吸入糖皮质激素.doc

1Inhaled corticosteroids: hazardous effects on voice-an update. 吸入糖皮质激素：有害影响语音更新。 Department of Clinical Surgery, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 摘要：Inhaled corticosteroids (ICS) have become the prevalent treatment in asthmatics. Hazards to voice are under-recognized. A total of 38 patients with voice complaints associated with the use of ICS were assessed by 79 strobovideolaryngoscopy (SVL) examinations, 24 single and 14 multiple SVL. Hoarseness and dysphonia were the primary reasons for referral. The ICS initially used most frequently was Advair Diskus (fluticasone propionate and salmeterol-inhalation powder-IP) in 22 patients, followed by Flovent (fluticasone propionate inhalation aerosol-pressurized metered-dose inhaler-PMDI) in 11. Duration of ICS usage varied from 2 weeks to 4-5 years. Higher dosage and frequency of use exacerbated problems. Hazards to voice previously unrecognized by real-time indirect mirror or fiberoptic laryngoscopy were identified by meticulous attention to SVL abnormalities. There was essentially no difference in occurrence of abnormalities whether analyzed from the perspective of the initial 38 or all 79 examinations. These included abnormal mucosal wave symmetry/periodicity (76-63%), phase closure (74-63%), glottic closure (63-59%), mucosal wave amplitude/magnitude (50-35%), supraglottic hyperactivity (39-25%), mucosal quality (34-34%), and glottic plane (10-5%).Candidiasis of the larynx was infrequently observed. Fluticasone ICS were a cause of steroid inhaler laryngitis, and the best treatment was their avoidance or cessation. Further prospective studies ideally might include SVL documented as a pretherapy baseline and then repeated in each ICS patient who developed hoarseness/dysphonia. 参考中文摘要：吸入糖皮质激素（ ICS ）的流行，已成为治疗哮喘。危害声音受到公认。一共有38例语音投诉与使用ICS的是由79 strobovideolaryngoscopy （ SVL ）考试， 24日和14多个单SVL 。声嘶和发音障碍是最主要的原因在于推介。 ICS的最初最常使用的是Advair吸入（丙酸氟替卡松和沙美特罗吸入粉末知识产权 ） 22例，其次是Flovent （替卡松吸入气雾剂加压计量吸入器 PMDI ） 11 。 ICS的使用期限从2个星期到4-5年。更高剂量和使用频率加剧的问 参考中文标题：评价声门良性病变：刚性伸缩频闪与悬挂microlaryngoscopy 。 作者单位：Department of Surgery, University of Wisconsin School of Medicine, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin 53792, USA. PMID及链接：16442777 /Archive/Detail/16442777 全文链接：在详细信息中查看 摘要：Rigid telescopic strobo-video-laryngoscopy (RTS) is a primary clinical assessment methodology in the office evaluation of benign glottic lesions. However, diagnostic observations can be made only at the time of suspension microlaryngoscopy (SML). The records of 100 consecutive patients undergoing microlaryngoscopy for benign glottic lesions were retrospectively reviewed. Nine of 100 patients were found to have additional glottic lesions during SML. Sixteen additional lesions were noted in these nine patients. Fifteen of 16 lesions were sulci and/or mucosal bridges. Forty-five percent (4/9) of the patients with additional lesions underwent a management change intraoperatively. Three patients underwent additional surgical dissection, and one underwent less dissection than was planned. The discrepancy in diagnosis between rigid telescopic strobo-video-laryngoscopy and suspension microlaryngoscopy highlights certain key points: (1) During office endoscopy, tangential views of the medial surface of the glottis limit the diagnostic sensitivity. (2) Sulci and mucosal bridges are most subject to this limitation. (3) Informed consent should address the potential need for a change in intraoperative management. It is advisable to discuss the possibility for dissection in both vocal folds, even if a unilateral lesion is observed in the office. (4) Microlaryngoscopy is the final diagnostic step in the evaluation of glottic pathology. Meticulous inspection and palpation of the glottis are recommended during SML. 