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PubMed1998

Risk factors for permanent hypernasality after adenoidectomy.

OBJECTIVES: To investigate the causes of persistent, apparently permanent hypernasal speech following adenoidectomy in 10 subjects without overt cleft palates, and to establish a protocol to be followed before this operation is performed. DESIGN: Retrospective and descriptive design. PARTICIPANTS: Ten subjects, fulfilling the following criteria, were included: (i) subjects had undergone adenoidectomy which resulted in hypernasal speech that persisted for longer than 3 months (and was therefore considered to be permanent); (ii) subjects did not have a cleft lip or overt cleft palate; (iii) there was no hearing loss of sufficient magnitude to account for the hypernasal speech; and (iv) the hypernasality was rated as severe by a speech therapist, could not be remedied by speech therapy alone and required further management by a plastic surgeon through pharyngosplasty. Ten subjects were found through the clinical records of speech therapists and plastic surgeons working in hospitals and private practice. The following information was obtained through interviews or by reading the case files: (i) identifying information; (ii) the presence of any of the factors reported in the literature to be associated with the permanent hypernasality or nasal emission, as well as the method of identification; and (iii) whether these factors had been identified before or after the adenoidectomy. RESULTS: Nine out of a total of 10 subjects showed preoperative perceptual and structural characteristics and/or case history factors that have been documented to constitute risk factors for the development of nasal speech, should an adenoidectomy be performed. The methods used to investigate these factors pre-operatively appear to have been inadequate. CONCLUSION: This undesirable sequel to surgery can be prevented if certain case history and speech factors are investigated and followed up with radiographic procedures if necessary.

Adenoidectomy↗
PubMed2000

Translational induction of liver-enriched transcriptional inhibitory protein during acute phase response leads to repression of CCAAT/enhancer binding protein alpha mRNA.

Lipopolysacharide (LPS) induced acute phase response (APR) in mouse liver leads to elevation of the low molecular weight CCAAT/Enhancer binding protein (C/EBP) beta isoform, liver-enriched transcriptional inhibitory protein (LIP). In this paper, we investigate the pathway for LIP induction during APR and the role of LIP in regulation of the C/EBPalpha promoter. The 5' region of C/EBPbeta mRNA has been shown to be involved in the regulation of LIP translation. Our data demonstrate that binding of cytoplasmic proteins to the 5' region of C/EBPbeta mRNA is altered in response to LPS administration. One of the major changes is induced binding of a cytoplasmic protein that is immunologically identical to the previously characterized RNA-binding protein CUGBP1. Induction of CUGBP1 binding activity in liver cytoplasm during APR is accompanied by the elevation of CUGBP1 binding activity on polysomes. CUGBP1 immunoprecipitated from livers of LPS-treated mice, but not from normal animals, is capable of inducing LIP translation in a cell-free translation system. The ability of CUGBP1 to induce LIP translation during APR depends on phosphorylation of CUGBP1. We show that elevation of LIP during APR and after partial hepatectomy leads to increased binding of LIP to the C/EBP consensus site found within the mouse C/EBPalpha promoter. This binding correlates with reduction of C/EBPalpha mRNA levels in both biological situations. Co-transfection experiments showed that full-length C/EBPbeta activates the C/EBPalpha promoter, while LIP blocks this activation. Our data suggest that the dominant negative isoform of C/EBPbeta, LIP, down-regulates the C/EBPalpha promoter in liver and in cultured hepatocytes. Because full-length C/EBPalpha and C/EBPbeta proteins regulate liver proliferation, this function of LIP may be important in liver growth and differentiation.

Acute-Phase Reaction↗
PubMed1993

The dysphagia diagnostic procedure as a treatment efficacy trial.

