Computational model for vocal tract dynamics in a suboscine bird.

PubMed

Assaneo, M F; Trevisan, M A

2010-09-01

In a recent work, active use of the vocal tract has been reported for singing oscines. The reconfiguration of the vocal tract during song serves to match its resonances to the syringeal fundamental frequency, demonstrating a precise coordination of the two main pieces of the avian vocal system for songbirds characterized by tonal songs. In this work we investigated the Great Kiskadee (Pitangus sulfuratus), a suboscine bird whose calls display a rich harmonic content. Using a recently developed mathematical model for the syrinx and a mobile vocal tract, we set up a computational model that provides a plausible reconstruction of the vocal tract movement using a few spectral features taken from the utterances. Moreover, synthetic calls were generated using the articulated vocal tract that accounts for all the acoustical features observed experimentally.

Relevance of the Implementation of Teeth in Three-Dimensional Vocal Tract Models

ERIC Educational Resources Information Center

Traser, Louisa; Birkholz, Peter; Flügge, Tabea Viktoria; Kamberger, Robert; Burdumy, Michael; Richter, Bernhard; Korvink, Jan Gerrit; Echternach, Matthias

2017-01-01

Purpose: Recently, efforts have been made to investigate the vocal tract using magnetic resonance imaging (MRI). Due to technical limitations, teeth were omitted in many previous studies on vocal tract acoustics. However, the knowledge of how teeth influence vocal tract acoustics might be important in order to estimate the necessity of…

Applicability of Cone Beam Computed Tomography to the Assessment of the Vocal Tract before and after Vocal Exercises in Normal Subjects.

PubMed

Garcia, Elisângela Zacanti; Yamashita, Hélio Kiitiro; Garcia, Davi Sousa; Padovani, Marina Martins Pereira; Azevedo, Renata Rangel; Chiari, Brasília Maria

2016-01-01

Cone beam computed tomography (CBCT), which represents an alternative to traditional computed tomography and magnetic resonance imaging, may be a useful instrument to study vocal tract physiology related to vocal exercises. This study aims to evaluate the applicability of CBCT to the assessment of variations in the vocal tract of healthy individuals before and after vocal exercises. Voice recordings and CBCT images before and after vocal exercises performed by 3 speech-language pathologists without vocal complaints were collected and compared. Each participant performed 1 type of exercise, i.e., Finnish resonance tube technique, prolonged consonant "b" technique, or chewing technique. The analysis consisted of an acoustic analysis and tomographic imaging. Modifications of the vocal tract settings following vocal exercises were properly detected by CBCT, and changes in the acoustic parameters were, for the most part, compatible with the variations detected in image measurements. CBCT was shown to be capable of properly assessing the changes in vocal tract settings promoted by vocal exercises. © 2017 S. Karger AG, Basel.

A Volumetric Analysis of the Vocal Tract Associated with Laryngectomees Using Acoustic Reflection Technology.

PubMed

Ng, Manwa L; Yan, Nan; Chan, Venus; Chen, Yang; Lam, Paul K Y

2018-06-28

Previous studies of the laryngectomized vocal tract using formant frequencies reported contradictory findings. Imagining studies of the vocal tract in alaryngeal speakers are limited due to the possible radiation effect as well as the cost and time associated with the studies. The present study examined the vocal tract configuration of laryngectomized individuals using acoustic reflection technology. Thirty alaryngeal and 30 laryngeal male speakers of Cantonese participated in the study. A pharyngometer was used to obtain volumetric information of the vocal tract. All speakers were instructed to imitate the production of /a/ when the length and volume information of the oral cavity, pharyngeal cavity, and the entire vocal tract were obtained. The data of alaryngeal and laryngeal speakers were compared. Pharyngometric measurements revealed no significant difference in the vocal tract dimensions between laryngeal and alaryngeal speakers. Despite the removal of the larynx and a possible alteration in the pharyngeal cavity during total laryngectomy, the vocal tract configuration (length and volume) in laryngectomized individuals was not significantly different from laryngeal speakers. It is suggested that other factors might have affected formant measures in previous studies. © 2018 S. Karger AG, Basel.

A Modeling Study of the Effects of Vocal Tract Movement Duration and Magnitude on the F2 Trajectory in CV Words

ERIC Educational Resources Information Center

Neely, Kimberly D.; Bunton, Kate; Story, Brad H.

2016-01-01

Purpose: This study used a computational vocal tract model to investigate the relationship of diphthong duration and vocal tract movement magnitude to measures of the F2 trajectory in CV words. Method: Three words ("bough," "boy," and "buy") were simulated on the basis of an adult female vocal tract model, in which…

Trigeminal and telencephalic projections to jaw and other upper vocal tract premotor neurons in songbirds: sensorimotor circuitry for beak movements during singing.

PubMed

Wild, J M; Krützfeldt, N E O

2012-02-15

During singing in songbirds, the extent of beak opening, like the extent of mouth opening in human singers, is partially correlated with the fundamental frequency of the sounds emitted. Since song in songbirds is under the control of "the song system" (a collection of interconnected forebrain nuclei dedicated to the learning and production of song), it might be expected that beak movements during singing would also be controlled by this system. However, direct neural connections between the telencephalic output of the song system and beak muscle motor neurons in the brainstem are conspicuous by their absence, leaving unresolved the question of how beak movements are affected during singing. By using standard tract tracing methods, we sought to answer this question by defining beak premotor neurons and examining their afferent projections. In the caudal medulla, jaw premotor cell bodies were located adjacent to the terminal field of the output of the song system, into which many premotor neurons extended their dendrites. The premotor neurons also received a novel input from the trigeminal ganglion and an overlapping input from a lateral arcopallial component of a trigeminal sensorimotor circuit that traverses the forebrain. The ganglionic input in songbirds, which is not present in doves and pigeons that vocalize with a closed beak, may modulate the activity of beak premotor neurons in concert with the output of the song system. These inputs to jaw premotor neurons could, together, affect beak movements as a means of modulating filter properties of the upper vocal tract during singing. Copyright © 2011 Wiley-Liss, Inc.

Trigeminal and Telencephalic Projections to Jaw and Other Upper Vocal Tract Premotor Neurons in Songbirds: Sensorimotor Circuitry for Beak Movements During Singing

PubMed Central

Wild, J.M.; Krützfeldt, N.E.O.

2014-01-01

During singing in songbirds, the extent of beak opening, like the extent of mouth opening in human singers, is partially correlated with the fundamental frequency of the sounds emitted. Since song in songbirds is under the control of “the song system” (a collection of interconnected forebrain nuclei dedicated to the learning and production of song), it might be expected that beak movements during singing would also be controlled by this system. However, direct neural connections between the telencephalic output of the song system and beak muscle motor neurons in the brainstem are conspicuous by their absence, leaving unresolved the question of how beak movements are affected during singing. By using standard tract tracing methods, we sought to answer this question by defining beak premotor neurons and examining their afferent projections. In the caudal medulla, jaw premotor cell bodies were located adjacent to the terminal field of the output of the song system, into which many premotor neurons extended their dendrites. The premotor neurons also received a novel input from the trigeminal ganglion and an overlapping input from a lateral arcopallial component of a trigeminal sensorimotor circuit that traverses the forebrain. The ganglionic input in songbirds, which is not present in doves and pigeons that vocalize with a closed beak, may modulate the activity of beak premotor neurons in concert with the output of the song system. These inputs to jaw premotor neurons could, together, affect beak movements as a means of modulating filter properties of the upper vocal tract during singing. PMID:21858818

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

PubMed Central

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, and∕or 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. PMID:19649157

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

PubMed

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.

Vocal production mechanisms in a non-human primate: morphological data and a model.

PubMed

Riede, Tobias; Bronson, Ellen; Hatzikirou, Haralambos; Zuberbühler, Klaus

2005-01-01

Human beings are thought to be unique amongst the primates in their capacity to produce rapid changes in the shape of their vocal tracts during speech production. Acoustically, vocal tracts act as resonance chambers, whose geometry determines the position and bandwidth of the formants. Formants provide the acoustic basis for vowels, which enable speakers to refer to external events and to produce other kinds of meaningful communication. Formant-based referential communication is also present in non-human primates, most prominently in Diana monkey alarm calls. Previous work has suggested that the acoustic structure of these calls is the product of a non-uniform vocal tract capable of some degree of articulation. In this study we test this hypothesis by providing morphological measurements of the vocal tract of three adult Diana monkeys, using both radiography and dissection. We use these data to generate a vocal tract computational model capable of simulating the formant structures produced by wild individuals. The model performed best when it combined a non-uniform vocal tract consisting of three different tubes with a number of articulatory manoeuvres. We discuss the implications of these findings for evolutionary theories of human and non-human vocal production.

Peripheral mechanisms for vocal production in birds - differences and similarities to human speech and singing.

PubMed

Riede, Tobias; Goller, Franz

2010-10-01

Song production in songbirds is a model system for studying learned vocal behavior. As in humans, bird phonation involves three main motor systems (respiration, vocal organ and vocal tract). The avian respiratory mechanism uses pressure regulation in air sacs to ventilate a rigid lung. In songbirds sound is generated with two independently controlled sound sources, which reside in a uniquely avian vocal organ, the syrinx. However, the physical sound generation mechanism in the syrinx shows strong analogies to that in the human larynx, such that both can be characterized as myoelastic-aerodynamic sound sources. Similarities include active adduction and abduction, oscillating tissue masses which modulate flow rate through the organ and a layered structure of the oscillating tissue masses giving rise to complex viscoelastic properties. Differences in the functional morphology of the sound producing system between birds and humans require specific motor control patterns. The songbird vocal apparatus is adapted for high speed, suggesting that temporal patterns and fast modulation of sound features are important in acoustic communication. Rapid respiratory patterns determine the coarse temporal structure of song and maintain gas exchange even during very long songs. The respiratory system also contributes to the fine control of airflow. Muscular control of the vocal organ regulates airflow and acoustic features. The upper vocal tract of birds filters the sounds generated in the syrinx, and filter properties are actively adjusted. Nonlinear source-filter interactions may also play a role. The unique morphology and biomechanical system for sound production in birds presents an interesting model for exploring parallels in control mechanisms that give rise to highly convergent physical patterns of sound generation. More comparative work should provide a rich source for our understanding of the evolution of complex sound producing systems. Copyright © 2009 Elsevier Inc. All rights reserved.

Vocal tract length and formant frequency dispersion correlate with body size in rhesus macaques.

PubMed

Fitch, W T

1997-08-01

Body weight, length, and vocal tract length were measured for 23 rhesus macaques (Macaca mulatta) of various sizes using radiographs and computer graphic techniques. linear predictive coding analysis of tape-recorded threat vocalizations were used to determine vocal tract resonance frequencies ("formants") for the same animals. A new acoustic variable is proposed, "formant dispersion," which should theoretically depend upon vocal tract length. Formant dispersion is the averaged difference between successive formant frequencies, and was found to be closely tied to both vocal tract length and body size. Despite the common claim that voice fundamental frequency (F0) provides an acoustic indication of body size, repeated investigations have failed to support such a relationship in many vertebrate species including humans. Formant dispersion, unlike voice pitch, is proposed to be a reliable predictor of body size in macaques, and probably many other species.

Voice classification and vocal tract of singers: a study of x-ray images and morphology.

PubMed

Roers, Friederike; Mürbe, Dirk; Sundberg, Johan

2009-01-01

This investigation compares vocal tract dimensions and the classification of singer voices by examining an x-ray material assembled between 1959 and 1991 of students admitted to the solo singing education at the University of Music, Dresden, Germany. A total of 132 images were available to analysis. Different classifications' values of the lengths of the total vocal tract, the pharynx, and mouth cavities as well as of the relative position of the larynx, the height of the palatal arch, and the estimated vocal fold length were analyzed statistically, and some significant differences were found. The length of the pharynx cavity seemed particularly influential on the total vocal tract length, which varied systematically with classification. Also studied were the relationships between voice classification and the body height and weight and the body mass index. The data support the hypothesis that there are consistent morphological vocal tract differences between singers of different voice classifications.

Numerical Simulation of the Self-Oscillations of the Vocal Folds and of the Resulting Acoustic Phenomena in the Vocal Tract

NASA Astrophysics Data System (ADS)

Švancara, P.; Horáček, J.; Švec, J. G.

The study presents a three-dimensional (3D) finite element (FE) model of the flow-induced self-oscillation of the human vocal folds in interaction with acoustics of simplified vocal tract models. The 3D vocal tract models of the acoustic spaces shaped for simulation of phonation of Czech vowels [a:], [i:] and [u:] were created by converting the data from the magnetic resonance images (MRI). For modelling of the fluid-structure interaction, explicit coupling scheme with separated solvers for fluid and structure domain was utilized. The FE model comprises vocal folds pretension before starting phonation, large deformations of the vocal fold tissue, vocal-fold collisions, fluid-structure interaction, morphing the fluid mesh according to the vocal-fold motion (Arbitrary Lagrangian-Eulerian approach), unsteady viscous compressible airflow described by the Navier-Stokes equations and airflow separation. The developed FE model enables to study the relationship between flow-induced vibrations of the vocal folds and acoustic wave propagation in the vocal tract and can also be used to simulate for example pathological changes in the vocal fold tissue and their influence on the voice production.

Vocal tract shapes in different singing functions used in musical theater singing-a pilot study.

PubMed

Echternach, Matthias; Popeil, Lisa; Traser, Louisa; Wienhausen, Sascha; Richter, Bernhard

2014-09-01

Singing styles in Musical Theater singing might differ in many ways from Western Classical singing. However, vocal tract adjustments are not understood in detail. Vocal tract shapes of a single professional Music Theater female subject were analyzed concerning different aspects of singing styles using dynamic real-time magnetic resonance imaging technology with a frame rate of 8 fps. The different tasks include register differences, belting, and vibrato strategies. Articulatory differences were found between head register, modal register, and belting. Also, some vibrato strategies ("jazzy" vibrato) do involve vocal tract adjustments, whereas others (classical vibrato) do not. Vocal tract shaping might contribute to the establishment of different singing functions in Musical Theater singing. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Development of vocal tract length during early childhood: A magnetic resonance imaging study

NASA Astrophysics Data System (ADS)

Vorperian, Houri K.; Kent, Ray D.; Lindstrom, Mary J.; Kalina, Cliff M.; Gentry, Lindell R.; Yandell, Brian S.

2005-01-01

Speech development in children is predicated partly on the growth and anatomic restructuring of the vocal tract. This study examines the growth pattern of the various hard and soft tissue vocal tract structures as visualized by magnetic resonance imaging (MRI), and assesses their relational growth with vocal tract length (VTL). Measurements on lip thickness, hard- and soft-palate length, tongue length, naso-oro-pharyngeal length, mandibular length and depth, and distance of the hyoid bone and larynx from the posterior nasal spine were used from 63 pediatric cases (ages birth to 6 years and 9 months) and 12 adults. Results indicate (a) ongoing growth of all oral and pharyngeal vocal tract structures with no sexual dimorphism, and a period of accelerated growth between birth and 18 months; (b) vocal tract structure's region (oral/anterior versus pharyngeal/posterior) and orientation (horizontal versus vertical) determine its growth pattern; and (c) the relational growth of the different structures with VTL changes with development-while the increase in VTL throughout development is predominantly due to growth of pharyngeal/posterior structures, VTL is also substantially affected by the growth of oral/anterior structures during the first 18 months of life. Findings provide normative data that can be used for modeling the development of the vocal tract. .

Advances in real-time magnetic resonance imaging of the vocal tract for speech science and technology research.

PubMed

Toutios, Asterios; Narayanan, Shrikanth S

2016-01-01

Real-time magnetic resonance imaging (rtMRI) of the moving vocal tract during running speech production is an important emerging tool for speech production research providing dynamic information of a speaker's upper airway from the entire mid-sagittal plane or any other scan plane of interest. There have been several advances in the development of speech rtMRI and corresponding analysis tools, and their application to domains such as phonetics and phonological theory, articulatory modeling, and speaker characterization. An important recent development has been the open release of a database that includes speech rtMRI data from five male and five female speakers of American English each producing 460 phonetically balanced sentences. The purpose of the present paper is to give an overview and outlook of the advances in rtMRI as a tool for speech research and technology development.

Advances in real-time magnetic resonance imaging of the vocal tract for speech science and technology research

PubMed Central

TOUTIOS, ASTERIOS; NARAYANAN, SHRIKANTH S.

2016-01-01

Real-time magnetic resonance imaging (rtMRI) of the moving vocal tract during running speech production is an important emerging tool for speech production research providing dynamic information of a speaker's upper airway from the entire mid-sagittal plane or any other scan plane of interest. There have been several advances in the development of speech rtMRI and corresponding analysis tools, and their application to domains such as phonetics and phonological theory, articulatory modeling, and speaker characterization. An important recent development has been the open release of a database that includes speech rtMRI data from five male and five female speakers of American English each producing 460 phonetically balanced sentences. The purpose of the present paper is to give an overview and outlook of the advances in rtMRI as a tool for speech research and technology development. PMID:27833745

Effect of level difference between left and right vocal folds on phonation: Physical experiment and theoretical study.

PubMed

Tokuda, Isao T; Shimamura, Ryo

2017-08-01

As an alternative factor to produce asymmetry between left and right vocal folds, the present study focuses on level difference, which is defined as the distance between the upper surfaces of the bilateral vocal folds in the inferior-superior direction. Physical models of the vocal folds were utilized to study the effect of the level difference on the phonation threshold pressure. A vocal tract model was also attached to the vocal fold model. For two types of different models, experiments revealed that the phonation threshold pressure tended to increase as the level difference was extended. Based upon a small amplitude approximation of the vocal fold oscillations, a theoretical formula was derived for the phonation threshold pressure. This theory agrees with the experiments, especially when the phase difference between the left and right vocal folds is not extensive. Furthermore, an asymmetric two-mass model was simulated with a level difference to validate the experiments as well as the theory. The primary conclusion is that the level difference has a potential effect on voice production especially for patients with an extended level of vertical difference in the vocal folds, which might be taken into account for the diagnosis of voice disorders.

Hoarseness and vocal tract discomfort and associated risk factors in air traffic controllers.

PubMed

Korn, Gustavo Polacow; Villar, Anna Carolina; Azevedo, Renata Rangel

2018-04-05

An air traffic controller is a professional who performs air traffic control functions in air traffic control units and is responsible for controlling the various stages of a flight. To compare hoarseness and vocal tract discomfort and their risk factors among air traffic controllers in the approach control of São Paulo. In a cross-sectional survey, a voice self-evaluation adapted from to self-evaluation prepared by the Brazilian Ministry of Labor for teachers was administered to 76 air traffic controllers at approach control of São Paulo, Brazil. The percentage of hoarseness and vocal tract discomfort was 19.7% and 38.2%, respectively. In relation to air pollution, the percentages of hoarseness and vocal tract discomfort were higher among those who consider their working environment to be intolerable than among those in a comfortable or disturbing environment. The percentage of hoarseness was higher among those who seek medical advice due to vocal complaints and among those who experience difficulty using their voice at work than among those who experience mild or no difficulty. The percentage of vocal tract discomfort was higher among those in a very tense and stressful environment than among those who consider their work environment to be mild or moderately tense and stressful. The percentage of vocal tract discomfort was higher among those who describe themselves as very tense and stressed or tense and stressed than among those who describe themselves as calm. Additionally, the percentage of vocal tract discomfort was higher among those who care about their health. Among air traffic controllers, the percentage of vocal tract discomfort was almost twice that of hoarseness. Both symptoms are prevalent among air traffic controllers who considered their workplace intolerable in terms of air pollution. Vocal tract discomfort was related to a tense and stressful environment, and hoarseness was related to difficulty using the voice at work. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Effect of artificially lengthened vocal tract on vocal fold oscillation's fundamental frequency.

PubMed

Hanamitsu, Masakazu; Kataoka, Hideyuki

2004-06-01

The fundamental frequency of vocal fold oscillation (F(0)) is controlled by laryngeal mechanics and aerodynamic properties. F(0) change per unit change of transglottal pressure (dF/dP) using a shutter valve has been studied and found to have nonlinear, V-shaped relationship with F(0). On the other hand, the vocal tract is also known to affect vocal fold oscillation. This study examined the effect of artificially lengthened vocal tract length on dF/dP. dF/dP was measured in six men using two mouthpieces of different lengths. The dF/dP graph for the longer vocal tract was shifted leftward relative to the shorter one. Using the one-mass model, the nadir of the "V" on the dF/dP graph was strongly influenced by the resonance around the first formant frequency. However, a more precise model is needed to account for the effects of viscosity and turbulence.

On Short-Time Estimation of Vocal Tract Length from Formant Frequencies

PubMed Central

Lammert, Adam C.; Narayanan, Shrikanth S.

2015-01-01

Vocal tract length is highly variable across speakers and determines many aspects of the acoustic speech signal, making it an essential parameter to consider for explaining behavioral variability. A method for accurate estimation of vocal tract length from formant frequencies would afford normalization of interspeaker variability and facilitate acoustic comparisons across speakers. A framework for considering estimation methods is developed from the basic principles of vocal tract acoustics, and an estimation method is proposed that follows naturally from this framework. The proposed method is evaluated using acoustic characteristics of simulated vocal tracts ranging from 14 to 19 cm in length, as well as real-time magnetic resonance imaging data with synchronous audio from five speakers whose vocal tracts range from 14.5 to 18.0 cm in length. Evaluations show improvements in accuracy over previously proposed methods, with 0.631 and 1.277 cm root mean square error on simulated and human speech data, respectively. Empirical results show that the effectiveness of the proposed method is based on emphasizing higher formant frequencies, which seem less affected by speech articulation. Theoretical predictions of formant sensitivity reinforce this empirical finding. Moreover, theoretical insights are explained regarding the reason for differences in formant sensitivity. PMID:26177102

Short-Term Effect of Two Semi-Occluded Vocal Tract Training Programs on the Vocal Quality of Future Occupational Voice Users: "Resonant Voice Training Using Nasal Consonants" versus "Straw Phonation"

ERIC Educational Resources Information Center

Meerschman, Iris; Van Lierde, Kristiane; Peeters, Karen; Meersman, Eline; Claeys, Sofie; D'haeseleer, Evelien

2017-01-01

Purpose: The purpose of this study was to determine the short-term effect of 2 semi-occluded vocal tract training programs, "resonant voice training using nasal consonants" versus "straw phonation," on the vocal quality of vocally healthy future occupational voice users. Method: A multigroup pretest--posttest randomized control…

The Vocal Tract Organ: A New Musical Instrument Using 3-D Printed Vocal Tracts.

PubMed

Howard, David M

2017-10-27

The advent and now increasingly widespread availability of 3-D printers is transforming our understanding of the natural world by enabling observations to be made in a tangible manner. This paper describes the use of 3-D printed models of the vocal tract for different vowels that are used to create an acoustic output when stimulated with an appropriate sound source in a new musical instrument: the Vocal Tract Organ. The shape of each printed vocal tract is recovered from magnetic resonance imaging. It sits atop a loudspeaker to which is provided an acoustic L-F model larynx input signal that is controlled by the notes played on a musical instrument digital interface device such as a keyboard. The larynx input is subject to vibrato with extent and frequency adjustable as desired within the ranges usually found for human singing. Polyphonic inputs for choral singing textures can be applied via a single loudspeaker and vocal tract, invoking the approximation of linearity in the voice production system, thereby making multiple vowel stops a possibility while keeping the complexity of the instrument in reasonable check. The Vocal Tract Organ offers a much more human and natural sounding result than the traditional Vox Humana stops found in larger pipe organs, offering the possibility of enhancing pipe organs of the future as well as becoming the basis for a "multi-vowel" chamber organ in its own right. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Vocal Tract Morphology in Inhaling Singing: An MRI-Based Study.

PubMed

Moerman, Mieke; Vanhecke, Françoise; Van Assche, Lieven; Vercruysse, Johan; Daemers, Kristin; Leman, Marc

2016-07-01

Inhaling singing is a recently developed singing technique explored by the soprano singer Françoise Vanhecke. It is based on an inspiratory airflow instead of an expiratory airflow. This article describes the anatomical structural differences of the vocal tract between inhaling and exhaling singing. We hypothesize that the vocal tract alters significantly in inhaling singing, especially concerning the configuration of the anatomical structures in the oral cavity and the subglottal region. This is a prospective study. A professional singer (F.V.) performed sustained tones from F5 chromatically rising up to Bb5 on the vowel /a/. Vocal tract anatomy is assessed by magnetic resonance imaging. Wilcoxon directional testing demonstrates (1) that the vocal tract volume above the glottal region does not differ statistically in contrast to the subglottal region and (2) significant changes in the configuration of the tongue, the upright position of the epiglottis, the length of the floor of mouth, and the distance between the teeth. The narrowing of the subglottis is considered to be secondary to suction forces used in the inhaling singing technique. The changes in the anatomical structures above the vocal folds possibly suggest a valve-like function controlling the air inlet together with the regulator function of the resonator capacities of the vocal tract. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Radiographic analysis of vocal tract length and its relation to overall body size in two canid species.

PubMed

Plotsky, K; Rendall, D; Riede, T; Chase, K

2013-09-01

Body size is an important determinant of resource and mate competition in many species. Competition is often mediated by conspicuous vocal displays, which may help to intimidate rivals and attract mates by providing honest cues to signaler size. Fitch proposed that vocal tract resonances (or formants) should provide particularly good, or honest, acoustic cues to signaler size because they are determined by the length of the vocal tract, which in turn, is hypothesized to scale reliably with overall body size. There is some empirical support for this hypothesis, but to date, many of the effects have been either mixed for males compared with females, weaker than expected in one or the other sex, or complicated by sampling issues. In this paper, we undertake a direct test of Fitch's hypothesis in two canid species using large samples that control for age- and sex-related variation. The samples involved radiographic images of 120 Portuguese water dogs Canis lupus familiaris and 121 Russian silver foxes Vulpes vulpes . Direct measurements were made of vocal tract length from X-ray images and compared against independent measures of body size. In adults of both species, and within both sexes, overall vocal tract length was strongly and significantly correlated with body size. Effects were strongest for the oral component of the vocal tract. By contrast, the length of the pharyngeal component was not as consistently related to body size. These outcomes are some of the clearest evidence to date in support of Fitch's hypothesis. At the same time, they highlight the potential for elements of both honest and deceptive body signaling to occur simultaneously via differential acoustic cues provided by the oral versus pharyngeal components of the vocal tract.

Radiographic analysis of vocal tract length and its relation to overall body size in two canid species

PubMed Central

Plotsky, K.; Rendall, D.; Riede, T.; Chase, K.

2013-01-01

Body size is an important determinant of resource and mate competition in many species. Competition is often mediated by conspicuous vocal displays, which may help to intimidate rivals and attract mates by providing honest cues to signaler size. Fitch proposed that vocal tract resonances (or formants) should provide particularly good, or honest, acoustic cues to signaler size because they are determined by the length of the vocal tract, which in turn, is hypothesized to scale reliably with overall body size. There is some empirical support for this hypothesis, but to date, many of the effects have been either mixed for males compared with females, weaker than expected in one or the other sex, or complicated by sampling issues. In this paper, we undertake a direct test of Fitch’s hypothesis in two canid species using large samples that control for age- and sex-related variation. The samples involved radiographic images of 120 Portuguese water dogs Canis lupus familiaris and 121 Russian silver foxes Vulpes vulpes. Direct measurements were made of vocal tract length from X-ray images and compared against independent measures of body size. In adults of both species, and within both sexes, overall vocal tract length was strongly and significantly correlated with body size. Effects were strongest for the oral component of the vocal tract. By contrast, the length of the pharyngeal component was not as consistently related to body size. These outcomes are some of the clearest evidence to date in support of Fitch’s hypothesis. At the same time, they highlight the potential for elements of both honest and deceptive body signaling to occur simultaneously via differential acoustic cues provided by the oral versus pharyngeal components of the vocal tract. PMID:24363497

The Vocal Repertoire of the Domesticated Zebra Finch: a Data Driven Approach to Decipher the Information-bearing Acoustic Features of Communication Signals

PubMed Central

Elie, Julie E.; Theunissen, Frédéric E.

2018-01-01

Although a universal code for the acoustic features of animal vocal communication calls may not exist, the thorough analysis of the distinctive acoustical features of vocalization categories is important not only to decipher the acoustical code for a specific species but also to understand the evolution of communication signals and the mechanisms used to produce and understand them. Here, we recorded more than 8,000 examples of almost all the vocalizations of the domesticated zebra finch, Taeniopygia guttata: vocalizations produced to establish contact, to form and maintain pair bonds, to sound an alarm, to communicate distress or to advertise hunger or aggressive intents. We characterized each vocalization type using complete representations that avoided any a priori assumptions on the acoustic code, as well as classical bioacoustics measures that could provide more intuitive interpretations. We then used these acoustical features to rigorously determine the potential information-bearing acoustical features for each vocalization type using both a novel regularized classifier and an unsupervised clustering algorithm. Vocalization categories are discriminated by the shape of their frequency spectrum and by their pitch saliency (noisy to tonal vocalizations) but not particularly by their fundamental frequency. Notably, the spectral shape of zebra finch vocalizations contains peaks or formants that vary systematically across categories and that would be generated by active control of both the vocal organ (source) and the upper vocal tract (filter). PMID:26581377

An acoustic glottal source for vocal tract physical models

NASA Astrophysics Data System (ADS)

Hannukainen, Antti; Kuortti, Juha; Malinen, Jarmo; Ojalammi, Antti

2017-11-01

A sound source is proposed for the acoustic measurement of physical models of the human vocal tract. The physical models are produced by fast prototyping, based on magnetic resonance imaging during prolonged vowel production. The sound source, accompanied by custom signal processing algorithms, is used for two kinds of measurements from physical models of the vocal tract: (i) amplitude frequency response and resonant frequency measurements, and (ii) signal reconstructions at the source output according to a target pressure waveform with measurements at the mouth position. The proposed source and the software are validated by computational acoustics experiments and measurements on a physical model of the vocal tract corresponding to the vowels [] of a male speaker.

Descended and mobile larynx, vocal tract elongation and rutting roars in male goitred gazelles (Gazella subgutturosa Güldenstaedt, 1780)

PubMed Central

Frey, Roland; Volodin, Ilya; Volodina, Elena; Soldatova, Natalia V; Juldaschev, Erkin T

2011-01-01

Similar to male humans, Homo sapiens, the males of a few polygynous ruminants – red deer Cervus elaphus, fallow deer Dama dama and Mongolian gazelle Procapra gutturosa– have a more or less enlarged, low-resting larynx and are capable of additional dynamic vocal tract elongation by larynx retraction during their rutting calls. The vocal correlates of a large larynx and an elongated vocal tract, a low fundamental frequency and low vocal tract resonance frequencies, deter rival males and attract receptive females. The males of the polygynous goitred gazelle, Gazella subgutturosa, provide another, independently evolved, example of an enlarged and low-resting larynx of high mobility. Relevant aspects of the rutting behaviour of territorial wild male goitred gazelles are described. Video and audio recordings served to study the acoustic effects of the enlarged larynx and vocal tract elongation on male rutting calls. Three call types were discriminated: roars, growls and grunts. In addition, the adult male vocal anatomy during the emission of rutting calls is described and functionally discussed using a 2D-model of larynx retraction. The combined morphological, behavioural and acoustic data are discussed in relation to the hypothesis of sexual selection for male-specific deep voices, resulting in convergent features of vocal anatomy in a few polygynous ruminants and in human males. PMID:21413987

High-speed registration of phonation-related glottal area variation during artificial lengthening of the vocal tract.

PubMed

Laukkanen, Anne-Maria; Pulakka, Hannu; Alku, Paavo; Vilkman, Erkki; Hertegård, Stellan; Lindestad, Per-Ake; Larsson, Hans; Granqvist, Svante

2007-01-01

Vocal exercises that increase the vocal tract impedance are widely used in voice training and therapy. The present study applies a versatile methodology to investigate phonation during varying artificial extension of the vocal tract. Two males and one female phonated into a hard-walled plastic tube (phi 2 cm), whose physical length was randomly pair-wise changed between 30 cm, 60 cm and 100 cm. High-speed image (1900 f/sec) sequences of the vocal folds were obtained via a rigid endoscope. Acoustic and electroglottographic signals (EGG) were recorded. Oral pressure during shuttering of the tube was used to give an estimate of subglottic pressure (Psub). The only trend observed was that with the two longer tubes compared to the shortest one, fundamental frequency was lower, open time of the glottis shorter, and Psub higher. The results may partly reflect increased vocal tract impedance as such and partly the increased vocal effort to compensate for it. In other parameters there were individual differences in tube length-related changes, suggesting complexity of the coupling between supraglottic space and the glottis.

A theoretical study of F0-F1 interaction with application to resonant speaking and singing voice.

PubMed

Titze, Ingo R

2004-09-01

An interactive source-filter system, consisting of a three-mass body-cover model of the vocal folds and a wave reflection model of the vocal tract, was used to test the dependence of vocal fold vibration on the vocal tract. The degree of interaction is governed by the epilarynx tube, which raises the vocal tract impedance to match the impedance of the glottis. The key component of the impedance is inertive reactance. Whenever there is inertive reactance, the vocal tract assists the vocal folds in vibration. The amplitude of vibration and the glottal flow can more than double, and the oral radiated power can increase up to 10 dB. As F0 approaches F1, the first formant frequency, the interactive source-filter system loses its advantage (because inertive reactance changes to compliant reactance) and the noninteractive system produces greater vocal output. Thus, from a voice training and control standpoint, there may be reasons to operate the system in either interactive and noninteractive modes. The harmonics 2F0 and 3F0 can also benefit from being positioned slightly below F1.

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

PubMed Central

Lester, Rosemary A.; 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 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. PMID:26328711

Two-dimensional vocal tracts with three-dimensional behavior in the numerical generation of vowels.

PubMed

Arnela, Marc; Guasch, Oriol

2014-01-01

Two-dimensional (2D) numerical simulations of vocal tract acoustics may provide a good balance between the high quality of three-dimensional (3D) finite element approaches and the low computational cost of one-dimensional (1D) techniques. However, 2D models are usually generated by considering the 2D vocal tract as a midsagittal cut of a 3D version, i.e., using the same radius function, wall impedance, glottal flow, and radiation losses as in 3D, which leads to strong discrepancies in the resulting vocal tract transfer functions. In this work, a four step methodology is proposed to match the behavior of 2D simulations with that of 3D vocal tracts with circular cross-sections. First, the 2D vocal tract profile becomes modified to tune the formant locations. Second, the 2D wall impedance is adjusted to fit the formant bandwidths. Third, the 2D glottal flow gets scaled to recover 3D pressure levels. Fourth and last, the 2D radiation model is tuned to match the 3D model following an optimization process. The procedure is tested for vowels /a/, /i/, and /u/ and the obtained results are compared with those of a full 3D simulation, a conventional 2D approach, and a 1D chain matrix model.

Inter-speaker speech variability assessment using statistical deformable models from 3.0 tesla magnetic resonance images.

PubMed

Vasconcelos, Maria J M; Ventura, Sandra M R; Freitas, Diamantino R S; Tavares, João Manuel R S

2012-03-01

The morphological and dynamic characterisation of the vocal tract during speech production has been gaining greater attention due to the motivation of the latest improvements in magnetic resonance (MR) imaging; namely, with the use of higher magnetic fields, such as 3.0 Tesla. In this work, the automatic study of the vocal tract from 3.0 Tesla MR images was assessed through the application of statistical deformable models. Therefore, the primary goal focused on the analysis of the shape of the vocal tract during the articulation of European Portuguese sounds, followed by the evaluation of the results concerning the automatic segmentation, i.e. identification of the vocal tract in new MR images. In what concerns speech production, this is the first attempt to automatically characterise and reconstruct the vocal tract shape of 3.0 Tesla MR images by using deformable models; particularly, by using active and appearance shape models. The achieved results clearly evidence the adequacy and advantage of the automatic analysis of the 3.0 Tesla MR images of these deformable models in order to extract the vocal tract shape and assess the involved articulatory movements. These achievements are mostly required, for example, for a better knowledge of speech production, mainly of patients suffering from articulatory disorders, and to build enhanced speech synthesizer models.

Computerized Tomography Measures During and After Artificial Lengthening of the Vocal Tract in Subjects With Voice Disorders.

PubMed

Guzman, Marco; Miranda, Gonzalo; Olavarria, Christian; Madrid, Sofia; Muñoz, Daniel; Leiva, Miguel; Lopez, Lorena; Bortnem, Cori

2017-01-01

The present study aimed to observe the effect of two types of tubes on vocal tract bidimensional and tridimensional images. Ten participants with hyperfunctional dysphonia were included. Computerized tomography was performed during production of sustained [a:], followed by sustained phonation into a drinking straw, and then repetition of sustained [a:]. A similar procedure was performed with a stirring straw after 15 minutes of vocal rest. Anatomic distances and area measures were obtained from computerized tomography midsagittal and transversal images. Vocal tract total volume was also calculated. During tube phonation, increases were measured in the vertical length of the vocal tract, oropharyngeal area, hypopharyngeal area, outlet of the epilaryngeal tube, and inlet to the lower pharynx. Also, the larynx was lower, and more closure was noted between the velum and the nasal passage. Tube phonation causes an increased total vocal tract volume, mostly because of the increased cross-sectional areas in the pharyngeal region. This change is more prominent when the tube offers more airflow resistance (stirring straw) compared with less airflow resistance (drinking straw). Based on our data and previous studies, it seems that vocal tract changes are not dependent on the voice condition (vocally trained, untrained, or disordered voices), but on the exercise itself and the type of instructions given to subjects. Tube phonation is a good option to reach therapeutic goals (eg, wide pharynx and low larynx) without giving biomechanical instructions, but only asking patients to feel easy voice and vibratory sensations. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

How to precisely measure the volume velocity transfer function of physical vocal tract models by external excitation

PubMed Central

Mainka, Alexander; Kürbis, Steffen; Birkholz, Peter

2018-01-01

Recently, 3D printing has been increasingly used to create physical models of the vocal tract with geometries obtained from magnetic resonance imaging. These printed models allow measuring the vocal tract transfer function, which is not reliably possible in vivo for the vocal tract of living humans. The transfer functions enable the detailed examination of the acoustic effects of specific articulatory strategies in speaking and singing, and the validation of acoustic plane-wave models for realistic vocal tract geometries in articulatory speech synthesis. To measure the acoustic transfer function of 3D-printed models, two techniques have been described: (1) excitation of the models with a broadband sound source at the glottis and measurement of the sound pressure radiated from the lips, and (2) excitation of the models with an external source in front of the lips and measurement of the sound pressure inside the models at the glottal end. The former method is more frequently used and more intuitive due to its similarity to speech production. However, the latter method avoids the intricate problem of constructing a suitable broadband glottal source and is therefore more effective. It has been shown to yield a transfer function similar, but not exactly equal to the volume velocity transfer function between the glottis and the lips, which is usually used to characterize vocal tract acoustics. Here, we revisit this method and show both, theoretically and experimentally, how it can be extended to yield the precise volume velocity transfer function of the vocal tract. PMID:29543829

Modulation of voice related to tremor and vibrato

NASA Astrophysics Data System (ADS)

Lester, Rosemary Anne

Modulation of voice is a result of physiologic oscillation within one or more components of the vocal system including the breathing apparatus (i.e., pressure supply), the larynx (i.e. sound source), and the vocal tract (i.e., sound filter). These oscillations may be caused by pathological tremor associated with neurological disorders like essential tremor or by volitional production of vibrato in singers. Because the acoustical characteristics of voice modulation specific to each component of the vocal system and the effect of these characteristics on perception are not well-understood, it is difficult to assess individuals with vocal tremor and to determine the most effective interventions for reducing the perceptual severity of the disorder. The purpose of the present studies was to determine how the acoustical characteristics associated with laryngeal-based vocal tremor affect the perception of the magnitude of voice modulation, and to determine if adjustments could be made to the voice source and vocal tract filter to alter the acoustic output and reduce the perception of modulation. This research was carried out using both a computational model of speech production and trained singers producing vibrato to simulate laryngeal-based vocal tremor with different voice source characteristics (i.e., vocal fold length and degree of vocal fold adduction) and different vocal tract filter characteristics (i.e., vowel shapes). It was expected that, by making adjustments to the voice source and vocal tract filter that reduce the amplitude of the higher harmonics, the perception of magnitude of voice modulation would be reduced. The results of this study revealed that listeners' perception of the magnitude of modulation of voice was affected by the degree of vocal fold adduction and the vocal tract shape with the computational model, but only by the vocal quality (corresponding to the degree of vocal fold adduction) with the female singer. Based on regression analyses, listeners' judgments were predicted by modulation information in both low and high frequency bands. The findings from these studies indicate that production of a breathy vocal quality might be a useful compensatory strategy for reducing the perceptual severity of modulation of voice for individuals with tremor affecting the larynx.

Vocal Tract Discomfort Scale (VTDS) and Voice Symptom Scale (VoiSS) in the Evaluation of Patients With Voice Disorders.

PubMed

Lopes, Leonardo Wanderley; de Oliveira Florencio, Vanessa; Silva, Priscila Oliveira Costa; da Nóbrega E Ugulino, Ana Celiane; Almeida, Anna Alice

2018-01-04

We aimed to correlate the Vocal Tract Discomfort Scale (VTDS) with the Voice Symptom Scale (VoiSS) for evaluation of patients with dysphonia. In addition, we aimed to compare vocal tract discomfort symptoms in patients with and without self-reported voice problem. This is a descriptive, cross-sectional, and retrospective study. We analyzed 143 women and 62 men with voice disorders, as confirmed by endoscopic larynx examination. All patients completed the VTDS and VoiSS at vocal evaluation. Descriptive statistics and the Spearman correlation test were applied to all variables. The degree of covariance of variables was noted. The Mann-Whitney U test was used to compare the average number of discomfort symptoms among patients with and without self-reported voice problems. A weak to moderate positive correlation was observed between the average number, frequency, and intensity of comfort symptom and the total score, physical domain score, and limitation domain score of the VoiSS. The vocal tract discomfort symptoms and the emotional domain score of the VoiSS were weakly correlated. Patients with self-reported voice problems had a higher number, frequency, and intensity of vocal tract discomfort symptoms. There is correlation between the VTDS and VoiSS scales, with greater references to vocal tract discomfort symptom in patients with self-reported voice problems. Therefore, the discomfort symptoms seem to influence the perception of the impact of a voice problem. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Effect of the losses in the vocal tract on determination of the area function.

PubMed

Gülmezoğlu, M Bilginer; Barkana, Atalay

2003-01-01

In this work, the cross-sectional areas of the vocal tract are determined for the lossy and lossless cases by using the pole-zero models obtained from the electrical equivalent circuit model of the vocal tract and the system identification method. The cross-sectional areas are used to compare the lossy and lossless cases. In the lossy case, the internal losses due to wall vibration, heat conduction, air friction and viscosity are considered, that is, the complex poles and zeros obtained from the models are used directly. Whereas, in the lossless case, only the imaginary parts of these poles and zeros are used. The vocal tract shapes obtained for the lossy case are close to the actual ones.

Vocal specialization through tracheal elongation in an extinct Miocene pheasant from China.

PubMed

Li, Zhiheng; Clarke, Julia A; Eliason, Chad M; Stidham, Thomas A; Deng, Tao; Zhou, Zhonghe

2018-05-25

Modifications to the upper vocal tract involving hyper-elongated tracheae have evolved many times within crown birds, and their evolution has been linked to a 'size exaggeration' hypothesis in acoustic signaling and communication, whereby smaller-sized birds can produce louder sounds. A fossil skeleton of a new extinct species of wildfowl (Galliformes: Phasianidae) from the late Miocene of China, preserves an elongated, coiled trachea that represents the oldest fossil record of this vocal modification in birds and the first documentation of its evolution within pheasants. The phylogenetic position of this species within Phasianidae has not been fully resolved, but appears to document a separate independent origination of this vocal modification within Galliformes. The fossil preserves a coiled section of the trachea and other remains supporting a tracheal length longer than the bird's body. This extinct species likely produced vocalizations with a lower fundamental frequency and reduced harmonics compared to similarly-sized pheasants. The independent evolution of this vocal feature in galliforms living in both open and closed habitats does not appear to be correlated with other factors of biology or its open savanna-like habitat. Features present in the fossil that are typically associated with sexual dimorphism suggest that sexual selection may have resulted in the evolution of both the morphology and vocalization mechanism in this extinct species.

Feminization laryngoplasty: assessment of surgical pitch elevation.

PubMed

Thomas, James P; Macmillan, Cody

2013-09-01

The aim of this study is to analyze change in pitch following feminization laryngoplasty, a technique to alter the vocal tract of male to female transgender patients. This is a retrospective review of 94 patients undergoing feminization laryngoplasty between June 2002 and April 2012 of which 76 individuals completed follow-up audio recordings. Feminization laryngoplasty is a procedure removing the anterior thyroid cartilage, collapsing the diameter of the larynx as well as shortening and tensioning the vocal folds to raise the pitch. Changes in comfortable speaking pitch, lowest vocal pitch and highest vocal pitch are assessed before and after surgery. Acoustic parameters of speaking pitch and vocal range were compared between pre- and postoperative results. The average comfortable speaking pitch preoperatively, C3# (139 Hz), was raised an average of six semitones to G3 (196 Hz), after surgical intervention. The lowest attainable pitch was raised an average of seven semitones and the highest attainable pitch decreased by an average of two semitones. One aspect of the procedure, thyrohyoid approximation (introduced in 2006 to alter resonance), did not affect pitch. Feminization laryngoplasty successfully increased the comfortable fundamental frequency of speech and removed the lowest notes from the patient's vocal range. It does not typically raise the upper limits of the vocal range.

The stabilized, wavelet-Mellin transform for analyzing the size and shape information of vocalized sounds

NASA Astrophysics Data System (ADS)

Irino, Toshio; Patterson, Roy

2005-04-01

We hear vowels produced by men, women, and children as approximately the same although there is considerable variability in glottal pulse rate and vocal tract length. At the same time, we can identify the speaker group. Recent experiments show that it is possible to identify vowels even when the glottal pulse rate and vocal tract length are condensed or expanded beyond the range of natural vocalization. This suggests that the auditory system has an automatic process to segregate information about shape and size of the vocal tract. Recently we proposed that the auditory system uses some form of Stabilized, Wavelet-Mellin Transform (SWMT) to analyze scale information in bio-acoustic sounds as a general framework for auditory processing from cochlea to cortex. This talk explains the theoretical background of the model and how the vocal information is normalized in the representation. [Work supported by GASR(B)(2) No. 15300061, JSPS.

Weight-Bearing MR Imaging as an Option in the Study of Gravitational Effects on the Vocal Tract of Untrained Subjects in Singing Phonation

PubMed Central

Traser, Louisa; Burdumy, Michael; Richter, Bernhard; Vicari, Marco; Echternach, Matthias

2014-01-01

Magnetic Resonance Imaging (MRI) of subjects in a supine position can be used to evaluate the configuration of the vocal tract during phonation. However, studies of speech phonation have shown that gravity can affect vocal tract shape and bias measurements. This is one of the reasons that MRI studies of singing phonation have used professionally trained singers as subjects, because they are generally considered to be less affected by the supine body position and environmental distractions. A study of untrained singers might not only contribute to the understanding of intuitive singing function and aid the evaluation of potential hazards for vocal health, but also provide insights into the effect of the supine position on singers in general. In the present study, an open configuration 0.25 T MRI system with a rotatable examination bed was used to study the effect of body position in 20 vocally untrained subjects. The subjects were asked to sing sustained tones in both supine and upright body positions on different pitches and in different register conditions. Morphometric measurements were taken from the acquired images of a sagittal slice depicting the vocal tract. The analysis concerning the vocal tract configuration in the two body positions revealed differences in 5 out of 10 measured articulatory parameters. In the upright position the jaw was less protruded, the uvula was elongated, the larynx more tilted and the tongue was positioned more to the front of the mouth than in the supine position. The findings presented are in agreement with several studies on gravitational effects in speech phonation, but contrast with the results of a previous study on professional singers of our group where only minor differences between upright and supine body posture were observed. The present study demonstrates that imaging of the vocal tract using weight-bearing MR imaging is a feasible tool for the study of sustained phonation in singing for vocally untrained subjects. PMID:25379885

Weight-bearing MR imaging as an option in the study of gravitational effects on the vocal tract of untrained subjects in singing phonation.

PubMed

Traser, Louisa; Burdumy, Michael; Richter, Bernhard; Vicari, Marco; Echternach, Matthias

2014-01-01

Magnetic Resonance Imaging (MRI) of subjects in a supine position can be used to evaluate the configuration of the vocal tract during phonation. However, studies of speech phonation have shown that gravity can affect vocal tract shape and bias measurements. This is one of the reasons that MRI studies of singing phonation have used professionally trained singers as subjects, because they are generally considered to be less affected by the supine body position and environmental distractions. A study of untrained singers might not only contribute to the understanding of intuitive singing function and aid the evaluation of potential hazards for vocal health, but also provide insights into the effect of the supine position on singers in general. In the present study, an open configuration 0.25 T MRI system with a rotatable examination bed was used to study the effect of body position in 20 vocally untrained subjects. The subjects were asked to sing sustained tones in both supine and upright body positions on different pitches and in different register conditions. Morphometric measurements were taken from the acquired images of a sagittal slice depicting the vocal tract. The analysis concerning the vocal tract configuration in the two body positions revealed differences in 5 out of 10 measured articulatory parameters. In the upright position the jaw was less protruded, the uvula was elongated, the larynx more tilted and the tongue was positioned more to the front of the mouth than in the supine position. The findings presented are in agreement with several studies on gravitational effects in speech phonation, but contrast with the results of a previous study on professional singers of our group where only minor differences between upright and supine body posture were observed. The present study demonstrates that imaging of the vocal tract using weight-bearing MR imaging is a feasible tool for the study of sustained phonation in singing for vocally untrained subjects.

Phonation Threshold Pressure Measurement with a Semi-Occluded Vocal Tract

ERIC Educational Resources Information Center

Titze, Ingo R.

2009-01-01

Purpose: The purpose of this article was to determine if a semi-occluded vocal tract could be used to measure phonation threshold pressure. This is in contrast to the shutter technique, where an alternation between a fully occluded tract and an unoccluded tract is used. Method: Five male and 5 female volunteers phonated through a thin straw held…

Lower Vocal Tract Morphologic Adjustments Are Relevant for Voice Timbre in Singing.

PubMed

Mainka, Alexander; Poznyakovskiy, Anton; Platzek, Ivan; Fleischer, Mario; Sundberg, Johan; Mürbe, Dirk

2015-01-01

The vocal tract shape is crucial to voice production. Its lower part seems particularly relevant for voice timbre. This study analyzes the detailed morphology of parts of the epilaryngeal tube and the hypopharynx for the sustained German vowels /a/, /e/, /i/, /o/, and /u/ by thirteen male singer subjects who were at the beginning of their academic singing studies. Analysis was based on two different phonatory conditions: a natural, speech-like phonation and a singing phonation, like in classical singing. 3D models of the vocal tract were derived from magnetic resonance imaging and compared with long-term average spectrum analysis of audio recordings from the same subjects. Comparison of singing to the speech-like phonation, which served as reference, showed significant adjustments of the lower vocal tract: an average lowering of the larynx by 8 mm and an increase of the hypopharyngeal cross-sectional area (+ 21:9%) and volume (+ 16:8%). Changes in the analyzed epilaryngeal portion of the vocal tract were not significant. Consequently, lower larynx-to-hypopharynx area and volume ratios were found in singing compared to the speech-like phonation. All evaluated measures of the lower vocal tract varied significantly with vowel quality. Acoustically, an increase of high frequency energy in singing correlated with a wider hypopharyngeal area. The findings offer an explanation how classical male singers might succeed in producing a voice timbre with increased high frequency energy, creating a singer`s formant cluster.

Lower Vocal Tract Morphologic Adjustments Are Relevant for Voice Timbre in Singing

PubMed Central

Mainka, Alexander; Poznyakovskiy, Anton; Platzek, Ivan; Fleischer, Mario; Sundberg, Johan; Mürbe, Dirk

2015-01-01

The vocal tract shape is crucial to voice production. Its lower part seems particularly relevant for voice timbre. This study analyzes the detailed morphology of parts of the epilaryngeal tube and the hypopharynx for the sustained German vowels /a/, /e/, /i/, /o/, and /u/ by thirteen male singer subjects who were at the beginning of their academic singing studies. Analysis was based on two different phonatory conditions: a natural, speech-like phonation and a singing phonation, like in classical singing. 3D models of the vocal tract were derived from magnetic resonance imaging and compared with long-term average spectrum analysis of audio recordings from the same subjects. Comparison of singing to the speech-like phonation, which served as reference, showed significant adjustments of the lower vocal tract: an average lowering of the larynx by 8 mm and an increase of the hypopharyngeal cross-sectional area (+ 21.9%) and volume (+ 16.8%). Changes in the analyzed epilaryngeal portion of the vocal tract were not significant. Consequently, lower larynx-to-hypopharynx area and volume ratios were found in singing compared to the speech-like phonation. All evaluated measures of the lower vocal tract varied significantly with vowel quality. Acoustically, an increase of high frequency energy in singing correlated with a wider hypopharyngeal area. The findings offer an explanation how classical male singers might succeed in producing a voice timbre with increased high frequency energy, creating a singer‘s formant cluster. PMID:26186691

Power Flow in Phonation

NASA Astrophysics Data System (ADS)

Zhang, Lucy; Yu, Feimi; Krane, Michael

2017-11-01

The control volume analysis of power flow during sustained phonation is performed using results of a fully-coupled aeroelastic-aeroacoustic simulation. The control volumes consist of the laryngeal region, and the larynx and the vocal tract. Two cases are considered: an effectively infinite length vocal tract, where sound produced in the larynx radiates away and is not reflected back, and a constant-area vocal tract of normal adult human dimensions, in which phonatory sound resonates before radiating from the mouth opening. In both cases the lungs are modeled to absorb all incident sound, while providing a constant volume flow toward the larynx. Control of the acoustic boundary conditions is accomplished using perfectly matched- layers, and flow from the lungs is provided by a source distribution near the entrance to the trachea region. For both cases the power flow for the larynx and larynx plus vocal tract control volumes are computed using the integral form of the mechanical energy equation, expanded to consider power exchanges between slightly compressible flow in the larynx and the acoustic fields in the vocal tract and trachea. The funding from NIH 2R01DC005642-10A1 is greatly acknowledged.

Effect of the signal measured from the glottis on determination of the vocal tract shape.

PubMed

Gülmezoğlu, M B; Barkana, A

1998-01-01

All-pole and pole-zero models for the vocal tract are developed. First an impulse train, then the pressure signal measured from the glottis, is used as the input in the models. The models for eight Turkish vowels produced by one male subject are studied to determine the effects of the presumed impulse train and the pressure signal measured from the glottis on the estimation of the vocal tract shape. The motion of the tongue is also examined for a whole word.

Human vocal tract resonances and the corresponding mode shapes investigated by three-dimensional finite-element modelling based on CT measurement.

PubMed

Vampola, Tomáš; Horáček, Jaromír; Laukkanen, Anne-Maria; Švec, Jan G

2015-04-01

Resonance frequencies of the vocal tract have traditionally been modelled using one-dimensional models. These cannot accurately represent the events in the frequency region of the formant cluster around 2.5-4.5 kHz, however. Here, the vocal tract resonance frequencies and their mode shapes are studied using a three-dimensional finite element model obtained from computed tomography measurements of a subject phonating on vowel [a:]. Instead of the traditional five, up to eight resonance frequencies of the vocal tract were found below the prominent antiresonance around 4.7 kHz. The three extra resonances were found to correspond to modes which were axially asymmetric and involved the piriform sinuses, valleculae, and transverse vibrations in the oral cavity. The results therefore suggest that the phenomenon of speaker's and singer's formant clustering may be more complex than originally thought.

Vocal Tract Images Reveal Neural Representations of Sensorimotor Transformation During Speech Imitation

PubMed Central

Carey, Daniel; Miquel, Marc E.; Evans, Bronwen G.; Adank, Patti; McGettigan, Carolyn

2017-01-01

Abstract Imitating speech necessitates the transformation from sensory targets to vocal tract motor output, yet little is known about the representational basis of this process in the human brain. Here, we address this question by using real-time MR imaging (rtMRI) of the vocal tract and functional MRI (fMRI) of the brain in a speech imitation paradigm. Participants trained on imitating a native vowel and a similar nonnative vowel that required lip rounding. Later, participants imitated these vowels and an untrained vowel pair during separate fMRI and rtMRI runs. Univariate fMRI analyses revealed that regions including left inferior frontal gyrus were more active during sensorimotor transformation (ST) and production of nonnative vowels, compared with native vowels; further, ST for nonnative vowels activated somatomotor cortex bilaterally, compared with ST of native vowels. Using test representational similarity analysis (RSA) models constructed from participants’ vocal tract images and from stimulus formant distances, we found that RSA searchlight analyses of fMRI data showed either type of model could be represented in somatomotor, temporal, cerebellar, and hippocampal neural activation patterns during ST. We thus provide the first evidence of widespread and robust cortical and subcortical neural representation of vocal tract and/or formant parameters, during prearticulatory ST. PMID:28334401

Vocal Tract Images Reveal Neural Representations of Sensorimotor Transformation During Speech Imitation.

PubMed

Carey, Daniel; Miquel, Marc E; Evans, Bronwen G; Adank, Patti; McGettigan, Carolyn

2017-05-01

Imitating speech necessitates the transformation from sensory targets to vocal tract motor output, yet little is known about the representational basis of this process in the human brain. Here, we address this question by using real-time MR imaging (rtMRI) of the vocal tract and functional MRI (fMRI) of the brain in a speech imitation paradigm. Participants trained on imitating a native vowel and a similar nonnative vowel that required lip rounding. Later, participants imitated these vowels and an untrained vowel pair during separate fMRI and rtMRI runs. Univariate fMRI analyses revealed that regions including left inferior frontal gyrus were more active during sensorimotor transformation (ST) and production of nonnative vowels, compared with native vowels; further, ST for nonnative vowels activated somatomotor cortex bilaterally, compared with ST of native vowels. Using test representational similarity analysis (RSA) models constructed from participants' vocal tract images and from stimulus formant distances, we found that RSA searchlight analyses of fMRI data showed either type of model could be represented in somatomotor, temporal, cerebellar, and hippocampal neural activation patterns during ST. We thus provide the first evidence of widespread and robust cortical and subcortical neural representation of vocal tract and/or formant parameters, during prearticulatory ST. © The Author 2017. Published by Oxford University Press.

Acoustic signatures of sound source-tract coupling.

PubMed

Arneodo, Ezequiel M; Perl, Yonatan Sanz; Mindlin, Gabriel B

2011-04-01

Birdsong is a complex behavior, which results from the interaction between a nervous system and a biomechanical peripheral device. While much has been learned about how complex sounds are generated in the vocal organ, little has been learned about the signature on the vocalizations of the nonlinear effects introduced by the acoustic interactions between a sound source and the vocal tract. The variety of morphologies among bird species makes birdsong a most suitable model to study phenomena associated to the production of complex vocalizations. Inspired by the sound production mechanisms of songbirds, in this work we study a mathematical model of a vocal organ, in which a simple sound source interacts with a tract, leading to a delay differential equation. We explore the system numerically, and by taking it to the weakly nonlinear limit, we are able to examine its periodic solutions analytically. By these means we are able to explore the dynamics of oscillatory solutions of a sound source-tract coupled system, which are qualitatively different from those of a sound source-filter model of a vocal organ. Nonlinear features of the solutions are proposed as the underlying mechanisms of observed phenomena in birdsong, such as unilaterally produced "frequency jumps," enhancement of resonances, and the shift of the fundamental frequency observed in heliox experiments. ©2011 American Physical Society

Acoustic signatures of sound source-tract coupling

PubMed Central

Arneodo, Ezequiel M.; Perl, Yonatan Sanz; Mindlin, Gabriel B.

2014-01-01

Birdsong is a complex behavior, which results from the interaction between a nervous system and a biomechanical peripheral device. While much has been learned about how complex sounds are generated in the vocal organ, little has been learned about the signature on the vocalizations of the nonlinear effects introduced by the acoustic interactions between a sound source and the vocal tract. The variety of morphologies among bird species makes birdsong a most suitable model to study phenomena associated to the production of complex vocalizations. Inspired by the sound production mechanisms of songbirds, in this work we study a mathematical model of a vocal organ, in which a simple sound source interacts with a tract, leading to a delay differential equation. We explore the system numerically, and by taking it to the weakly nonlinear limit, we are able to examine its periodic solutions analytically. By these means we are able to explore the dynamics of oscillatory solutions of a sound source-tract coupled system, which are qualitatively different from those of a sound source-filter model of a vocal organ. Nonlinear features of the solutions are proposed as the underlying mechanisms of observed phenomena in birdsong, such as unilaterally produced “frequency jumps,” enhancement of resonances, and the shift of the fundamental frequency observed in heliox experiments. PMID:21599213

Effects of a Semioccluded Vocal Tract on Laryngeal Muscle Activity and Glottal Adduction in a Single Female Subject

PubMed Central

Laukkanen, Anne-Maria; Titze, Ingo R.; Hoffman, Henry; Finnegan, Eileen

2015-01-01

Voice training exploits semiocclusives, which increase vocal tract interaction with the source. Modeling results suggest that vocal economy (maximum flow declination rate divided by maximum area declination rate, MADR) is improved by matching the glottal and vocal tract impedances. Changes in MADR may be correlated with thyroarytenoid (TA) muscle activity. Here the effects of impedance matching are studied for laryngeal muscle activity and glottal resistance. One female repeated [pa:p:a] before and immediately after (a) phonation into different-sized tubes and (b) voiced bilabial fricative [β:]. To allow estimation of subglottic pressure from the oral pressure, [p] was inserted also in the repetitions of the semiocclusions. Airflow was registered using a flow mask. EMG was registered from TA, cricothyroid (CT) and lateral cricoarytenoid (LCA) muscles. Phonation was simulated using a 7 × 5 × 5 point-mass model of the vocal folds, allowing inputs of simulated laryngeal muscle activation. The variables were TA, CT and LCA activities. Increased vocal tract impedance caused the subject to raise TA activity compared to CT and LCA activities. Computer simulation showed that higher glottal economy and efficiency (oral radiated power divided by aerodynamic power) were obtained with a higher TA/CT ratio when LCA activity was tuned for ideal adduction. PMID:19011306

Visualizing sound emission of elephant vocalizations: evidence for two rumble production types.

PubMed

Stoeger, Angela S; Heilmann, Gunnar; Zeppelzauer, Matthias; Ganswindt, André; Hensman, Sean; Charlton, Benjamin D

2012-01-01

Recent comparative data reveal that formant frequencies are cues to body size in animals, due to a close relationship between formant frequency spacing, vocal tract length and overall body size. Accordingly, intriguing morphological adaptations to elongate the vocal tract in order to lower formants occur in several species, with the size exaggeration hypothesis being proposed to justify most of these observations. While the elephant trunk is strongly implicated to account for the low formants of elephant rumbles, it is unknown whether elephants emit these vocalizations exclusively through the trunk, or whether the mouth is also involved in rumble production. In this study we used a sound visualization method (an acoustic camera) to record rumbles of five captive African elephants during spatial separation and subsequent bonding situations. Our results showed that the female elephants in our analysis produced two distinct types of rumble vocalizations based on vocal path differences: a nasally- and an orally-emitted rumble. Interestingly, nasal rumbles predominated during contact calling, whereas oral rumbles were mainly produced in bonding situations. In addition, nasal and oral rumbles varied considerably in their acoustic structure. In particular, the values of the first two formants reflected the estimated lengths of the vocal paths, corresponding to a vocal tract length of around 2 meters for nasal, and around 0.7 meters for oral rumbles. These results suggest that African elephants may be switching vocal paths to actively vary vocal tract length (with considerable variation in formants) according to context, and call for further research investigating the function of formant modulation in elephant vocalizations. Furthermore, by confirming the use of the elephant trunk in long distance rumble production, our findings provide an explanation for the extremely low formants in these calls, and may also indicate that formant lowering functions to increase call propagation distances in this species'.

Visualizing Sound Emission of Elephant Vocalizations: Evidence for Two Rumble Production Types

PubMed Central

Stoeger, Angela S.; Heilmann, Gunnar; Zeppelzauer, Matthias; Ganswindt, André; Hensman, Sean; Charlton, Benjamin D.

2012-01-01

Recent comparative data reveal that formant frequencies are cues to body size in animals, due to a close relationship between formant frequency spacing, vocal tract length and overall body size. Accordingly, intriguing morphological adaptations to elongate the vocal tract in order to lower formants occur in several species, with the size exaggeration hypothesis being proposed to justify most of these observations. While the elephant trunk is strongly implicated to account for the low formants of elephant rumbles, it is unknown whether elephants emit these vocalizations exclusively through the trunk, or whether the mouth is also involved in rumble production. In this study we used a sound visualization method (an acoustic camera) to record rumbles of five captive African elephants during spatial separation and subsequent bonding situations. Our results showed that the female elephants in our analysis produced two distinct types of rumble vocalizations based on vocal path differences: a nasally- and an orally-emitted rumble. Interestingly, nasal rumbles predominated during contact calling, whereas oral rumbles were mainly produced in bonding situations. In addition, nasal and oral rumbles varied considerably in their acoustic structure. In particular, the values of the first two formants reflected the estimated lengths of the vocal paths, corresponding to a vocal tract length of around 2 meters for nasal, and around 0.7 meters for oral rumbles. These results suggest that African elephants may be switching vocal paths to actively vary vocal tract length (with considerable variation in formants) according to context, and call for further research investigating the function of formant modulation in elephant vocalizations. Furthermore, by confirming the use of the elephant trunk in long distance rumble production, our findings provide an explanation for the extremely low formants in these calls, and may also indicate that formant lowering functions to increase call propagation distances in this species'. PMID:23155427

Vocal tract characteristics in Parkinson's disease.

PubMed

Gillivan-Murphy, Patricia; Carding, Paul; Miller, Nick

2016-06-01

Voice tremor is strongly linked to the Parkinson's disease speech-voice symptom complex. Little is known about the underlying anatomic source(s) of voice tremor when it occurs. We review recent literature addressing this issue. Additionally we report findings from a study we conducted employing rating of vocal tract structures viewed using nasolaryngoscopy during vocal and nonspeech tasks. In Parkinson's disease, using laryngeal electromyography, tremor has not been identified in muscles in the vocal folds even when perceived auditorily. Preliminary findings using nasolaryngoscopy suggest that Parkinson's disease voice tremor is not associated with the vocal folds and may involve the palate, the global larynx, and the arytenoids. Tremor in the vertical larynx on /a/, and tremor in the arytenoid cartilages on /s/ differentiated patients with Parkinson's disease from neurologically healthy controls. Visual reliable detection of tremor when it is absent or borderline present, is challenging. Parkinson's disease voice tremor is likely to be related to oscillatory movement in structures across the vocal tract rather than just the vocal folds. To progress clinical practice, more refined tools for the visual rating of tremor would be beneficial. How far voice tremor represents a functionally significant factor for speakers would also add to the literature.

The respiratory-vocal system of songbirds: anatomy, physiology, and neural control.

PubMed

Schmidt, Marc F; Martin Wild, J

2014-01-01

This wide-ranging review presents an overview of the respiratory-vocal system in songbirds, which are the only other vertebrate group known to display a degree of respiratory control during song rivalling that of humans during speech; this despite the fact that the peripheral components of both the respiratory and vocal systems differ substantially in the two groups. We first provide a brief description of these peripheral components in songbirds (lungs, air sacs and respiratory muscles, vocal organ (syrinx), upper vocal tract) and then proceed to a review of the organization of central respiratory-related neurons in the spinal cord and brainstem, the latter having an organization fundamentally similar to that of the ventral respiratory group of mammals. The second half of the review describes the nature of the motor commands generated in a specialized "cortical" song control circuit and how these might engage brainstem respiratory networks to shape the temporal structure of song. We also discuss a bilaterally projecting "respiratory-thalamic" pathway that links the respiratory system to "cortical" song control nuclei. This necessary pathway for song originates in the brainstem's primary inspiratory center and is hypothesized to play a vital role in synchronizing song motor commands both within and across hemispheres. © 2014 Elsevier B.V. All rights reserved.

The respiratory-vocal system of songbirds: Anatomy, physiology, and neural control

PubMed Central

Schmidt, Marc F.; Wild, J. Martin

2015-01-01

This wide-ranging review presents an overview of the respiratory-vocal system in songbirds, which are the only other vertebrate group known to display a degree of respiratory control during song rivalling that of humans during speech; this despite the fact that the peripheral components of both the respiratory and vocal systems differ substantially in the two groups. We first provide a brief description of these peripheral components in songbirds (lungs, air sacs and respiratory muscles, vocal organ (syrinx), upper vocal tract) and then proceed to a review of the organization of central respiratory-related neurons in the spinal cord and brainstem, the latter having an organization fundamentally similar to that of the ventral respiratory group of mammals. The second half of the review describes the nature of the motor commands generated in a specialized “cortical” song control circuit and how these might engage brainstem respiratory networks to shape the temporal structure of song. We also discuss a bilaterally projecting “respiratory-thalamic” pathway that links the respiratory system to “cortical” song control nuclei. This necessary pathway for song originates in the brainstem’s primary inspiratory center and is hypothesized to play a vital role in synchronizing song motor commands both within and across hemispheres. PMID:25194204

Flow-structure interaction simulation of voice production in a canine larynx

NASA Astrophysics Data System (ADS)

Jiang, Weili; Zheng, Xudong; Xue, Qian; Oren, Liran; Khosla, Sid

2017-11-01

Experimental measurements conducted on a hemi-larynx canine vocal fold showed that negative pressures formed in the glottis near the superior surface of the vocal fold in the closing phase even without a supra-glottal vocal tract. It was hypothesized that such negative pressures were due to intraglottal vortices caused by flow separation in a divergent vocal tract during vocal fold closing phase. This work aims to test this hypothesis from the numerical aspect. Flow-structure interaction simulations are performed in realistic canine laryngeal shapes. In the simulations, a sharp interface immersed boundary method based incompressible flow solver is utilized to model the air flow; a finite element based solid mechanics solver is utilized to model the vocal fold vibration. The geometric structure of the vocal fold and vocal tract are based on MRI scans of a mongrel canine. The vocal fold tissue is modeled as transversely isotropic nonlinear materials with a vertical stiffness gradient. Numerical indentation is first performed and compared with the experiment data to obtain the material properties. Simulation setup about the inlet and outlet pressure follows the setup in the experiment. Simulation results including the fundamental frequency, air flow rate, the divergent angle will be compared with the experimental data, providing the validation of the simulation approach. The relationship between flow separation, intra-glottal vortices, divergent angle and flow rate will be comprehensively analyzed.

An investigation of articulatory setting using real-time magnetic resonance imaging

PubMed Central

Ramanarayanan, Vikram; Goldstein, Louis; Byrd, Dani; Narayanan, Shrikanth S.

2013-01-01

This paper presents an automatic procedure to analyze articulatory setting in speech production using real-time magnetic resonance imaging of the moving human vocal tract. The procedure extracts frames corresponding to inter-speech pauses, speech-ready intervals and absolute rest intervals from magnetic resonance imaging sequences of read and spontaneous speech elicited from five healthy speakers of American English and uses automatically extracted image features to quantify vocal tract posture during these intervals. Statistical analyses show significant differences between vocal tract postures adopted during inter-speech pauses and those at absolute rest before speech; the latter also exhibits a greater variability in the adopted postures. In addition, the articulatory settings adopted during inter-speech pauses in read and spontaneous speech are distinct. The results suggest that adopted vocal tract postures differ on average during rest positions, ready positions and inter-speech pauses, and might, in that order, involve an increasing degree of active control by the cognitive speech planning mechanism. PMID:23862826

Improved vocal tract reconstruction and modeling using an image super-resolution technique.

