Water holding capacity and collagen profile of bovine m. infraspinatus during postmortem ageing.

Changes in the water holding capacity (WHC) and collagen profile in bovine m. infraspinatus during ageing in a vacuum at 3 °C up to 20 days were studied. Moisture, expressible water and total collagen content were determined in raw samples and muscles were then subjected to thermal treatment in steam. Moisture, collagen fractions (total, water-soluble, insoluble, acetic acid-soluble, total soluble) and cooking loss were determined in the cooked meat. Ageing time did not significantly influence WHC (expressible water content as a % of moisture), moisture content in raw and cooked meat or cooking loss. Between the 5th and 10th day of ageing a significant increase was noted in acetic acid-soluble collagen and total soluble collagen content along with a decrease in insoluble collagen content (p b 0.05). A significant negative relationship was found between the expressible water content and the water-soluble collagen. It was concluded that connective tissue ageing of bovine m. infraspinatus might be finished after 10 days.

The effect of muscle, cooking method and final internal temperature on quality parameters of beef roast.

The aim of the study was to evaluate the influence of cooking conditions (dry air and steam) and final internal temperature (75, 85, 95°C) on the physico-chemical properties of beef infraspinatus (INF) and semimembranosus (SEM) muscles as well as their tenderness and juiciness. Cooking method and temperature influenced moisture, total collagen content in cooked meat and cooking loss, whereas muscle type affected fat, total collagen content and cooking loss. Warner-Bratzler shear force values were affected by cooking method, which also influenced juiciness of roasts. Temperature affected tenderness and juiciness, whereas muscle type influenced juiciness. The most desirable tenderness had INF heated in steam and dry air to 95°C. Processing SEM in dry air to 85 and 95°C lowered the juiciness of the roasts. There were significant correlations between physico-chemical, sensorial and image attributes, however high accuracy of prediction (r(2)>0.8) was achieved only for SEM muscle.

Impact of diets with different proportions of linseed and sunflower oils on the growth, liver histology, immunological and chemical blood parameters, and proximate composition of pikeperch Sander lucioperca (L.).

The aim of the study was to determine the impact of applying different proportions of linseed (LO) and sunflower (SFO) oils in pikeperch diets on growth, histological changes in the liver, immunological and blood chemical parameters. The fish were fed isoenergetic and isoprotein feeds containing SFO (group 100SFO) or LO (group 100LO) in quantities of 67 g kg/feed, and a mixture of oils: 47 g SFO and 20 g LO kg/feed (group 70SFO/30LO) and 20 g SFO and 47 g LO kg/feed (group 30SFO/70LO). Dietary ratios of polyunsaturated fatty acids from the n-3 and n-6 series (n3/n6 index) were 0.36-2.15. Pikeperch were reared for 56 days in three replicates for each dietary treatment. Various dietary oils and ratios of n3/n6 did not impact fish growth, feed conversion ratio, viscerosomatic and hepatosomatic index, and size of the hepatocytes. Feeding the fish high quantities of LO and SO oils (groups 100LO and 100SFO) reduced the immunological response of the phagocytes and lymphocytes in the fish. Moreover, this resulted in significant differences among groups in the quantity of linolenic and linoleic acid in whole fish bodies, viscera, fillets, and livers. Various quantities of vegetable oils in the fish diets did not impact the quantity of arachidonic, eicosapentaenoic and docosahexaenoic acid in the fillets and livers. The immunological index and low quantities of linoleic acid in the fillets obtained in group 30SFO/70LO indicate that the n3/n6 dietary ratio of 1.35 was the most advantageous for feeding juvenile pikeperch feeds with vegetable oils.

Computerized voice therapy in hypofunctional dysphonia.

