Objectives : To compare the voice quality and voice problems of untrained professional voice user groups with that of normal control group without voice problem. Materials and Methods : The sustained vowel sounds of 13 male and 36 female teachers, 46 clergies and 15 telephone operators, and 40 normal male and 20 normal female persons were analyzed, using a videostroboscopy and acoustic analyzer. Together with these analyses, a questionnaire associated with risk factors for current and past voice problems was handed over to the patients. Results : The most common symptom in subjective groups was the voice fatigue. In stroboscopic examination, the professional voice user groups shelved functional voice disorder findings regardless of the Intensity of voice use. In the clergy and teacher using loud voice, vocal polyp, vocal nodule and hyperfunction of laryngeal muscle were frequently observed. In the clergy and telephone operator, jitter and shimmer were significantly increased. In the female teacher, the value of jitter, fundamental frequency variation and fundamental frequency were statiscally significant. However, the voice of male teacher showed no significant findings in the acoustic and aerodynamic studies. Conclusion : In the management of voice problems for untrained professional voice user groups, it is important to find the exact causes and patterns of voice problems, and to be individualized the management according to the causes.
Vocal nodule due to vocal hyperfunction is one of the representative chronic diseases of vocal folds, and it can be cured by surgical movement, and/or voice therapy. The present study is, focusing on the latter, to compare the acoustic and aerodynamic results of the pretreatment with those of posttreatment, and then to investigate the objective date on the efficiency of the voice therapy for the patients with vocal nodules. 11 females(age : 7-49) and 5 males(age : 8-40), total 16 patients wi vocal nodules treated by voice therapy were participated as subjects. Six measurements and comparisons of pretreatment and posttreatment of the results were performed : litter, shimmer, and noise-to-harmonic ratio as acoustic analyses ; maximum phonation time, mean flow rate, and the subtraction of mean flow rate from maximum flow rate as aerodynamic analyses. As a result, 14 of 16 subjects showed improvement at more than 4 of 6 measurements, and in group data, every measurements of posttreatment was improved significantly than the pretreatment. On the whole, the improvement of aerodynamic aspects was more statistically significant than that of acoustic ones.
Hyperfunction of the upper esophageal sphincter (UES) can cause severe dysphagia. This condition referred as cricopharyngeal dysphagia may occur after head and neck surgery due to altered muscle spasm and stenosis of the pharyngo-esophageal segment. Among various treatment options available, Botulinum toxin A (Botox) injection offers a nonsurgical treatment which is useful especially for debilitated patients, and there has been a recent increase in the clinical use of Botox by otolaryngologists for managing such conditions. A 55-year-old male with base of tongue (BOT) cancer suffered from severe dysphagia after total glossectomy and neck dissection treatment. Videofluoroscopic swallow study (VFSS) and flexible endoscopic evaluation of swallowing (FEES) showed inability to pass food through the UES due to cricopharyngeal spasm. After injection of 10 U of Bot ox into each cricopharyngeus muscles (total 20 U) via EMG-guided percutaneous injection, swallowing function had improved and oral nutrition was possible, with food passing through the UES visualized on VFSS and FEES.
Functional dysphonia (FD) is a disease entity which includes various voice disorders in the absence of structural or neurologic laryngeal pathology. Muscle tension dysphonia (MTD), psychogenic dysphonia are representative FD with completely different pathogenesis. Therefore there is no standard treatment modality for FD, the first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. MTD is a functional voice disorder caused by hyperfunction of intrinsic and extrinsic laryngeal musculature. Symptoms include increased vocal effort, roughness, fatigue and odynophonia. First line for MTD is indirect or direct voice therapy. Unfortunately, many patients with MTD improve with voice therapy alone. For these patients, various modalities tried; lidocaine application, surgical excision of the false vocal folds, and botulinum toxin injection, etc. Botulinum toxin injections are widely used in the field of otolaryngology, especially for spasmodic dysphonia. However, its use in FD or MTD has only been described in few case reports. The aim of this lecture is to evaluate the feasibility of botulinum toxin injection for FD, especially MTD.
