternative contribution in advancing the knowledge and working mechanisms of these tissues.

  12. Reinterpretation of histology of proximal colon polyps called hyperplastic in 2001

    Institute of Scientific and Technical Information of China (English)

    Omer Khalid; Sofyan Radaideh; Oscar W Cummings; Michael J O'Brien; John R Goldblum; Douglas K Rex

    2009-01-01

    AIM: To evaluate how proximal colon polyps interpreted as hyperplastic polyps in 2001 would be interpreted by expert pathologists in 2007. METHODS: Forty consecutive proximal colon polyps ≥ 5 mm in size, removed in 2001, and originally interpreted as hyperplastic polyps by general pathologists at Indiana University, were reviewed in 2007 by 3 GI pathologists. RESULTS: The gastrointestinal (GI) pathologists interpreted 85%, 43% and 30% of the polyps as sessile serrated polyps (sessile serrated adenomas). The overall Kappa was 0.16. When diagnoses were compared in pairs, Kappa values were 0.38 and 0.25 (fair agreement) and 0.14 (slight agreement). CONCLUSION: Many polyps interpreted as hyperplastic in 2001 were considered sessile serrated lesions by GI pathologists in 2007, but there is substantial inter-observer variation amongst GI pathologists.

  13. Feasibility of coblation versus laser resection in recurrent nasal polyps

    Science.gov (United States)

    Ilgner, Justus; Schramm, Karsten; Duwel, Philip; Donner, Andreas; Westhofen, Martin

    2005-04-01

    Introduction: Chronic sinusitis with nasal polyps is one of the commonest diseases of the upper airways, with a recurrence rate of about 15%. Minimally-invasive endoscopic laser procedures have been established to reduce the need for conventional revision surgery whenever medical follow-up fails. However, laser surgery requires special considerations for surgical, safety and economic aspects. This study evaluates the feasibility of coblation versus laser resection for recurrent nasal polyps. Material and methods: 6 nasal polyps were harvested each from the ostiomeatal complex of patients undergoing microscopic endonasal surgery for chronic sinusitis. 3 were dissected using a Neodymium:YAG laser system (Dornier MediLas 5060N) set at 10, 20 and 30w in cw mode with a 600μm bare fiber in contact mode with negative feedback power control, while further 3 polyps were dissected using a Coblation system (ArthroCare® Coblator® I) with a 30° angled and a 0° straight probe with 2.4 mm outer diameter. The specimens were examined histologically for carbonization and coagulation as well as unaltered tissue. Results: Laser resection resulted in a carbonization zone of 30μm in depth plus a coagulation zone of about 100μm, depending on the water content and type of tissue. While the carbonization zone was smaller with coblation, coagulation zones were comparable, leaving ample amount of unaltered tissue available for further diagnosis. Conclusion: Both resection techniques are generally feasible to be used in day case surgery for recurrent polyps. While the coblation system required no special safety requirements, accessibility of the sinuses was limited by the rigidity of applicators that are available.

  14. Intravenous contrast enhanced computed tomography colonoscopy in children with suspected colonic polyps

    Energy Technology Data Exchange (ETDEWEB)

    Bhatia, Anmol, E-mail: anmol_bhatia26@yahoo.co.in [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160 012 (India); Saxena, Akshay K., E-mail: fatakshay@yahoo.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160 012 (India); Kalra, Naveen, E-mail: navkal2004@yahoo.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160 012 (India); Sodhi, Kushaljit S., E-mail: sodhiks@gmail.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160 012 (India); Thapa, Babu R., E-mail: brthapa1@yahoo.co.in [Division of Pediatric Gastroenterology, Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160 012 (India); Rao, Katragadda L.N., E-mail: klnrao@hotmail.com [Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160 012 (India); Khandelwal, Niranjan, E-mail: khandelwaln@hotmail.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160 012 (India)

    2013-06-15

    Objective: The purpose of this study was to evaluate the diagnostic performance of intravenous contrast enhanced computed tomographic colonoscopy (IVCTC) in the diagnosis of clinically suspected colorectal polyps in children, using conventional colonoscopy (CC) as the gold standard. Methods: This was a prospective study conducted between July 2008 and June 2010. 30 pediatric patients with history of rectal bleeding and clinically suspected to have colorectal polyps were enrolled. All of the patients underwent IVCTC followed by CC. 30 IVCTC and 31 CC were performed in 30 patients. The findings of IVCTC were compared with those of CC. Statistical analysis was performed to obtain diagnostic performance values of IVCTC on per polyp (sensitivity and positive predictive value) and per patient (sensitivity, specificity, positive predictive value and negative predictive value) basis. Results: By IVCTC, 63 polyps were detected in 28 patients of which 53 polyps were eligible for inclusion in the statistical analysis. 60 polyps were detected by CC in 28 patients of which 50 polyps were eligible for inclusion in the statistical analysis. The per polyp sensitivity and positive predictive values were 94% and 88.6% respectively. The per patient sensitivity, specificity, positive predictive value, and negative predictive values were 96.4, 50, 96.4, and 50% respectively. Twenty polyps, in 10 patients, were visualized only after intravenous contrast administration of which 5 polyps, in 5 patients, were likely to have been missed in the absence of the intravenous contrast injection as these polyps were submerged in fluid. Four patients would have had a false negative CTC examination if the intravenous contrast had not been injected; while in another patient, the number of polyps would have been underestimated. Conclusion: CTC is capable of serving as a safe and efficient non-invasive tool for evaluating children with clinically suspected colorectal polyps. Administration of

  15. Evaluation of clinico-pathological features and Helicobacter pylori infection in gastric inflammatory fibroid polyps.

    Science.gov (United States)

    Albuquerque, Andreia; Rios, Elisabete; Carneiro, Fátima; Macedo, Guilherme

    2014-12-01

    Inflammatory fibroid polyps are rare mesenchymal lesions. The frequency of Helicobacter pylori infection in the gastric mucosa overlying inflammatory fibroid polyps and its relation with the histologic features of the polyps are undetermined. The clinico-pathological features of inflammatory fibroid polyps, the frequency of Helicobacter pylori infection in the overlying gastric mucosa, and its putative impact on the phenotype of the polyps were evaluated. Gastric inflammatory fibroid polyps diagnosed in our Hospital from 1998 to 2012 were reviewed and the histological. The histological sections were stained with hematoxylin and eosin and modified Giemsa for the evaluation of Helicobacter pylori infection. Inconclusive cases were further analyzed by immunohistochemistry with anti-Helicobacter pylori antibody. Diagnosis was confirmed in 54 polyps, 85 % developed in females, mean age 63 ± 11 years. Most polyps were sessile (74 %), with a mean size of 15 ± 12 mm, 96 % were located in the antrum and 85 % were removed by snare polypectomy. Helicobacter pylori infection was identified in 48 % of the polyps. Most inflammatory fibroid polyps developed in the submucosa, and mucosal extension was observed in 96 % of the cases. Chronic gastritis was observed in all cases (63 % with activity, 31 % with intestinal metaplasia, and 61 % with foveolar hyperplasia). Erosion and ulceration of the overlying gastric mucosa was observed in 48 % and 11 % of the polyps, respectively. Onion skin features were present in 52 % of the polyps and were more frequently observed in cases without evidence of Helicobacter pylori infection. Background changes in gastric mucosa were not distinctive according to Helicobacter pylori infection. Chronic atrophic gastritis with intestinal metaplasia was associated with the presence of perivascular onion skin lesions. To our knowledge, this is the second largest series of gastric inflammatory fibroid polyps. Helicobacter pylori infection was