OBJECTIVE: The aim of this study was to analyze the efficiency and applicability of the Kay CSL 4500 system with the Sona-Speech II software model 3650 (Kay Pentax, Lincoln Park, NJ) in the voice therapy of patients affected by hypofunctional dysphonia. DESIGN: The study evaluated the effect of visual biofeedback, obtained with the Sona-Speech II software, on dysphonia associated with hypofunction dysphonia. SETTING: The study was conducted with 40 male adults affected by hypofunctional dysphonia in the Otolaryngology Department of the University of Genoa (Italy) between April 2008 and April 2009. METHODS: Before, at the end of, and 3 months after voice therapy, all subjects underwent an otolaryngology visit, videostroboscopy, and voice analysis through the Multi-Dimensional Voice Program (Kay Elemetrics, Lincoln Park, NJ) as an evaluation of nasal resonance and the Voice Handicap Index (VHI). Each cycle of rehabilitation was characterized by 30 daily consecutive sessions, each for 25 minutes. During each session, the patient was asked to perform specific computer exercises. MAIN OUTCOME MEASURES: The following acoustic parameters were estimated: average of fundamental frequency, percentage of jitter, shimmer, noise to harmonics ratio, voice turbulence index, soft phonation index, degree of voicelessness, degree of voice breaks, and peak amplitude variation. RESULTS: Our data showed significant (p < .05) improvements in acoustic and other parameters in the patients submitted to voice therapy. CONCLUSIONS: Our preliminary results suggest the applicability and efficiency of the Kay CSL 4500 system in association with the Sona-Speech II software model 3650 in a voice therapy program.

Acoustic features of voice after septoplasty.

BACKGROUND: The aim of this study was to evaluate changes in acoustic features of voice after septoplasty and to establish concepts of patient management and a rational therapeutic approach. MATERIAL/METHODS: Before and one month after surgery, phonetically balanced sentences and sustained vowels a, e, and i were recorded and digitalized with MDVP (Multi Dimensional Voice Program, Kay Elemetrics) in all patients for an evaluation of nasal resonance, voice handicap index (VHI), and active anterior rhinomanometry. These parameters were estimated: average fundamental frequency (Fo), jitter percent, shimmer, noise-to-harmonics ratio (NHR), voice turbulence index (VTI), soft phonation index (SPI), degree of voicelessness (DUV), degree of voice breaks (DVB), and peak amplitude variation (vAm). RESULTS: One month after surgery the data showed an improvement in all the acoustic parameters and a normalization of nasalance. CONCLUSIONS: The results highlight the impact of septoplasty on nasalance and voice. In selected cases, such as severe nasal septum deviation, the decision to perform septoplasty depends on its potential effect on speech and respiratory function. An objective evaluation of voice and nasalance helps the specialist in the management of these patients.

Effects of uvulopalatopharyngoplasty with Harmonic Scalpel on speech and voice.

The aim of this study was to evaluate changes in acoustic features of speech and voice after uvulopalatopharyngoplasty (UPPP) with the Harmonic Scalpel (HS), using the multidimensional voice program (MDVP) in conjunction with other tests. Before and 6 months after surgery, phonetically balanced sentences and sustained vowels a, e, i were carried out and digitalized with MDVP in all the patients, as an evaluation of nasal resonance (trough the Glatzel and the Gutzmann tests), speech articulation and voice handicap index (VHI). These parameters were estimated: average of fundamental frequency, Jitter, Shimmer, noise-to-harmonics ratio, voice turbulence index, soft phonation index, degree of voiceless, degree of voice breaks and peak amplitude variation. Six months after surgery, improvements in all the acoustic parameters, in nasalance and VHI were achieved. In our experiences UPPP, with the HS, improves speech and voice in patients affected by snoring and/or obstructive sleep apnea syndrome.

Effects of tonsillectomy on speech and voice.