The study has been carried out for the comparative analysis of relevant literature in order to highlight the present topic "Clinical study on effect on Virechana karma (therapeutic purgation)". Total no. of 40 cases has been selected from OPD and IPD of Panchakarma department, through proper history taking and clinical examination prior to VirechanaKarma. Only VirechanaKarmaYogya subjects were selected for the VirechanaKarma. Analysis of VirechanKarma on the basis of Vegiki (purgative bouts), Maniki (quantity), Langiki (clinical features) and Aantiki (end product) features were done in this study. In this study a highly significant relief was found in patients i.e. p<0.001 due to Virechana mainly vitiated PittaDosha (the heat energy in the body) and secondary Kaphadosha (mucus) and VataDosha (subtle energy associated with movement) are being expelled out which might have accounted for better relief in VirechanYogya (indicated) individuals (Pitta Pradhan Vyadhi (vitiated pitta), RaktajRoga (hemopoietic diseases), ShodhanYogyaAvastha (detoxification), etc.) in the above group of patients. VirechanaDravyas have properties like Tikshna (hyperfunction), Sukshma(subtle), Ushna (heat), etc. are described in Ayurvedic classics which play a vital role in the mode of action of VirechanaKarma has also been explained under probable mode of action.
The heterodimeric amino acid transporter family is a subfamily of SLC7 solute transporter family which includes 14-transmembrane cationic amino acid transporters and 12-transmembrane heterodimeric amino acid transporters. The members of heterodimeric amino acid transporter family are linked via a disulfide bond to single membrane spanning glycoproteins such as 4F2hc (4F2 heavy chain) and rBAT $(related\;to\;b^0,\;^+-amino\;acid\;transporter)$. Six members are associated with 4F2hc and one is linked to rBAT. Two additional members were identified as ones associated with unknown heavy chains. The members of heterodimeric amino acid transporter family exhibit diverse substrate selectivity and are expressed in variety of tissues. They play variety of physiological roles including epithelial transport of amino acids as well as the roles to provide cells in general with amino acids for cellular nutrition. The dysfunction or hyperfunction of the members of the heterodimeric amino acid transporter family are involved in some diseases and pathologic conditions. The genetic defects of the renal and intestinal transporters $b^{0,+}AT/BAT1\;(b^{0,+}-type\;amino\;acid\;transporter/b^{0,+}-type\;amino\;acid\;transporter\;1)$ and $y^+LAT1\;(y^+L-type\;amino\;acid\;transporter\;1)$ result in the amino aciduria with sever clinical symptoms such as cystinuria and lysin uric protein intolerance, respectively. LAT1 is proposed to be involved in the progression of malignant tumor. xCT (x-C-type transporter) functions to protect cells against oxidative stress, while its over-function may be damaging neurons leading to the exacerbation of brain damage after brain ischemia. Because of broad substrate selectivity, system L transporters such as LAT1 transport amino acid-related compounds including L-Dopa and function as a drug transporter. System L also interacts with some environmental toxins with amino acid-related structure such as cysteine-conjugated methylmercury. Therefore, these transporter would be candidates for drug targets based on new therapeutic strategies.
This study was carried out to investigate the relationship between tensed mandibular positions, muscle tenderness and EMG activity, respectively, and between range of motion of the neck and sternocleidomastoid muscle tenderness. Under stressful conditions, most of people take several types of behavioral patterns. Two of them observed frequently are clenching of teeth and grasping of fist. Prolonged clenching or grasping should increase electromyographic activity of associated muscle, especially muscles of mastication and neck muscles and will cause hyperfunction, dysfunction and muscle pain. So it is necessary to relate EMG activity with muscle pain. The author performed routine clinical examination in 47 patients with Temporomandibular Disorders, especially for presence or absence of muscle tenderness. Mandibular rest position was used as a baseline reference position and two more position in which EMG activity was taken were rest postion with grasping of fist and teeth clenching position. BioEMG of Biopak system (Bioresearch Inc, USA) was used for measuring of integrated EMG in masseter, anterior temporalis, anterior belly of digastic muscle and sternocleidomastoid muscle. To measure of the range of neck motion. CROM(Cervical-Range-of Motion, USA) was used. The obtained results were as follows : 1. EMG activity of all muscles except in masseter was higher in grasping of fist than those in rest position and there were significant correlation in EMG activity between the two position except in anterior belly of digastric muscle. 2. When comparing EMG activity between tender and non-tender muscle, all examined muscles did not show any significant difference. From this data, we could conclude that EMG activity was generally not changed with tenderness, of couse, it might be dependent with degree of muscle tenderness. 3. Number of tender points in examined muscles was also not significantly different between in patients with masticatory muscle disorders and in patients with internal derangement. 4. Cervical posture and range of motion of the neck was not differed significantly between in patients with and in patients without tenderness of sternocleidomastoid muscle.