In all of these case reports, the patient's swallow function and the effect of therapy procedures on this function could be observed and measured from the videofluoroscopic assessment. In some cases, effects could be measured using other imaging procedures. The effects of each swallow therapy procedure can be measured by examining specific physiologic elements of the swallow. Table 3 presents the various therapy procedures and appropriate efficacy measures for each. In some cases, introduction of therapy procedures into the diagnostic evaluation can immediately enable the patient to begin eating. In other cases, evaluation of the effectiveness of the therapy procedure can validate its appropriateness for use with a patient in building the neuromuscular control necessary to return to oral intake. Not all therapy procedures can be introduced into the diagnostic setting, however, since they do not all result in immediate effects. For example, range of motion exercises for the lips, tongue, and/or jaw do not have an immediate effect, but typically show an effect after 2 to 3 wks. However, the clinician can still quantify the effects of range of motion exercises by measuring the patient's structural movement at each therapy session. When a second assessment is completed, change in range of motion of the target structure can be assessed by comparing the first and second studies. Introducing treatment techniques into the diagnostic swallowing assessment requires the clinician to read the results of the radiographic study or other imaging procedure immediately and identify the physiologic dysfunction so that appropriate therapy procedures can be selected and introduced. Because videofluoroscopy involves X-ray exposure to the patient, all possible treatment techniques cannot be attempted while in X-ray. Rather, the clinician must select those techniques believed to be most appropriate for that patient's anatomy and swallow physiology. When effective techniques are identified, the videotape of the diagnostic procedure can be used as an educational tool with the patient and his or her family, nurses, physicians, and others to educate and counsel them regarding the rationale for use of particular procedures with the patient, including introduction of particular posture, diets, etc. This type of visual evidence often improves patient and family compliance with therapy recommendations.

Adult↗
PubMed2000

Secreted lipases of Candida albicans: cloning, characterisation and expression analysis of a new gene family with at least ten members.

Extracellular lipolytic activity enabled the human pathogen Candida albicans to grow on lipids as the sole source of carbon. Nine new members of a lipase gene family (LIP2-LIP10) with high similarities to the recently cloned lipase gene LIP1 were cloned and characterised. The ORFs of all ten lipase genes are between 1281 and 1416 bp long and encode highly similar proteins with up to 80% identical amino acid sequences. Each deduced lipase sequence has conserved lipase motifs, four conserved cysteine residues, conserved putative N-glycosylation sites and similar hydrophobicity profiles. All LIP genes, except LIP7, also encode an N-terminal signal sequence. LIP3-LIP6 were expressed in all media and at all time points of growth tested as shown by Northern blot and RT-PCR analyses. LIP1, LIP3, LIP4, LIP5, LIP6 and LIP8 were expressed in medium with Tween 40 as a sole source of carbon. However, the same genes were also expressed in media without lipids. Two other genes, LIP2 and LIP9, were only expressed in media lacking lipids. Transcripts of most lipase genes were detected during the yeast-to-hyphal transition. Furthermore, LIP5, LIP6, LIP8 and LIP9 were found to be expressed during experimental infection of mice. These data indicate lipid-independent, highly flexible in vitro and in vivo expression of a large number of LIP genes, possibly reflecting broad lipolytic activity, which may contribute to the persistence and virulence of C. albicans in human tissue.

Amino Acid Sequence↗
PubMed1986

Exfoliative cheilitis--a factitious disorder?

Exfoliative cheilitis is an uncommon lip lesion usually of great concern to the patient and quite refractory to treatment. The available literature was surveyed, and 3 cases have been described to illustrate various aspects of the condition. The difficulty of treating such lesions has been discussed, and a proposition put forward that the lesions are of a factitious nature.

Adult↗
PubMed1991

The perioral muscular phenomenon: Part II.

Over twenty-five years of studying the perioral musculature, clinical observation of the dental and peridental tissues of hundreds of patients, and examining seven anatomy books--have revealed that there is a serious deficiency in our knowledge of this musculature and its effects on the dental tissues and this part of the face. Believed to be of no unusual significance, it has been almost ignored through the years. One hears vague terms such as lip pressure and cheek pressure; but no comprehensive studies of this musculature, how it functions and the effects of these functions are to be found in literature. By its actions, this musculature effects many phases of dentistry, directly or indirectly; and orthodontics is affected most of all. By its manipulations of the dental tissues, the alveolar bone and gingiva, it ultimately determines the position of the teeth. Almost every person exhibits pressure signs or damage to the tissues. The only exceptions are babies. By reading these signs, the strength and physical configuration of the pertinent parts of the musculature can be determined. This ability to 'read the signs' should be developed since it helps fine tune the diagnostic process. Only by this means may the correct surgical procedures be carried out. A representative sample from over 1200 cases treated in this manner in more than twenty years will be shown.