PubMed

Zhou, Xinhui; Woo, Jonghye; Stone, Maureen; Prince, Jerry L; Espy-Wilson, Carol Y

2013-06-01

Magnetic resonance imaging has been widely used in speech production research. Often only one image stack (sagittal, axial, or coronal) is used for vocal tract modeling. As a result, complementary information from other available stacks is not utilized. To overcome this, a recently developed super-resolution technique was applied to integrate three orthogonal low-resolution stacks into one isotropic volume. The results on vowels show that the super-resolution volume produces better vocal tract visualization than any of the low-resolution stacks. Its derived area functions generally produce formant predictions closer to the ground truth, particularly for those formants sensitive to area perturbations at constrictions.

A Vowel-Based Method for Vocal Tract Control in Clarinet Pedagogy

ERIC Educational Resources Information Center

González, Darleny; Payri, Blas

2017-01-01

Our review of scientific literature shows that the activity inside the clarinetist's vocal tract (VT) affects pitch and timbre, while also facilitating technical exercises. Clarinetists adapt their VT intuitively and, in some cases, may compensate an inadequate VT configuration through unnecessary pressure, resulting in technical blockage,…

Contemporary Commercial Music Singing Students-Voice Quality and Vocal Function at the Beginning of Singing Training.

PubMed

Sielska-Badurek, Ewelina M; Sobol, Maria; Olszowska, Katarzyna; Niemczyk, Kazimierz

2017-10-03

The purpose of this study was to assess the voice quality and the vocal tract function in popular singing students at the beginning of their singing training at the High School of Music. This is a retrospective cross-sectional study. The study consisted of 45 popular singing students (35 females and 10 males, mean age: 19.9 ± 2.8 years). They were assessed in the first 2 months of their 4-year singing training at the High School of Music, between 2013 and 2016. Voice quality and vocal tract function were evaluated using videolaryngostroboscopy, palpation of the vocal tract structures, the perceptual speaking and singing voice assessment, acoustic analysis, maximal phonation time, the Voice Handicap Index, and the Singing Voice Handicap Index (SVHI). Twenty-two percent of Contemporary Commercial Music singing students began their education in the High School, with vocal nodules. Palpation of the vocal tract structure showed in 50% correct motions and tension in speaking and in 39.3% in singing. Perceptual voice assessment showed in 80% proper speaking voice quality and in 82.4% proper singing voice quality. The mean vocal fundamental frequency while speaking in females was 214 Hz and in males was 116 Hz. Dysphonia Severity Index was at the level of 2, and maximum phonation time was 17.7 seconds. The Voice Handicap Index and the SVHI remained within the normal range: 7.5 and 19, respectively. Perceptual singing voice assessment correlated with the SVHI (P = 0.006). Twenty-two percent of the Contemporary Commercial Music singing students began their education in the High School, with organic vocal fold lesions. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Phonation Threshold Pressure Measurement With a Semi-Occluded Vocal Tract

PubMed Central

Titze, Ingo R.

2015-01-01

Purpose The purpose of this article was to determine if a semi-occluded vocal tract could be used to measure phonation threshold pressure. This is in contrast to the shutter technique, where an alternation between a fully occluded tract and an unoccluded tract is used. Method Five male and 5 female volunteers phonated through a thin straw held between the lips. Oral pressure behind the lips was measured. Mathematical predictions of phonation threshold pressures were compared to the measured ones over a range of frequencies. Results It was shown that, for a 2.5-mm diameter straw, phonation threshold pressures were obtainable over a 2-octave range of fundamental frequency by all volunteers. In magnitude, the pressures agreed with the 0.2–0.5 kPa values obtained in previous investigations. Sensitivity to viscoelastic and geometric properties of the vocal folds was generally not compromised with greater oral impedance, but some differences were predicted theoretically in contrast to an open mouth configuration. Conclusion Because phonation threshold pressure is always dependent on vocal tract interaction, it may be advantageous to choose an exact and fixed oral semi-occlusion for the measurement and interpret the results in light of the known acoustic load. PMID:19641082

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

NASA Astrophysics Data System (ADS)

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.

Vocal tract and glottal function during and after vocal exercising with resonance tube and straw.

PubMed

Guzman, Marco; Laukkanen, Anne-Maria; Krupa, Petr; Horáček, Jaromir; Švec, Jan G; Geneid, Ahmed

2013-07-01

The present study aimed to investigate the vocal tract and glottal function during and after phonation into a tube and a stirring straw. A male classically trained singer was assessed. Computerized tomography (CT) was performed when the subject produced [a:] at comfortable speaking pitch, phonated into the resonance tube and when repeating [a:] after the exercise. Similar procedure was performed with a narrow straw after 15 minutes silence. Anatomic distances and area measures were obtained from CT midsagittal and transversal images. Acoustic, perceptual, electroglottographic (EGG), and subglottic pressure measures were also obtained. During and after phonation into the tube or straw, the velum closed the nasal passage better, the larynx position lowered, and hypopharynx area widened. Moreover, the ratio between the inlet of the lower pharynx and the outlet of the epilaryngeal tube became larger during and after tube/straw phonation. Acoustic results revealed a stronger spectral prominence in the singer/speaker's formant cluster region after exercising. Listening test demonstrated better voice quality after straw/tube than before. Contact quotient derived from EGG decreased during both tube and straw and remained lower after exercising. Subglottic pressure increased during straw and remained somewhat higher after it. CT and acoustic results indicated that vocal exercises with increased vocal tract impedance lead to increased vocal efficiency and economy. One of the major changes was the more prominent singer's/speaker's formant cluster. Vocal tract and glottal modifications were more prominent during and after straw exercising compared with tube phonation. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Vocal Tract Representation in the Recognition of Cerebral Palsied Speech

ERIC Educational Resources Information Center

Rudzicz, Frank; Hirst, Graeme; van Lieshout, Pascal

2012-01-01

Purpose: In this study, the authors explored articulatory information as a means of improving the recognition of dysarthric speech by machine. Method: Data were derived chiefly from the TORGO database of dysarthric articulation (Rudzicz, Namasivayam, & Wolff, 2011) in which motions of various points in the vocal tract are measured during speech.…

Automatic detection of obstructive sleep apnea using speech signals.

PubMed

Goldshtein, Evgenia; Tarasiuk, Ariel; Zigel, Yaniv

2011-05-01

Obstructive sleep apnea (OSA) is a common disorder associated with anatomical abnormalities of the upper airways that affects 5% of the population. Acoustic parameters may be influenced by the vocal tract structure and soft tissue properties. We hypothesize that speech signal properties of OSA patients will be different than those of control subjects not having OSA. Using speech signal processing techniques, we explored acoustic speech features of 93 subjects who were recorded using a text-dependent speech protocol and a digital audio recorder immediately prior to polysomnography study. Following analysis of the study, subjects were divided into OSA (n=67) and non-OSA (n=26) groups. A Gaussian mixture model-based system was developed to model and classify between the groups; discriminative features such as vocal tract length and linear prediction coefficients were selected using feature selection technique. Specificity and sensitivity of 83% and 79% were achieved for the male OSA and 86% and 84% for the female OSA patients, respectively. We conclude that acoustic features from speech signals during wakefulness can detect OSA patients with good specificity and sensitivity. Such a system can be used as a basis for future development of a tool for OSA screening. © 2011 IEEE

[Rare case of upper respiratory tract obstruction secondary to massive hematoma of pharynx, larynx and trachea].

PubMed

Kozakiewicz, Jacek; Gierlotka, Agata; Dec, Maciej; Stockfish, Jerzy

2010-01-01

The rare case of 75-years-old female patient was presented in this paper. She reported hoarseness in addition to pharyngeal pain, dysphagia and medium level dyspnea. Her exploration revealed a wide hematoma of the left lateral wall of orohypopharynx spreading to the left aryepiglottic fold, left aryepiglottic cartilage, false and true vocal fold and later to left lateral and posterior tracheal wall. The patient did not require a control of airway by intubation or tracheotomy according to quick relief after pharmacological treatment.

Articulatory speech synthesis and speech production modelling

NASA Astrophysics Data System (ADS)

Huang, Jun

This dissertation addresses the problem of speech synthesis and speech production modelling based on the fundamental principles of human speech production. Unlike the conventional source-filter model, which assumes the independence of the excitation and the acoustic filter, we treat the entire vocal apparatus as one system consisting of a fluid dynamic aspect and a mechanical part. We model the vocal tract by a three-dimensional moving geometry. We also model the sound propagation inside the vocal apparatus as a three-dimensional nonplane-wave propagation inside a viscous fluid described by Navier-Stokes equations. In our work, we first propose a combined minimum energy and minimum jerk criterion to estimate the dynamic vocal tract movements during speech production. Both theoretical error bound analysis and experimental results show that this method can achieve very close match at the target points and avoid the abrupt change in articulatory trajectory at the same time. Second, a mechanical vocal fold model is used to compute the excitation signal of the vocal tract. The advantage of this model is that it is closely coupled with the vocal tract system based on fundamental aerodynamics. As a result, we can obtain an excitation signal with much more detail than the conventional parametric vocal fold excitation model. Furthermore, strong evidence of source-tract interaction is observed. Finally, we propose a computational model of the fricative and stop types of sounds based on the physical principles of speech production. The advantage of this model is that it uses an exogenous process to model the additional nonsteady and nonlinear effects due to the flow mode, which are ignored by the conventional source- filter speech production model. A recursive algorithm is used to estimate the model parameters. Experimental results show that this model is able to synthesize good quality fricative and stop types of sounds. Based on our dissertation work, we carefully argue that the articulatory speech production model has the potential to flexibly synthesize natural-quality speech sounds and to provide a compact computational model for speech production that can be beneficial to a wide range of areas in speech signal processing.

Pitch bending and glissandi on the clarinet: roles of the vocal tract and partial tone hole closure.

PubMed

Chen, Jer-Ming; Smith, John; Wolfe, Joe

2009-09-01

Clarinettists combine non-standard fingerings with particular vocal tract configurations to achieve pitch bending, i.e., sounding pitches that can deviate substantially from those of standard fingerings. Impedance spectra were measured in the mouth of expert clarinettists while they played normally and during pitch bending, using a measurement head incorporated within a functioning clarinet mouthpiece. These were compared with the input impedance spectra of the clarinet for the fingerings used. Partially uncovering a tone hole by sliding a finger raises the frequency of clarinet impedance peaks, thereby allowing smooth increases in sounding pitch over some of the range. To bend notes in the second register and higher, however, clarinettists produce vocal tract resonances whose impedance maxima have magnitudes comparable with those of the bore resonance, which then may influence or determine the sounding frequency. It is much easier to bend notes down than up because of the phase relations of the bore and tract resonances, and the compliance of the reed. Expert clarinettists performed the glissando opening of Gershwin's 'Rhapsody in Blue'. Here, players coordinate the two effects: They slide their fingers gradually over open tone holes, while simultaneously adjusting a strong vocal tract resonance to the desired pitch.

The Effect of Traditional Singing Warm-Up Versus Semioccluded Vocal Tract Exercises on the Acoustic Parameters of Singing Voice.

PubMed

Duke, Emily; Plexico, Laura W; Sandage, Mary J; Hoch, Matthew

2015-11-01

This study investigated the effect of traditional vocal warm-up versus semioccluded vocal tract exercises on the acoustic parameters of voice through three questions: does vocal warm-up condition significantly alter the singing power ratio of the singing voice? Is singing power ratio dependent upon vowel? Is perceived phonatory effort affected by warm-up condition? Hypotheses were that vocal warm-up would alter the singing power ratio, and that semioccluded vocal tract warm-up would affect the singing power ratio more than no warm-up or traditional warm-up, that singing power ratio would vary across vowel, and that perceived phonatory effort would vary with warm-up condition. This study was a within-participant repeated measures design with counterbalanced conditions. Thirteen male singers were recorded under three different conditions: no warm-up, traditional warm-up, and semioccluded vocal tract exercise warm-up. Recordings were made of these singers performing the Star Spangled Banner, and singing power ratio (SPR) was calculated from four vowels. Singers rated their perceived phonatory effort (PPE) singing the Star Spangled Banner after each warm-up condition. Warm-up condition did not significantly affect SPR. SPR was significantly different for /i/ and /e/. PPE was not significantly different between warm-up conditions. The present study did not find significant differences in SPR between warm-up conditions. SPR differences for /i/, support previous findings. PPE did not differ significantly across warm-up condition despite the expectation that traditional or semioccluded warm-up would cause a decrease. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Developmental Sexual Dimorphism of the Oral and Pharyngeal Portions of the Vocal Tract: An Imaging Study

ERIC Educational Resources Information Center

Vorperian, Houri K.; Wang, Shubing; Schimek, E. Michael; Durtschi, Reid B.; Kent, Ray D.; Gentry, Lindell R.; Chung, Moo K.

2011-01-01

Purpose: The anatomic origin for prepubertal vowel acoustic differences between male and female subjects remains unknown. The purpose of this study is to examine developmental sex differences in vocal tract (VT) length and its oral and pharyngeal portions. Method: Nine VT variables were measured from 605 imaging studies (magnetic resonance imaging…

Voice Training and Therapy with a Semi-Occluded Vocal Tract: Rationale and Scientific Underpinnings

ERIC Educational Resources Information Center

Titze, Ingo R.

2006-01-01

Purpose: Voice therapy with a semi-occluded vocal tract has a long history. The use of lip trills, tongue trills, bilabial fricatives, humming, and phonation into tubes or straws has been hailed by clinicians, singing teachers, and voice coaches as efficacious for training and rehabilitation. Little has been done, however, to provide the…

A magnetic resonance imaging-based articulatory and acoustic study of “retroflex” and “bunched” American English ∕r∕

PubMed Central

Zhou, Xinhui; Espy-Wilson, Carol Y.; Boyce, Suzanne; Tiede, Mark; Holland, Christy; Choe, Ann

2008-01-01

Speakers of rhotic dialects of North American English show a range of different tongue configurations for ∕r∕. These variants produce acoustic profiles that are indistinguishable for the first three formants [Delattre, P., and Freeman, D. C., (1968). “A dialect study of American English r’s by x-ray motion picture,” Linguistics 44, 28–69; Westbury, J. R. et al. (1998), “Differences among speakers in lingual articulation for American English ∕r∕,” Speech Commun. 26, 203–206]. It is puzzling why this should be so, given the very different vocal tract configurations involved. In this paper, two subjects whose productions of “retroflex” ∕r∕ and “bunched” ∕r∕ show similar patterns of F1–F3 but very different spacing between F4 and F5 are contrasted. Using finite element analysis and area functions based on magnetic resonance images of the vocal tract for sustained productions, the results of computer vocal tract models are compared to actual speech recordings. In particular, formant-cavity affiliations are explored using formant sensitivity functions and vocal tract simple-tube models. The difference in F4∕F5 patterns between the subjects is confirmed for several additional subjects with retroflex and bunched vocal tract configurations. The results suggest that the F4∕F5 differences between the variants can be largely explained by differences in whether the long cavity behind the palatal constriction acts as a half- or a quarter-wavelength resonator. PMID:18537397

Using statistical deformable models to reconstruct vocal tract shape from magnetic resonance images.

PubMed

Vasconcelos, M J M; Rua Ventura, S M; Freitas, D R S; Tavares, J M R S

2010-10-01

The mechanisms involved in speech production are complex and have thus been subject to growing attention by the scientific community. It has been demonstrated that magnetic resonance imaging (MRI) is a powerful means in the understanding of the morphology of the vocal tract. Over the last few years, statistical deformable models have been successfully used to identify and characterize bones and organs in medical images and point distribution models (PDMs) have gained particular relevance. In this work, the suitability of these models has been studied to characterize and further reconstruct the shape of the vocal tract in the articulation of Portuguese European (EP) speech sounds, one of the most spoken languages worldwide, with the aid of MR images. Therefore, a PDM has been built from a set of MR images acquired during the artificially sustained articulation of 25 EP speech sounds. Following this, the capacity of this statistical model to characterize the shape deformation of the vocal tract during the production of sounds was analysed. Next, the model was used to reconstruct five EP oral vowels and the EP fricative consonants. As far as a study on speech production is concerned, this study is considered to be the first approach to characterize and reconstruct the vocal tract shape from MR images by using PDMs. In addition, the findings achieved permit one to conclude that this modelling technique compels an enhanced understanding of the dynamic speech events involved in sustained articulations based on MRI, which are of particular interest for speech rehabilitation and simulation.

A Computerized Tomography Study of Vocal Tract Setting in Hyperfunctional Dysphonia and in Belting.

PubMed

Saldias, Marcelo; Guzman, Marco; Miranda, Gonzalo; Laukkanen, Anne-Maria

2018-04-03

Vocal tract setting in hyperfunctional patients is characterized by a high larynx and narrowing of the epilaryngeal and pharyngeal region. Similar observations have been made for various singing styles, eg, belting. The voice quality in belting has been described to be loud, speech like, and high pitched. It is also often described as sounding "pressed" or "tense". The above mentioned has led to the hypothesis that belting may be strenuous to the vocal folds. However, singers and teachers of belting do not regard belting as particularly strenuous. This study investigates possible similarities and differences between hyperfunctional voice production and belting. This study concerns vocal tract setting. Four male patients with hyperfunctional dysphonia and one male contemporary commercial music singer were registered with computerized tomography while phonating on [a:] in their habitual speaking pitch. Additionally, the singer used the pitch G4 in belting. The scannings were studied in sagittal and transversal dimensions by measuring lengths, widths, and areas. Various similarities were found between belting and hyperfunction: high vertical larynx position, small hypopharyngeal width, and epilaryngeal outlet. On the other hand, belting differed from dysphonia (in addition to higher pitch) by a wider lip and jaw opening, and larger volumes of the oral cavity. Belting takes advantage of "megaphone shape" of the vocal tract. Future studies should focus on modeling and simulation to address sound energy transfer. Also, they should consider aerodynamic variables and vocal fold vibration to evaluate the "price of decibels" in these phonation types. Copyright © 2018. Published by Elsevier Inc.

Air Pressure Responses to Sudden Vocal Tract Pressure Bleeds during Production of Stop Consonants: New Evidence of Aeromechanical Regulation.

ERIC Educational Resources Information Center

Zajac, David J.; Weissler, Mark C.

2004-01-01

Two studies were conducted to evaluate short-latency vocal tract air pressure responses to sudden pressure bleeds during production of voiceless bilabial stop consonants. It was hypothesized that the occurrence of respiratory reflexes would be indicated by distinct patterns of responses as a function of bleed magnitude. In Study 1, 19 adults…

A Randomized Controlled Trial of Two Semi-Occluded Vocal Tract Voice Therapy Protocols

ERIC Educational Resources Information Center

Kapsner-Smith, Mara R.; Hunter, Eric J.; Kirkham, Kimberly; Cox, Karin; Titze, Ingo R.

2015-01-01

Purpose: Although there is a long history of use of semi-occluded vocal tract gestures in voice therapy, including phonation through thin tubes or straws, the efficacy of phonation through tubes has not been established. This study compares results from a therapy program on the basis of phonation through a flow-resistant tube (FRT) with Vocal…

Toward dynamic magnetic resonance imaging of the vocal tract during speech production.

PubMed

Ventura, Sandra M Rua; Freitas, Diamantino Rui S; Tavares, João Manuel R S

2011-07-01

The most recent and significant magnetic resonance imaging (MRI) improvements allow for the visualization of the vocal tract during speech production, which has been revealed to be a powerful tool in dynamic speech research. However, a synchronization technique with enhanced temporal resolution is still required. The study design was transversal in nature. Throughout this work, a technique for the dynamic study of the vocal tract with MRI by using the heart's signal to synchronize and trigger the imaging-acquisition process is presented and described. The technique in question is then used in the measurement of four speech articulatory parameters to assess three different syllables (articulatory gestures) of European Portuguese Language. The acquired MR images are automatically reconstructed so as to result in a variable sequence of images (slices) of different vocal tract shapes in articulatory positions associated with Portuguese speech sounds. The knowledge obtained as a result of the proposed technique represents a direct contribution to the improvement of speech synthesis algorithms, thereby allowing for novel perceptions in coarticulation studies, in addition to providing further efficient clinical guidelines in the pursuit of more proficient speech rehabilitation processes. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Morphological Variation in the Adult Hard Palate and Posterior Pharyngeal Wall

PubMed Central

Lammert, Adam; Proctor, Michael; Narayanan, Shrikanth

2013-01-01

Purpose Adult human vocal tracts display considerable morphological variation across individuals, but the nature and extent of this variation has not been extensively studied for many vocal tract structures. There exists a need to analyze morphological variation and, even more basically, to develop a methodology for morphological analysis of the vocal tract. Such analysis will facilitate fundamental characterization of the speech production system, with broad implications from modeling to explaining inter-speaker variability. Method A data-driven methodology to automatically analyze the extent and variety of morphological variation is proposed and applied to a diverse subject pool of 36 adults. Analysis is focused on two key aspects of vocal tract structure: the midsagittal shape of the hard palate and the posterior pharyngeal wall. Result Palatal morphology varies widely in its degree of concavity, but also in anteriority and sharpness. Pharyngeal wall morphology, by contrast, varies mostly in terms of concavity alone. The distribution of morphological characteristics is complex, and analysis suggests that certain variations may be categorical in nature. Conclusion Major modes of morphological variation are identified, including their relative magnitude, distribution and categorical nature. Implications of these findings for speech articulation strategies and speech acoustics are discussed. PMID:23690566

Peripheral Mechanisms for Vocal Production in Birds--Differences and Similarities to Human Speech and Singing

ERIC Educational Resources Information Center

Riede, Tobias; Goller, Franz

2010-01-01

Song production in songbirds is a model system for studying learned vocal behavior. As in humans, bird phonation involves three main motor systems (respiration, vocal organ and vocal tract). The avian respiratory mechanism uses pressure regulation in air sacs to ventilate a rigid lung. In songbirds sound is generated with two independently…

A real-time LPC-based vocal tract area display for voice development.

PubMed

Rossiter, D; Howard, D M; Downes, M

1994-12-01

This article reports the design and implementation of a graphical display that presents an approximation to vocal tract area in real time for voiced vowel articulation. The acoustic signal is digitally sampled by the system. From these data a set of reflection coefficients is derived using linear predictive coding. A matrix of area coefficients is then determined that approximates the vocal tract area of the user. From this information a graphical display is then generated. The complete cycle of analysis and display is repeated at approximately 20 times/s. Synchronised audio and visual sequences can be recorded and used as dynamic targets for articulatory development. Use of the system is illustrated by diagrams of system output for spoken cardinal vowels and for vowels sung in a trained and untrained style.

The singing power ratio as an objective measure of singing voice quality in untrained talented and nontalented singers.

PubMed

Watts, Christopher; Barnes-Burroughs, Kathryn; Estis, Julie; Blanton, Debra

2006-03-01

A growing body of contemporary research has investigated differences between trained and untrained singing voices. However, few studies have separated untrained singers into those who do and do not express abilities related to singing talent, including accurate pitch control and production of a pleasant timbre (voice quality). This investigation studied measures of the singing power ratio (SPR), which is a quantitative measure of the resonant quality of the singing voice. SPR reflects the amplification or suppression in the vocal tract of the harmonics produced by the sound source. This measure was acquired from the voices of untrained talented and nontalented singers as a means to objectively investigate voice quality differences. Measures of SPR were acquired from vocal samples with fast Fourier transform (FFT) power spectra to analyze the amplitude level of the partials in the acoustic spectrum. Long-term average spectra (LTAS) were also analyzed. Results indicated significant differences in SPR between groups, which suggest that vocal tract resonance, and its effect on perceived vocal timbre or quality, may be an important variable related to the perception of singing talent. LTAS confirmed group differences in the tuning of vocal tract harmonics.

Two-dimensional model of vocal fold vibration for sound synthesis of voice and soprano singing

NASA Astrophysics Data System (ADS)

Adachi, Seiji; Yu, Jason

2005-05-01

Voiced sounds were simulated with a computer model of the vocal fold composed of a single mass vibrating both parallel and perpendicular to the airflow. Similarities with the two-mass model are found in the amplitudes of the glottal area and the glottal volume flow velocity, the variation in the volume flow waveform with the vocal tract shape, and the dependence of the oscillation amplitude upon the average opening area of the glottis, among other similar features. A few dissimilarities are also found in the more symmetric glottal and volume flow waveforms in the rising and falling phases. The major improvement of the present model over the two-mass model is that it yields a smooth transition between oscillations with an inductive load and a capacitive load of the vocal tract with no sudden jumps in the vibration frequency. Self-excitation is possible both below and above the first formant frequency of the vocal tract. By taking advantage of the wider continuous frequency range, the two-dimensional model can successfully be applied to the sound synthesis of a high-pitched soprano singing, where the fundamental frequency sometimes exceeds the first formant frequency. .

Acoustic correlates of body size and individual identity in banded penguins

PubMed Central

Gamba, Marco; Gili, Claudia; Pessani, Daniela

2017-01-01

Animal vocalisations play a role in individual recognition and mate choice. In nesting penguins, acoustic variation in vocalisations originates from distinctiveness in the morphology of the vocal apparatus. Using the source-filter theory approach, we investigated vocal individuality cues and correlates of body size and mass in the ecstatic display songs the Humboldt and Magellanic penguins. We demonstrate that both fundamental frequency (f0) and formants (F1-F4) are essential vocal features to discriminate among individuals. However, we show that only duration and f0 are honest indicators of the body size and mass, respectively. We did not find any effect of body dimension on formants, formant dispersion nor estimated vocal tract length of the emitters. Overall, our findings provide the first evidence that the resonant frequencies of the vocal tract do not correlate with body size in penguins. Our results add important information to a growing body of literature on the role of the different vocal parameters in conveying biologically meaningful information in bird vocalisations. PMID:28199318

Immediate effects of the semi-occluded vocal tract exercise with LaxVox® tube in singers.

PubMed

Fadel, Congeta Bruniere Xavier; Dassie-Leite, Ana Paula; Santos, Rosane Sampaio; Santos, Celso Gonçalves Dos; Dias, Cláudio Antônio Sorondo; Sartori, Denise Jussara

The purpose of this study was to analyze the immediate effects of the semi-occluded vocal tract exercise (SOVTE) using the LaxVox® tube in singers. Participants were 23 singers, classical singing students, aged 18 to 47 years (mean age = 27.2 years). First, data was collected through the application of a demographic questionnaire and the recording of sustained emission - vowel /ε/, counting 1-10, and a music section from the participants' current repertoire. After that, the participants were instructed and performed the SOVTE using the LaxVox® tube for three minutes. Finally, the same vocal samples were collected immediately after SOVTE performance and the singers responded to a questionnaire on their perception regarding vocal changes after the exercise. The vocal samples were analyzed by referees (speech-language pathologists and singing teachers) and by means of acoustic analysis. Most of the singers reported improved voice post-exercise in both tasks - speech and singing. Regarding the perceptual assessment (sustained vowel, speech, and singing), the referees found no difference between pre- and post-exercise emissions. The acoustic analysis of the sustained vowel showed increased Fundamental Frequency (F0) and reduction of the Glottal to Noise Excitation (GNE) ratio post-exercise. The semi-occluded vocal tract exercise with LaxVox® tube promotes immediate positive effects on the self-assessment and acoustic analysis of voice in professional singers without vocal complains. No immediate significant changes were observed with respect to auditory-perceptual evaluation of speech and singing.

A Parietal-Temporal Sensory-Motor Integration Area for the Human Vocal Tract: Evidence from an fMRI Study of Skilled Musicians

ERIC Educational Resources Information Center

Pa, Judy; Hickok, Gregory

2008-01-01

Several sensory-motor integration regions have been identified in parietal cortex, which appear to be organized around motor-effectors (e.g., eyes, hands). We investigated whether a sensory-motor integration area might exist for the human vocal tract. Speech requires extensive sensory-motor integration, as does other abilities such as vocal…

Vocal warm-up and breathing training for teachers: randomized clinical trial

PubMed Central

Pereira, Lílian Paternostro de Pina; Masson, Maria Lúcia Vaz; Carvalho, Fernando Martins

2015-01-01

OBJECTIVE To compare the effectiveness of two speech therapy interventions, vocal warm-up and breathing training, focusing on teachers’ voice quality. METHODS A single-blind, randomized, parallel clinical trial was conducted. The research included 31 20 to 60-year old teachers from a public school in Salvador, BA, Northeasatern Brazil, with minimum workloads of 20 hours a week, who have or have not reported having vocal alterations. The exclusion criteria were the following: being a smoker, excessive alcohol consumption, receiving additional speech therapy assistance while taking part in the study, being affected by upper respiratory tract infections, professional use of the voice in another activity, neurological disorders, and history of cardiopulmonary pathologies. The subjects were distributed through simple randomization in groups vocal warm-up (n = 14) and breathing training (n = 17). The teachers’ voice quality was subjectively evaluated through the Voice Handicap Index (Índice de Desvantagem Vocal, in the Brazilian version) and computerized voice analysis (average fundamental frequency, jitter, shimmer, noise, and glottal-to-noise excitation ratio) by speech therapists. RESULTS Before the interventions, the groups were similar regarding sociodemographic characteristics, teaching activities, and vocal quality. The variations before and after the intervention in self-assessment and acoustic voice indicators have not significantly differed between the groups. In the comparison between groups before and after the six-week interventions, significant reductions in the Voice Handicap Index of subjects in both groups were observed, as wells as reduced average fundamental frequencies in the vocal warm-up group and increased shimmer in the breathing training group. Subjects from the vocal warm-up group reported speaking more easily and having their voices more improved in a general way as compared to the breathing training group. CONCLUSIONS Both interventions were similar regarding their effects on the teachers’ voice quality. However, each contribution has individually contributed to improve the teachers’ voice quality, especially the vocal warm-up. PMID:26465664

A model of acoustic interspeaker variability based on the concept of formant-cavity affiliation

NASA Astrophysics Data System (ADS)

Apostol, Lian; Perrier, Pascal; Bailly, Gérard

2004-01-01

A method is proposed to model the interspeaker variability of formant patterns for oral vowels. It is assumed that this variability originates in the differences existing among speakers in the respective lengths of their front and back vocal-tract cavities. In order to characterize, from the spectral description of the acoustic speech signal, these vocal-tract differences between speakers, each formant is interpreted, according to the concept of formant-cavity affiliation, as a resonance of a specific vocal-tract cavity. Its frequency can thus be directly related to the corresponding cavity length, and a transformation model can be proposed from a speaker A to a speaker B on the basis of the frequency ratios of the formants corresponding to the same resonances. In order to minimize the number of sounds to be recorded for each speaker in order to carry out this speaker transformation, the frequency ratios are exactly computed only for the three extreme cardinal vowels [eye, aye, you] and they are approximated for the remaining vowels through an interpolation function. The method is evaluated through its capacity to transform the (F1,F2) formant patterns of eight oral vowels pronounced by five male speakers into the (F1,F2) patterns of the corresponding vowels generated by an articulatory model of the vocal tract. The resulting formant patterns are compared to those provided by normalization techniques published in the literature. The proposed method is found to be efficient, but a number of limitations are also observed and discussed. These limitations can be associated with the formant-cavity affiliation model itself or with a possible influence of speaker-specific vocal-tract geometry in the cross-sectional direction, which the model might not have taken into account.

Unusual case of choking due to assassin bug ( Cydnocoris gilvus).

PubMed

Sonar, Vaibhav; Patil, Sachin

2018-01-01

Choking is a form of asphyxia which is caused by an obstruction within the air passages. Here, we report a case of obstruction of the upper respiratory tract due to assassin bug ( Cydnocoris gilvus) where allegations of medical negligence were made by relatives of the deceased. Autopsy findings demonstrated that an insect was present inside the larynx, lodged at the epiglottis. Multiple haemorrhagic patches were present at the base of the tongue, larynx, epiglottis, vocal cords and tracheal bifurcation. As Reduviidae can be successfully used as a biological pest-control agents, they should be used with due precaution.

Acoustic Characteristics in Epiglottic Cyst.

PubMed

Lee, YeonWoo; Kim, GeunHyo; Wang, SooGeun; Jang, JeonYeob; Cha, Wonjae; Choi, HongSik; Kim, HyangHee

2018-05-03

The purpose of this study was to analyze the acoustic characteristics associated with alternation deformation of the vocal tract due to large epiglottic cyst, and to confirm the relation between the anatomical change and resonant function of the vocal tract. Eight men with epiglottic cyst were enrolled in this study. The jitter, shimmer, noise-to-harmonic ratio, and first two formants were analyzed in vowels /a:/, /e:/, /i:/, /o:/, and /u:/. These values were analyzed before and after laryngeal microsurgery. The F1 value of /a:/ was significantly raised after surgery. Significant differences of formant frequencies in other vowels, jitter, shimmer, and noise-to-harmonic ratio were not presented. The results of this study could be used to analyze changes in the resonance of vocal tracts due to the epiglottic cysts. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Vocal Tract Discomfort and Voice-Related Quality of Life in Wind Instrumentalists.

PubMed

Cappellaro, Juliane; Beber, Bárbara Costa

2018-05-01

This study aimed to investigate vocal tract discomfort and quality of life in the voice of wind instrumentalists. It is a cross-sectional study. The sample was composed of 37 musicians of the orchestra of Caxias do Sul city, RS, Brazil. The participants answered a nonstandard questionnaire about demographic and professional information, the Voice-Related Quality of Life (V-RQOL), the Vocal Tract Discomfort (VTD) scale, and additional items about fatigue after playing the instrument and pain in the cervical muscles. Correlation analyses were performed using Spearman correlation test. The most frequent symptoms mentioned by musicians in the VTD, for both frequency and intensity of occurrence, were dryness, ache, irritability, and cervical muscle pain, in addition to the frequency of occurrence of fatigue after playing. The musicians showed high scores in the V-RQOL survey. Several symptoms evaluated by the VTD had a negative correlation with the musicians' years of orchestra membership and with V-RQOL scores. Symptoms of vocal tract discomfort are present in wind instrumentalists in low frequency and intensity of occurrence. However, these symptoms affect the musicians' voice-related quality of life, and they occur more in musicians with fewer years of orchestra membership. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Anticipatory Posturing of the Vocal Tract Reveals Dissociation of Speech Movement Plans from Linguistic Units

PubMed Central

Tilsen, Sam; Spincemaille, Pascal; Xu, Bo; Doerschuk, Peter; Luh, Wen-Ming; Feldman, Elana; Wang, Yi

2016-01-01

Models of speech production typically assume that control over the timing of speech movements is governed by the selection of higher-level linguistic units, such as segments or syllables. This study used real-time magnetic resonance imaging of the vocal tract to investigate the anticipatory movements speakers make prior to producing a vocal response. Two factors were varied: preparation (whether or not speakers had foreknowledge of the target response) and pre-response constraint (whether or not speakers were required to maintain a specific vocal tract posture prior to the response). In prepared responses, many speakers were observed to produce pre-response anticipatory movements with a variety of articulators, showing that that speech movements can be readily dissociated from higher-level linguistic units. Substantial variation was observed across speakers with regard to the articulators used for anticipatory posturing and the contexts in which anticipatory movements occurred. The findings of this study have important consequences for models of speech production and for our understanding of the normal range of variation in anticipatory speech behaviors. PMID:26760511

Anticipatory Posturing of the Vocal Tract Reveals Dissociation of Speech Movement Plans from Linguistic Units.

PubMed

Tilsen, Sam; Spincemaille, Pascal; Xu, Bo; Doerschuk, Peter; Luh, Wen-Ming; Feldman, Elana; Wang, Yi

2016-01-01

Models of speech production typically assume that control over the timing of speech movements is governed by the selection of higher-level linguistic units, such as segments or syllables. This study used real-time magnetic resonance imaging of the vocal tract to investigate the anticipatory movements speakers make prior to producing a vocal response. Two factors were varied: preparation (whether or not speakers had foreknowledge of the target response) and pre-response constraint (whether or not speakers were required to maintain a specific vocal tract posture prior to the response). In prepared responses, many speakers were observed to produce pre-response anticipatory movements with a variety of articulators, showing that that speech movements can be readily dissociated from higher-level linguistic units. Substantial variation was observed across speakers with regard to the articulators used for anticipatory posturing and the contexts in which anticipatory movements occurred. The findings of this study have important consequences for models of speech production and for our understanding of the normal range of variation in anticipatory speech behaviors.

Study of human phonation in a full-body domain

NASA Astrophysics Data System (ADS)

Saurabh, Shakti; Bodony, Daniel

2015-11-01

The generation and propagation of the human voice is studied in two-dimensions using a full-body domain, using direct numerical simulation. The fluid/air in the vocal tract is modeled as a compressible and viscous fluid interacting with the non-linear, viscoelastic vocal folds (VF). The VF tissue material properties are multi-layered, with varying stiffness, and a finite-strain model is utilized and implemented in a quadratic finite element code. The fluid-solid domains are coupled through a boundary-fitted interface and utilize a Poisson equation-based mesh deformation method. The full-body domain includes the near VF region, the vocal tract, a simplified model of the soft palate and mouth, and extends out into the acoustic far-field. A new kind of inflow boundary condition based upon a quasi-one-dimensional formulation with constant sub-glottal volume velocity, which is linked to the VF movement, has been adopted. The sound pressure levels (SPL) measured are realistic and we analyze their connection to the VF dynamics and glottal and vocal tract geometries. Supported by the National Science Foundation (CAREER award number 1150439).

Computational Modeling of Fluid–Structure–Acoustics Interaction during Voice Production

PubMed Central

Jiang, Weili; Zheng, Xudong; Xue, Qian

2017-01-01

The paper presented a three-dimensional, first-principle based fluid–structure–acoustics interaction computer model of voice production, which employed a more realistic human laryngeal and vocal tract geometries. Self-sustained vibrations, important convergent–divergent vibration pattern of the vocal folds, and entrainment of the two dominant vibratory modes were captured. Voice quality-associated parameters including the frequency, open quotient, skewness quotient, and flow rate of the glottal flow waveform were found to be well within the normal physiological ranges. The analogy between the vocal tract and a quarter-wave resonator was demonstrated. The acoustic perturbed flux and pressure inside the glottis were found to be at the same order with their incompressible counterparts, suggesting strong source–filter interactions during voice production. Such high fidelity computational model will be useful for investigating a variety of pathological conditions that involve complex vibrations, such as vocal fold paralysis, vocal nodules, and vocal polyps. The model is also an important step toward a patient-specific surgical planning tool that can serve as a no-risk trial and error platform for different procedures, such as injection of biomaterials and thyroplastic medialization. PMID:28243588

Simulation of singing qualities governed by lower vocal tract adjustments

NASA Astrophysics Data System (ADS)

Titze, Ingo R.

2003-04-01

In previous meetings, voice qualities such as pressed, ring, yawn, and twang were discussed in a speech context. It was shown that these qualities have unique spectral characteristics brought about by combinations of glottal and lower vocal tract adjustments (the epilarynx tube and the pharynx). Yawn has a wide glottis, a wide epilarynx tube, and a wide pharynx. On the contrary, twang has a general narrowing of all these airway sections. Ring has a wide pharynx and a relatively narrow epilarynx tube. A pressed voice is primary laryngeal, with a narrowed glottis. In this presentation, similar adjustments are made for singing with a voice simulator that controls vocal tract area functions and glottal flow pulses by rules. Results suggest that various singing styles, such as country-western, opera, or pop, may in part be characterized by these unique combinations of source and filter adjustments.

Computational fluid dynamics in the assessment of patients' postoperative status after glottis-widening surgery.

PubMed

Marków, Magdalena; Janecki, Daniel; Orecka, Bogusława; Misiołek, Maciej; Warmuziński, Krzysztof

2017-09-01

Computational fluid dynamics (CFD), a rapidly developing instrument with a number of practical applications, allows calculation and visualization of the changing parameters of airflow in the upper respiratory tract. The aim of this study was to demonstrate the advantages of CFD as an instrument for noninvasive tests of the larynx in patients who had undergone surgical treatment due to bilateral vocal fold paralysis. Surface measurements of the glottic space were made during maximum adduction of the vocal folds. Additionally, the following spirometric parameters were determined: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and peak expiratory flow (PEF) rate. Based on the measurements, commercial mesh generation software was used to develop a geometrical model of the glottic space. The computations were carried out using a general purpose CFD code. The analysis included patients who were surgically treated for BVFP in the authors' department between 1999 and 2012. The study group consisted of 22 women (91.67%) and 2 men (8.33%). It was observed that the pressure drop calculated for free breathing depends on the area of the glottis and is independent of its shape. Importantly, for areas below approx. 40 mm2, a sudden rise occurred in the resistance to flow; for the smallest glottic areas studied, the pressure drop was almost 6 times higher than for an area of 40 mm2. Consequently, in cases of areas below 40 mm2 even minor enlargement of the glottic opening can lead to a marked improvement in breathing comfort. Computational fluid dynamics is a useful method for calculating and visualizing the changing parameters of airflow in the upper respiratory tract.

Magnetic resonance imaging of the brain and vocal tract: Applications to the study of speech production and language learning.

PubMed

Carey, Daniel; McGettigan, Carolyn

2017-04-01

The human vocal system is highly plastic, allowing for the flexible expression of language, mood and intentions. However, this plasticity is not stable throughout the life span, and it is well documented that adult learners encounter greater difficulty than children in acquiring the sounds of foreign languages. Researchers have used magnetic resonance imaging (MRI) to interrogate the neural substrates of vocal imitation and learning, and the correlates of individual differences in phonetic "talent". In parallel, a growing body of work using MR technology to directly image the vocal tract in real time during speech has offered primarily descriptive accounts of phonetic variation within and across languages. In this paper, we review the contribution of neural MRI to our understanding of vocal learning, and give an overview of vocal tract imaging and its potential to inform the field. We propose methods by which our understanding of speech production and learning could be advanced through the combined measurement of articulation and brain activity using MRI - specifically, we describe a novel paradigm, developed in our laboratory, that uses both MRI techniques to for the first time map directly between neural, articulatory and acoustic data in the investigation of vocalisation. This non-invasive, multimodal imaging method could be used to track central and peripheral correlates of spoken language learning, and speech recovery in clinical settings, as well as provide insights into potential sites for targeted neural interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

High-frame-rate full-vocal-tract 3D dynamic speech imaging.

PubMed

Fu, Maojing; Barlaz, Marissa S; Holtrop, Joseph L; Perry, Jamie L; Kuehn, David P; Shosted, Ryan K; Liang, Zhi-Pei; Sutton, Bradley P

2017-04-01

To achieve high temporal frame rate, high spatial resolution and full-vocal-tract coverage for three-dimensional dynamic speech MRI by using low-rank modeling and sparse sampling. Three-dimensional dynamic speech MRI is enabled by integrating a novel data acquisition strategy and an image reconstruction method with the partial separability model: (a) a self-navigated sparse sampling strategy that accelerates data acquisition by collecting high-nominal-frame-rate cone navigator sand imaging data within a single repetition time, and (b) are construction method that recovers high-quality speech dynamics from sparse (k,t)-space data by enforcing joint low-rank and spatiotemporal total variation constraints. The proposed method has been evaluated through in vivo experiments. A nominal temporal frame rate of 166 frames per second (defined based on a repetition time of 5.99 ms) was achieved for an imaging volume covering the entire vocal tract with a spatial resolution of 2.2 × 2.2 × 5.0 mm 3 . Practical utility of the proposed method was demonstrated via both validation experiments and a phonetics investigation. Three-dimensional dynamic speech imaging is possible with full-vocal-tract coverage, high spatial resolution and high nominal frame rate to provide dynamic speech data useful for phonetic studies. Magn Reson Med 77:1619-1629, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

A nose that roars: anatomical specializations and behavioural features of rutting male saiga

PubMed Central

Frey, Roland; Volodin, Ilya; Volodina, Elena

2007-01-01

The involvement of the unique saiga nose in vocal production has been neglected so far. Rutting male saigas produce loud nasal roars. Prior to roaring, they tense and extend their noses in a highly stereotypic manner. This change of nose configuration includes dorsal folding and convex curving of the nasal vestibulum and is maintained until the roar ends. Red and fallow deer males that orally roar achieve a temporary increase of vocal tract length (vtl) by larynx retraction. Saiga males attain a similar effect by pulling their flexible nasal vestibulum rostrally, allowing for a temporary elongation of the nasal vocal tract by about 20%. Decrease of formant frequencies and formant dispersion, as acoustic effects of an increase of vtl, are assumed to convey important information on the quality of a dominant male to conspecifics, e.g. on body size and fighting ability. Nasal roaring in saiga may equally serve to deter rival males and to attract females. Anatomical constraints might have set a limit to the rostral pulling of the nasal vestibulum. It seems likely that the sexual dimorphism of the saiga nose was induced by sexual selection. Adult males of many mammalian species, after sniffing or licking female urine or genital secretions, raise their head and strongly retract their upper lip and small nasal vestibulum while inhalating orally. This flehmen behaviour is assumed to promote transport of non-volatile substances via the incisive ducts into the vomeronasal organs for pheromone detection. The flehmen aspect in saiga involves the extensive flexible walls of the greatly enlarged nasal vestibulum and is characterized by a distinctly concave configuration of the nose region, the reverse of that observed in nasal roaring. A step-by-step model for the gradual evolution of the saiga nose is presented here. PMID:17971116

Endoscopy of the upper respiratory tract during treadmill exercise: a clinical study of 100 horses.

PubMed

Kannegieter, N J; Dore, M L

1995-03-01

Endoscopy of the upper respiratory tract was performed in 100 horses during high speed treadmill exercise. Reasons for endoscopy were a history of an abnormal noise during exercise in 75 horses, poor performance in 17 horses and to evaluate the results of upper respiratory tract surgery in 8 horses. Of the 75 horses with a history of an abnormal noise during exercise the cause was determined in 67 (89%). Endoscopic abnormalities were detected at rest in 40 of these 75 horses (53%). In these 40 horses, a similar diagnosis as to the cause of the abnormal noise was made at rest and during exercise on the treadmill in 19 cases, while in the remaining 21 the endoscopic findings during exercise varied from that seen at rest. This included 3 horses in which a diagnosis was made at rest but no abnormalities were detected during exercise. Some of the findings during treadmill endoscopy included laryngeal dysfunction, grades 3, 4 and 5 (22 cases), dorsal displacement of the soft palate (20), epiglottic entrapment (8), epiglottic flutter (4), aryepiglottic fold flutter (4), pharyngeal collapse (3), arytenoiditis (3), vocal cord flutter (3), false nostril noise (2), pharyngeal lymphoid hyperplasia (2), soft palate haemorrhage (1) and positional arytenoid collapse (1). More than one abnormality was observed during exercise in 7 horses. A complete and correct diagnosis based on the resting endoscopy findings alone was made in 19 (25%) of these 75 cases. In the 17 horses examined because of poor performance, no abnormalities were detected during treadmill endoscopy that were not evident at rest.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of practice and experience on the arcuate fasciculus: comparing singers, instrumentalists, and non-musicians.

PubMed

Halwani, Gus F; Loui, Psyche; Rüber, Theodor; Schlaug, Gottfried

2011-01-01

Structure and function of the human brain are affected by training in both linguistic and musical domains. Individuals with intensive vocal musical training provide a useful model for investigating neural adaptations of learning in the vocal-motor domain and can be compared with learning in a more general musical domain. Here we confirm general differences in macrostructure (tract volume) and microstructure (fractional anisotropy, FA) of the arcuate fasciculus (AF), a prominent white-matter tract connecting temporal and frontal brain regions, between singers, instrumentalists, and non-musicians. Both groups of musicians differed from non-musicians in having larger tract volume and higher FA values of the right and left AF. The AF was then subdivided in a dorsal (superior) branch connecting the superior temporal gyrus and the inferior frontal gyrus (STG ↔ IFG), and ventral (inferior) branch connecting the middle temporal gyrus and the inferior frontal gyrus (MTG ↔ IFG). Relative to instrumental musicians, singers had a larger tract volume but lower FA values in the left dorsal AF (STG ↔ IFG), and a similar trend in the left ventral AF (MTG ↔ IFG). This between-group comparison controls for the general effects of musical training, although FA was still higher in singers compared to non-musicians. Both musician groups had higher tract volumes in the right dorsal and ventral tracts compared to non-musicians, but did not show a significant difference between each other. Furthermore, in the singers' group, FA in the left dorsal branch of the AF was inversely correlated with the number of years of participants' vocal training. Our findings suggest that long-term vocal-motor training might lead to an increase in volume and microstructural complexity of specific white-matter tracts connecting regions that are fundamental to sound perception, production, and its feedforward and feedback control which can be differentiated from a more general musician effect.

Short-Term Effect of Two Semi-Occluded Vocal Tract Training Programs on the Vocal Quality of Future Occupational Voice Users: "Resonant Voice Training Using Nasal Consonants" Versus "Straw Phonation".

PubMed

Meerschman, Iris; Van Lierde, Kristiane; Peeters, Karen; Meersman, Eline; Claeys, Sofie; D'haeseleer, Evelien

2017-09-18

The purpose of this study was to determine the short-term effect of 2 semi-occluded vocal tract training programs, "resonant voice training using nasal consonants" versus "straw phonation," on the vocal quality of vocally healthy future occupational voice users. A multigroup pretest-posttest randomized control group design was used. Thirty healthy speech-language pathology students with a mean age of 19 years (range: 17-22 years) were randomly assigned into a resonant voice training group (practicing resonant exercises across 6 weeks, n = 10), a straw phonation group (practicing straw phonation across 6 weeks, n = 10), or a control group (receiving no voice training, n = 10). A voice assessment protocol consisting of both subjective (questionnaire, participant's self-report, auditory-perceptual evaluation) and objective (maximum performance task, aerodynamic assessment, voice range profile, acoustic analysis, acoustic voice quality index, dysphonia severity index) measurements and determinations was used to evaluate the participants' voice pre- and posttraining. Groups were compared over time using linear mixed models and generalized linear mixed models. Within-group effects of time were determined using post hoc pairwise comparisons. No significant time × group interactions were found for any of the outcome measures, indicating no differences in evolution over time among the 3 groups. Within-group effects of time showed a significant improvement in dysphonia severity index in the resonant voice training group, and a significant improvement in the intensity range in the straw phonation group. Results suggest that the semi-occluded vocal tract training programs using resonant voice training and straw phonation may have a positive impact on the vocal quality and vocal capacities of future occupational voice users. The resonant voice training caused an improved dysphonia severity index, and the straw phonation training caused an expansion of the intensity range in this population.

Computerized Analysis of Acoustic Characteristics of Patients with Internal Nasal Valve Collapse Before and After Functional Rhinoplasty

PubMed Central

Rezaei, Fariba; Omrani, Mohammad Reza; Abnavi, Fateme; Mojiri, Fariba; Golabbakhsh, Marzieh; Barati, Sohrab; Mahaki, Behzad

2015-01-01

Acoustic analysis of sounds produced during speech provides significant information about the physiology of larynx and vocal tract. The analysis of voice power spectrum is a fundamental sensitive method of acoustic assessment that provides valuable information about the voice source and characteristics of vocal tract resonance cavities. The changes in long-term average spectrum (LTAS) spectral tilt and harmony to noise ratio (HNR) were analyzed to assess the voice quality before and after functional rhinoplasty in patients with internal nasal valve collapse. Before and 3 months after functional rhinoplasty, 12 participants were evaluated and HNR and LTAS spectral tilt in /a/ and /i/ vowels were estimated. It was seen that an increase in HNR and a decrease in LTAS spectral tilt existed after surgery. Mean LTAS spectral tilt in vowel /a/ decreased from 2.37 ± 1.04 to 2.28 ± 1.17 (P = 0.388), and it was decreased from 4.16 ± 1.65 to 2.73 ± 0.69 in vowel /i/ (P = 0.008). Mean HNR in the vowel /a/ increased from 20.71 ± 3.93 to 25.06 ± 2.67 (P = 0.002), and it was increased from 21.28 ± 4.11 to 25.26 ± 3.94 in vowel /i/ (P = 0.002). Modification of the vocal tract caused the vocal cords to close sufficiently, and this showed that although rhinoplasty did not affect the larynx directly, it changes the structure of the vocal tract and consequently the resonance of voice production. The aim of this study was to investigate the changes in voice parameters after functional rhinoplasty in patients with internal nasal valve collapse by computerized analysis of acoustic characteristics. PMID:26955564

Primate feedstock for the evolution of consonants.

PubMed

Lameira, Adriano R; Maddieson, Ian; Zuberbühler, Klaus

2014-02-01

The evolution of speech remains an elusive scientific problem. A widespread notion is that vocal learning, underlined by vocal-fold control, is a key prerequisite for speech evolution. Although present in birds and non-primate mammals, vocal learning is ostensibly absent in non-human primates. Here we argue that the main road to speech evolution has been through controlling the supralaryngeal vocal tract, for which we find evidence for evolutionary continuity within the great apes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Modeling source-filter interaction in belting and high-pitched operatic male singing

PubMed Central

Titze, Ingo R.; Worley, Albert S.

2009-01-01

Nonlinear source-filter theory is applied to explain some acoustic differences between two contrasting male singing productions at high pitches: operatic style versus jazz belt or theater belt. Several stylized vocal tract shapes (caricatures) are discussed that form the bases of these styles. It is hypothesized that operatic singing uses vowels that are modified toward an inverted megaphone mouth shape for transitioning into the high-pitch range. This allows all the harmonics except the fundamental to be “lifted” over the first formant. Belting, on the other hand, uses vowels that are consistently modified toward the megaphone (trumpet-like) mouth shape. Both the fundamental and the second harmonic are then kept below the first formant. The vocal tract shapes provide collective reinforcement to multiple harmonics in the form of inertive supraglottal reactance and compliant subglottal reactance. Examples of lip openings from four well-known artists are used to infer vocal tract area functions and the corresponding reactances. PMID:19739766

Acoustic analysis of trill sounds.

PubMed

Dhananjaya, N; Yegnanarayana, B; Bhaskararao, Peri

2012-04-01

In this paper, the acoustic-phonetic characteristics of steady apical trills--trill sounds produced by the periodic vibration of the apex of the tongue--are studied. Signal processing methods, namely, zero-frequency filtering and zero-time liftering of speech signals, are used to analyze the excitation source and the resonance characteristics of the vocal tract system, respectively. Although it is natural to expect the effect of trilling on the resonances of the vocal tract system, it is interesting to note that trilling influences the glottal source of excitation as well. The excitation characteristics derived using zero-frequency filtering of speech signals are glottal epochs, strength of impulses at the glottal epochs, and instantaneous fundamental frequency of the glottal vibration. Analysis based on zero-time liftering of speech signals is used to study the dynamic resonance characteristics of vocal tract system during the production of trill sounds. Qualitative analysis of trill sounds in different vowel contexts, and the acoustic cues that may help spotting trills in continuous speech are discussed.

Acoustic changes in voice after tonsillectomy.

PubMed

Saida, H; Hirose, H

1996-01-01

The vocal tract from the glottis to the lips is considered to he a resonator and the voice is changeable depending upon the shape of the vocal tract. In this report, we examined the change in pharyngeal size and acoustic feature of voice after tonsillectomy. Subjects were 20 patients. The distance between both anterior pillars (glossopalatine arches), and between both posterior pillars (pharyngopalatine arches) was measured weekly. For acoustic measurements, the five Japanese vowels and Japanese conversational sentences were recorded and analyzed. The distance between both anterior pillars became wider 2 weeks postoperatively, and tended to become narrower thereafter. The distance between both posterior pillars became wider even after 4 weeks postoperatively. No consistent changes in F0, F1 and F2 were found after surgery. Although there was a tendency for a decrease in F3, tonsillectomy did not appear to change the acoustical features of the Japanese vowels remarkably. It was assumed that the subject may adjust the shape of the vocal tract to produce consistent speech sounds after the surgery using auditory feedback.

Vocal mechanics in Darwin's finches: correlation of beak gape and song frequency.

PubMed

Podos, Jeffrey; Southall, Joel A; Rossi-Santos, Marcos R

2004-02-01

Recent studies of vocal mechanics in songbirds have identified a functional role for the beak in sound production. The vocal tract (trachea and beak) filters harmonic overtones from sounds produced by the syrinx, and birds can fine-tune vocal tract resonance properties through changes in beak gape. In this study, we examine patterns of beak gape during song production in seven species of Darwin's finches of the Galápagos Islands. Our principal goals were to characterize the relationship between beak gape and vocal frequency during song production and to explore the possible influence therein of diversity in beak morphology and body size. Birds were audio and video recorded (at 30 frames s(-1)) as they sang in the field, and 164 song sequences were analyzed. We found that song frequency regressed significantly and positively on beak gape for 38 of 56 individuals and for all seven species examined. This finding provides broad support for a resonance model of vocal tract function in Darwin's finches. Comparison among species revealed significant variation in regression y-intercept values. Body size correlated negatively with y-intercept values, although not at a statistically significant level. We failed to detect variation in regression slopes among finch species, although the regression slopes of Darwin's finch and two North American sparrow species were found to differ. Analysis within one species (Geospiza fortis) revealed significant inter-individual variation in regression parameters; these parameters did not correlate with song frequency features or plumage scores. Our results suggest that patterns of beak use during song production were conserved during the Darwin's finch adaptive radiation, despite the evolution of substantial variation in beak morphology and body size.

Applicability of the Arabic version of Vocal Tract Discomfort Scale (VTDS) with student singers as professional voice users.

PubMed

Darawsheh, Wesam B; Natour, Yaser S; Sada, Eve G

2018-07-01

This pilot study aimed to evaluate the internal consistency, convergent construct validity and criterion validity of Arabic version of the Vocal Tract Discomfort Scale (VTDS), and to investigate the correlation between the scores of the VTDS, the VHI and the acoustic measures of fundamental frequency (F0), shimmer, jitter and signal-to-noise ratio (SNR). A cross-sectional study where 97 participants participated (47 males and 50 females) (mean age 20.5 ± 2.1 years) (31 student singers and 66 other non-professional voice user students). Participants were without self-perceived voice disorders who completed the VTDS-Arab scale and the Voice Handicap Index (VHI-Arab), and recorded a vocal sample of/a:/at a comfortable level. A positive internal consistency that signifies reliability was confirmed by Cronbach's α = .884 and 0.874 for the VTDS-Arab frequency and severity subscales, respectively. A moderate positive correlation was found between the VTDS-Arab (frequency, severity, total) and the VHI-Arab total where values of Pearson's correlation coefficient were r= 0.459, 0.430 and 0.451, respectively. Weak correlations were found between all of the acoustic measures and the scores of the VTDS-Arab and VHI-Arab (total and subscales). The area under curve for the VTDS was AUC= 0.824, 0.804 and 0.817 for the VTDS frequency, VTDS severity and VTDS total, respectively. The VTDS-Arab is a valid and reliable tool in measuring vocal tract sensations and predicting the perception of vocal handicap in student singers and can be used to predict the vocal load among professional voice users.

Laser vocal cordectomy fails to effectively reduce respiratory noise in horses with laryngeal hemiplegia.

PubMed

Brown, Jennifer A; Derksen, Frederik J; Stick, John A; Hartmann, William M; Robinson, N Edward

2005-01-01

To report the effect of unilateral laser vocal cordectomy on respiratory noise and airway function in horses with experimentally induced laryngeal hemiplegia (LH). Experimental study. Six Standardbred horses without upper airway abnormalities at rest or during high-speed treadmill exercise. Respiratory sounds and inspiratory trans-upper airway pressure (P(Ui)) were measured before (baseline) and 14 days after induction of LH by left recurrent laryngeal neurectomy, and again 30, 60, 90, and 120 days after endoscopically assisted laser cordectomy of the left vocal cord. Data were collected with the horses exercising on a treadmill at a speed producing maximum heart rate (HR(max)). In horses exercising at HR(max), induction of LH caused a significant increase in P(Ui), sound level (SL), and the sound intensity of formant 2 (F(2)) and 3 (F(3)). The sound intensity of formant 1 (F(1)) was unaffected by induction of LH. Laser vocal cordectomy had no effect on SL, or on the sound intensity of F(1) and F(3). At 30, 60, 90, and 120 days after surgery, P(Ui) and the sound intensity of F(2) were significantly reduced, but these variables remained significantly different from baseline values. Unilateral laser vocal cordectomy did not effectively improve upper airway noise in horses with LH. The procedure decreased upper airway obstruction to the same degree as bilateral ventriculocordectomy. Currently, laser vocal cordectomy cannot be recommended for the treatment of upper airway noise in horses with LH.

Pitch (F0) and formant profiles of human vowels and vowel-like baboon grunts: The role of vocalizer body size and voice-acoustic allometry

NASA Astrophysics Data System (ADS)

Rendall, Drew; Kollias, Sophie; Ney, Christina; Lloyd, Peter

2005-02-01

Key voice features-fundamental frequency (F0) and formant frequencies-can vary extensively between individuals. Much of the variation can be traced to differences in the size of the larynx and vocal-tract cavities, but whether these differences in turn simply reflect differences in speaker body size (i.e., neutral vocal allometry) remains unclear. Quantitative analyses were therefore undertaken to test the relationship between speaker body size and voice F0 and formant frequencies for human vowels. To test the taxonomic generality of the relationships, the same analyses were conducted on the vowel-like grunts of baboons, whose phylogenetic proximity to humans and similar vocal production biology and voice acoustic patterns recommend them for such comparative research. For adults of both species, males were larger than females and had lower mean voice F0 and formant frequencies. However, beyond this, F0 variation did not track body-size variation between the sexes in either species, nor within sexes in humans. In humans, formant variation correlated significantly with speaker height but only in males and not in females. Implications for general vocal allometry are discussed as are implications for speech origins theories, and challenges to them, related to laryngeal position and vocal tract length. .

FE Modelling of the Fluid-Structure-Acoustic Interaction for the Vocal Folds Self-Oscillation

NASA Astrophysics Data System (ADS)

Švancara, Pavel; Horáček, J.; Hrůza, V.

The flow induced self-oscillation of the human vocal folds in interaction with acoustic processes in the simplified vocal tract model was explored by three-dimensional (3D) finite element (FE) model. Developed FE model includes vocal folds pretension before phonation, large deformations of the vocal fold tissue, vocal folds contact, fluid-structure interaction, morphing the fluid mesh according the vocal folds motion (Arbitrary Lagrangian-Eulerian approach), unsteady viscous compressible airflow described by the Navier-Stokes equations and airflow separation during the glottis closure. Iterative partitioned approach is used for modelling the fluid-structure interaction. Computed results prove that the developed model can be used for simulation of the vocal folds self-oscillation and resulting acoustic waves. The developed model enables to numerically simulate an influence of some pathological changes in the vocal fold tissue on the voice production.

Vocal development in a Waddington landscape

PubMed Central

Teramoto, Yayoi; Takahashi, Daniel Y; Holmes, Philip; Ghazanfar, Asif A

2017-01-01

Vocal development is the adaptive coordination of the vocal apparatus, muscles, the nervous system, and social interaction. Here, we use a quantitative framework based on optimal control theory and Waddington’s landscape metaphor to provide an integrated view of this process. With a biomechanical model of the marmoset monkey vocal apparatus and behavioral developmental data, we show that only the combination of the developing vocal tract, vocal apparatus muscles and nervous system can fully account for the patterns of vocal development. Together, these elements influence the shape of the monkeys’ vocal developmental landscape, tilting, rotating or shifting it in different ways. We can thus use this framework to make quantitative predictions regarding how interfering factors or experimental perturbations can change the landscape within a species, or to explain comparative differences in vocal development across species DOI: http://dx.doi.org/10.7554/eLife.20782.001 PMID:28092262

Resonance strategies used in Bulgarian women's singing style: a pilot study.

PubMed

Henrich, Nathalie; Kiek, Mara; Smith, John; Wolfe, Joe

2007-01-01

Are the characteristic timbre and loudness of Bulgarian women's singing related to tuning of resonances of the vocal tract? We studied an Australian female singer, who practises and teaches Bulgarian singing technique. Two different vocal qualities of this style were studied. The louder teshka is characterized by a sonorous voice production. The less loud leka has a smoother timbre that is closer to that of the head voice register. Six vowels in each of teshka, leka and the subject's 'normal' (i.e. Western rather than Bulgarian) style were studied. The acoustic resonances of the singer's vocal tract were measured directly during singing by injecting a synthesized, broad-band acoustic current. This singer does not use resonance tuning consistently in her classical Western style. However, in both teshka and leka, she tunes the first tract resonance close to the second harmonic of the voice for most vowels. This tuning boosts the power output in the radiation field for that harmonic. This tuning also contributes to the very strong second harmonic which is a characteristic of the timbre identified as the Bulgarian style.

Morphometric Differences of Vocal Tract Articulators in Different Loudness Conditions in Singing.

PubMed

Echternach, Matthias; Burk, Fabian; Burdumy, Michael; Traser, Louisa; Richter, Bernhard

2016-01-01

Dynamic MRI analysis of phonation has gathered interest in voice and speech physiology. However, there are limited data addressing the extent to which articulation is dependent on loudness. 12 professional singer subjects of different voice classifications were analysed concerning the vocal tract profiles recorded with dynamic real-time MRI with 25fps in different pitch and loudness conditions. The subjects were asked to sing ascending scales on the vowel /a/ in three loudness conditions (comfortable=mf, very soft=pp, very loud=ff, respectively). Furthermore, fundamental frequency and sound pressure level were analysed from the simultaneously recorded optical audio signal after noise cancellation. The data show articulatory differences with respect to changes of both pitch and loudness. Here, lip opening and pharynx width were increased. While the vertical larynx position was rising with pitch it was lower for greater loudness. Especially, the lip opening and pharynx width were more strongly correlated with the sound pressure level than with pitch. For the vowel /a/ loudness has an effect on articulation during singing which should be considered when articulatory vocal tract data are interpreted.

High-speed imaging of vocal fold vibrations and larynx movements within vocalizations of different vowels.

PubMed

Maurer, D; Hess, M; Gross, M

1996-12-01

Theoretic investigations of the "source-filter" model have indicated a pronounced acoustic interaction of glottal source and vocal tract. Empirical investigations of formant pattern variations apart from changes in vowel identity have demonstrated a direct relationship between the fundamental frequency and the patterns. As a consequence of both findings, independence of phonation and articulation may be limited in the speech process. Within the present study, possible interdependence of phonation and phoneme was investigated: vocal fold vibrations and larynx position for vocalizations of different vowels in a healthy man and woman were examined by high-speed light-intensified digital imaging. We found 1) different movements of the vocal folds for vocalizations of different vowel identities within one speaker and at similar fundamental frequency, and 2) constant larynx position within vocalization of one vowel identity, but different positions for vocalizations of different vowel identities. A possible relationship between the vocal fold vibrations and the phoneme is discussed.

A robotic voice simulator and the interactive training for hearing-impaired people.

PubMed

Sawada, Hideyuki; Kitani, Mitsuki; Hayashi, Yasumori

2008-01-01

A talking and singing robot which adaptively learns the vocalization skill by means of an auditory feedback learning algorithm is being developed. The robot consists of motor-controlled vocal organs such as vocal cords, a vocal tract and a nasal cavity to generate a natural voice imitating a human vocalization. In this study, the robot is applied to the training system of speech articulation for the hearing-impaired, because the robot is able to reproduce their vocalization and to teach them how it is to be improved to generate clear speech. The paper briefly introduces the mechanical construction of the robot and how it autonomously acquires the vocalization skill in the auditory feedback learning by listening to human speech. Then the training system is described, together with the evaluation of the speech training by auditory impaired people.

Evaluation of Synthetic Self-Oscillating Models of the Vocal Folds

NASA Astrophysics Data System (ADS)

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).

Vocal Cord Paralysis

MedlinePlus

... paralysis. Known causes may include: Injury to the vocal cord during surgery. Surgery on or near your neck or upper ... Factors that may increase your risk of developing vocal cord paralysis include: Undergoing throat or chest surgery. People who need surgery on their thyroid, throat ...

Factors limiting vocal-tract length discrimination in cochlear implant simulations.

PubMed

Gaudrain, Etienne; Başkent, Deniz

2015-03-01

Perception of voice characteristics allows normal hearing listeners to identify the gender of a speaker, and to better segregate speakers from each other in cocktail party situations. This benefit is largely driven by the perception of two vocal characteristics of the speaker: The fundamental frequency (F0) and the vocal-tract length (VTL). Previous studies have suggested that cochlear implant (CI) users have difficulties in perceiving these cues. The aim of the present study was to investigate possible causes for limited sensitivity to VTL differences in CI users. Different acoustic simulations of CI stimulation were implemented to characterize the role of spectral resolution on VTL, both in terms of number of channels and amount of channel interaction. The results indicate that with 12 channels, channel interaction caused by current spread is likely to prevent CI users from perceiving VTL differences typically found between male and female speakers.

Transcultural Adaptation and Validation of the German Version of the Vocal Tract Discomfort Scale.

PubMed

Lukaschyk, Julia; Brockmann-Bauser, Meike; Beushausen, Ulla

2017-03-01

Currently, there is no standardized German questionnaire to assess vocal tract discomfort in voice patients. The aim of this study was to evaluate the internal consistency, reliability, and validity of the German version of the Vocal Tract Discomfort (VTD) Scale. This is a cross-sectional study. First, a cross-cultural translation and adaptation from English to German was performed. One hundred seven patients between the ages of 18 and 76 with voice disorders were divided into two different diagnosis-related groups (organic and functional voice disorder) and 50 vocally healthy adults were included. All participants completed the VTD Scale and the Voice Handicap Index (VHI). The internal consistency of the VTD Scale was analyzed through Cronbach's α coefficient. Pearson correlation between the VDT Scale and VHI total scores was used to determine criterion validity. The VDT Scale score differences related to diagnosis groups were assessed with analysis of variance. Excellent internal consistency was found (α = 0.919, P < 0.05), and criterion validity was confirmed by a high correlation between the total VTD Scale and VHI (r = 0.674). There was a significant difference between the diagnosis groups' total VTD Scale score (F[4.135] = 15.114, P = 0.000). Furthermore, the vocally healthy adults had significantly lower values than the two diagnosis groups (x¯: 11.48, s = 8.340). The German version of the VTD Scale has an excellent internal consistency and reliability, and shows high clinical validity. Thus, it is a useful instrument in voice diagnostics. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Analysis of Measured and Simulated Supraglottal Acoustic Waves.