  16. Angiogenesis, fibrinogenesis and presence of synechiae after exeresis of a swine vocal fold mucosal microflap and use of topical mitomycin-C Estudo da angiogênese, fibrogênese e presença de sinéquias após exérese de fragmento de mucosa de pregas vocais de suínos utilizando instrumental frio e mitomicina-C tópica

    Directory of Open Access Journals (Sweden)

    Vinicius Ribas de Carvalho Duarte Fonseca

    2010-02-01

    Full Text Available PURPOSE: To evaluate swine vocal fold healing in a period of 30 days after topical mitomycin-C application. METHODS: Twelve swine underwent exeresis of mucosal flaps from the free edge of the anterior third of both vocal folds with a cold instrument (laryngeal scissors. The animals were divided into two groups: EG (Experimental Group, consisting of 6 animals undergoing topical MMC application (4 mg/dL on the operated area for 4 minutes; CG (Control Group, 6 animals undergoing topical saline solution application on the operated area for 4 minutes. After 30 days, the animals were sacrificed and the larynges were collected and examined for the presence of synechiae as well as a histological immunohistochemical assessment of immature and mature collagen deposition, number of blood vessels and myofibroblasts. RESULTS: Mature collagen deposition in the EG was 452.12 μm² and 1332.31μm² in the CG; immature collagen deposition was 1511.73μm² in the EG and 1020.61μm² in the CG. The number of myofibroblasts was 1.556 in the EG and 3.583 in the CG. The number of blood vessels was 2.565 in EG and 6.917 in the CG. There were no synechiae in the two studied groups. CONCLUSIONS: There was an increase in immature collagen deposition in the experimental group when compared with the control group. There was a decrease in mature collagen deposition in the experimental group when compared with the control group. There was a decrease in the number of myofibroblasts in the experimental group when compared with the control group. A decrease in blood vessels was observed in the experimental group when compared with the control group. There was no synechia formation in either studied group.OBJETIVO: Avaliar a cicatrização de pregas vocais de suínos utilizando mitomicina-C tópica, em 30 dias. MÉTODOS: Doze suínos foram submetidos à exérese de mucosa do bordo livre do terço anterior de ambas as pregas vocais com instrumental frio (tesoura curva e divididos

  17. Audio-vocal responses of vocal fundamental frequency and formant during sustained vowel vocalizations in different noises.

    Science.gov (United States)

    Lee, Shao-Hsuan; Hsiao, Tzu-Yu; Lee, Guo-She

    2015-06-01

    Sustained vocalizations of vowels [a], [i], and syllable [mə] were collected in twenty normal-hearing individuals. On vocalizations, five conditions of different audio-vocal feedback were introduced separately to the speakers including no masking, wearing supra-aural headphones only, speech-noise masking, high-pass noise masking, and broad-band-noise masking. Power spectral analysis of vocal fundamental frequency (F0) was used to evaluate the modulations of F0 and linear-predictive-coding was used to acquire first two formants. The results showed that while the formant frequencies were not significantly shifted, low-frequency modulations (production, the motor speech controls on F0 may depend on a feedback mechanism while articulation should rely more on a feedforward mechanism. Power spectral analysis of F0 might be applied to evaluate audio-vocal control for various hearing and neurological disorders in the future. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Fast protein folding kinetics

    Science.gov (United States)

    Gelman, Hannah; Gruebele, Martin

    2014-01-01

    Fast folding proteins have been a major focus of computational and experimental study because they are accessible to both techniques: they are small and fast enough to be reasonably simulated with current computational power, but have dynamics slow enough to be observed with specially developed experimental techniques. This coupled study of fast folding proteins has provided insight into the mechanisms which allow some proteins to find their native conformation well less than 1 ms and has uncovered examples of theoretically predicted phenomena such as downhill folding. The study of fast folders also informs our understanding of even “slow” folding processes: fast folders are small, relatively simple protein domains and the principles that govern their folding also govern the folding of more complex systems. This review summarizes the major theoretical and experimental techniques used to study fast folding proteins and provides an overview of the major findings of fast folding research. Finally, we examine the themes that have emerged from studying fast folders and briefly summarize their application to protein folding in general as well as some work that is left to do. PMID:24641816

  19. A galaxy of folds.

    Science.gov (United States)

    Alva, Vikram; Remmert, Michael; Biegert, Andreas; Lupas, Andrei N; Söding, Johannes

    2010-01-01

    Many protein classification systems capture homologous relationships by grouping domains into families and superfamilies on the basis of sequence similarity. Superfamilies with similar 3D structures are further grouped into folds. In the absence of discernable sequence similarity, these structural similarities were long thought to have originated independently, by convergent evolution. However, the growth of databases and advances in sequence comparison methods have led to the discovery of many distant evolutionary relationships that transcend the boundaries of superfamilies and folds. To investigate the contributions of convergent versus divergent evolution in the origin of protein folds, we clustered representative domains of known structure by their sequence similarity, treating them as point masses in a virtual 2D space which attract or repel each other depending on their pairwise sequence similarities. As expected, families in the same superfamily form tight clusters. But often, superfamilies of the same fold are linked with each other, suggesting that the entire fold evolved from an ancient prototype. Strikingly, some links connect superfamilies with different folds. They arise from modular peptide fragments of between 20 and 40 residues that co-occur in the connected folds in disparate structural contexts. These may be descendants of an ancestral pool of peptide modules that evolved as cofactors in the RNA world and from which the first folded proteins arose by amplification and recombination. Our galaxy of folds summarizes, in a single image, most known and many yet undescribed homologous relationships between protein superfamilies, providing new insights into the evolution of protein domains.

  20. Ultra structure of the denervated vocal muscle mechanically in hogs (sus scrofa domestica

    Directory of Open Access Journals (Sweden)

    Leão, Henrique Zaquia

    2010-03-01

    Full Text Available Introduction: The literature is not clear in the ultra-structural manifestations of the vocal wrinkles after neural wound. Objective: To verify the alterations that occur in a vocal fold mechanically denervated. Method: In this prospective study, it were utilized 15 hogs of commercial race (Sus scrofa domesticates, with age of 4 to 12 weeks. The animals were distributed in three groups, chosen at random. Everybody was submitted to the denervation of the right vocal fold, with surgical removal of a segment with three centimeters of the recurring right laryngeal nerve. After 45, 90 and 180 days of the operations, it was proceeded the biopsy of the vocal muscles, it was prosecuted the samples for transmission electron microscopy and, for the ultra-structural study, utilized the transmission electron microscopy Philips, model EM208S. Results: The biopsied groups with 45 and 90 days after operation of mechanical denervation, presented disorganization miofibrilar, only vestigial lines Z in many samples, as well like altered mithochondrions presenting limited sizes, and matrix mithocondrial rarefied with rare mithocondrial cristae present. The biopsied group with 180 days after operation of denervation, presented regular sarcomeres, mithocondrions with sizes and regular number with correct positioning between the sarcomerical units. Conclusion: The finds in the ultra-structure of the vocal muscles suggest to re enervation of the muscle being that the muscular mithochondrions were the most sensible structures to the denervated condition, successions by the cytoarchiteture of the miofibrilas; the finds in the ultra-structure of the vocal muscles suggests to reinervation of the muscle in the period of approximately six months.

