Bacterial signatures in thrombus aspirates of patients with myocardial infarction.

BACKGROUND: Infectious agents, especially bacteria and their components originating from the oral cavity or respiratory tract, have been suggested to contribute to inflammation in the coronary plaque, leading to rupture and the subsequent development of coronary thrombus. We aimed to measure bacterial DNA in thrombus aspirates of patients with ST-segment-elevation myocardial infarction and to check for a possible association between bacteria findings and oral pathology in the same cohort. METHODS AND RESULTS: Thrombus aspirates and arterial blood from patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention (n=101; 76% male; mean age, 63.3 years) were analyzed with real-time quantitative polymerase chain reaction with specific primers and probes to detect bacterial DNA from several oral species and Chlamydia pneumoniae. The median value for the total amount of bacterial DNA in thrombi was 16 times higher than that found in their blood samples. Bacterial DNA typical for endodontic infection, mainly oral viridans streptococci, was measured in 78.2% of thrombi, and periodontal pathogens were measured in 34.7%. Bacteria-like structures were detected by transmission electron microscopy in all 9 thrombus samples analyzed; whole bacteria were detected in 3 of 9 cases. Monocyte/macrophage markers for bacteria recognition (CD14) and inflammation (CD68) were detected in thrombi (8 of 8) by immunohistochemistry. Among the subgroup of 30 patients with myocardial infarction examined by panoramic tomography, a significant association between the presence of periapical abscesses and oral viridans streptococci DNA-positive thrombi was found (odds ratio, 13.2; 95% confidence interval, 2.11-82.5; P=0.004). CONCLUSIONS: Dental infection and oral bacteria, especially viridans streptococci, may be associated with the development of acute coronary thrombosis.

Acoustic comparison of vowel sounds produced before and after orthognathic surgery for mandibular advancement.

PURPOSE: The effects of orthognathic surgery on the phonetic quality of speech were studied by analyzing the main acoustic features of vowel sounds. PATIENTS AND METHODS: Five men with dentofacial deformities undergoing surgical operation for correction of malocclusion were enrolled in the study. The speech material consisted of 8 vowels in sentence context. Every utterance was repeated 10 times in 3 different sessions: before the operation, 6 weeks after the operation, and 30 weeks after the operation. The acoustic features (F1, F2, F0, duration) of vowels were measured and analyzed. RESULTS: At the group level, no significant acoustic changes were found between the 3 different sessions in any parameter measured (all F values <1). The results show that the operation had individual and variable effects on vowel quality, ranging from slightly affected to completely unaffected. The 2 lowest vocal-tract resonances changed in frequency for 2 of the subjects, and 1 subject had short-term changes returning to the presurgical level. Significant changes of F0 were observed for 1 subject, and 3 of the subjects had short-term changes. No significant changes were found for duration. One subject had no significant changes in any parameter measured. CONCLUSIONS: No long-lasting perceptually significant changes were identified in vowel production in patients undergoing a variety of orthognathic procedures. The facial skeleton (consisting of palate, maxilla, mandible, dentition, nasal cavity, etc) imposes direct limits on the morphology of the resonating vocal tract cavities, and is therefore of immediate relevance to both speech articulation and acoustics.

Effects of transitory lingual nerve impairment on speech: an acoustic study of vowel sounds.

PURPOSE: The purpose of the study was to evaluate the effects of the lingual nerve impairment on phonetic quality of speech by analyzing the main acoustic features of vowel sounds when the normal lingual nerve function was partly distorted by local anesthesia. PATIENTS AND METHODS: The study group consisted of 7 men, whose right side lingual nerve was anesthetized with 0.8 mL of Ultracaine D-Suprarenin (Aventis Pharma Deutschland GmpH, Frankfurt am Main, Germany). The speech material analyzed consisted of 8 vowels produced in sentence context by speakers. Every utterance was repeated 10 times with and without local anesthesia. After recording, the speech samples were analyzed with a computerized speech laboratory. In addition, the vowels of 1 man with permanent nerve impairment were studied. RESULTS: The results show that the deprived function of the tongue after lingual nerve impairment had various effects on vowel quality for every subject. The main acoustic determinants of different vowels, the lowest vocal tract resonances, changed in frequency. In addition, the total duration of vowels changed and the vowels had different fundamental frequencies. However, these effects were extremely individual and variable. CONCLUSIONS: According to the results of acoustic analysis, the distortion of lingual nerve function has effects on vowel production. Some of these changes were so extensive that they also could be perceptually detectable. Lingual nerve impairment seems to have potential to change speech production.

Effects of transitory lingual nerve impairment on speech: an acoustic study of diphthong sounds.

PURPOSE: The effects of lingual nerve impairment on the phonetic quality of diphthongs were studied by analyzing changes in their main acoustic features when anesthetic was injected into the lingual nerve to partly block the normal neural feedback mechanisms in speech. PATIENTS AND METHODS: The speech material consisted of 8 diphthongs in word context produced by 7 male speakers. Every utterance was repeated 10 times using normal speech rate and intonation with and without the anesthesia (Ultracain D-Suprarenin, 0.8 mL; Aventis Pharma Deutscland GmpH, Frankfurt am Main, Germany). In addition, 1 male speaker with permanent nerve impairment was studied. The acoustic features (F1, F2, F0, and duration) were analyzed using Computerized Speech Laboratory (CSL 4300B; Kay Elemetrics, Lincoln Park, NJ). RESULTS: At the group level, no general significant acoustic changes were found between the 2 conditions. The changes were highly individual and variable across the subjects. Significant changes were observed for all the subjects, most prominently for the subject with permanent nerve impairment. CONCLUSIONS: According to the results, lingual nerve impairment has effects on the production of diphthongs. A comparison between monophthongs and diphthongs showed that the alterations are more significant for the diphthongs than for other vowels indicating the more demanding, complicated, and complex manner of articulation of diphthongs.