Subjective and objective assessment of voice quality in pregnancy.

During pregnancy, voice quality disorders may occur in form of: edema, dryness, nervousness. The aim of the study is subjective and objective evaluation of voice quality in pregnant women. The study included 20 women in the third trimester of pregnancy, age of 20-31 diagnosed at the Department of Clinical Phonoaudiology and Logopedics, Medical University of Bialystok. Subjective assessment has been based on the GRBAS scale. Objective assessment of the vocal organ used the HSDI technique (High Speed Digital Imaging). In the laryngeal visualization, high-speed camera (HS) using rigid endoscope with 90 ° optics has been used. Vibration of vocal folds has been recorded during phonation of vowel "e" at 4000 frames / sec. The glottal closure (GTs), symmetry, regularity and synchronization of vocal folds vibration have been assessed. In estimating the degree of glottal insufficiency, kymography of the larynx has been performed by analyzing the value of Open Quotient (OQ). Objective acoustic evaluation of voice has been also conducted using DiagnoScope Specjalista Program. Hoarseness has been observed in 15 pregnant women, whereas voice fatigability in 20 patients. Using HSDI, the edema of vocal folds in part of the group has been observed. Decreased MPT has been found in all examined women in the third trimester of pregnancy. Hoarseness and fatigability of voice are the most frequent subjective symptoms of voice organ in the third trimester of pregnancy. Decreased MPT is recorded objectively, as well as edema and insufficiency of vocal folds using HSDI technique.

A fast and scalable kymograph alignment algorithm for nanochannel-based optical DNA mappings.

Optical mapping by direct visualization of individual DNA molecules, stretched in nanochannels with sequence-specific fluorescent labeling, represents a promising tool for disease diagnostics and genomics. An important challenge for this technique is thermal motion of the DNA as it undergoes imaging; this blurs fluorescent patterns along the DNA and results in information loss. Correcting for this effect (a process referred to as kymograph alignment) is a common preprocessing step in nanochannel-based optical mapping workflows, and we present here a highly efficient algorithm to accomplish this via pattern recognition. We compare our method with the one previous approach, and we find that our method is orders of magnitude faster while producing data of similar quality. We demonstrate proof of principle of our approach on experimental data consisting of melt mapped bacteriophage DNA.

Visual assessment of voice disorders in patients with occupational dysphonia.

INTRODUCTION: In a group of persons using the voice occupationally, the frequent symptoms are hoarseness, voice fatigability and aphonia. Pathological changes in the larynx may have organic or functional character which require different methods of treatment and rehabilitation. Visualization of vibrations of the vocal folds is an essential condition for an appropriate assessment of the causes of dysphonia. OBJECTIVE: The purpose of the study is assessment of the usefulness of a high-speed imaging (HSI) system in the diagnosis of functional and organic dysphonia of occupational character, compared with digital kymography (DKG) and digital stroboscopy (DS) with a high resolution module. MATERIAL AND METHODS: The study group consisted of 64 patients with voice quality disorders with features of occupational dysphonia. The control group consisted of 15 patients with euphonic voice. Analysis of the voice quality parameters during phonation of the 'e' vowel was performed using HSI, DKG and stroboscopy of high resolution, by means of a digital HS camera (HRES Endocam, Richard Wolf GmbH, Knittlingen, Germany). Vocal folds vibrations were registered at the rate of 4,000 frames per second. RESULTS: HSI is the most reliable diagnostic tool giving the possibility of an analysis of the true vibrations of the vocal folds. It also enables an observation of the aperiodicity of vibrations of the vocal folds, while DS with high resolution allows diagnosis of the periodicity of the vibrations. CONCLUSIONS: HSI is particularly useful in the diagnosis of neurologically-based pathology of the voice (paralytic dysphonia) and organic dysphonia. The quickest method of diagnosing the phonatory paresis of the glottis is DKG. The advantage of both HSI and DKG is the non-invasiveness of examinations; however, their limitations are time-consuming and the high cost of equipment.

A portable high-speed camera system for vocal fold examinations.