Adolescent↗
PubMed1988

Accumulation and decay of DG42 gene products follow a gradient pattern during Xenopus embryogenesis.

The DG42 gene is expressed during a short window during embryogenesis of Xenopus laevis. The mRNA for this gene can be first detected just after midblastula, peaks at late gastrula, and decays by the end of neurulation. The sequence of the DG42 cDNA and genomic DNA predicts a 70,000-Da protein that is not related to any other known protein. Antibodies prepared against portions of the DG42 open reading frame that had been expressed in bacteria detected a 70,000-Da protein in the embryo with a temporal course of appearance and decay that follows that of the RNA by several hours. Localization of the mRNA in dissected embryos and immunohistochemical detection of the protein showed that DG42 expression moves as a wave or gradient through the embryo. The RNA is first detected in the animal region of the blastula, and by early gastrula is found everywhere except in the outer layer of the dorsal blastopore lip. By midgastrula DG42 protein is present in the inner ectodermal layer and the endoderm; it disappears from dorsal ectoderm as the neural plate is induced and later decays in a dorsoventral direction. The last remnants of DG42 protein are seen in ventral regions of the gut at the tailbud stage.

Animals↗
PubMed1991

The perioral muscular phenomenon: Part I.

More than twenty-five years of studying the perioral musculature, clinical observation of the dental and peridental tissues of hundreds of patients, and examining seven anatomy books--have revealed that there is a serious deficiency in our knowledge of this musculature and its effects on the dental tissues and this part of the face. Believed to be of no unusual significance, it has been almost ignored through the years. One hears vague terms such as lip pressure and cheek pressure; but no comprehensive studies of this musculature, how it functions and the effects of these functions are to be found in literature. By its actions, this musculature effects many phases of dentistry, directly or indirectly; and orthodontics is affected most of all. By its manipulations of the dental tissues, the alveolar bone and gingiva, it ultimately determines the position of the teeth. Almost every person is a live laboratory specimen in which pressure signs or damage to the tissues can be observed. By reading these signs, the strength and physical configuration of the pertinent parts of the musculature can be determined. This ability to 'read the signs' should be actively developed to fine tune the diagnosis. The perioral musculature phenomenon is a significant aetiological factor in many malocclusions.

Alveolar Process↗
PubMed1989

The effect of rapid maxillary expansion on nasal airway resistance.

The purpose of this investigation was to provide quantitative data describing the effects of rapid palatal expansion on nasal airway resistance. Rapid palatal expansion is an orthodontic procedure which is commonly used to widen the maxilla to correct maxillary narrowing resulting in the orthodontic abnormality of crossbite and to provide more space for alignment of crowded teeth. Recordings of nasal airway resistance were taken prior to expansion, immediately after expansion (approximately one month), after a retention period of approximately 4 months and approximately one year after initiation of treatment. Findings indicate an average reduction in nasal airway resistance of 48.7 per cent which was statistically significant at the 0.005 level. The reduction also appeared stable throughout the post treatment observation period (maximum one year) as each series of readings was statistically significantly lower than the initial reading, but not significantly different from each other. Reduction of nasal airway resistance was highly correlated to the initial nasal resistance level prior to rapid maxillary expansion. Those individuals with the greater initial resistance tended to have greater reductions in airway resistance following the expansion.

Adolescent↗
PubMedDate not supplied

Frequency analysis of electromyographically measured covert speech behavior.

Eleven subjects were asked to silently read slides of the letters "P" and "T," and to view meaningless control slides similarly as they were presented visually. One-eighth-second electromyographic excerpts were sampled from the baseline and response periods. The data were then transformed into the frequency domain for inferential analyses. The mean power spectral frequencies for the response period were significantly lower than those for the base-line in the overall analysis. There were, however, no significant changes from baseline as a function of kind of stimulus (T, P, or Control) or muscle activated (lips or tongue). It was concluded that there was a generalized responding, not unique to the processing of the specific stimuli studied. Frequency analysis of EMG measures of covert behavior holds some promise of yielding unique information not available through traditional analysis procedures, but more sensitive methods than those used here would be required to demonstrate this.