  1. First Communion: The Emergence of Vocal Relationships.

    Science.gov (United States)

    Locke, John L.

    2001-01-01

    Proposes that vocal communion between infant and caregiver supports infants' language acquisition and connectedness with caregivers. Recommends research to determine whether social behaviors such as joint attention and vocal imitation are functionally related to language learning or are only symptomatic of a survival-centered caregiving…

  2. Pulmonary mucormycosis presenting with vocal cord paralysis

    OpenAIRE

    Gayathri Devi, H. J.; Mohan Rao, K.N.; K M Prathima; Moideen, Riyaz

    2013-01-01

    Pulmonary mucormycosis is a relatively uncommon infection. It can present in various forms. Very few cases of pulmonary mucormycosis presenting as vocal cord paralysis have been described in the literature. We report a case of pulmonary mucormycosis presenting as vocal cord paralysis in an uncontrolled diabetic patient.

  3. Phonetic characteristics of vocalizations during pain

    Directory of Open Access Journals (Sweden)

    Stefan Lautenbacher

    2017-06-01

    Conclusion:. Vocalization characteristics of pain seem to be best described by an increase in pitch and in loudness. Future studies using more specific and comprehensive phonetic analyses will surely help to provide an even more precise characterization of vocalizations because of pain.

  4. Comportamento vocal de cantores populares

    OpenAIRE

    Zimmer,Valquíria; Cielo,Carla Aparecida; Ferreira,Fernanda Mariotto

    2012-01-01

    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...

  5. Acoustic allometry revisited: morphological determinants of fundamental frequency in primate vocal production.

    Science.gov (United States)

    Garcia, Maxime; Herbst, Christian T; Bowling, Daniel L; Dunn, Jacob C; Fitch, W Tecumseh

    2017-09-05

    A fundamental issue in the evolution of communication is the degree to which signals convey accurate ("honest") information about the signaler. In bioacoustics, the assumption that fundamental frequency (f o) should correlate with the body size of the caller is widespread, but this belief has been challenged by various studies, possibly because larynx size and body size can vary independently. In the present comparative study, we conducted excised larynx experiments to investigate this hypothesis rigorously and explore the determinants of f o. Using specimens from eleven primate species, we carried out an inter-specific investigation, examining correlations between the minimum f o produced by the sound source, body size and vocal fold length (VFL). We found that, across species, VFL predicted minimum f o much better than body size, clearly demonstrating the potential for decoupling between larynx size and body size in primates. These findings shed new light on the diversity of primate vocalizations and vocal morphology, highlighting the importance of vocal physiology in understanding the evolution of mammal vocal communication.

  6. 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

  7. Insights on Coral Adaptation from Polyp and Colony Morphology, Skeletal Density Banding and Carbonate Depositional Facies

    Science.gov (United States)

    Oehlert, A. M.; Hill, C. A.; Piggot, A. M.; Fouke, B. W.

    2008-12-01

    As one of the core reservoirs of primary production in the world's oceans, tropical coral reefs support a complex ecosystem that directly impacts over ninety percent of marine organisms at some point in their life cycle. Corals themselves are highly complex organisms and exhibit a range of growth forms that range from branching to massive, foliaceous, columnar, encrusting, free living and laminar coralla. Fierce competition over scarce resources available to each individual coral species creates niche specialization. Throughout the Phanerozic geological record, this has driven speciation events and created distinct skeletal growth morphologies that have differential abilities in feeding strategy. In turn, this has presumably led to the development of niche specialization that can be quantitatively measured through hierarchical morphological differences from the micrometer to the meter scale. Porter (1976) observed significant differences in skeletal morphology between Caribbean coral species that reflects an adaptive geometry based on feeding strategy. Within the Montastraea species complex there are four major morphologies; columnar, bouldering, irregular mounding, and skirted. Each morphotype can be found forming high abundance along the bathymetric gradient of coral reefs that grow along the leeward coast of Curacao, Netherlands Antilles. We have undertaken a study to determine the relative relationships amongst coral morphology, skeletal density and feeding strategy by comparing the morphometric measurements of individual polyps as well as the entire colony along spatial and bathymetric gradients. Polyp diameter, mouth size, interpolyp area, and interpolyp distance were measured from high-resolution images taken on a stereoscope, and evaluated with AxioVision image analysis software. These high-resolution optical analyses have also revealed new observations regarding folded tissue structures of the outer margin of polyps in the Montastrea complex. Skeletal

  8. On Safe Folding

    NARCIS (Netherlands)

    Bossi, Annalisa; Cocco, Nicoletta; Etalle, Sandro; Bruynooghe, Maurice; Wirsing, Martin

    1993-01-01

    In [3] a general fold operation has been introduced for definite programs wrt computed answer substitution semantics. It differs from the fold operation defined by Tamaki and Sato in [26,25] because its application does not depend on the transformation history. This paper extends the results in [3

  9. Fast protein folding kinetics.

    Science.gov (United States)

    Gelman, Hannah; Gruebele, Martin

    2014-05-01

    Fast-folding proteins have been a major focus of computational and experimental study because they are accessible to both techniques: they are small and fast enough to be reasonably simulated with current computational power, but have dynamics slow enough to be observed with specially developed experimental techniques. This coupled study of fast-folding proteins has provided insight into the mechanisms, which allow some proteins to find their native conformation well fast folders also informs our understanding of even 'slow' folding processes: fast folders are small; relatively simple protein domains and the principles that govern their folding also govern the folding of more complex systems. This review summarizes the major theoretical and experimental techniques used to study fast-folding proteins and provides an overview of the major findings of fast-folding research. Finally, we examine the themes that have emerged from studying fast folders and briefly summarize their application to protein folding in general, as well as some work that is left to do.

  10. Association between the location of colon polyps at baseline and surveillance colonoscopy: a retrospective study

    Directory of Open Access Journals (Sweden)

    Ana Oliveira

    Full Text Available Introduction: Several factors are used to stratify the probability of polyp recurrence. However, there are no studies correlating the location of the initial polyps and the recurrent ones. The aim of this study was to verify whether the polyp location at the surveillance colonoscopy was correlated with the location of the previously excised polyps at the baseline colonoscopy. Methods: A retrospective study of patients submitted to colonoscopy with presence and excision of all polyps, followed by a surveillance colonoscopy. Polyp location was divided into proximal/distal to splenic flexure and rectum. Characteristics and recurrent rates at the same colon location were also evaluated. Results: Out of the 346 patients who underwent repeated colonoscopy, 268 (77.4% had at least 1 polyp detected. For all the segments there was an increased risk of recurrent polyps in the same location and it was about four times higher in proximal (OR 3.5; CI 2.1-6.0 and distal colon segments (OR 3.8; CI 2.1-6.8, followed by three times higher in the rectum (OR 2.6; CI 1.5-4.6. No difference was found between the rates of recurrence at the same segment, taking into consideration the polyp morphology, size, polypectomy technique employed and histological classification. Conclusion: There seems to be a significant association between polyp location at baseline and surveillance colonoscopy.