AIM: In this article, we present a new portable low-cost system for high-speed examinations of the vocal folds. Analysis of glottal vibratory parameters from the high-speed recordings is compared with videostroboscopic recordings. METHODS AND RESULTS: The high-speed system is built around a Fastec 1 monochrome camera, which is used with newly developed software, High-Speed Studio (HSS). The HSS has options for video/image recording, contains a database, and has a set of analysis options. The Fastec/HSS system has been used clinically since 2011 in more than 2000 patient examinations and recordings. The Fastec 1 camera has sufficient time resolution (≥4000 frames/s) and light sensitivity (ISO 3200) to produce images for detailed analyses of parameters pertinent to vocal fold function. The camera can be used with both rigid and flexible endoscopes. The HSS software includes options for analyses of glottal vibrations, such as kymogram, phase asymmetry, glottal area variation, open and closed phase, and angle of vocal fold abduction. It can also be used for separate analysis of the left and vocal fold movements, including maximum speed during opening and closing, a parameter possibly related to vocal fold elasticity. A blinded analysis of 32 patients with various voice disorders examined with both the Fastec/HSS system and videostroboscopy showed that the high-speed recordings were significantly better for the analysis of glottal parameters (eg, mucosal wave and vibration asymmetry). CONCLUSIONS: The monochrome high-speed system can be used in daily clinical work within normal clinical time limits for patient examinations. A detailed analysis can be made of voice disorders and laryngeal pathology at a relatively low cost.

Noninvasive assessment of cardiac motion: comparison of the apexcardiogram and cardiokymorgram.

The apexcardiogram (ACG) and cardiokymogram (CKG) (displacement cardiogram) tracings were compared in 45 patients with a variety of cardiac diseases and in 16 normal subjects. The ACG and CKG were generally comparable in waveform and timing of standard tracing intervals; however, on a case by case comparison frequent discrepancies between the ACG and CKG were observed. In 13 patients where no ACG could be recorded, an interpretable CKG tracing was obtained. However, the CKG produced frequent artifacts, mirror images, was very sensitive to probe position, and was judged to be of limited advantage over the ACG.

Radionuclide kymography for the assessment of regional myocardial wall motion.

Regional myocardial wall motion is usually evaluated qualitatively from ECG-gated end-systolic and end-diastolic blood-pool images. Radionuclide kymography, which displays a one-dimensional scintigraphic image in time, synchronized with the electrocardiogram, provides a method to quantitate this motion. The technique is analogous to M-mode ultrasound in that one dimension is displayed as a function of time, but the activity distribution is displayed in place of acoustic interfaces. The motion of regional myocardial segments can be measured from multiple kymographic projections across the cardiac blood pool, after equilibration of a radioactive tracer. Radionuclide kymography is potentially better quantitatively than gated blood-pool imaging and is not hindered by viewing windows as are single- and multiple-transducer ultrasonography. Regional wall motion determined from radionuclide kymography correlated well with that determined from contrast left ventriculography in a series of patients. Since the kymographic sweep is initiated by the R wave of the ECG and proceeds continuously throughout the cardiac cycle, the temporal sequence of regional myocardial contraction can be directly assessed and related to corresponding portions of the ECG.

Prostatism and prostatectomy: the value of urine flow rate measurement in the preoperative assessment for operation.

Urine flow rates were measured before and after elective prostatic operations in 53 patients. The over-all success rate was 72 per cent, as assessed by the changes in symptoms and urine flow rates. Patients with less than a satisfactory operative result had more frequency and urgency and higher preoperative urine flow rates than patients with good results from the operation. Since bladder conditions unassociated with bladder outflow obstruction may be responsible for the poor results it is recommended that urine flow rates be measured before an elective prostatic operation so that patients unlikely to benefit from an operation may be identified.

Urodynamic assessment of stress incontinence and its therapeutic implications.

Urethral fibrosis and sphincter incompetence commonly are associated in the genesis of stress incontinence. Other factors are often associated, such as bladder hyperactivity and increased demand on the sphincter mechanism created by contracted or large atonic bladder or polyuria. The frequent association of several factors and the limited information given by the classical methods suggest a need for the routine use of objective urodynamic studies in the assessment of stress incontinence. A more conservative, better oriented, therapeutic approach may result from this concept.