A Questionnaire to Assess Phonation and Problems in Daily Living for Provox® Voice Prosthesis Users in Japan.

The aim of this study was to investigate the problems in daily life of Provox® users in Japan with the use of a questionnaire survey and to consider future guidance methods for these patients. We mailed questionnaires to 190 members of a Japanese laryngectomized patient group. We received 118 questionnaires with valid responses. The total voice handicap index (VHI) score was 44.1. Patients were allocated to two groups based on the type of surgery they underwent-laryngectomy or jejunum reconstruction. The VHI score was significantly lower in the simple laryngectomy group than that in the free jejunum reconstruction group (p < 0.01). Only 55.9% of the patients reported having received voice rehabilitation therapy. For other problems of daily life, many patients answered "bad/very bad" for the "smelling," "eating/drinking hot foodstuffs," "blowing nose," and "quantity of sputum" categories. Based on our results, there is a requirement for an effective rehabilitation therapy and appropriate guidance for patients with the Provox® voice prosthesis.

Effects of Nasal Airflow-Inducing Maneuver in Total Laryngectomy Patients Based on Changes to Olfactory Test Results: A Retrospective Study.

INTRODUCTION: This study aims to retrospectively examine temporal changes in three aspects, i.e., olfactory threshold test, olfactory identification test, and olfactory perception on daily living test, caused by the use of the nasal airflow-inducing maneuver (NAIM). METHODS: The olfactory threshold test (Sniffin' Sticks test), olfactory identification test (Open Essence [OE]), and olfactory perception on daily living test (self-administered odor question; SAOQ) were administered to 46 patients who had undergone a total laryngectomy (NAIM Start group: 17; Using group: 19; and Nonuse group: 10). The tests were immediately performed after the NAIM and again after an average of 8 months. RESULTS: In the NAIM Start group, all olfactory functions significantly improved in the second test compared with the first test (Sniffin' Sticks test and OE, p < 0.01 for both; self-administered, p < 0.05). Additionally, in terms of the intergroup changes among scores for the Sniffin' Sticks test and OE, the NAIM Start group showed a significant difference compared with all of the other groups (Start group > Using and Nonuse group, p < 0.01). The NAIM Using group did not exhibit any significant changes. In the NAIM Nonuse group, olfactory identification function was lower in the second test compared with the first test and showed a trend toward a significant difference (OE, p < 0.1). Temporal changes in SAOQ showed a significant increase in all intragroup comparisons. However, there were no significant differences observed in terms of the changes between the groups. CONCLUSION: The results demonstrated that even in those who were not using NAIM and undergoing olfactory rehabilitation after laryngectomy (NAIM Start group), the subsequent daily use of NAIM and voluntary rehabilitation aided in the recovery of olfactory function to the same level as that in the already using NAIM group. SAOQ results were considered because of the experimenter effect and they appeared to be unrelated to use NAIM. This study showed that in total laryngectomy patients who did not receive olfactory rehabilitation, olfactory identification was reduced.

Efficacy of Nasal Airflow-Inducing Maneuver in Laryngectomy Patients: A Retrospective Cohort Study.