PubMed

Fraile, Rubén; Evdokimova, Vera V; Evgrafova, Karina V; Godino-Llorente, Juan I; Skrelin, Pavel A

2016-09-01

To date, although much attention has been paid to the estimation and modeling of the voice source (ie, the glottal airflow volume velocity), the measurement and characterization of the supraglottal pressure wave have been much less studied. Some previous results have unveiled that the supraglottal pressure wave has some spectral resonances similar to those of the voice pressure wave. This makes the supraglottal wave partially intelligible. Although the explanation for such effect seems to be clearly related to the reflected pressure wave traveling upstream along the vocal tract, the influence that nonlinear source-filter interaction has on it is not as clear. This article provides an insight into this issue by comparing the acoustic analyses of measured and simulated supraglottal and voice waves. Simulations have been performed using a high-dimensional discrete vocal fold model. Results of such comparative analysis indicate that spectral resonances in the supraglottal wave are mainly caused by the regressive pressure wave that travels upstream along the vocal tract and not by source-tract interaction. On the contrary and according to simulation results, source-tract interaction has a role in the loss of intelligibility that happens in the supraglottal wave with respect to the voice wave. This loss of intelligibility mainly corresponds to spectral differences for frequencies above 1500 Hz. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Nordic rattle: the hoarse vocalization and the inflatable laryngeal air sac of reindeer (Rangifer tarandus)

PubMed Central

Frey, Roland; Gebler, Alban; Fritsch, Guido; Nygrén, Kaarlo; Weissengruber, Gerald E

2007-01-01

Laryngeal air sacs have evolved convergently in diverse mammalian lineages including insectivores, bats, rodents, pinnipeds, ungulates and primates, but their precise function has remained elusive. Among cervids, the vocal tract of reindeer has evolved an unpaired inflatable ventrorostral laryngeal air sac. This air sac is not present at birth but emerges during ontogenetic development. It protrudes from the laryngeal vestibulum via a short duct between the epiglottis and the thyroid cartilage. In the female the growth of the air sac stops at the age of 2–3 years, whereas in males it continues to grow up to the age of about 6 years, leading to a pronounced sexual dimorphism of the air sac. In adult females it is of moderate size (about 100 cm3), whereas in adult males it is large (3000–4000 cm3) and becomes asymmetric extending either to the left or to the right side of the neck. In both adult females and males the ventral air sac walls touch the integument. In the adult male the air sac is laterally covered by the mandibular portion of the sternocephalic muscle and the skin. Both sexes of reindeer have a double stylohyoid muscle and a thyroepiglottic muscle. Possibly these muscles assist in inflation of the air sac. Head-and-neck specimens were subjected to macroscopic anatomical dissection, computer tomographic analysis and skeletonization. In addition, isolated larynges were studied for comparison. Acoustic recordings were made during an autumn round-up of semi-domestic reindeer in Finland and in a small zoo herd. Male reindeer adopt a specific posture when emitting their serial hoarse rutting calls. Head and neck are kept low and the throat region is extended. In the ventral neck region, roughly corresponding to the position of the large air sac, there is a mane of longer hairs. Neck swelling and mane spreading during vocalization may act as an optical signal to other males and females. The air sac, as a side branch of the vocal tract, can be considered as an additional acoustic filter. Individual acoustic recognition may have been the primary function in the evolution of a size-variable air sac, and this function is retained in mother–young communication. In males sexual selection seems to have favoured a considerable size increase of the air sac and a switch to call series instead of single calls. Vocalization became restricted to the rutting period serving the attraction of females. We propose two possibilities for the acoustic function of the air sac in vocalization that do not exclude each other. The first assumes a coupling between air sac and the environment, resulting in an acoustic output that is a combination of the vocal tract resonance frequencies emitted via mouth and nostrils and the resonance frequencies of the air sac transmitted via the neck skin. The second assumes a weak coupling so that resonance frequencies of the air sac are lost to surrounding tissues by dissipation. In this case the resonance frequencies of the air sac solely influence the signal that is further filtered by the remaining vocal tract. According to our results one acoustic effect of the air sac in adult reindeer might be to mask formants of the vocal tract proper. In other cervid species, however, formants of rutting calls convey essential information on the quality of the sender, related to its potential reproductive success, to conspecifics. Further studies are required to solve this inconsistency. PMID:17310544

Retrieving Tract Variables From Acoustics: A Comparison of Different Machine Learning Strategies.

PubMed

Mitra, Vikramjit; Nam, Hosung; Espy-Wilson, Carol Y; Saltzman, Elliot; Goldstein, Louis

2010-09-13

Many different studies have claimed that articulatory information can be used to improve the performance of automatic speech recognition systems. Unfortunately, such articulatory information is not readily available in typical speaker-listener situations. Consequently, such information has to be estimated from the acoustic signal in a process which is usually termed "speech-inversion." This study aims to propose and compare various machine learning strategies for speech inversion: Trajectory mixture density networks (TMDNs), feedforward artificial neural networks (FF-ANN), support vector regression (SVR), autoregressive artificial neural network (AR-ANN), and distal supervised learning (DSL). Further, using a database generated by the Haskins Laboratories speech production model, we test the claim that information regarding constrictions produced by the distinct organs of the vocal tract (vocal tract variables) is superior to flesh-point information (articulatory pellet trajectories) for the inversion process.

Role of vocal tract characteristics in individual discrimination by Japanese macaques (Macaca fuscata).

PubMed

Furuyama, Takafumi; Kobayasi, Kohta I; Riquimaroux, Hiroshi

2016-08-23

The Japanese macaque (Macaca fuscata) exhibits a species-specific communication sound called the "coo call" to locate group members and maintain within-group contact. Monkeys have been demonstrated to be capable of discriminating between individuals based only on their voices, but there is still debate regarding how the fundamental frequencies (F0) and filter properties of the vocal tract characteristics (VTC) contribute to individual discrimination in nonhuman primates. This study was performed to investigate the acoustic keys used by Japanese macaques in individual discrimination. Two animals were trained with standard Go/NoGo operant conditioning to distinguish the coo calls of two unfamiliar monkeys. The subjects were required to continue depressing a lever until the stimulus changed from one monkey to the other. The test stimuli were synthesized by combining the F0s and VTC from each individual. Both subjects released the lever when the VTC changed, whereas they did not when the F0 changed. The reaction times to the test stimuli were not significantly different from that to the training stimuli that shared the same VTC. Our data suggest that vocal tract characteristics are important for the identification of individuals by Japanese macaques.

Morphometric Differences of Vocal Tract Articulators in Different Loudness Conditions in Singing

PubMed Central

Echternach, Matthias; Burk, Fabian; Burdumy, Michael; Traser, Louisa; Richter, Bernhard

2016-01-01

Introduction Dynamic MRI analysis of phonation has gathered interest in voice and speech physiology. However, there are limited data addressing the extent to which articulation is dependent on loudness. Material and Methods 12 professional singer subjects of different voice classifications were analysed concerning the vocal tract profiles recorded with dynamic real-time MRI with 25fps in different pitch and loudness conditions. The subjects were asked to sing ascending scales on the vowel /a/ in three loudness conditions (comfortable = mf, very soft = pp, very loud = ff, respectively). Furthermore, fundamental frequency and sound pressure level were analysed from the simultaneously recorded optical audio signal after noise cancellation. Results The data show articulatory differences with respect to changes of both pitch and loudness. Here, lip opening and pharynx width were increased. While the vertical larynx position was rising with pitch it was lower for greater loudness. Especially, the lip opening and pharynx width were more strongly correlated with the sound pressure level than with pitch. Conclusion For the vowel /a/ loudness has an effect on articulation during singing which should be considered when articulatory vocal tract data are interpreted. PMID:27096935

Influence of the ventricular folds on a voice source with specified vocal fold motion1

PubMed Central

McGowan, Richard S.; Howe, Michael S.

2010-01-01

The unsteady drag on the vocal folds is the major source of sound during voiced speech. The drag force is caused by vortex shedding from the vocal folds. The influence of the ventricular folds (i.e., the “false” vocal folds that protrude into the vocal tract a short distance downstream of the glottis) on the drag and the voice source are examined in this paper by means of a theoretical model involving vortex sheets in a two-dimensional geometry. The effect of the ventricular folds on the output acoustic pressure is found to be small when the movement of the vocal folds is prescribed. It is argued that the effect remains small when fluid-structure interactions account for vocal fold movement. These conclusions can be justified mathematically when the characteristic time scale for change in the velocity of the glottal jet is large compared to the time it takes for a vortex disturbance to be convected through the vocal fold and ventricular fold region. PMID:20329852

Combined Functional Voice Therapy in Singers With Muscle Tension Dysphonia in Singing.

PubMed

Sielska-Badurek, Ewelina; Osuch-Wójcikiewicz, Ewa; Sobol, Maria; Kazanecka, Ewa; Rzepakowska, Anna; Niemczyk, Kazimierz

2017-07-01

The purpose of this study was to evaluate vocal tract function and the voice quality in singers with muscle tension dysphonia (MTD) after undergoing combined functional voice therapy of the singing voice. This is a prospective, randomized study. Forty singers (29 females and 11 males, mean age: 24.6 ± 8.8 years) with MTD were enrolled in the study. The study group consisted of 20 singers who underwent combined functional voice therapy (10-15 individual sessions, 30-40 minutes each). Singers who did not opt for vocal rehabilitation consisted of the control group. Effects of rehabilitation were assessed with videolaryngostroboscopy, palpation of the vocal tract structures, flexible fiberoptic evaluation of the pharynx and the larynx, perceptual speaking and singing voice assessment, acoustic analysis, maximal phonation time, and the Voice Handicap Index. After combined functional voice therapy in the study group, great improvement was noticed in palpation of the vocal tract structures (P < 0.001), perceptual voice assessment (P < 0.001), phonetograms (P = 0.002), and singing range obtained from acoustic analysis of glissando (P < 0.001). In the control group, no statistically significant differences were found between the first and the second assessments. Combined functional voice therapy proved to be an efficacious treatment method in singers with MTD in singing. Development of palpation and perceptual singing voice examination protocols enables one to compare results before and after rehabilitation in clinics. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Fundamental frequency, phonation maximum time and vocal complaints in morbidly obese women

PubMed Central

de SOUZA, Lourdes Bernadete Rocha; PEREIRA, Rayane Medeiros; dos SANTOS, Marquiony Marques; GODOY, Cynthia Meida de Almeida

2014-01-01

Background Obese people have abnormal deposition of fat in the vocal tract that can interfere with the acoustic voice. Aim To relate the fundamental frequency, the maximum phonation time and voice complaints from a group of morbidly obese women. Methods Observational, cross-sectional and descriptive study that included 44 morbidly obese women, mean age of 42.45 (±10.31) years old, observational group and 30 women without obesity, control group, with 33.79 (±4.51)years old. The voice recording was done in a quiet environment, on a laptop using the program ANAGRAF acoustic analysis of speech sounds. To extract the values ​​of fundamental frequency the subjects were asked to produce vowel [a] at usual intensity for a period in average of three seconds. After the voice recording, participants were prompted to produce sustained vowel [ a] , [ i] and [ u] at usual intensity and height, using a stopwatch to measure the time that each participant could hold each vowel. Results The majority, 31(70.5%), had vocal complaints, with a higher percentage for complaints of vocal fatigue 20(64.51%) and voice failures 19(61.29%) followed by dryness of the throat in 15 (48.38%) and effort to speak 13(41.93%). There was no statistically significant difference regarding the mean fundamental frequency of the voice in both groups, but there was significance between the two groups regarding maximum phonation. Conclusion Increased adipose tissue in the vocal tract interfered in the vocal parameters. PMID:24676298

The Human Voice in Speech and Singing

NASA Astrophysics Data System (ADS)

Lindblom, Björn; Sundberg, Johan

This chapter speech describes various aspects of the human voice as a means of communication in speech and singing. From the point of view of function, vocal sounds can be regarded as the end result of a three stage process: (1) the compression of air in the respiratory system, which produces an exhalatory airstream, (2) the vibrating vocal folds' transformation of this air stream to an intermittent or pulsating air stream, which is a complex tone, referred to as the voice source, and (3) the filtering of this complex tone in the vocal tract resonator. The main function of the respiratory system is to generate an overpressure of air under the glottis, or a subglottal pressure. Section 16.1 describes different aspects of the respiratory system of significance to speech and singing, including lung volume ranges, subglottal pressures, and how this pressure is affected by the ever-varying recoil forces. The complex tone generated when the air stream from the lungs passes the vibrating vocal folds can be varied in at least three dimensions: fundamental frequency, amplitude and spectrum. Section 16.2 describes how these properties of the voice source are affected by the subglottal pressure, the length and stiffness of the vocal folds and how firmly the vocal folds are adducted. Section 16.3 gives an account of the vocal tract filter, how its form determines the frequencies of its resonances, and Sect. 16.4 gives an account for how these resonance frequencies or formants shape the vocal sounds by imposing spectrum peaks separated by spectrum valleys, and how the frequencies of these peaks determine vowel and voice qualities. The remaining sections of the chapter describe various aspects of the acoustic signals used for vocal communication in speech and singing. The syllable structure is discussed in Sect. 16.5, the closely related aspects of rhythmicity and timing in speech and singing is described in Sect. 16.6, and pitch and rhythm aspects in Sect. 16.7. The impressive control of all these acoustic characteristics of vocal signals is discussed in Sect. 16.8, while Sect. 16.9 considers expressive aspects of vocal communication.

The Human Voice in Speech and Singing

NASA Astrophysics Data System (ADS)

Lindblom, Björn; Sundberg, Johan

This chapter describes various aspects of the human voice as a means of communication in speech and singing. From the point of view of function, vocal sounds can be regarded as the end result of a three stage process: (1) the compression of air in the respiratory system, which produces an exhalatory airstream, (2) the vibrating vocal folds' transformation of this air stream to an intermittent or pulsating air stream, which is a complex tone, referred to as the voice source, and (3) the filtering of this complex tone in the vocal tract resonator. The main function of the respiratory system is to generate an overpressure of air under the glottis, or a subglottal pressure. Section 16.1 describes different aspects of the respiratory system of significance to speech and singing, including lung volume ranges, subglottal pressures, and how this pressure is affected by the ever-varying recoil forces. The complex tone generated when the air stream from the lungs passes the vibrating vocal folds can be varied in at least three dimensions: fundamental frequency, amplitude and spectrum. Section 16.2 describes how these properties of the voice source are affected by the subglottal pressure, the length and stiffness of the vocal folds and how firmly the vocal folds are adducted. Section 16.3 gives an account of the vocal tract filter, how its form determines the frequencies of its resonances, and Sect. 16.4 gives an account for how these resonance frequencies or formants shape the vocal sounds by imposing spectrum peaks separated by spectrum valleys, and how the frequencies of these peaks determine vowel and voice qualities. The remaining sections of the chapter describe various aspects of the acoustic signals used for vocal communication in speech and singing. The syllable structure is discussed in Sect. 16.5, the closely related aspects of rhythmicity and timing in speech and singing is described in Sect. 16.6, and pitch and rhythm aspects in Sect. 16.7. The impressive control of all these acoustic characteristics of vocal signals is discussed in Sect. 16.8, while Sect. 16.9 considers expressive aspects of vocal communication.

A three-dimensional study of the glottal jet

NASA Astrophysics Data System (ADS)

Krebs, F.; Silva, F.; Sciamarella, D.; Artana, G.

2012-05-01

This work builds upon the efforts to characterize the three-dimensional features of the glottal jet during vocal fold vibration. The study uses a Stereoscopic Particle Image Velocimetry setup on a self-oscillating physical model of the vocal folds with a uniform vocal tract. Time averages are documented and analyzed within the framework given by observations reported for jets exiting elongated nozzles. Phase averages are locked to the audio signal and used to obtain a volumetric reconstruction of the jet. From this reconstruction, the intra-cycle dynamics of the jet axis switching is disclosed.

Theoretical Analysis of Maximum Flow Declination Rate versus Maximum Area Declination Rate in Phonation

ERIC Educational Resources Information Center

Titze, Ingo R.

2006-01-01

Purpose: Maximum flow declination rate (MFDR) in the glottis is known to correlate strongly with vocal intensity in voicing. This declination, or negative slope on the glottal airflow waveform, is in part attributable to the maximum area declination rate (MADR) and in part to the overall inertia of the air column of the vocal tract (lungs to…

Subglottal pressure, tracheal airflow, and intrinsic laryngeal muscle activity during rat ultrasound vocalization

PubMed Central

2011-01-01

Vocal production requires complex planning and coordination of respiratory, laryngeal, and vocal tract movements, which are incompletely understood in most mammals. Rats produce a variety of whistles in the ultrasonic range that are of communicative relevance and of importance as a model system, but the sources of acoustic variability were mostly unknown. The goal was to identify sources of fundamental frequency variability. Subglottal pressure, tracheal airflow, and electromyographic (EMG) data from two intrinsic laryngeal muscles were measured during 22-kHz and 50-kHz call production in awake, spontaneously behaving adult male rats. During ultrasound vocalization, subglottal pressure ranged between 0.8 and 1.9 kPa. Pressure differences between call types were not significant. The relation between fundamental frequency and subglottal pressure within call types was inconsistent. Experimental manipulations of subglottal pressure had only small effects on fundamental frequency. Tracheal airflow patterns were also inconsistently associated with frequency. Pressure and flow seem to play a small role in regulation of fundamental frequency. Muscle activity, however, is precisely regulated and very sensitive to alterations, presumably because of effects on resonance properties in the vocal tract. EMG activity of cricothyroid and thyroarytenoid muscle was tonic in calls with slow or no fundamental frequency modulations, like 22-kHz and flat 50-kHz calls. Both muscles showed brief high-amplitude, alternating bursts at rates up to 150 Hz during production of frequency-modulated 50-kHz calls. A differentiated and fine regulation of intrinsic laryngeal muscles is critical for normal ultrasound vocalization. Many features of the laryngeal muscle activation pattern during ultrasound vocalization in rats are shared with other mammals. PMID:21832032

Social Communication and Vocal Recognition in Free-Ranging Rhesus Monkeys

NASA Astrophysics Data System (ADS)

Rendall, Christopher Andrew

Kinship and individual identity are key determinants of primate sociality, and the capacity for vocal recognition of individuals and kin is hypothesized to be an important adaptation facilitating intra-group social communication. Research was conducted on adult female rhesus monkeys on Cayo Santiago, Puerto Rico to test this hypothesis for three acoustically distinct calls characterized by varying selective pressures on communicating identity: coos (contact calls), grunts (close range social calls), and noisy screams (agonistic recruitment calls). Vocalization playback experiments confirmed a capacity for both individual and kin recognition of coos, but not screams (grunts were not tested). Acoustic analyses, using traditional spectrographic methods as well as linear predictive coding techniques, indicated that coos (but not grunts or screams) were highly distinctive, and that the effects of vocal tract filtering--formants --contributed more to statistical discriminations of both individuals and kin groups than did temporal or laryngeal source features. Formants were identified from very short (23 ms.) segments of coos and were stable within calls, indicating that formant cues to individual and kin identity were available throughout a call. This aspect of formant cues is predicted to be an especially important design feature for signaling identity efficiently in complex acoustic environments. Results of playback experiments involving manipulated coo stimuli provided preliminary perceptual support for the statistical inference that formant cues take precedence in facilitating vocal recognition. The similarity of formants among female kin suggested a mechanism for the development of matrilineal vocal signatures from the genetic and environmental determinants of vocal tract morphology shared among relatives. The fact that screams --calls strongly expected to communicate identity--were not individually distinctive nor recognized suggested the possibility that their acoustic structure and role in signaling identity might be constrained by functional or morphological design requirements associated with their role in signaling submission.

Vocal effort modulates the motor planning of short speech structures

NASA Astrophysics Data System (ADS)

Taitz, Alan; Shalom, Diego E.; Trevisan, Marcos A.

2018-05-01

Speech requires programming the sequence of vocal gestures that produce the sounds of words. Here we explored the timing of this program by asking our participants to pronounce, as quickly as possible, a sequence of consonant-consonant-vowel (CCV) structures appearing on screen. We measured the delay between visual presentation and voice onset. In the case of plosive consonants, produced by sharp and well defined movements of the vocal tract, we found that delays are positively correlated with the duration of the transition between consonants. We then used a battery of statistical tests and mathematical vocal models to show that delays reflect the motor planning of CCVs and transitions are proxy indicators of the vocal effort needed to produce them. These results support that the effort required to produce the sequence of movements of a vocal gesture modulates the onset of the motor plan.

The effect of a voiced lip trill on estimated glottal closed quotient.

PubMed

Gaskill, Christopher S; Erickson, Molly L

2008-11-01

The use of lip trills has been advocated for both vocal habilitation and rehabilitation. A voiced lip trill requires continuous vibration of the lips while simultaneously maintaining phonation. The mechanism of any effects of a lip trill on vocal fold vibration is still unknown. While other techniques that either constrict or artificially lengthen the vocal tract have been investigated, no studies thus far have systematically examined the effect of lip trills on vocal fold vibration. Classically trained singers and vocally untrained participants produced a lip trill for approximately 1 minute, and vocal fold closed quotient (CQ) was calculated both during the lip trill and on a sustained spoken vowel before and after the trill. Data are reported for both a group design and a single-subject design. Most participants showed a tendency for a reduction in CQ during the lip trill, with a more pronounced change in the untrained participants.

Interactive Augmentation of Voice Quality and Reduction of Breath Airflow in the Soprano Voice.

PubMed

Rothenberg, Martin; Schutte, Harm K

2016-11-01

In 1985, at a conference sponsored by the National Institutes of Health, Martin Rothenberg first described a form of nonlinear source-tract acoustic interaction mechanism by which some sopranos, singing in their high range, can use to reduce the total airflow, to allow holding the note longer, and simultaneously enrich the quality of the voice, without straining the voice. (M. Rothenberg, "Source-Tract Acoustic Interaction in the Soprano Voice and Implications for Vocal Efficiency," Fourth International Conference on Vocal Fold Physiology, New Haven, Connecticut, June 3-6, 1985.) In this paper, we describe additional evidence for this type of nonlinear source-tract interaction in some soprano singing and describe an analogous interaction phenomenon in communication engineering. We also present some implications for voice research and pedagogy. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

The physiological basis of Glottal electromagnetic micropower sensors (GEMS) and their use in defining an excitation function for the human vocal tract

NASA Astrophysics Data System (ADS)

Burnett, Gregory Clell

1999-10-01

The definition, use, and physiological basis of Glottal Electromagnetic Micropower Sensors (GEMS) is presented. These sensors are a new type of low power (<20 milliwatts radiated) microwave regime (900 MHz to 2.5 GHz) multi-purpose motion sensor developed at the Lawrence Livermore National Laboratory. The GEMS are sensitive to movement in an adjustable field of view (FOV) surrounding the antennae. In this thesis, the GEMS has been utilized for speech research, targeted to receive motion signals from the subglottal region of the trachea. The GEMS signal is analyzed to determine the physiological source of the signal, and this information is used to calculate the subglottal pressure, effectively an excitation function for the human vocal tract. For the first time, an excitation function may be calculated in near real time using a noninvasive procedure. Several experiments and models are presented to demonstrate that the GEMS signal is representative of the motion of the subglottal posterior wall of the trachea as it vibrates in response to the pressure changes caused by the folds as they modulate the airflow supplied by the lungs. The vibrational properties of the tracheal wall are modeled using a lumped-element circuit model. Taking the output of the vocal tract to be the audio pressure captured by a microphone and the input to be the subglottal pressure, the transfer function of the vocal tract (including the nasal cavities) can be approximated every 10-30 milliseconds using an autoregressive moving-average model. Unlike the currently utilized method of transfer function approximation, this new method only involves noninvasive GEMS measurements and digital signal processing and does not demand the difficult task of obtaining precise physical measurements of the tract and subsequent estimation of the transfer function using its cross-sectional area. The ability to measure the physical motion of the trachea enables a significant number of potential applications, ranging from very accurate pitch detection to speech synthesis, speaker verification, and speech recognition.

Ultrasonography assessment of vocal cords mobility in children after cardiac surgery.

PubMed

Shaath, Ghassan A; Jijeh, Abdulraouf; Alkurdi, Ahmad; Ismail, Sameh; Elbarbary, Mahmoud; Kabbani, Mohamed S

2012-07-01

Upper airway obstruction after pediatric cardiac surgery is not uncommon. In the cardiac surgical population, an important etiology is vocal cord paresis or paralysis following extubation. In this study, we aimed to evaluate the feasibility and accuracy of ultrasonography (US) assessment of the vocal cords mobility and compare it to fiber-optic laryngoscope (FL). A prospective pilot study has been conducted in Pediatric Cardiac ICU (PCICU) at King Abdulaziz Cardiac Center (KACC) from the 1st of June 2009 till the end of July 2010. Patients who had cardiac surgery manifested with significant signs of upper airway obstruction were included. Each procedure was performed by different operators who were blinded to each other report. Results of invasive (FL) and non-invasive ultrasonography (US) investigations were compared. Ten patients developed persistent significant upper airway obstruction after cardiac surgery were included in the study. Their mean ± SEM of weight and age were 4.6 ± 0.4 kg and 126.4 ± 51.4 days, respectively. All patients were referred to bedside US screening for vocal cord mobility. The results of US were compared subsequently with FL findings. Results were identical in nine (90%) patients and partially different in one (10%). Six patients showed abnormal glottal movement while the other four patients demonstrated normal vocal cords mobility by FL. Sensitivity of US was 100% and specificity of 80%. US assessment of vocal cord is simple, non-invasive and reliable tool to assess vocal cords mobility in the critical care settings. This screening tool requires skills that can be easily obtained.

ANALYSIS OF FLOW-STRUCTURE COUPLING IN A MECHANICAL MODEL OF THE VOCAL FOLDS AND THE SUBGLOTTAL SYSTEM.

PubMed

Howe, M S; McGowan, R S

2009-11-01

An analysis is made of the nonlinear interactions between flow in the subglottal vocal tract and glottis, sound waves in the subglottal system and a mechanical model of the vocal folds. The mean flow through the system is produced by a nominally steady contraction of the lungs, and mechanical experiments frequently involve a 'lung cavity' coupled to an experimental subglottal tube of arbitrary or ill-defined effective length L, on the basis that the actual value of L has little or no influence on excitation of the vocal folds. A simple, self-exciting single mass mathematical model of the vocal folds is used to investigate the sound generated within the subglottal domain and the unsteady volume flux from the glottis for experiments where it is required to suppress feedback of sound from the supraglottal vocal tract. In experiments where the assumed absorption of sound within the sponge-like interior of the lungs is small, the influence of changes in L can be very significant: when the subglottal tube behaves as an open-ended resonator (when L is as large as half the acoustic wavelength) there is predicted to be a mild increase in volume flux magnitude and a small change in waveform. However, the strong appearance of second harmonics of the acoustic field is predicted at intermediate lengths, when L is roughly one quarter of the acoustic wavelength. In cases of large lung damping, however, only modest changes in the volume flux are predicted to occur with variations in L.

Effect of body position on vocal tract acoustics: Acoustic pharyngometry and vowel formants.

PubMed

Vorperian, Houri K; Kurtzweil, Sara L; Fourakis, Marios; Kent, Ray D; Tillman, Katelyn K; Austin, Diane

2015-08-01

The anatomic basis and articulatory features of speech production are often studied with imaging studies that are typically acquired in the supine body position. It is important to determine if changes in body orientation to the gravitational field alter vocal tract dimensions and speech acoustics. The purpose of this study was to assess the effect of body position (upright versus supine) on (1) oral and pharyngeal measurements derived from acoustic pharyngometry and (2) acoustic measurements of fundamental frequency (F0) and the first four formant frequencies (F1-F4) for the quadrilateral point vowels. Data were obtained for 27 male and female participants, aged 17 to 35 yrs. Acoustic pharyngometry showed a statistically significant effect of body position on volumetric measurements, with smaller values in the supine than upright position, but no changes in length measurements. Acoustic analyses of vowels showed significantly larger values in the supine than upright position for the variables of F0, F3, and the Euclidean distance from the centroid to each corner vowel in the F1-F2-F3 space. Changes in body position affected measurements of vocal tract volume but not length. Body position also affected the aforementioned acoustic variables, but the main vowel formants were preserved.

Vocal tract resonances in singing: The soprano voice

NASA Astrophysics Data System (ADS)

Joliveau, Elodie; Smith, John; Wolfe, Joe

2004-10-01

The vocal tract resonances of trained soprano singers were measured while they sang a range of vowels softly at different pitches. The measurements were made by broad band acoustic excitation at the mouth, which allowed the resonances of the tract to be measured simultaneously with and independently from the harmonics of the voice. At low pitch, when the lowest resonance frequency R1 exceeded f0, the values of the first two resonances R1 and R2 varied little with frequency and had values consistent with normal speech. At higher pitches, however, when f0 exceeded the value of R1 observed at low pitch, R1 increased with f0 so that R1 was approximately equal to f0. R2 also increased over this high pitch range, probably as an incidental consequence of the tuning of R1. R3 increased slightly but systematically, across the whole pitch range measured. There was no evidence that any resonances are tuned close to harmonics of the pitch frequency except for R1 at high pitch. The variations in R1 and R2 at high pitch mean that vowels move, converge, and overlap their positions on the vocal plane (R2,R1) to an extent that implies loss of intelligibility. .

Vocal power and pressure–flow relationships in excised tiger larynges

PubMed Central

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

2010-01-01

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. PMID:21037066

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

PubMed

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.

The effect of resonance tubes on glottal contact quotient with and without task instruction: a comparison of trained and untrained voices.

PubMed

Gaskill, Christopher S; Quinney, Dana M

2012-05-01

Phonation into narrow tubes or straws has been used as a voice training and voice therapy technique and belongs to a group of techniques known as semi-occluded vocal tract exercises. The use of what are called resonance tubes has received renewed attention in the voice research literature, in both theoretical and empirical studies. The assumption is that the partially occluded and lengthened vocal tract alters supraglottal acoustics in such a way as to allow phonation near a lowered first vocal tract formant, which has been suggested as a way to bring about a more efficient glottal closure pattern for sustained oscillation. In this study, two groups of male participants, 10 with no vocal training and 10 with classical vocal training, phonated into a resonance tube for approximately 1 minute. Electroglottography was used to estimate glottal contact quotient (CQ) during spoken /a/ vowels before tube phonation, during tube phonation, and again during spoken /a/ vowels after tube phonation. Half of each group of participants was made to keep pitch and loudness consistent for all phases of the experiment, replicating the method of a previous study by this author. The other half was instructed to practice phonating into the resonance tube before collecting data and was encouraged to find a pitch and loudness combination that maximized ease of phonation and a sense of forward oral resonance. Glottal CQ altered considerably from baseline for almost all participants during tube phonation, with a larger variability than that during vowel production. Small differences in glottal CQ were found as a function of training and instruction, with most participants' CQ increasing during tube phonation. A small post-tube phonation effect was found primarily for the trained and instructed group. Secondary single-subject analyses revealed large intersubject variation, highlighting the highly individualized response to the resonance tube task. Continued study of resonance tubes is recommended, comparing both male and female as well as vocally trained and untrained participants. Future studies should continue to examine systematic variations in task instruction, length of practice, and resonance tube dimensions. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Relation of structural and vibratory kinematics of the vocal folds to two acoustic measures of breathy voice based on computational modeling

PubMed Central

Samlan, Robin A.; Story, Brad H.

2011-01-01

Purpose To relate vocal fold structure and kinematics to two acoustic measures: cepstral peak prominence (CPP) and the amplitude of the first harmonic relative to the second (H1-H2). Method A computational, kinematic model of the medial surfaces of the vocal folds was used to specify features of vocal fold structure and vibration in a manner consistent with breathy voice. Four model parameters were altered: degree of vocal fold adduction, surface bulging, vibratory nodal point, and supraglottal constriction. CPP and H1-H2 were measured from simulated glottal area, glottal flow and acoustic waveforms and related to the underlying vocal fold kinematics. Results CPP decreased with increased separation of the vocal processes, whereas the nodal point location had little effect. H1-H2 increased as a function of separation of the vocal processes in the range of 1–1.5 mm and decreased with separation > 1.5 mm. Conclusions CPP is generally a function of vocal process separation. H1*-H2* will increase or decrease with vocal process separation based on vocal fold shape, pivot point for the rotational mode, and supraglottal vocal tract shape, limiting its utility as an indicator of breathy voice. Future work will relate the perception of breathiness to vocal fold kinematics and acoustic measures. PMID:21498582

The larynx of roaring and non-roaring cats.

PubMed

Hast, M H

1989-04-01

Dissections were made of the larynges of 14 species of the cat family, with representative specimens from all genera. It was found that the vocal folds of the larynx of genus Panthera (with the exception of the snow leopard) form the basic structure of a sound generator well-designed to produce a high acoustical energy. Combined with an efficient sound radiator (vocal tract) that can be adjusted in length, a Panthera can use its vocal instrument literally to blow its own horn with a 'roar'. Also, it is proposed that laryngeal morphology can be used as an anatomical character in mammalian taxonomy.

Acoustic passaggio pedagogy for the male voice.

PubMed

Bozeman, Kenneth Wood

2013-07-01

Awareness of interactions between the lower harmonics of the voice source and the first formant of the vocal tract, and of the passive vowel modifications that accompany them, can assist in working out a smooth transition through the passaggio of the male voice. A stable vocal tract length establishes the general location of all formants, including the higher formants that form the singer's formant cluster. Untrained males instinctively shorten the tube to preserve the strong F1/H2 acoustic coupling of voce aperta, resulting in 'yell' timbre. If tube length and shape are kept stable during pitch ascent, the yell can be avoided by allowing the second harmonic to rise above the first formant, creating the balanced timbre of voce chiusa.

Air Pressure Responses to Sudden Vocal Tract Pressure Bleeds During Production of Stop Consonants: New Evidence of Aeromechanical Regulation

PubMed Central

Zajac, David J.; Weissler, Mark C.

2011-01-01

Two studies were conducted to evaluate short-latency vocal tract air pressure responses to sudden pressure bleeds during production of voiceless bilabial stop consonants. It was hypothesized that the occurrence of respiratory reflexes would be indicated by distinct patterns of responses as a function of bleed magnitude. In Study 1, 19 adults produced syllable trains of /pΛ/ using a mouthpiece coupled to a computer-controlled perturbator. The device randomly created bleed apertures that ranged from 0 to 40 mm2 during production of the 2nd or 4th syllable of an utterance. Although peak oral air pressure dropped in a linear manner across bleed apertures, it averaged 2 to 3 cm H2O at the largest bleed. While slope of oral pressure also decreased in a linear trend, duration of the oral pressure pulse remained relatively constant. The patterns suggest that respiratory reflexes, if present, have little effect on oral air pressure levels. In Study 2, both oral and subglottal air pressure responses were monitored in 2 adults while bleed apertures of 20 and 40 mm2 were randomly created. For 1 participant, peak oral air pressure dropped across bleed apertures, as in Study 1. Subglottal air pressure and slope, however, remained relatively stable. These patterns provide some support for the occurrence of respiratory reflexes to regulate subglottal air pressure. Overall, the studies indicate that the inherent physiologic processes of the respiratory system, which may involve reflexes, and passive aeromechanical resistance of the upper airway are capable of developing oral air pressure in the face of substantial pressure bleeds. Implications for understanding speech production and the characteristics of individuals with velopharyngeal dysfunction are discussed. PMID:15324286

Investigation of the impact of thyroid surgery on vocal tract steadiness.

PubMed

Timon, Conrad I; Hirani, Shashi P; Epstein, Ruth; Rafferty, Mark A

2010-09-01

Subjective nonspecific upper aerodigestive symptoms are not uncommon after thyroid surgery. These are postulated to be related to injury of an extrinsic perithyroid nerve plexus that innervates the muscles of the supraglottic and glottic larynx. This plexus is thought to receive contributing branches from both the recurrent and superior laryngeal nerves. The technique of linear predictive coding was used to estimate the F(2) values from a sustained vowel /a/ in patients before and 48 hours after thyroid or parathyroid surgery. These patients were controlled against a matched pair undergoing surgery without any theoretical effect on the supraglottic musculature. In total, 12 patients were recruited into each group. Each patient had the formant frequency fluctuation (FFF) and the formant frequency fluctuation ratio (FFFR) calculated for F(1) and F(2). Mixed analysis of variance (ANOVA) for all acoustic parameters revealed that the chiF(2)FF showed a significant "time" main effect (F(1,22)=7.196, P=0.014, partial eta(2)=0.246) and a significant "time by group interaction" effect (F(1,22)=8.036, P=0.010, eta(p)(2)=0.268), with changes over time for the thyroid group but not for the controls. Similarly, mean chiF(2)FFR showed a similar significant "time" main effect (F(1,22)=6.488, P=0.018, eta(p)(2)=0.228) and a "time by group interaction" effect (F(1,22)=7.134, P=0.014, eta(p)(2)=0.245). This work suggests that thyroid surgery produces a significant reduction in vocal tract stability in contrast to the controls. This noninvasive measurement offers a potential instrument to investigate the functional implications of any disturbance that thyroid surgery may have on pharyngeal innervations. 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Formant characteristics of human laughter.

PubMed

Szameitat, Diana P; Darwin, Chris J; Szameitat, André J; Wildgruber, Dirk; Alter, Kai

2011-01-01

Although laughter is an important aspect of nonverbal vocalization, its acoustic properties are still not fully understood. Extreme articulation during laughter production, such as wide jaw opening, suggests that laughter can have very high first formant (F(1)) frequencies. We measured fundamental frequency and formant frequencies of the vowels produced in the vocalic segments of laughter. Vocalic segments showed higher average F(1) frequencies than those previously reported and individual values could be as high as 1100 Hz for male speakers and 1500 Hz for female speakers. To our knowledge, these are the highest F(1) frequencies reported to date for human vocalizations, exceeding even the F(1) frequencies reported for trained soprano singers. These exceptionally high F(1) values are likely to be based on the extreme positions adopted by the vocal tract during laughter in combination with physiological constraints accompanying the production of a "pressed" voice. Copyright © 2011 The Voice Foundation. All rights reserved.

Altai pika (Ochotona alpina) alarm calls: individual acoustic variation and the phenomenon of call-synchronous ear folding behavior.

PubMed

Volodin, Ilya A; Matrosova, Vera A; Frey, Roland; Kozhevnikova, Julia D; Isaeva, Inna L; Volodina, Elena V

2018-06-11

Non-hibernating pikas collect winter food reserves and store them in hay piles. Individualization of alarm calls might allow discrimination between colony members and conspecifics trying to steal food items from a colony pile. We investigated vocal posture, vocal tract length, and individual acoustic variation of alarm calls, emitted by wild-living Altai pikas Ochotona alpina toward a researcher. Recording started when a pika started calling and lasted as long as possible. The alarm call series of 442 individual callers from different colonies consisted of discrete short (0.073-0.157 s), high-frequency (7.31-15.46 kHz), and frequency-modulated calls separated by irregular intervals. Analysis of 442 discrete calls, the second of each series, revealed that 44.34% calls lacked nonlinear phenomena, in 7.02% nonlinear phenomena covered less than half of call duration, and in 48.64% nonlinear phenomena covered more than half of call duration. Peak frequencies varied among individuals but always fitted one of three maxima corresponding to the vocal tract resonance frequencies (formants) calculated for an estimated 45-mm oral vocal tract. Discriminant analysis using variables of 8 calls per series of 36 different callers, each from a different colony, correctly assigned over 90% of the calls to individuals. Consequently, Altai pika alarm calls are individualistic and nonlinear phenomena might further increase this acoustic individualization. Additionally, video analysis revealed a call-synchronous, very fast (0.13-0.23 s) folding, depression, and subsequent re-expansion of the pinna confirming an earlier report of this behavior that apparently contributes to protecting the hearing apparatus from damage by the self-generated high-intensity alarm calls.

Relation of structural and vibratory kinematics of the vocal folds to two acoustic measures of breathy voice based on computational modeling.

PubMed

Samlan, Robin A; Story, Brad H

2011-10-01

To relate vocal fold structure and kinematics to 2 acoustic measures: cepstral peak prominence (CPP) and the amplitude of the first harmonic relative to the second (H1-H2). The authors used a computational, kinematic model of the medial surfaces of the vocal folds to specify features of vocal fold structure and vibration in a manner consistent with breathy voice. Four model parameters were altered: degree of vocal fold adduction, surface bulging, vibratory nodal point, and supraglottal constriction. CPP and H1-H2 were measured from simulated glottal area, glottal flow, and acoustic waveforms and were related to the underlying vocal fold kinematics. CPP decreased with increased separation of the vocal processes, whereas the nodal point location had little effect. H1-H2 increased as a function of separation of the vocal processes in the range of 1.0 mm to 1.5 mm and decreased with separation > 1.5 mm. CPP is generally a function of vocal process separation. H1*-H2* (see paragraph 6 of article text for an explanation of the asterisks) will increase or decrease with vocal process separation on the basis of vocal fold shape, pivot point for the rotational mode, and supraglottal vocal tract shape, limiting its utility as an indicator of breathy voice. Future work will relate the perception of breathiness to vocal fold kinematics and acoustic measures.

How do clarinet players adjust the resonances of their vocal tracts for different playing effects?

NASA Astrophysics Data System (ADS)

Fritz, Claudia; Wolfe, Joe

2005-11-01

In a simple model, the reed of the clarinet is mechanically loaded by the series combination of the acoustical impedances of the instrument itself and of the player's airway. Here we measure the complex impedance spectrum of players' airways using an impedance head adapted to fit inside a clarinet mouthpiece. A direct current shunt with high acoustical resistance allows players to blow normally, so the players can simulate the tract condition under playing conditions. The reproducibility of the results suggest that the players' ``muscle memory'' is reliable for this task. Most players use a single, highly stable vocal tract configuration over most of the playing range, except for the altissimo register. However, this ``normal'' configuration varies substantially among musicians. All musicians change the configuration, often drastically for ``special effects'' such as glissandi and slurs: the tongue is lowered and the impedance magnitude reduced when the player intends to lower the pitch or to slur downwards, and vice versa.

Vocal tract length development during the first two decades of life: A magnetic resonance imaging study

NASA Astrophysics Data System (ADS)

Vorperian, Houri K.; Chung, Moo K.; Gentry, Lindell R.; Kent, Ray D.; Choih, Celia S.; Durtschi, Reid B.; Ziegert, Andrew J.

2005-09-01

As the vocal tract length (VTL) increases more than twofold from infancy to adulthood, its geometric proportions change. This study assesses the developmental changes of the various hard and soft tissue structures in the vicinity of the vocal tract (VT), and evaluates the relational growth of the various structures with VTL. Magnetic resonance images from 327 cases, ages birth to age 20, were used to secure quantitative measurements of the various soft, cartilaginous and bony structures in the oral and pharyngeal regions using established procedures [Vorperian et al. (1999), (2005)]. Structures measured include: lip thickness, hard- and soft-palate length, tongue length, naso-oro-pharyngeal length, mandibular length and depth, and distance of the hyoid bone and larynx from the posterior nasal spine. Findings indicate: (a) ongoing growth of all oral and pharyngeal structures with changes in growth rate as a function of age; (b) a strong interdependency between structure orientation and its growth curve; and (c) developmental changes in the relational growth of the different VT structures with VTL. Findings provide normative data on the anatomic changes of the supra-laryngeal speech apparatus, and can be used to model the development of the VT. [Work supported by NIH-NIDCD Grants R03-DC4362 R01-DC006282, and NIH-NICHHD P30-HK03352.

Development of upper tract stones in patients with congenital neurogenic bladder.

PubMed

Stephany, Heidi A; Clayton, Douglass B; Tanaka, Stacy T; Thomas, John C; Pope, John C; Brock, John W; Adams, Mark C

2014-02-01

Patients with neurogenic bladder are at increased risk of developing upper tract stones. We hypothesized that patients with lower urinary tract stone disease are at greater risk of developing upper tract stones. We performed a 10-year retrospective case-control study of patients with neurogenic bladder to determine the association between bladder and upper tract stones. Independent risk factors for upper tract stones were assessed. Cases and controls were matched 1:1. Univariable analysis was performed by Fisher's exact test and the Mann-Whitney U test. Multivariable logistic regression was performed. 52 cases and controls were identified. Cases were significantly more likely to be non-ambulatory, have bowel-urinary tract interposition, thoracic level dysraphism, and history of bladder stones. On multivariable analysis, independent predictors of stone formation were male sex (OR 2.82; p = 0.02), dysraphism involving the thoracic spine (OR 3.37; p = 0.014) bowel-urinary tract interposition (OR 2.611; p = 0.038), and a history of bladder stones (OR 3.57; p = 0.015). Patients with neurogenic bladder are at increased risk for upper tract stones. The presence of bladder stones may herald the development of upper tract stones. The predictors of stone disease identified should guide prospective studies to better understand the natural history of upper tract stone development in this population. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Upper tract urothelial recurrence following radical cystectomy for transitional cell carcinoma of the bladder: an analysis of 1,069 patients with 10-year followup.

PubMed

Sanderson, Kristin M; Cai, Jie; Miranda, Gustavo; Skinner, Donald G; Stein, John P

2007-06-01

Risk factors for upper tract recurrence following radical cystectomy for transitional cell carcinoma of the bladder are not yet well-defined. We reviewed our population of patients who underwent radical cystectomy to identify prognostic factors and clinical outcomes associated with upper tract recurrence. From our prospective database of 1,359 patients who underwent radical cystectomy we identified 1,069 patients treated for transitional cell carcinoma of the bladder between January 1985 and December 2001. Univariate analysis was completed to determine factors predictive of upper tract recurrence. A total of 853 men and 216 women were followed for a median of 10.3 years (maximum 18.5). There were 27 (2.5%) upper tract recurrences diagnosed at a median of 3.3 years (range 0.4 to 9.3). Only urethral tumor involvement was predictive of upper tract recurrence. In men superficial transitional cell carcinoma of the prostatic urethra was associated with an increased risk of upper tract recurrence compared with prostatic stromal invasion or absence of prostatic transitional cell carcinoma (p <0.01). In women urethral transitional cell carcinoma was associated with an increased risk of upper tract recurrence (p = 0.01). Despite routine surveillance 78% of upper tract recurrence was detected after development of symptoms. Median survival following upper tract recurrence was 1.7 years (range 0.2 to 8.8). Detection of asymptomatic upper tract recurrence via surveillance did not predict lower nephroureterectomy tumor stage, absence of lymph node metastases or improved survival. Patients with bladder cancer are at lifelong risk for late oncological recurrence in the upper tract urothelium. Patients with evidence of tumor involvement within the urethra are at highest risk. Surveillance regimens frequently fail to detect tumors before symptoms develop. However, radical nephroureterectomy can provide prolonged survival.

The singing/acting mature adult--singing instruction perspective.

PubMed

Westerman Gregg, J

1997-06-01

Complete knowledge of anatomy and physiology of the vocal mechanism and tract is essential for the voice teacher to be maximally effective. Possible contributing factors to vocal attrition in the mature singer/actor are outlined: poor posture, inadequate respiratory function, lack of adequate hydration, phonatory hyperfunction, habitual speaking pitch at too low a frequency, lack of resonance, tongue tension affecting phonation, resonation, and articulation. Techniques for rehabilitation of the damaged voice are recommended.

Neuronal Control of Mammalian Vocalization, with Special Reference to the Squirrel Monkey

NASA Astrophysics Data System (ADS)

Jürgens, Uwe

Squirrel monkey vocalization can be considered as a suitable model for the study in humans of the neurobiological basis of nonverbal emotional vocal utterances, such as laughing, crying, and groaning. Evaluation of electrical and chemical brain stimulation data, lesioning studies, single-neurone recordings, and neuroanatomical tracing work leads to the following conclusions: The periaqueductal gray and laterally bordering tegmentum of the midbrain represent a crucial area for the production of vocalization. This area collects the various vocalization-triggering stimuli, such as auditory, visual, and somatosensory input from diverse sensory-processing structures, motivation-controlling input from some limbic structures, and volitional impulses from the anterior cingulate cortex. Destruction of this area causes mutism. It is still under dispute whether the periaqueductal region harbors the vocal pattern generator or merely couples vocalization-triggering information to motor-coordinating structures further downward in the brainstem. The periaqueductal region is connected with the phonatory motoneuron pools indirectly via one or several interneurons. The nucleus retroambiguus represents a crucial relay station for the laryngeal and expiratory component of vocalization. The articulatory component reaches the orofacial motoneuron pools via the parvocellular reticular formation. Essential proprioceptive feedback from the larynx and lungs enter the vocal-controlling network via the solitary tract nucleus.

The larynx of roaring and non-roaring cats.

PubMed Central

Hast, M H

1989-01-01

Dissections were made of the larynges of 14 species of the cat family, with representative specimens from all genera. It was found that the vocal folds of the larynx of genus Panthera (with the exception of the snow leopard) form the basic structure of a sound generator well-designed to produce a high acoustical energy. Combined with an efficient sound radiator (vocal tract) that can be adjusted in length, a Panthera can use its vocal instrument literally to blow its own horn with a 'roar'. Also, it is proposed that laryngeal morphology can be used as an anatomical character in mammalian taxonomy. Images Fig. 1 PMID:2606766

[Clinical-psychological components in the consideration of functional dysphonia--a review].

PubMed

Kiese-Himmel, C

2015-03-01

The etiopathogenesis of functional dysphonia is complex; it is not sufficient to look solely at vocal behavior aspects. The predisposing basis for functional dysphonia can lie in the constitution of an individual, his/her professional speaking and speech behavior and/or may be personality-based. (Prolonged) psychosocial stress, vocal overstressing, unfavorable speaking habits, infection of the upper respiratory tract, inflammatory processes in the larynx, emotional life events and COSO events are considered as possible triggers. The interaction of predisposed and causal factors is unknown. Stress, overall fatigue, anxiety, depression and/or certain personality traits (which complicate or hamper coping) are considered as perpetuating factors. In any case, overlaps between voice symptoms and reactive psychic as well as social problems have to be kept in mind (e. g. the burden of suffering, depressive processing, speaking anxiety, socially withdrawal). Because the association of multiple psychosocial factors with functional dysphonia is not distinct--such are always existent in organ medically unexplained symptoms--functional dysphonia has to be diagnostically differentiated. For the purpose of the article, a psycho-diagnostic path following the ICD-10 chapter V along general lines is presented. Until now, it is unknown which psychosocial factors discriminate a psychogenic dysphonia from muscle tension dysphonia. © Georg Thieme Verlag KG Stuttgart · New York.

Sensorimotor learning in children and adults: Exposure to frequency-altered auditory feedback during speech production.

PubMed

Scheerer, N E; Jacobson, D S; Jones, J A

2016-02-09

Auditory feedback plays an important role in the acquisition of fluent speech; however, this role may change once speech is acquired and individuals no longer experience persistent developmental changes to the brain and vocal tract. For this reason, we investigated whether the role of auditory feedback in sensorimotor learning differs across children and adult speakers. Participants produced vocalizations while they heard their vocal pitch predictably or unpredictably shifted downward one semitone. The participants' vocal pitches were measured at the beginning of each vocalization, before auditory feedback was available, to assess the extent to which the deviant auditory feedback modified subsequent speech motor commands. Sensorimotor learning was observed in both children and adults, with participants' initial vocal pitch increasing following trials where they were exposed to predictable, but not unpredictable, frequency-altered feedback. Participants' vocal pitch was also measured across each vocalization, to index the extent to which the deviant auditory feedback was used to modify ongoing vocalizations. While both children and adults were found to increase their vocal pitch following predictable and unpredictable changes to their auditory feedback, adults produced larger compensatory responses. The results of the current study demonstrate that both children and adults rapidly integrate information derived from their auditory feedback to modify subsequent speech motor commands. However, these results also demonstrate that children and adults differ in their ability to use auditory feedback to generate compensatory vocal responses during ongoing vocalization. Since vocal variability also differed across the children and adult groups, these results also suggest that compensatory vocal responses to frequency-altered feedback manipulations initiated at vocalization onset may be modulated by vocal variability. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

Vocal palsy increases the risk of lower respiratory tract infection in low-risk, low-morbidity patients undergoing thyroidectomy for benign disease: A big data analysis.

PubMed

Nouraei, S A R; Allen, J; Kaddour, H; Middleton, S E; Aylin, P; Darzi, A; Tolley, N S

2017-12-01

Thyroidectomy is the commonest operation that places normally functioning laryngeal nerves at risk of injury. Vocal palsy is a major risk factor for dysphonia, dysphagia, and less commonly, airway obstruction. We investigated the association between post-thyroidectomy vocal palsy and long-term risks of pneumonia and laryngeal failure. An N=near-all analysis of the English administrative dataset using a previously validated informatics algorithm to identify young and otherwise low-risk patients undergoing first-time elective thyroidectomy for benign disease. Information about age, sex, morbidities, social deprivation and post-operative and late complications were derived. Between 2004 and 2012, 43 515 patients between the ages of 20 and 69 who had no history of cancer, neurological, or respiratory disease underwent elective total or hemithyroidectomy without concomitant or late neck dissection, parathyroidectomy or laryngotracheal surgery for benign thyroid disease for the first and only time. Information about age, sex, morbidities and in-hospital and late complications was recorded. Mean age at surgery was 46±12. There was a strong female preponderance (85%), and most patients (89%) had no recorded Charlson comorbidities Most patients (65%) underwent hemithyroidectomy. Late vocal palsy was recorded in 449 (1.03%) patients, and its occurrence was an independent risk factor for emergency hospital readmission (n=7113; Hazard Ratio 1.52; 95% confidence interval 1.21-1.91), hospitalisation for lower respiratory tract infection (n=944; HR 2.04; 95% CI 1.07-3.75), dysphagia (n=564; HR 3.47; 95% CI 1.57-7.65) and gastrostomy/tracheostomy placement (n=80; HR 20.8; 95% CI 2.5-171.2). Independent risk factors for late vocal palsy were age, burden of morbidities, total thyroidectomy, post operative bleeding, male sex, and annual surgeon volume <30. There is a significant association between post-thyroidectomy vocal palsy and long-term risks of hospital readmission, dysphagia, hospitalisation for lower respiratory tract infection, and gastrostomy/tracheostomy tube placement. This adds weight to the need, from a thyroid surgical perspective, to undertake universal post-thyroidectomy laryngeal surveillance as a minimum standard of care, with a focus on post-operative dysphagia and aspiration, and from a medical/respiratory perspective, to initiate investigations to identify occult vocal palsy in patients who present with pneumonia, who have a history of thyroid surgery. © 2017 John Wiley & Sons Ltd.

Adapted to Roar: Functional Morphology of Tiger and Lion Vocal Folds

PubMed Central

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. PMID:22073246

A Randomized Controlled Trial of Two Semi-Occluded Vocal Tract Voice Therapy Protocols

PubMed Central

Hunter, Eric J.; Kirkham, Kimberly; Cox, Karin; Titze, Ingo R.

2015-01-01

Purpose Although there is a long history of use of semi-occluded vocal tract gestures in voice therapy, including phonation through thin tubes or straws, the efficacy of phonation through tubes has not been established. This study compares results from a therapy program on the basis of phonation through a flow-resistant tube (FRT) with Vocal Function Exercises (VFE), an established set of exercises that utilize oral semi-occlusions. Method Twenty subjects (16 women, 4 men) with dysphonia and/or vocal fatigue were randomly assigned to 1 of 4 treatment conditions: (a) immediate FRT therapy, (b) immediate VFE therapy, (c) delayed FRT therapy, or (d) delayed VFE therapy. Subjects receiving delayed therapy served as a no-treatment control group. Results Voice Handicap Index (Jacobson et al., 1997) scores showed significant improvement for both treatment groups relative to the no-treatment group. Comparison of the effect sizes suggests FRT therapy is noninferior to VFE in terms of reduction in Voice Handicap Index scores. Significant reductions in Roughness on the Consensus Auditory-Perceptual Evaluation of Voice (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kraemer, & Hillman, 2009) were found for the FRT subjects, with no other significant voice quality findings. Conclusions VFE and FRT therapy may improve voice quality of life in some individuals with dysphonia. FRT therapy was noninferior to VFE in improving voice quality of life in this study. PMID:25675335

Prospective comparison of molecular signatures in urothelial cancer of the bladder and the upper urinary tract--is there evidence for discordant biology?

PubMed

Krabbe, Laura-Maria; Lotan, Yair; Bagrodia, Aditya; Gayed, Bishoy A; Darwish, Oussama M; Youssef, Ramy F; Bolenz, Christian; Sagalowsky, Arthur I; Raj, Ganesh V; Shariat, Shahrokh F; Kapur, Payal; Margulis, Vitaly

2014-04-01

Upper tract urothelial carcinoma is rare and less well studied than bladder cancer. It remains questionable if findings in bladder cancer can safely be extrapolated to upper tract urothelial carcinoma. We prospectively evaluate molecular profiles of upper tract urothelial carcinoma and bladder cancer using a cell cycle biomarker panel. Immunohistochemical staining for p21, p27, p53, cyclin E and Ki-67 was prospectively performed for 96 patients with upper tract urothelial carcinoma and 159 patients with bladder cancer with nonmetastatic high grade urothelial carcinoma treated with extirpative surgery. Data were compared between the groups according to pathological stage. Primary outcome was assessment of differences in marker expression. Secondary outcome was difference in survival according to marker status. During a median followup of 22.0 months 31.2% of patients with upper tract urothelial carcinoma and 28.3% of patients with bladder cancer had disease recurrence, and 20.8% and 27.7% died of upper tract urothelial carcinoma and bladder cancer, respectively. The number of altered markers was not significantly different between the study groups. Overall 34 patients (35.4%) with upper tract urothelial carcinoma and 62 (39.0%) with bladder cancer had an unfavorable marker score (more than 2 markers altered). There were no significant differences between upper tract urothelial carcinoma and bladder cancer in the alteration status of markers, the number of altered markers and biomarker score when substratified by pathological stage. There were no significant differences in survival outcomes between patients with upper tract urothelial carcinoma and those with bladder cancer according to the number of altered markers and biomarker score. Our results demonstrate the molecular similarity of upper tract urothelial carcinoma and bladder cancer in terms of cell cycle and proliferative tissue markers. These findings have important implications and support the further extrapolation of treatment paradigms established in bladder cancer to upper tract urothelial carcinoma. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Fluid-acoustic interactions and their impact on pathological voiced speech

NASA Astrophysics Data System (ADS)

Erath, Byron D.; Zanartu, Matias; Peterson, Sean D.; Plesniak, Michael W.

2011-11-01

Voiced speech is produced by vibration of the vocal fold structures. Vocal fold dynamics arise from aerodynamic pressure loadings, tissue properties, and acoustic modulation of the driving pressures. Recent speech science advancements have produced a physiologically-realistic fluid flow solver (BLEAP) capable of prescribing asymmetric intraglottal flow attachment that can be easily assimilated into reduced order models of speech. The BLEAP flow solver is extended to incorporate acoustic loading and sound propagation in the vocal tract by implementing a wave reflection analog approach for sound propagation based on the governing BLEAP equations. This enhanced physiological description of the physics of voiced speech is implemented into a two-mass model of speech. The impact of fluid-acoustic interactions on vocal fold dynamics is elucidated for both normal and pathological speech through linear and nonlinear analysis techniques. Supported by NSF Grant CBET-1036280.

Endoscopic laterofixation in bilateral vocal cords paralysis in children.

PubMed

Lidia, Zawadzka-Glos; Magdalena, Frackiewicz; Mieczyslaw, Chmielik

2010-06-01

Vocal cords paralysis is the second most frequent cause of laryngeal stridor in children. Symptoms of congenital vocal cords paralysis can occur shortly after birth or later. Vocal cords paralysis can be unilateral or bilateral. Symptoms of unilateral paralysis include hoarse weeping or stridor during a deep inhalation. In children unilateral vocal cords paralysis often retreats spontaneously or can be completely compensated. Children with bilateral vocal cords paralysis present mainly breathing disorders while phonation is normal. Symptoms are different, starting from complete occlusion of respiratory tracts and ending on small symptoms connected with the lack of effort tolerance. When symptoms are severe, patients from this group require a tracheotomy. The lack of restoration of normal function of vocal cords or lack of complete compensation and maintenance of symptoms are an indication for surgical treatment. The aim of this study is to present results of the treatment of bilateral vocal cords paralysis in children using the endoscopic method of laterofixation of vocal cords. In the Pediatric ENT Department between 1998 and 2009 sixty four children with dyspnoea and/or phonation disorders caused by vocal cords paralysis were treated. In ten cases laterofixation of vocal cords was performed, in most cases with good result. In this article the authors present the method of endoscopic laterofixation and achieved results. Endoscopic laterofixation of vocal cords in children is a safe and an easy method of surgical treatment of bilateral vocal cords paralysis. This method can be used as a first and often as a one stage treatment of vocal cords paralysis. In some cases this procedure is insufficient and has to be completed with other methods. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

The evolution of speech: a comparative review.

PubMed

Fitch

2000-07-01

The evolution of speech can be studied independently of the evolution of language, with the advantage that most aspects of speech acoustics, physiology and neural control are shared with animals, and thus open to empirical investigation. At least two changes were necessary prerequisites for modern human speech abilities: (1) modification of vocal tract morphology, and (2) development of vocal imitative ability. Despite an extensive literature, attempts to pinpoint the timing of these changes using fossil data have proven inconclusive. However, recent comparative data from nonhuman primates have shed light on the ancestral use of formants (a crucial cue in human speech) to identify individuals and gauge body size. Second, comparative analysis of the diverse vertebrates that have evolved vocal imitation (humans, cetaceans, seals and birds) provides several distinct, testable hypotheses about the adaptive function of vocal mimicry. These developments suggest that, for understanding the evolution of speech, comparative analysis of living species provides a viable alternative to fossil data. However, the neural basis for vocal mimicry and for mimesis in general remains unknown.

Vibration and Noise in Magnetic Resonance Imaging of the Vocal Tract: Differences between Whole-Body and Open-Air Devices.

PubMed

Přibil, Jiří; Přibilová, Anna; Frollo, Ivan

2018-04-05

This article compares open-air and whole-body magnetic resonance imaging (MRI) equipment working with a weak magnetic field as regards the methods of its generation, spectral properties of mechanical vibration and acoustic noise produced by gradient coils during the scanning process, and the measured noise intensity. These devices are used for non-invasive MRI reconstruction of the human vocal tract during phonation with simultaneous speech recording. In this case, the vibration and noise have negative influence on quality of speech signal. Two basic measurement experiments were performed within the paper: mapping sound pressure levels in the MRI device vicinity and picking up vibration and noise signals in the MRI scanning area. Spectral characteristics of these signals are then analyzed statistically and compared visually and numerically.

Endoscopic laser arytenoidectomy with the use of CO2 laser

NASA Astrophysics Data System (ADS)

Malandrakis, S.; Prokopakis, E. P.; Sidoris, M.; Karatzanis, A.; Velegrakis, G.; Helidonis, Emmanuel S.

2004-06-01

Upper airway obstruction due to bilateral vocal cord paralysis presents a serious challenge to the Otolaryngologist. Various surgical techniques have been advocated for the management of patients with vocal cord patients with vocal cord paralysis. Among these techniques, the individual use of laser CO2 arytenoidectomy and posterior cordotomy has gained wide acceptance. In this report, we describe our experience in the management of bilateral vocal cord paralysis by combining posterior partial cordotomy as described by Dennis and Kashima with total arytenoidectomy as described by Ossoff. We report the long term results in the management of 24 patients with bilateral vocal cord paralysis treated in our Department during the last 9 years.

An association between Helicobacter pylori and upper respiratory tract disease: Fact or fiction?

PubMed Central

Kariya, Shin; Okano, Mitsuhiro; Nishizaki, Kazunori

2014-01-01

Helicobacter pylori (H. pylori) is a major cause of chronic gastritis and gastric ulcers and considerable evidence supports the notion that infection with this bacterium is also associated with gastric malignancy in addition to various other conditions including pulmonary, vascular and autoimmune disorders. Gastric juice infected with H. pylori might play an important role in upper respiratory tract infection. Although direct and/or indirect mechanisms might be involved in the association between H. pylori and upper respiratory tract diseases, the etiological role of H. pylori in upper respiratory tract disorders has not yet been fully elucidated. Although various studies over the past two decades have suggested a relationship between H. pylori and upper respiratory tract diseases, the findings are inconsistent. The present overview describes the outcomes of recent investigations into the impact of H. pylori on upper respiratory tract and adjacent lesions. PMID:24587622

A study of voice production characteristics of astronuat speech during Apollo 11 for speaker modeling in space.

PubMed

Yu, Chengzhu; Hansen, John H L

2017-03-01

Human physiology has evolved to accommodate environmental conditions, including temperature, pressure, and air chemistry unique to Earth. However, the environment in space varies significantly compared to that on Earth and, therefore, variability is expected in astronauts' speech production mechanism. In this study, the variations of astronaut voice characteristics during the NASA Apollo 11 mission are analyzed. Specifically, acoustical features such as fundamental frequency and phoneme formant structure that are closely related to the speech production system are studied. For a further understanding of astronauts' vocal tract spectrum variation in space, a maximum likelihood frequency warping based analysis is proposed to detect the vocal tract spectrum displacement during space conditions. The results from fundamental frequency, formant structure, as well as vocal spectrum displacement indicate that astronauts change their speech production mechanism when in space. Moreover, the experimental results for astronaut voice identification tasks indicate that current speaker recognition solutions are highly vulnerable to astronaut voice production variations in space conditions. Future recommendations from this study suggest that successful applications of speaker recognition during extended space missions require robust speaker modeling techniques that could effectively adapt to voice production variation caused by diverse space conditions.

Acoustics of the trained versus untrained singing voice.

PubMed

Howard, David M

2009-06-01

Acoustic voice analysis is now widely available on today's multimedia computers and knowledge of the acoustics of the trained and untrained singing voice has advanced dramatically in recent years. New techniques have emerged that are providing clearer representations of aspects of the physiology of voice function and a greater understanding of the differences between the voices of untrained and trained singers. Improvements in endoscope technology are changing understanding of vocal fold function and videokymography provides a new way of interpreting the output; some new and interesting possibilities are emerging. Larynx height variation is a feature of untrained singing and singing in different styles and its measurement has been inaccurate hitherto; perhaps the laryngoaltimeter will provide a solution. Magnetic resonance imaging is now a vital tool for vocal tract shape measurement but a new bio-inspired computing is offering a possible alternative. Differences between an untrained and trained singing voice lie in one or more of breathing technique, larynx settings or vocal tract settings. Measurement techniques in each of these areas are important to provide data on the singing voice, and accurate data are essential for natural personalized electronic voice synthesis in the future.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, Nicholas, E-mail: nibrown@cantab.net; Olayos, Elizabeth; Elmer, Sandra

Management of intractable haematuria and obstructive urosepsis from upper tract urothelial carcinoma can be problematic in patients not suitable for surgery, chemotherapy or radiotherapy. Interventional radiology techniques provide alternative approaches in this setting, such as complete kidney embolization to cease urine output, percutaneous nephrostomy, antegrade injection of sclerotherapy agents and sterilisation of the upper collecting system. Related approaches have been successfully employed to sclerose renal cysts, lymphoceles, chyluria and intractable lower tract haemorrhage. No reports of percutaneous, antegrade sclerotherapy in the upper urinary tract have previously been published. We present a case of recurrent haematuria and obstructive urosepsis caused bymore » invasive upper tract urothelial carcinoma in a non-operative patient, which was treated with renal embolisation and percutaneous upper tract urothelial sclerotherapy.« less

Disrupting vagal feedback affects birdsong motor control.

PubMed

Méndez, Jorge M; Dall'asén, Analía G; Goller, Franz

2010-12-15

Coordination of different motor systems for sound production involves the use of feedback mechanisms. Song production in oscines is a well-established animal model for studying learned vocal behavior. Whereas the online use of auditory feedback has been studied in the songbird model, very little is known about the role of other feedback mechanisms. Auditory feedback is required for the maintenance of stereotyped adult song. In addition, the use of somatosensory feedback to maintain pressure during song has been demonstrated with experimentally induced fluctuations in air sac pressure. Feedback information mediating this response is thought to be routed to the central nervous system via afferent fibers of the vagus nerve. Here, we tested the effects of unilateral vagotomy on the peripheral motor patterns of song production and the acoustic features. Unilateral vagotomy caused a variety of disruptions and alterations to the respiratory pattern of song, some of which affected the acoustic structure of vocalizations. These changes were most pronounced a few days after nerve resection and varied between individuals. In the most extreme cases, the motor gestures of respiration were so severely disrupted that individual song syllables or the song motif were atypically terminated. Acoustic changes also suggest altered use of the two sound generators and upper vocal tract filtering, indicating that the disruption of vagal feedback caused changes to the motor program of all motor systems involved in song production and modification. This evidence for the use of vagal feedback by the song system with disruption of song during the first days after nerve cut provides a contrast to the longer-term effects of auditory feedback disruption. It suggests a significant role for somatosensory feedback that differs from that of auditory feedback.

Disrupting vagal feedback affects birdsong motor control

PubMed Central

Méndez, Jorge M.; Dall'Asén, Analía G.; Goller, Franz

2010-01-01

Coordination of different motor systems for sound production involves the use of feedback mechanisms. Song production in oscines is a well-established animal model for studying learned vocal behavior. Whereas the online use of auditory feedback has been studied in the songbird model, very little is known about the role of other feedback mechanisms. Auditory feedback is required for the maintenance of stereotyped adult song. In addition, the use of somatosensory feedback to maintain pressure during song has been demonstrated with experimentally induced fluctuations in air sac pressure. Feedback information mediating this response is thought to be routed to the central nervous system via afferent fibers of the vagus nerve. Here, we tested the effects of unilateral vagotomy on the peripheral motor patterns of song production and the acoustic features. Unilateral vagotomy caused a variety of disruptions and alterations to the respiratory pattern of song, some of which affected the acoustic structure of vocalizations. These changes were most pronounced a few days after nerve resection and varied between individuals. In the most extreme cases, the motor gestures of respiration were so severely disrupted that individual song syllables or the song motif were atypically terminated. Acoustic changes also suggest altered use of the two sound generators and upper vocal tract filtering, indicating that the disruption of vagal feedback caused changes to the motor program of all motor systems involved in song production and modification. This evidence for the use of vagal feedback by the song system with disruption of song during the first days after nerve cut provides a contrast to the longer-term effects of auditory feedback disruption. It suggests a significant role for somatosensory feedback that differs from that of auditory feedback. PMID:21113000

Temporal processing of speech in a time-feature space

NASA Astrophysics Data System (ADS)

Avendano, Carlos

1997-09-01

The performance of speech communication systems often degrades under realistic environmental conditions. Adverse environmental factors include additive noise sources, room reverberation, and transmission channel distortions. This work studies the processing of speech in the temporal-feature or modulation spectrum domain, aiming for alleviation of the effects of such disturbances. Speech reflects the geometry of the vocal organs, and the linguistically dominant component is in the shape of the vocal tract. At any given point in time, the shape of the vocal tract is reflected in the short-time spectral envelope of the speech signal. The rate of change of the vocal tract shape appears to be important for the identification of linguistic components. This rate of change, or the rate of change of the short-time spectral envelope can be described by the modulation spectrum, i.e. the spectrum of the time trajectories described by the short-time spectral envelope. For a wide range of frequency bands, the modulation spectrum of speech exhibits a maximum at about 4 Hz, the average syllabic rate. Disturbances often have modulation frequency components outside the speech range, and could in principle be attenuated without significantly affecting the range with relevant linguistic information. Early efforts for exploiting the modulation spectrum domain (temporal processing), such as the dynamic cepstrum or the RASTA processing, used ad hoc designed processing and appear to be suboptimal. As a major contribution, in this dissertation we aim for a systematic data-driven design of temporal processing. First we analytically derive and discuss some properties and merits of temporal processing for speech signals. We attempt to formalize the concept and provide a theoretical background which has been lacking in the field. In the experimental part we apply temporal processing to a number of problems including adaptive noise reduction in cellular telephone environments, reduction of reverberation for speech enhancement, and improvements on automatic recognition of speech degraded by linear distortions and reverberation.

Simulations of temporal patterns of oral airflow in men and women using a two-mass model of the vocal folds under dynamic control

NASA Astrophysics Data System (ADS)

Lucero, Jorge C.; Koenig, Laura L.

2005-03-01

In this study we use a low-dimensional laryngeal model to reproduce temporal variations in oral airflow produced by speakers in the vicinity of an abduction gesture. It attempts to characterize these temporal patterns in terms of biomechanical parameters such as glottal area, vocal fold stiffness, subglottal pressure, and gender differences in laryngeal dimensions. A two-mass model of the vocal folds coupled to a two-tube approximation of the vocal tract is fitted to oral airflow records measured in men and women during the production of /aha/ utterances, using the subglottal pressure, glottal width, and Q factor as control parameters. The results show that the model is capable of reproducing the airflow records with good approximation. A nonlinear damping characteristics is needed, to reproduce the flow variation at glottal abduction. Devoicing is achieved by the combined action of vocal fold abduction, the decrease of subglottal pressure, and the increase of vocal fold tension. In general, the female larynx has a more restricted region of vocal fold oscillation than the male one. This would explain the more frequent devoicing in glottal abduction-adduction gestures for /h/ in running speech by women, compared to men. .

Acoustic Properties of the Voice Source and the Vocal Tract: Are They Perceptually Independent?

PubMed

Erickson, Molly L

2016-11-01

This study sought to determine whether the properties of the voice source and vocal tract are perceptually independent. Within-subjects design. This study employed a paired-comparison paradigm where listeners heard synthetic voices and rated them as same or different using a visual analog scale. Stimuli were synthesized using three different source slopes and two different formant patterns (mezzo-soprano and soprano) on the vowel /a/ at four pitches: A3, C4, B4, and F5. Whereas formant pattern was the strongest effect, difference in source slope also affected perceived quality difference. Source slope and formant pattern were not independently perceived. These results suggest that when judging laryngeal adduction using perceptual information, judgments may not be accurate when the stimuli are of differing formant patterns. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

HUMAN SPEECH: A RESTRICTED USE OF THE MAMMALIAN LARYNX

PubMed Central

Titze, Ingo R.

