Medidas acústicas para detecção de rouquidão em crianças

Muito freqüentemente, pais e professores não reconhecem a presença das alterações vocais na criança, podendo trazer conseqüências educacionais e sociais para o seu desenvolvimento. O objetivo deste estudo foi o de descrever a configuração laríngea utilizando a videofibrolaringoscopia em um grupo de crianças órfãs, associando estes resultados com a análise computadorizada da voz, identificando parâmetros acústicos capazes de predizer alterações vocais e/ou estruturais das pregas vocais. Foram avaliados 50 meninos entre 3 e 10 anos de idade, sem história de patologia laríngea e, que viviam em um orfanato. As crianças foram divididas em 2 grupos: A: aquelas que apresentavam lesões (cistos e nódulos) nas pregas vocais (25 meninos); B: aquelas que não apresentavam lesões nas pregas vocais (25 meninos). Foram analisados 5 parâmetros acústicos da voz das crianças: freqüência fundamental, quociente de perturbação da freqüência, quociente de perturbação da amplitude, jitter e shimmer. A configuração glótica foi avaliada, sendo seus resultados analisados conjuntamente com a análise acústica. Os resultados indicaram a presença de nódulos vocais e de fenda triangular médio-posterior com diferença significante entre os dois grupos. A análise acústica computadorizada da voz não mostrou diferença significante entre os grupos estudados. Nós não observamos diferença significante com relação ao tipo de fechamento glótico e constrição laríngea no grupo de crianças sem lesão estrutural das pregas vocais. Considerando a análise computadorizada da voz, não houve diferença significante entre os grupos com relação aos parâmetros estudados.Very often, parents and teachers do not recognize the presence of hoarseness in children, a fact which may have consequences for the child's social and educational development. The objective of the present study was to assess laryngeal configuration using videofibrolaryngoscopy in a group of boys living in an orphanage, and to associate the results of this analysis with the results of computerized voice analysis, so as to identify acoustic parameters which may be used as predictors of vocal and/or structural alterations in the vocal fold. We analyzed 50 boys between 3 and 10 years of age, without history of laryngeal pathology, living in a private orphanage. The children were divided into two groups: A) with lesions (unilateral vocal cyst or bilateral small nodules) in the vocal fold (25 subjects); and B) without lesions in the vocal fold (25 subjects). Five parameters were assessed: fundamental frequency, pitch period perturbation quotient, amplitude perturbation quotient, jitter, and shimmer. Glottic configuration was analyzed; results were compared with the results of acoustic analysis. The results indicate that the presence of vocal nodules and median posterior glottic chink was significantly different in the two groups. The computerized analysis results were not statistically different for the two groups. Conclusion: We did not observe a significant difference with respect to type of glottic closure and laryngeal constriction in the group of children without lesion. Regarding the computerized analysis of voice, there were no significant differences between the groups in terms of the parameters studied

Isolated schwannoma of the olfactory groove : a case report

Introduction: schwannoma of the olfactory groove is an extremely rare tumor that can share a differential diagnosis with meningioma or neuroblastoma. Objectives: the authors present a case of giant schwannoma involving the anterior cranial fossa and ethmoid sinuses. Case Report: the patient presented with a 30-month history of left nasal obstruction, anosmia, and sporadic ipsilateral bleeding. Computed tomography of the paranasal sinuses revealed expansive lesion on the left nasal cavity extending to nasopharynx up to ethmoid and sphenoid sinuses bilaterally with intraorbital and parasellar extension to the skull base. Magnetic resonance imaging scan confirmed the expansive tumor without dural penetration. Biopsy revealed no evidence of malignancy and probable neural cell. Bifrontal craniotomy was performed combined with lateral rhinotomy (Weber-Ferguson approach), and the lesion was totally removed. The tumor measured 8.0 4.3 3.7 cm and microscopically appeared as a schwannoma composed of interwoven bundles of elongated cells (Antoni A regions)mixed with less cellular regions (Antoni B). Immunohistochemical study stained intensively for vimentin and S-100. Conclusion Schwannomas of the olfactory groove are extremely rare, and the findings of origin of this tumor is still uncertain but recent studies point most probably to the meningeal branches of trigeminal nerve or anterior ethmoidal nerves

Noise-to-harmonics ratio as an acoustic measure of voice disorders in boys

This prospective study assessed the efficacy of computerized noise-to-harmonics ratio (NHR) to quantify perceptual and endoscopic findings of dysphonia and/or structural lesion of the vocal fold. Fifty Brazilian boys without vocal complaints were submitted to computerized, perceptual, and endoscopic examination. Thirty boys were dysphonic-3 were classified into the grade category, 5 into breathiness, 9 into roughness, and 15 into grade/breathiness. Vocal fold lesions were observed in 25 boys (17 nodules and 8 cysts). The Mann-Whitney U test revealed that NHR was significantly higher in boys with a structural lesion (p = 0.007) and in boys with dysphonia (p < 0.0001). However, according to a logistic regression model, only the occurrence of dysphonia was explained by NHR; the risk for having dysphonia increased approximately twice (odds ratio = 1.92, 95% confidence interval = 1.3-2.9) with each increase of 0.01 in NHR. Our results suggest that noise is a useful quantitative index to confirm a perceptual diagnosis of dysphonia and to evaluate quantitative changes in a dysphonic voice over time. However, we believe that computerized analysis should be used as a complement, rather than a substitute, for perceptual evaluation. Further studies with a larger sample are required to investigate the relationship between noise and lesions of the vocal folds.Univ Luterana Brasil, Dept Otolaryngol Head & Neck Surg, Porto Alegre, RS, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Otolaryngol & Human Commun Disorders Dept, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Otolaryngol & Human Commun Disorders Dept, Sao Paulo, BrazilWeb of Scienc

Solubilization of proteins from human lymph node tissue and two-dimensional gel storage.

In the present study, we compared six different solubilization buffers and optimized two-dimensional electrophoresis (2-DE) conditions for human lymph node proteins. In addition, we developed a simple protocol for 2-D gel storage. Efficient solubilization was obtained with lysis buffers containing (a) 8 M urea, 4% CHAPS (3-[(3-cholamidopropyl) dimethylammonio]-1-propanesulfonate), 40 mM Tris base, 65 mM DTT (dithiothreitol) and 0.2% carrier ampholytes; (b) 5 M urea, 2 M thiourea, 2% CHAPS, 2% SB 3-10 (N-decyl-N,N-dimethyl-3-ammonio-1-propanesulfonate), 40 mM Tris base, 65 mM DTT and 0.2% carrier ampholytes or (c) 7 M urea, 2 M thiourea, 4% CHAPS, 65 mM DTT and 0.2% carrier ampholytes. The optimal protocol for isoelectric focusing (IEF) was accumulated voltage of 16,500 Vh and 0.6% DTT in the rehydration solution. In the experiments conducted for the sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), best results were obtained with a doubled concentration (50 mM Tris, 384 mM glycine, 0.2% SDS) of the SDS electrophoresis buffer in the cathodic reservoir as compared to the concentration in the anodic reservoir (25 mM Tris, 192 mM glycine, 0.1% SDS). Among the five protocols tested for gel storing, success was attained when the gels were stored in plastic bags with 50% glycerol. This is the first report describing the successful solubilization and 2D-electrophoresis of proteins from human lymph node tissue and a 2-D gel storage protocol for easy gel handling before mass spectrometry (MS) analysis