OBJECTIVE: To evaluate the effectiveness of the nasal airflow-inducing maneuver (NAIM) using the Sniffin' Sticks (Burghart, Wedel, Germany) olfactory threshold test, Open Essence (OE, FUJIFILM Wako Pure Chemical Corporation, Osaka, Japan) olfactory identification test, and self-administered odor questionnaire (SAOQ) for olfactory perception in NAIM experienced and NAIM first-time groups. For NAIM first-time group, the relationships between time from laryngectomy to first NAIM, olfactory threshold, and identification ability were also evaluated. STUDY DESIGN: Retrospective cohort study. METHODS: Sixty-six patients who had undergone laryngectomy (NAIM experienced group: 23; NAIM first-time group: 43) underwent the threshold test, OE, and SAOQ. RESULTS: Mean results of the threshold test were 2.7 (±2.3) and 2.5 (±3.0) for the NAIM experienced and NAIM first-time groups, respectively, indicating no significant differences (P = .35). The mean number of correct responses in OE was 4.5 (±2.7) and 3.2 (±3.0) in the NAIM experienced and nonrehabilitation groups, respectively, indicating a higher number in the NAIM experienced group (P = .06). Mean result of SAOQ was 47.9% (±30.9%) and 25.5% (±27.0%) in the NAIM experienced and NAIM first-time groups, respectively, indicating a significantly higher result in the NAME experienced group (P = .003). There were no correlations of threshold test and identification test scores with time from laryngectomy to the first NAIM (threshold test: r = 0.03, P = .87; OE: r = -0.03, P = .87). CONCLUSION: NAIM enabled odor perception in patients who underwent laryngectomy, and SAOQ was an effective method for evaluating this. Further, olfactory tests in both groups showed that NAIM might restore olfaction irrespective of time elapsed since laryngectomy. LEVEL OF EVIDENCE: 4. Laryngoscope, 130: 2013-2018, 2020.

A questionnaire to assess olfactory rehabilitation for laryngectomized patients (Provox voice prosthesis users) in Japan.

OBJECTIVE: We used a questionnaire to investigate olfactory function and the present state of olfactory rehabilitation for laryngectomized patients in Japan. METHODS: This study was conducted using a questionnaire survey. We mailed questionnaires to 190 members of a Japanese laryngectomized patient group (the nonprofit organization YOUSAY-KAI). The survey queried the following items: (1) basic information (age, sex, alaryngeal speech method, etc.); (2) questions about olfactory rehabilitation, such as the individual's experience of olfactory rehabilitation, the number of days from laryngectomy to the start of olfactory rehabilitation, and the location of rehabilitation (i.e., hospital or patient association); (3) free comments; and (4) the self-administered Odor Questionnaire (SAOQ). RESULTS: We received 121/190 questionnaires by the submission deadline. Of these, 105 questionnaires were valid. All 105 responders used the Provox voice prosthesis as the alaryngeal speech method. Only 4.7% (5/105) of the patients received olfactory rehabilitation in hospitals. Many comments in the free comment column included demands for olfactory rehabilitation such as "I want to know where we can have olfactory rehabilitation" and "I want to have rehabilitation if olfaction recovers." The SAOQ score was significantly higher in the rehabilitation group (mean, 42.5%) compared to the nonrehabilitation group (mean, 22.1%) (p<0.05). There was no correlation between the SAOQ score and the number of days from laryngectomy to the start of rehabilitation (r=0.08, p=0.76)． CONCLUSION: Patient demand for olfactory rehabilitation is strong, but this therapy is not widely offered to laryngectomized patients in Japan. Notably, the SAOQ scores showed that olfactory rehabilitation may have an effect, even if it is initiated after laryngectomy. We believe that when patients choose voice prosthesis for speech, their olfaction deteriorates unless they undergo olfactory rehabilitation separately from speech rehabilitation. It is therefore necessary to administer olfactory rehabilitation for laryngectomized patients who have never received olfactory rehabilitation, as well as for patients scheduled to undergo laryngectomy.

Molecular size fractionation of soil humic acids using preparative high performance size-exclusion chromatography.

High performance size-exclusion chromatography (HPSEC) is useful for the molecular size separation of soil humic acids (HAs), but there is no method available for various HAs with different chemical properties. In this paper the authors propose a new preparative HPSEC method for various soil HAs. Three soil HAs with different chemical properties were fractionated by a Shodex OHpak SB-2004 HQ column with 10mM sodium phosphate buffer (pH 7.0)/acetonitrile (3:1, v/v) as an eluent. The HAs eluted within a reasonable column range time (12-25 min) without peak tailing. Preparative HPSEC chromatograms of these HAs indicated that non-size-exclusion effects were suppressed. The separated fractions were analyzed by HPSEC to determine their apparent molecular weights. These decreased sequentially from fraction 1 to fraction 10, suggesting that the HAs had been separated by their molecular size. The size-separated fractions of the soil HA were mixed to compare them with unfractionated HA. The analytical HPSEC chromatogram of the mixed HA was almost identical to that of the unfractionated HA. It appears that the HAs do not adsorb specifically to the column during preparative HPSEC. Our preparative HPSEC method allows for rapid and reproducible separation of various soil HAs by molecular size.