参考中文摘要：刚性伸缩strobo视频喉镜（即时战略）的一个主要临床评估方法办公室评价良性声门病变。然而，诊断意见只能在暂停的时候microlaryngoscopy （ SML信息） 。记录的100例声门microlaryngoscopy良性病变进行回顾。 9 100例患者中发现有更多的声门病变在SML信息。 16个额外的病灶中指出这九个病人。 15 16病灶沟和/或黏膜桥梁。第四十四百分之五（ 4月9日）的额外性病变患者进行了管理改革术。 3名患者进行了额外的外科解剖，并进行了不到一个夹层比计划。差异诊断与 相关链接：PubMed Google学术搜索 Google引文 中文提供：测试求助： 求助全文(仅为测试发帖,无法获取全文) 求助文摘人工翻译(10医币以下会员每天限1篇，违则禁止求助) 绿色通道： 求助全文(应助快,成功概率高) 求助参考文献信息 求助引文信息 3Ultrastructural evaluation of 585-nm pulsed-dye laser-treated glottal dysplasia. 参考中文标题：超微结构评价585纳米的脉冲染料激光治疗声门发育不良。 作者单位：Department of Otology and Laryngology, Harvard Medical School, Division of Laryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114, USA. PMID及链接：16457987 /Archive/Detail/16457987 全文链接：在详细信息中查看 摘要：OBJECTIVE/HYPOTHESIS: To describe the ultrastructural changes occurring within pulsed-dye laser (PDL)-treated glottal tissues. STUDY DESIGN: Prospective. METHODS: Nine patients presenting with glottal dysplasia requiring biopsy to rule out microinvasive carcinoma were enrolled in this prospective study. At least two samples were obtained in each case: one from a PDL-treated area and another from a non-PDL-treated area (obtained from a nonphonatory region as an internal control). In some cases, a third sample was obtained from the junction between PDL- and non-PDL-treated areas. All samples were examined with light microscopy (H and E stain) and transmission electron microscopy. Observations were made of morphological changes within the epithelium, epithelial/ superficial lamina propria (SLP) junction, and the lamina propria of tissues treated with the PDL. Eight of nine patients were followed for a period of 9-25 months (mean, 18 months) with two recurrences that were retreated with awake-PDL and followed for an additional 8.3 and 9.5 months without recurrence. Vocal fold appearance returned to normal within 3-4 weeks posttreatment. RESULTS: Intraepithelial desmosome junctions were preferentially destroyed, and regional blood vessels were coagulated. The PDL consistently caused a separation of epithelial cells away from the basement membrane. CONCLUSIONS: The PDL allowed for both a surgical and a nonsurgical multimodality method for treatment of precancerous lesions with minimal effects on the SLP. 参考中文摘要：目标/假设：为了描述的超微结构变化发生在脉冲染料激光（牙周）治疗声门组织。研究设计：前瞻性。方法： 9例呈现声门发育不良，需要活检，以排除微小癌已报名参加本前瞻性研究。至少有两个样本取得的每一个案件：一名来自牙周治疗领域，另一名来自非牙周治疗领域（从一家nonphonatory地区作为内部控制） 。在某些情况下，第三个样品取自交界的牙周膜和非牙周治疗的领域。所有样品进行了分析与光镜（高和E染色）和透射电子显微镜。意见提出的形态学变化的上皮细胞，上皮/浅固有层（ SLP ）交界处，以及固有的组织的 相关链接：PubMed Google学术搜索 Google引文 中文提供：测试求助： 求助全文(仅为测试发帖,无法获取全文) 求助文摘人工翻译(10医币以下会员每天限1篇，违则禁止求助) 绿色通道： 求助全文(应助快,成功概率高) 求助参考文献信息 求助引文信息 4Clinical characteristics and voice analysis of patients with mutational dysphonia: clinical significance of diplophonia and closed quotients. 参考中文标题：临床特征和语音分析病人的突变性发音障碍：临床意义diplophonia和关闭商数。 