2016-01-01

Purpose Speech has been hailed as unique to human evolution. While the inventory of distinct sounds producible with vocal tract articulators is a great advantage in human oral communication, it is argued here that the larynx as a sound source in speech is limited in its range and capability because a low fundamental frequency is ideal for phonemic intelligibility and source-filter independence. Method Four existing data sets were combined to make an argument regarding exclusive use of the larynx for speech: (1) range of fundamental frequency, (2) laryngeal muscle activation, (3) vocal fold length in relation to sarcomere length of the major laryngeal muscles, and (4) vocal fold morphological development. Results Limited data support the notion that speech tends to produce a contracture of the larynx. The morphological design of the human vocal folds, like that of primates and other mammals, is optimized for vocal communication over distances for which higher fundamental frequency, higher intensity, and fewer unvoiced segments are utilized than in conversational speech. Conclusion The positive message is that raising one’s voice to call, shout, or sing, or executing pitch glides to stretch the vocal folds, can counteract this trend toward a contracted state. PMID:27397113

Ontogeny of individual and litter identity signaling in grunts of piglets.

PubMed

Syrová, Michaela; Policht, Richard; Linhart, Pavel; Špinka, Marek

2017-11-01

Many studies have shown that animal vocalizations can signal individual identity and group/family membership. However, much less is known about the ontogeny of identity information-when and how this individual/group distinctiveness in vocalizations arises and how it changes during the animal's life. Recent findings suggest that even species that were thought to have limited vocal plasticity could adjust their calls to sound more similar to each other within a group. It has already been shown that sows can acoustically distinguish their own offspring from alien piglets and that litters differ in their calls. Surprisingly, individual identity in piglet calls has not been reported yet. In this paper, this gap is filled, and it is shown that there is information about piglet identity. Information about litter identity is confirmed as well. Individual identity increased with age, but litter vocal identity did not increase with age. The results were robust as a similar pattern was apparent in two situations differing in arousal: isolation and back-test. This paper argues that, in piglets, increased individual discrimination results from the rapid growth of piglets, which is likely to be associated with growth and diversification of the vocal tract rather than from social effects and vocal plasticity.

When is prior ureteral stent placement necessary to access the upper urinary tract in prepubertal children?

PubMed

Corcoran, Anthony T; Smaldone, Marc C; Mally, Dev; Ost, Michael C; Bellinger, Mark F; Schneck, Francis X; Docimo, Steven G; Wu, Hsi-Yang

2008-10-01

We studied the possibility that age, height, weight and body mass index could be used to predict the likelihood of successful ureteroscopic access to the upper urinary tract without previous stent placement in prepubertal children. We retrospectively reviewed all ureteroscopic procedures for upper tract calculi in prepubertal children from 2003 to 2007. We compared age, height, weight and body mass index in patients who underwent successful primary flexible ureteroscopic access and in those who required initial stent placement to perform ureteroscopy. Successful primary ureteroscopic access to the upper tract was achieved in 18 of 30 patients (60%). There was no difference in mean age (9.9 vs 9.5 years, p = 0.8), height (132 vs 128 cm, p = 0.6), weight (37 vs 36 kg, p = 0.86) or body mass index (19.3 vs 20.5 kg/m(2), p = 0.55) between patients with successful vs unsuccessful upper tract access. Locations that prevented access to the upper urinary tract were evenly distributed among the ureteral orifice, iliac vessels and ureteropelvic junction. Age, height, weight and body mass index could not predict the likelihood of successful ureteroscopic access to the upper tract. Placement of a ureteral stent for passive ureteral dilation is not necessary for successful ureteroscopic access to the renal pelvis in prepubertal children. An initial attempt at ureteroscopy, with placement of a ureteral stent if upper tract access is unsuccessful, decreases the number of procedures while maintaining a low complication rate.

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

PubMed

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

2017-01-01

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

New Evidence That Nonlinear Source-Filter Coupling Affects Harmonic Intensity and fo Stability During Instances of Harmonics Crossing Formants.

PubMed

Maxfield, Lynn; Palaparthi, Anil; Titze, Ingo

2017-03-01

The traditional source-filter theory of voice production describes a linear relationship between the source (glottal flow pulse) and the filter (vocal tract). Such a linear relationship does not allow for nor explain how changes in the filter may impact the stability and regularity of the source. The objective of this experiment was to examine what effect unpredictable changes to vocal tract dimensions could have on fo stability and individual harmonic intensities in situations in which low frequency harmonics cross formants in a fundamental frequency glide. To determine these effects, eight human subjects (five male, three female) were recorded producing fo glides while their vocal tracts were artificially lengthened by a section of vinyl tubing inserted into the mouth. It was hypothesized that if the source and filter operated as a purely linear system, harmonic intensities would increase and decrease at nearly the same rates as they passed through a formant bandwidth, resulting in a relatively symmetric peak on an intensity-time contour. Additionally, fo stability should not be predictably perturbed by formant/harmonic crossings in a linear system. Acoustic analysis of these recordings, however, revealed that harmonic intensity peaks were asymmetric in 76% of cases, and that 85% of fo instabilities aligned with a crossing of one of the first four harmonics with the first three formants. These results provide further evidence that nonlinear dynamics in the source-filter relationship can impact fo stability as well as harmonic intensities as harmonics cross through formant bandwidths. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

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

PubMed

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. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed

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.

Aerodynamically and acoustically driven modes of vibration in a physical model of the vocal folds.

PubMed

Zhang, Zhaoyan; Neubauer, Juergen; Berry, David A

2006-11-01

In a single-layered, isotropic, physical model of the vocal folds, distinct phonation types were identified based on the medial surface dynamics of the vocal fold. For acoustically driven phonation, a single, in-phase, x-10 like eigenmode captured the essential dynamics, and coupled with one of the acoustic resonances of the subglottal tract. Thus, the fundamental frequency appeared to be determined primarily by a subglottal acoustic resonance. In contrast, aerodynamically driven phonation did not naturally appear in the single-layered model, but was facilitated by the introduction of a vertical constraint. For this phonation type, fundamental frequency was relatively independent of the acoustic resonances, and two eigenmodes were required to capture the essential dynamics of the vocal fold, including an out-of-phase x-11 like eigenmode and an in-phase x-10 like eigenmode, as described in earlier theoretical work. The two eigenmodes entrained to the same frequency, and were decoupled from subglottal acoustic resonances. With this independence from the acoustic resonances, vocal fold dynamics appeared to be determined primarily by near-field, fluid-structure interactions.

Patients with Urinary Incontinence Appear More Likely to Develop Upper Urinary Tract Stones: A Nationwide, Population-Based Study with 8-Year Follow-Up

PubMed Central

Chung, Hsiao-Jen; Lin, Alex Tong-Long; Lin, Chih-Chieh; Chen, Tzeng-Ji; Chen, Kuang-Kuo

2016-01-01

This study aimed to investigate associations between primary urinary incontinence and development of upper urinary tract stones in a nationwide population in Taiwan. Data of 1,777 adults with primary urinary incontinence and 26,655 controls (groups A, B, and C) without urinary incontinence at study inception were retrieved from the National Health Insurance System database in Taiwan and were analyzed retrospectively. No enrolled subjects had previous diagnosis of upper urinary tract stones or spinal cord injury. All subjects were followed through end of 2009, with a minimum follow-up of 8 years. A greater percentage of study subjects (334/1777, 18.8%) developed upper urinary tract stones than that of control groups A (865/8885, 9.7%) and B (888/8885, 10%), and C (930/8885, 10.5%) (all p-values < 0.0001). Urinary incontinence was associated with significantly increased risk of developing urinary tract stones (HR 1.99, 95% CI, 1.70–2.34, p < 0.001). Age and metabolic syndrome status were both associated with developing upper urinary tract stones (both p-values < 0.0001). After adjusting for metabolic syndrome, regression analysis showed that urinary incontinence was still associated with a significantly increased risk of developing upper urinary tract stones (HR 1.99, 95% CI = 1.76–2.26, p < 0.0001). Long-term follow-up of Taiwanese patients with primary urinary incontinence suggests that urinary incontinence is associated with a significantly increased risk of developing upper urinary tract stones. Study findings suggest that physicians treating patients with urinary incontinence should give attention to early detection of upper urinary tract stones. PMID:27536881

Patients with Urinary Incontinence Appear More Likely to Develop Upper Urinary Tract Stones: A Nationwide, Population-Based Study with 8-Year Follow-Up.

PubMed

Chung, Hsiao-Jen; Lin, Alex Tong-Long; Lin, Chih-Chieh; Chen, Tzeng-Ji; Chen, Kuang-Kuo

2016-01-01

This study aimed to investigate associations between primary urinary incontinence and development of upper urinary tract stones in a nationwide population in Taiwan. Data of 1,777 adults with primary urinary incontinence and 26,655 controls (groups A, B, and C) without urinary incontinence at study inception were retrieved from the National Health Insurance System database in Taiwan and were analyzed retrospectively. No enrolled subjects had previous diagnosis of upper urinary tract stones or spinal cord injury. All subjects were followed through end of 2009, with a minimum follow-up of 8 years. A greater percentage of study subjects (334/1777, 18.8%) developed upper urinary tract stones than that of control groups A (865/8885, 9.7%) and B (888/8885, 10%), and C (930/8885, 10.5%) (all p-values < 0.0001). Urinary incontinence was associated with significantly increased risk of developing urinary tract stones (HR 1.99, 95% CI, 1.70-2.34, p < 0.001). Age and metabolic syndrome status were both associated with developing upper urinary tract stones (both p-values < 0.0001). After adjusting for metabolic syndrome, regression analysis showed that urinary incontinence was still associated with a significantly increased risk of developing upper urinary tract stones (HR 1.99, 95% CI = 1.76-2.26, p < 0.0001). Long-term follow-up of Taiwanese patients with primary urinary incontinence suggests that urinary incontinence is associated with a significantly increased risk of developing upper urinary tract stones. Study findings suggest that physicians treating patients with urinary incontinence should give attention to early detection of upper urinary tract stones.

HOCUS: The Haskins optically-corrected ultrasound system for measuring speech articulation

NASA Astrophysics Data System (ADS)

Whalen, D. H.; Iskarous, Khalil; Tiede, Mark K.; Ostry, David J.

2004-05-01

The tongue is the most important supralaryngeal articulator for speech, yet, because it is typically out of view, its movements have been difficult to quantify. Here is described a new combination of techniques involving ultrasound in conjunction with an optoelectric motion measurement system (Optotrak). Combining these, the movements of the tongue are imaged and simultaneously corrected for motion of the head and of the ultrasound transceiver. Optotrak's infrared-emitting diodes are placed on the transceiver and the speakers head in order to localize the ultrasound image of the tongue relative to the hard palate. The palate can be imaged with ultrasound by having the ultrasound signal penetrate a water bolus held against the palate by the tongue. This trace is coregistered with the head and potentially with the same talker's sagittal MR image, to provide additional information on the unimaged remainder of the tract. The tongue surface, from the larynx to near the tip, can then be localized in relationship to the hard palate. The result is a fairly complete view of the tongue within the vocal tract at sampling rates appropriate for running speech. A comparison with other imaging vocal tract systems will be presented. [Work supported by NIH Grant DC-02717.

[COMPLICATIONS OF STENTINGOF UPPER URINARY TRACT].

PubMed

Shkodkin, S V; Kogan, M I; Lyubushkin, A V; Miroshnichenko, O V

2015-01-01

Restoring the passage of urine through the upper urinary tract routinely is achieved by installing of external or internal drainage. Due to its objective advantages, internal drainage has been successfully used in surgery of the upper urinary tract. This review outlines the problems associated with the use ofinternal stents, namely difficultyin installation, migration, and reflux and stent obstruction, bacterial colonization of the stent, the development of functional and morphological changes in the drained segment of urinary tract.

Chlamydia muridarum with Mutations in Chromosomal Genes tc0237 and/or tc0668 Is Deficient in Colonizing the Mouse Gastrointestinal Tract

PubMed Central

Shao, Lili; Zhang, Tianyuan; Liu, Quanzhong; Wang, Jie

2017-01-01

ABSTRACT Chlamydiae colonize the gastrointestinal tracts of both animals and humans. However, their medical significance remains unknown. We have previously shown that wild-type Chlamydia muridarum spreads to and establishes stable colonization of the gastrointestinal tract following intravaginal inoculation. In the present study, we found that C. muridarum with mutations in chromosomal genes tc0237 and/or tc0668 was defective in spreading to the mouse gastrointestinal tract, which correlated with its attenuated pathogenicity in the upper genital tract. This correlation was more consistent than that of chlamydial pathogenicity with ascending infection in the genital tract, since attenuated C. muridarum spread significantly less to the gastrointestinal tract but maintained robust ascending infection of the upper genital tract. Transcervical inoculation further confirmed the correlation between C. muridarum spreading to the gastrointestinal tract and its pathogenicity in the upper genital tract. Finally, defective spreading of C. muridarum mutants was due to their inability to colonize the gastrointestinal tract since intragastric inoculation did not rescue the mutants' colonization. Thus, promoting C. muridarum colonization of the gastrointestinal tract may represent a primary function of the TC0237 and TC0668 proteins. Correlation of chlamydial colonization of the gastrointestinal tract with chlamydial pathogenicity in the upper genital tract suggests a potential role for gastrointestinal chlamydiae in genital tract pathogenicity. PMID:28584162

Great talent, excellent voices-no problem for pubertal girls?

PubMed

Decoster, Wivine; Ghesquiere, Sofie; Van Steenberge, Sebastiaan

2008-01-01

This research on 17 girls (aged 9;9 y to 16;11 y) singing in an established choir was focused on two issues: 1) the variety in physical and vocal development using Gackle's model, and 2) the matching of vocal demands and abilities. Developmental and acoustical data on the speaking and singing voice revealed considerable variation between individual girl singers. The model was greatly applicable. However, all girls had a greater total singing range, mainly in favour of the lower tones, and 11 girls used a lower speaking fundamental frequency. A third of the girls met the vocal and developmental features of their stage at a younger age. Next the lower limit of the frequency range of all girls was several semitones below the lowest notes of the pieces being worked on at the time of the experiment. However the upper limit of the pieces coincided with or exceeded their upper frequency limit.

Multilevel Analysis in Analyzing Speech Data

ERIC Educational Resources Information Center

Guddattu, Vasudeva; Krishna, Y.

2011-01-01

The speech produced by human vocal tract is a complex acoustic signal, with diverse applications in phonetics, speech synthesis, automatic speech recognition, speaker identification, communication aids, speech pathology, speech perception, machine translation, hearing research, rehabilitation and assessment of communication disorders and many…

Can blind persons accurately assess body size from the voice?

PubMed

Pisanski, Katarzyna; Oleszkiewicz, Anna; Sorokowska, Agnieszka

2016-04-01

Vocal tract resonances provide reliable information about a speaker's body size that human listeners use for biosocial judgements as well as speech recognition. Although humans can accurately assess men's relative body size from the voice alone, how this ability is acquired remains unknown. In this study, we test the prediction that accurate voice-based size estimation is possible without prior audiovisual experience linking low frequencies to large bodies. Ninety-one healthy congenitally or early blind, late blind and sighted adults (aged 20-65) participated in the study. On the basis of vowel sounds alone, participants assessed the relative body sizes of male pairs of varying heights. Accuracy of voice-based body size assessments significantly exceeded chance and did not differ among participants who were sighted, or congenitally blind or who had lost their sight later in life. Accuracy increased significantly with relative differences in physical height between men, suggesting that both blind and sighted participants used reliable vocal cues to size (i.e. vocal tract resonances). Our findings demonstrate that prior visual experience is not necessary for accurate body size estimation. This capacity, integral to both nonverbal communication and speech perception, may be present at birth or may generalize from broader cross-modal correspondences. © 2016 The Author(s).

Volitional exaggeration of body size through fundamental and formant frequency modulation in humans

PubMed Central

Pisanski, Katarzyna; Mora, Emanuel C.; Pisanski, Annette; Reby, David; Sorokowski, Piotr; Frackowiak, Tomasz; Feinberg, David R.

2016-01-01

Several mammalian species scale their voice fundamental frequency (F0) and formant frequencies in competitive and mating contexts, reducing vocal tract and laryngeal allometry thereby exaggerating apparent body size. Although humans’ rare capacity to volitionally modulate these same frequencies is thought to subserve articulated speech, the potential function of voice frequency modulation in human nonverbal communication remains largely unexplored. Here, the voices of 167 men and women from Canada, Cuba, and Poland were recorded in a baseline condition and while volitionally imitating a physically small and large body size. Modulation of F0, formant spacing (∆F), and apparent vocal tract length (VTL) were measured using Praat. Our results indicate that men and women spontaneously and systemically increased VTL and decreased F0 to imitate a large body size, and reduced VTL and increased F0 to imitate small size. These voice modulations did not differ substantially across cultures, indicating potentially universal sound-size correspondences or anatomical and biomechanical constraints on voice modulation. In each culture, men generally modulated their voices (particularly formants) more than did women. This latter finding could help to explain sexual dimorphism in F0 and formants that is currently unaccounted for by sexual dimorphism in human vocal anatomy and body size. PMID:27687571

Can blind persons accurately assess body size from the voice?

PubMed Central

Oleszkiewicz, Anna; Sorokowska, Agnieszka

2016-01-01

Vocal tract resonances provide reliable information about a speaker's body size that human listeners use for biosocial judgements as well as speech recognition. Although humans can accurately assess men's relative body size from the voice alone, how this ability is acquired remains unknown. In this study, we test the prediction that accurate voice-based size estimation is possible without prior audiovisual experience linking low frequencies to large bodies. Ninety-one healthy congenitally or early blind, late blind and sighted adults (aged 20–65) participated in the study. On the basis of vowel sounds alone, participants assessed the relative body sizes of male pairs of varying heights. Accuracy of voice-based body size assessments significantly exceeded chance and did not differ among participants who were sighted, or congenitally blind or who had lost their sight later in life. Accuracy increased significantly with relative differences in physical height between men, suggesting that both blind and sighted participants used reliable vocal cues to size (i.e. vocal tract resonances). Our findings demonstrate that prior visual experience is not necessary for accurate body size estimation. This capacity, integral to both nonverbal communication and speech perception, may be present at birth or may generalize from broader cross-modal correspondences. PMID:27095264

Stenting Prior to Cystectomy is an Independent Risk Factor for Upper Urinary Tract Recurrence.

PubMed

Kiss, Bernhard; Furrer, Marc A; Wuethrich, Patrick Y; Burkhard, Fiona C; Thalmann, George N; Roth, Beat

2017-12-01

Patients with bladder cancer who present with hydronephrosis may require drainage of the affected kidney before receiving further cancer treatment. Drainage can be done by retrograde stenting or percutaneously. However, retrograde stenting carries the risk of tumor cell spillage to the upper urinary tract. The aim of this study was to evaluate whether patients with bladder cancer are at higher risk for upper urinary tract recurrence if retrograde stenting has been performed prior to radical cystectomy. We retrospectively analyzed the records of 1,005 consecutive patients with bladder cancer who underwent radical cystectomy at our department between January 2000 and June 2016. Negative intraoperative ureteral margins were mandatory for study inclusion. Patients received regular followup according to our institutional protocol, including imaging of the upper urinary tract and urine cytology. Preoperative drainage of the upper urinary tract was performed in 114 of the 1,005 patients (11%), including in 53 (46%) by Double-J® stenting and in 61 (54%) by percutaneous nephrostomy. Recurrence developed in the upper urinary tract in 31 patients (3%) at a median of 17 months after cystectomy, including 7 of 53 (13%) in the Double-J group, 0% in the nephrostomy group and 24 of 891 (3%) in the no drainage group. Multivariate regression analysis revealed a higher risk of upper urinary tract recurrence if patients underwent Double-J stenting (HR 4.54, 95% CI 1.43-14.38, p = 0.01) and preoperative intravesical instillations (HR 2.94, 95% CI 1.40-6.16, p = 0.004). Patients who undergo Double-J stenting prior to radical cystectomy are at higher risk for upper urinary tract recurrence. If preoperative upper urinary tract drainage is required, percutaneous drainage might be recommended. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Clinicopathological characteristics of patients with upper urinary tract urothelial cancer with loss of immunohistochemical expression of the DNA mismatch repair proteins in universal screening.

PubMed

Urakami, Shinji; Inoshita, Naoko; Oka, Suguru; Miyama, Yu; Nomura, Sachio; Arai, Masami; Sakaguchi, Kazushige; Kurosawa, Kazuhiro; Okaneya, Toshikazu

2018-02-01

To assess the detection rate of putative Lynch syndrome-associated upper urinary tract urothelial cancer among all upper urinary tract urothelial cancers and to examine its clinicopathological characteristics. A total of 143 patients with upper urinary tract urothelial cancer who had received total nephroureterectomy were immunohistochemically stained for the expression of mismatch repair proteins MLH1, PMS2, MSH2 and MSH6. For all suspected mismatch repair-deficient cases, MMR genetic testing was recommended and clinicopathological features were examined. Loss of mismatch repair proteins was found in seven patients (5%) who were thus categorized as putative Lynch syndrome-associated upper urinary tract urothelial cancer. Five of these patients showed dual loss of MSH2/MSH6. Two patients were confirmed to be MSH2 germline mutation carriers. Histologically, all seven tumors were low-grade atypical urothelial carcinoma and showed its unique histological features, such as an inverted papilloma-like growth pattern and a villous to papillary structure with mild stratification of tumor cells. Six tumors had no invasion of the muscularis propria. No recurrence or cancer-related deaths were reported in these seven patients. Just three patients met the revised Amsterdam criteria. This is the first report that universally examined mismatch repair immunohistochemical screening for upper urinary tract urothelial cancers. The prevalence (5%) of putative Lynch syndrome-associated upper urinary tract urothelial cancers is much higher than we had expected. We ascertained that putative Lynch syndrome-associated upper urinary tract urothelial cancers were clinically in the early stage and histologically classified into low-grade malignancy with its characteristic pathological features. The clinicopathological characteristics that we found in the present study could become additional possible markers in the diagnosis of Lynch syndrome-associated upper urinary tract urothelial cancers. © 2017 The Japanese Urological Association.

Acoustic characteristics used by Japanese macaques for individual discrimination.

PubMed

Furuyama, Takafumi; Kobayasi, Kohta I; Riquimaroux, Hiroshi

2017-10-01

The vocalizations of primates contain information about speaker individuality. Many primates, including humans, are able to distinguish conspecifics based solely on vocalizations. The purpose of this study was to investigate the acoustic characteristics used by Japanese macaques in individual vocal discrimination. Furthermore, we tested human subjects using monkey vocalizations to evaluate species specificity with respect to such discriminations. Two monkeys and five humans were trained to discriminate the coo calls of two unfamiliar monkeys. We created a stimulus continuum between the vocalizations of the two monkeys as a set of probe stimuli (whole morph). We also created two sets of continua in which only one acoustic parameter, fundamental frequency ( f 0 ) or vocal tract characteristic (VTC), was changed from the coo call of one monkey to that of another while the other acoustic feature remained the same ( f 0 morph and VTC morph, respectively). According to the results, the reaction times both of monkeys and humans were correlated with the morph proportion under the whole morph and f 0 morph conditions. The reaction time to the VTC morph was correlated with the morph proportion in both monkeys, whereas the reaction time in humans, on average, was not correlated with morph proportion. Japanese monkeys relied more consistently on VTC than did humans for discriminating monkey vocalizations. Our results support the idea that the auditory system of primates is specialized for processing conspecific vocalizations and suggest that VTC is a significant acoustic feature used by Japanese macaques to discriminate conspecific vocalizations. © 2017. Published by The Company of Biologists Ltd.

A Chinese alligator in heliox: formant frequencies in a crocodilian

PubMed Central

Reber, Stephan A.; Nishimura, Takeshi; Janisch, Judith; Robertson, Mark; Fitch, W. Tecumseh

2015-01-01

ABSTRACT Crocodilians are among the most vocal non-avian reptiles. Adults of both sexes produce loud vocalizations known as ‘bellows’ year round, with the highest rate during the mating season. Although the specific function of these vocalizations remains unclear, they may advertise the caller's body size, because relative size differences strongly affect courtship and territorial behaviour in crocodilians. In mammals and birds, a common mechanism for producing honest acoustic signals of body size is via formant frequencies (vocal tract resonances). To our knowledge, formants have to date never been documented in any non-avian reptile, and formants do not seem to play a role in the vocalizations of anurans. We tested for formants in crocodilian vocalizations by using playbacks to induce a female Chinese alligator (Alligator sinensis) to bellow in an airtight chamber. During vocalizations, the animal inhaled either normal air or a helium/oxygen mixture (heliox) in which the velocity of sound is increased. Although heliox allows normal respiration, it alters the formant distribution of the sound spectrum. An acoustic analysis of the calls showed that the source signal components remained constant under both conditions, but an upward shift of high-energy frequency bands was observed in heliox. We conclude that these frequency bands represent formants. We suggest that crocodilian vocalizations could thus provide an acoustic indication of body size via formants. Because birds and crocodilians share a common ancestor with all dinosaurs, a better understanding of their vocal production systems may also provide insight into the communication of extinct Archosaurians. PMID:26246611

Psychogenic Respiratory Distress: A Case of Paradoxical Vocal Cord Dysfunction and Literature Review

PubMed Central

Leo, Raphael J.; Konakanchi, Ramesh

1999-01-01

Background: Pulmonary disease such as asthma is a psychosomatic disorder vulnerable to exacerbations precipitated by psychological factors. A case is described in which a patient thought to have treatment-refractory asthma was discovered to have a conversion reaction, specifically paradoxical vocal cord dysfunction (PVCD), characterized by abnormal vocal cord adduction during inspiration. Data Sources: Reports of PVCD were located using a MEDLINE search and review of bibliographies. MEDLINE (English language only) was searched from 1966 through December 1998 using the terms functional asthma, functional upper airway obstruction, laryngeal diseases, Munchausen's stridor, paradoxical vocal cord dysfunction, psychogenic stridor, respiratory stridor, vocal cord dysfunction, and vocal cord paralysis. A total of 170 cases of PVCD were reviewed. Study Findings: PVCD appears to be significantly more common among females. PVCD spans all age groups, including pediatric, adolescent, and adult patients. PVCD was most often misdiagnosed as asthma or upper airway disease. Because patients present with atypical and/or refractory symptoms, several diagnostic tests are employed to evaluate patients with PVCD; laryngoscopy is the most common. Direct visualization of abnormal vocal cord movement is the most definitive means of establishing the diagnosis of PVCD. A number of psychiatric disturbances are related to PVCD, including conversion and anxiety disorders. PVCD is associated with severe psychosocial stress and difficulties with modulation of intense emotional states. Conclusions: Psychogenic respiratory distress produced by PVCD can be easily misdiagnosed as severe or refractory asthma or other pulmonary disease states. Recognition of PVCD is important to avoid unnecessary medications and invasive treatments. Primary care physicians can detect cases of PVCD by attending to clinical symptoms, implementing appropriate laboratory investigations, and examining the psychological covariates of the disorder. Psychotherapy and speech therapy are effective in treating most cases of PVCD. PMID:15014694

[Study of the supra-glottic pressure during partial constriction of the vocal tract].

PubMed

Suares, M; Cayrayre, F; Ouaknine, M; de la Brèteque, B Amy; Giovanni, A

2004-01-01

Phonation in a small plastic tube 22 cm length and 5 mms diameter (basic exercise of the method of Dr Amy de la Brèteque), is current practice in vocal rehabilitation in France. This work aims to show the effects of this method on the glottic vibration. The hypothesis was that at the time of phonation in the tube with a strong flow as recommended in the method, the vocal cords vibrate without contact. This limits the mechanical trauma at this level. We have analyzed the sound production in a tube in 11 trained and not trained subjects. We simultaneously collected the intra-oral air pressure and the vocal signal which was subjected to a spectral analysis. Spectral analysis confirmed that the signal was produced correctly i.e. with a strong flow and without interruption of the sound less rich in harmonics. We interpreted these results in the light of our preceding works on the glottic vibration and we show that this vocal production was of the sinusoidal type; this implies the absence of physical contact between the vocal cords, which validates our hypothesis. Further works are necessary to better understand the physical relations between the supra-glottic aerodynamic phenomena and the vibratory functioning of the vocal cords and also to analyze the therapeutic potential ofthe method within speech therapy rehabilitation.

Vocal Tract Adjustments of Dysphonic and Non-Dysphonic Women Pre- and Post-Flexible Resonance Tube in Water Exercise: A Quantitative MRI Study.

PubMed

Yamasaki, Rosiane; Murano, Emi Z; Gebrim, Eloisa; Hachiya, Adriana; Montagnoli, Arlindo; Behlau, Mara; Tsuji, Domingos

2017-07-01

To compare vocal tract (VT) adjustments of dysphonic and non-dysphonic women before and after flexible resonance tube in water exercise (FRTWE) at rest and during phonation using magnetic resonance imaging. Prospective study. Twenty women, aged 20-40 years, 10 dysphonic with vocal nodules (VNG) and 10 controls (CG), underwent four sets of sagittal VT MRI: two pre-FRTWE, at rest and during phonation, and two post-FRTWE, during phonation and at rest. The subjects performed 3 minutes of exercise. Nine parameters at rest and 21 during phonation were performed. Pre-FRTWE, eight significant differences were found, three at rest and five during phonation: at rest - laryngeal vestibule area, distance from epiglottis to pharyngeal posterior wall (PPW) and interarytenoid complex length were smaller in the VNG; during phonation - laryngeal vestibule area, angle between PPW and vocal fold (VF), epiglottis to PPW, and anterior commissure of the larynx to laryngeal posterior wall were smaller in the VNG; tongue area was larger in the VNG. Post-FRTWE, only three significant differences were found, two during phonation and one at rest: during phonation - angle between PPW and VF and the membranous portion of the VF length were smaller in the VNG; at rest - distance from epiglottis to PPW was smaller in the VNG. Results suggest that the habitual VT adjustments of dysphonic and non-dysphonic women are different at rest and during phonation. The FRTWE promoted positive VT changes in the VNG, reducing the intergroup differences. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Vocal Qualities in Music Theater Voice: Perceptions of Expert Pedagogues.

PubMed

Bourne, Tracy; Kenny, Dianna

2016-01-01

To gather qualitative descriptions of music theater vocal qualities including belt, legit, and mix from expert pedagogues to better define this voice type. This is a prospective, semistructured interview. Twelve expert teachers from United States, United Kingdom, Asia, and Australia were interviewed by Skype and asked to identify characteristics of music theater vocal qualities including vocal production, physiology, esthetics, pitch range, and pedagogical techniques. Responses were compared with published studies on music theater voice. Belt and legit were generally described as distinct sounds with differing physiological and technical requirements. Teachers were concerned that belt should be taught "safely" to minimize vocal health risks. There was consensus between teachers and published research on the physiology of the glottis and vocal tract; however, teachers were not in agreement about breathing techniques. Neither were teachers in agreement about the meaning of "mix." Most participants described belt as heavily weighted, thick folds, thyroarytenoid-dominant, or chest register; however, there was no consensus on an appropriate term. Belt substyles were named and generally categorized by weightedness or tone color. Descriptions of male belt were less clear than for female belt. This survey provides an overview of expert pedagogical perspectives on the characteristics of belt, legit, and mix qualities in the music theater voice. Although teacher responses are generally in agreement with published research, there are still many controversial issues and gaps in knowledge and understanding of this vocal technique. Breathing techniques, vocal range, mix, male belt, and vocal registers require continuing investigation so that we can learn more about efficient and healthy vocal function in music theater singing. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Ultrasonic scissors-assisted 'open-book' thyroidectomy in massive goiter compressing airway and causing unilateral vocal cord paralysis.

PubMed

M, Irfan; Yaroko, Ali Ango; S M, Najeb; Periasamy, Centilnathan

2013-04-01

A massive goiter may constrict the trachea resulting in shortness of breath. Recurrent laryngeal nerve compression may cause vocal cord paralysis. We highlight a case of a 62- year-old female with a 30 year history of an anterior neck swelling gradually increasing in size. She presented with acute symptoms of upper airway obstruction and voice changes. Emergency thyroidectomy was performed by dividing the middle part of the gland using ultrasonic scissors. The recovery was uneventful and the patient regained normal vocal cord function post operatively.

Upper Respiratory Tract Diseases in Athletes in Different Sports Disciplines.

PubMed

Gałązka-Franta, Anna; Jura-Szołtys, Edyta; Smółka, Wojciech; Gawlik, Radosław

2016-12-01

Upper respiratory tract diseases in athletes are a very common medical problem. Training conditions in different sports disciplines increase the risk of upper respiratory disease. Epidemiological evidence suggests that heavy acute or chronic exercise is related to an increased incidence of upper respiratory tract infections in athletes. Regular physical exercise at high intensity may lead to transient immunosuppression due to high prevalence of allergic diseases in athletes. Regardless of the cause they can exclude athletes from the training program and significantly impair their performance. In the present work, the most common upper respiratory tract diseases in athletes taking into account the disciplines in which they most often occur were presented. The focus was laid on symptoms, diagnostic methods and pharmacotherapy. Moreover, preventive procedures which can help reduce the occurrence of upper respiratory tract disease in athletes were presented. Management according to anti-doping rules, criteria for return to training and competition as an important issues of athlete's health were discussed.

Lynch Syndrome: A Primer for Urologists and Panel Recommendations.

PubMed

Mork, Maureen; Hubosky, Scott G; Rouprêt, Morgan; Margulis, Vitaly; Raman, Jay; Lotan, Yair; O'Brien, Timothy; You, Nancy; Shariat, Shahrokh F; Matin, Surena F

2015-07-01

Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer, is a common genetic disease. The predisposition of patients with Lynch syndrome to urological cancer, particularly upper tract urothelial carcinoma, is underappreciated. Urologists may be involved in several aspects of care involving Lynch syndrome, including identifying undiagnosed patients, surveillance of those with established Lynch syndrome or screening family members, in addition to treating patients with Lynch syndrome in whom upper tract urothelial carcinoma develops. We sought to increase awareness in the urological community about Lynch syndrome and provide some guidance where little currently exists. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement we reviewed the available published literature and guidelines from 1998 to 2014 on Lynch syndrome and its association with upper tract urothelial carcinoma. Recommendations based on the literature and the consensus of expert opinion are provided. No randomized or prospective study has been done to evaluate Lynch syndrome in the setting of urological cancer. All data were based on retrospective studies. Lynch syndrome is an autosomal dominant genetic disease caused by germline mutations in 4 mismatch repair genes, leading to the accumulation of DNA errors in microsatellite regions. Upper tract urothelial carcinoma develops in up to 28% of patients with known Lynch syndrome. The diagnosis of Lynch syndrome is established by clinical criteria, tumor tissue testing and genetic evaluation. Urologists should suspect Lynch syndrome when a patient with upper tract urothelial carcinoma presents before age 60 years or meets the 3-2-1 rule. Screening patients with Lynch syndrome for upper tract urothelial carcinoma presents a particular challenge. While no ideal screening test exists, at a minimum routine urinalysis is recommended using the American Urological Association guideline of 3 or more red blood cells per high power field as a trigger for further assessment. Upper tract urothelial carcinoma associated with Lynch syndrome presents at a younger age than sporadic upper tract urothelial carcinoma. It shows a higher proportion of ureteral cancer with a female preponderance and a possible predisposition to bilaterality. Lynch syndrome is a common genetic disease that is an underappreciated cause of upper tract urothelial carcinoma and possibly other urological cancers. Optimal screening for upper tract urothelial carcinoma in this population is unclear. Further study is needed to identify the best screening test and interval of testing. Urologists should consider routine tissue testing of de novo upper tract urothelial carcinoma tissue in individuals at risk. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

High EDSS can predict risk for upper urinary tract damage in patients with multiple sclerosis.

PubMed

Ineichen, Benjamin V; Schneider, Marc P; Hlavica, Martin; Hagenbuch, Niels; Linnebank, Michael; Kessler, Thomas M

2018-04-01

Neurogenic lower urinary tract dysfunction (NLUTD) is very common in patients with multiple sclerosis (MS), and it might jeopardize renal function and thereby increase mortality. Although there are well-known urodynamic risk factors for upper urinary tract damage, no clinical prediction parameters are available. We aimed to assess clinical parameters potentially predicting urodynamic risk factors for upper urinary tract damage. A consecutive series of 141 patients with MS referred from neurologists for primary neuro-urological work-up including urodynamics were prospectively evaluated. Clinical parameters taken into account were age, sex, duration, and clinical course of MS and Expanded Disability Status Scale (EDSS). Multivariate modeling revealed EDSS as a clinical parameter significantly associated with urodynamic risk factors for upper urinary tract damage (odds ratio = 1.34, 95% confidence interval (CI) = 1.06-1.71, p = 0.02). Using receiver operator characteristic (ROC) curves, an EDSS of 5.0 as cutoff showed a sensitivity of 86%-87% and a specificity of 52% for at least one urodynamic risk factor for upper urinary tract damage. High EDSS is significantly associated with urodynamic risk factors for upper urinary tract damage and allows a risk-dependent stratification in daily neurological clinical practice to identify MS patients requiring further neuro-urological assessment and treatment.

Intra- and interobserver reliability estimates for identification and grading of upper respiratory tract abnormalities recorded in horses at rest and during overground endoscopy.

PubMed

McGivney, C L; Sweeney, J; David, F; O'Leary, J M; Hill, E W; Katz, L M

2017-07-01

Previous studies support good intra- and interobserver agreements for endoscopic evaluation of various upper respiratory tract (URT) diseases in horses. However, these studies mainly assessed resting endoscopic examination videos and/or focussed on a single URT abnormality. To estimate intra- and interobserver agreement for identification and grading of all URT abnormalities from resting and overground endoscopy (OGE) videos of Thoroughbreds. Blinded, fully crossed design. Resting and OGE URT videos for n = 43 Thoroughbreds were retrospectively chosen based on identification of common URT disorders. The videos were randomly evaluated in duplicate by 4 raters blinded to all information including prior URT disorder(s) diagnosis. Abnormalities were graded using well-described ordinal scales. Intra- and interobserver agreements were estimated using Cohen's weighted κ and Krippendorff's α, respectively. Intraobserver agreement was perfect/nearly perfect for arytenoid symmetry at exercise, epiglottic entrapment and epiglottic retroversion, substantial for arytenoid asymmetry at rest, palatal dysfunction (PD), medial deviation of the aryepiglottic folds (MDAF), pharyngeal mucus and epiglottic grade at exercise and moderate for vocal fold collapse (VFC), ventromedial luxation of the apex of the corniculate process of the arytenoid (VLAC), nasopharyngeal collapse (NPC) and epiglottic grade at rest. Interobserver agreement was substantial for arytenoid symmetry at exercise and PD and moderate for arytenoid asymmetry at rest, MDAF, VLAC and epiglottic entrapment. It was only fair for VFC, epiglottic grade at exercise, epiglottic retroversion, pharyngeal mucus and NPC and poor for epiglottic grade at rest. Sample size was insufficient to allow assessment of the effect of one abnormality on the grading of another abnormality. Observers were consistent in grading URT disorders. However, significant disparity in grading existed between observers for some conditions affecting reliability. © 2016 EVJ Ltd.

Radiation Doses to Structures Within and Adjacent to the Larynx are Correlated With Long-Term Diet- and Speech-Related Quality of Life

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dornfeld, Ken; Simmons, Joel R.; Karnell, Lucy

Purpose: To test the hypothesis that radiation dose to key sites in the upper aerodigestive tract is associated with long-term functional outcome after (chemo)radiotherapy for head-and-neck cancers. Methods and Materials: This study examined the outcome for 27 patients treated with intensity-modulated radiotherapy for definitive management of their head-and-neck cancer who were disease free for at least 1 year after treatment. Head-and-neck cancer-specific quality of life (QoL) was assessed before treatment and at 1 year after treatment. Type of diet tolerated, presence of a feeding tube, and degree of weight loss 1 year after treatment were also used as outcome measures.more » Radiation doses delivered to various points along the upper aerodigestive tract, including base of tongue, lateral pharyngeal walls, and laryngeal structures, were determined from each treatment plan. Radiation doses for each of these points were tested for correlation with outcome measures. Results: Higher doses delivered to the aryepiglottic folds, false vocal cords, and lateral pharyngeal walls near the false cords correlated with a more restrictive diet, and higher doses to the aryepiglottic folds correlated with greater weight loss (p < 0.05) 1 year after therapy. Better posttreatment speech QoL scores were associated with lower doses delivered to structures within and surrounding the larynx. Conclusion: Our data show an inverse relationship between radiation dose delivered to laryngeal structures and speech and diet and QoL outcomes after definitive (chemo)radiation treatment. These findings suggest that efforts to deliver lower doses to laryngeal structures may improve outcomes after definitive (chemo)radiation therapy.« less

Voice Quality After a Semi-Occluded Vocal Tract Exercise With a Ventilation Mask in Contemporary Commercial Singers: Acoustic Analysis and Self-Assessments.

PubMed

Fantini, Marco; Succo, Giovanni; Crosetti, Erika; Borragán Torre, Alfonso; Demo, Roberto; Fussi, Franco

2017-05-01

The current study aimed at investigating the immediate effects of a semi-occluded vocal tract exercise with a ventilation mask in a group of contemporary commercial singers. A randomized controlled study was carried out. Thirty professional or semi-professional singers with no voice complaints were randomly divided into two groups on recruitment: an experimental group and a control group. The same warm-up exercise was performed by the experimental group with an occluded ventilation mask placed over the nose and the mouth and by the control group without the ventilation mask. Voice was recorded before and after the exercise. Acoustic and self-assessment analysis were accomplished. The acoustic parameters of the voice samples recorded before and after training were compared, as well as the parameters' variations between the experimental and the control group. Self-assessment results of the experimental and the control group were compared too. Significant changes after the warm-up exercise included jitter, shimmer, and singing power ratio (SPR) in the experimental group. No significant changes were recorded in the control group. Significant differences between the experimental and the control group were found for ΔShimmer and ΔSPR. Self-assessment analysis confirmed a significantly higher phonatory comfort and voice quality perception for the experimental group. The results of the present study support the immediate advantageous effects on singing voice of a semi-occluded vocal tract exercise with a ventilation mask in terms of acoustic quality, phonatory comfort, and voice quality perception in contemporary commercial singers. Long-term effects still remain to be studied. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Impact of smoking on the age at diagnosis of upper tract urothelial carcinoma: Subanalysis of the Japanese Urological Association multi-institutional national database.

PubMed

Miyazaki, Jun; Nishiyama, Hiroyuki; Fujimoto, Hiroyuki; Ohyama, Chikara; Koie, Takuya; Hinotsu, Shiro; Kikuchi, Eiji; Sakura, Mizuaki; Inokuchi, Junichi; Hara, Tomohiko

2015-11-01

To examine the influence of smoking history on the diagnosis and other tumor characteristics of upper tract urothelial carcinoma in Japan. A total of 1509 patients with upper tract urothelial carcinoma who were diagnosed in 2005 from 348 Japanese institutions were registered using the multi-institutional national database of the Japanese Urological Association and included in this analysis. Clinical data of the patients were collected in 2011. The associations between the patients' self-reported smoking history and their age at the diagnosis of upper tract urothelial carcinoma, sex, pathological T stage and tumor grade were analyzed. The mean age at the diagnosis of upper tract urothelial carcinoma was approximately 5 years earlier for the 238 current smokers than for the 618 current non-smokers (P < 0.0001). Similar associations between smoking and the early diagnosis of upper tract urothelial carcinoma were shown in the sex subgroups and in subgroups stratified by pathological T stages. Among the current smokers, the age at diagnosis for the smoking ≥ 20 cigarettes per day group was 6.5 years lower than that of the < 20 cigarettes per day group, which was significantly different (P < 0.0001). Current smoking is a significant risk factor for the earlier diagnosis of upper tract urothelial carcinoma. The finding is important from the perspective of both healthcare and medical economies. © 2015 The Japanese Urological Association.

Direct numerical simulation of human phonation

NASA Astrophysics Data System (ADS)

Bodony, Daniel; Saurabh, Shakti

2017-11-01

The generation and propagation of the human voice in three-dimensions is studied using direct numerical simulation. A full body domain is employed for the purpose of directly computing the sound in the region past the speaker's mouth. The air in the vocal tract is modeled as a compressible and viscous fluid interacting with the elastic vocal folds. The vocal fold tissue material properties are multi-layered, with varying stiffness, and a linear elastic transversely isotropic model is utilized and implemented in a quadratic finite element code. The fluid-solid domains are coupled through a boundary-fitted interface and utilize a Poisson equation-based mesh deformation method. A kinematic constraint based on a specified minimum gap between the vocal folds is applied to prevent collision during glottal closure. Both near VF flow dynamics and far-field acoustics have been studied. A comparison is drawn to current two-dimensional simulations as well as to data from the literature. Near field vocal fold dynamics and glottal flow results are studied and in good agreement with previous three-dimensional phonation studies. Far-field acoustic characteristics, when compared to their two-dimensional counterpart, are shown to be sensitive to the dimensionality. Supported by the National Science Foundation (CAREER Award Number 1150439).

Experiments on the Acoustics of Whistling.

ERIC Educational Resources Information Center

Shadle, Christine H.

1983-01-01

The acoustics of speech production allows the prediction of resonances for a given vocal tract configuration. Combining these predictions with aerodynamic theory developed for mechanical whistles makes theories about human whistling more complete. Several experiments involving human whistling are reported which support the theory and indicate new…

Theoretical Aspects of Speech Production.

ERIC Educational Resources Information Center

Stevens, Kenneth N.

1992-01-01

This paper on speech production in children and youth with hearing impairments summarizes theoretical aspects, including the speech production process, sound sources in the vocal tract, vowel production, and consonant production. Examples of spectra for several classes of vowel and consonant sounds in simple syllables are given. (DB)

Embodied, Embedded Language Use

PubMed Central

Fowler, Carol A.

2011-01-01

Language use has a public face that is as important to study as the private faces under intensive psycholinguistic study. In the domain of phonology, public use of speech must meet an interpersonal “parity” constraint if it is to serve to communicate. That is, spoken language forms must reliably be identified by listeners. To that end, language forms are embodied, at the lowest level of description, as phonetic gestures of the vocal tract that lawfully structure informational media such as air and light. Over time, under the parity constraint, sound inventories emerge over communicative exchanges that have the property of sufficient identifiability. Communicative activities involve more than vocal tract actions. Talkers gesture and use facial expressions and eye gaze to communicate. Listeners embody their language understandings, exhibiting dispositions to behave in ways related to language understanding. Moreover, linguistic interchanges are embedded in the larger context of language use. Talkers recruit the environment in their communicative activities, for example, in using deictic points. Moreover, in using language as a “coordination device,” interlocutors mutually entrain. PMID:21243080

[Persistent Bilateral Vocal Cord Paralysis after General Anesthesia in a Patient with Multiple System Atrophy: A Case Report].

PubMed

Konishi, Hanako; Mizota, Toshiyuki; Fukuda, Kazuhiko

2015-06-01

We report a case of persistent bilateral vocal cord paralysis which developed after spine surgery under general anesthesia in a patient with multiple system atrophy. A 64-year-old woman was scheduled to receive spinal fusion surgery for kyphoscoliosis. She did not have apparent symptoms of vocal cord paralysis such as hoarseness before surgery. The surgery was performed smoothly under general anesthesia with endotracheal intubation. However, immediately after extubation, the patient developed severe upper airway obstruction and was re-intubated. Fiberoptic laryngoscopy revealed bilateral vocal cord abductor paralysis. Vocal cord paralysis did not improve and she received tracheotomy on the 12th day after surgery. She also showed symptoms of autonomic nervous system dysfunction and cerebellar ataxia, and was diagnosed as multiple system atrophy on postoperative day 64. We discuss differential diagnosis of persistent vocal cord paralysis after general anesthesia, and anesthetic management of a patient with multiple system atrophy.

Neck and shoulder muscle activity and thorax movement in singing and speaking tasks with variation in vocal loudness and pitch.

PubMed

Pettersen, Viggo; Bjørkøy, Kåre; Torp, Hans; Westgaard, Rolf Harald

2005-12-01

The aim of this study was to examine respiratory phasing and loading levels of sternocleidomastoideus (STM), scalenus (SC), and upper trapezius (TR) muscles in vocalization tasks with variation in vocal loudness and pitch. Eight advanced singing students, aged 22 to 28 years, participated. Surface electromyographic (EMG) activity was recorded from STM, SC, and TR. Thorax movement was detected by two strain gauge sensors placed around the upper (upper TX) and lower (lower TX) thorax. A glissando and simplified singing and speaking tasks were performed. Sustained vowels /a:-i-ae-o:/ were sung in a glissando from lowest to highest pitch (mixed voice/falsetto) back to lowest pitch and in short singing sequences at comfortable, low, and high pitches. The same vowels were spoken softly and loudly for about the same length. The subjects inhaled between the vowels. It was concluded that the inspiratory phased STM and SC muscles produced a counterforce to compression of upper TX at high pitches in glissando. STM and SC were activated to higher levels during phonation than in inhalation. As breathing demands were reduced, STM and SC activity was lowered and the respiratory phasing of peak amplitude changed to inhalation. TR contributed to exhalation in demanding singing with long breathing cycles, but it was less active in singing tasks with short breathing cycles and was essentially inactive in simplified speaking tasks.

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

PubMed Central

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 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. PMID:27106298

Adult-onset tic disorder, motor stereotypies, and behavioural disturbance associated with antibasal ganglia antibodies.

PubMed

Edwards, Mark J; Dale, Russell C; Church, Andrew J; Trikouli, Eleni; Quinn, Niall P; Lees, Andrew J; Giovannoni, Gavin; Bhatia, Kailash P

2004-10-01

The onset of tics in adulthood is rare and, unlike the childhood variety, there is commonly a secondary environmental cause. We present four cases (1 man, 3 women) with an adult onset tic disorder (mean age of onset, 36 years; range, 27-42 years) associated with the presence of serum antibasal ganglia antibodies (ABGA). One patient had motor tics and unusual motor stereotypies, 2 had multiple motor and vocal tics, and the remaining patient had motor tics only. Concomitant psychiatric disturbance was noted in 3 cases. In 2 cases, there was a close temporal relationship between upper respiratory tract infection and the subsequent onset of tics. Imaging was possible in three cases and was normal in two but revealed a lesion involving the right caudate and lentiform nuclei in the other. We suggest that there might be a causal relationship between ABGA and the clinical syndrome in these cases and that ABGA should be considered as a possible etiology for adult-onset tics. (c) 2004 Movement Disorder Society.

Aeroelastic Model of Vocal-Fold Vibrating Element for Studying the Phonation Threshold

NASA Astrophysics Data System (ADS)

Horáček, J.; Švec, J. G.

2002-10-01

An original theoretical model for vibration onset of the vocal folds in the air-flow coming from the human subglottal tract is designed, which allows studying the influence of the physical properties of the vocal folds (e.g., geometrical shape, mass, viscosity) on their vibration characteristics (such as the natural frequencies, mode shapes of vibration and the thresholds of instability). The mathematical model of the vocal fold is designed as a simplified dynamic system of two degrees of freedom (rotation and translation) vibrating on an elastic foundation in the wall of a channel conveying air. An approximate unsteady one-dimensional flow theory for the inviscid incompressible fluid is presented for the phonatory air-flow. A generally defined shape of the vocal-fold surface is considered for expressing the unsteady aerodynamic forces in the glottis. The parameters of the mechanical part of the model, i.e., the mass, stiffness and damping matrices, are related to the geometry and material density of the vocal folds as well as to the fundamental natural frequency and damping known from experiments. The coupled numerical solution yields the vibration characteristics (natural frequencies, damping and mode shapes of vibration), including the instability thresholds of the aeroelastic system. The vibration characteristics obtained from the coupled numerical solution of the system appear to be in reasonable qualitative agreement with the physiological data and clinical observations. The model is particularly suitable for studying the phonation threshold, i.e., the onset of vibration of the vocal folds.

Predicted singers' vocal fold lengths and voice classification-a study of x-ray morphological measures.

PubMed

Roers, Friederike; Mürbe, Dirk; Sundberg, Johan

2009-07-01

Students admitted to the solo singing education at the University of Music Dresden, Germany have been submitted to a detailed physical examination of a variety of factors with relevance to voice function since 1959. In the years 1959-1991, this scheme of examinations included X-ray profiles of the singers' vocal tracts. This material of 132 X-rays of voice professionals was used to investigate different laryngeal morphological measures and their relation to vocal fold length. Further, the study aimed to investigate if there are consistent anatomical differences between singers of different voice classifications. The study design used was a retrospective analysis. Vocal fold length could be measured in 29 of these singer subjects directly. These data showed a strong correlation with the anterior-posterior diameter of the subglottis and the trachea as well as with the distance from the anterior contour of the thyroid cartilage to the anterior contour of the spine. These relations were used in an attempt to predict the 132 singers' vocal fold lengths. The results revealed a clear covariation between predicted vocal fold length and voice classification. Anterior-posterior subglottic-tracheal diameter yielded mean vocal fold lengths of 14.9, 16.0, 16.6, 18.4, 19.5, and 20.9mm for sopranos, mezzo-sopranos, altos, tenors, baritones, and basses, respectively. The data support the assumption that there are consistent anatomical laryngeal differences between singers of different voice classifications, which are of relevance to pitch range and timbre of the voice.

Detection of Obstructive sleep apnea in awake subjects by exploiting body posture effects on the speech signal.

PubMed

Kriboy, M; Tarasiuk, A; Zigel, Y

2014-01-01

Obstructive sleep apnea (OSA) is a common sleep disorder. OSA is associated with several anatomical and functional abnormalities of the upper airway. It was shown that these abnormalities in the upper airway are also likely to be the reason for increased rate of apneic events in the supine position. Functional and structural changes in the vocal tract can affect the acoustic properties of speech. We hypothesize that acoustic properties of speech that are affected by body position may aid in distinguishing between OSA and non-OSA patients. We aimed to explore the possibility to differentiate OSA and non-OSA patients by analyzing the acoustic properties of their speech signal in upright sitting and supine positions. 35 awake patients were recorded while pronouncing sustained vowels in the upright sitting and supine positions. Using linear discriminant analysis (LDA) classifier, accuracy of 84.6%, sensitivity of 92.7%, and specificity of 80.0% were achieved. This study provides the proof of concept that it is possible to screen for OSA by analyzing and comparing speech properties acquired in upright sitting vs. supine positions. An acoustic-based screening system during wakefulness may address the growing needs for a reliable OSA screening tool; further studies are needed to support these findings.

Endoscopic Management of Upper Urinary Tract Urothelial Carcinoma.

PubMed

Samson, Patrick; Smith, Arthur D; Hoenig, David; Okeke, Zeph

2018-05-01

Endoscopic management of upper tract urothelial carcinoma has become more popular over the last few decades as there has been an impetus for renal preservation in these patients. While radical nephroureterectomy has been the gold standard in treatment of this disease, ureteroscopic and percutaneous management has become a viable option for select patients. The literature on endoscopic management of upper urinary tract tumors was explored. Different management methods are discussed, both from published literature and experience of the authors of this chapter. We review the indications, details of the procedure, and troubleshooting methods in the endoscopic management of upper tract urothelial carcinoma. Imperative indications as well as controversial indications are discussed. The role and efficacy of adjuvant intrarenal topical agents are examined as well as the protocol for administering these agents. Follow-up protocols are also reviewed. In select patients, endoscopic management with ureteroscopy and/or percutaneous resection of upper tract urothelial tumors is appropriate and can preserve renal function while obtaining comparable oncologic control compared with radical surgery.

[Primary upper urinary tract tumors and subsequent location in the bladder].

PubMed

Azémar, M-D; Audouin, M; Revaux, A; Misraï, V; Comperat, E; Bitker, M-O; Chartier-Kastler, E; Richard, F; Cussenot, O; Rouprêt, M

2009-10-01

The urothelium is the epithelium that lines the upper and lower urinary tract. Over 95% of urothelial carcinomas are derived from urothelium. They can be located in the lower tract (bladder, urethra) or upper tract (pyelocaliceal cavities, ureter). Urothelial carcinomas are the fourth most common tumours after prostate (or breast) cancer, lung cancer and colorectal cancer. On one hand, bladder tumours account for 90-95% of urothelial carcinomas. It is the most common malignancy of the urinary tract and the second most common malignancy of the urogenital tract after prostate cancer. It accounts for 5-10% of all cancers diagnosed each year in Europe. On the other hand, upper urinary tract urothelial cell carcinomas (UUT-UCC) are scarce and account for only 5-10% of urothelial carcinomas. Recurrence in the bladder after primary UUT-UCC occurs in 15-50% of UUT-UCC. Differences in treatment modalities of the primary UUT-UCC do not play a key role in the subsequent appearance of a bladder recurrence. However, others factors have been described such as stage and location in the upper tract of the primary tumour or upper tract tumour multifocality. Previous history of bladder tumour is also associated with the risk that another tumour arises in the bladder subsequently. However, it becomes difficult to distinguish between natural history of bladder tumour and evolution of UUT-UCC in these cases. In most cases, bladder cancer occurs in the first two years after UUT-UCC management. Surveillance protocol is based on cystoscopy and on urinary cytology during at least every three months for two years. Current surveillance regimen have a low level of evidence considering the paucity of UUT-UCC.

Seasonal and pandemic human influenza viruses attach better to human upper respiratory tract epithelium than avian influenza viruses.

PubMed

van Riel, Debby; den Bakker, Michael A; Leijten, Lonneke M E; Chutinimitkul, Salin; Munster, Vincent J; de Wit, Emmie; Rimmelzwaan, Guus F; Fouchier, Ron A M; Osterhaus, Albert D M E; Kuiken, Thijs

2010-04-01

Influenza viruses vary markedly in their efficiency of human-to-human transmission. This variation has been speculated to be determined in part by the tropism of influenza virus for the human upper respiratory tract. To study this tropism, we determined the pattern of virus attachment by virus histochemistry of three human and three avian influenza viruses in human nasal septum, conchae, nasopharynx, paranasal sinuses, and larynx. We found that the human influenza viruses-two seasonal influenza viruses and pandemic H1N1 virus-attached abundantly to ciliated epithelial cells and goblet cells throughout the upper respiratory tract. In contrast, the avian influenza viruses, including the highly pathogenic H5N1 virus, attached only rarely to epithelial cells or goblet cells. Both human and avian viruses attached occasionally to cells of the submucosal glands. The pattern of virus attachment was similar among the different sites of the human upper respiratory tract for each virus tested. We conclude that influenza viruses that are transmitted efficiently among humans attach abundantly to human upper respiratory tract, whereas inefficiently transmitted influenza viruses attach rarely. These results suggest that the ability of an influenza virus to attach to human upper respiratory tract is a critical factor for efficient transmission in the human population.

Is laughter a better vocal change detector than a growl?

PubMed

Pinheiro, Ana P; Barros, Carla; Vasconcelos, Margarida; Obermeier, Christian; Kotz, Sonja A

2017-07-01

The capacity to predict what should happen next and to minimize any discrepancy between an expected and an actual sensory input (prediction error) is a central aspect of perception. Particularly in vocal communication, the effective prediction of an auditory input that informs the listener about the emotionality of a speaker is critical. What is currently unknown is how the perceived valence of an emotional vocalization affects the capacity to predict and detect a change in the auditory input. This question was probed in a combined event-related potential (ERP) and time-frequency analysis approach. Specifically, we examined the brain response to standards (Repetition Positivity) and to deviants (Mismatch Negativity - MMN), as well as the anticipatory response to the vocal sounds (pre-stimulus beta oscillatory power). Short neutral, happy (laughter), and angry (growls) vocalizations were presented both as standard and deviant stimuli in a passive oddball listening task while participants watched a silent movie and were instructed to ignore the vocalizations. MMN amplitude was increased for happy compared to neutral and angry vocalizations. The Repetition Positivity was enhanced for happy standard vocalizations. Induced pre-stimulus upper beta power was increased for happy vocalizations, and predicted the modulation of the standard Repetition Positivity. These findings indicate enhanced sensory prediction for positive vocalizations such as laughter. Together, the results suggest that positive vocalizations are more effective predictors in social communication than angry and neutral ones, possibly due to their high social significance. Copyright © 2017 Elsevier Ltd. All rights reserved.

Upper tract urothelial carcinomas: frequency of association with mismatch repair protein loss and lynch syndrome.

PubMed

Harper, Holly L; McKenney, Jesse K; Heald, Brandie; Stephenson, Andrew; Campbell, Steven C; Plesec, Thomas; Magi-Galluzzi, Cristina

2017-01-01

Increased risk for upper tract urothelial carcinoma is described in patients with Lynch syndrome, caused by germline mutations in mismatch repair genes. We aimed to identify the frequency of mismatch repair protein loss in upper tract urothelial carcinoma and its potential for identifying an association with Lynch syndrome. We queried our database to identify upper tract urothelial carcinomas. Patients were cross-referenced for history of colorectal carcinoma or other common Lynch syndrome-associated neoplasms to enrich for potential Lynch syndrome cases. Tumor histopathologic characteristics were reviewed and each case was analyzed for loss of mismatch repair proteins, MLH1, MSH2, MSH6, and PMS2, by immunohistochemistry. Of 444 patients with upper tract urothelial carcinoma, a subset of 215 (encompassing 30 with upper tract urothelial carcinoma and another common Lynch syndrome-associated neoplasm) was analyzed for loss of mismatch repair protein expression. Of 30 patients with Lynch syndrome-associated neoplasms, six had documented Lynch syndrome, including two with Muir-Torre syndrome. Mismatch repair protein loss was identified in 7% of total upper tract urothelial carcinomas and 30% of patients with Lynch syndrome-associated neoplasms (including all patients with Lynch syndrome/Muir-Torre syndrome). Of patients without history of Lynch syndrome-associated neoplasms, 5 of 184 (2.7%) had loss of mismatch repair protein expression. Twelve cases with mismatch repair protein loss demonstrated loss of MSH2 and MSH6, and 2 had isolated loss of MSH6. MLH1 and PMS2 expression were consistently retained. Although increased intratumoral lymphocytes, inverted growth, pushing tumor-stromal interface, and lack of nuclear pleomorphism were more commonly seen in cases with mismatch repair protein loss, only intratumoral lymphocytes and presence of pushing borders were statistically significant. MLH1 and PMS2 testing appear to have little utility in upper tract urothelial carcinoma; however, mismatch repair protein loss of MSH2 and/or MSH6 by immunohistochemistry seems relatively sensitive and specific for identifying patients with potential Lynch syndrome.

Different Vocal Parameters Predict Perceptions of Dominance and Attractiveness.

PubMed

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.

Vocal perfection in yodelling--pitch stabilities and transition times.

PubMed

Echternach, Matthias; Richter, Bernhard

2010-04-01

Yodelling is a special kind of vocal performance in traditional music which consists of rapid and repeated changes in pitch. It is assumed that these pitch changes are accompanied by register changes. We analysed, using the laryngograph, yodelling on different vowels by four professional yodelling teachers (two male, two female), four professional classically trained singers, and four untrained voices. Results reveal that pitch changes in yodelling are associated with decrease of electroglottograpgic (EGG) contact quotient for the upper pitch, indicating a register shift. Furthermore, in contrast to untrained voices, for the yodellers lower and upper pitches were more stable with respect to fundamental frequency and perturbation values, and the pitch transitions were faster.

Recurrent Urinary Tract Infections Due to Bacterial Persistence or Reinfection in Women-Does This Factor Impact Upper Tract Imaging Findings?

PubMed

Wu, Yuefeng Rose; Rego, Lauren L; Christie, Alana L; Lavelle, Rebecca S; Alhalabi, Feras; Zimmern, Philippe E

2016-08-01

We compared the rates of upper tract imaging abnormalities of recurrent urinary tract infections due to bacterial persistence or reinfection. Following institutional review board approval we reviewed a prospectively maintained database of women with documented recurrent urinary tract infections (3 or more per year) and trigonitis. We searched for demographic data, urine culture findings and findings on radiology interpreted upper tract imaging, including renal ultrasound, computerized tomography or excretory urogram. Patients with irretrievable images, absent or incomplete urine culture results for review, no imaging performed, an obvious source of recurrent urinary tract infections or a history of pyelonephritis were excluded from analysis. Of 289 women from 2006 to 2014 with symptomatic recurrent urinary tract infections 116 met study inclusion criteria. Mean ± SD age was 65.0 ± 14.4 years. Of the women 95% were white and 81% were postmenopausal. Almost a third were sexually active and none had prolapse stage 2 or greater. Of the 116 women 48 (41%) had persistent and 68 (59%) had reinfection recurrent urinary tract infection. Imaging included ultrasound in 52 patients, computerized tomography in 26, ultrasound and computerized tomography in 31, and excretory urogram with ultrasound/computerized tomography in 7. Of the total of 58 imaging findings in 55 women 57 (98%) were noncontributory. One case (0.9%) of mild hydronephrosis was noted in the persistent recurrent urinary tract infection group but it was not related to any clinical parameters. Escherichia coli was the dominant bacteria in 71% of persistent and 47% of reinfection recurrent urinary tract infections in the most recently reported urine culture. This study reaffirms that upper tract imaging is not indicated for bacterial reinfection, recurrent urinary tract infections. However, the same conclusion can be extended to recurrent urinary tract infections secondary to bacterial persistence, thus, questioning the routine practice of upper tract studies in white postmenopausal women with recurrent urinary tract infections and trigonitis. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Does topical lidocaine before tracheal intubation attenuate airway responses in children? An observational audit.

PubMed

Hamilton, Nigel D; Hegarty, Mary; Calder, Alyson; Erb, Thomas O; von Ungern-Sternberg, Britta S

2012-04-01

The use of topical lidocaine, applied to the airways with various administration techniques, is common practice in pediatric anesthesia in many institutions. However, it remains unclear whether these practices achieve their intended goal of reducing the risk of perioperative respiratory adverse events (PRAE) in children undergoing elective endotracheal intubation without neuromuscular blockade (NMB). The relative frequency of PRAE (laryngospasm, coughing, desaturation <95%) associated with no use of topical airway lidocaine (TAL), with TAL sprayed directly onto the vocal cords, and TAL administered blindly into the pharynx was assessed. This prospective audit involved 1000 patients undergoing general anesthesia with elective endotracheal intubation without NMB. Patients with suspected difficult airways or undergoing airway surgery were excluded. The use of TAL and the mode of administration were recorded. Respiratory adverse events were recorded in the perioperative period. Two hundred and fifty-four patients had the vocal cords sprayed under direct vision, 236 had lidocaine blindly dripped into the pharynx, and 510 received no TAL. The mean age and known risk factors for PRAE (asthma, recent upper respiratory tract infection (≤2 weeks), passive smoking, hayfever, past or present eczema, nocturnal dry cough) were similar among the groups. The proportion of patients with desaturation (<95%) between induction of anesthesia and discharge from the recovery room was higher in the two groups who received TAL (data combined for all patients receiving lidocaine regardless of administration method, P = 0.01) compared to those who received no TAL. No difference in the rates of laryngospasm (P = 0.13) or cough (P = 0.07) was observed among the groups. There was no difference in the rates of PRAE between the groups given TAL directly onto the vocal cords and in those whom received TAL blindly. The incidence of desaturation was higher in patients receiving TAL compared with children who did not. This association should perhaps be considered when contemplating the use of this technique. © 2011 Blackwell Publishing Ltd.

Interspeaker Variability in Hard Palate Morphology and Vowel Production

ERIC Educational Resources Information Center

Lammert, Adam; Proctor, Michael; Narayanan, Shrikanth

2013-01-01

Purpose: Differences in vocal tract morphology have the potential to explain interspeaker variability in speech production. The potential acoustic impact of hard palate shape was examined in simulation, in addition to the interplay among morphology, articulation, and acoustics in real vowel production data. Method: High-front vowel production from…

Effects of Long-Term Tracheostomy on Spectral Characteristics of Vowel Production.

ERIC Educational Resources Information Center

Kamen, Ruth Saletsky; Watson, Ben C.

1991-01-01

Eight preschool children who underwent tracheotomy during the prelingual period were compared to matched controls on a variety of speech measures. Children with tracheotomies showed reduced acoustic vowel space, suggesting they were limited in their ability to produce extreme vocal tract configurations for vowels postdecannulation. Oral motor…

On the Evolution of Human Language.

ERIC Educational Resources Information Center

Lieberman, Philip

Human linguistic ability depends, in part, on the gradual evolution of man's supralaryngeal vocal tract. The anatomic basis of human speech production is the result of a long evolutionary process in which the Darwinian process of natural selection acted to retain mutations. For auditory perception, the listener operates in terms of the acoustic…

Speaking Tongues Are Actively Braced

ERIC Educational Resources Information Center

Gick, Bryan; Allen, Blake; Roewer-Després, François; Stavness, Ian

2017-01-01

Purpose: Bracing of the tongue against opposing vocal-tract surfaces such as the teeth or palate has long been discussed in the context of biomechanical, somatosensory, and aeroacoustic aspects of tongue movement. However, previous studies have tended to describe bracing only in terms of contact (rather than mechanical support), and only in…

Laughter among Deaf Signers

ERIC Educational Resources Information Center

Provine, Robert R.; Emmorey, Karen

2006-01-01

The placement of laughter in the speech of hearing individuals is not random but "punctuates" speech, occurring during pauses and at phrase boundaries where punctuation would be placed in a transcript of a conversation. For speakers, language is dominant in the competition for the vocal tract since laughter seldom interrupts spoken phrases. For…

The Role of the Listener's State in Speech Perception

ERIC Educational Resources Information Center

Viswanathan, Navin

2009-01-01

Accounts of speech perception disagree on whether listeners perceive the acoustic signal (Diehl, Lotto, & Holt, 2004) or the vocal tract gestures that produce the signal (e.g., Fowler, 1986). In this dissertation, I outline a research program using a phenomenon called "perceptual compensation for coarticulation" (Mann, 1980) to examine this…

Respiratory tract immune response to microbial pathogens.

PubMed

Wilkie, B N

1982-11-15

Effective resistance to respiratory tract infection depends principally on specific immunity on mucosal surfaces of the upper or lower respiratory tract. Respiratory tract immune response comprises antibody and cell-mediated systems and may be induced most readily by surface presentation of replicating agents but can result from parenteral or local presentation of highly immunogenic antigens. Upper and lower respiratory tract systems differ in immunologic competence, with the lungs having a greater inventory of protective mechanisms than the trachea or nose. Several effective vaccines have been developed for prevention or modification of respiratory tract diseases.

The anatomic basis for the acquisition of speech and obstructive sleep apnea: evidence from cephalometric analysis supports The Great Leap Forward hypothesis.

PubMed

Davidson, Terence M; Sedgh, Jacob; Tran, Duyen; Stepnowsky, Carl J

2005-11-01

We previously postulated how evolutionary changes in man's upper respiratory tract to facilitate speech, a phenomenon Jared Diamond calls The Great Leap Forward, have predisposed man to obstructive sleep apnea (OSA) [Diamond J. The Third Chimpanzee: the evolution and future of the human animal. New York: HarperCollins Publishers; 1992. p. 21, 23, 32-54, 54-6; Davidson TM. The Great Leap Forward: the anatomic evolution of obstructive sleep apnea. Sleep Medicine 2003;4:185-94]. We grouped these anatomic changes into four categories: klinorynchy, laryngeal descent, craniobase angulation and supralaryngeal vocal tract (SVT) ratio of SVT(H):SVT(V). This study was designed to investigate the relationship between cephalometric measures corresponding to these anatomic changes and OSA. One hundred and twenty-three male subjects presenting with symptoms of OSA underwent unattended multi-channel home sleep studies. We obtained cephalometric measurements from standard lateral cephalograms. Pearson correlation coefficients were calculated between cephalometrics and apnea-hypopnea index (AHI), age, and body mass index (BMI). Our results showed significant correlation between AHI and klinorynchy, laryngeal descent, and craniobase angulation. Overall, our data supports the theory that evolutionary anatomic changes to facilitate speech correlate with OSA severity. The cumulative changes in each cephalometric category trended in the directions hypothesized and support the Great Leap theory of OSA evolution.