Afferent Pathways↗
PubMed1996

Evaluation of pulse oximetry in anaesthetised foals using multiple combinations of transducer type and transducer attachment site.

A commercially available pulse oximeter was evaluated in anaesthetised foals to determine its accuracy for estimating arterial haemoglobin saturation (SaO2). Five different transducer/transducer attachment site (TTAS) combinations were evaluated; 1-3) a fingertip transmission transducer attached to the foal's ear, lip and tongue, 4) an adhesive transmission transducer positioned on the foal's ear and 5) a forehead reflectance transducer placed on the ventral aspect of the foal's tail-base. Eight normal, Quarter Horse foals (age 5-10 days) were studied while under general anaesthesia. Alterations in arterial carbon dioxide tension (PaCO2) were produced by changing the level of ventilation. At each level of ventilation, alterations of arterial haemoglobin saturation (SaO2) were produced by varying the inspired fraction of oxygen (FIO2). At each level of ventilation and each level of FIO2, arterial blood samples were obtained for blood gas analysis while pulse oximeter readings were recorded simultaneously for each TTAS combination. Arterial blood oxygen saturation (SaO2) was calculated from arterial blood gas values and the equine blood oxygen dissociation curve. Pulse oximeter readings from each TTAS combination were compared with SaO2 values with linear regression analyses. Bias and precision values were determined and the sensitivity and specificity of each TTAS combination for detecting desaturation (SaO2 < 90%) were determined. Linear regression analyses indicated significant (P < 0.05) linear correlation between oxygen saturation determined by pulse oximeter (SpO2) and SaO2 for each of the 5 TTAS combinations. The combinations TTAS-1, TTAS-3 and TTAS-4 tended slightly to underestimate SaO2 at high SaO2 ranges, but overestimated SaO2 at low ranges of SaO2. Combination TTAS-2 overestimated SaO2 over all ranges of SaO2. Combination TTAS-5 consistently underestimated SaO2 at all ranges of SaO2. In general, accuracy and precision of each TTAS combination decreased at lower SaO2 ranges. All TTAS combinations, except TTAS-2 and TTAS-4, had good sensitivity for detecting SaO2 less than 90%. All TTAS combinations except TTAS-5 demonstrated good specificity. We concluded that pulse oximetry appears to be a valuable method for assessing SaO2 and detecting desaturation in anaesthetised foals. Clinicians should be aware that the type of transducer used and the anatomical site to which it is attached can have marked effects on the accuracy of pulse oximetry; and that different TTAS combinations may behave differently over various ranges of SaO2.

Anesthesia↗
PubMed1985

Familial canine dermatomyositis: clinical, electrodiagnostic, and genetic studies.

Three Collies with a skin disorder, 6 progeny from a breeding of 2 of the Collies (incross litter), and the 4 progeny from the breeding of an affected Collie male and a normal Labrador Retriever female (outcross litter) were examined. By 7 to 11 weeks of age, all 6 dogs in the incross litter developed a qualitatively similar, but variably severe, dermatitis of the ears, face, lips, tip of the tail, and over bony prominences of limbs. Later, myopathic signs characterized by bilaterally symmetrical skeletal muscle atrophy of the head, neck, trunk, and extremities; facial palsy; decreased jaw tone; stiff gait; and hyperreflexia were observed in the dogs more severely affected by the dermatitis. Of the 4 dogs in the outcross litter, 3 had similar, but milder, clinical manifestations of the dermatitis and myopathy. Cutaneous lesions consisted of intraepidermal and subepidermal vesicles or pustules with intradermal infiltration by leukocytes. Muscle lesions included myositis; myofiber degeneration, regeneration, and atrophy; and fibrosis. A generalized myopathy in the severely affected dogs was indicated by abnormal readings on needle electromyograms and normal motor nerve conduction velocities. Spontaneous needle electromyogram abnormalities were fibrillation potentials, positive sharp waves, and bizarre high-frequency discharges. Retrospective and prospective genetic analyses disclosed a definite familial tendency and indicated the condition has an autosomal dominant component.