作者单位：Department of Otorhinolaryngology, Institute of Logopedics and Phoniatrics, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. PMID及链接：16426813 /Archive/Detail/16426813 全文链接：在详细信息中查看 摘要：The aim of this study was to investigate the acoustic and electroglottographic characteristics of patients with mutational dysphonia before and after voice therapy. The clinical records of 15 patients with mutational dysphonia were reviewed, and their voice recordings were analyzed with the help of the Lx Speech Studio program (Laryngograph Ltd, London, UK). After voice therapy combined with the manual compression method, the subjects voices lowered in pitch and improved in quality. In addition, we classified the mutational dysphonia into four categories according to the presence of diplophonia and closed quotients. The most common type among the categories was characterized by a bimodal distribution of fundamental frequency (diplophonia), accompanied by a low closed quotient (falsetto voice) at high frequencies. However, the results also showed that mutational dysphonia cannot be generalized as always having a falsetto voice, as shown in other types. The effect of therapy was different for each type, and those cases with both diplophonia and a non-trained falsetto voice could be treated more readily. Consequently, the diplophonia and closed quotient, which were easily analyzed using Lx Speech Studio program, are important factors in the classification of mutational dysphonia. Identification of these characteristics may affect treatment choices, facilitate monitoring of the efficacy of therapy, and aid in estimating prognosis. 参考中文摘要：本研究的目的是调查和electroglottographic的声学特性的突变性发音障碍患者前后语音治疗。临床记录的15例突变性发音障碍进行了审查，他们的录音进行分析的帮助下，光照语音工作室程序（ Laryngograph有限公司，伦敦，英国） 。在语音治疗结合人工压缩方法，受试者的声音降低音高和改进质量。此外，我们分类的突变性发音障碍分为四类据在场的情况下diplophonia和关闭商数。最常见的类别的特点是双峰分布的基本频率（ diplophonia ） ，伴随着低收商数（假嗓子声音）在高频率 相关链接：PubMed Google学术搜索 Google引文 中文提供：测试求助： 求助全文(仅为测试发帖,无法获取全文) 求助文摘人工翻译(10医币以下会员每天限1篇，违则禁止求助) 绿色通道： 求助全文(应助快,成功概率高) 求助参考文献信息 求助引文信息 5Are real-time displays of benefit in the singing studio? An exploratory study. 参考中文标题：是实时显示的受益歌唱工作室？一个探索性研究。 作者单位：Media Engineering Research Group, Department of Electronics, University of York, Heslington, York, United Kingdom. dhohm.york.ac.uk PMID及链接：16472974 /Archive/Detail/16472974 全文链接：在详细信息中查看 摘要：This article reports on an exploratory research project to evaluate the usefulness or otherwise of real-time visual feedback in the singing studio. The primary purpose of the work was not to optimize the technology for this application, but to work alongside teachers and students to study the impact of real-time visual feedback technology use on the students learning experiences. An action research methodology was used to explore the benefit of real-time displays over an extended period. The experimental phase of the work was guided by a Liaison Panel of teachers and academics in the areas of singing, pedagogy, voice science, speech therapy, and linguistic science. Qualitative data were collected from eight students working with two professional singing teachers. The teachers and students acted as co-researchers under the action research paradigm. Teachers and students alike kept journals of their teaching and learning experiences. Singing lessons were observed regularly by the research team, coded for teacher and student behaviors, and all co-researchers were interviewed at the mid- and endpoint of the project. The use of technology had a positive impact on the learning process, and this is evidenced through case study data. 参考中文摘要：本文报告一个探索性研究项目，以评估是否有用或以其他方式的实时视觉反馈的歌唱录音。其主要目的是工作不优化技术的这种应用，但一起工作的教师和学生学习的影响的实时视觉反馈技术的使用对学生的学习经验。