Case-study magnetic resonance imaging and acoustic investigation of the effects of vocal warm-up on two voice professionals.

PubMed

Laukkanen, Anne-Maria; Horáček, Jaromir; Havlík, Radan

2012-07-01

Vocal warm-up (WU)-related changes were studied in one male musical singer and one female speech trainer. They sustained vowels before and after WU in a magnetic resonance imaging (MRI) device. Acoustic recordings were made in a studio. The vocal tract area increased after WU, a formant cluster appeared between 2 and 4.5 kHz, and SPL increased. Evidence of larynx lowering was only found for the male. The pharyngeal inlet over the epilaryngeal outlet ratio (A(ph)/A(e)) increased by 10%-28%, being 3-4 for the male and 5-7 for the female. The results seem to represent different voice training traditions. A singer's formant cluster may be achievable without a high A(ph)/A(e) (≥ 6), but limitations of the 2D method should be taken into account.

Speech Research. A Report on the Status and Progress of Studies on the Nature of Speech, Instrumentation for Its Investigation, and Practical Applications.

DTIC Science & Technology

1980-01-01

Bell3 Donald Hailey Steven Eady Fredericka Bell-Berti* Terry Halwes Jo Estill Catherine Best+ Sabina D. Koroluk Laurie Feldman Gloria J. Borden* Agnes M...tract (Fant, 1971; Stevens & House, 1955, 1961). For oral phonemes, ,.he vocal tract may simply be viewed as a tube consisting of the pharyngeal and...coupling of the nasal and oral cavities. In experiments with synthesized speech, House and Stevens (1956) varied the ratio of the driving point impedance of

Urothelial carcinoma of the bladder and the upper tract: disparate twins.

PubMed

Green, David A; Rink, Michael; Xylinas, Evanguelos; Matin, Surena F; Stenzl, Arnulf; Roupret, Morgan; Karakiewicz, Pierre I; Scherr, Douglas S; Shariat, Shahrokh F

2013-04-01

Urothelial carcinoma of the bladder is the 4th most common malignancy in men and the 8th most common cause of male cancer death in the United States. Conversely, upper tract urothelial carcinoma accounts for only 5% to 10% of all urothelial carcinoma. Due to the relative preponderance of urothelial carcinoma of the bladder, much of the clinical decision making regarding upper tract urothelial carcinoma is extrapolated from evidence that is based on urothelial carcinoma of the bladder cohorts. In fact, only 1 major urological organization has treatment guidelines specific for upper tract urothelial carcinoma. While significant similarities exist between these 2 diseases, ignoring the important differences may be preventing us from optimizing therapy in patients with upper tract urothelial carcinoma. Therefore, we explored these dissimilarities, including the differential importance of gender, anatomy, staging, intracavitary therapy, surgical lymphadenectomy and perioperative systemic chemotherapy on the behavior of urothelial carcinoma of the bladder and upper tract urothelial carcinoma. A nonsystematic literature search using the MEDLINE/PubMed® database was conducted to identify original articles, review articles and editorials. Searches were limited to the English language and studies in humans and in adults, and used the key words urothelial carcinoma, upper tract urothelial carcinoma or transitional cell carcinoma combined with several different sets of key words to identify appropriate publications for each section of the manuscript. The key words, broken down by section, were 1) epidemiology, sex, gender; 2) location, tumor location; 3) staging, stage; 4) intracavitary, intravesical, topical therapy; 5) lymphadenectomy, lymph node, lymph node dissection and 6) adjuvant, neoadjuvant, chemotherapy. Women who present with urothelial carcinoma of the bladder do so with less favorable tumor characteristics and have worse survival than men. However, gender does not appear to be associated with survival outcomes in upper tract urothelial carcinoma. The prognostic effect that urothelial carcinoma tumor location has on outcomes prediction is a matter of debate, and the influence of tumor location may reflect our technical ability to accurately stage and treat the disease more than the actual tumor biology. Moreover, technical limitations of upper tract urothelial carcinoma sampling compared to transurethral resection for urothelial carcinoma of the bladder are the most important source of staging differences between the 2 diseases. Intravesical chemotherapy and immunotherapy are essential components of standard of care for most nonmuscle invasive bladder cancer, while adjuvant intracavitary therapy for patients with upper tract urothelial carcinoma treated endoscopically or percutaneously has been sparsely used and without any clear guidelines. The widespread adoption of the use of intracavitary therapy in the upper tract will likely not only require additional data to support its efficacy, but will also require a less cumbersome means of administration. Lymphadenectomy at the time of radical cystectomy is widely accepted while lymphadenectomy at the time of radical nephroureterectomy is performed largely at the discretion of the surgeon. Among other reasons, this may be due in part to the variable lymphatic drainage along the course of the ureter compared to the relatively confined lymphatic landing sites for the bladder. Level I evidence has demonstrated a clear survival benefit for systemic chemotherapy before radical surgery or radiation in patients with clinical T2-4N0M0 urothelial carcinoma of the bladder. Such data are not available in the population with upper tract urothelial carcinoma. However, the use of neoadjuvant chemotherapy may be even more important in upper tract urothelial carcinoma than in urothelial carcinoma of the bladder because of the obligatory kidney function loss that occurs at radical nephroureterectomy. While urothelial carcinoma of the bladder and upper tract urothelial carcinoma share many characteristics, they represent 2 distinct diseases. There are practical, anatomical, biological and molecular differences that warrant consideration when risk stratifying and treating patients with these disparate twin diseases. To overcome the challenges that impede progress toward evidence-based medicine in upper tract urothelial carcinoma, we believe that focused collaborative efforts will best augment our understanding of this rare disease and ultimately improve the care we deliver to our patients. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Colonization of the lower urogenital tract with Ureaplasma parvum can cause asymptomatic infection of the upper reproductive system in women: a preliminary study.

PubMed

Kasprzykowska, Urszula; Elias, Joanna; Elias, Marek; Mączyńska, Beata; Sobieszczańska, Beata Magdalena

2014-05-01

Genital ureaplasmas are considered opportunistic pathogens of human genitourinary tract involved in adverse pregnancy sequelae and infertility. While association of Ureaplasma urealyticum with urogenital tract infections is well established, the role of Ureaplasma parvum in these infections is still insufficient. In the study, we compared how often cervicovaginal colonization with U. parvum is associated with the presence of these microorganisms in the upper genitourinary tract of fertile and infertile women. We used PCR assay to determine the prevalence of U. parvum and U. urealyticum in pairs of specimens, i.e., vaginal swabs and Douglas' pouch fluid samples from consecutive 40 women with no symptoms of genital tract infection. In total, 19 (47.5 %) of the 40 samples were positive for ureaplasmas. U. parvum was simultaneously detected in pairs of samples in five (55.5 %) of the nine (47.4 %) women positive in PCR assay. As many as 5 (18.5 %) of the 27 infertile women and 1 (7.7 %) of the 13 fertile women showed infection of the upper genital tract with U. parvum. The results of the study demonstrated that colonization of the lower genital tract with U. parvum can produce asymptomatic infection of the upper reproductive system in women. These findings also imply that U. parvum may be present in the upper genital tract at the time of conception and might be involved in adverse pregnancy outcomes.

Universal Point of Care Testing for Lynch Syndrome in Patients with Upper Tract Urothelial Carcinoma.

PubMed

Metcalfe, Michael J; Petros, Firas G; Rao, Priya; Mork, Maureen E; Xiao, Lianchun; Broaddus, Russell R; Matin, Surena F

2018-01-01

Patients with Lynch syndrome are at risk for upper tract urothelial carcinoma. We sought to identify the incidence and most reliable means of point of care screening for Lynch syndrome in patients with upper tract urothelial carcinoma. A total of 115 consecutive patients with upper tract urothelial carcinoma without a history of Lynch syndrome were universally screened during followup from January 2013 through July 2016. We evaluated patient and family history using AMS (Amsterdam criteria) I and II, and tumor immunohistochemistry for mismatch repair proteins and microsatellite instability. Patients who were positive for AMS I/II, microsatellite instability or immunohistochemistry were classified as potentially having Lynch syndrome and referred for clinical genetic analysis and counseling. Patients with known Lynch syndrome served as positive controls. Of the 115 patients 16 (13.9%) screened positive for potential Lynch syndrome. Of these patients 7.0% met AMS II criteria, 11.3% had loss of at least 1 mismatch repair protein and 6.0% had high microsatellite instability. All 16 patients were referred for germline testing, 9 completed genetic analysis and counseling, and 6 were confirmed to have Lynch syndrome. All 7 patients with upper tract urothelial carcinoma who had a known history of Lynch syndrome were positive for AMS II criteria and at least a single mismatch repair protein loss while 5 of 6 had high microsatellite instability. We identified 13.9% of upper tract urothelial carcinoma cases as potential Lynch syndrome and 5.2% as confirmed Lynch syndrome at the point of care. These findings have important implications for universal screening of upper tract urothelial carcinoma, representing one of the highest rates of undiagnosed genetic disease in a urological cancer. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Upper respiratory tract infection in children, domestic temperatures, and humidity.

PubMed Central

Ross, A; Collins, M; Sanders, C

1990-01-01

STUDY OBJECTIVE--The aim of the study was to seek for a possible association between the incidence of upper respiratory tract infections and air temperature and humidity in the home. DESIGN--Recordings of temperature and relative humidity were made in living rooms and children's bedrooms over a six month period and related to incidence of upper respiratory tract infection. SETTING--The study was carried out in one general practice of 10,000 patients. PATIENTS--297 children aged 24-59 months were studied, selected in random order from the practice age-sex register. MEASUREMENTS AND MAIN RESULTS--Temperature and humidity recordings were made with thermohygrograph recorders over six days. Upper respiratory tract infections were recorded (a) retrospectively over the previous 12 months, and (b) during the study period. Past history of acute otitis media and recent family history of respiratory infection were also obtained. No significant association was found between the variables, although the bedrooms of children with reported upper respiratory tract infections were cooler overnight than those of non-infected children (mean difference 0.8 degrees C, 95% confidence limits 0.7 degrees C). No association was found between reported or recorded upper respiratory tract infections and age or type of home, family size, level of occupancy, social class, or smoking habits. Only 15 children (5%) were identified by their parents as having had asthma, but 58 (19.5%) had had a "wheezy chest". A greater proportion of children who wheezed slept in cooler bedrooms, had gas fires rather than central heating, and had more smokers in the house. CONCLUSIONS--No association between upper respiratory tract infection and domestic temperature or humidity levels could be shown in this study. Since dampness is repeatedly presented as a health risk, further study is required. PMID:2370503

Stratus 9/VOCALS: Ninth Setting of the Stratus Ocean Reference Station & VOCALS Regional Experiment. Cruise RB-08-06, September 29-December 2, 2008. Leg 1: Charleston-Arica, September 29-November 3, 2008, Leg 2: Arica-Arica, November 9?December 2, 2008

DTIC Science & Technology

2009-04-01

set-up and data download. xi. High-Resolution Pulse-to-Pulse Coherent Doppler Sonars Upper Ocean Turbulence As part of the Stratus (S9) buoy...deployed during the VOCALS 2008 cruise, pulse-to-pulse coherent Doppler sonars were added to the subsurface instrumentation of the buoy for...measurements of the turbulence and mixing within and below the mixed layer. See Table 3-4. The coherent Doppler sonars are Nortek model Aquadopp HR

[Evaluation of upper urinary tract function in patients undergoing autoplastic surgery for hydronphrosis of the intrarenal pelvis].

PubMed

Kurbanaliev, R M; Usupbaev, A Ch; Kolesnichenko, I V; Sadyrbekov, N Zh; Sultanov, B M

2018-05-01

To investigate the functional state of the upper urinary tract in patients undergoing autoplastic surgery for a hydronophrosis of the intrarenal pelvis. The study comprised 78 patients with the intrarenal pelvis and impaired urinary outflow due to stricture of the ureteropelvic junction and vascular conflict (interatrial and arteriovenous narrowing), who underwent pyeloplasty using autologous tunica vaginalis. All patients underwent an incision of ureteropelvic stricture and resection of the parietal layer of the tunica vaginalis which was used to repair the obstruction site and internal stenting of the upper urinary tract. The patients were examined at baseline and during follow-up ranging from 3 months to 3 years. At three months after surgery, there was a decrease in the size of the renal pelvis and calyces with an improvement of all parameters of uro- and hemodynamics. At three years after surgery, the structural and functional parameters of the upper urinary tract were completely restored. Obstructive uropathy, resulting from the intrarenal pelvis, leads to persistently impaired urinary outflow from the upper urinary tract. Surgical intervention is the only curative treatment able to restore the urinary flow. In men with the intrarenal pelvis, the autoplastic surgery of the ureteropelvic junction obstruction using a parietal layer of the tunica vaginalis is an effective surgical modality improving renal pelvis capacity and contributing to the recovery of urinary outflow from the upper urinary tract.

[Conservative management of upper tract urinary fistulae using ureteral trans-vesico-parietal stent].

PubMed

Le Guilchet, T; Audenet, F; Hurel, S; Beaugerie, A; Fontaine, E; Terrier, N; Timsit, M O; Mejean, A

2016-03-01

Ureteral stents and ureteral catheters externalized through the urethra are not ideal solutions to manage complicated upper urinary tract fistulae. We sought an effective method of drainage, minimally invasive, reproducible allowing a rapid patient's discharge. Between November 2013 and February 2015, an ureteral stent was exteriorized in trans-vesico-parietal by an endoscopic and percutaneous access in patients with complicated upper urinary tract fistulae. Monitoring of tolerance, complications and urinary fistula healing was performed. Nine consecutive patients had an ureteral stent exteriorized in trans-vesico-parietal to manage complicated upper urinary tract fistulae. There was no failure in introducing the catheter, or postoperative complication. Catheters were left in place on average 36.1days (24-55). The patients were able to return home with the catheter in place in 77.8% of cases. The tolerance of the catheter was good. All fistulae were able to be treated conservatively at the end of the drainage period. Trans-vesico-parietal ureteral catheters enable efficient and reproducible conservative treatment of upper tract urinary fistulae regardless of their cause. 5. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Unusually high-pitched neonate distress calls of the open-habitat Mongolian gazelle ( Procapra gutturosa) and their anatomical and hormonal predictors

NASA Astrophysics Data System (ADS)

Volodin, Ilya A.; Volodina, Elena V.; Frey, Roland; Kirilyuk, Vadim E.; Naidenko, Sergey V.

2017-06-01

In neonate ruminants, the acoustic structure of vocalizations may depend on sex, vocal anatomy, hormonal profiles and body mass and on environmental factors. In neonate wild-living Mongolian gazelles Procapra gutturosa, hand-captured during biomedical monitoring in the Daurian steppes at the Russian-Mongolian border, we spectrographically analysed distress calls and measured body mass of 22 individuals (6 males, 16 females). For 20 (5 male, 15 female) of these individuals, serum testosterone levels were also analysed. In addition, we measured relevant dimensions of the vocal apparatus (larynx, vocal folds, vocal tract) in one stillborn male Mongolian gazelle specimen. Neonate distress calls of either sex were high in maximum fundamental frequency (800-900 Hz), but the beginning and minimum fundamental frequencies were significantly lower in males than in females. Body mass was larger in males than in females. The levels of serum testosterone were marginally higher in males. No correlations were found between either body mass or serum testosterone values and any acoustic variable for males and females analysed together or separately. We discuss that the high-frequency calls of neonate Mongolian gazelles are more typical for closed-habitat neonate ruminants, whereas other open-habitat neonate ruminants (goitred gazelle Gazella subgutturosa, saiga antelope Saiga tatarica and reindeer Rangifer tarandus) produce low-frequency (<200 Hz) distress calls. Proximate cause for the high fundamental frequency of distress calls of neonate Mongolian gazelles is their very short, atypical vocal folds (4 mm) compared to the 7-mm vocal folds of neonate goitred gazelles, producing distress calls as low as 120 Hz.

Identification of Distinct Layers Within the Stratified Squamous Epithelium of the Adult Human True Vocal Fold

PubMed Central

Dowdall, Jayme R.; Sadow, Peter M.; Hartnick, Christopher; Vinarsky, Vladimir; Mou, Hongmei; Zhao, Rui; Song, Phillip C.; Franco, Ramon A.; Rajagopal, Jayaraj

2016-01-01

Objectives/Hypothesis A precise molecular schema for classifying the different cell types of the normal human vocal fold epithelium is lacking. We hypothesize that the true vocal fold epithelium has a cellular architecture and organization similar to that of other stratified squamous epithelia including the skin, cornea, oral mucosa, and esophagus. In analogy to disorders of the skin and gastrointestinal tract, a molecular definition of the normal cell types within the human vocal fold epithelium and a description of their geometric relationships should serve as a foundation for characterizing cellular changes associated with metaplasia, dysplasia, and cancer. Study Design Qualitative study with adult human larynges. Methods Histologic sections of normal human laryngeal tissue were analyzed for morphology (hematoxylin and eosin) and immunohistochemical protein expression profile, including cytokeratins (CK13 and CK14), cornified envelope proteins (involucrin), basal cells (NGFR/p75), and proliferation markers (Ki67). Results We demonstrated that three distinct cell strata with unique marker profiles are present within the stratified squamous epithelium of the true vocal fold. We used these definitions to establish that cell proliferation is restricted to certain cell types and layers within the epithelium. These distinct cell types are reproducible across five normal adult larynges. Conclusion We have established that three layers of cells are present within the normal adult stratified squamous epithelium of the true vocal fold. Furthermore, replicating cell populations are largely restricted to the parabasal strata within the epithelium. This delineation of distinct cell populations will facilitate future studies of vocal fold regeneration and cancer. Level of Evidence N/A. PMID:25988619

Resonance tube phonation in water: High-speed imaging, electroglottographic and oral pressure observations of vocal fold vibrations--a pilot study.

PubMed

Granqvist, Svante; Simberg, Susanna; Hertegård, Stellan; Holmqvist, Sofia; Larsson, Hans; Lindestad, Per-Åke; Södersten, Maria; Hammarberg, Britta

2015-10-01

Phonation into glass tubes ('resonance tubes'), keeping the free end of the tube in water, has been a frequently used voice therapy method in Finland and more recently also in other countries. The purpose of this exploratory study was to investigate what effects tube phonation with and without water has on the larynx. Two participants were included in the study. The methods used were high-speed imaging, electroglottographic observations of vocal fold vibrations, and measurements of oral pressure during tube phonation. Results showed that the fluctuation in the back pressure during tube phonation in water altered the vocal fold vibrations. In the high-speed imaging, effects were found in the open quotient and amplitude variation of the glottal opening. The open quotient increased with increasing water depth (from 2 cm to 6 cm). A modulation effect by the water bubbles on the vocal fold vibrations was seen both in the high-speed glottal area tracings and in the electroglottography signal. A second experiment revealed that the increased average oral pressure was largely determined by the water depth. The increased open quotient can possibly be explained by an increased abduction of the vocal folds and/or a reduced transglottal pressure. The back pressure of the bubbles also modulates glottal vibrations with a possible 'massage' effect on the vocal folds. This effect and the well-defined average pressure increase due to the known water depth are different from those of other methods using a semi-occluded vocal tract.

Identification of distinct layers within the stratified squamous epithelium of the adult human true vocal fold.

PubMed

Dowdall, Jayme R; Sadow, Peter M; Hartnick, Christopher; Vinarsky, Vladimir; Mou, Hongmei; Zhao, Rui; Song, Phillip C; Franco, Ramon A; Rajagopal, Jayaraj

2015-09-01

A precise molecular schema for classifying the different cell types of the normal human vocal fold epithelium is lacking. We hypothesize that the true vocal fold epithelium has a cellular architecture and organization similar to that of other stratified squamous epithelia including the skin, cornea, oral mucosa, and esophagus. In analogy to disorders of the skin and gastrointestinal tract, a molecular definition of the normal cell types within the human vocal fold epithelium and a description of their geometric relationships should serve as a foundation for characterizing cellular changes associated with metaplasia, dysplasia, and cancer. Qualitative study with adult human larynges. Histologic sections of normal human laryngeal tissue were analyzed for morphology (hematoxylin and eosin) and immunohistochemical protein expression profile, including cytokeratins (CK13 and CK14), cornified envelope proteins (involucrin), basal cells (NGFR/p75), and proliferation markers (Ki67). We demonstrated that three distinct cell strata with unique marker profiles are present within the stratified squamous epithelium of the true vocal fold. We used these definitions to establish that cell proliferation is restricted to certain cell types and layers within the epithelium. These distinct cell types are reproducible across five normal adult larynges. We have established that three layers of cells are present within the normal adult stratified squamous epithelium of the true vocal fold. Furthermore, replicating cell populations are largely restricted to the parabasal strata within the epithelium. This delineation of distinct cell populations will facilitate future studies of vocal fold regeneration and cancer. N/A. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Concordance of Two Endoscopic Procedures for Diagnosis of Carcinoma of the Upper Aerodigestive Tract

ClinicalTrials.gov

2014-08-15

Upper Aerodigestive Tract Lesions; Neoplasms, Oropharyngeal; Oropharyngeal Cancer; Neoplasms, Hypopharyngeal; Hypopharyngeal Cancer; Head and Neck Neoplasms; UADT Neoplasms; Carcinoma, Squamous Cell; Papilloma

Experience of curing serious obstruction of advanced-stage upper digestive tract tumor using laser under endoscope

NASA Astrophysics Data System (ADS)

Mu, Hai-Bin; Zhang, Man-Ling; Zhang, Xiao-Qiang; Zhang, Feng-Qiu; Kong, De-Jia; Tang, Li-Bin

1998-11-01

The patients who suffer from upper digestive tract tumor, such as cancer of esophagus, cancer of cardia, all have serious obstruction and fail to get nutrition and can not bear the strike of the radiotherapy and chemotherapy. In order to reduce the obstruction symptom and suffering of the patients and to prolong their life time, since 1989, our hospital used the laser to cure the upper digestive tract tumor 11 cases with serious obstruction and got remarkable curative effect.

Upper respiratory tract (image)

MedlinePlus

The major passages and structures of the upper respiratory tract include the nose or nostrils, nasal cavity, mouth, throat (pharynx), and voice box (larynx). The respiratory system is lined with a mucous membrane that ...

Rehabilitation of a patient with complete mandibulectomy and partial glossectomy.

PubMed

Meyerson, M D; Johnson, B H; Weitzman, R S

1980-05-01

Following a number of radiologic and surgical procedures for the treatment of oral cancer, a patient with severe facial disfigurement and alteration of the vocal tract acquired acceptable speech. Consultation among referring physicians and speech pathologists can aid such a patient by facilitating the rehabilitative process through improvement of communicative skills.

Tissue-Point Motion Tracking in the Tongue from Cine MRI and Tagged MRI

ERIC Educational Resources Information Center

Woo, Jonghye; Stone, Maureen; Suo, Yuanming; Murano, Emi Z.; Prince, Jerry L.

2014-01-01

Purpose: Accurate tissue motion tracking within the tongue can help professionals diagnose and treat vocal tract--related disorders, evaluate speech quality before and after surgery, and conduct various scientific studies. The authors compared tissue tracking results from 4 widely used deformable registration (DR) methods applied to cine magnetic…

The interaction of glottal-pulse rate and vocal-tract length in judgements of speaker size, sex, and age

NASA Astrophysics Data System (ADS)

Smith, David R. R.; Patterson, Roy D.

2005-11-01

Glottal-pulse rate (GPR) and vocal-tract length (VTL) are related to the size, sex, and age of the speaker but it is not clear how the two factors combine to influence our perception of speaker size, sex, and age. This paper describes experiments designed to measure the effect of the interaction of GPR and VTL upon judgements of speaker size, sex, and age. Vowels were scaled to represent people with a wide range of GPRs and VTLs, including many well beyond the normal range of the population, and listeners were asked to judge the size and sex/age of the speaker. The judgements of speaker size show that VTL has a strong influence upon perceived speaker size. The results for the sex and age categorization (man, woman, boy, or girl) show that, for vowels with GPR and VTL values in the normal range, judgements of speaker sex and age are influenced about equally by GPR and VTL. For vowels with abnormal combinations of low GPRs and short VTLs, the VTL information appears to decide the sex/age judgement.

Comparison of Magnetic Resonance Imaging-based vocal tract area functions obtained from the same speaker in 1994 and 2002

PubMed Central

Story, Brad H.

2008-01-01

A new set of area functions for vowels has been obtained with Magnetic Resonance Imaging (MRI) from the same speaker as that previously reported in 1996 [Story, Titze, & Hoffman, JASA, 100, 537–554 (1996)]. The new area functions were derived from image data collected in 2002, whereas the previously reported area functions were based on MR images obtained in 1994. When compared, the new area function sets indicated a tendency toward a constricted pharyngeal region and expanded oral cavity relative to the previous set. Based on calculated formant frequencies and sensitivity functions, these morphological differences were shown to have the primary acoustic effect of systematically shifting the second formant (F2) downward in frequency. Multiple instances of target vocal tract shapes from a specific speaker provide additional sampling of the possible area functions that may be produced during speech production. This may be of benefit for understanding intra-speaker variability in vowel production and for further development of speech synthesizers and speech models that utilize area function information. PMID:18177162

Major depressive disorder discrimination using vocal acoustic features.

PubMed

Taguchi, Takaya; Tachikawa, Hirokazu; Nemoto, Kiyotaka; Suzuki, Masayuki; Nagano, Toru; Tachibana, Ryuki; Nishimura, Masafumi; Arai, Tetsuaki

2018-01-01

The voice carries various information produced by vibrations of the vocal cords and the vocal tract. Though many studies have reported a relationship between vocal acoustic features and depression, including mel-frequency cepstrum coefficients (MFCCs) which applied to speech recognition, there have been few studies in which acoustic features allowed discrimination of patients with depressive disorder. Vocal acoustic features as biomarker of depression could make differential diagnosis of patients with depressive state. In order to achieve differential diagnosis of depression, in this preliminary study, we examined whether vocal acoustic features could allow discrimination between depressive patients and healthy controls. Subjects were 36 patients who met the criteria for major depressive disorder and 36 healthy controls with no current or past psychiatric disorders. Voices of reading out digits before and after verbal fluency task were recorded. Voices were analyzed using OpenSMILE. The extracted acoustic features, including MFCCs, were used for group comparison and discriminant analysis between patients and controls. The second dimension of MFCC (MFCC 2) was significantly different between groups and allowed the discrimination between patients and controls with a sensitivity of 77.8% and a specificity of 86.1%. The difference in MFCC 2 between the two groups reflected an energy difference of frequency around 2000-3000Hz. The MFCC 2 was significantly different between depressive patients and controls. This feature could be a useful biomarker to detect major depressive disorder. Sample size was relatively small. Psychotropics could have a confounding effect on voice. Copyright © 2017 Elsevier B.V. All rights reserved.

Voice Handicap Index and Interpretation of the Cutoff Points Using Receiver Operating Characteristic Curve as Screening for Young Adult Female Smokers.

PubMed

Tafiadis, Dionysios; Kosma, Evangelia I; Chronopoulos, Spyridon K; Papadopoulos, Aggelos; Drosos, Konstantinos; Siafaka, Vassiliki; Toki, Eugenia I; Ziavra, Nausica

2018-01-01

The relationship between smoking and alterations of the vocal tract and larynx is well known. This pathology leads to the degradation of voice performance in daily living. Multiple assessment methods of vocal tract and larynx have been developed, and in recent years they were enriched with self-reported questionnaires such as Voice Handicap Index (VHI). This study determined the cutoff points of VHI's total score and its three domains for young female smokers in Greece. These estimated cutoff points could be used by voice specialists as an indicator for further clinical evaluation (foreseeing a potential risk of developing a vocal symptom because of smoking habits). A sample of 120 female nondysphonic smokers (aged 18-31) was recruited. Participants filled out the VHI and Voice Evaluation Form. VHI's cutoff point of total score was calculated at the value of 19.50 (sensitivity: 0.780, 1-specificity: 0.133). Specifically, the construct domain of functional was 7.50 (sensitivity: 0.900, 1-specificity: 0.217), for physical it was 8.50 (sensitivity: 0.867, 1-specificity: 0.483), and for emotional it was 7.50 (sensitivity: 0.833, 1-specificity: 0.200) through the use of receiver operating characteristic. Furthermore, VHI could be used as a monitoring tool for smokers and as a feedback for smoking cessation. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Two parametric voice source models and their asymptotic analysis

NASA Astrophysics Data System (ADS)

Leonov, A. S.; Sorokin, V. N.

2014-05-01

The paper studies the asymptotic behavior of the function for the area of the glottis near moments of its opening and closing for two mathematical voice source models. It is shown that in the first model, the asymptotics of the area function obeys a power law with an exponent of no less that 1. Detailed analysis makes it possible to refine these limits depending on the relative sizes of the intervals of a closed and open glottis. This work also studies another parametric model of the area of the glottis, which is based on a simplified physical-geometrical representation of vocal-fold vibration processes. This is a special variant of the well-known two-mass model and contains five parameters: the period of the main tone, equivalent masses on the lower and upper edge of vocal folds, the coefficient of elastic resistance of the lower vocal fold, and the delay time between openings of the upper and lower folds. It is established that the asymptotics of the obtained function for the area of the glottis obey a power law with an exponent of 1 both for opening and closing.

Vocal Function and Upper Airway Thermoregulation in Five Different Environmental Conditions

ERIC Educational Resources Information Center

Sandage, Mary J.; Connor, Nadine P.; Pascoe, David D.

2014-01-01

Purpose: Phonation threshold pressure and perceived phonatory effort were hypothesized to increase and upper airway temperature to decrease following exposure to cold and/or dry air. Greater changes were expected with mouth versus nose breathing. Method: In a within-participant repeated measures design, 15 consented participants (7 men, 8 women)…

The Vocal Tract Discomfort Scale: Validity and Reliability of the Persian Version in the Assessment of Patients With Muscle Tension Dysphonia.

PubMed

Torabi, Hadi; Khoddami, Seyyedeh Maryam; Ansari, Noureddin Nakhostin; Dabirmoghaddam, Payman

2016-11-01

To cross-culturally adapt of Persian Vocal Tract Discomfort (VTDp) scale and evaluate its validity and reliability in the assessment of patients with muscle tension dysphonia (MTD). A cross-sectional and prospective cohort design was used to psychometrically test the VTDp. The VTD scale was cross-culturally adapted into Persian language following standard forward-backward translations. The VTDp scale was administrated to 100 patients with MTD (54 men and 46 women; mean age: 38.05 ± 10.02 years) and 50 healthy volunteers (26 men and 24 women; mean age: 36.50 ± 12.27 years). Forty-five patients with MTD completed the VTDp 7 days later for test-retest reliability. Patients also completed the Persian Voice Handicap Index (VHIp) to assess construct validity. The results of discriminative validity demonstrated that the VTDp was able to discriminate between patients with MTD and healthy participants. The internal consistency was confirmed with Cronbach α .77 and 0.73 for VTDp frequency and severity subscales, respectively. The test-retest reliability was excellent with an intraclass correlation coefficient (ICC agreement ) of 0.93 for the frequency subscale and 0.91 for the severity subscale. Construct validity of the VTDp was shown with significant correlations between the VTDp frequency and severity subscales and the VHIp total scores (0.36 and 0.37, respectively). The standard error of measurement and smallest detectable change values for VTDp frequency (2.11 and 5.85, respectively) and severity (2.25 and 6.23, respectively) were acceptable. The Bland-Altman analysis for assessing the agreement between test and retest measurements showed no systematic bias. The VTDp is a valid and reliable self-administered scale to measure patient's vocal tract sensations in Persian-speaking population. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

A Joyful Noise: The Vocal Health of Worship Leaders and Contemporary Christian Singers.

PubMed

Neto, Leon; Meyer, David

2017-03-01

Contemporary commercial music (CCM) is a term that encompasses many styles of music. A growing subset of CCM is contemporary Christian music, a genre that has outpaced other popular styles such as Latin, jazz, and classical music. Contemporary Christian singers (CCSs) and worship leaders (WLs) are a subset of CCM musicians that face unique vocal demands and risks. They typically lack professional training and often perform in acoustically disadvantageous venues with substandard sound reinforcement systems. The vocal needs and risks of these singers are not well understood, and because of this, their training and care may be suboptimal. The aim of the present study was to investigate the vocal health of this growing population and their awareness of standard vocal hygiene principles. An online questionnaire was designed and administered to participants in the Americas, Europe, Australia, and Asia. A total of 614 participants responded to the questionnaire, which is made available in English, Portuguese, and Spanish. Many participants reported vocal symptoms such as vocal fatigue (n = 213; 34.7%), tickling or choking sensation (n = 149; 24.3%), loss of upper range (n = 172; 28%), and complete loss of voice (n = 25; 4.1%). One third of the participants (n = 210; 34%) indicated that they do not warm up their voices before performances and over half of the participants (n = 319; 52%) have no formal vocal training. Results suggest that this population demonstrates low awareness of vocal hygiene principles, frequently experience difficulty with their voices, and may face elevated risk of vocal pathology. Future studies of this population may confirm the vocal risks that our preliminary findings suggest. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Vocal cord dysfunction related to water-damaged buildings.

PubMed

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

2013-01-01

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

[Analysis for related factors of upper urinary tract deterioration in patients with spinal cord injury].

PubMed

Jing, Hua-fang; Liao, Li-min; Fu, Guang; Wu, Juan; Ju, Yan-he; Chen, Guo-qing

2014-08-18

To evaluate the related factors of upper urinary tract deterioration in spinal cord injured patients. Medical records of spinal cord injured patients from Jan.2002 to Sep.2009 were retrospectively reviewed. All the patients were divided into the upper urinary tract deterioration group and non-deterioration group according to the diagnostic criteria. Indexes such as demographic characteristic (gender, age), spinal cord injury information (cause, level, completeness), statuses of urinary tract system (bladder management, urine routine, urine culture, ultrasound, serum creatinine, fever caused by urinary tract infection) and urodynamics information(bladder compliance, bladder stability, bladder sensation, detrusor sphincter dyssynergia, detrusor leak point pressure, maximum cystometric capacity, relative safe bladder capacity, maximum flow rate, maximum urethra closure pressure) were compared between the two groups.Then Logistic regression analysis were performed. There was significantly difference between the two groups in spinal cord injury level(χ(2) = 8.840, P = 0.031),bladder management(χ(2) = 11.362, P = 0.045), urinary rutine(χ(2) = 17.983, P = 0.000), fever caused by urinary tract infection(χ(2)= 64.472, P = 0.000), bladder compliance(χ(2) = 6.531, P = 0.011), bladder sensation(χ(2) = 11.505, P = 0.009), maximum cystometric capacity(t = 2.209, P = 0.043), and detrusor-sphincter dyssynergia(χ(2) = 4.247, P = 0.039). The multiple-factor non-conditional Logistic regression analysis showed that bladder management (OR = 1.114, P = 0.006), fever caused by urinary tract infection(OR = 1.018,P = 0.000), bladder compliance (OR = 1.588, P = 0.040) and detrusor-sphincter dyssynergia(OR = 1.023, P = 0.034) were the key factors of upper urinary tract deterioration in spinal cord injured patients. Urinary tract infection, lower bladder compliance, detrusor-sphincter dyssynergia and unreasonable bladder management are the risk factors of upper urinary tract deterioration in spinal cord injured patients.

Stenting of the Upper Gastrointestinal Tract: Current Status

DOE Office of Scientific and Technical Information (OSTI.GOV)

Katsanos, Konstantinos; Sabharwal, Tarun, E-mail: tarun.sabharwal@gstt.nhs.uk; Adam, Andreas

2010-08-15

Minimally invasive image-guided insertion of self-expanding metal stents in the upper gastrointestinal tract is the current treatment of choice for palliation of malignant esophageal or gastroduodenal outlet obstructions. A concise review is presented of contemporary stenting practice of the upper gastrointestinal tract, and the procedures in terms of appropriate patient evaluation, indications, and contraindications for treatment are analyzed, along with available stent designs, procedural steps, clinical outcomes, inadvertent complications, and future technology. Latest developments include biodegradable polymeric stents for benign disease and radioactive or drug-eluting stents for malignant obstructions.

Developmental pattern of diacylglycerol lipase-α (DAGLα) immunoreactivity in brain regions important for song learning and control in the zebra finch (Taeniopygia guttata).

PubMed

Soderstrom, Ken; Wilson, Ashley R

2013-11-01

Zebra finch song is a learned behavior dependent upon successful progress through a sensitive period of late-postnatal development. This learning is associated with maturation of distinct brain nuclei and the fiber tract interconnections between them. We have previously found remarkably distinct and dense CB1 cannabinoid receptor expression within many of these song control brain regions, implying a normal role for endocannabinoid signaling in vocal learning. Activation of CB1 receptors via daily treatments with exogenous agonist during sensorimotor stages of song learning (but not in adulthood) results in persistent alteration of song patterns. Now we are working to understand physiological changes responsible for this cannabinoid-altered vocal learning. We have found that song-altering developmental treatments are associated with changes in expression of endocannabinoid signaling elements, including CB1 receptors and the principal CNS endogenous agonist, 2-AG. Within CNS, 2-AG is produced largely through activity of the α isoform of the enzyme diacylglycerol lipase (DAGLα). To better appreciate the role of 2-AG production in normal vocal development we have determined the spatial distribution of DAGLα expression within zebra finch CNS during vocal development. Early during vocal development at 25 days, DAGLα staining is typically light and of fibroid processes. Staining peaks late in the sensorimotor stage of song learning at 75 days and is characterized by fiber, neuropil and some staining of both small and large cell somata. Results provide insight to the normal role for endocannabinoid signaling in the maturation of brain regions responsible for song learning and vocal-motor output, and suggest mechanisms by which exogenous cannabinoid exposure alters acquisition of this form of vocal communication. Copyright © 2013 Elsevier B.V. All rights reserved.

An experimental investigation of velocity fields in divergent glottal models of the human vocal tract

NASA Astrophysics Data System (ADS)

Erath, Byron D.; Plesniak, Michael W.

2005-09-01

In speech, sound production arises from fluid-structure interactions within the larynx as well as viscous flow phenomena that is most likely to occur during the divergent orientation of the vocal folds. Of particular interest are the flow mechanisms that influence the location of flow separation points on the vocal folds walls. Physiologically scaled pulsatile flow fields in 7.5 times real size static divergent glottal models were investigated. Three divergence angles were investigated using phase-averaged particle image velocimetry (PIV). The pulsatile glottal jet exhibited a bi-modal stability toward both glottal walls, although there was a significant amount of variance in the angle the jet deflected from the midline. The attachment of the Coanda effect to the glottal model walls occurred when the pulsatile velocity was a maximum, and the acceleration of the waveform was zero. The location of the separation and reattachment points of the flow from the glottal models was a function of the velocity waveform and divergence angle. Acoustic analogies show that a dipole sound source contribution arising from the fluid interaction (Coanda jet) with the vocal fold walls is expected. [Work funded by NIH Grant RO1 DC03577.

Vocal training in an anthropometrical aspect.

PubMed

Wyganowska-Świątkowska, Marzena; Kowalkowska, Iwona; Flicińska-Pamfil, Grażyna; Dąbrowski, Mikołaj; Kopczyński, Przemysław; Wiskirska-Woźnica, Bożena

2017-12-01

As shown in our previous paper, the dimensions of the cerebral parts of the cranium and face of the vocal students were higher than those of the non-singing students. The aim of the present study was to analyse the type of voice and its development depending on selected dimensions. A total of 56 vocal students - 36 women and 20 men - who underwent anthropometric measurements were divided into groups according to their voice type. Two professors of singing made a subjective, independent evaluation of individual students' vocal development progress during the four years of training. The findings were analysed statistically with the current licensed versions of Statistica software. We found statistically significant positive correlation between: the head length, head and face width, depth of upper and middle face, nose length and student's voice development. The dimensions of the head and the face have no impact on type of voice; however, some anatomical characteristics may have impact on voice development.

Human Language Technology: Opportunities and Challenges

DTIC Science & Technology

2005-01-01

because of the connections to and reliance on signal processing. Audio diarization critically includes indexing of speakers [12], since speaker ...to reduce inter- speaker variability in training. Standard techniques include vocal-tract length normalization, adaptation of acoustic models using...maximum likelihood linear regression (MLLR), and speaker -adaptive training based on MLLR. The acoustic models are mixtures of Gaussians, typically with

Analysis of 3-D Tongue Motion from Tagged and Cine Magnetic Resonance Images

ERIC Educational Resources Information Center

Xing, Fangxu; Woo, Jonghye; Lee, Junghoon; Murano, Emi Z.; Stone, Maureen; Prince, Jerry L.

2016-01-01

Purpose: Measuring tongue deformation and internal muscle motion during speech has been a challenging task because the tongue deforms in 3 dimensions, contains interdigitated muscles, and is largely hidden within the vocal tract. In this article, a new method is proposed to analyze tagged and cine magnetic resonance images of the tongue during…

Vowel Acoustic Space Development in Children: A Synthesis of Acoustic and Anatomic Data

ERIC Educational Resources Information Center

Vorperian, Houri K.; Kent, Ray D.

2007-01-01

Purpose: This article integrates published acoustic data on the development of vowel production. Age specific data on formant frequencies are considered in the light of information on the development of the vocal tract (VT) to create an anatomic-acoustic description of the maturation of the vowel acoustic space for English. Method: Literature…

Analysis of a Digital Technique for Frequency Transposition of Speech.

DTIC Science & Technology

1985-09-01

scaled excitation function drives the vocal tract model. In a phone interview with James Kaiser of Bell Laboratories, he mentioned that current thinking...is processed using the Fast Fourier Transform (FFT) and then low pass filtered if desired. mAbe (Pb) FFT LPF- nih ~a s5ee.. S. 4Nrf#Nr Flow Chart for

Study of Airflow Out of the Mouth During Speech.

ERIC Educational Resources Information Center

Catford, J.C.; And Others

Airflow outside the mouth is diagnostic of articulatory activities in the vocal tract, both total volume-velocity and the distribution of particle velocities over the flow-front being useful for this purpose. A system for recording and displaying both these types of information is described. This consists of a matrix of l6 hot-wire anemometer flow…

Characteristics of the Lax Vowel Space in Dysarthria

ERIC Educational Resources Information Center

Tjaden, Kris; Rivera, Deanna; Wilding, Gregory; Turner, Greg S.

2005-01-01

It has been hypothesized that lax vowels may be relatively unaffected by dysarthria, owing to the reduced vocal tract shapes required for these phonetic events (G. S. Turner, K. Tjaden, & G. Weismer, 1995). It also has been suggested that lax vowels may be especially susceptible to speech mode effects (M. A. Picheny, N. I. Durlach, & L. D. Braida,…

[Analysis of development, safety and efficacy of percutaneous nephrolithotomy for management of upper urinary tract calculi in pediatric patients].

PubMed

Yu, L P; Xu, T

2017-08-18

To evaluate the development, safety and efficacy of percutaneous nephrolithotomy(PNL) for management of upper urinary tract calculi in pediatric patients. In the study, 77 pediatric patients undergoing 87 PNLs through mini or standard tract for upper urinary tract calculi between January 2005 and December 2016 in Peking University People's hospital were reviewed, including 69 renal calculi, 6 upper ureteral calculi, 12 renal and upper ureteral calculi, 35 single calculi, 43 multiple calculi and 9 staghorn calculi. The development and efficacy of PNL in pediatric patients were studied by analyzing the characteristics and clinical indexes, and by reviewing the associated literature. The Clavien classification system was used to evaluate the complications after PNL. A total of 87 PNLs were performed in 77 pediatric patients. Eighty-one upper urinary tract calculi were managed through a single tract(93.1%), 5 pediatric patients were managed through 2 tracts(5.7%), and 1 pediatric patient was managed through 3 tracts(1.2%). The mean operating time was (77.0±29.8) min. The stone-free rate after one session was 100% for single calculi and 71.2% for multiple or staghorn calculi, 5(5.8%) children underwent auxiliary procedure to remove the residual calculi and the final stone-free rate of PNL was 88.5%. One of the main complications of pediatric PNL was fever. Sixteen (18.4%) had moderate fever(38-39 °C), 5 (5.7%) had high fever (39-40 °C) and there were no severe complications of infection, such as sepsis or septic shock. The mean hemoglobin loss was (10.3±16.1) g/L and the serum creatinine rise was (7.0±13.3) μmol/L. One(1.2%) pediatric patient suffered ureteroscopic lithotripsy because of the obstruction by the residual stone in ureter. No injury of organs or retroperitoneal urinary extravasation occurred. General assessment of the complications showed Clavien grade I complications in 14 (16.1%) pediatric patients, grade II in 7(8.0%) children and grade III in 1(1.2%) children. There was no grade IV or V complications. The overall complication rate was 25.3%. PNL for management of upper urinary tract calculi in pediatric patients is effective. Complications after PNL, as assessed with Clavien classification system, are mild and PNL in pediatric patients is safe.

Quantitative Study for the Surface Dehydration of Vocal Folds Based on High-Speed Imaging.

PubMed

Li, Lin; Zhang, Yu; Maytag, Allison L; Jiang, Jack J

2015-07-01

From the perspective of the glottal area and mucosal wave, quantitatively estimate the differences of vocal fold on laryngeal activity during phonation at three different dehydration levels. Controlled three sets of tests. A dehydration experiment for 10 excised canine larynges was conducted at 16 cm H2O. According to the dehydration cycle time (H), dehydration levels were divided into three degrees (0% H, 50% H, 75% H). The glottal area and mucosal wave under three dehydration levels were extracted from high-speed images and digital videokymography (DKG) image sequences. Direct and non-direct amplitude components were derived from glottal areas. The amplitude and frequency of mucosal wave were calculated from DKG image sequences. These parameters in condition of three dehydration levels were compared for statistical analysis. The results showed a significant difference in direct (P = 0.001; P = 0.005) and non-direct (P = 0.005; P = 0.016) components of glottal areas between every two different dehydration levels. Considering the right-upper, right-lower, left-upper, and left-lower of vocal fold, the amplitudes of mucosal waves consistently decreased with increasing of dehydration levels. But, there was no significant difference in frequency. Surface dehydration could give rise to complex variation of vocal fold on tissues and vibratory mechanism, which should need analyzing from multiple perspectives. The results suggested that the combination of glottal area and mucosal wave could be better to research the change of vocal fold at different dehydrations. It would become a better crucial research tool for the clinical treatment of dehydration-induced laryngeal pathologies. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

In Vivo and Ex Vivo Imaging Reveals a Long-Lasting Chlamydial Infection in the Mouse Gastrointestinal Tract following Genital Tract Inoculation

PubMed Central

Zhang, Qi; Huang, Yumeng; Gong, Siqi; Yang, Zhangsheng; Sun, Xin; Schenken, Robert

2015-01-01

Intravaginal infection with Chlamydia muridarum in mice can ascend to the upper genital tract, resulting in hydrosalpinx, a pathological hallmark for tubal infertility in women infected with C. trachomatis. Here, we utilized in vivo imaging of C. muridarum infection in mice following an intravaginal inoculation and confirmed the rapid ascent of the chlamydial organisms from the lower to upper genital tracts. Unexpectedly, the C. muridarum-derived signal was still detectable in the abdominal area 100 days after inoculation. Ex vivo imaging of the mouse organs revealed that the long-lasting presence of the chlamydial signal was restricted to the gastrointestinal (GI) tract, which was validated by directly measuring the chlamydial live organisms and genomes in the same organs. The C. muridarum organisms spreading from the genital to the GI tracts were detected in different mouse strains and appeared to be independent of oral or rectal routes. Mice prevented from orally taking up excretions also developed the long-lasting GI tract infection. Inoculation of C. muridarum directly into the upper genital tract, which resulted in a delayed vaginal shedding of live organisms, accelerated the chlamydial spreading to the GI tract. Thus, we have demonstrated that the genital tract chlamydial organisms may use a systemic route to spread to and establish a long-lasting infection in the GI tract. The significance of the chlamydial spreading from the genital to GI tracts is discussed. PMID:26099591

Vocal function and upper airway thermoregulation in five different environmental conditions.

PubMed

Sandage, Mary J; Connor, Nadine P; Pascoe, David D

2014-02-01

Phonation threshold pressure and perceived phonatory effort were hypothesized to increase and upper airway temperature to decrease following exposure to cold and/or dry air. Greater changes were expected with mouth versus nose breathing. In a within-participant repeated measures design, 15 consented participants (7 men, 8 women) completed 20-min duration trials to allow for adequate thermal equilibration for both nose and mouth breathing in 5 different environments: 3 temperatures (°C) matched for relative humidity (% RH), cold (15 °C, 40% RH), thermally neutral (25 °C, 40% RH), and hot (35 °C, 40% RH); and 2 temperatures with variable relative humidity to match vapor pressure for the neutral environment (25 °C, 40% RH), cold (15 °C, 74% RH) and hot (35 °C, 23% RH). Following each equilibration trial, measures were taken in this order: upper airway temperature (transnasal thermistor probe), phonation threshold pressure, and perceived phonatory effort. Data were analyzed using repeated measures analysis of variance, and no significant differences were established. The study hypotheses were not supported. Findings suggest that the upper airway is tightly regulated for temperature when challenged by a realistic range of temperature and relative humidity environments. This is the first study of its kind to include measurement of upper airway temperature in conjunction with measures of vocal function.

[The response of the upper respiratory tract to the impact of atmospheric pollution].

PubMed

Mukhamadiev, R A; Ismagilov, Sh M

2015-01-01

The present literature review characterizes the environmental conditions in the Russian Federation in general and the Republic of Tatarstan in particular with special reference to the influence of atmospheric pollution on the development and the clinical picture of the diseases of the respiratory organs including pathology of the upper respiratory tract in the populations of the industrial centres and other environmentally unfriendly areas. The views of the domestic and foreign authors concerning the role of the environmental factors in the clinical picture of the upper respiratory tract disorders are described in detail. The authors emphasize the necessity of the further investigationsinto this problem and the development of the methods for the prevention of diseases of the upper respiratory react.

Effect of High-Dose vs Standard-Dose Wintertime Vitamin D Supplementation on Viral Upper Respiratory Tract Infections in Young Healthy Children

PubMed Central

Aglipay, Mary; Birken, Catherine S.; Parkin, Patricia C.; Loeb, Mark B.; Thorpe, Kevin; Chen, Yang; Laupacis, Andreas; Mamdani, Muhammad; Macarthur, Colin; Hoch, Jeffrey S.; Mazzulli, Tony

2017-01-01

Importance Epidemiological studies support a link between low 25-hydroxyvitamin D levels and a higher risk of viral upper respiratory tract infections. However, whether winter supplementation of vitamin D reduces the risk among children is unknown. Objective To determine whether high-dose vs standard-dose vitamin D supplementation reduces the incidence of wintertime upper respiratory tract infections in young children. Design, Setting, and Participants A randomized clinical trial was conducted during the winter months between September 13, 2011, and June 30, 2015, among children aged 1 through 5 years enrolled in TARGet Kids!, a multisite primary care practice–based research network in Toronto, Ontario, Canada. Interventions Three hundred forty-nine participants were randomized to receive 2000 IU/d of vitamin D oral supplementation (high-dose group) vs 354 participants who were randomized to receive 400 IU/d (standard-dose group) for a minimum of 4 months between September and May. Main Outcome Measures The primary outcome was the number of laboratory-confirmed viral upper respiratory tract infections based on parent-collected nasal swabs over the winter months. Secondary outcomes included the number of influenza infections, noninfluenza infections, parent-reported upper respiratory tract illnesses, time to first upper respiratory tract infection, and serum 25-hydroxyvitamin D levels at study termination. Results Among 703 participants who were randomized (mean age, 2.7 years, 57.7% boys), 699 (99.4%) completed the trial. The mean number of laboratory-confirmed upper respiratory tract infections per child was 1.05 (95% CI, 0.91-1.19) for the high-dose group and 1.03 (95% CI, 0.90-1.16) for the standard-dose group, for a between-group difference of 0.02 (95% CI, −0.17 to 0.21) per child. There was no statistically significant difference in number of laboratory-confirmed infections between groups (incidence rate ratio [RR], 0.97; 95% CI, 0.80-1.16). There was also no significant difference in the median time to the first laboratory-confirmed infection: 3.95 months (95% CI, 3.02-5.95 months) for the high-dose group vs 3.29 months (95% CI, 2.66-4.14 months) for the standard-dose group, or number of parent-reported upper respiratory tract illnesses between groups (625 for high-dose vs 600 for standard-dose groups, incidence RR, 1.01; 95% CI, 0.88-1.16). At study termination, serum 25-hydroxyvitamin D levels were 48.7 ng/mL (95% CI, 46.9-50.5 ng/mL) in the high-dose group and 36.8 ng/mL (95% CI, 35.4-38.2 ng/mL) in the standard-dose group. Conclusions and Relevance Among healthy children aged 1 to 5 years, daily administration of 2000 IU compared with 400 IU of vitamin D supplementation did not reduce overall wintertime upper respiratory tract infections. These findings do not support the routine use of high-dose vitamin D supplementation in children for the prevention of viral upper respiratory tract infections. Trial Registration clinicaltrials.gov Identifier: NCT01419262 PMID:28719693

Effect of High-Dose vs Standard-Dose Wintertime Vitamin D Supplementation on Viral Upper Respiratory Tract Infections in Young Healthy Children.

PubMed

Aglipay, Mary; Birken, Catherine S; Parkin, Patricia C; Loeb, Mark B; Thorpe, Kevin; Chen, Yang; Laupacis, Andreas; Mamdani, Muhammad; Macarthur, Colin; Hoch, Jeffrey S; Mazzulli, Tony; Maguire, Jonathon L

2017-07-18

Epidemiological studies support a link between low 25-hydroxyvitamin D levels and a higher risk of viral upper respiratory tract infections. However, whether winter supplementation of vitamin D reduces the risk among children is unknown. To determine whether high-dose vs standard-dose vitamin D supplementation reduces the incidence of wintertime upper respiratory tract infections in young children. A randomized clinical trial was conducted during the winter months between September 13, 2011, and June 30, 2015, among children aged 1 through 5 years enrolled in TARGet Kids!, a multisite primary care practice-based research network in Toronto, Ontario, Canada. Three hundred forty-nine participants were randomized to receive 2000 IU/d of vitamin D oral supplementation (high-dose group) vs 354 participants who were randomized to receive 400 IU/d (standard-dose group) for a minimum of 4 months between September and May. The primary outcome was the number of laboratory-confirmed viral upper respiratory tract infections based on parent-collected nasal swabs over the winter months. Secondary outcomes included the number of influenza infections, noninfluenza infections, parent-reported upper respiratory tract illnesses, time to first upper respiratory tract infection, and serum 25-hydroxyvitamin D levels at study termination. Among 703 participants who were randomized (mean age, 2.7 years, 57.7% boys), 699 (99.4%) completed the trial. The mean number of laboratory-confirmed upper respiratory tract infections per child was 1.05 (95% CI, 0.91-1.19) for the high-dose group and 1.03 (95% CI, 0.90-1.16) for the standard-dose group, for a between-group difference of 0.02 (95% CI, -0.17 to 0.21) per child. There was no statistically significant difference in number of laboratory-confirmed infections between groups (incidence rate ratio [RR], 0.97; 95% CI, 0.80-1.16). There was also no significant difference in the median time to the first laboratory-confirmed infection: 3.95 months (95% CI, 3.02-5.95 months) for the high-dose group vs 3.29 months (95% CI, 2.66-4.14 months) for the standard-dose group, or number of parent-reported upper respiratory tract illnesses between groups (625 for high-dose vs 600 for standard-dose groups, incidence RR, 1.01; 95% CI, 0.88-1.16). At study termination, serum 25-hydroxyvitamin D levels were 48.7 ng/mL (95% CI, 46.9-50.5 ng/mL) in the high-dose group and 36.8 ng/mL (95% CI, 35.4-38.2 ng/mL) in the standard-dose group. Among healthy children aged 1 to 5 years, daily administration of 2000 IU compared with 400 IU of vitamin D supplementation did not reduce overall wintertime upper respiratory tract infections. These findings do not support the routine use of high-dose vitamin D supplementation in children for the prevention of viral upper respiratory tract infections. clinicaltrials.gov Identifier: NCT01419262.

Can we improve the biopsy quality of upper urinary tract urothelial tumors? Single-center preliminary results of a new biopsy forceps.

PubMed

Al-Qahtani, Saeed M; Legraverend, Dorian; Gil-Diez de Medina, Sixtina; Sibony, Mathilde; Traxer, Olivier

2014-01-01

Our aim was to evaluate the biopsy quality of upper urinary tract urothelial transitional cell carcinoma with a new biopsy forceps (BIGopsy®, Cook Medical) compared to a classic biopsy forceps (Piranha®, Boston Scientific). From December 2009 to December 2011, 20 patients with upper urinary tract urothelial transitional cell carcinoma underwent conservative treatment endoscopically. All lesions were evaluated and biopsied with 3 Fr cup forceps using both types of forceps (BIGopsy and Piranha). A single pathologist blindly analyzed the specimens in order to determine the optimal biopsy for each patient. Specimen histopathology results were graded; however, they were staged if the lamina propria was not invaded (T1) or if the tumor was detected at the lamina propria (T1+). Of the 20 upper urinary tract lesions, 12 (60%) were in the renal pelvis, 3 (15%) in the upper calyx, 1 (5%) in the middle calyx, 1 (5%) in the lower calyx, 1 (5%) in the upper third of the ureter and 2 (10%) in the middle third of the ureter. We did not detect T1 in all biopsies. One patient had no valid biopsies by both forceps. A diagnosis of urothelial carcinoma was made in 17 BIGopsy biopsies compared to 7 Piranha biopsies. Despite the limited number of cases, our study demonstrated the advantage of the new forceps (BIGopsy) in obtaining a valid biopsy of upper urinary tract urothelial tumors. Therefore, we recommend it in evaluating this pathology for optimal treatment. © 2014 S. Karger AG, Basel.

The Use of Voice Cues for Speaker Gender Recognition in Cochlear Implant Recipients

ERIC Educational Resources Information Center

Meister, Hartmut; Fürsen, Katrin; Streicher, Barbara; Lang-Roth, Ruth; Walger, Martin

2016-01-01

Purpose: The focus of this study was to examine the influence of fundamental frequency (F0) and vocal tract length (VTL) modifications on speaker gender recognition in cochlear implant (CI) recipients for different stimulus types. Method: Single words and sentences were manipulated using isolated or combined F0 and VTL cues. Using an 11-point…

System and method for characterizing voiced excitations of speech and acoustic signals, removing acoustic noise from speech, and synthesizing speech

DOEpatents

Burnett, Greg C.; Holzrichter, John F.; Ng, Lawrence C.

2002-01-01

Low power EM waves are used to detect motions of vocal tract tissues of the human speech system before, during, and after voiced speech. A voiced excitation function is derived. The excitation function provides speech production information to enhance speech characterization and to enable noise removal from human speech.

Role of Vocal Tract Morphology in Speech Development: Perceptual Targets and Sensorimotor Maps for Synthesized French Vowels from Birth to Adulthood.

ERIC Educational Resources Information Center

Menard, Lucie; Schwartz, Jean-Luc; Boe, Louise-Jean

2004-01-01

The development of speech from infancy to adulthood results from the interaction of neurocognitive factors, by which phonological representations and motor control abilities are gradually acquired, and physical factors, involving the complex changes in the morphology of the articulatory system. In this article, an articulatory-to-acoustic model,…

SDI Software Technology Program Plan Version 1.5

DTIC Science & Technology

1987-06-01

computer generation of auditory communication of meaningful speech. Most speech synthesizers are based on mathematical models of the human vocal tract, but...oral/ auditory and multimodal communications. Although such state-of-the-art interaction technology has not fully matured, user experience has...superior I pattern matching capabilities and the subliminal intuitive deduction capability. The error performance of humans can be helped by careful

The Contribution of the Insula to Motor Aspects of Speech Production: A Review and a Hypothesis

ERIC Educational Resources Information Center

Ackermann, Hermann; Riecker, Axel

2004-01-01

Based on clinical and functional imaging data, the left anterior insula has been assumed to support prearticulatory functions of speech motor control such as the ''programming'' of vocal tract gestures. In order to further elucidate this model, a recent functional magnetic resonance imaging (fMRI) study of our group (Riecker, Ackermann,…

Discrimination of speaker sex and size when glottal-pulse rate and vocal-tract length are controlled.

PubMed

Smith, David R R; Walters, Thomas C; Patterson, Roy D

2007-12-01

A recent study [Smith and Patterson, J. Acoust. Soc. Am. 118, 3177-3186 (2005)] demonstrated that both the glottal-pulse rate (GPR) and the vocal-tract length (VTL) of vowel sounds have a large effect on the perceived sex and age (or size) of a speaker. The vowels for all of the "different" speakers in that study were synthesized from recordings of the sustained vowels of one, adult male speaker. This paper presents a follow-up study in which a range of vowels were synthesized from recordings of four different speakers--an adult man, an adult woman, a young boy, and a young girl--to determine whether the sex and age of the original speaker would have an effect upon listeners' judgments of whether a vowel was spoken by a man, woman, boy, or girl, after they were equated for GPR and VTL. The sustained vowels of the four speakers were scaled to produce the same combinations of GPR and VTL, which covered the entire range normally encountered in every day life. The results show that listeners readily distinguish children from adults based on their sustained vowels but that they struggle to distinguish the sex of the speaker.

Chaos tool implementation for non-singer and singer voice comparison (preliminary study)

NASA Astrophysics Data System (ADS)

Dajer, Me; Pereira, Jc; Maciel, Cd

2007-11-01

Voice waveform is linked to the stretch, shorten, widen or constrict vocal tract. The articulation effects of the singer's vocal tract modify the voice acoustical characteristics and differ from the non-singer voices. In the last decades, Chaos Theory has shown the possibility to explore the dynamic nature of voice signals from a different point of view. The purpose of this paper is to apply the chaos technique of phase space reconstruction to analyze non- singers and singer voices in order to explore the signal nonlinear dynamic, and correlate them with traditional acoustic parameters. Eight voice samples of sustained vowel /i/ from non-singers and eight from singers were analyzed with "ANL" software. The samples were also acoustically analyzed with "Analise de Voz 5.0" in order to extract acoustic perturbation measures jitter and shimmer, and the coefficient of excess - (EX). The results showed different visual patterns for the two groups correlated with different jitter, shimmer, and coefficient of excess values. We conclude that these results clearly indicate the potential of phase space reconstruction technique for analysis and comparison of non-singers and singer voices. They also show a promising tool for training voices application.

[Bacterial culture and drug sensitivity analysis of upper urinary tract calculi complicating with infection].

PubMed

Wang, Shu; Shi, Yong-kang; Huang, Xiao-bo; Ma, Kai; Xu, Qing-quan; Xiong, Lin-lin; Li, Jian-xing; Wang, Xia-feng

2014-10-18

To investigate the bacteriology and drug sensitivity of upper urinary tract calculi patients, and to provide information for choosing suitable antibiotics. In the study, 21 patients who suffered from lithiasis in upper urinary tract and required an emergency drainage for acute obstruction and infection were the "acute group"; 64 patients with calculi in upper urinary tract and accompanied with no infectious symptoms were the "common group". The bacteriology and drug sensitivity of the two groups were investigated. Gram-negative bacteria infected the most common of upper urinary tract calculi patients with infection, accounting for 71.4% in the acute group and 65.7% in the common group, among which Escherichia coli were the predominant ones (35.7% in the acute group and 32.9% in the common group). No difference was found between these two groups in bacterial distribution (P>0.05). Although the average drug resistance rate of Gram-negative bacteria in the acute group was higher than that in the common group, it revealed no significant difference (P>0.05). The drug resistance rate to semisynthetic penicillin, cefuroxime and ceftriaxone were more than 50%, 60%, and 50%, respectively. Quinolones, such as ciprofloxacin and levofloxacin, got a 45% drug resistance. Aminoglycoside, carbapenema were sensitive to Gram-negative bacteria. Cefoperazone/sulbactam and piperacillin/tazobactam were more effective than ceftriaxone and piperacillin, respectively. There was no significant difference between upper urinary tract calculi patients with acute infection and common infection in bacteriology and drug sensitivity. Semisynthetic penicillin, the second generation of cephalosporin and quinolone were no longer the good choices of empirical use. Antibiotics combined with β-lactamase inhibitors would be an ideal empirical therapeutic choice.

Upper urinary tract carcinoma in Lynch syndrome cases.

PubMed

Crockett, David G; Wagner, David G; Holmäng, Sten; Johansson, Sonny L; Lynch, Henry T

2011-05-01

Patients with Lynch syndrome are much more likely to have generally rare upper urinary tract urothelial carcinoma but not bladder urothelial carcinoma. While the risk has been quantified, to our knowledge there is no description of how this population of patients with Lynch syndrome and upper urinary tract cancer differs from the general population with upper urinary tract cancer. We obtained retrospective data on a cohort of patients with Lynch syndrome from the Hereditary Cancer Center in Omaha, Nebraska and compared the data to those on a control general population from western Sweden. These data were supplemented by a new survey about exposure to known risk factors. Of the patients with Lynch syndrome 91% had mutations in MSH2 rather than in MSH1 and 79% showed upper tract urothelial carcinoma a mean of 15.85 years after prior Lynch syndrome-type cancer. Median age at diagnosis was 62 years vs 70 in the general population (p <0.0001). Only half of our patients had a significant smoking history and the male-to-female ratio was 0.95. Of patients with Lynch syndrome 51% had urothelial carcinoma in the ureter while it occurred in the renal pelvis in 65% of the general population (p = 0.0013). Similar numbers of high grade tumors were found in the Lynch syndrome and general populations (88% and 74%, respectively, p = 0.1108). Upper urinary tract tumors develop at a younger age and are more likely to be in the ureter with an almost equal gender ratio in patients with Lynch syndrome. It has high grade potential similar to that in the general population. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Active Surveillance of Birth Defects Among US Department of Defense Beneficiaries: A Feasibility Study

DTIC Science & Technology

1999-05-01

cleft palate / lip , upper alimentary, male reproductive, and urinary tract birth defects than the active surveillance database. Prevalence for the...the passive CEIS surveillance contained a smaller number of cleft palate / lip , upper alimentary, male reproductive, and urinary tract birth defects...Cardiovascular 33 29 8 63 Respiratory 4 3 0 4 Cleft palate / lip 12 4 3 14 Upper alimentary

Long-term results of permanent metallic stent implantation in the treatment of benign upper urinary tract occlusion.

PubMed

Li, Xun; He, Zhaohui; Yuan, Jian; Zeng, Guohua; He, Yongzhong; Lei, Ming

2007-08-01

The management of complicated benign upper urinary tract occlusion is extremely challenging, especially in patients unable to undergo an open operative procedure. We report the long-term results of a permanent metallic stent for benign upper urinary tract occlusion. From October 1995 to December 1998, 13 patients (8 men and 5 women, with a mean age of 43 years) with benign upper tract occlusion have been treated by metallic stent implantation. All patients had a nephrostomy tube to relieve the obstruction and the average time of the nephrostomy tube stay was 27 months, ranging from 3 to 131 months. The average length of occlusion was 2.7 cm, ranging from 1 to 3.6 cm. Ultrasonography, urography, diuresis renography and urine culture were performed every 3 months after stent insertion. Ureteroscopy was done when needed. The mean follow-up was 92 months (12-132 months). Ureteral patency was achieved in six patients and assisted patency with a Double-J stent was achieved in three patients. In two patients the kidney had to be removed because of progressive malfunction and in two patients the metal stent had to be extracted with the Holmium: YAG laser, burning it down due to the uncontrollable pyonephrosis. In three patients the ipsilateral flank pain recurred. One of these patients experienced urine leakage due to the initial nephrostomy tract: a ureteroscopy revealed a complete hyperplastic urothelial response. Proximal stone formations were found in 2 patients and all were removed by percutaneous nephrolithotomy (PCNL). No stent migration or fragmentation was observed. The implantation of metal stent is a safe and effective treatment for benign upper urinary tract occlusion, and has satisfying long-term outcome in selected cases. A further investigation is needed for its impact on the urodynamics of upper urinary tract.

FLOW SIMULATION IN THE HUMAN UPPER RESPIRATORY TRACT

EPA Science Inventory

ABSTRACT

Computer simulations of airflow patterns within the human upper respiratory tract (URT) are presented. The URT model includes airways of the head (nasal and oral), throat (pharyngeal and laryngeal), and lungs (trachea and main bronchi). The head and throat mor...

CD4+ T cells are necessary and sufficient to confer protection against C. trachomatis infection in the murine upper genital tract

PubMed Central

Gondek, David C.; Olive, Andrew J.; Stary, Georg; Starnbach, Michael N.

2012-01-01

Chlamydia trachomatis infection is the most common bacterial sexually transmitted disease in the United States. Chlamydia infections that ascend to the upper genital tract can persist, trigger inflammation, and result in serious sequelae such as infertility. However, mouse models where the vaginal vault is inoculated with C. trachomatis do not recapitulate the course of human disease. These intravaginal infections of the mouse do not ascend efficiently to the upper genital tract, do not cause persistent infection, do not induce significant inflammation, and do not induce significant CD4+ T cell infiltration. Here we describe a non-invasive transcervical infection model where we bypass the cervix and directly inoculate C. trachomatis into the uterus. We show that direct C. trachomatis infection of the murine upper genital tract stimulates a robust Chlamydia-specific CD4+ T cell response that is both necessary and sufficient to clear infection and provide protection against re-infection. PMID:22855710

Replication and Shedding of MERS-CoV in Upper Respiratory Tract of Inoculated Dromedary Camels

PubMed Central

Adney, Danielle R.; van Doremalen, Neeltje; Brown, Vienna R.; Bushmaker, Trenton; Scott, Dana; de Wit, Emmie; Munster, Vincent J.

2014-01-01

In 2012, a novel coronavirus associated with severe respiratory disease in humans emerged in the Middle East. Epidemiologic investigations identified dromedary camels as the likely source of zoonotic transmission of Middle East respiratory syndrome coronavirus (MERS-CoV). Here we provide experimental support for camels as a reservoir for MERS-CoV. We inoculated 3 adult camels with a human isolate of MERS-CoV and a transient, primarily upper respiratory tract infection developed in each of the 3 animals. Clinical signs of the MERS-CoV infection were benign, but each of the camels shed large quantities of virus from the upper respiratory tract. We detected infectious virus in nasal secretions through 7 days postinoculation, and viral RNA up to 35 days postinoculation. The pattern of shedding and propensity for the upper respiratory tract infection in dromedary camels may help explain the lack of systemic illness among naturally infected camels and the means of efficient camel-to-camel and camel-to-human transmission. PMID:25418529

Laparoscopic nephroureterectomy: making management of upper-tract transitional-cell carcinoma entirely minimally invasive.

PubMed

Keeley, F X; Tolley, D A

1998-04-01

Endoscopic treatment of upper-tract transitional-cell carcinoma (TCC) is well established. Nevertheless, many patients still required major ablative surgery. We have applied our experience with laparoscopic nephrectomy to the performance of laparoscopic nephroureterectomy in order to make the management of upper-tract TCC entirely minimally invasive. Since 1993, we have performed 22 laparoscopic nephroureterectomies for upper-tract TCC. Initially, we excluded patients with tumors below the pelvic brim, but we now offer a trial of laparoscopy to all patients. We describe the evolution of our technique, which involves resecting the ureteral orifice prior to laparoscopic dissection of the kidney and ureter. We have had to convert three cases to open surgery, one each for bleeding, failure to progress, and unappreciated tumor extent. Operative times averaged 156 minutes, which compares well with contemporary times for open nephroureterectomy. Complication rates, transfusion requirements, and length of stay, although higher than those of laparoscopic nephrectomy, were all reduced in comparison with open nephroureterectomy.

The VAMOS Ocean-Cloud-Atmosphere-Land Study Regional Experiment (VOCALS-REx): Goals, platforms, and field operations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wood, R.; Springston, S.; Mechoso, C. R.