  11. Folding by Design

    Science.gov (United States)

    Dodd, Paul; Damasceno, Pablo; Glotzer, Sharon

    2014-03-01

    A form of self-assembly, ``self-folding'' presents an alternative approach to the creation of reconfigurable, responsive materials with applications ranging from robotics to drug design. However, the complexity of interactions present in biological and engineered systems that undergo folding makes it challenging to isolate the main factors controlling their assembly and dis-assembly. Here we use computer simulations of simple, minimalistic self-foldable structures and investigate their stochastic folding process. By dynamically accessing all the states that lead to, or inhibit, successful folding, we show that the mechanisms by which general stochastic systems can achieve their ``native'' structures can be identified and used to design rules for optimized folding propensity. Research supported by the National Science Foundation, Emerging Frontiers in Research and Innovation Award # EFRI-1240264.

  12. KRAS and BRAF somatic mutations in colonic polyps and the risk of metachronous neoplasia.

    Science.gov (United States)

    Juárez, Miriam; Egoavil, Cecilia; Rodríguez-Soler, María; Hernández-Illán, Eva; Guarinos, Carla; García-Martínez, Araceli; Alenda, Cristina; Giner-Calabuig, Mar; Murcia, Oscar; Mangas, Carolina; Payá, Artemio; Aparicio, José R; Ruiz, Francisco A; Martínez, Juan; Casellas, Juan A; Soto, José L; Zapater, Pedro; Jover, Rodrigo

    2017-01-01

    High-risk features of colonic polyps are based on size, number, and pathologic characteristics. Surveillance colonoscopy is often recommended according to these findings. This study aimed to determine whether the molecular characteristics of polyps might provide information about the risk of metachronous advanced neoplasia. We retrospectively included 308 patients with colonic polyps. A total of 995 polyps were collected and tested for somatic BRAF and KRAS mutations. Patients were classified into 3 subgroups, based on the polyp mutational profile at baseline, as follows: non-mutated polyps (Wild-type), at least one BRAF-mutated polyp, or at least one KRAS-mutated polyp. At surveillance, advanced adenomas were defined as adenomas ≥ 10 mm and/or with high grade dysplasia or a villous component. In contrast, advanced serrated polyps were defined as serrated polyps ≥ 10 mm in any location, located proximal to the splenic flexure with any size or with dysplasia. At baseline, 289 patients could be classified as wild-type (62.3%), BRAF mutated (14.9%), or KRAS mutated (22.8%). In the univariate analysis, KRAS mutations were associated with the development of metachronous advanced polyps (OR: 2.36, 95% CI: 1.22-4.58; P = 0.011), and specifically, advanced adenomas (OR: 2.42, 95% CI: 1.13-5.21; P = 0.023). The multivariate analysis, adjusted for age and sex, also showed associations with the development of metachronous advanced polyps (OR: 2.27, 95% CI: 1.15-4.46) and advanced adenomas (OR: 2.23, 95% CI: 1.02-4.85). Our results suggested that somatic KRAS mutations in polyps represent a potential molecular marker for the risk of developing advanced neoplasia.

  13. Human Papillomavirus (HPV Prevalence in Nasal and Antrochoanal Polyps and Association with Clinical Data.

    Directory of Open Access Journals (Sweden)

    Mareike Knör

    Full Text Available The pathogenesis of sinonasal polyposis remains unclear, in spite of several investigative approaches. Antrochoanal polyps, a subgroup of sinonasal polyposis along with allergic- and chronic-inflammatory nasal polyps, mostly originate from the maxillary sinus and develop as a unilateral, pedunculated mass towards the nasopharynx. The human papillomavirus (HPV is discussed as a possible causative and influencing factor in development and progression of sinonasal polyposis. This study aims to elucidate HPV frequency in nasal polyps and antrochoanal polyps.Genomic DNA from 257 tissue specimens (166 nasal polyps, 39 antrochoanal polyps and 52 nasal turbinates was subjected to three different established HPV- polymerase chain reaction assays, testing for 37 low- and high-risk HPV. In addition, immunohistochemical analyses for HPV16 were carried out, as well as immunohistochemistry and western blots of p16, a biomarker for HPV induced cancer.HPV-DNA was detected in 53.8% of antrochoanal polyps, 15.1% of nasal polyps, and 5.8% of nasal turbinates. HPV16 was the predominant type with a detection rate of 76% in nasal polyps and 62% in antrochoanal polyps. Immunohistochemically, HPV positive tissues stained positive for HPV16 antigens and p16 in epithelial cell layers. No significant p16 overexpression was traceable in antrochoanal polyps, nasal polyps and nasal turbinates by western blot. There was no correlation of HPV-status with sex, age, smoking, alcohol consumption or allergic background.The present study shows a significant frequency of high-risk type HPV16 in antrochoanal polyps. Absence of oncogenic transformation or correlation of the HPV-status with clinical data suggests a latent superinfection, possibly because of anatomical proximity to the oropharynx.

  14. Histomorphometric analysis of collagen and elastic fibres in the cranial and caudal fold of the porcine glottis.

    Science.gov (United States)

    Lang, A; Koch, R; Rohn, K; Gasse, H

    2015-06-01

    The porcine glottis differs from the human glottis in its cranial and caudal vocal folds (CraF, CauF). The fibre apparatus of these folds was studied histomorphometrically in adult minipigs. For object definition and quantification, the colour-selection tools of the Adobe-Photoshop program were used. Another key feature was the subdivision of the cross-sections of the folds into proportional subunits. This allowed a statistical analysis irrespective of differences in thickness of the folds. Both folds had a distinct, dense subepithelial layer equivalent to the basement membrane zone in humans. The subsequent, loose layer was interpreted - in principle - as being equivalent to Reinke's space of the human vocal fold. The next two layers were not clearly separated. Due to this, the concept of a true vocal ligament did not appear applicable to neither CauF nor CraF. Instead, the body-cover model was emphasized by our findings. The missing vocalis muscle in the CraF is substituted by large collagen fibre bundles in a proportional depth corresponding to the position of the muscle of the CauF. The distribution of elastic fibres made the CraF rather than the CauF more similar to the human vocal fold. We suggest that these data are useful for those wishing to use the porcine glottis as a model for studying oscillatory properties during phonation.

  15. Collagen Microstructure in the Vocal Ligament: Initial Results on the Potential Effects of Smoking

    Science.gov (United States)

    Kelleher, Jordan E.; Siegmund, Thomas; Chan, Roger W.