行动研究方法是用来探索造福实时显示在较长时期。实验阶段的工作是指导，联络小组的教师和学者在唱歌，教育学，语音学，言语治疗，和语言的科学。定性数据的收集来自8个学生与教师两个专业唱歌。在教师和学生担任共同作用下的研究人员研究范式。教师和学生都保持期刊的教学和学习经验。唱歌观察，定期研究小组，代号为教师和学生的 相关链接：PubMed Google学术搜索 Google引文 中文提供：测试求助： 求助全文(仅为测试发帖,无法获取全文) 求助文摘人工翻译(10医币以下会员每天限1篇，违则禁止求助) 绿色通道： 求助全文(应助快,成功概率高) 求助参考文献信息 求助引文信息 6From the urine of sacred cows to the laying on of hands and beyond-G. Paul Moore lecture. 参考中文标题：从圣牛尿的按手及以后-摹。保罗摩尔讲座。 作者单位：SUNY Upstate Medical University, Otolaryngology and Communication Sciences, Syracuse, New York 13224, USA. PMID及链接：16457986 /Archive/Detail/16457986 全文链接：在详细信息中查看 相关链接：PubMed Google学术搜索 Google引文 中文提供：测试求助： 求助全文(仅为测试发帖,无法获取全文) 求助文摘人工翻译(10医币以下会员每天限1篇，违则禁止求助) 绿色通道： 求助全文(应助快,成功概率高) 求助参考文献信息 求助引文信息 7The acoustic characteristics of professional opera singers performing in chorus versus solo mode. 参考中文标题：的声学特性的专业歌剧演员表演的合唱与独奏模式。 作者单位：Australian Centre for Applied Research in Music Performance, Sydney Conservatorium of Music, University of Sydney, Sydney, Australia. PMID及链接：16427767 /Archive/Detail/16427767 全文链接：在详细信息中查看 摘要：In this study, members of a professional opera chorus were recorded using close microphones, while singing in both choral and solo modes. The analysis included computation of long-term average spectra (LTAS) for the two song sections performed and calculation of singing power ratio (SPR) and energy ratio (ER), which provide an indication of the relative energy in the singers formant region. Vibrato rate and extent were determined from two matched vowels, and SPR and ER were calculated for these vowels. Subjects sung with equal or more power in the singers formant region in choral versus solo mode in the context of the piece as a whole and in individual vowels. There was no difference in vibrato rate and extent between the two modes. Singing in choral mode, therefore, required the ability to use a similar vocal timbre to that required for solo opera singing. 参考中文摘要：在这项研究中，成员的专业歌剧合唱录密切麦克风使用，而在这两个合唱团演唱和独奏模式。分析包括计算长期平均谱（长期安排）两个部分进行歌曲的演唱和计算功率比（战略石油储备）和能源比（雌） ，这说明相对能源歌手的共振区域。颤音速度和程度，确定由两个匹配元音和战略石油储备和ER计算这些元音。主题宋平等或更多权力歌手的共振区域的合唱与独奏模式的背景下一块作为一个整体和个别元音。没有任何差异颤音速度和程度之间的两种模式。合唱团演唱模式，因此，需要的能力，使用了类似的声音音色到所需要的独唱歌剧演唱。 相关链接：PubMed Google学术搜索 Google引文 中文提供：测试求助： 求助全文(仅为测试发帖,无法获取全文) 求助文摘人工翻译(10医币以下会员每天限1篇，违则禁止求助) 绿色通道： 求助全文(应助快,成功概率高) 求助参考文献信息 求助引文信息 8Perceptual identification and acoustic measures of the resonant voice based on "Lessacs Y-Buzz"-a preliminary study with actors. 参考中文标题：感知识别和声学措施的基础上共振的声音“ Lessac的Y型信号” -一个初步研究与行动者。 作者单位：Centro de Estudos da Voz, Sao Paulo, Brazil. PMID及链接：16458480 /Archive/Detail/16458480 全文链接：在详细信息中查看 摘要：This study aimed to verify whether the resonant voice based on Lessacs Y-Buzz can be perceived by listeners as resonant and different from habitual voice and to compare them to determine whether this sound exploration improves the vocal production. Nine newly graduated actors, six men and three women without voice complaints, were the subjects. They received a session of Lessacs Y-Buzz training from the primary investigator. Before training, they were asked to sustain the vowel /i/ at comfortable frequency and habitual loudness. After training, they were requested to sustain the Y-Buzz they had learned at a comfortable frequency and habitual loudness. Three speech-language pathologists (SLP) trained in voice developed an auditory-perceptive analysis. The pre- and posttraining voice samples were randomly spliced together, edited, and