2011-01-21

The VAMOS Ocean-Cloud-Atmosphere-Land Study Regional Experiment (VOCALS-REx) was an international field program designed to make observations of poorly understood but critical components of the coupled climate system of the southeast Pacific. This region is characterized by strong coastal upwelling, the coolest SSTs in the tropical belt, and is home to the largest subtropical stratocumulus deck on Earth. The field intensive phase of VOCALS-REx took place during October and November 2008 and constitutes a critical part of a broader CLIVAR program (VOCALS) designed to develop and promote scientific activities leading to improved understanding, model simulations, and predictions of the southeastern Pacificmore » (SEP) coupled ocean-atmosphere-land system, on diurnal to interannual timescales. The other major components of VOCALS are a modeling program with a model hierarchy ranging from the local to global scales, and a suite of extended observations from regular research cruises, instrumented moorings, and satellites. The two central themes of VOCALS-REx focus upon (a) links between aerosols, clouds and precipitation and their impacts on marine stratocumulus radiative properties, and (b) physical and chemical couplings between the upper ocean and the lower atmosphere, including the role that mesoscale ocean eddies play. A set of hypotheses designed to be tested with the combined field, monitoring and modeling work in VOCALS is presented here. A further goal of VOCALS-REx is to provide datasets for the evaluation and improvement of large-scale numerical models. VOCALS-REx involved five research aircraft, two ships and two surface sites in northern Chile. We describe the instrument payloads and key mission strategies for these platforms and give a summary of the missions conducted.« less

The source-filter theory of whistle-like calls in marmosets: Acoustic analysis and simulation of helium-modulated voices.

PubMed

Koda, Hiroki; Tokuda, Isao T; Wakita, Masumi; Ito, Tsuyoshi; Nishimura, Takeshi

2015-06-01

Whistle-like high-pitched "phee" calls are often used as long-distance vocal advertisements by small-bodied marmosets and tamarins in the dense forests of South America. While the source-filter theory proposes that vibration of the vocal fold is modified independently from the resonance of the supralaryngeal vocal tract (SVT) in human speech, a source-filter coupling that constrains the vibration frequency to SVT resonance effectively produces loud tonal sounds in some musical instruments. Here, a combined approach of acoustic analyses and simulation with helium-modulated voices was used to show that phee calls are produced principally with the same mechanism as in human speech. The animal keeps the fundamental frequency (f0) close to the first formant (F1) of the SVT, to amplify f0. Although f0 and F1 are primarily independent, the degree of their tuning can be strengthened further by a flexible source-filter interaction, the variable strength of which depends upon the cross-sectional area of the laryngeal cavity. The results highlight the evolutionary antiquity and universality of the source-filter model in primates, but the study can also explore the diversification of vocal physiology, including source-filter interaction and its anatomical basis in non-human primates.

Voicing produced by a constant velocity lung source

PubMed Central

Howe, M. S.; McGowan, R. S.

2013-01-01

An investigation is made of the influence of subglottal boundary conditions on the prediction of voiced sounds. It is generally assumed in mathematical models of voicing that vibrations of the vocal folds are maintained by a constant subglottal mean pressure pI, whereas voicing is actually initiated by contraction of the chest cavity until the subglottal pressure becomes large enough to separate the vocal folds. The problem is reformulated to determine voicing characteristics in terms of a prescribed volumetric flow rate Qo of air from the lungs—the evolution of the resulting time-dependent subglottal mean pressure p¯_(t) is then governed by glottal mechanics, the aeroacoustics of the vocal tract, and the influence of continued contraction of the lungs. The new problem is analyzed in detail for an idealized mechanical vocal system that permits precise specification of all boundary conditions. Predictions of the glottal volume velocity pulse shape are found to be in good general agreement with the traditional constant-pI theory when pI is set equal to the time averaged value of p¯_(t). But, in all cases examined the constant-pI approximation yields values of the mean flow rates Qo and sound pressure levels that are smaller by as much as 10%. PMID:23556600

High speed MRI of laryngeal gestures during speech production

NASA Astrophysics Data System (ADS)

Nissenbaum, Jon; Hillman, Robert E.; Kobler, James B.; Curtin, Hugh D.; Halle, Morris; Kirsch, John E.

2002-05-01

Dynamic sequences of magnetic resonance images (MRI) of the vocal tract were obtained with a frame rate of 144 frames/second. Changes in vertical position and length of the vocal folds, both observable in the mid-sagittal plane, have been argued to play a role in consonant production in addition to their primary function in the control of vocal fundamental frequency (F0) [W. G. Ewan and R. Krones, J. Phonet. 2, 327-335 (1974); A. Lofqvist et al., Haskins Lab. Status Report Speech Res., SR-97/98, pp. 25-40, 1989], but temporal resolution of available techniques has hindered direct imaging of these articulations. A novel data acquisition sequence was used to circumvent the imaging time imposed by standard MRI (typically 100-500 ms). Images were constructed by having subjects rhythmically repeat short utterances 256 times using the same F0 contour. Sixty-four lines of MR data were sampled during each repetition, at 7 millisecond increments, yielding partial raw data sets for 64 time points. After all repetitions were completed, one frame per time point was constructed by combining raw data from the corresponding time point during every repetition. Preliminary results indicate vocal fold shortening and lowering only during voiced consonants and in production of lower F0.

3-D PARTICLE TRANSPORT WITHIN THE HUMAN UPPER RESPIRATORY TRACT

EPA Science Inventory

In this study trajectories of inhaled particulate matter (PM) were simulated within a three-dimensional (3-D) computer model of the human upper respiratory tract (URT). The airways were described by computer-reconstructed images of a silicone rubber cast of the human head, throat...

Investigation into the response of the auditory and acoustic communications systems in the Beluga whale (Delphinapterus leucas) of the St. Lawrence River Estuary to noise, using vocal classification

NASA Astrophysics Data System (ADS)

Scheifele, Peter Martin

2003-06-01

Noise pollution has only recently become recognized as a potential danger to marine mammals in general, and to the Beluga Whale (Delphinapterus leucas) in particular. These small gregarious Odontocetes make extensive use of sound for social communication and pod cohesion. The St. Lawrence River Estuary is habitat to a small, critically endangered population of about 700 Beluga whales who congregate in four different sites in its upper estuary. The population is believed to be threatened by the stress of high-intensity, low frequency noise. One way to determine whether noise is having an effect on an animal's auditory ability might be to observe a natural and repeatable response of the auditory and vocal systems to varying noise levels. This can be accomplished by observing changes in animal vocalizations in response to auditory feedback. A response such as this observed in humans and some animals is known as the Lombard Vocal Response, which represents a reaction of the auditory system directly manifested by changes in vocalization level. In this research this population of Beluga Whales was tested to determine whether a vocalization-as-a-function-of-noise phenomenon existed by using Hidden Markhov "classified" vocalizations as targets for acoustical analyses. Correlation and regression analyses indicated that the phenomenon does exist and results of a human subjects experiment along with results from other animal species known to exhibit the response strongly implicate the Lombard Vocal Response in the Beluga.

Effects of a Straw Phonation Protocol on Acoustic and Perceptual Measures of an SATB Chorus.

PubMed

Manternach, Jeremy N; Daugherty, James F

2017-12-29

Recent scholarship has suggested that semi-occluded vocal tract (SOVT) exercises may increase vocal economy of individuals by reducing vocal effort while maintaining or increasing acoustic output. Choral singers, however, may use different resonance techniques or change voicing behaviors in an effort to hear their own sound in relation to others. One investigation revealed significant increases in a choir's mean spectral energy after participating in a straw phonation protocol. However, that study reported only acoustic measures and did not include choristers' perceptions of the choral sound and their own voicing efficiency. The purpose of this study was to measure the effect of a straw phonation protocol on acoustic (long-term average spectrum) and perceptual (self-report) measures of the choral sound of an intact soprano, alto, tenor, and bass (SATB) choir. This is a quasi-experimental, one-group, pretest-posttest design. An SATB choir (N = 48 singers) performed a Renaissance motet, participated in a 4-minute voicing protocol with a small straw, and then sang the motet a second time. They completed the same procedure later in the rehearsal. Long-term average spectrum results indicated no statistically significant mean changes in spectral energy after the SOVT protocols. Most participants, however, perceived that the choir sounded better (78.26%) and that their own vocal production was more efficient or comfortable (73.91%) following the protocol. Choristers perceived less vocal effort while maintaining vocal output after straw phonation, which may feasibly align with extant solo research. More research may determine whether this result is due specifically to SOVTs. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Laryngeal evidence for the first and second passaggio in professionally trained sopranos

PubMed Central

Burk, Fabian; Köberlein, Marie; Selamtzis, Andreas; Döllinger, Michael; Burdumy, Michael; Richter, Bernhard

2017-01-01

Introduction Due to a lack of empirical data, the current understanding of the laryngeal mechanics in the passaggio regions (i.e., the fundamental frequency ranges where vocal registration events usually occur) of the female singing voice is still limited. Material and methods In this study the first and second passaggio regions of 10 professionally trained female classical soprano singers were analyzed. The sopranos performed pitch glides from A3 (ƒo = 220 Hz) to A4 (ƒo = 440 Hz) and from A4 (ƒo = 440 Hz) to A5 (ƒo = 880 Hz) on the vowel [iː]. Vocal fold vibration was assessed with trans-nasal high speed videoendoscopy at 20,000 fps, complemented by simultaneous electroglottographic (EGG) and acoustic recordings. Register breaks were perceptually rated by 12 voice experts. Voice stability was documented with the EGG-based sample entropy. Glottal opening and closing patterns during the passaggi were analyzed, supplemented with open quotient data extracted from the glottal area waveform. Results In both the first and the second passaggio, variations of vocal fold vibration patterns were found. Four distinct patterns emerged: smooth transitions with either increasing or decreasing durations of glottal closure, abrupt register transitions, and intermediate loss of vocal fold contact. Audible register transitions (in both the first and second passaggi) generally coincided with higher sample entropy values and higher open quotient variance through the respective passaggi. Conclusions Noteworthy vocal fold oscillatory registration events occur in both the first and the second passaggio even in professional sopranos. The respective transitions are hypothesized to be caused by either (a) a change of laryngeal biomechanical properties; or by (b) vocal tract resonance effects, constituting level 2 source-filter interactions. PMID:28467509

Effects of the epilarynx area on vocal fold dynamics and the primary voice signal.

PubMed

Döllinger, Michael; Berry, David A; Luegmair, Georg; Hüttner, Björn; Bohr, Christopher

2012-05-01

For the analysis of vocal fold dynamics, sub- and supraglottal influences must be taken into account, as recent studies have shown. In this work, we analyze the influence of changes in the epilaryngeal area on vocal fold dynamics. We investigate two excised female larynges in a hemilarynx setup combined with a synthetic vocal tract consisting of hard plastic and simulating the vowel /a/. Eigenmodes, amplitudes, and velocities of the oscillations, the subglottal pressures (P(sub)), and sound pressure levels (SPLs) of the generated signal are investigated as a function of three distinctive epilaryngeal areas (28.4 mm(2), 71.0 mm(2), and 205.9 mm(2)). The results showed that the SPL is independent of the epilarynx cross section and exhibits a nonlinear relation to the insufflated airflow. The P(sub) decreased with an increase in the epilaryngeal area and displayed linear relations to the airflow. The principal eigenfunctions (EEFs) from the vocal fold dynamics exhibited lateral movement for the first EEF and rotational motion for the second EEF. In total, the first two EEFs covered a minimum of 60% of the energy, with an average of more than 50% for the first EEF. Correlations to the epilarynx areas were not found. Maximal values for amplitudes (up to 2.5 mm) and velocities (up to 1.57 mm/ms) changed with varying epilaryngeal area but did not show consistent behavior for both larynges. We conclude that the size of the epilaryngeal area has significant influence on vocal fold dynamics but does not significantly affect the resultant SPL. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Experiments on Analysing Voice Production: Excised (Human, Animal) and In Vivo (Animal) Approaches

PubMed Central

Döllinger, Michael; Kobler, James; Berry, David A.; Mehta, Daryush D.; Luegmair, Georg; Bohr, Christopher

2015-01-01

Experiments on human and on animal excised specimens as well as in vivo animal preparations are so far the most realistic approaches to simulate the in vivo process of human phonation. These experiments do not have the disadvantage of limited space within the neck and enable studies of the actual organ necessary for phonation, i.e., the larynx. The studies additionally allow the analysis of flow, vocal fold dynamics, and resulting acoustics in relation to well-defined laryngeal alterations. Purpose of Review This paper provides an overview of the applications and usefulness of excised (human/animal) specimen and in vivo animal experiments in voice research. These experiments have enabled visualization and analysis of dehydration effects, vocal fold scarring, bifurcation and chaotic vibrations, three-dimensional vibrations, aerodynamic effects, and mucosal wave propagation along the medial surface. Quantitative data will be shown to give an overview of measured laryngeal parameter values. As yet, a full understanding of all existing interactions in voice production has not been achieved, and thus, where possible, we try to indicate areas needing further study. Recent Findings A further motivation behind this review is to highlight recent findings and technologies related to the study of vocal fold dynamics and its applications. For example, studies of interactions between vocal tract airflow and generation of acoustics have recently shown that airflow superior to the glottis is governed by not only vocal fold dynamics but also by subglottal and supraglottal structures. In addition, promising new methods to investigate kinematics and dynamics have been reported recently, including dynamic optical coherence tomography, X-ray stroboscopy and three-dimensional reconstruction with laser projection systems. Finally, we touch on the relevance of vocal fold dynamics to clinical laryngology and to clinically-oriented research. PMID:26581597

Using active shape modeling based on MRI to study morphologic and pitch-related functional changes affecting vocal structures and the airway.

PubMed

Miller, Nicola A; Gregory, Jennifer S; Aspden, Richard M; Stollery, Peter J; Gilbert, Fiona J

2014-09-01

The shape of the vocal tract and associated structures (eg, tongue and velum) is complicated and varies according to development and function. This variability challenges interpretation of voice experiments. Quantifying differences between shapes and understanding how vocal structures move in relation to each other is difficult using traditional linear and angle measurements. With statistical shape models, shape can be characterized in terms of independent modes of variation. Here, we build an active shape model (ASM) to assess morphologic and pitch-related functional changes affecting vocal structures and the airway. Using a cross-sectional study design, we obtained six midsagittal magnetic resonance images from 10 healthy adults (five men and five women) at rest, while breathing out, and while listening to, and humming low and high notes. Eighty landmark points were chosen to define the shape of interest and an ASM was built using these (60) images. Principal component analysis was used to identify independent modes of variation, and statistical analysis was performed using one-way repeated-measures analysis of variance. Twenty modes of variation were identified with modes 1 and 2 accounting for half the total variance. Modes 1 and 9 were significantly associated with humming low and high notes (P < 0.001) and showed coordinated changes affecting the cervical spine, vocal structures, and airway. Mode 2 highlighted wide structural variations between subjects. This study highlights the potential of active shape modeling to advance understanding of factors underlying morphologic and pitch-related functional variations affecting vocal structures and the airway in health and disease. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Perioperative patient radiation exposure in the endoscopic removal of upper urinary tract calculi.

PubMed

Jamal, Joseph E; Armenakas, Noel A; Sosa, R Ernest; Fracchia, John A

2011-11-01

The efficacy of computed tomography (CT) in detailing upper urinary tract calculi is well established. There is no established acceptable annual recommended limit for medical exposure, yet the global accepted upper limit for occupational radiation exposure is <50 millisieverts (mSv) in any one year. We sought to appreciate the CT and fluoroscopic radiation exposure to our patients undergoing endoscopic removal of upper tract calculi during the periprocedure period. All patients undergoing upper urinary endoscopic stone removal between 2005 and 2009 were identified. To calculate the cumulative radiation exposure, we included all ionizing radiation imaging performed during a periprocedure period, which we defined as ≤90 days pre- and post-therapeutic procedure. A total of 233 upper urinary tract therapeutic patient stone procedures were identified; 127 patients underwent ureteroscopy (URS) and 106 patients underwent percutaneous nephrolithotomy (PCNL). A mean 1.58 CTs were performed per patient. Ninety (38.6%) patients underwent ≥2 CTs in the periprocedure period, with an average number in this group of 2.49 CT/patient, resulting in approximately 49.8 mSv of CT radiation exposure. Patients who were undergoing URS were significantly more likely to have multiple CTs (P=0.003) than those undergoing PCNL. Median fluoroscopic procedure exposures were 43.3 mGy for patients who were undergoing PCNL and 27.6 mGy for those patients undergoing URS. CT radiation exposure in the periprocedure period for patients who were undergoing endoscopic upper tract stone removal is considerable. Added to this is the procedure-related fluoroscopic radiation exposure. Urologic surgeons should be aware of the cumulative amount of ionizing radiation received by their patients from multiple sources.

Enhanced upper genital tract pathologies by blocking Tim-3 and PD-L1 signaling pathways in mice intravaginally infected with Chlamydia muridarum.

PubMed

Peng, Bo; Lu, Chunxue; Tang, Lingli; Yeh, I-Tien; He, Zhimin; Wu, Yimou; Zhong, Guangming

2011-12-14

Although Tim-3 & PD-L1 signaling pathways play important roles in negatively regulating immune responses, their roles in chlamydial infection have not been evaluated. Neutralization antibodies targeting Tim-3 and PD-L1 were used to treat mice. Following an intravaginal infection with C. muridarum organisms, mice with or without the dual antibody treatment were compared for live chlamydial organism shedding from the lower genital tract and inflammatory pathology in the upper genital tract. Mice treated with anti-Tim-3 and anti-PD-L1 antibodies displayed a time course of live organism shedding similar to that of mice treated with equivalent amounts of isotype-matched IgG molecules. The combined antibody blocking failed to alter either the lower genital tract cytokine or systemic humoral and cellular adaptive responses to C. muridarum infection. However, the antibody blocking significantly enhanced C. muridarum-induced pathologies in the upper genital tract, including more significant hydrosalpinx and inflammatory infiltration in uterine horn and oviduct tissues. The Tim-3 and PD-L1-mediated signaling can significantly reduce pathologies in the upper genital tract without suppressing immunity against chlamydial infection, suggesting that Tim-3 and PD-L1-mediated negative regulation may be manipulated to attenuate tubal pathologies in women persistently infected with C. trachomatis organisms.

Knowledge of Upper Respiratory Tract Infection In Elementary School Children.

ERIC Educational Resources Information Center

McCann-Sanford, Thurma; And Others

1982-01-01

This study assessed elementary school students' knowledge of upper respiratory tract infection and correlated it with parental socioeconomic status, ethnic background, and school absences. Schools chosen for the study represented different socioeconomic and ethnic populations. Students had a general knowledge of the etiology, symptoms, treatment,…

Difference in Voice Problems and Noise Reports Between Teachers of Public and Private Schools in Upper Egypt.

PubMed

Abo-Hasseba, Ahmed; Waaramaa, Teija; Alku, Paavo; Geneid, Ahmed

2017-07-01

This study aimed to assess teachers' voice symptoms and noise in schools in Upper Egypt and to study possible differences between teachers in public and private schools. A cross-sectional analysis via questionnaire was carried out. Four schools were chosen randomly to represent primary and preparatory schools as well as public and private ones. In these schools, a total of 140 teachers participated in the study. They answered a questionnaire on vocal and throat symptoms and their effects on working and social activities, as well as levels and effects of experienced noise. Of all teachers, 47.9% reported moderate or severe dysphonia within the last 6 months, and 21.4% reported daily dysphonia. All teachers reported frequent feelings of being in noise, with 82.2% feeling it sometimes or always during the working day, resulting in a need to raise their voice. Teachers in public schools experienced more noise from nearby classes. The working conditions and vocal health of teachers in Upper Egypt, especially in public schools, are alarming. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Status Report on Speech Research

DTIC Science & Technology

1992-06-01

fronts following pn. -ieme of English). As for phonetic Phonological and A, ticulatomy Characteris tics of Spoken Language coarticulation, Keating proposes...activated tic and antagonistic muscles, and the fixed bound- motoneurons will produce the functionally-specific aries of the vocal tract (the immobile...00121. tative methods will be presented. 45 46 Gracca INTERPRETATION OF MOVEMENT respective acoustic signals, it can be s.~ en that there are marked

Resource Utilization in Ambulatory Primary Care at Darnall Army Community Hospital, Fort Hood, Texas

DTIC Science & Technology

1991-07-23

population: gastroenteritis (GI), otitis media (OM), and upper respiratory infection (URI). These resources will be thc- dependent variables of the study...1991. The children ranged in age from 3 to 5 years old and were diagnosed with otitis media , upper respiratory tract infection, and gastroenteritis. A...x-rays wer-e rarely ordered to confirm the diagnoses of otitis media , gastroeinteritis. and upper respiratory tract infection. Only eight, laboratory

The adenoid as a key factor in upper airway infections.

PubMed

van Cauwenberge, P B; Bellussi, L; Maw, A R; Paradise, J L; Solow, B

1995-06-01

The adenoids (and the nasopharynx) play a key role in the normal functioning and in various pathologies of the upper respiratory tract. In this paper the role of adenoidal pathology and the beneficial effect of adenoidectomy in some upper respiratory tract and facial anomalies and diseases are discussed; otitis media with effusion, recurrent acute otitis media, sinusitis, snoring and sleep apnea and abnormal patterns in the midface growth and development.

Helium Speech: An Application of Standing Waves

NASA Astrophysics Data System (ADS)

Wentworth, Christopher D.

2011-04-01

Taking a breath of helium gas and then speaking or singing to the class is a favorite demonstration for an introductory physics course, as it usually elicits appreciative laughter, which serves to energize the class session. Students will usually report that the helium speech "raises the frequency" of the voice. A more accurate description of the phenomenon requires that we distinguish between the frequencies of sound produced by the larynx and the filtering of those frequencies by the vocal tract. We will describe here an experiment done by introductory physics students that uses helium speech as a context for learning about the human vocal system and as an application of the standing sound-wave concept. Modern acoustic analysis software easily obtained by instructors for student use allows data to be obtained and analyzed quickly.

The neural control of singing

PubMed Central

Zarate, Jean Mary

2013-01-01

Singing provides a unique opportunity to examine music performance—the musical instrument is contained wholly within the body, thus eliminating the need for creating artificial instruments or tasks in neuroimaging experiments. Here, more than two decades of voice and singing research will be reviewed to give an overview of the sensory-motor control of the singing voice, starting from the vocal tract and leading up to the brain regions involved in singing. Additionally, to demonstrate how sensory feedback is integrated with vocal motor control, recent functional magnetic resonance imaging (fMRI) research on somatosensory and auditory feedback processing during singing will be presented. The relationship between the brain and singing behavior will be explored also by examining: (1) neuroplasticity as a function of various lengths and types of training, (2) vocal amusia due to a compromised singing network, and (3) singing performance in individuals with congenital amusia. Finally, the auditory-motor control network for singing will be considered alongside dual-stream models of auditory processing in music and speech to refine both these theoretical models and the singing network itself. PMID:23761746

Laughter Among Deaf Signers

PubMed Central

Provine, Robert R.; Emmorey, Karen

2008-01-01

The placement of laughter in the speech of hearing individuals is not random but “punctuates” speech, occurring during pauses and at phrase boundaries where punctuation would be placed in a transcript of a conversation. For speakers, language is dominant in the competition for the vocal tract since laughter seldom interrupts spoken phrases. For users of American Sign Language, however, laughter and language do not compete in the same way for a single output channel. This study investigated whether laughter occurs simultaneously with signing, or punctuates signing, as it does speech, in 11 signed conversations (with two to five participants) that had at least one instance of audible, vocal laughter. Laughter occurred 2.7 times more often during pauses and at phrase boundaries than simultaneously with a signed utterance. Thus, the production of laughter involves higher order cognitive or linguistic processes rather than the low-level regulation of motor processes competing for a single vocal channel. In an examination of other variables, the social dynamics of deaf and hearing people were similar, with “speakers” (those signing) laughing more than their audiences and females laughing more than males. PMID:16891353

Laughter among deaf signers.

PubMed

Provine, Robert R; Emmorey, Karen

2006-01-01

The placement of laughter in the speech of hearing individuals is not random but "punctuates" speech, occurring during pauses and at phrase boundaries where punctuation would be placed in a transcript of a conversation. For speakers, language is dominant in the competition for the vocal tract since laughter seldom interrupts spoken phrases. For users of American Sign Language, however, laughter and language do not compete in the same way for a single output channel. This study investigated whether laughter occurs simultaneously with signing, or punctuates signing, as it does speech, in 11 signed conversations (with two to five participants) that had at least one instance of audible, vocal laughter. Laughter occurred 2.7 times more often during pauses and at phrase boundaries than simultaneously with a signed utterance. Thus, the production of laughter involves higher order cognitive or linguistic processes rather than the low-level regulation of motor processes competing for a single vocal channel. In an examination of other variables, the social dynamics of deaf and hearing people were similar, with "speakers" (those signing) laughing more than their audiences and females laughing more than males.

Vocal Function and Upper Airway Thermoregulation in Five Different Environmental Conditions

PubMed Central

Sandage, Mary J.; Connor, Nadine P.; Pascoe, David D.

2013-01-01

Purpose Phonation threshold pressure and perceived phonatory effort were hypothesized to increase and upper airway temperature decrease following exposure to cold and/or dry air. Greater changes were expected with mouth versus nose breathing. Method Using a within-participant repeated measures design, 15 consented participants (7 men, 8 women) completed 20-minute duration trials to allow for adequate thermal equilibration for both nose and mouth breathing in five different environments: three temperatures (°C) matched for relative humidity (%RH): cold (15°C/40% RH), thermally neutral (25°C/40% RH), and hot (35°C/40% RH); and two temperatures with variable relative humidity to match vapor pressure for the neutral environment (25°C/40% RH): cold (15°C/74% RH) and hot (35°C; 23% RH). Following each equilibration trial, measures were taken in this order: upper airway temperature (transnasal thermistor probe), phonation threshold pressure, and perceived phonatory effort. Results Data were analyzed using repeated measures analysis of variance and no significant differences were established. Conclusions The study hypotheses were not supported. Findings suggest that the upper airway is tightly regulated for temperature when challenged by a realistic range of temperature/relative humidity environments. This is the first study of its kind to include measurement of upper airway temperature in conjunction with measures of vocal function. PMID:23900031

Evidence of biphonation and source-filter interactions in the bugles of male North American wapiti (Cervus canadensis).

PubMed

Reby, D; Wyman, M T; Frey, R; Passilongo, D; Gilbert, J; Locatelli, Y; Charlton, B D

2016-04-15

With an average male body mass of 320 kg, the wapiti, ITALIC! Cervus canadensis, is the largest extant species of Old World deer (Cervinae). Despite this large body size, male wapiti produce whistle-like sexual calls called bugles characterised by an extremely high fundamental frequency. Investigations of the biometry and physiology of the male wapiti's relatively large larynx have so far failed to account for the production of such a high fundamental frequency. Our examination of spectrograms of male bugles suggested that the complex harmonic structure is best explained by a dual-source model (biphonation), with one source oscillating at a mean of 145 Hz (F0) and the other oscillating independently at an average of 1426 Hz (G0). A combination of anatomical investigations and acoustical modelling indicated that the F0 of male bugles is consistent with the vocal fold dimensions reported in this species, whereas the secondary, much higher source at G0 is more consistent with an aerodynamic whistle produced as air flows rapidly through a narrow supraglottic constriction. We also report a possible interaction between the higher frequency G0 and vocal tract resonances, as G0 transiently locks onto individual formants as the vocal tract is extended. We speculate that male wapiti have evolved such a dual-source phonation to advertise body size at close range (with a relatively low-frequency F0 providing a dense spectrum to highlight size-related information contained in formants) while simultaneously advertising their presence over greater distances using the very high-amplitude G0 whistle component. © 2016. Published by The Company of Biologists Ltd.

[Peculiarities of upper urinary tract drainage during surgical treatment of staghorn and multiple nephrolithiasis].

PubMed

Imamverdiev, S B; Talybov, T A; Mamedov, R N

2014-01-01

This work was designed to evaluate methods of kidney drainage used in the surgical treatment of 250 patients with staghorn and multiple nephrolithiasis (SMN). All of them underwent open surgery that was followed by drainage of the upper urinary tract in 192 patients. Internal stenting was used in 111 cases, pyelostomy in 28, nephrostomy in 47, and internal stenting with nephrostoma in 6 cases. 91 and 20 patients had a stent inserted into the upper urinary tract in a retrograde and antegrade manner respectively. Retrograde stenting was bilateral in 14 and unilateral in 66 cases. 85% of the cases with ureter stents were followed up as outpatients for 4-5 weeks and only 10% for 6-7 weeks. Forty and ten patients with stents presented with marked dysuria and hematuria respectively. On the whole, combined antibacterial treatment with drainage of the upper urinary tract significantly improved long-term results of SMN treatment. It is concluded that nephrostomy and pyelostomy should be performed on days 14-18 and 10-12 respectively whereas the stent needs to be removed between weeks 2 and 8 after surgery.

[Cefazolin efficacy and antibiotic sensitivity against pathogenic bacteria in pediatric with acute upper urinary tract infection].

PubMed

Fuke, Toshiya; Abe, Yoshifusa; Hoshino, Akihiro; Oto, Hideyasu; Sakai, Naho; Murayama, Junichiro; Yoshida, Koichiro; Itabashi, Kazuo

2010-05-01

Acute upper urinary tract infection may cause sepsis, especially in neonates and infants, mandating the choice of appropriate, effective antibacterials minimizing increasing bacterial resistance. Frequently prescribing broad-spectrum cephalosporinin is one such example. Different antibacterial therapies are initiated clinically due to treatment protocol differences among institutions, disease severity, etc. We studied the efficacy of cefazolin (CEZ), a first-generation cephalosporin, as first-line parenteral treatment in acute upper urinary tract infection. We found that 88.9% of microbial infections have indications for CEZ. CEZ efficacy is 91.3%, and 97.2% of urine cultures show negative results. Escherichia coli sensitivity to antibacterial agents is 90.9% of the minimal inhibitory concentration (MIC) < 4 for CEZ, 93.9% of MIC < 1 for ceftazidime (CAZ), 63.6% of MIC < 4 for ampicillin, and 81.8% of MIC < 2 for gentamicin. CEZ thus has the same efficacy as CAZ and is more effective than other antibacterial agents against E. coli. We concluded that CEZ is an effective antibacterial in initial antibacterial pediatric therapy in acute upper urinary tract infection.

Pulsed dye laser application in ablation of vascular ectasias of the larynx: a preliminary animal study

NASA Astrophysics Data System (ADS)

Woo, Peak; Wang, Zhi; Perrault, Donald F., Jr.; McMillan, Kathleen; Pankratov, Michail M.

1995-05-01

Vascular ectasias (dilatation) and vascular lesions of the larynx are difficult to treat with exciting modalities. Varix (enlarged vessel) of the vocal folds, vocal fold hemorrhage, vascular polyp, hemangioma, intubation or contact granuloma are common problems which disturb voice. Current applications of CO2 laser and cautery often damage the delicate vocal fold cover. The 585 nm dermatologic pulsed dye laser may be an ideal substitute. Two adult canines were examined under anesthesia via microlaryngoscopy technique. Pulsed dye laser (SPTL-1a, Candela Laser Corp., Wayland, MA) energy was delivered via the micromanipulator with the 3.1-mm spot size in single pulses of 6, 8, and 10 Joules/cm2 and applied to the vessels of the vocal folds, epiglottis, and arytenoid cartilage. Endoscopic examination was carried out immediately after the treatment and at 4 weeks postoperatively. The animals were sacrificed at 3 weeks, larynges excised, and whole organ laryngeal section were prepared for histology. Pulsed dye laser thrombosed vessels of the vocal fold using 6 or 8 Joules/cm2. Vascular break and leakage occurred at 10 Joules/cm2. Follow up examination showed excellent vessel obliteration or thrombosis without scarring or injury to the overlying tissues. Histologic examination shows vascular thrombosis without inflammation and fibrosis in the vocal fold cover. Pulsed dye laser may have promise in treatment of vascular lesions of the larynx and upper airway.

Extensive upper respiratory tract sarcoidosis

PubMed Central

Soares, Mafalda Trindade; Sousa, Carolina; Garanito, Luísa; Freire, Filipe

2016-01-01

Sarcoidosis is a chronic granulomatous disease of unknown aetiology. It can affect any part of the organism, although the lung is the most frequently affected organ. Upper airway involvement is rare, particularly if isolated. Sarcoidosis is a diagnosis of exclusion, established by histological evidence of non-caseating granulomas and the absence of other granulomatous diseases. The authors report a case of a man with sarcoidosis manifesting as a chronic inflammatory stenotic condition of the upper respiratory tract and trachea. PMID:27090537

Subglottal Impedance-Based Inverse Filtering of Voiced Sounds Using Neck Surface Acceleration

PubMed Central

Zañartu, Matías; Ho, Julio C.; Mehta, Daryush D.; Hillman, Robert E.; Wodicka, George R.

2014-01-01

A model-based inverse filtering scheme is proposed for an accurate, non-invasive estimation of the aerodynamic source of voiced sounds at the glottis. The approach, referred to as subglottal impedance-based inverse filtering (IBIF), takes as input the signal from a lightweight accelerometer placed on the skin over the extrathoracic trachea and yields estimates of glottal airflow and its time derivative, offering important advantages over traditional methods that deal with the supraglottal vocal tract. The proposed scheme is based on mechano-acoustic impedance representations from a physiologically-based transmission line model and a lumped skin surface representation. A subject-specific calibration protocol is used to account for individual adjustments of subglottal impedance parameters and mechanical properties of the skin. Preliminary results for sustained vowels with various voice qualities show that the subglottal IBIF scheme yields comparable estimates with respect to current aerodynamics-based methods of clinical vocal assessment. A mean absolute error of less than 10% was observed for two glottal airflow measures –maximum flow declination rate and amplitude of the modulation component– that have been associated with the pathophysiology of some common voice disorders caused by faulty and/or abusive patterns of vocal behavior (i.e., vocal hyperfunction). The proposed method further advances the ambulatory assessment of vocal function based on the neck acceleration signal, that previously have been limited to the estimation of phonation duration, loudness, and pitch. Subglottal IBIF is also suitable for other ambulatory applications in speech communication, in which further evaluation is underway. PMID:25400531

Tongue Reading: Comparing the Interpretation of Visual Information from inside the Mouth, from Electropalatographic and Ultrasound Displays of Speech Sounds

ERIC Educational Resources Information Center

Cleland, Joanne; Mccron, Caitlin; Scobbie, James M.

2013-01-01

Speakers possess a natural capacity for lip reading; analogous to this, there may be an intuitive ability to "tongue-read." Although the ability of untrained participants to perceive aspects of the speech signal has been explored for some visual representations of the vocal tract (e.g. talking heads), it is not yet known to what extent…

Imaging for understanding speech communication: Advances and challenges

NASA Astrophysics Data System (ADS)

Narayanan, Shrikanth

2005-04-01

Research in speech communication has relied on a variety of instrumentation methods to illuminate details of speech production and perception. One longstanding challenge has been the ability to examine real-time changes in the shaping of the vocal tract; a goal that has been furthered by imaging techniques such as ultrasound, movement tracking, and magnetic resonance imaging. The spatial and temporal resolution afforded by these techniques, however, has limited the scope of the investigations that could be carried out. In this talk, we focus on some recent advances in magnetic resonance imaging that allow us to perform near real-time investigations on the dynamics of vocal tract shaping during speech. Examples include Demolin et al. (2000) (4-5 images/second, ultra-fast turbo spin echo) and Mady et al. (2001,2002) (8 images/second, T1 fast gradient echo). A recent study by Narayanan et al. (2004) that used a spiral readout scheme to accelerate image acquisition has allowed for image reconstruction rates of 24 images/second. While these developments offer exciting prospects, a number of challenges lie ahead, including: (1) improving image acquisition protocols, hardware for enhancing signal-to-noise ratio, and optimizing spatial sampling; (2) acquiring quality synchronized audio; and (3) analyzing and modeling image data including cross-modality registration. [Work supported by NIH and NSF.

Some Behavioral and Neurobiological Constraints on Theories of Audiovisual Speech Integration: A Review and Suggestions for New Directions

PubMed Central

Altieri, Nicholas; Pisoni, David B.; Townsend, James T.

2012-01-01

Summerfield (1987) proposed several accounts of audiovisual speech perception, a field of research that has burgeoned in recent years. The proposed accounts included the integration of discrete phonetic features, vectors describing the values of independent acoustical and optical parameters, the filter function of the vocal tract, and articulatory dynamics of the vocal tract. The latter two accounts assume that the representations of audiovisual speech perception are based on abstract gestures, while the former two assume that the representations consist of symbolic or featural information obtained from visual and auditory modalities. Recent converging evidence from several different disciplines reveals that the general framework of Summerfield’s feature-based theories should be expanded. An updated framework building upon the feature-based theories is presented. We propose a processing model arguing that auditory and visual brain circuits provide facilitatory information when the inputs are correctly timed, and that auditory and visual speech representations do not necessarily undergo translation into a common code during information processing. Future research on multisensory processing in speech perception should investigate the connections between auditory and visual brain regions, and utilize dynamic modeling tools to further understand the timing and information processing mechanisms involved in audiovisual speech integration. PMID:21968081

Some behavioral and neurobiological constraints on theories of audiovisual speech integration: a review and suggestions for new directions.

PubMed

Altieri, Nicholas; Pisoni, David B; Townsend, James T

2011-01-01

Summerfield (1987) proposed several accounts of audiovisual speech perception, a field of research that has burgeoned in recent years. The proposed accounts included the integration of discrete phonetic features, vectors describing the values of independent acoustical and optical parameters, the filter function of the vocal tract, and articulatory dynamics of the vocal tract. The latter two accounts assume that the representations of audiovisual speech perception are based on abstract gestures, while the former two assume that the representations consist of symbolic or featural information obtained from visual and auditory modalities. Recent converging evidence from several different disciplines reveals that the general framework of Summerfield's feature-based theories should be expanded. An updated framework building upon the feature-based theories is presented. We propose a processing model arguing that auditory and visual brain circuits provide facilitatory information when the inputs are correctly timed, and that auditory and visual speech representations do not necessarily undergo translation into a common code during information processing. Future research on multisensory processing in speech perception should investigate the connections between auditory and visual brain regions, and utilize dynamic modeling tools to further understand the timing and information processing mechanisms involved in audiovisual speech integration.

Effects of fundamental frequency and vocal-tract length cues on sentence segregation by listeners with hearing loss

PubMed Central

Mackersie, Carol L.; Dewey, James; Guthrie, Lesli A.

2011-01-01

The purpose was to determine the effect of hearing loss on the ability to separate competing talkers using talker differences in fundamental frequency (F0) and apparent vocal-tract length (VTL). Performance of 13 adults with hearing loss and 6 adults with normal hearing was measured using the Coordinate Response Measure. For listeners with hearing loss, the speech was amplified and filtered according to the NAL-RP hearing aid prescription. Target-to-competition ratios varied from 0 to 9 dB. The target sentence was randomly assigned to the higher or lower values of F0 or VTL on each trial. Performance improved for F0 differences up to 9 and 6 semitones for people with normal hearing and hearing loss, respectively, but only when the target talker had the higher F0. Recognition for the lower F0 target improved when trial-to-trial uncertainty was removed (9-semitone condition). Scores improved with increasing differences in VTL for the normal-hearing group. On average, hearing-impaired listeners did not benefit from VTL cues, but substantial inter-subject variability was observed. The amount of benefit from VTL cues was related to the average hearing loss in the 1–3-kHz region when the target talker had the shorter VTL. PMID:21877813

Measuring acoustic impedances using a semi-infinite waveguide reference: Applications to wind instruments and vocal tracts

NASA Astrophysics Data System (ADS)

Wolfe, Joe; Smith, John; Tann, John; France, Ryan

2002-11-01

Acoustic pressures may generally be measured with much greater sensitivity, dynamic range, and frequency response than acoustic currents. Consequently, most measurements of acoustic impedance consist of comparison with standard impedances. The method reported here uses a semi-infinite waveguide as the reference because its impedance is purely resistive, frequency independent and accurately known, independent of theories of the boundary layer. Waveguides are effectively infinite for pulses shorter than the echo return time, or if the attenuation due to wall losses (typically 80 dB) exceeds the dynamic range of the experiment. The measurement signal from a high output impedance source is calibrated to have Fourier components proportional to fn, where n may be 1 for convenience or chosen to improve the signal:noise ratio. The method has been used on diverse systems over the range 50 Hz to 13 kHz. When applied to systems with simple geometries, the technique yields results with a little higher wall losses than those expected from the calculations of Rayleigh and Benade. Discontinuities introduce further losses as well as the expected departures from simple one-dimensional models. Measurements on musical wind instruments and on the human vocal tract are reported. [Work supported by the Australian Research Council.

Upper aerodigestive tract disorders and gastro-oesophageal reflux disease.

PubMed

Ciorba, Andrea; Bianchini, Chiara; Zuolo, Michele; Feo, Carlo Vittorio

2015-02-16

A wide variety of symptoms and diseases of the upper aerodigestive tract are associated to gastro-oesophageal reflux disease (GORD). These disorders comprise a large variety of conditions such as asthma, chronic otitis media and sinusitis, chronic cough, and laryngeal disorders including paroxysmal laryngospasm. Laryngo-pharyngeal reflux disease is an extraoesophageal variant of GORD that can affect the larynx and pharynx. Despite numerous research efforts, the diagnosis of laryngopharyngeal reflux often remains elusive, unproven and controversial, and its treatment is then still empiric. Aim of this paper is to review the current literature on upper aerodigestive tract disorders in relation to pathologic gastro-oesophageal reflux, focusing in particular on the pathophysiology base and results of the surgical treatment of GORD.

Upper aerodigestive tract disorders and gastro-oesophageal reflux disease

PubMed Central

Ciorba, Andrea; Bianchini, Chiara; Zuolo, Michele; Feo, Carlo Vittorio

2015-01-01

A wide variety of symptoms and diseases of the upper aerodigestive tract are associated to gastro-oesophageal reflux disease (GORD). These disorders comprise a large variety of conditions such as asthma, chronic otitis media and sinusitis, chronic cough, and laryngeal disorders including paroxysmal laryngospasm. Laryngo-pharyngeal reflux disease is an extraoesophageal variant of GORD that can affect the larynx and pharynx. Despite numerous research efforts, the diagnosis of laryngopharyngeal reflux often remains elusive, unproven and controversial, and its treatment is then still empiric. Aim of this paper is to review the current literature on upper aerodigestive tract disorders in relation to pathologic gastro-oesophageal reflux, focusing in particular on the pathophysiology base and results of the surgical treatment of GORD. PMID:25685756

Upper aerodigestive tract cancer and the lung: a tale of two aspirations.

PubMed

Vaideeswar, P; Ghodke, R

2012-01-01

Patients with upper aerodigestive epithelial cancers frequently develop second primary cancers due to common risk factors or develop distant metastases depending on the locoregional status of the primary tumor. In most instances, the organ affected is the lung. Pulmonary spread usually occurs due to hematogenous or lymphatic dissemination. The following is a report of two patients with upper aerodigestive tract squamous cell carcinomas who developed lung metastases due to aspiration, a route not well documented in recent literature.

Voice correlates of mating success in men: examining "contests" versus "mate choice" modes of sexual selection.

PubMed

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

2011-06-01

Men's copulatory success can often be predicted by measuring traits involved in male contests and female choice. Previous research has demonstrated relationships between one such vocal trait in men, mean fundamental frequency (F(0)), and the outcomes and indicators of sexual success with women. The present study investigated the role of another vocal parameter, F(0) variation (the within-subject SD in F(0) across the utterance, F(0)-SD), in predicting men's reported number of female sexual partners in the last year. Male participants (N = 111) competed with another man for a date with a woman. Recorded interactions with the competitor ("competitive recording") and the woman ("courtship recording") were analyzed for five non-linguistic vocal parameters: F(0)-SD, mean F(0), intensity, duration, and formant dispersion (D( f ), an acoustic correlate of vocal tract length), as well as dominant and attractive linguistic content. After controlling for age and attitudes toward uncommitted sex (SOI), lower F(0)-SD (i.e., a more monotone voice) and more dominant linguistic content were strong predictors of the number of past-year sexual partners, whereas mean F(0) and D( f ) did not significantly predict past-year partners. These contrasts have implications for the relative importance of male contests and female choice in shaping men's mating success and hence the origins and maintenance of sexually dimorphic traits in humans.

Phonation threshold pressure: Comparison of calculations and measurements taken with physical models of the vocal fold mucosa

PubMed Central

Fulcher, Lewis P.; Scherer, Ronald C.

2011-01-01

In an important paper on the physics of small amplitude oscillations, Titze showed that the essence of the vertical phase difference, which allows energy to be transferred from the flowing air to the motion of the vocal folds, could be captured in a surface wave model, and he derived a formula for the phonation threshold pressure with an explicit dependence on the geometrical and biomechanical properties of the vocal folds. The formula inspired a series of experiments [e.g., R. Chan and I. Titze, J. Acoust. Soc. Am 119, 2351–2362 (2006)]. Although the experiments support many aspects of Titze’s formula, including a linear dependence on the glottal half-width, the behavior of the experiments at the smallest values of this parameter is not consistent with the formula. It is shown that a key element for removing this discrepancy lies in a careful examination of the properties of the entrance loss coefficient. In particular, measurements of the entrance loss coefficient at small widths done with a physical model of the glottis (M5) show that this coefficient varies inversely with the glottal width. A numerical solution of the time-dependent equations of the surface wave model shows that adding a supraglottal vocal tract lowers the phonation threshold pressure by an amount approximately consistent with Chan and Titze’s experiments. PMID:21895097

Phonation threshold pressure: comparison of calculations and measurements taken with physical models of the vocal fold mucosa.

PubMed

Fulcher, Lewis P; Scherer, Ronald C

2011-09-01

In an important paper on the physics of small amplitude oscillations, Titze showed that the essence of the vertical phase difference, which allows energy to be transferred from the flowing air to the motion of the vocal folds, could be captured in a surface wave model, and he derived a formula for the phonation threshold pressure with an explicit dependence on the geometrical and biomechanical properties of the vocal folds. The formula inspired a series of experiments [e.g., R. Chan and I. Titze, J. Acoust. Soc. Am 119, 2351-2362 (2006)]. Although the experiments support many aspects of Titze's formula, including a linear dependence on the glottal half-width, the behavior of the experiments at the smallest values of this parameter is not consistent with the formula. It is shown that a key element for removing this discrepancy lies in a careful examination of the properties of the entrance loss coefficient. In particular, measurements of the entrance loss coefficient at small widths done with a physical model of the glottis (M5) show that this coefficient varies inversely with the glottal width. A numerical solution of the time-dependent equations of the surface wave model shows that adding a supraglottal vocal tract lowers the phonation threshold pressure by an amount approximately consistent with Chan and Titze's experiments. © 2011 Acoustical Society of America

Perception of Male Caller Identity in Koalas (Phascolarctos cinereus): Acoustic Analysis and Playback Experiments

PubMed Central

Charlton, Benjamin D.; Ellis, William A. H.; McKinnon, Allan J.; Brumm, Jacqui; Nilsson, Karen; Fitch, W. Tecumseh

2011-01-01

The ability to signal individual identity using vocal signals and distinguish between conspecifics based on vocal cues is important in several mammal species. Furthermore, it can be important for receivers to differentiate between callers in reproductive contexts. In this study, we used acoustic analyses to determine whether male koala bellows are individually distinctive and to investigate the relative importance of different acoustic features for coding individuality. We then used a habituation-discrimination paradigm to investigate whether koalas discriminate between the bellow vocalisations of different male callers. Our results show that male koala bellows are highly individualized, and indicate that cues related to vocal tract filtering contribute the most to vocal identity. In addition, we found that male and female koalas habituated to the bellows of a specific male showed a significant dishabituation when they were presented with bellows from a novel male. The significant reduction in behavioural response to a final rehabituation playback shows this was not a chance rebound in response levels. Our findings indicate that male koala bellows are highly individually distinctive and that the identity of male callers is functionally relevant to male and female koalas during the breeding season. We go on to discuss the biological relevance of signalling identity in this species' sexual communication and the potential practical implications of our findings for acoustic monitoring of male population levels. PMID:21633499

Anatomy and Physiology of the Urinary Tract: Relation to Host Defense and Microbial Infection

PubMed Central

HICKLING, DUANE R.; SUN, TUNG-TIEN; WU, XUE-RU

2015-01-01

The urinary tract exits to a body surface area that is densely populated by a wide range of microbes. Yet, under most normal circumstances, it is typically considered sterile, i.e., devoid of microbes, a stark contrast to the gastrointestinal and upper respiratory tracts where many commensal and pathogenic microbes call home. Not surprisingly, infection of the urinary tract over a healthy person’s lifetime is relatively infrequent, occurring once or twice or not at all for most people. For those who do experience an initial infection, the great majority (70% to 80%) thankfully do not go on to suffer from multiple episodes. This is a far cry from the upper respiratory tract infections, which can afflict an otherwise healthy individual countless times. The fact that urinary tract infections are hard to elicit in experimental animals except with inoculum 3–5 orders of magnitude greater than the colony counts that define an acute urinary infection in humans (105 cfu/ml), also speaks to the robustness of the urinary tract defense. How can the urinary tract be so effective in fending off harmful microbes despite its orifice in a close vicinity to that of the microbe-laden gastrointestinal tract? While a complete picture is still evolving, the general consensus is that the anatomical and physiological integrity of the urinary tract is of paramount importance in maintaining a healthy urinary tract. When this integrity is breached, however, the urinary tract can be at a heightened risk or even recurrent episodes of microbial infections. In fact, recurrent urinary tract infections are a significant cause of morbidity and time lost from work and a major challenge to manage clinically. Additionally, infections of the upper urinary tract often require hospitalization and prolonged antibiotic therapy. In this chapter, we provide an overview of the basic anatomy and physiology of the urinary tract with an emphasis on their specific roles in host defense. We also highlight the important structural and functional abnormalities that predispose the urinary tract to microbial infections. PMID:26350322

Anatomy and Physiology of the Urinary Tract: Relation to Host Defense and Microbial Infection.

PubMed

Hickling, Duane R; Sun, Tung-Tien; Wu, Xue-Ru

2015-08-01

The urinary tract exits to a body surface area that is densely populated by a wide range of microbes. Yet, under most normal circumstances, it is typically considered sterile, i.e., devoid of microbes, a stark contrast to the gastrointestinal and upper respiratory tracts where many commensal and pathogenic microbes call home. Not surprisingly, infection of the urinary tract over a healthy person's lifetime is relatively infrequent, occurring once or twice or not at all for most people. For those who do experience an initial infection, the great majority (70% to 80%) thankfully do not go on to suffer from multiple episodes. This is a far cry from the upper respiratory tract infections, which can afflict an otherwise healthy individual countless times. The fact that urinary tract infections are hard to elicit in experimental animals except with inoculum 3-5 orders of magnitude greater than the colony counts that define an acute urinary infection in humans (105 cfu/ml), also speaks to the robustness of the urinary tract defense. How can the urinary tract be so effective in fending off harmful microbes despite its orifice in a close vicinity to that of the microbe-laden gastrointestinal tract? While a complete picture is still evolving, the general consensus is that the anatomical and physiological integrity of the urinary tract is of paramount importance in maintaining a healthy urinary tract. When this integrity is breached, however, the urinary tract can be at a heightened risk or even recurrent episodes of microbial infections. In fact, recurrent urinary tract infections are a significant cause of morbidity and time lost from work and a major challenge to manage clinically. Additionally, infections of the upper urinary tract often require hospitalization and prolonged antibiotic therapy. In this chapter, we provide an overview of the basic anatomy and physiology of the urinary tract with an emphasis on their specific roles in host defense. We also highlight the important structural and functional abnormalities that predispose the urinary tract to microbial infections.

Radical and sparing surgical treatment of patients with upper urinary tract transitional cell carcinomas (UUT -TCC) - preliminary results.

PubMed

Jabłonowski, Zbigniew; Kędzierski, Robert; Sosnowski, Marek

2011-01-01

Tumors originating from transitional epithelium of the renal pelvis and ureter are infrequent. Their course is asymptomatic at early stages of the disease, and diagnosis and institution of appropriate treatment delayed. The aim of the study is to assess the results of treatment in patients with upper urinary tract transitional cell carcinomas (UUT-TCC). Fifteen patients treated in 2005-2010 for UUT-TCC were qualified for the retrospective study. Clinical symptoms, diagnostic methods, tumor location, clinical stage and histopathological characteristics of the tumors were assessed. Then, the instituted treatment and its results were analyzed. The average follow-up period was 51 month (range 6-65), UUT-TCC accounted for 6.7% of renal tumors treated. Concurrent treated vesical tumors were observed in 4 (26.7%) patients. Primary UUT-TCC was diagnosed in 10 (66.7%) patients. Radical surgery was performed in 10 (66.7%) patients, whereas 5 (33.3%) underwent sparing operations. Macroscopic hematuria was the predominant clinical symptom. In most cases T2-T3 clinical stage (60.0%) and high-grade (66.7%) were observed. Development of an upper urinary tract tumor after treatment of a vesical tumor was noted in 4 (26.7%) patients. During the follow-up period, urinary bladder carcinomas were diagnosed in 5 (33.3%) patients with primary upper urinary tract tumors. Nephroureterectomy remains the standard treatment for UUT-TCC. Organ-sparing surgery is possible in selected patients with low clinical stage and low grade tumors. Patients treated for urinary bladder carcinomas require regular monitoring of the upper urinary tract.

Should Complete and Incomplete Spinal Cord Injury Patients Receive the Same Attention in Urodynamic Evaluations and Ultrasonography Examinations of the Upper Urinary Tract?

ERIC Educational Resources Information Center

Akkoc, Yesim; Cinar, Yasemin; Kismali, Erkan

2012-01-01

The aim of the study was to compare urodynamic findings and upper urinary tract (UUT) abnormalities detected by ultrasonography in complete and incomplete suprasacral spinal cord injury (SCI) patients with neurogenic detrusor overactivity. Thirty-eight suprasacral SCI patients who underwent ultrasonography evaluation of the UUT and urodynamic…

Decreased measles antibody response after measles-mumps-rubella vaccine in infants with colds.

PubMed

Krober, M S; Stracener, C E; Bass, J W

1991-04-24

We examined the possibility that the common cold or afebrile upper respiratory tract infection might interfere with successful immunization in children who receive standard measles-mumps-rubella vaccine. Infants 15 to 18 months of age presenting at our well-child clinics for routine examination and immunizations were divided into two groups. Those infants with a history and physical findings of upper respiratory tract infection were compared with healthy control group infants who did not have upper respiratory tract infections, and who did not have a history of upper respiratory tract infection symptoms within the previous month. Both groups were studied for their serologic response to measles-mumps-rubella vaccination. Prevaccination serum samples were obtained prior to vaccine administration and postvaccination serum samples were obtained 6 to 8 weeks later. Measles antibody was measured in these serum samples by an indirect fluorescein-tagged antibody test. Ten (21%) of 47 infants with colds failed to develop measles antibody, while only one (2%) of 51 well infants failed to develop antibody. We conclude that infants with colds have a significant seroconversion failure rate associated with measles vaccine administration and that this may be the cause of some primary measles vaccine failures.

[Role of retroperitoneal laparoscopic nephroureterectomy in the current treatment of upper urinary tract urothelial carcinoma].

PubMed

Burghelea, C; Ghervan, L; Bărbos, A; Lucan, V C; Elec, F; Moga, S; Bologa, F; Constantin, L; Iacob, G; Partiu, A

2008-01-01

Nowadays, the standard treatment for upper tract transitional cell carcinoma is open nephroureterectomy, by double lumbar and iliac approach, with peri-meat bladder cuff excision. Since the first laparoscopic nephroureterectomy was performed, several surgical teams were interested by this approach for the treatment of the upper tract transitional cell carcinoma. To plead for retro-peritoneoscopic nephroureterectomy and to assess the surgical indications. Were analyzed the results of the recent published series on nephroureterectomy for upper urinary tract transitional cell carcinoma. Were included studies on conventional, laparoscopic and retro-peritoneoscopic nephroureterectomy, with at least 10 cases, published after 2000. The advantages of retro-peritoneoscopic nephroureterectomy are: minimum blood loss, reduced analgesic intake, a shorter hospital stay and a faster return to previous activities, lower rate of intra- or postoperative complications compared with trans-peritoneal laparoscopy or conventional surgery. With a proper case selection the oncologic safety of the retro-peritoneoscopy is equivalent with open surgery. On short term, retro-peritoneoscopic approach shows similar oncological outcome with other techniques. Retroperitoneal laparoscopic nephroureterectomy is a viable alternative to conventional or trans-peritoneoscopic procedure, with clear cut benefits for the patient. Retro-peritoneoscopy is associated with a low morbidity.

Aristolochic acid nephropathy: Harbinger of a global iatrogenic disease.

PubMed

Grollman, Arthur P

2013-01-01

This review constitutes an overview of our investigations of aristolochic acid nephropathy, a chronic kidney disease associated with carcinomas of the upper urinary tract. Our studies began by confirming the hypothesis that chronic dietary poisoning by aristolochic acid was responsible for endemic (Balkan) nephropathy. A unique TP53 mutational signature in urothelial tumors and the presence of aristolactam-DNA adducts in the renal cortex, defined in the course of this research, proved to be robust biomarkers of exposure to this potent nephrotoxin and human carcinogen. Armed with this information, we used molecular epidemiologic approaches and novel mechanistic information to establish the causative role of aristolochic acid in upper urinary tract carcinoma in Taiwan, where one-third of the population had been prescribed herbal remedies containing Aristolochia, and the recorded incidence of upper urinary tract cancers is the highest in the world. As traditional Chinese medicine is practiced similarly in Taiwan and China, it is likely that upper urinary tract carcinomas and their attendant aristolochic acid nephropathy are prevalent in China and other Asian countries where Aristolochia herbs have been used for centuries in the treatment and prevention of disease, creating a potential public health problem of considerable magnitude. Copyright © 2012 Wiley Periodicals, Inc.

Upper GI tract lesions in familial adenomatous polyposis (FAP): enrichment of pyloric gland adenomas and other gastric and duodenal neoplasms.

PubMed

Wood, Laura D; Salaria, Safia N; Cruise, Michael W; Giardiello, Francis M; Montgomery, Elizabeth A

2014-03-01

Patients with familial adenomatous polyposis (FAP), an autosomal dominant cancer predisposition syndrome caused by mutations in the APC gene, develop neoplasms in both the upper and lower gastrointestinal (GI) tract. To clarify the upper GI tract lesions in FAP patients in a tertiary care setting, we reviewed specimens from 321 endoscopies in 66 patients with FAP. Tubular adenomas in the small bowel were the most common neoplasms (present in 89% of patients), although only 1 patient developed invasive carcinoma of the small bowel. Several types of gastric neoplasms were identified--65% of patients had at least 1 fundic gland polyp, and 23% of patients had at least 1 gastric foveolar-type gastric adenoma. Pyloric gland adenomas were also enriched, occurring in 6% of patients--this is a novel finding in FAP patients. Despite the high frequency of gastric neoplasms, only 1 patient developed carcinoma in the stomach. The very low frequency of carcinoma in these patients suggests that current screening procedures prevent the vast majority of upper GI tract carcinomas in patients with FAP, at least in the tertiary care setting.

The cryptic plasmid is more important for Chlamydia muridarum to colonize the mouse gastrointestinal tract than to infect the genital tract.

PubMed

Shao, Lili; Melero, Jose; Zhang, Nu; Arulanandam, Bernard; Baseman, Joel; Liu, Quanzhong; Zhong, Guangming

2017-01-01

Chlamydia has been detected in the gastrointestinal tracts of both animals and humans. However, the mechanism by which Chlamydia colonizes the gut remains unclear. Chlamydia muridarum is known to spread from the genital to the gastrointestinal tracts hematogenously. The C. muridarum plasmid is a key pathogenic determinant in the mouse upper genital tract although plasmid-deficient C. muridarum is still able to colonize the upper genital tract. We now report that plasmid-deficient C. muridarum exhibits significantly delayed/reduced spreading from the mouse genital to the gastrointestinal tracts. C. muridarum with or without plasmid maintained similar levels in the mouse circulatory system following intravenous inoculation but the hematogenous plasmid-deficient C. muridarum was significantly less efficient in colonizing the gastrointestinal tract. Consistently, plasmid-deficient C. muridarum failed to restore normal colonization in the gastrointestinal tract even after intragastric inoculation at a high dose. Thus, we have demonstrated a plasmid-dependent colonization of C. muridarum in the gastrointestinal tract, supporting the concept that C. muridarum may have acquired the plasmid for adaptation to the mouse gastrointestinal tract during oral-fecal transmission. Since the plasmid is more important for C. muridarum to colonize the gastrointestinal tract than to infect the genital tract, the current study has laid a foundation for further defining the host pathways targeted by the plasmid-encoded or -regulated chlamydial effectors.

The cryptic plasmid is more important for Chlamydia muridarum to colonize the mouse gastrointestinal tract than to infect the genital tract

PubMed Central

Shao, Lili; Melero, Jose; Zhang, Nu; Arulanandam, Bernard; Baseman, Joel; Liu, Quanzhong

2017-01-01

Chlamydia has been detected in the gastrointestinal tracts of both animals and humans. However, the mechanism by which Chlamydia colonizes the gut remains unclear. Chlamydia muridarum is known to spread from the genital to the gastrointestinal tracts hematogenously. The C. muridarum plasmid is a key pathogenic determinant in the mouse upper genital tract although plasmid-deficient C. muridarum is still able to colonize the upper genital tract. We now report that plasmid-deficient C. muridarum exhibits significantly delayed/reduced spreading from the mouse genital to the gastrointestinal tracts. C. muridarum with or without plasmid maintained similar levels in the mouse circulatory system following intravenous inoculation but the hematogenous plasmid-deficient C. muridarum was significantly less efficient in colonizing the gastrointestinal tract. Consistently, plasmid-deficient C. muridarum failed to restore normal colonization in the gastrointestinal tract even after intragastric inoculation at a high dose. Thus, we have demonstrated a plasmid-dependent colonization of C. muridarum in the gastrointestinal tract, supporting the concept that C. muridarum may have acquired the plasmid for adaptation to the mouse gastrointestinal tract during oral-fecal transmission. Since the plasmid is more important for C. muridarum to colonize the gastrointestinal tract than to infect the genital tract, the current study has laid a foundation for further defining the host pathways targeted by the plasmid-encoded or -regulated chlamydial effectors. PMID:28542376

A simple method for accurate endotracheal placement of an intubation tube in Guinea pigs to assess lung injury following chemical exposure.

PubMed

Nambiar, M P; Gordon, R K; Moran, T S; Richards, S M; Sciuto, A M

2007-01-01

ABSTRACT Guinea pigs are considered as the animal model of choice for toxicology and medical countermeasure studies against chemical warfare agents (CWAs) and toxic organophosphate pesticides because of the low levels of carboxylesterase compared to rats and mice. However, it is difficult to intubate guinea pigs without damaging the larynx to perform CWA inhalation experiments. We describe an easy technique of intubation of guinea pigs for accurate endotracheal placement of the intubation tube. The technique involves a speculum made by cutting the medium-size ear speculum in the midline leaving behind the intact circular connector to the otoscope. Guinea pigs were anesthetized with Telazol/meditomidine, the tongue was pulled using blunt forceps, and an otoscope attached with the specially prepared speculum was inserted gently. Insertion of the speculum raises the epiglottis and restrains the movements of vocal cord, which allows smooth insertion of the metal stylet-reinforced intubation tube. Accurate endotracheal placement of the intubation tube was achieved by measuring the length from the tracheal bifurcation to vocal cord and vocal cord to the upper front teeth. The average length of the trachea in guinea pigs (275 +/- 25 g) was 5.5 +/- 0.2 cm and the distance from the vocal cord to the front teeth was typically 3 cm. Coinciding an intubation tube marked at 6 cm with the upper front teeth accurately places the intubation tube 2.5 cm above the tracheal bifurcation. This simple method of intubation does not disturb the natural flora of the mouth and causes minimum laryngeal damage. It is rapid and reliable, and will be very valuable in inhalation exposure to chemical/biological warfare agents or toxic chemicals to assess respiratory toxicity and develop medical countermeasures.

Speech production following partial glossectomy.

PubMed

Fletcher, S G

1988-08-01

Changes in the dimensions and patterns of articulation used by three speakers to compensate for different amounts of tongue tissue excised during partial glossectomy were investigated. Place of articulation was shifted to parts of the vocal tract congruent with the speakers' surgically altered lingual morphology. Certain metrical properties of the articulatory gestures, such as width of the sibilant groove, were maintained. Intelligibility data indicated that perceptually acceptable substitute sounds could be produced by such transposed gestures.

Long-term exercising video-endoscopic examination of the upper airway following laryngoplasty surgery: a prospective cross-sectional study of 41 horses.

PubMed

Barnett, T P; O'Leary, J M; Parkin, T D H; Dixon, P M; Barakzai, S Z

2013-09-01

To investigate upper respiratory tract function in horses, previously undergoing laryngoplasty (LP), using exercising video-endoscopy. To evaluate arytenoid abduction and stability, diagnose any concurrent upper airway problems, and correlate these with the owners' perception of success. Horses undergoing LP during a 6-year period at one hospital were initially included. Those available for re-examination were exercised for a duration and intensity considered maximal for their discipline using an over-ground endoscope. Resting and exercising laryngeal and pharyngeal videos were analysed blindly. Multivariable analysis was used to test associations between resting and exercising endoscopic variables, and also between endoscopic variables and owner questionnaire findings. Forty-one horses were included and 78% had a form of upper airway collapse at exercise, with 41% having complex forms, despite 93% of owners reporting the surgery to have been beneficial. Horses with poor abduction (grades 4 or 5/5) were 6 times more likely to make respiratory noise compared with those with good (grades 2 or 3/5) abduction (P = 0.020; 95% confidence interval [CI] 1.3-27.0), and those not having a ventriculectomy were 4.9 times more likely to produce respiratory noise post operatively (P = 0.048; 95% CI 1.0-23.9). Palatal dysfunction was observed in 24% of horses at rest, and 56% at exercise, with the diagnosis at rest and exercise significantly associated (P = 0.001). Increasing severity of pharyngeal lymphoid hyperplasia (prevalence 61%) was significantly associated with increasing arytenoid abduction (P = 0.01). Thirty-four per cent of horses had aryepiglottic fold collapse and 22% of horses had vocal fold collapse. Many horses that had previously had LP were diagnosed with upper airway abnormalities, despite the procedure being considered as beneficial by most owners. When investigating cases of ongoing respiratory noise or poor performance following LP, exercising endoscopy must be considered. Continued respiratory noise may be associated with poor arytenoid abduction and not performing concurrent ventriculectomy. © 2012 EVJ Ltd.

Variation of p53 mutational spectra between carcinoma of the upper and lower respiratory tract.

PubMed

Law, J C; Whiteside, T L; Gollin, S M; Weissfeld, J; El-Ashmawy, L; Srivastava, S; Landreneau, R J; Johnson, J T; Ferrell, R E

1995-07-01

Mutations of the p53 tumor suppressor gene are the most common genetic alterations associated with human cancer. Tumor-associated p53 mutations often show characteristic tissue-specific profiles which may infer environmentally induced mutational mechanisms. The p53 mutational frequency and spectrum were determined for 95 carcinomas of the upper and lower respiratory tract (32 lung and 63 upper respiratory tract). Mutations were identified at a frequency of 30% in upper respiratory tract (URT) tumors and 31% in lung tumors. All 29 identified mutations were single-base substitutions. Comparison of the frequency of specific base substitutions between lung and URT showed a striking difference. Transitions occurred at a frequency of 68% in URT, but only 30% in lung. Mutations involving G:C-->A:T transitions, which are commonly reported in gastric and esophageal tumors, were the most frequently identified alteration in URT (11/19). Mutations involving G:C-->T:A transversions, which were relatively common in lung tumors (3/10) and are representative of tobacco smoke-induced mutations were rare in URT tumors (1/19). Interestingly, G:C-->A:T mutations at CpG sites, which are characteristic of endogenous processes, were observed frequently in URT tumors (9/19) but only rarely in lung tumors (1/10), suggesting that both endogenous and exogenous factors are responsible for the observed differences in mutational spectra between the upper and lower respiratory systems.

Hemostatic powder TC-325 in the management of upper and lower gastrointestinal bleeding: a two-year experience at a single institution.

PubMed

Chen, Yen-I; Barkun, Alan; Nolan, Sabrina

2015-02-01

TC-325 is a novel endoscopic hemostatic powder. Our aim was to describe a single-center experience with the use of TC-325 in the upper and lower gastrointestinal tract, while for the first time attempting to determine how long the powder remains on a lesion. The charts of consecutive patients receiving TC-325 therapy between July 2011 and July 2013 were reviewed retrospectively. Primary endpoints included immediate hemostasis and early rebleeding (≤ 72 hours). Overall, 60 patients received 67 treatments with TC-325: 21 for nonmalignant nonvariceal upper gastrointestinal bleeding, 19 for malignant upper gastrointestinal bleeding, 11 for lower gastrointestinal bleeding, and 16 for intra-procedural bleeding. Immediate hemostasis was achieved in 66 cases (98.5 %), with 6 cases (9.5 %) of early rebleeding. No serious adverse events were noted. No TC-325 powder was identified in the 11 patients who underwent second-look endoscopy, performed within 24 hours in 4 patients. TC-325 appears safe and effective for managing bleeding in the upper and lower gastrointestinal tract with a variety of causes. The time during which the powder remains in the gastrointestinal tract is short, with complete elimination from the gastrointestinal tract as early as within 24 hours after use. © Georg Thieme Verlag KG Stuttgart · New York.

Factors influencing the development of otitis media among Sicilian children affected by upper respiratory tract infections.

PubMed

Martines, Francesco; Salvago, Pietro; Ferrara, Sergio; Messina, Giuseppe; Mucia, Marianna; Plescia, Fulvio; Sireci, Federico

2016-01-01

Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding) have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. To investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. A case-control study of 204 children with upper respiratory tract infections who developed otitis media during a 3 weeks monitoring period and 204 age and sex-matched healthy controls. Seventeen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis and multivariate logistic regression analysis were used to examine the association between risk factors and occurrence of otitis media. Otitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (p<0.05); children were more susceptible to develop otitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (p<0.05). Allergy and urban localization increased the risk of otitis media in children exposed to smoke respectively of 166% and 277% (p<0.05); the joint effect of asthma and presence of pets in allergic population increased the risk of recurrence of 11%, while allergy, cough and runny nose together increased this risk of 74%. Upper respiratory tract infections and otitis media are common childhood diseases strongly associated with low parental educational attainment (p=0.0001), exposure to smoke (p=0.0001), indoor exposure to mold (p=0.0001), laryngopharyngeal reflux disease (p=0.0002) and the lack of breast-feeding (p=0.0014); an increased risk of otitis media recurrences was observed in the presence of allergy, persistent cough and runny nose (p=0.0001). The modification of the identified risk factors for otitis media should be recommended to realize a correct primary care intervention. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Upper and lower respiratory tract microbiota in horses: bacterial communities associated with health and mild asthma (inflammatory airway disease) and effects of dexamethasone.

PubMed

Bond, Stephanie L; Timsit, Edouard; Workentine, Matthew; Alexander, Trevor; Léguillette, Renaud

2017-08-23

The microbial composition of the equine respiratory tract, and differences due to mild equine asthma (also called Inflammatory Airway Disease (IAD)) have not been reported. The primary treatment for control of IAD in horses are corticosteroids. The objectives were to characterize the upper and lower respiratory tract microbiota associated with respiratory health and IAD, and to investigate the effects of dexamethasone on these bacterial communities using high throughput sequencing. The respiratory microbiota of horses was dominated by four major phyla, Proteobacteria (43.85%), Actinobacteria (21.63%), Firmicutes (16.82%), and Bacteroidetes (13.24%). Fifty genera had a relative abundance > 0.1%, with Sphingomonas and Pantoea being the most abundant. The upper and lower respiratory tract microbiota differed in healthy horses, with a decrease in richness in the lower airways, and 2 OTUs that differed in abundance. There was a separation between bacterial communities in the lower respiratory tract of healthy and IAD horses; 6 OTUs in the tracheal community had different abundance with disease status, with Streptococcus being increased in IAD horses. Treatment with dexamethasone had an effect on the lower respiratory tract microbiota of both heathy and IAD horses, with 8 OTUs increasing in abundance (including Streptococcus) and 1 OTU decreasing. The lower respiratory tract microbiota differed between healthy and IAD horses. Further research on the role of Streptococcus in IAD is warranted. Dexamethasone treatment affected the lower respiratory tract microbiota, which suggests that control of bacterial overgrowth in IAD horses treated with dexamethasone could be part of the treatment strategy.