Characterization and grouping of aquatic fulvic acids isolated from clear-water rivers and lakes in Japan.

Characteristics of aquatic fulvic acids (FAs) from 10 clear waters in Japan (around the temperate zone) were revealed by several analytical techniques-high performance size exclusion chromatography (HPSEC), elemental analysis, liquid-state (13)C NMR spectroscopy, isotopic analyses (delta(13)C and delta(15)N), and compared with those of International Humic Substances Society (IHSS) standard samples including FAs from brown waters (Suwannee, Pony, and Nordic FAs). Generally clear-water FAs were different from brown-water FAs in chemical properties. Weight-average molecular weights (Mw) of the clear-water FAs were similar to each other, whereas their elemental compositions and carbon species distribution were different. The clear-water FAs all exhibited a high proportion of alkyl carbons, which may be attributed to microbial activity. delta(13)C and delta(15)N values of the FAs indicated that there would be a huge gap between origin and chemical structure of clear-water FA. Results of the chemical structural analyses described above were not always linked to those of the isotopic analyses (delta(13)C and delta(15)N). Multivariate statistical analysis, i.e. cluster and principal component analysis was applied to reveal differences or similarities in a more objective manner. The FAs were always classified into two clear-water groups and one brown-water group. Aryl-C and O-Alkyl-C contents were important for the grouping. We speculate that the grouping might depend on the differences of aquatic microbial activity caused by the differences of residence time of water.

Optimization of conditions for high-performance size-exclusion chromatography of different soil humic acids.

A method of high-performance size-exclusion chromatography (HPSEC) for a wide variety of soil humic acids (HAs) was developed. Two types of soil HAs (Cambisol and Andosol HAs), which have substantially different chemical properties, showed different effects of salt and organic solvent concentrations in the eluent on chromatograms. A Shodex OHpak SB-805 HQ column with 10 mM sodium phosphate buffer (pH 7.0) containing 25% of acetonitrile (v/v) was found to be applicable for different HAs, and showed high reproducibility and recovery (87.0 - 94.5%). The Cambisol HA was fractionated into five fractions using an ultrafiltration with different molecular-weight cut-offs. The order of the molecular weights of the five fractions calculated from the HPSEC analysis corresponded to that defined by ultrafiltration. This supported the reliability of the method.

Population of Humic Acid Degrading Microorganisms in Andosols under Different Vegetation Types and Grassland Management Regimens.

To examine the effect of vegetation type and grassland management regimen on the distribution of humus-degrading microorganisms, populations of humic acid-degrading (HAD) bacteria and fungi at three Andosol sites were investigated using the dilution plate method. Each site had three different vegetation types (Eulalia grassland, bamboo grassland, and coniferous plantations). Among the six grassland sites, two were maintained by burning and the others by cutting. HAD microorganisms were found in all soil samples. Low densities and small percentages of HAD bacteria were detected with no significant differences in the number of bacteria found between different vegetation types and grasslands managed in different ways. In contrast, the densities and percentages of HAD fungi differed according to vegetation type and management regimen. Specifically, the percentages of HAD fungi were significantly higher for burned grasslands. At burned sites, the numbers and percentages of HAD bacteria remained at a consistently low level, and no distinct seasonal changes were observed. In contrast, marked seasonal fluctuations in HAD fungi were detected. The percentages of these fungi remained relatively high between April and December. These fluctuations are likely due to the effects of burning on soil microorganisms.