    2014-01-01

    Objective This investigation quantitatively characterizes the collagenous microstructure of human vocal ligament specimens excised postmortem from non-smokers and smokers. Study Design Retrospective Cohort Study Methods Second harmonic generation (SHG) imaging was performed at three anatomical locations of vocal ligament specimens: anterior, mid-membranous, and posterior regions. Two microstructural parameters were extracted from the SHG images: (1) normalized fiber density, and (2) fiber dispersion coefficient, quantifying the degree of collagen fiber dispersion about a preferred direction. Results For both the non-smoker and smoker subjects, the fiber dispersion coefficient was heterogeneous. Differences in the collagenous structure of non-smokers and smoker subjects were pronounced at the mid-membranous location. However, the directionality of the heterogeneity in the smoker subjects was opposite to that in the non-smoker subjects. Specifically, the fiber dispersion coefficient in the non-smoker subjects was lower in the midmembranous region (indicating more fiber alignment) than at the anterior/posterior regions, but for the smoker subjects the fiber dispersion coefficient was higher at the mid-membranous region. The normalized fiber density was near constant in the non-smoker subjects, but the smoker subjects had fewer fibers in the mid-membranous region than at the anterior/posterior regions. Conclusion Spatial microstructural variations may exist in the vocal fold ligament both in non-smokers and smokers. Smoking appears to influence the degree and direction of microstructure heterogeneity in the vocal fold ligament. PMID:24473992

  16. Analysis of VHI in Patients with Vocal Polyps or Vocal Nodules%声带息肉和声带小结的VHI分析

    Institute of Scientific and Technical Information of China (English)

    黄雪琨; 刘秀金; 朱玲; 刘红

    2013-01-01

    目的 探讨声带息肉和声带小结嗓音障碍指数(VHI)的临床意义及其相关性.方法 分别对声带息肉组(n = 35)、声带小结组(n=29)及对照组(n=22)进行VHI调查,VHI调查包括功能(F)、生理(P)、情感(E)三个范畴,记录三方面得分及总分(TVH)分值.结果 声带息肉组VHI的F、P、E、TVH平均值分别为9.57±7.62,18.86±8.91,8.97±8.77,36.83±21.32分,声带小结组VHI的F、P、E、TVH平均值分别为9.75±7.87,20.62±7.95,7.62±7.79,38.00±20.78分,正常组的VHI的F、P、E、TVH平均值分别为0.55±0.80,0.73±1.03,0,1.27±1.67分,声带息肉和声带小结的VHI平均值均高于对照组(P<0.01),声带息肉和声带小结VHI平均值比较,P>0.05;声带息肉和声带小结患者每日说话时间、病程与VHI之间无相关性(P>0.05);声带息肉的职业用声者VHI (39.48±22.67)和非用声职业(27.88±13.42)比较,P>0.05;声带小结的职业用声者的VHI平均值(42.35±22.11)和非职业用声者(31.83±17.82)比较,差异亦无统计学意义(P>0.05).结论 声带息肉和声带小结的VHI可主观反映患者嗓音障碍程度,每日说话时间、病程和职业不是VHI的影响因素.

  17. Discriminating dysplasia: Optical tomographic texture analysis of colorectal polyps.

    Science.gov (United States)

    Li, Wenqi; Coats, Maria; Zhang, Jianguo; McKenna, Stephen J

    2015-12-01

    Optical projection tomography enables 3-D imaging of colorectal polyps at resolutions of 5-10 µm. This paper investigates the ability of image analysis based on 3-D texture features to discriminate diagnostic levels of dysplastic change from such images, specifically, low-grade dysplasia, high-grade dysplasia and invasive cancer. We build a patch-based recognition system and evaluate both multi-class classification and ordinal regression formulations on a 90 polyp dataset. 3-D texture representations computed with a hand-crafted feature extractor, random projection, and unsupervised image filter learning are compared using a bag-of-words framework. We measure performance in terms of error rates, F-measures, and ROC surfaces. Results demonstrate that randomly projected features are effective. Discrimination was improved by carefully manipulating various important aspects of the system, including class balancing, output calibration and approximation of non-linear kernels.

  18. [Detection of T-antigen in colorectal adenocarcinoma and polyps].

    Science.gov (United States)

    Xu, S; Lu, Y; Wang, Q

    1995-10-01

    Galactose oxidase method was employed to detect the beta-D-Gal (1-->3) -D-Gal NAc residue of T-antigen present in the large intestinal mucus of 156 subjects. The positive rates of the test were 84.4%, 29.1%, and 7.2% in the mucus samples obtained from 32 patients with colorectal adenocarcinomas, 55 with polyps and 69 controls respectively. Chi-square test demonstrated that there were significant differences between the group of carcinoma and control (P < 0.001) as well as between also polyp and control (P < 0.01). The test had a high sensitivity (84.4%) and specificity (92.8%) in the diagnosis of colorectal cancer and may be used as a practical mass screening test for colorectal neoplasms.

  19. Urethral polyp in a 1-month-old child

    Energy Technology Data Exchange (ETDEWEB)

    Beluffi, Giampiero [Department of Radiodiagnosis, IRCCS Policlinico S. Matteo, Section of Paediatric Radiology, Piazzale Golgi, 2, I-27100, Pavia PV (Italy); Berton, Francesca; Gola, Giada [University of Pavia, IRCCS Policlinico S. Matteo, Institute of Radiology, Pavia (Italy); Chiari, Giorgio; Romano, Piero; Cassani, Ferdinando [IRCCS Policlinico S. Matteo, Division of Paediatric Surgery, Pavia (Italy)

    2005-07-01

    Urethral polyps are a rare finding in children, particularly in the very young. They are suspected by the presence of various clinical signs such as obstruction, voiding dysfunction and haematuria. There is an association with other urinary tract congenital anomalies. They are usually benign fibro-epithelial lesions with no tendency to recur and are treated by surgical ablation, fulguration or laser therapy. We report a 1-month-old boy with an antenatally diagnosed left ectopic pelvic kidney, postnatal urinary tract infection and no clinical signs of obstruction. Voiding cystourethrography to exclude vesico-ureteric reflux showed a trabeculated bladder and a mobile filling defect in the posterior urethra. Owing to its large size, cystotomy was necessary to remove the polyp successfully. (orig.)

  20. Hyperplastic Polyps Are Innocuous Lesions in Hereditary Nonpolyposis Colorectal Cancers

    Directory of Open Access Journals (Sweden)

    D. Speake

    2011-01-01

    Full Text Available Aims. To compare methylation profiles, protein expression, and microsatellite instability (MSI of sporadic, HNPCC, and familial hyperplastic polyps (HPs. Methods. Methylation-specific PCR (MSP and pyrosequencing assessed p16, MGMT, hMLH-1, MINT 1, and MINT 31 methylation. IHC (Immunohistochemistry assessed Ki67, CK20, hMLH-1, hMSH-2, and hMSH-6 protein expression. MSI analysis was performed on those polyps with adequate DNA remaining. Results. 124 HPs were identified 78 sporadic, 21 HNPCC, 25 familial, and the HNPCC group demonstrated no significant differences in overall methylation (P=.186 Chi2. The familial group demonstrated significantly less over all methylation levels (P=.004 Chi2. Conclusions. HPs that occur in HNPCC have no more worrying features at a molecular level than those patients with HPs in a sporadic setting.