Animals↗
PubMedDate not supplied

Effect of cleft type on overall speech intelligibility and resonance.

The main purpose of this study was to measure and compare the effect of an unilateral cleft lip and palate (UCLP) and a bilateral cleft lip and palate (BCLP) on overall speech intelligibility, nasalance and nasality. An additional objective was to compare the nasalance and nasality patterns of cleft palate children with the available normative data for normal children. The subjects were 37 children with an UCLP (19/37) or a BCLP (18/37) with normal cognitive and motor functions and normal hearing levels. All subjects had a non-syndromic cleft, followed the same surgical protocol and did not undergo secondary pharyngeal surgery. To measure and compare the effect of cleft type, objective and subjective assessment techniques were used. For the objective assessment of nasal resonance the nasometer and the mirror-fogging test were used. Nasalance scores were obtained, while patients produced sounds, read three standard passages or repeated sentences focusing on specific consonants. A perceptual evaluation of speech, the Gutzmann (1913) test and the tests of Bzoch (1989) were used as subjective assessment techniques. The perceptual assessment of the overall speech intelligibility was based on the spontaneous speech and reading or repeating of the nasometric sentences. These samples were judged by three speech pathologists using a 4-category nominal scale. A subjective test (Morley, 1945) was used to evaluate the velopharyngeal mechanism. The findings of the present study show no statistically significant differences for nasalance values, nasality and overall speech intelligibility between the UCLP and BCLP children. Significant differences were found between the data of the normal group and the cleft palate children. These differences included nasalance values as well as nasality data and overall speech intelligibility.

Adolescent↗
PubMed2001

Growth, dye degradation and ligninolytic activity studies on Zimbabwean white rot fungi.

White rot fungi were collected from Chirinda and Chimanimani hardwood forests in Zimbabwe and studied with respect to growth temperature optima and dye decolorization. Temperature optima were found to vary (between 25-37 degrees C) amongst the isolates. The isolates were screened for their ability to degrade the polymeric dyes; blue dextran and Poly R478 and the triphenylmethane dyes; cresol red, crystal violet and bromophenol blue. Semi-quantitative determination of the hydrolytic enzyme activities possessed by the white rot fungi was determined using the API ZYM system. Lignin peroxidase (LiP), manganese peroxidase (MnP) and laccase activities in the fungi were also determined. No LiP was detected in any of the isolates but all isolates showed manganese peroxidase and laccase activities. Time related decolorization studies and optimum pH determinations for Poly R478 degradation by the isolates were carried out in liquid cultures. The most significant rates of Poly R478 decolorization in liquid cultures were found with the following isolates: Trametes cingulata, Trametes versicolor, Trametes pocas, DSPM95 (a species to be identified), Datronia concentrica and Pycnoporus sanguineus.

Journal Article↗
PubMedDate not supplied

An immunoassay method for rapid detection of Staphylococcus aureus in cosmetics, pharmaceutical products, and raw materials.

The TECRA Staphylococcus aureus Visual Immunoassay allows a presumptive positive or negative result for the presence of S. aureus to be obtained within 26 h, in contrast to 4-5 days by traditional cultural methods. Presumptive positive immunoassay results are confirmed by streaking the enrichment broth onto conventional agar media. A validation study was undertaken to compare the TECRA assay with a cultural reference method based on the Bacteriological Analytical Manual (8th Ed.), which is also consistent with U.S. Pharmacopoeia requirements. The products tested included a range of cosmetics (toothpaste, shampoos, conditioners, sunscreens, moisturizers, lip and eye creams) and pharmaceuticals (cough mixtures, laxatives, ulcer treatments, infant formulae, antiseptic cream), as well as some pharmaceutical ingredients. Samples were inoculated with S. aureus at 10-20 cfu/g, and then enriched for 24 h at 35 degrees-37 degrees C at a product-to-sample ratio of 1:100. Two different enrichment broths were used for the study: Tryptone Soya Broth with 4% Tween 80 and Modified Letheen Broth. For both enrichment broths, results of the immunoassay and the reference method showed close correlation. The TECRA S. aureus Visual Immunoassay provides a rapid and convenient alternative to cultural methods and provides advantages to industry, such as greater speed of product and ingredient release and faster tracing of contamination problems. Because the immunoassay may be read either visually or with the aid of a plate reader, there is no need for an initial outlay on capital equipment. However, the assay can be automated if required.