The aim of this study was to evaluate changes in acoustic features of speech after tonsillectomy and to establish concepts of patient management and rational therapeutic approach. Before and 1 month after surgery, phonetically balanced sentences and sustained vowels a, e, i were carried out and digitalized with Multi-Dimensional Voice Program (Kay Elemetrics, Lincoln Park, NJ) in all the patients, as an evaluation of nasal resonance, speech articulation, and voice handicap index (VHI). These parameters were estimated: average of fundamental frequency, Jitter percent, Shimmer, noise-to-harmonics ratio, voice turbulence index, soft phonation index, degree of voiceless, degree of voice breaks, and peak amplitude variation. Our data showed that 1 month after tonsillectomy, improvements in all the acoustic parameters, a subjective decrease of hypernasality, and an improvement of speech articulation and VHI were achieved. These data suggest the reduction of the nasal resonance and highlight the role of tonsillectomy in the improvement of voice and speech quality. Furthermore, tonsillectomy should be performed before consideration of pharyngeal flap surgery. Our results highlight that objective evaluation of speech and voice helps the specialist to improve patient management and avoid unnecessary and dangerous surgical procedures.

Sulphurous water inhalations in the prophylaxis of recurrent upper respiratory tract infections.

OBJECTIVE: The aim of this study was to evaluate the efficacy and the effect of sulphurous thermal water inhalations in the treatment of the recurrent upper respiratory tract (RURT) infections in children. METHODS: A total of 100 children with RURT infections were included. All children underwent a 12-day course warm vapour inhalations. For the inhalations, we used sulphurous thermal water in the group A, while physiological solution in the group B. At the beginning, at the end and 3 months after start, all children underwent medical history, ENT examination, plasma levels of immunoglobulins class E, G, A, M (IgE, IgG, IgA, IgM), subjective assessment of symptoms (VAS), nasal mucociliar transport time (NMTT) determination, and evaluation of frequency, duration, severity and social impact of RURT episodes. RESULTS: Compared with group B, after the treatment and at the end of the study, in children treated with sulphurous thermal water, the serum concentration of IgE was significantly (p<0.05) lower (75.13+/-27.1mg/dl vs 96.87+/-41.3mg/dl; 74.23+/-26.2mg/dl vs 98.24+/-42.7 mg/dl), IgA titers were higher (238.14+/-122.1mg/dl vs 218.62+/-115.8 mg/dl; 239.72+/-119.7 mg/dl vs 210.46+/-107.3mg/dl), serum concentrations of IgG and IgM unchanged, VAS scores presented a significant (p<0.05) improvement (1.8+/-0.19 vs 6.8+/-0.54; 1.9+/-0.21 vs 6.9+/-0.61), NMTT was normal (11.15+/-1.59 min vs 17.63+/-2.17; 11.25+/-2.10 min vs 17.77+/-2.19 min) and frequency, duration, severity and social impact of RURT episodes were significantly (p<0.05) lower. CONCLUSIONS: Our findings indicate that, in addition to their known effects, the sulphurous water also have an immunomodulant activity that contributes to their therapeutic effects.

The impact of tonsillectomy with or without adenoidectomy on speech and voice.

OBJECTIVES: The aim of this study was to evaluate changes in acoustic features of speech and voice after tonsillectomy with or without adenoidectomy. METHODS: Before and 1 month after surgery the following parameters were estimated: average of fundamental frequency (Fo), Jitter percent (Jitt), Shimmer, noise-to-harmonics ratio (NHR), voice turbulence index (VTI), soft phonation index (SPI), degree of voiceless (DUV), degree of voice breaks (DVB) and peak amplitude variation (vAm); as an evaluation of nasal resonance, speech articulation and voice handicap index (VHI). RESULTS: The results were statistically evaluated using the unpaired t-test. Probability values below 0.05 were regarded as significant. One month after surgery, our data showed significant (P<0.05) improvements of the acoustic and other parameters in the children submitted to adenotonsillectomy: Fo (176Hz vs. 206Hz, after sustained vowels: 206Hz vs. 192Hz; 148Hz vs. 168Hz; 171Hz vs. 161Hz after balanced sentences), Jitt (0.85% vs. 1.81% to 0.82% vs. 1.81%), Shimmer (3.41% vs. 5.81% to 4.89% vs. 5.73%), NHR (0.16 vs. 0.42 to 0.29 vs. 0.39), VTI (0.05 vs. 0.38 to 0.28 vs. 0.37), SPI (14.78 vs. 21.14-19.89 vs. 21.89), DUV (0% vs. 0.44% to 0% vs. 0.48%), DVB (0% vs. 0.42% to 0% vs. 0.42%) and vAm (8.93% vs. 23.89% to 8.89% vs. 24.25%). CONCLUSIONS: The results suggest the role of adenotonsillectomy in the improvement of voice and speech quality and of objective evaluation of speech and voice in the correct management of these children.