  1. Hamartomatous polyps - a clinical and molecular genetic study

    DEFF Research Database (Denmark)

    Jelsig, Anne Marie

    2016-01-01

    the knowledge on clinical course and molecular genetics in patients with HPs and HPS, and to investigate research participants' attitude towards the results of extensive genetic testing. Paper I: In the first paper we investigated the occurrence, anatomic distribution, and other demographics of juvenile polyps......-Jeghers syndrome, and the PTEN hamartoma tumour syndrome. Currently, the HPS diagnoses are based on clinical criteria and are often assisted with genetic testing as candidate genes have been described for each syndrome. This thesis is based on six scientific papers. The overall aim of the studies was to expand......% fulfilled to diagnostic criteria of JPS. The majority of patients had a single juvenile polyp. Paper II: In this paper we conducted a review of the HPS based on the current literature. Paper III: We investigated the hypothesis that patients with one or few HPs may have a HPS based on genetic screening. We...

  2. Korean Guidelines for Colorectal Cancer Screening and Polyp Detection

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Bo In [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of); Hong, Sung Pil [Yensei University College of Medicine, Seoul (Korea, Republic of); Kim, Seong Eun [Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

    2012-04-15

    Colorectal cancer is currently the second most common cancer among Korean males and the fourth most common among females. Since the majority of colorectal cancer case present following the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are vital methods in its prevention. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish national guidelines for colorectal cancer screening and polyp detection. The proposed guidelines have been developed by the Korean Multi-Society Task Force using evidence-based methods. Systematic reviews and meta-analyses have been used to form the statements contained in the guidelines. This paper discusses the epidemiology of colorectal cancers and adenomas in Korea as well as optimal methods for screening of colorectal cancer and detection of adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.

  3. Local tissue hypoxia and formation of nasal polyps

    Institute of Scientific and Technical Information of China (English)

    姜舒; 董震; 朱冬冬; 杨占泉

    2003-01-01

    Objective To explore the response of nasal mucosa epithelial cells to hypoxia in terms of formation of nasal polyps (NP). Methods Epithelial cells of NP and inferior turbinate (IT) were cultured serum-fr ee under normal oxygen and hypoxic circumstances with stimulation of IL-1β and TNFα. The vascular endothelial growth factor (VEGF)mRNA and VEGF protein leve ls of the cultured cells were detected using in situ hybridization and ELISA, re spectively. Results The expression of VEGF mRNA was significantly higher in epithelial cells of NP t han in IT exposed to pro-inflammatory cytokines or hypoxia (P<0.01). VEGF levels were higher in NP epithelial cells than those of IT (P<0.01) under hypoxia.Conclusion VEGF-induced by hypoxia is very important for the early stages of forming polyps.

  4. Congenital hairy polyp of the nasopharynx: A case report

    Directory of Open Access Journals (Sweden)

    Baljošević Ivan

    2007-01-01

    Full Text Available Introduction. Hairy polyps are very rare benign tumors that can occur anywhere in the body, and they are the most common congenital nasopharyngeal masses. Case report. A two-day-old full-term female was admitted to the newborn Special Care Unit with noisy breathing, intermittent upper airway obstruction and feeding difficulty. A 3.4 kg infant was born by spontaneous vaginal delivery to a healthy mother, following a normal pregnancy. On admission, she presented with noisy inspiratory breathing which was louder and more labored in prone position. Flexible endoscopy showed a pale sausage-like mass protruding from nasopharynx just behind the soft palate, to the oropharynx and back. A computed tomography scan showed a 1.8 cm round mass in the right nasopharynx, with central fat density and no intracranial communication. The mass was excised transorally with no evidence of a residual tumor. The infant made a full and uneventful postoperative recovery. Discussion. Hairy polyps usually occur as isolated defects and they are not associated with other congenital anomalies. Genetic predisposition has not been established. It does not have malignant alteration. However, there is some confusion about the histological classification of these lesions. One theory supports the idea that hairy polyps originate from disturbed development of stomodeum in the 28th week of gestation and regression of the nasopharyngeal membrane. The second theory supports the idea of origin from the first or second bronchial arch. Probably the best assumption would be that it develops as a special and unique entity. Conclusion. Hairy polyp is an unusual malformation that most frequently appears during the first days after birth. Complete resection provides permanent cure. .

  5. Thymosin ß4 expression in colorectal polyps and adenomas

    Science.gov (United States)

    Nemolato, Sonia; Cabras, Tiziana; Restivo, Angelo; Zorcolo, Luigi; Di Felice, Eliana; Fanni, Daniela; Gerosa, Clara; Messana, Irene; Castagnola, Massimo; Faa, Gavino; Casula, Giuseppe

    2013-01-01

    OBJECTIVE: Thymosin beta 4 (Tβ4) is a ubiquitous peptide that plays pivotal roles in the cytoskeletal system and in cell differentiation. Recently, a role for Tβ4 has been proposed in experimental and human carcinogenesis, including gastrointestinal cancer. This study was aimed at evaluating the relationship between Tβ4 immunoreactivity and the initial steps of carcinogenesis. METHODS: In total, 60 intestinal biopsies, including 10 hyperplastic polyps, 10 sessile serrated adenomas/polyps, 15 colorectal adenomas with low-grade dysplasia, 15 adenomas with high-grade dysplasia, 15 adenocarcinomas and 10 samples of normal colon mucosa, were analyzed for Tβ4 expression by immunohistochemistry. RESULTS: Weak cytoplasmic reactivity for Tβ4 was detected in the normal colon mucosa. No reactivity for Tβ4 was found in hyperplastic and sessile serrated polyps/adenomas. Tβ4 expression was observed in 10/15 colorectal adenocarcinomas. In adenomas with low-grade dysplasia, Tβ4 immunoreactivity was mainly detected in dysplastic glands but was absent in hyperplastic glands. Tβ4 immunoreactivity was characterized by spot-like perinuclear staining. In high-grade dysplastic polyps, immunostaining for Tβ4 appeared diffuse throughout the entire cytoplasm of dysplastic cells. Spot-like perinuclear reactivity was detected in adenocarcinoma tumor cells. CONCLUSIONS: Our study shows for the first time that Tβ4 is expressed during different steps of colon carcinogenesis. The shift of Tβ4 immunolocalization from low-grade to high-grade dysplastic glands suggests a role for Tβ4 in colorectal carcinogenesis. However, the real meaning of Tβ4 reactivity in dysplastic intestinal epithelium remains unknown. PMID:24141838

  6. Endometrial polyp surveillance in premenopausal breast cancer patients using tamoxifen

    Science.gov (United States)

    Jeon, Se Jeong; Lee, Jae Il; Kim, Hee Seung; Kim, Jae Weon; Park, Noh Hyun; Song, Yong Sang