The impact of rate reduction and increased vocal intensity on coarticulation in dysarthria

NASA Astrophysics Data System (ADS)

Tjaden, Kris

2003-04-01

The dysarthrias are a group of speech disorders resulting from impairment to nervous system structures important for the motor execution of speech. Although numerous studies have examined how dysarthria impacts articulatory movements or changes in vocal tract shape, few studies of dysarthria consider that articulatory events and their acoustic consequences overlap or are coarticulated in connected speech. The impact of rate, loudness, and clarity on coarticulatory patterns in dysarthria also are poorly understood, although these prosodic manipulations frequently are employed as therapy strategies to improve intelligibility in dysarthria and also are known to affect coarticulatory patterns for at least some neurologically healthy speakers. The current study examined the effects of slowed rate and increased vocal intensity on anticipatory coarticulation for speakers with dysarthria secondary to Multiple Sclerosis (MS), as inferred from the acoustic signal. Healthy speakers were studied for comparison purposes. Three repetitions of twelve target words embedded in the carrier phrase ``It's a -- again'' were produced in habitual, loud, and slow speaking conditions. F2 frequencies and first moment coefficients were used to infer coarticulation. Both group and individual speaker trends will be examined in the data analyses.

Bilateral vocal fold immobility: a 13 year review of etiologies, management and the utility of the Empey index.

PubMed

Brake, Maria K; Anderson, Jennifer

2015-06-26

Bilateral vocal fold immobility (BVFI) is a rare diagnosis causing dyspnea, dysphonia and dysphagia. Management depends on respiratory performance, airway patency, vocal ability, and quality-of-life priorities. The authors review the presentation, management and outcome in patients diagnosed with BVFI. The utility and efficacy of the Empey index (EI) and the Expiratory Disproportion Index (EDI) are evaluated as an objective monitoring tools for BVFI patients. A 13-year retrospective review was performed of BVFI patients at St. Michael's Hospital, University of Toronto, a tertiary referral centre for laryngology. Forty-eight patients were included; 46 presented with airway obstruction symptoms. Tracheotomy was required for airway management in 40% of patients throughout the course of their treatment, which was reduced to 19% at the end of the study period. Twenty-one patients underwent endoscopic arytenoidectomy/cordotomy. Non-operative management included continuous positive airway pressure devices. Pulmonary function testing was carried out in 29 patients. Only a portion of the BVFI patients met the defined upper airway obstruction criteria (45% EI and 52% EDI). Seven patients had complete pre- and post-operative PFTs for comparison and all seven had ratios that significantly improved post-operatively which correlated clinically. The EI and EDI have limited use in evaluating patients with who have variable upper airway obstruction, but may be helpful in monitoring within subject airway function changes.

Warfighter Sustainability: Maximizing Human Performance in Hostile Environments

DTIC Science & Technology

2008-10-01

Study 4: Effects of Beta Glucan on Symptoms of Upper Tract Infection in Wildland Firefighters. ix Approved for public release...Study 4: Effects of Beta Glucan on Symptoms of Upper Tract Infection in Wildland Firefighters. The use of a beta glucan supplement may decrease...reduce the required fluid intake during extended operations without compromising work output. In addition, the ingestion of a beta glucan supplement may

Procalcitonin Testing to Guide Antibiotic Therapy in Acute Upper and Lower Respiratory Tract Infections.

PubMed

Schuetz, Philipp; Wirz, Yannick; Mueller, Beat

2018-03-06

Is the use of procalcitonin for guiding antibiotic decisions in patients with acute upper and lower respiratory tract infections associated with improved clinical outcomes compared with usual care? Among patients with varying types and severity of acute respiratory infection, using procalcitonin to guide decisions about antibiotics is associated with lower rates of antibiotic exposure, antibiotic-related adverse effects, and mortality.

Therapeutic upper gastrointestinal tract endoscopy in Paediatric Gastroenterology

PubMed Central

Rahman, Imdadur; Patel, Praful; Boger, Philip; Rasheed, Shahnawaz; Thomson, Mike; Afzal, Nadeem Ahmad

2015-01-01

Since the first report of use of endoscopy in children in the 1970s, there has seen an exponential growth in published experience and innovation in the field. In this review article we focus on modern age therapeutic endoscopy practice, explaining use of traditional as well as new and innovative techniques, for diagnosis and treatment of diseases in the paediatric upper gastrointestinal tract. PMID:25789087

Trial of Postoperative Radiation, Cisplatin, and Panitumumab in Locally Advanced Head and Neck Cancer

ClinicalTrials.gov

2017-09-04

Cancer of Head; Cancer of Head and Neck; Cancer of Neck; Cancer of the Head; Cancer of the Head and Neck; Cancer of the Neck; Head and Neck Cancer; Head Cancer; Head Neoplasms; Head, Neck Neoplasms; Neck Cancer; Neck Neoplasms; Neoplasms, Head; Neoplasms, Head and Neck; Neoplasms, Neck; Neoplasms, Upper Aerodigestive Tract; UADT Neoplasms; Upper Aerodigestive Tract Neoplasms

Improved detection of Pneumocystis jirovecii in upper and lower respiratory tract specimens from children with suspected pneumocystis pneumonia using real-time PCR: a prospective study

PubMed Central

2011-01-01

Background Pneumocystis pneumonia (PCP) is a major cause of hospitalization and mortality in HIV-infected African children. Microbiologic diagnosis relies predominantly on silver or immunofluorescent staining of a lower respiratory tract (LRT) specimens which are difficult to obtain in children. Diagnosis on upper respiratory tract (URT) specimens using PCR has been reported useful in adults, but data in children are limited. The main objectives of the study was (1) to compare the diagnostic yield of PCR with immunofluorescence (IF) and (2) to investigate the usefulness of upper compared to lower respiratory tract samples for diagnosing PCP in children. Methods Children hospitalised at an academic hospital with suspected PCP were prospectively enrolled. An upper respiratory sample (nasopharyngeal aspirate, NPA) and a lower respiratory sample (induced sputum, IS or bronchoalveolar lavage, BAL) were submitted for real-time PCR and direct IF for the detection of Pneumocystis jirovecii. A control group of children with viral lower respiratory tract infections were investigated with PCR for PCP. Results 202 children (median age 3.3 [inter-quartile range, IQR 2.2 - 4.6] months) were enrolled. The overall detection rate by PCR was higher than by IF [180/349 (52%) vs. 26/349 (7%) respectively; p < 0.0001]. PCR detected more infections compared to IF in lower respiratory tract samples [93/166 (56%) vs. 22/166 (13%); p < 0.0001] and in NPAs [87/183 (48%) vs. 4/183 (2%); p < 0.0001]. Detection rates by PCR on upper (87/183; 48%) compared with lower respiratory tract samples (93/166; 56%) were similar (OR, 0.71; 95% CI, 0.46 - 1.11). Only 2/30 (6.6%) controls were PCR positive. Conclusion Real-time PCR is more sensitive than IF for the detection of P. jirovecii in children with PCP. NPA samples may be used for diagnostic purposes when PCR is utilised. Wider implementation of PCR on NPA samples is warranted for diagnosing PCP in children. PMID:22123076

Upper urinary tract urothelial cell carcinoma: location as a predictive factor for concomitant bladder carcinoma.

PubMed

Cosentino, Marco; Palou, Joan; Gaya, Josep M; Breda, Alberto; Rodriguez-Faba, Oscar; Villavicencio-Mavrich, Humberto

2013-02-01

To investigate the existence of predictive factors for concomitant, primary UUT-UCC and BC. Upper urinary tract urothelial cell carcinoma (UUT-UCC) is a pan-urothelial disease of the transitional epithelial cells. Although several studies have shown the association of bladder recurrence following UUT-UCC, little is known on the incidence of concomitant UUT-UCC and bladder cancer (BC) without previous BC. A retrospective review of 673 patients diagnosed and treated for UUT-UCC was performed. Patients with history of BC were excluded. We investigated age, sex, location of the upper tract tumor (calyx, renal pelvis, upper ureter, mid-ureter, lower ureter), multifocality, clinical symptoms, tumor grade and pathological stage. Contingency tables and chi-square test were used for categorical variables and analysis of variance (ANOVA) for quantitative variables. 450 patients eligible for inclusion were identified. Of these, 76 (17 %) presented concomitant primary UUT-UCC and BC. Location of primary UUT-UCC was in calyx and/or renal pelvis in 25 patients (34 %), upper ureter 8 (11 %) and lower ureter 37 (49 %). In 6 patients (8 %), data were missing. Concomitant BC was found in 10, 18, and 33 % of patients with primary caliceal/renal pelvis, upper ureter and lower ureter UUT-UCC, respectively. On multivariate analysis, location of UUT-UCC was the only predictive factor for concomitant bladder tumor (OR: 1.7; 95 % CI, 1.007-2.906 p = 0.047). Our findings suggest that the possibility of concomitant BC in primary diagnosed patient with UUT-UCC is as high as 33 % and mainly depends on upper tract tumor location.

Use of plant extracts as an efficient alternative therapy of respiratory tract infections.

PubMed

Šmejkal, Karel; Rjašková, Veronika

Medicinal plants are advantageously used in the treatment of respiratory tract diseases. Upper respiratory tract catarrh is one of the diseases associated with seasonal weakening of immunity, and therefore, plant drugs with a non-specific immunomodulation effect are often used. Such plants include, but are not limited to, Echinacea (Echinacea purpurea) and American ginseng (Panax quinquefolius). In combination with medicinal plants having antibacterial and antiseptic effects, such as thyme (Thymus vulgaris) and pelargonium (Pelargonium sidoides), they can constitute efficient help in the treatment of respiratory tract diseases, shorten the duration of the disease and reduce the need of antibiotic therapy. The text presented summarizes the basic information about these plants, their ingredients, mechanisms of action and clinical tests confirming their effect and monitoring eventual adverse effects.Key words: Echinacea purpurea Panax quinquefolius Pelargonium sidoides Thymus vulgaris upper respiratory tract catarrh immunity.

Simultaneous antegrade/retrograde upper urinary tract access: Bart's modified lateral position for complex upper tract endourologic pathologic features.

PubMed

Moraitis, Konstantinos; Philippou, Prodromos; El-Husseiny, Tamer; Wazait, Hassan; Masood, Junaid; Buchholz, Noor

2012-02-01

To determine whether the Bart's modified lateral position is safe and effective for achieving simultaneous anterograde and retrograde access in complex upper urinary tract pathologic features. From November 2006 to September 2010, 45 procedures were performed, with the patients in the modified lateral position. The indication for these procedures was the presence of complex unilateral upper urinary tract pathologic features. The patients with muscular and/or skeletal abnormalities were excluded. All procedures were performed using simultaneous anterograde and retrograde access with the patient under general anesthesia. The preoperative investigation protocol included assessment of the stone burden and location using enhanced abdominal computed tomography. The patients were routinely examined 6 weeks after the procedure with a combination of plain abdominal radiography and renal ultrasonography. For patients treated for conditions causing upper urinary tract obstruction (pelviureteral junction obstruction and/or ureteral strictures), a mercaptoacetyltriglycine renography was performed at 4, 12, and 24 months postoperatively. The mean patient age was 51.2 years (range 17-79). Stone clearance was achieved by a single combined procedure in 36 patients (80%). Successful recanalization was achieved in all patients with pelviureteral junction obstruction and ureteral strictures. In 4 patients (8.8%), persistent hematuria was noted, and 2 patients (4.4%) developed postoperative urinary sepsis and were treated conservatively. Modification to the lateral position compares equally with contemporary percutaneous nephrolithotomy series. It provides wide exposure of the flank, allowing the choice of multiple access sites, enhanced control, and a wide angle for handling of the antegrade instruments. Two surgeons can work simultaneously, addressing complex endourologic pathologic features in high-risk patients. Copyright © 2012. Published by Elsevier Inc.

Validity of administrative coding in identifying patients with upper urinary tract calculi.

PubMed

Semins, Michelle J; Trock, Bruce J; Matlaga, Brian R

2010-07-01

Administrative databases are increasingly used for epidemiological investigations. We performed a study to assess the validity of ICD-9 codes for upper urinary tract stone disease in an administrative database. We retrieved the records of all inpatients and outpatients at Johns Hopkins Hospital between November 2007 and October 2008 with an ICD-9 code of 592, 592.0, 592.1 or 592.9 as one of the first 3 diagnosis codes. A random number generator selected 100 encounters for further review. We considered a patient to have a true diagnosis of an upper tract stone if the medical records specifically referenced a kidney stone event, or included current or past treatment for a kidney stone. Descriptive and comparative analyses were performed. A total of 8,245 encounters coded as upper tract calculus were identified and 100 were randomly selected for review. Two patients could not be identified within the electronic medical record and were excluded from the study. The positive predictive value of using all ICD-9 codes for an upper tract calculus (592, 592.0, 592.1) to identify subjects with renal or ureteral stones was 95.9%. For 592.0 only the positive predictive value was 85%. However, although the positive predictive value for 592.1 only was 100%, 26 subjects (76%) with a ureteral stone were not appropriately billed with this code. ICD-9 coding for urinary calculi is likely to be sufficiently valid to be useful in studies using administrative data to analyze stone disease. However, ICD-9 coding is not a reliable means to distinguish between subjects with renal and ureteral calculi. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer.

PubMed

Wang, Agnes J; Goldsmith, Zachariah G; Neisius, Andreas; Astroza, Gaston M; Oredein-McCoy, Olugbemisola; Iqbal, Muhammad W; Simmons, W Neal; Madden, John F; Preminger, Glenn M; Inman, Brant A; Lipkin, Michael E; Ferrandino, Michael N

2013-03-01

Abstract Background and Purpose: Topical chemotherapy for urothelial cancer is dependent on adequate contact time of the chemotherapeutic agent with the urothelium. To date, there has not been a reliable method of maintaining this contact for renal or ureteral urothelial carcinoma. We evaluated the safety and feasibility of using a reverse thermosensitive polymer to improve dwell times of mitomycin C (MMC) in the upper tract. Using a porcine model, four animals were treated ureteroscopically with both upper urinary tracts receiving MMC mixed with iodinated contrast. One additional animal received MMC percutaneously. The treatment side had ureteral outflow blocked with a reverse thermosensitive polymer plug. MMC dwell time was monitored fluoroscopically and intrarenal pressures measured. Two animals were euthanized immediately, and three animals were euthanized 5 days afterward. In control kidneys, drainage occurred at a mean of 5.3±0.58 minutes. Intrarenal pressures stayed fairly stable: 9.7±14.0 cm H20. In treatment kidneys, dwell time was extended to 60 minutes, when the polymer was washed out. Intrarenal pressures in the treatment kidneys peaked at 75.0±14.7 cm H20 and reached steady state at 60 cm H20. Pressures normalized after washout of the polymer with cool saline. Average washout time was 11.8±9.6 minutes. No histopathologic differences were seen between the control and treatment kidneys, or with immediate compared with delayed euthanasia. A reverse thermosensitive polymer can retain MMC in the upper urinary tract and appears to be safe from our examination of intrarenal pressures and histopathology. This technique may improve the efficacy of topical chemotherapy in the management of upper tract urothelial carcinoma.

Epidemiology of upper urinary tract stone disease in a Taiwanese population: a nationwide, population based study.

PubMed

Huang, Wei-Yi; Chen, Yu-Fen; Carter, Stacey; Chang, Hong-Chiang; Lan, Chung-Fu; Huang, Kuo-How

2013-06-01

We investigated the epidemiology of upper urinary tract stone disease in Taiwan using a nationwide, population based database. This study was based on the National Health Insurance Research Database of Taiwan, which contains data on all medical beneficiary claims from 22.72 million enrollees, accounting for almost 99% of the Taiwanese population. The Longitudinal Health Insurance Database 2005, a subset of the National Health Insurance Research Database, contains data on all medical benefit claims from 1997 through 2010 for a subset of 1 million beneficiaries randomly sampled from the 2005 enrollment file. For epidemiological analysis we selected subjects whose claims records included the diagnosis of upper urinary tract urolithiasis. The age adjusted rate of medical care visits for upper urinary tract urolithiasis decreased by 6.5% from 1,367/100,000 subjects in 1998 to 1,278/100,000 in 2010. There was a significantly decreasing trend during the 13-year period in visits from female and all subjects (r(2) = 0.86, p = 0.001 and r(2) = 0.52, p = 0.005, respectively). In contrast, an increasing trend was noted for male subjects (r(2) = 0.45, p = 0.012). The age adjusted prevalence in 2010 was 9.01%, 5.79% and 7.38% in male, female and all subjects, respectively. The overall recurrence rate at 1 and 5 years was 6.12% and 34.71%, respectively. Male subjects had a higher recurrence rate than female subjects. Our study provides important information on the epidemiology of upper urinary tract stone disease in Taiwan, helping to quantify the burden of urolithiasis and establish strategies to decrease the risk of urolithiasis. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Concurrent Preoperative Presence of Hydronephrosis and Flank Pain Independently Predicts Worse Outcome of Upper Tract Urothelial Carcinoma.

PubMed

Yeh, Hsin-Chih; Jan, Hau-Chern; Wu, Wen-Jeng; Li, Ching-Chia; Li, Wei-Ming; Ke, Hung-Lung; Huang, Shu-Pin; Liu, Chia-Chu; Lee, Yung-Chin; Yang, Sheau-Fang; Liang, Peir-In; Huang, Chun-Nung

2015-01-01

To investigate the impact of preoperative hydronephrosis and flank pain on prognosis of patients with upper tract urothelial carcinoma. In total, 472 patients with upper tract urothelial carcinoma managed by radical nephroureterectomy were included from Kaohsiung Medical University Hospital Healthcare System. Clinicopathological data were collected retrospectively for analysis. The significance of hydronephrosis, especially when combined with flank pain, and other relevant factors on overall and cancer-specific survival were evaluated. Of the 472 patients, 292 (62%) had preoperative hydronephrosis and 121 (26%) presented with flank pain. Preoperative hydronephrosis was significantly associated with age, hematuria, flank pain, tumor location, and pathological tumor stage. Concurrent presence of hydronephrosis and flank pain was a significant predictor of non-organ-confined disease (multivariate-adjusted hazard ratio = 2.10, P = 0.025). Kaplan-Meier analysis showed significantly poorer overall and cancer-specific survival in patients with preoperative hydronephrosis (P = 0.005 and P = 0.026, respectively) and in patients with flank pain (P < 0.001 and P = 0.001, respectively) than those without. However, only simultaneous hydronephrosis and flank pain independently predicted adverse outcome (hazard ratio = 1.98, P = 0.016 for overall survival and hazard ratio = 1.87, P = 0.036 for and cancer-specific survival, respectively) in multivariate Cox proportional hazards models. In addition, concurrent presence of hydronephrosis and flank pain was also significantly predictive of worse survival in patient with high grade or muscle-invasive disease. Notably, there was no difference in survival between patients with hydronephrosis but devoid of flank pain and those without hydronephrosis. Concurrent preoperative presence of hydronephrosis and flank pain predicted non-organ-confined status of upper tract urothelial carcinoma. When accompanied with flank pain, hydronephrosis represented an independent predictor for worse outcome in patients with upper tract urothelial carcinoma.

Ureteropyeloscopy in the diagnosis of patients with upper tract hematuria: an initial clinical study.

PubMed

Yazaki, T; Kamiyama, Y; Tomomasa, H; Shimizu, H; Okano, Y; Iiyama, T; Iizumi, T; Umeda, T

1999-05-01

To study the usefulness and safety of ureteropyeloscopy in the diagnosis of upper tract hematuria of unknown etiology by standard diagnostic methods. Fifteen patients with upper tract hematuria of unknown etiology were the subjects of the present study. Prior to ureteropyeloscopy, they underwent standard diagnostic methods, including cystourethroscopy, excretory urography and computed tomography scan. The upper tract (ureter, renal pelvis and calyces) was inspected systematically with a flexible ureteropyeloscope under epidural anesthesia. A biopsy specimen was obtained when neoplasm of a suspicious lesion was seen. Bleeding and hemangiomatous lesions were fulgurated at the time of ureteropyeloscopy. Unilateral gross hematuria was seen in 12 patients. Imaging studies revealed a filling defect in four patients, ureteral stenosis in one patient and nutcracker phenomenon in one patient. Urine cytology was positive in three patients and suspicious in four patients. Results of ureteropyeloscopy were papillary tumor in three patients, whitish encrustation in one patient, redness of the renal pelvis in one patient, bleeding from the renal calyx in two patients, hemangiomatous lesion in one patient, ureteral stenosis in two patients and no abnormalities in five patients. Biopsies were performed in five patients. The pathology results were transitional cell carcinoma in four patients and no abnormality in one patient. Although a ureteral stent catheter was placed in one patient, no serious complications were encountered during or after the procedures. Ureteropyeloscopy was useful and relatively safe. This endoscopic examination can differentiate insignificant lesions from significant lesions by visual inspection of the lesions, in addition, pathological diagnosis by biopsy specimen can also be performed if deemed necessary. Ureteropyeloscopy is recommended in the diagnosis of upper tract hematuria of unknown etiology.

Contemporary surgical trends in the management of upper tract calculi.

PubMed

Oberlin, Daniel T; Flum, Andrew S; Bachrach, Laurie; Matulewicz, Richard S; Flury, Sarah C

2015-03-01

Upper tract nephrolithiasis is a common surgical condition that is treated with multiple surgical techniques, including shock wave lithotripsy, ureteroscopy and percutaneous nephrolithotomy. We analyzed case logs submitted to the ABU by candidates for initial certification and recertification to help elucidate the trends in management of upper tract urinary calculi. Annualized case logs from 2003 to 2012 were analyzed. We used logistic regression models to assess how surgeon specific attributes affected the way that upper tract stones were treated. Cases were identified by the CPT code of the corresponding procedure. A total of 6,620 urologists in 3 certification groups recorded case logs, including 2,275 for initial certification, 2,381 for first recertification and 1,964 for second recertification. A total of 441,162 procedures were logged, of which 54.2% were ureteroscopy, 41.3% were shock wave lithotripsy and 4.5% were percutaneous nephrolithotomy. From 2003 to 2013 there was an increase in ureteroscopy from 40.9% to 59.6% and a corresponding decrease in shock wave lithotripsy from 54% to 36.3%. For new urologists ureteroscopy increased from 47.6% to 70.9% of all stones cases logged and for senior clinicians ureteroscopy increased from 40% to 55%. Endourologists performed a significantly higher proportion of percutaneous nephrolithotomies than nonendourologists (10.6% vs 3.69%, p <0.0001) and a significantly smaller proportion of shock wave lithotripsies (34.2% vs 42.2%, p = 0.001). Junior and senior clinicians showed a dramatic adoption of endoscopic techniques. Treatment of upper tract calculi is an evolving field and provider specific attributes affect how these stones are treated. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Feasibility and safety of a novel magnetic-assisted capsule endoscope system in a preliminary examination for upper gastrointestinal tract.

PubMed

Lien, Gi-Shih; Wu, Ming-Shun; Chen, Chun-Nan; Liu, Chih-Wen; Suk, Fat-Moon

2018-04-01

Current capsule endoscopy procedures are ineffective for upper gastrointestinal (GI) tract examination because they do not allow for operator-controlled navigation of the capsule. External controllability of a capsule endoscope with an applied magnetic field is a possible solution to this problem. We developed a novel magnetic-assisted capsule endoscope (MACE) system to visualize the entire upper GI tract. The present study evaluated the safety and feasibility of the MACE system for the examination of the upper GI tract, including the esophagus, stomach, and duodenum. The present open clinical study enrolled ten healthy volunteers. All participants swallowed a MACE, and an external magnetic field navigator was used for magnetic capsule manipulation in the upper GI tract. We assessed the maneuverability of the magnetic capsule and completeness of the MACE examination as well as the safety and tolerability of the procedure. The present study enrolled ten healthy volunteers with a mean age and body mass index of 47.7 years and 25.6 kg/m 2 , respectively. One volunteer withdrew because of difficulty in swallowing the capsule. In total, nine volunteers underwent the MACE examination. The average examination time was 27.1 min. The maneuverability of the capsule was assessed as good and fair in 55.6 and 44.4% of the participants, respectively. The overall completeness of the examination in the esophagus, stomach, and duodenum was 100, 85.2, and 86.1%, respectively. No severe adverse events occurred during this study. All participants exhibited satisfactory tolerance of the MACE examination. The MACE system has satisfactory maneuverability and visualization completeness with excellent acceptance and tolerance.

[Clinical, ureteroscopic and photodynamic diagnosis of urothelial carcinomas of the upper tract: state-of-the art review for the yearly scientific report of the French National Association of Urology].

PubMed

Nison, L; Bozzini, G; Rouprêt, M; Traxer, O; Colin, P

2014-11-01

To propose a state-of-the art of current knowledge about clinical, ureteroscopic and photodynamic for the diagnosis of the upper urinary tract cancer (UTUC). A systematic review of the literature search was performed from the database Medline (NLM, Pubmed), focused on the following keywords: urothelial carcinomas; upper urinary tract; ureter; renal pelvis; diagnosis; fluorescence; ureteroscopy; photodynamic technique; biopsy; cytology. Gross hematuria and flank pain are the two main clinical symptoms revealing a UTUC in daily clinical practice. Urinary cystoscopy and cystoscopy are mandatory to rule out a concomittant synchronous bladder tumour. Flexible ureteroscopy has revolutionized the management of UTUC by allowing a full exploration of upper urinary tract, an endoscopi vizualization of the tumour and assessment of grade with biopsies. A flexible ureteroscopy is mandatory in diagnostic evaluation of UTUC as soon as a conservative management is being considered. New investigation technologies such as fluorescence, narrow band imaging and optical coherence tomography (± combined with ultra sound), are promising for a near future. It has to be understood that the diagnostic work-up of a UTUC has to be exhaustive and particularly the search of another urothelial carcinoma within the urinary tract. Flexible ureterosocopy has revolutionized the diagnosis and management of UTUC and belongs fully to its initial evaluation. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Procalcitonin and C-reactive protein in urinary tract infection diagnosis.

PubMed

Xu, Rui-Ying; Liu, Hua-Wei; Liu, Ji-Ling; Dong, Jun-Hua

2014-05-30

Urinary infections are a common type of pediatric disease, and their treatment and prognosis are closely correlated with infection location. Common clinical manifestations and laboratory tests are insufficient to differentiate between acute pyelonephritis and lower urinary tract infection. This study was conducted to explore a diagnostic method for upper and lower urinary tract infection differentiation. The diagnostic values of procalcitonin (PCT) and C-reactive protein (CRP) were analyzed using the receiver operating characteristic curve method for upper and lower urinary tract infection differentiation. PCT was determined using chemiluminescent immunoassay. The PCT and CRP values in children with acute pyelonephritis were significantly higher than those in children with lower urinary tract infection (3.90 ± 3.51 ng/ml and 68.17 ± 39.42 mg/l vs. 0.48 ± 0.39 ng/ml and 21.39 ± 14.92 mg/l). The PCT values were correlated with the degree of renal involvement, whereas the CRP values failed to show such a significant correlation. PCT had a sensitivity of 90.47% and a specificity of 88% in predicting nephropathia, whereas CRP had sensitivity of 85.71% and a specificity of 48%. Both PCT and CRP can be used for upper and lower urinary tract infection differentiation, but PCT has higher sensitivity and specificity in predicting pyelonephritis than CRP. PCT showed better results than CRP. PCT values were also correlated with the degree of renal involvement.

[Intrarenal Bacillus Calmette-Guerin perfusion therapy was effective for carcinoma in situ of the upper urinary tract after ileal conduit replacement : a case report].

PubMed

Hayashi, Takuji; Yamanaka, Yohei; Kinjo, Takanori; Katayama, Kinzo; Kamoto, Akihito; Mori, Naoki; Yoshioka, Toshiaki

2014-04-01

A 63-year-old man who had undergone radical cystectomy and ileal conduit formation for invasive bladder cancer 3 years before presented with continuous positive urinary cytology in the ileal conduit. His diagnosis was carcinoma in situ (CIS) of the left upper urinary tract. He was treated with Bacillus Calmette-Guérin (BCG) perfusion therapy using a single-J ureteric stent. BCG (80 mg) in 100 ml saline was instilled in a one-hour period weekly for 6 weeks. Usage of another catheter was effective for continuing the therapy. Urinary cytology in the left upper urinary tract and the ileal conduit became negative after the therapy. There was no evidence of recurrence or metastasis of urothelial carcinoma 6 months after the therapy.

Cephalexin

MedlinePlus

... caused by bacteria such as pneumonia and other respiratory tract infections; and infections of the bone, skin, ... condition and are having a dental or upper respiratory tract (nose, mouth, throat, voice box) procedure, in ...

Pulse Vector-Excitation Speech Encoder

NASA Technical Reports Server (NTRS)

Davidson, Grant; Gersho, Allen

1989-01-01

Proposed pulse vector-excitation speech encoder (PVXC) encodes analog speech signals into digital representation for transmission or storage at rates below 5 kilobits per second. Produces high quality of reconstructed speech, but with less computation than required by comparable speech-encoding systems. Has some characteristics of multipulse linear predictive coding (MPLPC) and of code-excited linear prediction (CELP). System uses mathematical model of vocal tract in conjunction with set of excitation vectors and perceptually-based error criterion to synthesize natural-sounding speech.

Evaluation of articulation simulation system using artificial maxillectomy models.

PubMed

Elbashti, M E; Hattori, M; Sumita, Y I; Taniguchi, H

2015-09-01

Acoustic evaluation is valuable for guiding the treatment of maxillofacial defects and determining the effectiveness of rehabilitation with an obturator prosthesis. Model simulations are important in terms of pre-surgical planning and pre- and post-operative speech function. This study aimed to evaluate the acoustic characteristics of voice generated by an articulation simulation system using a vocal tract model with or without artificial maxillectomy defects. More specifically, we aimed to establish a speech simulation system for maxillectomy defect models that both surgeons and maxillofacial prosthodontists can use in guiding treatment planning. Artificially simulated maxillectomy defects were prepared according to Aramany's classification (Classes I-VI) in a three-dimensional vocal tract plaster model of a subject uttering the vowel /a/. Formant and nasalance acoustic data were analysed using Computerized Speech Lab and the Nasometer, respectively. Formants and nasalance of simulated /a/ sounds were successfully detected and analysed. Values of Formants 1 and 2 for the non-defect model were 675.43 and 976.64 Hz, respectively. Median values of Formants 1 and 2 for the defect models were 634.36 and 1026.84 Hz, respectively. Nasalance was 11% in the non-defect model, whereas median nasalance was 28% in the defect models. The results suggest that an articulation simulation system can be used to help surgeons and maxillofacial prosthodontists to plan post-surgical defects that will be facilitate maxillofacial rehabilitation. © 2015 John Wiley & Sons Ltd.

Measuring the neck frequency response function of laryngectomy patients: Implications for the design of electrolarynx devices

NASA Astrophysics Data System (ADS)

Meltzner, Geoffrey S.; Kobler, James B.; Hillman, Robert E.

2003-08-01

Measurements of the neck frequency response function (NFRF), defined as the ratio of the spectrum of the estimated volume velocity that excites the vocal tract to the spectrum of the acceleration delivered to the neck wall, were made at three different positions on the necks of nine laryngectomized subjects (five males and four females) and four normal laryngeal speakers (two males and two females). A minishaker driven by broadband noise provided excitation to the necks of subjects as they configured their vocal tracts to mimic the production of the vowels /aye/, /æ/, and /I/. The sound pressure at the lips was measured with a microphone and an impedance head mounted on the shaker measured the acceleration. The neck wall passed low-frequency sound energy better than high-frequency sound energy, and thus the NFRF was accurately modeled as a low-pass filter. The NFRFs of the different subject groups (female laryngeal, male laryngeal speakers, laryngectomized males, and laryngectomized females) differed from each other in terms of corner frequency and gain, with both types of male subjects presenting NFRFs with larger overall gains. In addition, there was a notable amount of intersubject variability within groups. Because the NFRF is an estimate of how sound energy passes through the neck wall, these results should aid in the design of improved neck-type electrolarynx devices.

[Case-control survey on risk factors of benign vocal fold lesions].

PubMed

Huang, Dong-Yan; Yang, Wei-Yan; Yu, Ping; He, Yao; Han, Dong-Yi

2008-02-01

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 In present series, 321 cases who were performed laryngoscope were invited to participate the survey. Among them 168 cases 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. 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. 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.

[Routine fluoroscopic investigations after primary bariatric surgery].

PubMed

Gärtner, D; Ernst, A; Fedtke, K; Jenkner, J; Schöttler, A; Reimer, P; Blüher, M; Schön, M R

2016-03-01

Staple line and anastomotic leakages are life-threatening complications after bariatric surgery. Upper gastrointestinal (GI) tract X-ray examination with oral administration of a water-soluble contrast agent can be used to detect leaks. The aim of this study was to evaluate the impact of routine upper GI tract fluoroscopy after primary bariatric surgery. Between January 2009 and December 2014 a total of 658 bariatric interventions were carried out of which 442 were primary bariatric operations. Included in this single center study were 307 sleeve gastrectomies and 135 Roux-en-Y gastric bypasses. Up to December 2012 upper GI tract fluoroscopy was performed routinely between the first and third postoperative days and the detection of leakages was evaluated. In the investigation period 8 leakages (2.6 %) after sleeve gastrectomy, 1 anastomotic leakage in gastrojejunostomy and 1 in jejunojejunostomy after Roux-en-Y gastric bypass occurred. All patients developed clinical symptoms, such as abdominal pain, tachycardia or fever. In one case the leakage was detected by upper GI fluoroscopy and in nine cases radiological findings were unremarkable. No leakages were detected in asymptomatic patients. Routine upper GI fluoroscopy is not recommended for uneventful postoperative courses after primary bariatric surgery.

Observational Data on the Psychological Experience of Childbirth.

ERIC Educational Resources Information Center

Standley, Kay

This paper explores the effects of the childbirth environment and demographic variables on the laboring woman's expressions of tension and pain. Four observable physical measures were combined into a behavioral index of pain and tension: irregular breathing, tension of the upper extremities (rigid muscle flexion), vocalizations of pain (a cry,…

Prevalence of upper urinary tract anomalies in hospitalized premature infants with urinary tract infection.

PubMed

Vachharajani, A; Vricella, G J; Najaf, T; Coplen, D E

2015-05-01

The 2011 American Academy of Pediatrics (AAP) guidelines address imaging after initial febrile urinary tract infection (UTI) in infants >2 months of age. We sought to determine the frequency of upper urinary tract anomalies (hydronephrosis and vesicoureteral reflux (VUR)) in hospitalized premature infants with UTI. We retrospectively reviewed the electronic medical records of neonatal intensive care unit (NICU) admissions at a tertiary care children's hospital between 1 January 2006 and 31 December 2010. We queried the records for UTI, renal ultrasound (US) and voiding cystourethrogram (VCUG). We identified 3518 unique admissions. UTI occurred in 118 infants (3%). Sixty-nine (60%) had a normal US. Renal dilation was predominantly renal pelvic dilation (12%) and isolated caliectasis (22%). VUR was identified in 15 (14%) infants evaluated with a VCUG. VUR was identified in nine (12%) infants without and in seven (16%) with an abnormality on US. Reflux was identified in 7% of male and 38% of female infants with a UTI. Anatomic abnormalities of the upper urinary tract are uncommon in premature infants with a UTI that occurs during neonatal hospitalization. In concordance with the AAP guidelines, a VCUG may not be required in all NICU infants under age 2 months after a single UTI.

Palliative management of malignant upper urinary tract obstruction

PubMed Central

Sountoulides, P; Mykoniatis, I; Dimasis, N

2014-01-01

Malignancies of the genitourinary tract are diagnosed with increased frequency compared to the past. Currently prostate and bladder cancer account for the majority of urological malignancies. While for prostate cancer recent developments in the management of local and metastatic disease are likely to lead the majority of patients to either cure from the disease or to longer survival time, for bladder cancer advanced disease will unfortunately lead to death within months. However, the common clinical scenario in both prostate and bladder cancer includes, in high incidence, upper urinary tract obstruction in the advanced stages of these malignancies. This coupled with the fact that average life expectancy in the western world is increasing, will result in a significant patient population with either advanced, non-curable disease or with problems related to the received therapeutic surgical or medical interventions. There is no doubt that in both circumstances the room and role of palliation therapy is increasing. The care of patients with advanced urologic malignancies requires a multi-disciplinary effort from physicians of many specialties under the guiding role of the treating urologist. This review focuses on currently available palliative therapeutic options for upper urinary tract obstruction in the setting of patients with advanced malignancies of the urinary tract, as recently significant advancements have been witnessed in this field. PMID:26052193

Palliative management of malignant upper urinary tract obstruction.

PubMed

Sountoulides, P; Mykoniatis, I; Dimasis, N

2014-01-01

Malignancies of the genitourinary tract are diagnosed with increased frequency compared to the past. Currently prostate and bladder cancer account for the majority of urological malignancies. While for prostate cancer recent developments in the management of local and metastatic disease are likely to lead the majority of patients to either cure from the disease or to longer survival time, for bladder cancer advanced disease will unfortunately lead to death within months. However, the common clinical scenario in both prostate and bladder cancer includes, in high incidence, upper urinary tract obstruction in the advanced stages of these malignancies. This coupled with the fact that average life expectancy in the western world is increasing, will result in a significant patient population with either advanced, non-curable disease or with problems related to the received therapeutic surgical or medical interventions. There is no doubt that in both circumstances the room and role of palliation therapy is increasing. The care of patients with advanced urologic malignancies requires a multi-disciplinary effort from physicians of many specialties under the guiding role of the treating urologist. This review focuses on currently available palliative therapeutic options for upper urinary tract obstruction in the setting of patients with advanced malignancies of the urinary tract, as recently significant advancements have been witnessed in this field.

NASAL-Geom, a free upper respiratory tract 3D model reconstruction software

NASA Astrophysics Data System (ADS)

Cercos-Pita, J. L.; Cal, I. R.; Duque, D.; de Moreta, G. Sanjuán

2018-02-01

The tool NASAL-Geom, a free upper respiratory tract 3D model reconstruction software, is here described. As a free software, researchers and professionals are welcome to obtain, analyze, improve and redistribute it, potentially increasing the rate of development, and reducing at the same time ethical conflicts regarding medical applications which cannot be analyzed. Additionally, the tool has been optimized for the specific task of reading upper respiratory tract Computerized Tomography scans, and producing 3D geometries. The reconstruction process is divided into three stages: preprocessing (including Metal Artifact Reduction, noise removal, and feature enhancement), segmentation (where the nasal cavity is identified), and 3D geometry reconstruction. The tool has been automatized (i.e. no human intervention is required) a critical feature to avoid bias in the reconstructed geometries. The applied methodology is discussed, as well as the program robustness and precision.

21 CFR 876.5130 - Urological catheter and accessories.

Code of Federal Regulations, 2010 CFR

2010-04-01

... device that is inserted through the urethra and used to pass fluids to or from the urinary tract. This..., coude catheters, balloon retention type catheters, straight catheters, upper urinary tract catheters...

[Massive hemorrhage of upper gastrointestinal tract caused by gastrointestinal stromal tumor of the stomach--case report].

PubMed

Lalović, Nenad; Dukić Vladicić, Nikolina; Marić, Radmil; Cuk, Mirjana; Simatović, Milan; Jokanović, Dragana

2012-01-01

Acute bleeding from the upper gastrointestinal system is a medical emergency which is followed by high mortality rate, ranging from 6 to 15% in spite of modern diagnostic methods and treatment. Bleeding from the upper gastrointestinal system may be caused by gastrointestinal stromal tumors of the stomach, which are mainly characterized by occult bleeding, while profuse bleeding rarely occurs accompanied by hemorrhagic shock. Gastrointestinal stromal tumors of stomach are the most common mesenchimal tumors of the gastrointestinal tract. In our study we showed a 60-year-old female patient with profuse bleeding from the stomach and the clinical picture of severe hemorrhagic shock, caused by gastrointestinal stromal tumor. An ovoid junction, raised towards the lumen, covered with ulcerated mucosa in several places and followed by massive arterial bleeding was found intraoperatively, after the performed gastrotomy. Histopathological examination with immunohistochemical analysis confirmed that this was a gastrointestinal stromal tumor of the stomach. Acute bleeding from the digestive system is a sudden and serious condition of the body. Urgent esophagogastroduodenoscopy is a sensitive and specific diagnostic and therapeutic method of choice. Massive bleeding from the upper gastrointestinal tract is very rarely caused by gastrointestinal stromal tumors, whose clinical picture is very heterogeneous and depends on tumor size and location. Abundant bleeding from the tumor is an indication for urgent surgical intervention. According to the literature massive hemorrhage of the upper digestive system can rarely be caused by gastrointestinal stromal tumor of the stomach. It is shown that abundant hemorrhage of the upper digestive tract can be caused with gastric gastrointestinal stromal tumor. Surgical resection is the main form of treatment of gastrointestinal stromal tumors of the digestive system and bleeding from these tumors caused by failure of endoscopic hemostasis.

Upper Tract Urological Laparoendoscopic Single-Site Surgery (LESS)

PubMed Central

Tugcu, Volkan; Sahin, Selcuk; Seker, Gokhan; Kargi, Taner; Tasci, Ali Ihsan

2015-01-01

Background and Objectives: Our objective is to report intermediate-term outcomes for patients who have undergone upper tract urologic laparoendoscopic single-site surgery (LESS) at a single institution. Methods: From January 1, 2008, through November 30, 2012, 107 cases treated with LESS were identified, including pyeloplasty (n = 30), ureterolithotomy (n = 32), nephrectomy (n = 35; simple = 31, partial = 4), and cyst decortication (n = 10). Perioperative data were reviewed, and conversion and complication rates were noted. Results: The median follow-up was 21.5 months for pyeloplasty, 20.5 for ureterolithotomy, 28.0 for simple nephrectomy, 14.0 for partial nephrectomy, and 19.0 for cyst decortication. Major complications were encountered in 8 patients, including 3 intraoperative complications (2 bowel injury with serosal tearing and 1 intraoperative bleeding), which were recognized and repaired with LESS or conversion to conventional laparoscopy (CL). During the intermediate postoperative period (30–90 days) major complications occurred in 5 patients: 4 ureteral strictures (Clavien-Dindo grade [CG] IIIb) and 1 urinoma formation (CG IIIa). During the early postoperative period (<30 days), the most common minor complications were flank pain (CG I) in 16 patients and urinary tract infection (CG II) in 11, followed by urinary leakage (CG I) in 8. Conclusions: Intermediate-term functional outcomes of this single-center study confirm that upper tract LESS is a challenging procedure that can be safe and effective when performed by an experienced team. Prospective studies with longer follow-up periods are needed to investigate the safety of LESS in the treatment of various upper urinary tract conditions. PMID:26648679

Vocal Cord Palsy in Children With Cancer: A 10-Year Analysis of UK Pediatric Intensive Care Admissions.

PubMed

Capsomidis, Anna; Hall, Andrew; Daya, Hamid; Round, Jonathan; Lancaster, Donna; Bate, Jessica

2017-05-01

Vocal cord palsy (VCP) is a rare but potentially life-threatening complication in children with cancer. This study reviews UK Intensive Care admissions for children with cancer and VCP using data obtained from the Pediatric Intensive Care Audit Network (PICANet) database. 26 children with cancer and VCP were admitted to intensive care from 2002 to 2012. The majority of admissions (23/26) required respiratory intervention (17 invasive ventilation, 8 noninvasive ventilation, and 5 tracheostomy). VCP should be considered early in children with cancer who present with signs of upper airway obstruction, especially in those receiving vinca-alkaloids as VCP is likely to be reversible.

Effects of topical benzocaine and lignocaine on upper airway reflex sensitivity.

PubMed

Raphael, J H; Stanley, G D; Langton, J A

1996-02-01

We studied the degree and duration of effect on upper airway reflex sensitivity of oral benzocaine lozenges, nebulised lignocaine and lignocaine sprayed onto the vocal cords under direct vision, using low concentrations of ammonia as a stimulus to upper airway receptors. Ten minutes after the administration of oral benzocaine 20 mg the threshold response of the upper airway to ammonia (NH3TR) had risen significantly from baseline mean (SEM) of 680 (95) to 975 (109) ppm of ammonia with a return to baseline values after 25 min (n = 8, p < 0.05, repeated measures of ANOVA; p < 0.001, t-test). A direct spray of lignocaine 100 mg onto the vocal cords resulted in a significant elevation in NH3TR from a baseline mean (SEM) of 665 (81) to a maximum of 1600 (88) ppm of ammonia with a significant elevation in the threshold persisting for 100 min (n = 7, p < 0.001, repeated measures of ANOVA; p < 0.05, t-test). The application of 4% nebulised lignocaine 4 ml significantly increased NH3TR from a baseline mean (SEM) of 770 (56) to a maximum of 1190 (63) ppm of ammonia with a significant elevation in the threshold persisting for 30 min (n = 8, p < 0.001, repeated measures of ANOVA; p < 0.05, t-test). The maximum elevations in NH3TR with the two methods of lignocaine delivery were significantly different (p < 0.01, 2-way ANOVA).

Does a pneumotach accurately characterize voice function?

NASA Astrophysics Data System (ADS)

Walters, Gage; Krane, Michael

2016-11-01

A study is presented which addresses how a pneumotach might adversely affect clinical measurements of voice function. A pneumotach is a device, typically a mask, worn over the mouth, in order to measure time-varying glottal volume flow. By measuring the time-varying difference in pressure across a known aerodynamic resistance element in the mask, the glottal volume flow waveform is estimated. Because it adds aerodynamic resistance to the vocal system, there is some concern that using a pneumotach may not accurately portray the behavior of the voice. To test this hypothesis, experiments were performed in a simplified airway model with the principal dimensions of an adult human upper airway. A compliant constriction, fabricated from silicone rubber, modeled the vocal folds. Variations of transglottal pressure, time-averaged volume flow, model vocal fold vibration amplitude, and radiated sound with subglottal pressure were performed, with and without the pneumotach in place, and differences noted. Acknowledge support of NIH Grant 2R01DC005642-10A1.

Relationship of bladder dysfunction with upper urinary tract deterioration in cerebral palsy.

PubMed

Gündoğdu, Gökhan; Kömür, Mustafa; Avlan, Dinçer; Sarı, Ferda Bacaksızlar; Delibaş, Ali; Taşdelen, Bahar; Naycı, Ali; Okuyaz, Cetin

2013-10-01

Although lower urinary tract dysfunction (LUTD) in patients with cerebral palsy (CP) has been previously documented by clinical observations and urodynamic tests, its correlation with upper urinary tract deterioration (UUTD) has not been demonstrated. This paper documents symptoms and urodynamic findings of LUTD and their relationship with UUTD in 33 children with CP. By sonography, 4 of these children were found to have UUTD. Age was found to correlate with UUTD, but gender difference and mental or motor functions did not. When comparing urinary symptoms with UUTD, incontinence (n = 31) did not correlate, but on the other hand symptoms of detrusor sphincter dyssynergia (interrupted voiding, urinary retention, hesitancy; n = 5) and culture proven febrile urinary tract infections (n = 4) did. Abnormal urodynamics findings were not diagnostic. We conclude that, apart from incontinence, dysfunctional voiding symptoms and febrile urinary tract infections are valuable indicators of UUTD. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Percutaneous Resection of Renal Urothelial Carcinoma Using Bipolar Electrocautery

PubMed Central

Kwan, Kevin G.; Chew, Ben H.; Luke, Patrick P.W.; Denstedt, John D.

2006-01-01

Percutaneous approaches to upper tract urothelial cancers have been performed in patients unsuitable for radical nephroureterectomy. We present the case of an 82-year-old man with significant comorbidities including dependency on a cardiac pacemaker. Without deactivating the pacemaker, we used bipolar cautery to percutaneously resect a large upper tract urothelial tumor in the renal pelvis. Bipolar cautery is a suitable method of percutaneous or transurethral resection in patients who are pacemaker dependent. PMID:17575777

The effect of an artificially lengthened vocal tract on estimated glottal contact quotient in untrained male voices.

PubMed

Gaskill, Christopher S; Erickson, Molly L

2010-01-01

The use of hard-walled narrow tubes, often called resonance tubes, for the purpose of voice therapy and voice training has a historical precedent and some theoretical support, but the mechanism of any potential benefit from the application of this technique is not well understood. Fifteen vocally untrained male participants produced a series of spoken /a/ vowels at a modal pitch and constant loudness, before and after a minute of repeated phonation into a 50-cm hard-walled glass tube at the same pitch and loudness targets. Electroglottography was used to measure the glottal contact quotient (CQ) during each phase of the experiment. Single-subject analysis revealed statistically significant changes in CQ during tube phonation, but with no discernable pattern across the 15 participants. These results indicate that the use of resonance tubes can have a distinct effect on glottal closure, but the mechanism behind this change remains unclear. The implication is that vocal loading techniques such as this need to be studied further with specific attention paid to the underlying mechanism of any measured changes in glottal behavior, and especially to the role of instruction and feedback in the therapeutic and pedagogical application of these techniques. Copyright 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Multi-disciplinary clinical protocol for the diagnosis of bulbar amyotrophic lateral sclerosis.

PubMed

Chiaramonte, Rita; Di Luciano, Carmela; Chiaramonte, Ignazio; Serra, Agostino; Bonfiglio, Marco

2018-04-23

The objective of this study was to examine the role of different specialists in the diagnosis of amyotrophic lateral sclerosis (ALS), to understand changes in verbal expression and phonation, respiratory dynamics and swallowing that occurred rapidly over a short period of time. 22 patients with bulbar ALS were submitted for voice assessment, ENT evaluation, Multi-Dimensional Voice Program (MDVP), spectrogram, electroglottography, fiberoptic endoscopic evaluation of swallowing. In the early stage of the disease, the oral tract and velopharyngeal port were involved. Three months after the initial symptoms, most of the patients presented hoarseness, breathy voice, dysarthria, pitch modulation problems and difficulties in pronunciation of explosive, velar and lingual consonants. Values of MDVP were altered. Spectrogram showed an additional formant, due to nasal resonance. Electroglottography showed periodic oscillation of the vocal folds only during short vocal cycle. Swallowing was characterized by weakness and incoordination of oro-pharyngeal muscles with penetration or aspiration. A specific multidisciplinary clinical protocol was designed to report vocal parameters and swallowing disorders that changed more quickly in bulbar ALS patients. Furthermore, the patients were stratified according to involvement of pharyngeal structures, and severity index. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

Vocal anatomy, tongue protrusion behaviour and the acoustics of rutting roars in free-ranging Iberian red deer stags (Cervus elaphus hispanicus)

PubMed Central

Frey, Roland; Volodin, Ilya; Volodina, Elena; Carranza, Juan; Torres-Porras, Jerónimo

2012-01-01

Roaring in rutting Iberian red deer stags Cervus elaphus hispanicus is unusual compared to other subspecies of red deer, which radiated from the Iberian refugium after the last glacial maximum. In all red deer stags, the larynx occupies a permanent low mid-neck resting position and is momentarily retracted almost down to the rostral end of the sternum during the production of rutting calls. Simultaneous with the retraction of the larynx, male Iberian red deer pronouncedly protrude the tongue during most of their rutting roars. This poses a mechanical challenge for the vocal tract (vt) and for the hyoid apparatus, as tongue and larynx are strongly pulled in opposite directions. This study (i) examines the vocal anatomy and the acoustics of the rutting roars in free-ranging male C. e. hispanicus; (ii) establishes a potential mechanism of simultaneous tongue protrusion and larynx retraction by applying a two-dimensional model based on graphic reconstructions in single video frames of unrestrained animals; and (iii) advances a hypothesis of evaporative cooling by tongue protrusion in the males of a subspecies of red deer constrained to perform all of the exhausting rutting activities, including acoustic display, in a hot and arid season. PMID:22257361

Effects of vocal training in a musicophile with congenital amusia.

PubMed

Wilbiks, Jonathan M P; Vuvan, Dominique T; Girard, Pier-Yves; Peretz, Isabelle; Russo, Frank A

2016-12-01

Congenital amusia is a condition in which an individual suffers from a deficit of musical pitch perception and production. Individuals suffering from congenital amusia generally tend to abstain from musical activities. Here, we present the unique case of Tim Falconer, a self-described musicophile who also suffers from congenital amusia. We describe and assess Tim's attempts to train himself out of amusia through a self-imposed 18-month program of formal vocal training and practice. We tested Tim with respect to music perception and vocal production across seven sessions including pre- and post-training assessments. We also obtained diffusion-weighted images of his brain to assess connectivity between auditory and motor planning areas via the arcuate fasciculus (AF). Tim's behavioral and brain data were compared to that of normal and amusic controls. While Tim showed temporary gains in his singing ability, he did not reach normal levels, and these gains faded when he was not engaged in regular lessons and practice. Tim did show some sustained gains with respect to the perception of musical rhythm and meter. We propose that Tim's lack of improvement in pitch perception and production tasks is due to long-standing and likely irreversible reduction in connectivity along the AF fiber tract.

Complications after common sheath reimplantation in pediatric patients with complicated duplex system.

PubMed

Lee, Yong Seung; Im, Young Jae; Shin, Sang Hee; Bascuna, Rosito T; Ha, Ji Yong; Han, Sang Won

2015-02-01

To report our experience of common sheath reimplantation (CSR) for ectopic ureterocele (EU) combined with ureteral duplication, describing success rates and postoperative complications, along with risk factors for developing postoperative incontinence. When the upper tract approach is not indicated in patients with EU, a bladder-level approach, involving either CSR or total reconstruction, is the remaining option. However, concerns exist about the high morbidity of bladder-level approaches. We retrospectively examined the postoperative results of 39 patients who underwent CSR between January 2001 and December 2012. Risk factors for the development of postoperative incontinence and decreases in differential renal function (DRF) were additionally analyzed. The median age at operation was 16.5 months. After CSR, upper urinary tract dilatation decreased in 36 patients (92.3%). During a median follow-up of 75.9 months, an additional operation was required in 7 patients (17.9%). Postoperative incontinence developed in 3 patients (7.7%). Median preoperative DRF was significantly lower in the postoperative incontinence group (P = .004). DRF decreased postoperatively in 5 of 36 patients (13.9%). No preoperative factors were related to the decrease in DRF. No patient developed hypertension or proteinuria. CSR decompressed the upper urinary tract effectively in our EU patients. Postoperative incontinence does not seem to be related to operation factors, but with preoperative DRF. When the upper tract approach is not indicated, CSR is a reasonable alternative. Total reconstruction is unnecessary as the remnant upper pole kidney after CSR does not lead to complications. Copyright © 2015 Elsevier Inc. All rights reserved.

Neck Circumference and Vocal Parameters in Women Before and After Bariatric Surgery.

PubMed

de Souza, Lourdes Bernadete Rocha; Pernambuco, Leandro de Araújo; dos Santos, Marquiony Marques; Pereira, Rayane Medeiros

2016-03-01

Morbidly obese patients may suffer from vocal disorders, as vocal production is directly related to the volume of the vocal tract, and the large-scale accumulation of fat in this region may interfere with voice production. The aim of this study was to analyze the neck circumference, fundamental frequency, and maximum phonation time of a group of morbidly obese women before and after bariatric surgery. An observational, longitudinal, and descriptive study was performed with patients of the Obesity and Related Diseases Surgery Unit of a university hospital. A total of 21 morbidly obese women aged 28-68 years, with a mean age of 41.33 years, participated in the study. Neck circumference was measured using a tape measure. To obtain fundamental frequency values, the patient was asked to produce the vowel [a] at normal intensity and pitch for an average period of 3 s. After recording, the participants were asked to produce the sustained vowels [a], [i], and [u] at normal intensity and pitch, with a stopwatch used to measure maximum phonation time. Eight months after surgery, patients were reassessed using the same data collecting procedures as were carried out prior to surgery. After surgery, there was an increase in the average value of fundamental frequency and maximum phonation time for all the vowels and a reduction in neck circumference. The differences were statistically significant. Weight reduction and a consequent decrease in neck circumference affected the changes in maximum phonation time and fundamental frequency values in the voices of these patients, after weight loss.

The association of benign prostatic hyperplasia with lower urinary tract stones in adult men: A retrospective multicenter study.

PubMed

Jung, Jae Hung; Park, Jinsung; Kim, Won Tae; Kim, Hong Wook; Kim, Hyung Joon; Hong, Sungwoo; Yang, Hee Jo; Chung, Hong

2018-04-01

To examine the relationship between benign prostatic hyperplasia (BPH) and the presence of lower urinary tract stones. We retrospectively reviewed the records of men with lower urinary tract stones who presented to three clinical centers in Korea over a 4-year period. We divided the patients into two groups based on the location of urinary stones: Group 1 (bladder calculi) and Group 2 (urethral calculi). We compared the characteristics of both groups and performed univariate and multivariate analyses with a logistic regression model to investigate the relationship between BPH and lower urinary tract stones. Of 221 patients, 194 (87.8%) had bladder calculi and 27 (12.2%) had urethral calculi. The mean age of Group 1 was higher than that of Group 2 (68.96 ± 12.11 years vs. 55.74 ± 14.20 years, p  < 0.001). The mean prostate volume of Group 1 was higher than that of Group 2 (44.47 ± 27.14 mL vs. 24.70 ± 6.41 mL, respectively, p  < 0.001). Multivariate logistic regression showed that age (OR = 1.075, 95%CI: 1.023-1.129) and prostate volume (OR = 1.069, 95%CI: 1.017-1.123) were independently associated with increased risk for bladder calculi. Upper urinary tract stones and/or hydronephrosis conferred a 3-fold risk for urethral calculi (OR = 3.468, 95%CI: 1.093-10.999). Age and prostate volume are independent risk factors for bladder calculi. In addition, men with upper urinary tract disease are at greater risk for urethral calculi, which may migrate from the upper urinary tract rather than from the bladder.

Prediction of cancer specific survival after radical nephroureterectomy for upper tract urothelial carcinoma: development of an optimized postoperative nomogram using decision curve analysis.

PubMed

Rouprêt, Morgan; Hupertan, Vincent; Seisen, Thomas; Colin, Pierre; Xylinas, Evanguelos; Yates, David R; Fajkovic, Harun; Lotan, Yair; Raman, Jay D; Zigeuner, Richard; Remzi, Mesut; Bolenz, Christian; Novara, Giacomo; Kassouf, Wassim; Ouzzane, Adil; Rozet, François; Cussenot, Olivier; Martinez-Salamanca, Juan I; Fritsche, Hans-Martin; Walton, Thomas J; Wood, Christopher G; Bensalah, Karim; Karakiewicz, Pierre I; Montorsi, Francesco; Margulis, Vitaly; Shariat, Shahrokh F

2013-05-01

We conceived and proposed a unique and optimized nomogram to predict cancer specific survival after radical nephroureterectomy in patients with upper tract urothelial carcinoma by merging the 2 largest multicenter data sets reported in this population. The international and the French national collaborative groups on upper tract urothelial carcinoma pooled data on 3,387 patients treated with radical nephroureterectomy for whom full data for nomogram development were available. The merged study population was randomly split into the development cohort (2,371) and the external validation cohort (1,016). Cox regressions were used for univariable and multivariable analyses, and to build different models. The ultimate reduced nomogram was assessed using Harrell's concordance index (c-index) and decision curve analysis. Of the 2,371 patients in the nomogram development cohort 510 (21.5%) died of upper tract urothelial carcinoma during followup. The actuarial cancer specific survival probability at 5 years was 73.7% (95% CI 71.9-75.6). Decision curve analysis revealed that the use of the best model was associated with benefit gains relative to the prediction of cancer specific survival. The optimized nomogram included only 5 variables associated with cancer specific survival on multivariable analysis, those of age (p = 0.001), T stage (p <0.001), N stage (p = 0.001), architecture (p = 0.02) and lymphovascular invasion (p = 0.001). The discriminative accuracy of the nomogram was 0.8 (95% CI 0.77-0.86). Using standard pathological features obtained from the largest data set of upper tract urothelial carcinomas worldwide, we devised and validated an accurate and ultimate nomogram, superior to any single clinical variable, for predicting cancer specific survival after radical nephroureterectomy. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Dietary inflammatory index and risk of upper aerodigestive tract cancer in Japanese adults

PubMed Central

Abe, Makiko; Shivappa, Nitin; Ito, Hidemi; Oze, Isao; Abe, Tetsuya; Shimizu, Yasuhiro; Hasegawa, Yasuhisa; Kiyohara, Chikako; Nomura, Masatoshi; Ogawa, Yoshihiro; Hebert, James R.; Matsuo, Keitaro

2018-01-01

Background The inflammatory potential of diet that has been shown to be associated with cancer risk. We examined the association between dietary inflammatory potential as measured by the dietary inflammatory index (DII®) and risk of upper aerodigestive tract cancers in a Japanese case-control study. Results A positive association was observed between increasing DII scores and overall upper aerodigestive tract cancers, and across anatomic subsites. For upper aerodigestive tract cancers, the ORQ4vsQ1 = 1.73 (95% CI: 1.37–2.20); head and neck cancer, the ORQ4vsQ1 was 1.92 (95% CI: 1.42–2.59); and for esophageal cancer, the ORQ4vsQ1 was1.71 (95% CI: 1.54–1.90). Risks for hypopharyngeal and nasopharyngeal cancers were greatly elevated: (ORQ4vsQ1 = 4.05 (95% CI: 1.24–13.25) for hypopharyngeal cancer and ORQ4vsQ1 = 4.99 (95% CI: 1.14–21.79) for nasopharyngeal cancer. Conclusion A more pro-inflammatory diet was associated with an elevated risk of upper aerodigestive tract cancers after accounting for important confounders. All anatomic subsites, except larynx, showed the consistently elevated risk with increasing DII score. Those subsites with known etiological associations with persistent infection showed the largest elevation in risk. These results warrant further evaluation in future studies. Materials and Methods This is a case-control study of 1,028 cases and 3,081 age- and sex-matched non-cancer controls recruited at Aichi Cancer Center. DII scores were computed based on estimates of macro- and micro-nutrients from a self-administered food frequency questionnaire. Scores were further categorized into quartiles (based on the distribution in controls). Conditional logistic regression models were fit to estimate odds ratio (OR) and 95% confidence intervals (CIs) adjusted for smoking, ethanol consumption, alcohol flushing, number of teeth, and occupation group. PMID:29844870

Concurrent Preoperative Presence of Hydronephrosis and Flank Pain Independently Predicts Worse Outcome of Upper Tract Urothelial Carcinoma

PubMed Central

Yeh, Hsin-Chih; Jan, Hau-Chern; Wu, Wen-Jeng; Li, Ching-Chia; Li, Wei-Ming; Ke, Hung-Lung; Huang, Shu-Pin; Liu, Chia-Chu; Lee, Yung-Chin; Yang, Sheau-Fang; Liang, Peir-In; Huang, Chun-Nung

2015-01-01

Objectives To investigate the impact of preoperative hydronephrosis and flank pain on prognosis of patients with upper tract urothelial carcinoma. Methods In total, 472 patients with upper tract urothelial carcinoma managed by radical nephroureterectomy were included from Kaohsiung Medical University Hospital Healthcare System. Clinicopathological data were collected retrospectively for analysis. The significance of hydronephrosis, especially when combined with flank pain, and other relevant factors on overall and cancer-specific survival were evaluated. Results Of the 472 patients, 292 (62%) had preoperative hydronephrosis and 121 (26%) presented with flank pain. Preoperative hydronephrosis was significantly associated with age, hematuria, flank pain, tumor location, and pathological tumor stage. Concurrent presence of hydronephrosis and flank pain was a significant predictor of non-organ-confined disease (multivariate-adjusted hazard ratio = 2.10, P = 0.025). Kaplan-Meier analysis showed significantly poorer overall and cancer-specific survival in patients with preoperative hydronephrosis (P = 0.005 and P = 0.026, respectively) and in patients with flank pain (P < 0.001 and P = 0.001, respectively) than those without. However, only simultaneous hydronephrosis and flank pain independently predicted adverse outcome (hazard ratio = 1.98, P = 0.016 for overall survival and hazard ratio = 1.87, P = 0.036 for and cancer-specific survival, respectively) in multivariate Cox proportional hazards models. In addition, concurrent presence of hydronephrosis and flank pain was also significantly predictive of worse survival in patient with high grade or muscle-invasive disease. Notably, there was no difference in survival between patients with hydronephrosis but devoid of flank pain and those without hydronephrosis. Conclusion Concurrent preoperative presence of hydronephrosis and flank pain predicted non-organ-confined status of upper tract urothelial carcinoma. When accompanied with flank pain, hydronephrosis represented an independent predictor for worse outcome in patients with upper tract urothelial carcinoma. PMID:26469704

[Antibiotic prescribing in acute respiratory tract infections in general practice].

PubMed

Malo, S; Bjerrum, L; Feja, C; Lallana, M J; Poncel, A; Rabanaque, M J

2015-06-01

Antimicrobial resistance is a worldwide threat to public health. Acute respiratory tract infections are the main reason for antibiotic prescribing in the Spanish paediatric population. The aim of the study was to describe the frequency of antibiotic prescription and their pattern of use in acute respiratory tract infections diagnosed in children in Primary Care in Aragón (Spain). A study was conducted over a 1-year period on children between 0 and 14 years-old, recording all episodes of acute otitis, acute pharyngotonsillitis, non-specific upper respiratory infection, and acute bronchitis. The proportion of episodes within each diagnosis receiving an antibiotic prescription was calculated, and the prescribing pattern was determined. Half (50%) of the children in Aragón were diagnosed with a respiratory tract infection during the study period. Non-specific upper respiratory infection was the most frequent diagnosis. An antibiotic was prescribed in 75% of pharyngotonsillitis episodes, 72% of otitis, 27% of bronchitis, and 16% of non-specific upper respiratory infections. Broad spectrum antibiotics, mainly amoxicillin and amoxicillin-clavulanic, were predominantly prescribed. Antibiotic prescribing in respiratory tract infections in children was generally high, and the choice of antibiotics was probably inappropriate in a high percentage of cases. Therefore an improvement in antibiotic prescribing in children appears to be needed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Upper respiratory tract infections in athletes.

PubMed

Page, Clifton L; Diehl, Jason J

2007-07-01

Upper respiratory tract infections (URTIs) represent the most common acute illnesses in the general population and account for the leading acute diagnoses in the outpatient setting. Given the athlete's expectation to return to activity as soon as possible, the sports medicine physician should be able to accurately diagnose and aggressively treat these illnesses. This article discusses the common pathogens, diagnosis, treatment options, and return-to-play decisions for URTIs, with a focus on the common cold, sinusitis, pharyngitis, and infectious mononucleosis in the athlete.

Audit of cytology of upper urinary tract.

PubMed

Malta, F; Lenos, M; Leotsakos, I; Katafigiotis, I; Gakiopoulou, H; Constantinides, C; Mikou, P

2016-10-01

Cytology is an essential tool for the investigation of urinary tract malignancy. In this audit, we aimed to assess our laboratory performance in the diagnosis of upper urinary tract malignancy and to use the information provided to improve our service. We retrieved cytology reports of upper urinary tract specimens from two periods, re-evaluated the cases, compared the reports with histology data and estimated the sensitivity, specificity and positive predictive value (PPV). In the time interval between the two periods, we adopted new terminology, established better communication with clinicians and gained experience in the field. Finally, the data from the two periods were compared. In phase A, we estimated a sensitivity of 73%, specificity of 86% and PPV of 84.6%. As a result of the cytological re-evaluation, correlation with histology and clinical follow-up, plus communication with the clinicians during the audit, we established new terminology and a new request form. A three tiered grading system of atypia (mild, moderate and severe) was replaced by a two tiered grading system. The first category "atypia probably benign" corresponded to "mild atypia" while the second category "atypia, not otherwise specified" corresponded to "moderate atypia". The cases diagnosed as "severe atypia" were reclassified as "suspicious for malignancy". In phase B, the sensitivity, specificity and PPV were 75%, 89% and 90%, respectively. Our laboratory performance is in concordance with reported data and has been improved through this study. The audit process is extremely valuable for the identification of problems, for taking action and, finally, for the improvement of the clinical cytology service in the field of upper urinary tract malignancy. © 2016 John Wiley & Sons Ltd.

Phytase in non-ruminant animal nutrition: a critical review on phytase activities in the gastrointestinal tract and influencing factors

PubMed Central

Dersjant-Li, Yueming; Awati, Ajay; Schulze, Hagen; Partridge, Gary

2015-01-01

This review focuses on phytase functionality in the digestive tract of farmed non-ruminant animals and the factors influencing in vivo phytase enzyme activity. In pigs, feed phytase is mainly active in the stomach and upper part of the small intestine, and added phytase activity is not recovered in the ileum. In poultry, feed phytase activities are mainly found in the upper part of the digestive tract, including the crop, proventriculus and gizzard. For fish with a stomach, phytase activities are mainly in the stomach. Many factors can influence the efficiency of feed phytase in the gastrointestinal tract, and they can be divided into three main groups: (i) phytase related; (ii) dietary related and (iii) animal related. Phytase-related factors include type of phytase (e.g. 3- or 6-phytase; bacterial or fungal phytase origin), the pH optimum and the resistance of phytase to endogenous protease. Dietary-related factors are mainly associated with dietary phytate content, feed ingredient composition and feed processing, and total P, Ca and Na content. Animal-related factors include species, gender and age of animals. To eliminate the antinutritional effects of phytate (IP6), it needs to be hydrolyzed as quickly as possible by phytase in the upper part of the digestive tract. A phytase that works over a wide range of pH values and is active in the stomach and upper intestine (along with several other characteristics and in addition to being refractory to endogenous enzymes) would be ideal. © 2014 The Authors. Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. PMID:25382707

Phytase in non-ruminant animal nutrition: a critical review on phytase activities in the gastrointestinal tract and influencing factors.

PubMed

Dersjant-Li, Yueming; Awati, Ajay; Schulze, Hagen; Partridge, Gary

2015-03-30

This review focuses on phytase functionality in the digestive tract of farmed non-ruminant animals and the factors influencing in vivo phytase enzyme activity. In pigs, feed phytase is mainly active in the stomach and upper part of the small intestine, and added phytase activity is not recovered in the ileum. In poultry, feed phytase activities are mainly found in the upper part of the digestive tract, including the crop, proventriculus and gizzard. For fish with a stomach, phytase activities are mainly in the stomach. Many factors can influence the efficiency of feed phytase in the gastrointestinal tract, and they can be divided into three main groups: (i) phytase related; (ii) dietary related and (iii) animal related. Phytase-related factors include type of phytase (e.g. 3- or 6-phytase; bacterial or fungal phytase origin), the pH optimum and the resistance of phytase to endogenous protease. Dietary-related factors are mainly associated with dietary phytate content, feed ingredient composition and feed processing, and total P, Ca and Na content. Animal-related factors include species, gender and age of animals. To eliminate the antinutritional effects of phytate (IP6), it needs to be hydrolyzed as quickly as possible by phytase in the upper part of the digestive tract. A phytase that works over a wide range of pH values and is active in the stomach and upper intestine (along with several other characteristics and in addition to being refractory to endogenous enzymes) would be ideal. © 2014 The Authors. Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Autosomal dominant hereditary sensory neuropathy with chronic cough and gastro-oesophageal reflux: clinical features in two families linked to chromosome 3p22-p24.