Bacteriological Techniques↗
PubMed1993

An evaluation of 4% prilocaine and 3% mepivacaine compared with 2% lidocaine (1:100,000 epinephrine) for inferior alveolar nerve block.

The purpose of this study was to measure the degree of anesthesia obtained with 4% prilocaine and 3% mepivacaine compared with 2% lidocaine (1:100,000 epinephrine) for inferior alveolar nerve block. Using a repeated measures design, 30 subjects randomly received an inferior alveolar injection using masked cartridges of each solution at three successive appointments. The first molar, first premolar, lateral incisor, and contralateral canine (control) were blindly tested with an Analytic Technology pulp tester at 3-min cycles for 50 min. Anesthetic success was defined as no subject response to the maximum output of the pulp tester (80 reading) within 16 min and maintenance of this reading for 50 min. Although subjects felt numb subjectively, anesthetic success as defined here occurred in 43 to 63% of the molars, in 53 to 67% of the premolars, and in 30 to 37% of the lateral incisors. No statistically significant differences in onset, success, or failure were found among the solutions. We conclude that the three preparations are equivalent for an inferior alveolar nerve block of 50-min duration.

Adult↗
PubMed1978

Frequency and cooccurrence of vocal tract dysfunctions in the speech of a large sample of Parkinson patients.

In this study, the frequency of occurrence of speech and voice symptoms in 200 Parkinson patients was defined by two expert listeners from high-fidelity tape recordings of conversational speech samples and readings of the sentence version of the Fisher-Logemann Test of Articulation Competence. Specific phonemes that were misarticulated were catalogued. Other vocal-tract dysfunctions, including laryngeal disorders, rate disorders, and hypernasality, were also recorded. Cooccurrence of symptoms in each patient was tabulated. Examination of the patterns of cooccurring dysfunctions permitted classifying the 200 patients into five groups: Group 1 (45% of the patients) with laryngeal dysfunction as their only vocal-tract symptom; Group 2 (13.5% of the patients) with laryngeal and back-tongue involvement; Group 3 (17% of the patients) with laryngeal, back-tongue, and tongue-blade dysfunction; Group 4 (5.5% of the patients) with laryngeal dysfunction, back-tongue involvement, tongue-blade dysfunction, and labial misarticulations; and Group 5 (9% of the patients) with laryngeal dysfunction and misarticulations of the back tongue, tongue blade, lips, and tongue tip. Disfluencies and hypernasality did not follow a systematic pattern of cooccurrence with other vocal-tract dysfunctions.

Humans↗
PubMed1996

Characterization of a transcription terminator of the procyclin PARP A unit of Trypanosoma brucei.

The polycistronic procylcin PARP (for procyclic acidic repetitive protein) A transcription unit of Trypanosoma brucei was completely characterized by the mapping of the termination region. In addition to the tandem of procyclin genes and GRESAG 2.1, this 7.5- to 9.5-kb unit contained another gene for a putative surface protein, termed PAG (for procyclin-associated gene) 3. The terminal 3-kb sequence did not contain significant open reading frames and cross-hybridized with the beginning of one or several transcription units specific to the bloodstream form. At least three separate fragments from the terminal region were able to inhibit chloramphenicol acetyltransferase expression when inserted between either the PARP, the ribosomal, or the variable surface glycoprotein promoter and a chloramphenicol acetyltransferase reporter gene. This inhibition was due to an orientation-dependent transcription termination caused by the combination of several attenuator elements with no obvious sequence conservation. The procyclin transcription terminator appeared unable to inhibit transcription by polymerase II.

Amino Acid Sequence↗