    2017-01-01

    Objective To describe the endometrial pathologic lesions in premenopausal breast cancer patients with a history of tamoxifen (TMX) use. Methods We retrospectively reviewed the medical records of 120 premenopausal breast cancer patients with a history of TMX use that had undergone a gynecological examination. Results Among 120 patients, 44.2% (n=53) were asymptomatic with an endometrial thickness ≥5 mm, as assessed by transvaginal ultrasonography. Of the patients that reported abnormal uterine bleeding, 5% (n=6) had an endometrial thickness <5 mm and 20% (n=24) had an endometrial thickness ≥5 mm by transvaginal ultrasonography. The final group of patients were asymptomatic, but showed an abnormal endometrial lesion, such as an endometrial polyp, by transvaginal ultrasonography (30.8%, n=37). Of the 56 benign lesions that were histologically reviewed, 50 (41.7%) were endometrial polyps, 3 (2.5%) were submucosal myomas, 2 (1.7%) were endometrial hyperplasias, and 1 (0.8%) was chronic endometritis. There were 64 (53.3%) other non-pathologic conditions, including secreting, proliferative, and atrophic endometrium, or in some cases, there was insufficient material for diagnosis. In our data, only one case was reported as a complex hyperplasia without atypia arising from an endometrial polyp, and one patient was diagnosed with endometrioid adenocarcinoma. Conclusion For premenopausal breast cancer patients with a history of TMX use, the majority of the patients were asymptomatic, and endometrial polyps were the most common endometrial pathology observed. Therefore, we believe that endometrial assessment before starting TMX treatment, and regular endometrial screening throughout TMX treatment, are reasonable suggestions for premenopausal breast cancer patients. PMID:28217668

  7. Nasal polyps with metaplastic ossification: CT and MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yi Kyung; Kim, Hyung-Jin; Kim, Eunhee; Kim, Sung Tae [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Kim, Jinna [Yonsei University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Chung, Seung-Kyu [Sungkyunkwan University School of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Seoul (Korea, Republic of); Ko, Young-Hyeh [Sungkyunkwan University School of Medicine, Department of Pathology, Samsung Medical Center, Seoul (Korea, Republic of)

    2010-12-15

    Metaplastic ossification is a rare event in nasal polyps. The purpose of this study was to review the computed tomography (CT) and magnetic resonance (MR) imaging findings of nasal polyps with metaplastic ossification. CT (n = 5) and MR (n = 3) images of five patients (four men and one woman; mean age, 59 years) with surgically proven nasal polyp with metaplastic ossification were retrospectively reviewed. The location and morphologic characteristics of metaplastic ossification were documented as well. All lesions were seen as lobulated (n = 3), ovoid (n = 1), or dumbbell-shaped (n = 1) benign-looking masses with a mean size of 3.7 cm (range, 2.4-6.5 cm), located unilaterally in the posterior nasal cavity and nasopharynx (n = 2), posterior nasoethmoidal tract (n = 2), and maxillary sinus and nasal cavity (n = 1). Compared with the brain stem, the soft tissue components of all lesions demonstrated isoattenuation on precontrast CT scans, slight hypointensity on T1-weighted MR images, and hyperintensity on T2-weighted MR images. On contrast-enhanced MR images, heterogeneous enhancement with marked peripheral enhancement was seen in two and homogeneous moderate enhancement in one. All lesions contained centrally located radiodense materials on CT scans, the shape of which was multiple clustered in three, single nodular in one, and single large lobulated in one. Although rare, metaplastic ossification can occur within nasal polyps. The possibility of its diagnosis may be raised when one sees a benign-looking sinonasal mass with centrally located radiodense materials on CT scans. MR imaging may be useful when mycetoma or inverted papilloma cannot be ruled out on CT scans. (orig.)

  8. [Congenital hairy polyp of the nasopharynx--a case report].

    Science.gov (United States)

    Baljosević, Ivan; Minić, Predrag; Duricić, Slavisa; Subarević, Vladan

    2007-01-01

    Hairy polyps are very rare benign tumors that can occur anywhere in the body, and they are the most common congenital nasopharyngeal masses. A two-day-old full-term female was admitted to the newborn Special Care Unit with noisy breathing, intermittent upper airway obstruction and feeding difficulty. A 3.4 kg infant was born by spontaneous vaginal delivery to a healthy mother, following a normal pregnancy. On admission, she presented with noisy inspiratory breathing which was louder and more labored in prone position. Flexible endoscopy showed a pale sausage-like mass protruding from nasopharynx just behind the soft palate, to the oropharynx and back. A computed tomography scan showed a 1.8 cm round mass in the right nasopharynx, with central fat density and no intracranial communication. The mass was excised transorally with no evidence of a residual tumor. The infant made a full and uneventful postoperative recovery. Hairy polyps usually occur as isolated defects and they are not associated with other congenital anomalies. Genetic predisposition has not been established. It does not have malignant alteration. However, there is some confusion about the histological classification of these lesions. One theory supports the idea that hairy polyps originate from disturbed development of stomodeum in the 28th week of gestation and regression of the nasopharyngeal membrane. The second theory supports the idea of origin from the first or second bronchial arch. Probably the best assumption would be that it develops as a special and unique entity. Hairy polyp is an unusual malformation that most frequently appears during the first days after birth. Complete resection provides permanent cure.

  9. Osteolytic nasal polyp of the maxillary sinus mimicking malignancy

    Directory of Open Access Journals (Sweden)

    Arvind Karikal

    2014-01-01

    Full Text Available We present an osteolytic nasal polyp of the maxillary sinus with clinical features and radiographic features mimicking that of a malignancy. Maxillary sinusitis being a common inflammatory condition progressed to cause destruction of the maxillary bone and spread into the facial soft tissue, which is quite a rare occurrence. We have discussed in detail the clinical, radiological, histopathology and management of this uncommon presentation of a common case.

  10. Clinicopathologic Analysis of 2,889 Nanchang-Area Patients with Colorectal Polyps

    Institute of Scientific and Technical Information of China (English)

    Guohua Li; Wangdi Liao; Ping Xu; Nonghua Lv; Chongwen Wang

    2007-01-01

    OBJECTIVE To study the clinicopathologic characteristics.changes in the nature and incidence of colorectal polyps in the Nanchang area,Jiangxi,Province.METHODS We retrospectively investigated the patients with colorectal polyps who were diagnosed by colonoscopy and pathology in our hospital from 1990 to 2004.The analysis involved the incidence,average patient age,polyp location and pathological types.We recorded the changes of the polyp clinicopathologic features by comparing the clinicopathologic types of colorectal polyps over five-year periods.RESULTS Of the 21,853 patients who received a colonoscopy,2,889(13.2%) were diagnosed with colorectal polyps.Their average age was 46.6±16.5 years,with a male to female ratio of 1.8:1.The males were older than females (47.1±17.5 vs.45.5±14.5.P<0.05).Location of the polyps:41% in the rectum.27-7% in the sigmoid colon.35.8% in the left side verus 23.1% in the right side (P<0.05).Patients with polyps located in the transverse and ascending colon were older than those with polyps in the rectum and sigmoid colon (P<O.05).Adenomatous polyps comprised the most common type (67%) and the rectum was the most common site for each type,especially juvenile and retention polyps.Juvenile polyps were found in the youngest patients (12±4.8,P<0.05)and the adenomatous in the oldest(52±14,P<0.05).The ratio of patients with polyposis comprised 1.2%.and patients with polyps accompanied with colorectal cancer comprised 6.1%.Examination of the changes in the incidence,the average patient age,and adenomatous type showed that they had all increased.but the frequency of inflammatory and retention polyps decreased.CONCLUSIoN Colorectal polyps are a common problem.The frequency iS greater in males compared to females and the rectum and sigmoid colon had the highest incidence.Most iuvenile and retention polyps were found in young patients.but most adenomatous occurred in adults.In recent years,the incidence of colorectal polyps