presented in pairs to perceptual judges who were asked to identify the most resonant of the pair. The voice samples were also acoustically compared through the Hoarseness Diagram and acoustic measures using the VoxMetria Software (CTS, version 2.0s, Brazil). The Y-Buzz trials were identified as resonant voice in 74% of the comparisons. The acoustic measures showed a statistically significant decrease of irregularity (P = 0.002) and shimmer (P = 0.38). The Hoarseness Diagram demonstrated how the resonant voice moved toward the normality for irregularity and noise components. The results showed that the resonant voice based on the Y-Buzz can be identified as resonant and different from normal voicing in the same subject, and it apparently implies a better vocal production demonstrating a significant decrease of shimmer and irregularity through the Hoarseness Diagram evaluation. 参考中文摘要：本研究旨在验证是否共振声音的基础上Lessac的Y型言论可以被看作是由听众谐振和习惯不同的声音，并加以比较，以确定这是否健全探索提高声乐生产。 9个刚毕业的演员，六男三女，无声音的投诉，是主体。他们收到了会议Lessac的Y型分类培训的主要调查员。训练前，他们被要求保持元音/我/在舒适的频率和习惯响度。经过培训，要求他们保持的Y - BUZZ服务的经验教训，他们在一个舒适的频率和习惯响度。三个语言病理学家（ SLP ）培训，开发了一个语音听觉感知分析。前和posttraining语音样本随机拼接 相关链接：PubMed Google学术搜索 Google引文 中文提供：测试求助： 求助全文(仅为测试发帖,无法获取全文) 求助文摘人工翻译(10医币以下会员每天限1篇，违则禁止求助) 绿色通道： 求助全文(应助快,成功概率高) 求助参考文献信息 求助引文信息 9Effects of vocal training and phonatory task on voice onset time. 参考中文标题：影响声乐训练和语音发声任务起始时间。 作者单位：Department of Communicative Disorders, East Tennessee State University, Johnson, City, Tennessee 37614, USA. PMID及链接：16426814 /Archive/Detail/16426814 全文链接：在详细信息中查看 摘要：OBJECTIVES/HYPOTHESIS: The purpose of this study was to examine the temporal-acoustic differences between trained singers and nonsingers during speech and singing tasks. METHODS: Thirty male participants were separated into two groups of 15 according to level of vocal training (ie, trained or untrained). The participants spoke and sang carrier phrases containing English voiced and voiceless bilabial stops, and voice onset time (VOT) was measured for the stop consonant productions. RESULTS: Mixed analyses of variance revealed a significant main effect between speech and singing for /p/ and /b/, with VOT durations longer during speech than singing for /p/, and the opposite true for /b/. Furthermore, a significant phonatory task by vocal training interaction was observed for /p/ productions. CONCLUSIONS: The results indicated that the type of phonatory task influences VOT and that these influences are most obvious in trained singers secondary to the articulatory and phonatory adjustments learned during vocal training. 参考中文摘要：目标/假设：本研究的目的是审查颞声训练的歌手之间的差异和nonsingers在讲话和唱歌的任务。方法： 30只雄性与会者分成两个组的15根据水平的声乐训练（即培训或未经训练的） 。与会者以唱承运人词组中英文表达和无声双唇站和语音发病时间（ VOT ）测定的停止辅音制作。结果：混合方差分析显示主要作用的一个重要讲话和唱歌之间的/人/和/桶/日，持续时间更长的同VOT比在讲话中唱的/人/和对面如此/桶/日。此外，一个重要任务的声乐发声训练相互作用观察/人/制作。结论：结果表明，类型的影响VOT发声的 相关链接：PubMed Google学术搜索 Google引文 中文提供：测试求助： 求助全文(仅为测试发帖,无法获取全文) 求助文摘人工翻译(10医币以下会员每天限1篇，违则禁止求助) 绿色通道： 求助全文(应助快,成功概率高) 求助参考文献信息 求助引文信息 10Phonatory impairment in Parkinsons disease: evidence from nonlinear dynamic analysis and perturbation analysis. 参考中文标题：发声障碍的帕金森氏症：证据的非线性动态分析和扰动分析。 作者单位：Department of Surgery, Division of Otolaryngology-HNS, University of Wisconsin Medical School, Madison, Wisconsin 53706, USA. PMID及链接：16377130 /Archive/Detail/16377130 全文链接：在详细信息中查看 摘要：Many persons with Parkinsons disease (PD) will eventually experience vocal impairment as their condition advances. U