Effects of adenotonsillectomy on speech spectrum in children.

OBJECTIVE: The vocal tract, which starts from the glottis and extends to the lips is considered to be a resonator for speech production. Enlarged palatine tonsils may cause hypernasal speech, oral breathing or muffled voice. Changes in the structure of this resonator are assumed to modify the speech characteristics. The aim of this study was to evaluate changes in acoustic feature of speech after adenotonsillectomy in children and to establish concepts of management and rational therapeutic approach. METHODS: Before and after surgery, an acoustic analysis was made to 40 children, aged between 5 and 14 years old, with enlarged palatine tonsils and hypetrophic adenoids. Phonetically balanced sentences were carried out and digitalized with Multi Dimensional Voice Program (MDVP, Kay Elemetrics). As a control group, 40 healthy children were identified. These parameters were estimated: average of fundamental frequency (Fo), Jitt, Shim, noise to harmonics ratio (NHR), voice turbulence index (VTI), soft phonation index (SPI), degree of voiceless (DUV) and degree of voice breaks (DVB). RESULTS: After adenotonsillectomy, our data showed an improvement in all the parameters: the analysis of Fo, Jitt, Shim, NHR, VTI, SPI, DUV and DVB showed a postoperative decrease; comparison with healthy children highlighted a postoperative normalization of NHR, VTI and DVB. CONCLUSIONS: The postoperative improvement of the parameters suggests a reduction of the nasal resonance and the improvement of voice quality. MDVP method may be useful for analyzing speech characteristics, evaluating the effects of surgical excision and therapeutic approach: in selected cases of patients with enlarged tonsils, the decision to perform tonsillectomy depends on its potential positive effect on speech too.

Sodium enoxaparin and venovenous hemofiltration in treating sudden sensorineural hearing loss and tinnitus.

Sudden sensorineural hearing loss (SSNHL) constitutes a considerable diagnostic challenge because it may be caused by many diverse conditions that may be difficult to recognize. No definitive treatment for SSNHL is universally accepted; the goal of this study was to evaluate the efficacy of sodium enoxaparin associated with venovenous hemofiltration in a therapeutic regimen. We treated 20 patients divided randomly into two numerically equal groups (A and B). Group A patients underwent this therapeutic protocol: Hemofiltration was performed at the first and last day of the protocol while, beginning on the second day of the protocol, sodium enoxaparin was administered subcutaneously at a dose of 4,000 IU once a day for 10 days. After the first hemofiltration, all the patients with complete auditory recovery were discharged without receiving the treatment with sodium enoxaparin. Group B patients received conventional therapy (cortisone, vasoactive agents, and vitamin complexes) administered in physiological solution intravenously twice daily for 10 days. In our randomized, controlled trial, treated patients in group A showed more improvement than did those in group B.

Electronystagmography finding in children with peripheral and central vestibular disorders.

OBJECTIVE: Dizziness and imbalance are uncommon in children, but often alarming for their families: a detailed interview and otoneurological examination are important for reaching a specific diagnosis and treatment. Children with vestibular disorders are thought to be difficult to examine: vestibular tests (caloric test, roto-acceleratory test, electronystagmography, opto-kinetic nystagmus, cranio-corpography and posturography) are used less frequently for children than in adult patients. The aim of the study was to determine whether the results of electronystagmography testing improve an emergency physician's diagnosis of dizziness in children. METHODS: Patients were selected on the basis of the following inclusion criteria: aged between 2 and 12 years and affected with vertiginous symptoms. All patients underwent the following instrumental examinations: blood tests, audiological screening, electronystagmography of spontaneous nystagmus or provoked by vestibular and optical stimulation and electroencephalogram. RESULTS: The results underlines an high incidence of central vertigo (83%): 52% of the children presented a prevailing unidirectional nystagmus at labyrinth stimulation and 48% of the children an asymmetry in the response of nystagmus at optical kinetic stimulation with quality alteration of shocks. CONCLUSIONS: Electronystagmography can register and evaluate the qualitative and quantitative characteristics of the nystagmic response and allow to distinguish between central or peripheric vertigo: different degrees and various combinations of the abnormal responses shown in optokinetic central test were the most characteristic of electronystagmography in patients with vestibular central vertigo.