  11. Prevalence and risk factors of the gallbladder polyps diagnosed by ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Mi Hwa; Cho, Pyong Kon [Dept. of Radiological science, Catholic University of Daegu, Daegu (Korea, Republic of); Kwon, Duck Moon [Dept. of Diagnostic Radiology, Daegu Health College, Daegu (Korea, Republic of)

    2015-06-15

    This study was designed to determine the prevalence of gallstones in the last three years and evaluate the associated risk factors in the population who underwent health screening. Although there are many studies reporting the prevalence and risk factors of GB polyp, the results varied among each report. The aims of this study were to evaluate the prevalence rate and risk factors of GB polyp, colon polyp and fatty liver in the population who underwent health screening. The study population consisted of 4,877 visited the health promotion center in Dalseogu, Daegu in Korea from January 2011 to December 2013. Each participant in the study had their biliary system gallbladder examined using ultrasonography. The prevalence of GB polyp was evaluated along with age, gender, metabolic syndrom, body mass index (BMI), Fatty liver, Colon polyp. A showed of total 383 (7.9%) people were found to have GB polyps. The prevalence of sex among 256 (9.8%) patients men and 127 (5.6%) women which showed significantly higher in male than in female subjects(p=0.001). The mean size of the GB polyps 4.92 mm (1.6-17 mm). The sizes of most GB polyps (73.6%) were less than 10 mm in diameter. 122 subjects (31.28%) had multiple GB polyps which 2 or more polyps and 261 subjects (68.2%) had single polyp. Independent risk factors related with GB polyp were male gender (OR 0.551, p<0.001), overweight that BMI above 23 kg/m{sup 2} (OR 0.713, p=0.002) triglyceride (OR 0.571, p<0.001), metabolic syndrome (OR 0.049, p=0.033) and colon polyp (OR 1.409, p=0.002). In spite of the conclusion, the prevalence GB polyp was higher than previous Korea and other country reports. The GB polyp in a healthy population was results as 7.9%. The risk factors of GB polyps were found to be male, being overweight, triglyceride, metabolic syndrome and colon polyp. Not only the subject of a health examination is needed but, a further study of the general public when possible.

  12. [Fungal allergy in chronic rhinosinusitis with or without polyps].

    Science.gov (United States)

    Erbek, Selim S; Topal, Ozgül; Erbek, Seyra; Cakmak, Ozcan

    2008-01-01

    Fungi, by systemic or local allergic effect, may play a role in the pathogenesis of chronic rhinosinusitis (CRS). We investigated the incidence of fungal allergy in patients with CRS and its effect on the clinical characteristics of the disease. The study included 127 patients, aged 18 years or over, with CRS (42 females, 85 males; mean age 43+/-12 years; range 19 to 78 years). Fungal allergy was determined by skin prick test and its effect was analyzed on blood eosinophil and total immunoglobulin E levels, the presence of polyps, and paranasal sinus computed tomography scores. Eighty-five patients (66.9%) were found to have allergy. The incidence of allergy did not differ between patients with and without polyps (p>0.05). House dust mites (62.2%) were the most frequent allergens. The incidence of fungal allergy was 38.8% in allergic patients. Isolated fungal allergy was detected in two patients (1.6%). The most frequent fungal allergens were Aspergillus, followed by Alternaria, and Penicillium. No association was found between fungal allergy and blood eosinophil and total immunoglobulin E levels, presence of polyps, or paranasal sinus computed tomography scores (p>0.05). The incidence of fungal allergy in patients with CRS was found to be high in this study. Tissue culture studies are required to determine the definitive relationship between fungal allergy and clinical features of CRS.

  13. Vocal Loading in Speaking a Foreign Language.

    Science.gov (United States)

    Järvinen, Kati; Laukkanen, Anne-Maria

    2015-01-01

    This study investigated whether speaking a foreign language affects the subjective notions of vocal fatigue, and whether acoustic measurements reveal a higher vocal loading. The speech samples of 20 native Finnish-speaking and 23 native English-speaking subjects were recorded in Finnish and in English. From the speech samples, fundamental frequency, equivalent sound level, total duration of voiced speech, speech rate, alpha ratio and L1-L0 level difference were analyzed. Vocal doses were calculated. According to subjective notions, the voice gets tired more quickly when speaking a foreign language. The mean fundamental frequency increased but the speech rate and total duration of voiced speech decreased significantly when speaking a foreign language. Thus, the vocal doses decreased. The subjective sensations of increased vocal fatigue may be due to increased mental stress rather than to higher vocal loading. However, a trend that speaking a foreign language may involve more loading was found in L1-L0 level difference and in the doses normalized to time dose. Longer speech samples should be studied. Voice quality-based indicators of vocal loading are worth testing in addition to the measures based on the amount of voicing in speech. © 2015 S. Karger AG, Basel.

  14. 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

  15. Vocal learning beyond imitation: mechanisms of adaptive vocal development in songbirds and human infants.

    Science.gov (United States)

    Tchernichovski, Ofer; Marcus, Gary

    2014-10-01

    Studies of vocal learning in songbirds typically focus on the acquisition of sensory templates for song imitation and on the consequent process of matching song production to templates. However, functional vocal development also requires the capacity to adaptively diverge from sensory templates, and to flexibly assemble vocal units. Examples of adaptive divergence include the corrective imitation of abnormal songs, and the decreased tendency to copy over-abundant syllables. Such frequency-dependent effects might mirror tradeoffs between the assimilation of group identity (culture) while establishing individual and flexibly expressive songs. Intriguingly, although the requirements for vocal plasticity vary across songbirds, and more so between birdsong and language, the capacity to flexibly assemble vocal sounds develops in a similar, stepwise manner across species. Therefore, universal features of vocal learning go well beyond the capacity to imitate. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Utilizing ultrasonography in the diagnosis of pediatric fibroepithelial polyps causing ureteropelvic junction obstruction.

    Science.gov (United States)

    Wang, Xiao Man; Jia, Li Qun; Wang, Yu; Wang, Ning

    2012-09-01

    Fibroepithelial polyps are a rare cause of ureteropelvic junction (UPJ) obstruction in children. Preoperative US diagnosis of fibroepithelial polyps is infrequently reported, with intravenous pylogram and retrograde pyelography being most commonly used for diagnosis. To recommend the most accurate process for diagnosing this disease in children by assessing a modified ultrasonographic procedure for the diagnosis of fibroepithelial polyps. A retrospective review of US and IVP imaging studies performed in surgically and histologically confirmed cases of fibroepithelial polyps in children. Each child was asked to drink as much water as possible 30 min before the US testing. For US, the renal pelvis, UPJ and the proximal ureter were inspected for an echogenic mass resulting in hydronephrosis. For IVP studies, abdominal plain films were performed at 7, 15 and 30 min following contrast injection. Thirty-five children, 34 boys and 1 girl, had confirmed fibroepithelial polyps. The children ranged in age from 3 to 14 years (mean age 9 years). Clinical presentation included intermittent vague abdominal pain (100%) and/or hematuria (9.7%) for a period ranging from 1 month to 5 years. Of the 35 children (37 polyps), 21 (23 polyps) wer