PubMed

Spring, Penelope J; Kok, Cindy; Nicholson, Garth A; Ing, Alvin J; Spies, Judith M; Bassett, Mark L; Cameron, John; Kerlin, Paul; Bowler, Simon; Tuck, Roger; Pollard, John D

2005-12-01

Autosomal dominant hereditary sensory neuropathy (HSN I) is a clinically and genetically heterogeneous group of disorders, and in some families it is due to mutations in the serine palmitoyltransferase (SPTLC1) gene. We have characterized two families with HSN I associated with cough and gastro-oesophageal reflux (GOR). From a large Australian family, 27 individuals and from a smaller family, 11 individuals provided clinical information and blood for genetic analysis. Affected individuals had an adult onset of paroxysmal cough, GOR and distal sensory loss. Cough could be triggered by noxious odours or by pressure in the external auditory canal (Arnold's ear-cough reflex). Other features included throat clearing, hoarse voice, cough syncope and sensorineural hearing loss. Neurophysiological and pathological studies demonstrated a sensory axonal neuropathy. Gastric emptying studies were normal, and autonomic function and sweat tests were either normal or showed distal hypohidrosis. Cough was likely to be due to a combination of denervation hypersensitivity of the upper airways and oesophagus, and prominent GOR. Most affected individuals were shown on 24 h ambulatory oesophageal pH monitoring to have multiple episodes of GOR, closely temporally associated with coughing. Hoarse voice was probably attributable to acid-induced laryngeal damage, and there was no evidence of vocal cord palsy. No other cause for cough was found on most respiratory or otorhinological studies. Linkage to chromosome 3p22-p24 has been found in both families, with no evidence of linkage to loci for known HSN I, autosomal dominant hereditary motor and sensory neuropathy, hereditary GOR or triple A syndrome. These families represent a genetically novel variant of HSN I, with a distinctive cough owing to involvement of the upper aerodigestive tract.

[Indications and limits to endourologic procedures for endometriosis of the urinary tract].

PubMed

Marino, G; Piras, D; Pedalino, M; Di Primio, O G; Vella, R; Vercesi, E

2010-01-01

The incidence of Urinary tract endometriosis (UTE) ranges from 1% to 3%; bladder is the most affected organ (85% of UTE), followed by ureter (12 - 14% of UTE), for which we distinguish an intrinsic very rare form and an extrinsic variety most frequently occurring in advanced pelvic endometriosis. From 1997 to 2010, 33 surgical procedures for urologic endometriosis were performed, involving the urinary tract, in 28 patients with mean age of 31 years (25-43). The localization of endometriosis were: 7 cases in the bladder, 2 cases in the vesicoureteral tract, and 19 cases of ureteral tract only. Of these, two cases were diagnosed with an intrinsic localization. Overall, we performed 3 TURB, 5 partial cystectomies (2 with open surgical approach and 3 by laparoscopy procedure), 12 laparoscopic ureterolysis and simultaneous protection of the upper urinary tract with stent, 9 cases of ureterocystoneostomy (UCNS) according to Lich-Gregoire procedure, and 3 according to Boari-Kuess procedure. Of the 12 patients who underwent ureterolysis with laparoscopic and stenting procedure, five cases required a UCNS according to Lich-Gregoire technique for persistent ureteral obstruction. The limits of endoscopic procedures in endometriosis of the urinary tract are correlated both to the degree of extension and the localization of the disease. It is mandatory to achieve an interdisciplinary consensus in order to ensure the disease removal and the simultaneous functional results of the upper urinary tract.

A HYBRID CFD-PBPK MODEL OF INHALED CHLORINE GAS UPTAKE AND TISSUE DOSIMETRY IN THE ISOLATED UPPER RESPIRATORY TRACT (URT) OF F344 RATS

EPA Science Inventory

Chlorine (Cl₂), an important commercial gas, is highly reactive in water, causing irritant effects in the respiratory tract on inhalation. Nasal extraction of Cl₂ is high and resultant lesions in the respiratory tract show a proximal to distal distribution ...

Cow’s Milk and Immune Function in the Respiratory Tract: Potential Mechanisms

PubMed Central

Perdijk, Olaf; van Splunter, Marloes; Savelkoul, Huub F. J.; Brugman, Sylvia; van Neerven, R. J. Joost

2018-01-01

During the last decades, the world has witnessed a dramatic increase in allergy prevalence. Epidemiological evidence shows that growing up on a farm is a protective factor, which is partly explained by the consumption of raw cow’s milk. Indeed, recent studies show inverse associations between raw cow’s milk consumption in early life and asthma, hay fever, and rhinitis. A similar association of raw cow’s milk consumption with respiratory tract infections is recently found. In line with these findings, controlled studies in infants with milk components such as lactoferrin, milk fat globule membrane, and colostrum IgG have shown to reduce respiratory infections. However, for ethical reasons, it is not possible to conduct controlled studies with raw cow’s milk in infants, so formal proof is lacking to date. Because viral respiratory tract infections and aeroallergen exposure in children may be causally linked to the development of asthma, it is of interest to investigate whether cow’s milk components can modulate human immune function in the respiratory tract and via which mechanisms. Inhaled allergens and viruses trigger local immune responses in the upper airways in both nasal and oral lymphoid tissue. The components present in raw cow’s milk are able to promote a local microenvironment in which mucosal immune responses are modified and the epithelial barrier is enforced. In addition, such responses may also be triggered in the gut after exposure to allergens and viruses in the nasal cavity that become available in the GI tract after swallowing. However, these immune cells that come into contact with cow’s milk components in the gut must recirculate into the blood and home to the (upper and lower) respiratory tract to regulate immune responses locally. Expression of the tissue homing-associated markers α4β7 and CCR9 or CCR10 on lymphocytes can be influenced by vitamin A and vitamin D3, respectively. Since both vitamins are present in milk, we speculate that raw milk may influence homing of lymphocytes to the upper respiratory tract. This review focuses on potential mechanisms via which cow’s milk or its components can influence immune function in the intestine and the upper respiratory tract. Unraveling these complex mechanisms may contribute to the development of novel dietary approaches in allergy and asthma prevention. PMID:29483908

Cow's Milk and Immune Function in the Respiratory Tract: Potential Mechanisms.

PubMed

Perdijk, Olaf; van Splunter, Marloes; Savelkoul, Huub F J; Brugman, Sylvia; van Neerven, R J Joost

2018-01-01

During the last decades, the world has witnessed a dramatic increase in allergy prevalence. Epidemiological evidence shows that growing up on a farm is a protective factor, which is partly explained by the consumption of raw cow's milk. Indeed, recent studies show inverse associations between raw cow's milk consumption in early life and asthma, hay fever, and rhinitis. A similar association of raw cow's milk consumption with respiratory tract infections is recently found. In line with these findings, controlled studies in infants with milk components such as lactoferrin, milk fat globule membrane, and colostrum IgG have shown to reduce respiratory infections. However, for ethical reasons, it is not possible to conduct controlled studies with raw cow's milk in infants, so formal proof is lacking to date. Because viral respiratory tract infections and aeroallergen exposure in children may be causally linked to the development of asthma, it is of interest to investigate whether cow's milk components can modulate human immune function in the respiratory tract and via which mechanisms. Inhaled allergens and viruses trigger local immune responses in the upper airways in both nasal and oral lymphoid tissue. The components present in raw cow's milk are able to promote a local microenvironment in which mucosal immune responses are modified and the epithelial barrier is enforced. In addition, such responses may also be triggered in the gut after exposure to allergens and viruses in the nasal cavity that become available in the GI tract after swallowing. However, these immune cells that come into contact with cow's milk components in the gut must recirculate into the blood and home to the (upper and lower) respiratory tract to regulate immune responses locally. Expression of the tissue homing-associated markers α4β7 and CCR9 or CCR10 on lymphocytes can be influenced by vitamin A and vitamin D3, respectively. Since both vitamins are present in milk, we speculate that raw milk may influence homing of lymphocytes to the upper respiratory tract. This review focuses on potential mechanisms via which cow's milk or its components can influence immune function in the intestine and the upper respiratory tract. Unraveling these complex mechanisms may contribute to the development of novel dietary approaches in allergy and asthma prevention.

In vitro activity of josamycin against Streptococcus pyogenes isolated from patients with upper respiratory tract infections in France.

PubMed

Auzou, M; Caillon, J; Poyart, C; Weber, P; Ploy, M-C; Leclercq, R; Cattoir, V

2015-07-01

The primary objective of our study was to obtain susceptibility data for josamycin against Streptococcus pyogenes isolated from patients presenting with upper respiratory tract infections in France. The secondary objective was to characterize the molecular mechanism of resistance in macrolide-resistant isolates. MICs of erythromycin, clarithromycin, azithromycin, josamycin, and clindamycin were determined by the broth microdilution method. Resistance genes erm(B), erm(TR), and mef(A) were screened by PCR. The MIC50 and MIC90 of josamycin against 193 isolates of S. pyogenes were 0.12 and 0.25mg/L, respectively, with a resistance rate estimated at 4.7%. Resistance was due to the erm(B) gene whereas strains harboring erm(TR) or mef(A) remained susceptible. Josamycin was active against >95% of S. pyogenes isolated from patients with upper respiratory tract infections, and can be used as an alternative for the treatment of pharyngitis. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Photodynamic therapy--1994: treatment of benign and malignant upper aerodigestive tract disease

NASA Astrophysics Data System (ADS)

Schweitzer, Vanessa G.

1995-03-01

From 1983 to 1994 Phase II and III clinical studies at Henry Ford Hospital demonstrated complete or partial responses in 46 of 47 patients treated with hematoporphyrin-derivative photodynamic therapy (HPD-PDT) for a variety of benign and malignant upper aerodigestive tract disease: (1) superficial `condemned mucosa' or `field cancerization' of the oral cavity; (2) stage III/IV head and neck cancer; (3) mucocutaneous AIDS-related Kaposi's sarcoma of the upper aerodigestive tract; (4) recurrent laryngotracheal papillomatosis; (5) severe dysplasia/adenocarcinoma in situ in Barrett's esophagus; (6) partial or completely obstructing terminal esophageal cancer. HPD-PDT produced complete responses in 19 patients (follow up 6 months to 8 years) with `field cancerization' (CIS, T1) of the oral cavity and larynx (6), adenocarcinoma in situ in Barrett's esophagus (2), mucocutaneous Kaposi's sarcoma (9), obstructing esophageal carcinoma (1), and stage IV squamous cell carcinoma of the nasopharynx (1). PDT treatment protocols, results, complications, and application as adjunct or primary oncologic therapy for head and neck disease are reviewed.

Update on narrow band imaging in disorders of the upper gastrointestinal tract.

PubMed

Singh, Rajvinder; Lee, Shok Y; Vijay, Nimal; Sharma, Prateek; Uedo, Noriya

2014-03-01

With the ever-increasing concern regarding morbidity and mortality associated with diseases of the gastrointestinal tract, the importance of an effective and efficient diagnostic tool cannot be overstated. The standard of care currently is an examination using conventional white light endoscopy. This approach may occasionally overlook areas exhibiting a premalignant change. Numerous image-enhanced modalities have been recently introduced. Narrow band imaging (NBI) appears to be the most prominent of these and perhaps the most commonly used. Thepresent review will focus on some of the newer studies on NBI and its utility in the diagnosis of malignant, pre-malignant and chronic inflammatory conditions of the upper gastrointestinal tract. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

Effects of human fatigue on speech signals

NASA Astrophysics Data System (ADS)

Stamoulis, Catherine

2004-05-01

Cognitive performance may be significantly affected by fatigue. In the case of critical personnel, such as pilots, monitoring human fatigue is essential to ensure safety and success of a given operation. One of the modalities that may be used for this purpose is speech, which is sensitive to respiratory changes and increased muscle tension of vocal cords, induced by fatigue. Age, gender, vocal tract length, physical and emotional state may significantly alter speech intensity, duration, rhythm, and spectral characteristics. In addition to changes in speech rhythm, fatigue may also affect the quality of speech, such as articulation. In a noisy environment, detecting fatigue-related changes in speech signals, particularly subtle changes at the onset of fatigue, may be difficult. Therefore, in a performance-monitoring system, speech parameters which are significantly affected by fatigue need to be identified and extracted from input signals. For this purpose, a series of experiments was performed under slowly varying cognitive load conditions and at different times of the day. The results of the data analysis are presented here.

Articulatory capacity of Neanderthals, a very recent and human-like fossil hominin

PubMed Central

Barney, Anna; Martelli, Sandra; Serrurier, Antoine; Steele, James

2012-01-01

Scientists seek to use fossil and archaeological evidence to constrain models of the coevolution of human language and tool use. We focus on Neanderthals, for whom indirect evidence from tool use and ancient DNA appears consistent with an adaptation to complex vocal-auditory communication. We summarize existing arguments that the articulatory apparatus for speech had not yet come under intense positive selection pressure in Neanderthals, and we outline some recent evidence and analyses that challenge such arguments. We then provide new anatomical results from our own attempt to reconstruct vocal tract (VT) morphology in Neanderthals, and document our simulations of the acoustic and articulatory potential of this reconstructed Neanderthal VT. Our purpose in this paper is not to polarize debate about whether or not Neanderthals were human-like in all relevant respects, but to contribute to the development of methods that can be used to make further incremental advances in our understanding of the evolution of speech based on fossil and archaeological evidence. PMID:22106429

Opposite hemispheric lateralization effects during speaking and singing at motor cortex, insula and cerebellum.

PubMed

Riecker, A; Ackermann, H; Wildgruber, D; Dogil, G; Grodd, W

2000-06-26

Aside from spoken language, singing represents a second mode of acoustic (auditory-vocal) communication in humans. As a new aspect of brain lateralization, functional magnetic resonance imaging (fMRI) revealed two complementary cerebral networks subserving singing and speaking. Reproduction of a non-lyrical tune elicited activation predominantly in the right motor cortex, the right anterior insula, and the left cerebellum whereas the opposite response pattern emerged during a speech task. In contrast to the hemodynamic responses within motor cortex and cerebellum, activation of the intrasylvian cortex turned out to be bound to overt task performance. These findings corroborate the assumption that the left insula supports the coordination of speech articulation. Similarly, the right insula might mediate temporo-spatial control of vocal tract musculature during overt singing. Both speech and melody production require the integration of sound structure or tonal patterns, respectively, with a speaker's emotions and attitudes. Considering the widespread interconnections with premotor cortex and limbic structures, the insula is especially suited for this task.

[Laparoscopic Proximal Gastrectomy as a Surgical Treatment for Upper Third Early Gastric Cancer].

PubMed

Park, Do Joong; Park, Young Suk; Ahn, Sang Hoon; Kim, Hyung Ho

2017-09-25

Recently, the incidence of upper third gastric cancer has increased, and with it the number of endoscopic submucosal dissection (ESD) procedures performed has been increasing. However, if ESD is not indicated or non-curable, surgical treatment may be necessary. In the case of lower third gastric cancer, it is possible to preserve the upper part of the stomach; however, in the case of upper third gastric cancer, total gastrectomy is still the standard treatment option, regardless of the stage. This is due to the complications associated with upper third gastric cancer, such as gastroesophageal reflux after proximal gastrectomy rather than oncologic problems. Recently, the introduction of the double tract reconstruction method after proximal gastrectomy has become one of the surgical treatment methods for upper third early gastric cancer. However, since there has not been a prospective comparative study evaluating its efficacy, the ongoing multicenter prospective randomized controlled trial (KLASS-05) comparing laparoscopic proximal gastrectomy with double tract reconstruction and laparoscopic total gastrectomy is expected to be important for determining the future of treatment of upper third early gastric cancer.

Bighorn sheep (Ovis canadensis) sinus tumors are associated with coinfections by potentially pathogenic bacteria in the upper respiratory tract.

PubMed

Fox, Karen A; Rouse, Natalie M; Huyvaert, Kathryn P; Griffin, Karen A; Killion, Halcyon J; Jennings-Gaines, Jessica; Edwards, William H; Quackenbush, Sandra L; Miller, Michael W

2015-01-01

Bighorn sheep (Ovis canadensis) sinus tumors are hyperplastic to neoplastic, predominantly stromal masses of the paranasal sinuses that expand the sinus lining and obstruct the sinus cavities. Obstruction of the sinus cavities and disruption of normal sinus lining anatomy may interfere with clearance of bacterial pathogens from the upper respiratory tract. To examine this possibility, we explored whether the presence of sinus tumor features (tumor score) affected the likelihood of detecting potentially pathogenic bacteria from upper respiratory sinus lining tissues in bighorn sheep. We developed or used existing PCR assays for the detection of leukotoxigenic Pasteurellaceae and Mycoplasma ovipneumoniae in sinus lining tissues collected from 97 bighorn sheep in Colorado, US from 2009 to 2012. With the use of logistic regression analyses we found that tumor score was a good predictor of the probability of detecting potentially pathogenic bacteria in sinus lining tissues; we were more likely to detect potentially pathogenic bacteria from samples with high tumor scores. These findings add to our understanding of possible mechanisms for the maintenance and shedding of bacterial agents from the upper respiratory tracts of bighorn sheep.

Flexible ureterorenoscopy and laser lithotripsy in children

PubMed Central

Yeow, When-Chan; Pemberton, Richard; Barker, Andrew

2009-01-01

Background: Flexible ureterorenoscopy (FUR) and laser lithotripsy (LL) are techniques used in the management of upper urinary tract disorders. These techniques, so far established in adults, are now being used in children as well. We report our experience with 26 cases of pediatric upper urinary tract disorders treated using these techniques. Methods: In the period from 1997 to 2006, FUR was performed in 26 children (14 males and 12 females) in the age group of three months to 15 years with a mean age of 8.2 years. Twenty five were stented prior to undergoing FUR and 24 presented with suspected upper tract stones (17 pelvicalyceal and seven midureteric). Two cases showed JJ stent migration post-pyeloplasty. Results: Eight cases involved diagnostic procedures. Six excluded the presence of renal calculi, one had focal medullary sponge kidney, and one had calcified papillae. There were 15 cases of therapeutic FUR. Of these, 12 had LL with only one had incomplete stone fragmentation which subsequently passed spontaneously. Other therapeutic procedures included removal of migrated JJ stents and FUR with the basket removal of a midureteric calculus. Three cases failed ureterorenoscopy due to technical difficulties. The overall success rate was 88.5% for FUR. Conclusion: FUR and LL are valuable minimally invasive techniques for the examination and treatment of pediatric upper urinary tract conditions. Preoperative stenting improves passage of the ureteroscope and with progressive miniaturization of instruments, the lower weight limit will decrease. PMID:20671848

Biostratigraphic sequence analysis of two Lower Miocene to Pliocene sections, Eastern Falcon, Northwestern Venezuela

DOE Office of Scientific and Technical Information (OSTI.GOV)

Diaz De Gamero, M.L.; Giffuni, G.; Castro Mora, M.

1993-02-01

The eastern region of the Falcon Basin in northwestern Venezuela comprises a thick sedimentary sequence deposited from a deep marine bathyal to neritic environment, ranging in age from the Middle Eocene to the Pliocene. A detailed biostratigraphic study (foraminifera and calcareous nannoplankton) was carried out in two sedimentary sequences outcropping in Cumarebo and Piritu, adjacent areas of eastern Falcon, representing: platform, slope and basinal settings. The Cumarebo section is continuous in the studied interval, from the Middle Miocene to the Pliocene. The Piritu section is continuous from the Lower to the lower Upper Miocene, terminating unconformably beneath a thin intervalmore » of middle Pliocene platform sediments, indicating tectonism during the latest Miocene. The sequence stratigraphical interpretation was based on the biostratigraphic analysis of the benthic and planktonic fossils, facies distribution and sedimentological data. Systems tracts, sequence boundaries and maximum flooding surfaces from cycles TB2.4 to TB3.5 of the cycle chart were identified. In the Cumarebo section, the upper Middle and Upper Miocene is mostly composed of shales, with some turbiditic sands belonging to a LSW system tract. The upper most Miocene contains a thick carbonate buildup (HST), and it is overlain by a Pliocene section that shallows upward from upper slope to outer shelf depositional environments. In the basinal (Piritu) section, most of the sediments are deep-water shales belonging to a LSW system tract, with some turbiditic sands in the upper Lower Miocene. TST and HST sediments, with scattered carbonate buildups in the upper Middle Miocene were also identified.« less

Wildlife of southern forests habitat & management (Chapter 15): Rabbits

Treesearch

James G. Dickson

2003-01-01

Rabbits, or lagomorphs, resemble rodents. But unlike rodents they have relatively large hind legs, large ears, a short fluffy tail, and 2 sets of upper incisors. Like rodents their incisors grow continually. They can either walk or hop, and are fleet and elusive when evading predators. They normally are silent but are capable of several different vocalizations. Rabbits...

Diagnosing and Managing IBD

MedlinePlus

... of your abdomen. Newer scanners have an open design to minimize claustrophobia. A CT of the abdomen ... CE) Upper tract Crohn’s disease EGD-Upper GI Series (UGIS) Perianal Crohn’s disease MRI-EUS PSC (primary ...

Upper Gastrointestinal (GI) Tract X-Ray (Radiography)

MedlinePlus

... to drinking barium, some patients are also given baking-soda crystals (similar to Alka-Seltzer) to further ... contrast upper GI series. The patient will swallow baking-soda crystals that create gas in the stomach ...

Radiology of sarcoidosis.

PubMed

James, D G; Timmis, B; Barter, S; Carstairs, S

1989-03-01

This review of the radiology of sarcoidosis encompasses intrathoracic involvement, upper respiratory tract sarcoidosis, pleural disease, and involvement of bone, joint, neurological system, heart, kidney and alimentary tract. Attention is drawn to the value of CT scans, magnetic resonance imaging, gallium, and neutron activation analysis.

Speech research

NASA Astrophysics Data System (ADS)

1992-06-01

Phonology is traditionally seen as the discipline that concerns itself with the building blocks of linguistic messages. It is the study of the structure of sound inventories of languages and of the participation of sounds in rules or processes. Phonetics, in contrast, concerns speech sounds as produced and perceived. Two extreme positions on the relationship between phonological messages and phonetic realizations are represented in the literature. One holds that the primary home for linguistic symbols, including phonological ones, is the human mind, itself housed in the human brain. The second holds that their primary home is the human vocal tract.

Performance constraints and the production of birdsong

NASA Astrophysics Data System (ADS)

Suthers, Roderick A.; Vallet, Eric; Zollinger, Sue Anne

2004-05-01

The role of physical and physiological constraints in determining the performance limits on the tempo and frequency bandwidth of birdsong was investigated. One series of experiments examined the mechanism by which a vocal mimic, the northern mockingbird (Mimus polygottos), copied the songs of other species with which it was tutored as a juvenile. Other experiments analyzed the motor basis of special canary (Serinus canaria) syllables eliciting sexual responses from females. In each case, the mechanism of vocalization was determined by measuring the respiratory dynamics and sound produced on each side of the songbirds duplex vocal organ, the syrinx. When mockingbirds copied the songs of other species the accuracy of their copy depended on the accuracy with which they reproduced the motor pattern used by the tutor species. Motor difficulty of various acoustic features was assessed by the accuracy of its copy. The high repetition rate, broadband canary syllables preferred by females required especially demanding bilateral motor skills. The results indicate that constraints on the rate of respiratory ventilation and bilateral syringeal coordination can set an upper limit on syllable repetition rate and frequency bandwidth. [Work supported by NIH and NSF.

Effect of Hygromycin-B on pigeons (Columba livia) with and without Trichomonas gallinae

USGS Publications Warehouse

Kocan, R.M.

1972-01-01

Hygromycin-B was administered in varied quantities to pigeons harboring nonvirulent Trichomonas gallinae and to pigeons free of T. gallinae. Both groups responded identically with large yellow caseous lesions in the upper digestive tract which superficially resembled canker (trichomoniasis). No mycotic association with the lesions could be established in either .group from sections stained with periodic acid-Schiff. The lesions observed in Hygromycin-B-treated pigeons were concluded to be the direct result of the drug on the mucosa of the pigeon's upper digestive tract.

[Isolation of C. pyloridis from children].

PubMed

Spirina, T S; Bokser, G V; Safonova, T B; Taranenko, L A; Levitskaia, S V

1989-01-01

The authors analyze the findings of gastroduodenal biopsies in 25 children aged 6 to 15 years suffering from mucosal inflammations and functional abnormalities of the upper portions of the digestive tract. Chocolate agar with various bases, one of which has been suggested by the authors, has been used for the isolation of C. pyloridis. Five cultures have been isolated. Microscopic examinations and biochemical identification of the isolates have lead the authors to a conclusion that campylobacter infections of the upper digestive tract may be diagnosed with certainty only after a comprehensive bacteriologic examination.

Effects of a Straw Phonation Protocol on Acoustic Measures of an SATB Chorus Singing Two Contrasting Renaissance Works.

PubMed

Manternach, Jeremy N; Clark, Chad; Daugherty, James F

2017-07-01

Researchers have found that semi-occluded vocal tract (SOVT) exercises may increase vocal economy by reducing phonation threshold pressure and effort while increasing or maintaining consistent acoustic output. This research has focused solely on individual singers. Much singing instruction, however, takes place in choral settings. Choral singers may use different resonance strategies or unconsciously adjust their singing based on the ability to hear their own sound in relation to others. Results of studies with individual singers, then, may not be directly applicable to choral settings. The purpose of this investigation was to measure the effect of an SOVT protocol (ie, straw phonation) on acoustic changes of conglomerate, choral sound. This is a quasi-experimental, one-group, pretest-posttest design. Participants in this study constituted an intact SATB choir (soprano, alto, tenor, and bass) (N = 15 singers) who performed from memory two unaccompanied pieces of varied tempos from memory, participated in a 4-minute straw phonation protocol with a small stirring straw, and then sang each piece a second time. The long-term average spectrum results indicated small, statistically significant increases in spectral energy for both pieces in the 0-10 kHz (.32 and .20 dB Sound Pressure Level) and 2-4 kHz regions (.46 and .25 dB SPL). These results, although not likely audible to average hearing humans, seem consistent with the assertion that singers enjoy vocal benefits with consistent or increased vocal output. SOVT exercises, therefore, may be useful as a time-efficient way to evoke more efficient and economical singing during choral warm-up and voice building procedures. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Vocal anatomy, tongue protrusion behaviour and the acoustics of rutting roars in free-ranging Iberian red deer stags (Cervus elaphus hispanicus).

PubMed

Frey, Roland; Volodin, Ilya; Volodina, Elena; Carranza, Juan; Torres-Porras, Jerónimo

2012-03-01

Roaring in rutting Iberian red deer stags Cervus elaphus hispanicus is unusual compared to other subspecies of red deer, which radiated from the Iberian refugium after the last glacial maximum. In all red deer stags, the larynx occupies a permanent low mid-neck resting position and is momentarily retracted almost down to the rostral end of the sternum during the production of rutting calls. Simultaneous with the retraction of the larynx, male Iberian red deer pronouncedly protrude the tongue during most of their rutting roars. This poses a mechanical challenge for the vocal tract (vt) and for the hyoid apparatus, as tongue and larynx are strongly pulled in opposite directions. This study (i) examines the vocal anatomy and the acoustics of the rutting roars in free-ranging male C. e. hispanicus; (ii) establishes a potential mechanism of simultaneous tongue protrusion and larynx retraction by applying a two-dimensional model based on graphic reconstructions in single video frames of unrestrained animals; and (iii) advances a hypothesis of evaporative cooling by tongue protrusion in the males of a subspecies of red deer constrained to perform all of the exhausting rutting activities, including acoustic display, in a hot and arid season. © 2012 The Authors. Journal of Anatomy © 2012 Anatomical Society.

Effect of Performance Time of the Semi-Occluded Vocal Tract Exercises in Dysphonic Children.

PubMed

Ramos, Lorena de Almeida; Gama, Ana Cristina Côrtes

2017-05-01

This study aimed to verify the effects of execution time on auditory-perceptual and acoustic responses in children with dysphonia completing straw phonation exercises. A randomized, prospective, comparative intra-subject study design was used. Twenty-seven children, ranging from 5 to 10 years of age, diagnosed with vocal cord nodules or cysts, were enrolled in the study. All subjects included in the Experimental Group were also included in the Control Group which involved complete voice rest. Sustained vowels (/a/e/ε/e/) counting from 1 to 10 were recorded before the exercises (m0) and then again after the first (m1), third (m3), fifth (m5), and seventh (m7) minutes of straw phonation exercises. The recordings were randomized and presented to five speech therapists, who evaluated vocal quality based on the Grade Roughness Breathiness Asthenia/Strain Instability scale. For acoustic analysis, fundamental frequency, jitter, shimmer, glottal to noise excitation ratio, and noise parameters were analyzed. Reduced roughness, breathiness, and noise measurements as well as increased glottal to noise excitation ratio were observed in the Experimental Group after 3 minutes of exercise. Reduced grade of dysphonia and breathiness were noted after 5 minutes. The ideal duration of straw phonation in children with dysphonia is from 3 to 5 minutes. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

INFLUENZA VIRUS HOST RESISTANCE MODELS IN MICE AND RATS: UTILIZATION FOR UMMUNE FUNCTION ASSESSMENT AND IMMUNOTOXICOLOGY

EPA Science Inventory

Each year influenza viruses are responsible for epidemic respiratory diseases with excess morbidity and mortality. he severity of influenza disease ranges from mid upper respiratory tract infections to severe lower respiratory tract infections involving pneumonia, bronchiolitis a...

A simple-shear rheometer for linear viscoelastic characterization of vocal fold tissues at phonatory frequencies.

PubMed

Chan, Roger W; Rodriguez, Maritza L

2008-08-01

Previous studies reporting the linear viscoelastic shear properties of the human vocal fold cover or mucosa have been based on torsional rheometry, with measurements limited to low audio frequencies, up to around 80 Hz. This paper describes the design and validation of a custom-built, controlled-strain, linear, simple-shear rheometer system capable of direct empirical measurements of viscoelastic shear properties at phonatory frequencies. A tissue specimen was subjected to simple shear between two parallel, rigid acrylic plates, with a linear motor creating a translational sinusoidal displacement of the specimen via the upper plate, and the lower plate transmitting the harmonic shear force resulting from the viscoelastic response of the specimen. The displacement of the specimen was measured by a linear variable differential transformer whereas the shear force was detected by a piezoelectric transducer. The frequency response characteristics of these system components were assessed by vibration experiments with accelerometers. Measurements of the viscoelastic shear moduli (G' and G") of a standard ANSI S2.21 polyurethane material and those of human vocal fold cover specimens were made, along with estimation of the system signal and noise levels. Preliminary results showed that the rheometer can provide valid and reliable rheometric data of vocal fold lamina propria specimens at frequencies of up to around 250 Hz, well into the phonatory range.

[The ultra-rapid cinematography of the larynx, its contributions in speech pathology].

PubMed

Chevaillier, G; Sauvaget, E; Herman, P; Tran Ba Huy, P

2010-01-01

The development in the medical field of high speed cinematography and its dissemination in the field of speech pathology will probably change the way we view the larynx and diagnose its disorders. So far only the stroboscope could inform us about the appearance of vocal cord vibration but with certain limitations. Indeed the wave motion of the vocal cords is really only apparent motion. It is made possible through the phenomenon of retinal persistence of images and light intermittent vocal folds set to the frequency of the voice and out of phase by a few Hertz. This technique has several disadvantages: The need for the voice to trigger the strobe light; a low number of frames per second (25 fps) recorded; frame loss for the period between unlit two flashes; limitation in the study of the upper voice spectrum (gearing). The ultra-rapid cinematography brings a big difference in design since the digital recording can shoot up to 4000 frames per second with permanent lighting of the larynx. The slow reading of short sequences permits us to view the actual movement of vibrating structures, and to analyze the behavior of the vibrator during the transitional phases of the attack, depreciation and termination of sound. The footage in high resolution permits a detailed analysis of the movements of opening and closing of the vocal cords in phonation and respiration, and the diagnosis of lesions.

Upper Gastrointestinal (GI) Series

MedlinePlus

... abdomen or ask you to change position several times to evenly coat your upper GI tract with the barium. If you are having a double-contrast study, you will swallow gas-forming crystals that mix with the barium coating your stomach. ...

Medicine use practices in management of symptoms of acute upper respiratory tract infections in children (≤12 years) in Kampala city, Uganda.

PubMed

Ocan, Moses; Aono, Mary; Bukirwa, Clare; Luyinda, Emmanuel; Ochwo, Cathy; Nsambu, Elastus; Namugonza, Stella; Makoba, Joseph; Kandaruku, Enock; Muyende, Hannington; Nakawunde, Aida

2017-09-21

Medicines are commonly accessed and used for management of illness in children without a prescription. This potentially increases the risk of unwanted treatment outcomes. We investigated medicine use practices in management of symptoms of acute upper respiratory tract infections among children (≤12 years) in households in Nakawa division, Kampala city. This was a cross-sectional study conducted among 390 randomly selected children. Data on use of medicines in children (≤12 years) during recent episode of acute upper respiratory tract infection was collected from their care takers using an interviewer administered questionnaire. A recall period of two weeks (14 days) was used in during data collection. The prevalence of giving children non-prescription antimicrobial medicines was 44.8% (38.3-52.2). The most common disease symptoms that the children reportedly had included flu, 84.9% (331/390), cough, 83.1% (324/390), and undefined fever, 69.7% (272/390). Medicines commonly given to children included, paracetamol 53.1% (207/390), Coartem 29.7% (116/390), cough linctus 20.8% (81/390), amoxicillin 18.9% (74/390), Co-trimoxazole 18.5% (72/390), and diphenhydramine 15.4% (60/390). The major sources of medicines given to the children was hospital/clinic, 57.26% (223/390). Most of the children, 81% were given more than one medicine at a time. The majority, 62.3% (243/390) of the care takers who gave the children medicine during the recent illness were not aware of any medicine (s) that should not be given to children. The predictors of non-prescription use of antimicrobial medicines in managing symptoms of acute upper respiratory tract infections in children included, medicines obtained from drug shop (PR: 1.45, CI: 1.14-1.85), medicines at home (PR: 1.8, CI: 0.83-1.198) and type of medicine (antimalarial) (PR: 2.8, CI: 1.17-6.68). Children are commonly given multiple medicines during episodes of acute upper respiratory tract infections with most antimicrobial agents accessed and used without a prescription in Kampala city, Uganda.

Laparoscopic upper urinary tract surgery for benign and malignant conditions. Does aetiology have an effect on health-related quality of life?

PubMed

Sahai, A; Tang, S; Challacombe, B; Murphy, D; Dasgupta, P

2007-12-01

We present health-related quality of life (HRQoL) data on a cohort of patients undergoing upper urinary tract laparoscopy for a variety of benign and malignant conditions. The Short Form 8 (SF-8) Health Survey is a validated HRQoL questionnaire that calculates scores for physical (PCS8) and mental (MCS8) components of health. It was administered prospectively to 58 patients. Radical nephrectomy or nephroureterectomy was carried out for upper tract malignancy (n = 21). Laparoscopy for benign disease (n = 37) included simple nephrectomy for giant hydronephrosis and small non-functioning kidneys, de-roofing of renal cysts and pyeloplasty. Data were collected before and 6 weeks after surgery. The mean pre- and postsurgery scores were 45.99; 47.43 and 43.93; 51.54 for PCS8 and MCS8 respectively. With regard to the PCS8 score, there was no significant difference before or after surgery (p = 0.585) or when analysing the benign (p = 0.343) or malignant (p = 0.509) groups individually. The MCS8 score, however, showed a significant increase after surgery (p < 0.0001). This remained significant when analysing just the benign (p < 0.0009) or the malignant (p < 0.0003) groups but neither group was more significant than the other (p = 0.750). Laparoscopic upper urinary tract surgery significantly improves mental and does not appear to reduce physical HRQoL in patients regardless of aetiology, 4 weeks following surgery. Interestingly, those operated on for malignant conditions do not have a greater improvement in mental health when compared with benign disease.

Flexible ureteroscopic lithotripsy for the treatment of upper urinary tract calculi in infants

PubMed Central

Li, Jun; Han, Tiandong; Tian, Ye; Wang, Wenying; Du, Yuan

2016-01-01

We evaluated the clinical value of flexible ureteroscopic lithotripsy for the treatment of upper urinary tract calculi in infants. Fifty-five infants with upper urinary tract calculi were included in this study: 41 males and 14 females. Retrograde intrarenal surgery was performed by an 8 Fr/30 cm flexible ureterorenoscope (POLY®) combined with a holmium laser. CT scanning or radiography of the kidneys, ureters, and bladder region was performed one month after the operation to confirm the clearance of calculi. All the 55 infants with calculi in 74 sides underwent 66 flexible ureteroscopic lithotripsy procedures. The median operation time was 30 min. The median amount of flushing fluid was 500 mL. The stone-free rate after a single session treatment was 94.6%, within which 10 infants underwent simultaneous bilateral flexible ureteroscopy lithotripsy. Catheters were retained in 45 infants for 24–48 h after the operation. Continuous high fever due to reflux was present in two cases. Flushing fluid extravasation was found in one infant. Some patients with minor complications, such as mild hematuria, irritation symptoms, and low fever, recovered without treatment. The duration of hospitalization time after the operation was approximately 1–5 days. Flexible ureteroscopic lithotripsy is a safe, highly efficient, minimally invasive, and reproducible operation for removal of upper urinary tract calculi in infants. This technique is a convenient method for postoperative management of patients that enhances their rapid recovery. It is a promising option for therapy of infants ineffectively treated by extracorporeal shockwave lithotripsy. PMID:27633576

Flexible ureteroscopic lithotripsy for the treatment of upper urinary tract calculi in infants.

PubMed

Li, Jun; Xiao, Jing; Han, Tiandong; Tian, Ye; Wang, Wenying; Du, Yuan

2017-01-01

We evaluated the clinical value of flexible ureteroscopic lithotripsy for the treatment of upper urinary tract calculi in infants. Fifty-five infants with upper urinary tract calculi were included in this study: 41 males and 14 females. Retrograde intrarenal surgery was performed by an 8 Fr/30 cm flexible ureterorenoscope (POLY®) combined with a holmium laser. CT scanning or radiography of the kidneys, ureters, and bladder region was performed one month after the operation to confirm the clearance of calculi. All the 55 infants with calculi in 74 sides underwent 66 flexible ureteroscopic lithotripsy procedures. The median operation time was 30 min. The median amount of flushing fluid was 500 mL. The stone-free rate after a single session treatment was 94.6%, within which 10 infants underwent simultaneous bilateral flexible ureteroscopy lithotripsy. Catheters were retained in 45 infants for 24-48 h after the operation. Continuous high fever due to reflux was present in two cases. Flushing fluid extravasation was found in one infant. Some patients with minor complications, such as mild hematuria, irritation symptoms, and low fever, recovered without treatment. The duration of hospitalization time after the operation was approximately 1-5 days. Flexible ureteroscopic lithotripsy is a safe, highly efficient, minimally invasive, and reproducible operation for removal of upper urinary tract calculi in infants. This technique is a convenient method for postoperative management of patients that enhances their rapid recovery. It is a promising option for therapy of infants ineffectively treated by extracorporeal shockwave lithotripsy.

Incidence of upper tract abnormalities in patients with neurovesical dysfunction secondary to multiple sclerosis: analysis of risk factors at initial urologic evaluation.

PubMed

Lemack, Gary E; Hawker, Kathleen; Frohman, Elliot

2005-05-01

To determine the incidence of upper tract abnormalities on renal ultrasonography in patients with multiple sclerosis (MS) referred for urologic evaluation, as well as to identify any risk factors present on the basis of the historical information and urodynamic findings. Data were derived from all patients with MS referred to the neurourology clinic during a 4-year period. The database was specifically queried for patients found to have upper tract abnormalities on screening renal ultrasonography. Demographic parameters, as well as laboratory values (creatinine) and urodynamic results, were evaluated for risk factors associated with abnormal upper tract findings. Of the 113 patients referred and evaluated, 66 completed both urodynamic testing and renal ultrasonography. Eleven (16.7%) had abnormal ultrasound findings, with focal caliectasis the most common finding. No demographic parameter (age, sex, time since MS diagnosis, MS pattern) was associated with a greater likelihood of abnormal renal ultrasonography on univariate analysis. Neither serum creatinine nor any urodynamic finding (including the presence of dyssynergia or the threshold and amplitude of detrusor overactivity) was associated with abnormal renal ultrasound findings. No patients in our series had any indication of obstructive uropathy more severe than mild hydronephrosis. Of the 16.7% of patients with any abnormal findings, most were noted to have minor caliectasis, likely to be of little clinical significance. Although no factors identifying patients at risk of renal abnormalities at presentation were found, ongoing evaluation of patients with baseline findings will serve to identify those at risk of progression.

Local Acetaldehyde—An Essential Role in Alcohol-Related Upper Gastrointestinal Tract Carcinogenesis

PubMed Central

Salaspuro, Mikko

2018-01-01

The resident microbiome plays a key role in exposure of the upper gastrointestinal (GI) tract mucosa to acetaldehyde (ACH), a carcinogenic metabolite of ethanol. Poor oral health is a significant risk factor for oral and esophageal carcinogenesis and is characterized by a dysbiotic microbiome. Dysbiosis leads to increased growth of opportunistic pathogens (such as Candida yeasts) and may cause an up to 100% increase in the local ACH production, which is further modified by organ-specific expression and gene polymorphisms of ethanol-metabolizing and ACH-metabolizing enzymes. A point mutation in the aldehyde dehydrogenase 2 gene has randomized millions of alcohol consumers to markedly increased local ACH exposure via saliva and gastric juice, which is associated with a manifold risk for upper GI tract cancers. This human cancer model proves conclusively the causal relationship between ACH and upper GI tract carcinogenesis and provides novel possibilities for the quantitative assessment of ACH carcinogenicity in the human oropharynx. ACH formed from ethanol present in “non-alcoholic” beverages, fermented food, or added during food preparation forms a significant epidemiologic bias in cancer epidemiology. The same also concerns “free” ACH present in mutagenic concentrations in multiple beverages and foodstuffs. Local exposure to ACH is cumulative and can be reduced markedly both at the population and individual level. At best, a person would never consume tobacco, alcohol, or both. However, even smoking cessation and moderation of alcohol consumption are associated with a marked decrease in local ACH exposure and cancer risk, especially among established risk groups. PMID:29303995

Half Fourier single-shot turbo spin-echo magnetic resonance urography for the evaluation of suspected renal colic in pregnancy.

PubMed

Mullins, Jeffrey K; Semins, Michelle J; Hyams, Elias S; Bohlman, Mark E; Matlaga, Brian R

2012-06-01

To report our experience with magnetic resonance urography (MRU) in pregnant women suspected of having obstructing upper tract calculi. The diagnosis of an upper tract calculus in the pregnant woman can be challenging. Recent evidence suggests that MRU can be used to effectively evaluate renal colic. From 2008-2011, 9 pregnant women were referred for evaluation of suspected renal colic caused by an obstructing upper tract stone. All patients underwent MRU with a half Fourier single-shot turbo spin-echo (HASTE) protocol. Medical records and imaging studies were reviewed for demographic and clinical data as well as outcome measures. The mean age of the subjects was 25 years (range 20-34); average gestational age of the fetus was 23 weeks (range 9-36). In all cases, a renal ultrasound was the initial imaging study obtained, with nondiagnostic findings. HASTE MRU detected 4 ureteral stones and 4 cases of physiological hydronephrosis of pregnancy. In one case, interpretation of the MRU was limited as a result of patient motion. Of the patients with obstructing stones, 1 required endourologic management during her pregnancy and 3 were followed conservatively. No adverse events related to MRU occurred. HASTE MRU is an informative imaging study for pregnant women with suspected upper tract stone disease. Information gathered from this study augments that gained from alternative modalities, and aids in medical decision-making. The lack of ionizing radiation exposure, coupled with the capture of detailed anatomic imaging, makes HASTE MRU a particularly useful study in this setting. Copyright © 2012 Elsevier Inc. All rights reserved.

Delayed prescribing for upper respiratory tract infections: a qualitative study of GPs' views and experiences

PubMed Central

Høye, Sigurd; Frich, Jan; Lindbœk, Morten

2010-01-01

Background Delayed prescribing has been promoted as a strategy that meets patients' expectations and helps to avoid unnecessary use of antibiotics in upper respiratory tract infections. Aim To explore GPs' views on and experiences with delayed prescribing in patients with acute upper respiratory tract infections. Design of study Qualitative study involving focus groups. Setting Norwegian general practice. Method Qualitative analysis of data collected from five focus groups comprising 33 GPs who took part in a quality-improvement programme of antibiotic prescribing. Results The views of GPs differed on the usefulness of delayed prescribing. GPs who endorsed the strategy emphasised shared decision making and the creation of opportunities for educating patients, whereas GPs who were negative applied the strategy mainly when being pressed to prescribe. Mild and mainly harmless conditions of a possible bacterial origin, such as acute sinusitis and acute otitis, were considered most suitable for delayed prescribing. A key argument for issuing a wait-and-see prescription was that it helped patients avoid seeking after-hours care. For issuing a wait-and-see prescription, the GPs required that the patient was ‘knowledgeable’, able to understand the indications for antibiotics, and motivated for shared decision making. GPs emphasised that patients should be informed thoroughly when receiving a wait-and-see prescription. Conclusion Not all GPs endorse delayed prescribing; however, it appears to be a feasible approach for managing patients with early symptoms of mild upper respiratory tract infections of a possible bacterial origin. Informing the patients properly while issuing wait-and-see prescriptions is essential. PMID:21144201

Treatment of Postoperative Leaks of the Upper Gastrointestinal Tract with Colonic Self-Expandable Metal Stents.

PubMed

Sousa, Paula; Castanheira, António; Martins, Diana; Pinho, Juliana; Araújo, Ricardo; Cancela, Eugénia; Ministro, Paula; Silva, Américo

2017-07-01

The use of self-expandable metal stents (SEMS) for the treatment of postoperative leaks of the upper gastrointestinal tract is already established. However, there are discrepancies between the relatively small caliber of the esophageal stents available and the postsurgical luminal size, which may determine an inadequate juxtaposition. As colonic stents have a bigger diameter, they might be more adequate. Additionally, stents with a larger diameter might have a lower risk of migration. The aim of this study was to evaluate the efficacy and complications associated with the use of colonic fully covered SEMS (FSEMS) in the treatment of postoperative leaks in critical patients. All patients with postoperative leaks of the upper gastrointestinal tract treated with colonic stents (Hanarostent® CCI) between 2010 and 2013 were retrospectively included. Four patients with postoperative leaks were treated with colonic SEMS. The underlying surgeries were a gastric bypass, an esophagogastrectomy for Boerhaave syndrome, a primary repair of esophagopleural fistula due to Boerhaave syndrome, and an esophagectomy due to esophageal cancer. The leaks were detected on average 17 days after the initial surgery. All patients needed admission to a critical care unit after index surgery. Stent placement was technically feasible in all patients. The median residence time of the stents was 7 weeks, and no complications were verified when they were removed. There were no cases of stent migration. The treatment was successful in all patients, with complete healing of the leaks. The placement of colonic FSEMS seems to be successful and safe in the treatment of postoperative leaks of the upper gastrointestinal tract.

Rhizoma Smilacis Glabrae inhibits pathogen-induced upper genital tract inflammation in rats through suppression of NF-κB pathway.

PubMed

Zou, Wei; Zhou, Hougang; Hu, Jian; Zhang, Li; Tang, Qiue; Wen, Xiaoke; Xiao, Zuoqi; Wang, Wei

2017-04-18

Rhizoma Smilacis Glabrae (RSG) is traditionally used to treat gynecological disease, which is simply recorded in Chinese Pharmacopoeia. However, whether it has effect on upper genital tract inflammation (UGTI) is unclear. To evaluate the pharmacological effect of RSG on UGTI in rats and analyze its phytochemistry characteristics. The substances in RSG extract was qualified by LC-Q-TOF-MS method, and 11 substances were further quantified. The RSG extract, at dose of 241, 482 (clinical dose) and 964mg/kg/day, was orally administered to UGTI rats whose upper genital tracts were multi-infected with pathogens. Infiltrations of neutrophil and lymphocyte and productions of IL-1β, IL-6, CXCL-1, MCP-1, RANTES, PGE2, COX-2, NF-κB p65 and IκB-α in upper genital tract were examined to evaluate the effects of RSG and its potential mechanism. A total of 77 substances were detected in RSG extract, with 50 substances putatively identified, most of which were flavonoids, phenolic acids and phenylpropanoids. The quantification analysis showed flavonoid had a relative high amount. In pharmacological study, RSG extract suppressed infiltrations of inflammatory cells, reduced over-productions of factors involved in inflammation and pelvic pain. A potential mechanism of these effects was blocking NF-κB signal pathway. The RSG extract exhibited anti-inflammatory effect on UGTI, with a potential mechanism of blocking the activation of NF-κB signal pathway. The effect may be involved in the presence of substances, such as flavonoids and phenolic acids. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Creating speech-synchronized animation.

PubMed

King, Scott A; Parent, Richard E

2005-01-01

We present a facial model designed primarily to support animated speech. Our facial model takes facial geometry as input and transforms it into a parametric deformable model. The facial model uses a muscle-based parameterization, allowing for easier integration between speech synchrony and facial expressions. Our facial model has a highly deformable lip model that is grafted onto the input facial geometry to provide the necessary geometric complexity needed for creating lip shapes and high-quality renderings. Our facial model also includes a highly deformable tongue model that can represent the shapes the tongue undergoes during speech. We add teeth, gums, and upper palate geometry to complete the inner mouth. To decrease the processing time, we hierarchically deform the facial surface. We also present a method to animate the facial model over time to create animated speech using a model of coarticulation that blends visemes together using dominance functions. We treat visemes as a dynamic shaping of the vocal tract by describing visemes as curves instead of keyframes. We show the utility of the techniques described in this paper by implementing them in a text-to-audiovisual-speech system that creates animation of speech from unrestricted text. The facial and coarticulation models must first be interactively initialized. The system then automatically creates accurate real-time animated speech from the input text. It is capable of cheaply producing tremendous amounts of animated speech with very low resource requirements.

Developmental change in variability of lip muscle activity during speech.

PubMed

Wohlert, Amy B; Smith, Anne

2002-12-01

Compared to adults, children's speech production measures sometimes show higher trial-to-trial variability in both kinematic and acoustic analyses. A reasonable hypothesis is that this variability reflects variations in neural drive to muscles as the developing system explores different solutions to achieving vocal tract goals. We investigated that hypothesis in the present study by analyzing EMG waveforms produced across repetitions of a phrase spoken by 7-year-olds, 12-year-olds, and young adults. The EMG waveforms recorded via surface electrodes at upper lip sites were clearly modulated in a consistent manner corresponding to lip closure for the bilabial consonants in the utterance. Thus we were able to analyze the amplitude envelope of the rectified EMG with a phrase-level variability index previously used with kinematic data. Both the 7- and 12-year-old children were significantly more variable on repeated productions than the young adults. These results support the idea that children are using varying combinations of muscle activity to achieve phonetic goals. Even at age 12 years, these children were not adult-like in their performance. These and earlier kinematic studies of the oral motor system suggest that children retain their flexibility, employing more degrees of freedom than adults, to dynamically control lip aperture during speech. This strategy is adaptive given the many neurophysiological and biomechanical changes that occur during the transition from adolescence to adulthood.

[Risk for the development of upper gastrointestinal bleeding in children in an intensive care unit].

PubMed

Gutiérrez-Gutiérrez, Glenda Karina; Villasís-Keever, Miguel Angel; González-Ortiz, Beatriz; Troconis-Trens, Germán; Tapia-Monge, Dora María; Flores-Calderón, Judith

2014-01-01

Although gastrointestinal tract bleeding can occur at any age, most studies trying to establish causes or risk factors for its development have been conducted in adults. The aim of this study was to determine risk factors in children admitted in a pediatric intensive care unit. A retrospective case-control study was conducted. Children who developed upper gastrointestinal bleeding children during their stay at the intensive care unit were considered the cases. Variables were obtained from medical records including age, sex, nutritional status, mechanical ventilation, use of nasogastric tube, development of complications, presence of coagulopathy, use of prophylaxis for upper gastrointestinal tract bleeding, fasting and use of steroids. Using a multivariate analysis, risk factors were identified, with odds ratios (OR) and 95 % confidence intervals (95 % CI) calculations. Out of 165 patients, 58 had upper gastrointestinal bleeding (35 %). Risk factors identified were prolonged clotting times (OR = 3.35), thrombocytopenia (OR = 2.39), development of sepsis (OR = 6.74) or pneumonia (OR = 4.37). Prophylaxis for upper gastrointestinal bleeding was not a protective factor. Upper gastrointestinal bleeding frequency in children hospitalized in an intensive care unit was high. Identifying risk factors should help to reduce upper gastrointestinal bleeding frequency.

CHARACTERIZATION OF FLOW-RESISTANT TUBES USED FOR SEMI-OCCLUDED VOCAL TRACT VOICE TRAINING AND THERAPY

PubMed Central

Smith, Simeon L.; Titze, Ingo R.

2016-01-01

Objectives To characterize the pressure-flow relationship of tubes used for semi-occluded vocal tract voice training/therapy, as well as to answer these major questions: (1) What is the relative importance of tube length to tube diameter? (2) What is the range of oral pressures achieved with tubes at phonation flow rates? (3) Does mouth configuration behind the tubes matter? Methods Plastic tubes of various diameters and lengths were mounted in line with an upstream pipe, and the pressure drop across each tube was measured at stepwise increments in flow rate. Basic flow theory and modified flow theory equations were used to describe the pressure-flow relationship of the tubes based on diameter and length. Additionally, the upstream pipe diameter was varied to explore how mouth shape affects tube resistance. Results The modified equation provided an excellent prediction of the pressure-flow relationship across all tube sizes (6% error compared to the experimental data). Variation in upstream pipe diameter yielded up to 10% deviation in pressure for tube sizes typically used in voice training/therapy. Conclusions Using the presented equations, resistance can be characterized for any tube based on diameter, length, and flow rate. With regard to the original questions, we found that: (1) For commonly used tubes, diameter is the critical variable for governing flow resistance; (2) For phonation flow rates, a range of tube dimensions produced pressures between 0 and 7.0 kPa; (3) The mouth pressure behind the lips will vary slightly with different mouth shapes, but this effect can be considered relatively insignificant. PMID:27133001

Hyoid bone development: An assessment of optimal CT scanner parameters and 3D volume rendering techniques

PubMed Central

Cotter, Meghan M.; Whyms, Brian J.; Kelly, Michael P.; Doherty, Benjamin M.; Gentry, Lindell R.; Bersu, Edward T.; Vorperian, Houri K.

2015-01-01

The hyoid bone anchors and supports the vocal tract. Its complex shape is best studied in three dimensions, but it is difficult to capture on computed tomography (CT) images and three-dimensional volume renderings. The goal of this study was to determine the optimal CT scanning and rendering parameters to accurately measure the growth and developmental anatomy of the hyoid and to determine whether it is feasible and necessary to use these parameters in the measurement of hyoids from in vivo CT scans. Direct linear and volumetric measurements of skeletonized hyoid bone specimens were compared to corresponding CT images to determine the most accurate scanning parameters and three-dimensional rendering techniques. A pilot study was undertaken using in vivo scans from a retrospective CT database to determine feasibility of quantifying hyoid growth. Scanning parameters and rendering technique affected accuracy of measurements. Most linear CT measurements were within 10% of direct measurements; however, volume was overestimated when CT scans were acquired with a slice thickness greater than 1.25 mm. Slice-by-slice thresholding of hyoid images decreased volume overestimation. The pilot study revealed that the linear measurements tested correlate with age. A fine-tuned rendering approach applied to small slice thickness CT scans produces the most accurate measurements of hyoid bones. However, linear measurements can be accurately assessed from in vivo CT scans at a larger slice thickness. Such findings imply that investigation into the growth and development of the hyoid bone, and the vocal tract as a whole, can now be performed using these techniques. PMID:25810349

Hyoid Bone Development: An Assessment Of Optimal CT Scanner Parameters and Three-Dimensional Volume Rendering Techniques.

PubMed

Cotter, Meghan M; Whyms, Brian J; Kelly, Michael P; Doherty, Benjamin M; Gentry, Lindell R; Bersu, Edward T; Vorperian, Houri K

2015-08-01

The hyoid bone anchors and supports the vocal tract. Its complex shape is best studied in three dimensions, but it is difficult to capture on computed tomography (CT) images and three-dimensional volume renderings. The goal of this study was to determine the optimal CT scanning and rendering parameters to accurately measure the growth and developmental anatomy of the hyoid and to determine whether it is feasible and necessary to use these parameters in the measurement of hyoids from in vivo CT scans. Direct linear and volumetric measurements of skeletonized hyoid bone specimens were compared with corresponding CT images to determine the most accurate scanning parameters and three-dimensional rendering techniques. A pilot study was undertaken using in vivo scans from a retrospective CT database to determine feasibility of quantifying hyoid growth. Scanning parameters and rendering technique affected accuracy of measurements. Most linear CT measurements were within 10% of direct measurements; however, volume was overestimated when CT scans were acquired with a slice thickness greater than 1.25 mm. Slice-by-slice thresholding of hyoid images decreased volume overestimation. The pilot study revealed that the linear measurements tested correlate with age. A fine-tuned rendering approach applied to small slice thickness CT scans produces the most accurate measurements of hyoid bones. However, linear measurements can be accurately assessed from in vivo CT scans at a larger slice thickness. Such findings imply that investigation into the growth and development of the hyoid bone, and the vocal tract as a whole, can now be performed using these techniques. © 2015 Wiley Periodicals, Inc.

Adapted cuing technique: facilitating sequential phoneme production.

PubMed

Klick, S L

1994-09-01

ACT is a visual cuing technique designed to facilitate dyspraxic speech by highlighting the sequential production of phonemes. In using ACT, cues are presented in such a way as to suggest sequential, coarticulatory movement in an overall pattern of motion. While using ACT, the facilitator's hand moves forward and back along the side of her (or his) own face. Finger movements signal specific speech sounds in formations loosely based on the manual alphabet for the hearing impaired. The best movements suggest the flowing, interactive nature of coarticulated phonemes. The synergistic nature of speech is suggested by coordinated hand motions which tighten and relax, move quickly or slowly, reflecting the motions of the vocal tract at various points during production of phonemic sequences. General principles involved in using ACT include a primary focus on speech-in-motion, the monitoring and fading of cues, and the presentation of stimuli based on motor-task analysis of phonemic sequences. Phonemic sequences are cued along three dimensions: place, manner, and vowel-related mandibular motion. Cuing vowels is a central feature of ACT. Two parameters of vowel production, focal point of resonance and mandibular closure, are cued. The facilitator's hand motions reflect the changing shape of the vocal tract and the trajectory of the tongue that result from the coarticulation of vowels and consonants. Rigid presentation of the phonemes is secondary to the facilitator's primary focus on presenting the overall sequential movement. The facilitator's goal is to self-tailor ACT in response to the changing needs and abilities of the client.(ABSTRACT TRUNCATED AT 250 WORDS)

Importance of viruses in acute otitis media.

PubMed

Nokso-Koivisto, Johanna; Marom, Tal; Chonmaitree, Tasnee

2015-02-01

Acute otitis media occurs as a complication of viral upper respiratory tract infection. Bacterial otopathogens and respiratory viruses interact and play important roles in acute otitis media development. A better understanding of viral and bacterial interactions may lead to innovative ways to lessen the burden of this common childhood disease. There has been increasing evidence that acute otitis media occurs during upper respiratory infection, even in the absence of nasopharyngeal bacterial colonization. Among the types of viruses associated with acute otitis media, respiratory syncytial virus continues to be the most commonly detected. It is still unclear whether viral load plays an important role in acute otitis media development, but symptomatic upper respiratory tract infection (as opposed to asymptomatic viral infection) is crucial. Widespread use of bacterial and viral vaccines in young children, including pneumococcal conjugate and influenza vaccines, has led to the reduction in otitis media-related healthcare use between 2001 and 2011. There has been no new vaccine against respiratory viruses other than influenza. Progress has been made toward the reduction of the burden of acute otitis media in the last decade. Success in reducing acute otitis media incidence will rely mainly on prevention of nasopharyngeal otopathogen colonization, as well as reduction in the incidence of viral upper respiratory tract infection.

A chicken influenza virus recognizes fucosylated α2,3 sialoglycan receptors on the epithelial cells lining upper respiratory tracts of chickens.

PubMed

Hiono, Takahiro; Okamatsu, Masatoshi; Nishihara, Shoko; Takase-Yoden, Sayaka; Sakoda, Yoshihiro; Kida, Hiroshi

2014-05-01

Influenza viruses recognize sialoglycans as receptors. Although viruses isolated form chickens preferentially bind to sialic acid α2,3 galactose (SAα2,3Gal) glycans as do those of ducks, chickens were not experimentally infected with viruses isolated from ducks. A chicken influenza virus, A/chicken/Ibaraki/1/2005 (H5N2) (Ck/IBR) bound to fucose-branched SAα2,3Gal glycans, whereas the binding towards linear SAα2,3Gal glycans was weak. On the epithelial cells of the upper respiratory tracts of chickens, fucose-branched SAα2,3Gal glycans were detected, but not linear SAα2,3Gal glycans. The growth of Ck/IBR in MDCK-FUT cells, which were genetically prepared to express fucose-branched SAα2,3Gal glycans, was significantly higher than that in the parental MDCK cells. The present results indicate that fucose-branched SAα2,3Gal glycans existing on the epithelial cells lining the upper respiratory tracts of chickens are critical for recognition by Ck/IBR. Copyright © 2014 Elsevier Inc. All rights reserved.

Exercising videoendoscopic evaluation of 45 horses with respiratory noise and/or poor performance after laryngoplasty.

PubMed

Davidson, Elizabeth J; Martin, Benson B; Rieger, Randall H; Parente, Eric J

2010-12-01

To (1) assess upper airway function by videoendoscopy in horses performing poorly after laryngoplasty and (2) establish whether dynamic collapse of the left arytenoid can be predicted by the degree of resting postsurgical abduction. Case series. Horses that had left laryngoplasty (n=45). Medical records (June 1993-December 2007) of horses evaluated for abnormal respiratory noise and/or poor performance after laryngoplasty were reviewed. Horses with video recordings of resting and exercising upper airway endoscopy were included and postsurgical abduction categorized. Horses with immediate postoperative endoscopy recordings were also evaluated and postsurgical abduction categorized. Relationships between resting postsurgical abduction and historical information with exercising endoscopic findings were examined. Dynamic collapse of the left arytenoid cartilage was probable in horses with no postsurgical abduction and could not be predicted in horses with grade 3 or 4 postsurgical abduction. Respiratory noise was associated with upper airway obstruction but was not specific for arytenoid collapse. Most horses with a left vocal fold had billowing of the fold during exercise. Other forms of dynamic collapse involved the right vocal fold, aryepiglottic folds, corniculate process of left arytenoid cartilage, dorsal displacement of soft palate, and pharyngeal collapse. Complex obstructions were observed in most examinations and in all horses with exercising collapse of the left arytenoid cartilage. There was no relationship between exercising collapse of the left arytenoid cartilage and grade 3 or 4 postsurgical abduction but was likely in horses with no abduction. © Copyright 2010 by The American College of Veterinary Surgeons.

Voice Disorder in Cystic Fibrosis Patients

PubMed Central

Lourenço, Bruna Mendes; Costa, Kauê Machado; da Silva Filho, Manoel

2014-01-01

Cystic fibrosis is a common autosomal recessive disorder with drastic respiratory symptoms, including shortness of breath and chronic cough. While most of cystic fibrosis treatment is dedicated to mitigating the effects of respiratory dysfunction, the potential effects of this disease on vocal parameters have not been systematically studied. We hypothesized that cystic fibrosis patients, given their characteristic respiratory disorders, would also present dysphonic symptoms. Given that voice disorders can severely impair quality of life, the identification of a potential cystic fibrosis-related dysphonia could be of great value for the clinical evaluation and treatment of this disease. We tested our hypothesis by measuring vocal parameters, using both objective physical measures and the GRBAS subjective evaluation method, in male and female cystic fibrosis patients undergoing conventional treatment and compared them to age and sex matched controls. We found that cystic fibrosis patients had a significantly lower vocal intensity and harmonic to noise ratio, as well as increased levels of jitter and shimmer. In addition, cystic fibrosis patients also showed higher scores of roughness, breathiness and asthenia, as well as a significantly altered general grade of dysphonia. When we segregated the results according to sex, we observed that, as a group, only female cystic fibrosis patients had significantly lower values of harmonic to noise ratio and an abnormal general grade of dysphonia in relation to matched controls, suggesting that cystic fibrosis exerts a more pronounced effect on vocal parameters of women in relation to men. Overall, the dysphonic characteristics of CF patients can be explained by dysfunctions in vocal fold movement and partial upper airway obstruction, potentially caused by the accumulation of mucus and chronic cough characteristic of CF symptomatology. Our results show that CF patients exhibit significant dysphonia and suggest they may potentially benefit from voice therapy as a parallel treatment strategy. PMID:24796691

Influence of Noise Resulting From the Location and Conditions of Classrooms and Schools in Upper Egypt on Teachers' Voices.

PubMed

Phadke, Ketaki Vasant; Abo-Hasseba, Ahmed; Švec, Jan G; Geneid, Ahmed

2018-05-03

Teachers are professional voice users, always at high risk of developing voice disorders due to high vocal demand and unfavorable environmental conditions. This study aimed at identifying possible correlations between teachers' voice symptoms and their perception of noise, the location of schools, as well as the location and conditions of their classrooms. One hundred forty teachers (ages 21-56) from schools in Upper Egypt participated in this study. They filled out a questionnaire including questions about the severity and frequency of their voice symptoms, noise perception, and the location and conditions of their schools and classrooms. Questionnaire responses were statistically analyzed to identify possible correlations. There were significant correlations (P < 0.05) between voice symptoms, teachers' noise perception, and noise resulting from the location and conditions of schools and classrooms. Teachers experienced severe dysphonia, neck pain, and increased vocal effort with weekly or daily recurrence. Among the teachers who participated in the study, 24.2% felt they were always in a noisy environment, with 51.4% of the total participants reporting having to raise their voices. The most common sources of noise were from student activities and talking in the teachers' own classrooms (61.4%), noise from adjacent classrooms (52.9%), and road traffic (40.7%). Adverse effect on teachers' voices due to noise from poor school and classroom conditions necessitates solutions for the future improvement of conditions in Egyptian schools. This study may help future studies that focus on developing guidelines for the better planning of Egyptian schools in terms of improved infrastructure and architecture, thus considering the general and vocal health of teachers. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Endourologic management of malignant ureteral obstruction: indications, results, and quality-of-life issues.

PubMed

Sountoulides, Petros; Pardalidis, Nikolaos; Sofikitis, Nikolaos

2010-01-01

Obstruction of the upper urinary tract is a problem commonly faced by practicing urologists. The constant evolution in endourology has effectively facilitated minimally invasive management of upper-tract obstruction. In a case in which malignancy is the cause of obstruction, however, the situation significantly changes. Questions arise regarding the need for relieving the obstruction, the means to accomplish this, and the benefits and drawbacks of each technique regarding both their efficacy and their impact on the patients well-being and the crucial issue of quality of life in the face of malignancy.

[Gastrointestinal bleeding--concepts of surgical therapy in the upper gastrointestinal tract].

PubMed

Knoefel, W T; Rehders, A

2006-02-01

Bleeding of the upper gastrointestinal tract is the main symptom of a variety of possible conditions and still results in considerable mortality. Endoscopy is the first diagnostic modality, enabling rapid therapeutic intervention. In case of intractable or relapsing bleeding, surgery is often inevitable. However, emergency operations result in significantly higher mortality rates. Therefore the option of early elective surgical intervention should be considered for patients at increased risk of relapsing bleeding. If bleeding is symptomatic due to a complex underlying condition such as hemosuccus pancreaticus or hemobilia, angiography is now recognized as the definitive investigation. Angiographic hemostasis can be achieved in most cases. Due to the underlying condition, surgical management still remains the mainstay in treating these patients. This paper reviews surgical strategy in handling upper gastrointestinal bleeding.

Muscular patterns and activation levels of auxiliary breathing muscles and thorax movement in classical singing.

PubMed

Pettersen, Viggo

2005-01-01

The aim of this paper is to present an overview of the findings in seven studies exploring muscular patterns and muscle activation levels in selected muscles by classical singers. In addition, the relationship of these muscles to thorax (TX) movement was investigated. Loading levels and respiratory phasing of upper trapezius (TR), sternocleidomastoideus (STM) and the scalenes (SC) were investigated in vocalization tasks with variation in vocal loudness and pitch. Further, muscle activity in the posterior neck (PN) was investigated in inhalation and phonation and, finally, TR, intercostal (INT), lateral abdominal (OBL) and anterior abdominal (RC) muscle loading in student and professional singers was examined. Muscle activity was recorded by use of an ambulatory four-channel monitoring system (Physiometer PHY 400, Premed, Norway). TX movement was traced with two strain gauge sensors (RES-117) placed around the upper TX and lower TX. A phasing of upper TR activity to INT and OBL activity was discovered, all muscles supporting the expiration phase. During phonation, TR contributes in the compression of the upper TX, thus serving as an accessory muscle of expiration. TR activity is reduced with short breathing cycles and is mostly inactive in simplified speaking tasks. During phonation, professional opera singers activate the expiratory-phased TR, INT, OBL and RC muscles to higher levels than student singers do. STM and SC show correlated activity patterns during inhalation and phonation by classical singers. During demanding singing, expiratory-phased STM and SC activity peaks produce a counterforce to the compression of upper TX at high pitches. As breathing demands are lowered, STM and SC activity are reduced and attain inspiratory phasing. Substantial muscle activity is observed in PN during inhalation and phonation. EMG biofeedback performed on TR and STM have a secondary effect of lowering EMG activity in PN. (c) 2005 S. Karger AG, Basel

Bilateral Cricoarytenoid Arthritis: A Cause of Recurrent Upper Airway Obstruction in Rheumatoid Arthritis

PubMed Central

Pradhan, Pradeep; Bhardwaj, Abhishek; Venkatachalam, VP

2016-01-01

We report a case of bilateral cricoarytenoid joint arthritis with history of rheumatoid arthritis, presented with stridor to the outpatient department. Endolaryngoscopy revealed adducted vocal cords and a nodule over left arytenoid which later confirmed to be rheumatoid nodule on histopathologic examination. Initially, although patient responded well to medical treatment, recurrence was noticed after 6 months follow-up. PMID:27418875

Endoscopic vacuum therapy for various defects of the upper gastrointestinal tract.

PubMed

Kuehn, Florian; Loske, Gunnar; Schiffmann, Leif; Gock, Michael; Klar, Ernst

2017-09-01

Postoperative, iatrogenic or spontaneous upper gastrointestinal defects result in significant morbidity and mortality of the patients. In the last few years, endoscopic vacuum therapy (EVT) has been recognized as a new promising method for repairing upper gastrointestinal defects of different etiology. However, probably due to insufficient data and no commercially available system for EVT of the upper gastrointestinal tract, until the end of 2014, covering of esophageal defects with self-expanding metal stents (SEMS) were still the mainstay of endoscopic therapy. The aim of this article is to review the data available about EVT for various upper gastrointestinal defects. A selective literature search was conducted in Medline and PubMed (2007-2016), taking into account all the published case series and case reports reporting on the use of EVT in the management of upper gastrointestinal defects. EVT works through intracorporal application of negative pressure at the defect zone with an electronic controlled vacuum device along a polyurethane sponge drainage. This results in closure of the esophageal defect and internal drainage of the septic focus, simultaneously. Compared to stenting, EVT enables regular viewing of wound conditions with control of the septic focus and adjustment of therapy. Moreover, endoscopical negative pressure is applicable in all esophageal regions (cricopharygeal, tubular, gastroesophageal junction) and in anastomotic anatomic variants. EVT can be used solely as a definite treatment or as a complimentary therapy combined with operative revision. In total, there are published data of more than 200 patients with upper gastrointestinal defects treated with EVT, showing succes rates from 70-100%. The available data indicate that EVT is feasible, safe and effective with good short-term and long-term clinical outcomes in the damage control of upper GI-tract leaks. Still, a prospective multi-center study has to be conducted to proof the definite benefit of EVT for patients with esophageal defects.