The use of recombinant tissue-type plasminogen activator for the treatment of sudden and chronic hearing loss.

We treated 80 patients with sudden hearing loss and 70 patients with chronic decreasing cochlear function to date with intravenous infusion of a glycoprotein analogous to recombinant tissue-type plasminogen activator (rt-PA): 3 mg dissolved in 250 mg of physiological saline given every 12 hours intravenously. Specifically excluded were patients with known abnormal coagulation. We treated no patient for longer than 20 days. Before therapy, 6 months therapy began, and at the end of treatment, all patients underwent the following instrumental examinations: prothrombin and fibrinogen level measurements, liminal tonal audiometry, tympanometry, and assessment of otoacoustic emissions and otoacoustic products of distortion. Daily during the treatment, we monitored the patients by liminal tonal audiometry and assessment of otoacoustic emissions with linear click emission and otoacoustic products of distortion. We discharged patients when their audibility threshold stabilized. No patient experienced side effects due to the treatment, and functional results were excellent in all (even more so if compared with the protocols of therapy previously used for these kinds of diseases). The tissue plasminogen activator was used with remarkable success for the treatment of sudden hearing loss; this study shows remarkable success with a very low dose of rt-PA as compared to the standard dosage used for treatment of myocardial infarction.

Sodium enoxaparin treatment of sensorineural hearing loss: an immune-mediated response?

The authors propose the existence of a new entity of autoimmune sensorineural hearing loss on the basis of diagnostic study and treatment experience with a series of 30 patients. Immunological mechanisms play an important role in the pathogenesis and natural course of various inner-ear diseases. Patients may present clinically with symptoms resembling Ménière's disease or even with sudden deafness. Currently, no widely used standard protocol for treatment of this autoimmune sensorineural hearing loss exists. Prompted by such observations, we implemented a protocol using a particular kind of heparin--sodium enoxaparin--with a low molecular weight. Patients were randomly assigned to two groups; to those in the first group, enoxaparin was administered subcutaneously at a dose of 2,000 IU twice daily for 10 days; the patients in the second group were treated with placebo. At the beginning and at the end of the therapy period, the patients were evaluated by instrumental examinations. Specifically excluded were patients with abnormal known coagulation. On discharge, all patients treated with enoxaparin presented both a subjective and objective decrease in symptoms. No patient experienced side effects from this treatment. The results indicate that administration of sodium enoxaparin abates sensorineural hearing loss in patients with autoimmune diseases. The clinical response to therapy can confirm diagnosis.

Descending necrotizing mediastinitis: ten years' experience.

Descending necrotizing mediastinitis is a rare disease that is usually caused by a spreading, diffuse inflammatory reaction (phlegmon) to an odontogenic infection or peritonsillar abscess. Reported mortality rates range from 25 to 40%. The use of antibiotics and advances in resuscitation procedures and critical care techniques have not essentially improved survival, and an effective treatment has not been clearly established. We report the findings of our 10-year study of 21 patients affected by phlegmon and/or fasciitis of the neck. The aim of our contribution is to help define the clinical criteria and diagnostic procedures that will improve the early diagnosis of mediastinal sepsis secondary to neck fasciitis and to suggest optimal treatment approaches. Our experience indicates that (1) cervical drainage alone is sufficient for cases of cervical phlegmon or mediastinal involvement that are limited to a single superior mediastinal space and (2) thoracotomy and drainage of mediastinal collections is necessary when mediastinal sepsis is more extensive.