I got the following result from the bibliographic study about the meaning of Hwa(火) and Hwa- byung(火病) at the concept and the aspect of pathological and etiological factors.The results are as follows.1. The pathological characteristics of Hwa(火) mean the inflammed state, the excited mental condition and perinervous hyperfunction caused by exopathy produced by any of the six extermal etiological factors(外感六淫) and Hwa caused by interior injury(內傷火熱).2. Hwa caused by the fire emotions(五志之火); anger, gladness, contemplation, sadress, fear by menta complications brings to Hwa caused by the five viscera(五臟之火) and Hwa caused by the stagnation of the liver - energy(肝鬱之火) is the rpresentive Hwa caused by the five viscera and the six hollow organs(贓腑之火).3. A symptom caused by a pathogenic Hwa(火證) is understood in a pathological sense involved an inflammed disease and is considered as a pathological state of excess syndrome(實證) caused by exterior Hwa( 外火).4. The pathologic process of Hwa-byung(火病) as the mental disease is based upon our people's emotion; Han(恨) to be pathologized without being overcome and can be considered as the process of Hwa caused by long-term(鬱久而火化).5. Hwa-byung(火病) means a psychosomatic disorder resulting from stress reaction caused by personal relations in the climacterium.Form the above mentioned study, the meaning of Hwa(火) and Hwa-byung(火病) is set theoretically and it also needs to be maintained reserching and studying about Hwa-byung(火病) consistantly.
The theory of liver by Jang suk-sun[張錫純] is that first, although liver exists at right side of body and spleen at left anatomically, function of liver presents at left side of body and function of spleen at right based on principle of 'interdependence between eum and yang' and 'join strength with elasticity', and in the relation between liver and spleen, if gi of spleen ascends, gi of liver also ascends, and if gi of stomach descents, gi of gall bladder also descents. So. care of spleen and stomach becomes main point in treating disease of liver. The meaning of 'the liver being in charge of the evaporation'[肝主氣化] is that first, it raises the primordial gi and forms the 'great g' for it's circulation of whole body. Second., it excretes the functional activity of gi and connects heart with kidney and guides the evaporation of the whole body by connecting innate nature with acquired nature. Third, 'the liver being in charge of the evaporation' is realized by the help of spleen and stomach. And he said that this functional activity of gi is one of distinctive features that distinguish Oriental medicine from Western medicine. He discoursed upon physiology of 'the liver being in charge of the evaporation' and 'the Body belonged to yin and the Use belonged to yang' after seeing an evil of abusing drugs that calm the liver and check hyperfunction of liver by contemporary doctors. And he established a treat of 'warming and recuperating the gi of liver' [溫補肝氣法] and used it for symptoms of 'deficiency of liver-gi'[肝氣虛], 'exhaution of liver-gi'[肝氣脫], and 'the liver-cold'[肝寒證].
According to the original documents, Sagungsan is considered as an effective drug for controlling the hypertensive epistaxis induced by tension of autonomic nerve and it's hyperfunction. The present experiment was designed to understand the effect of Sagungsan extract on the hemostatic action, intracranial pressure, blood pressure and cardiovascular system in experimental animals. And thus the bleeding time, prothrombin time, capillary dilation, blood pressure, Intracranial pressure, and enzymatic analysis of the ATPase activities were studied. The result obtained here were as followings: 1. Sagungsan water extract reduced the bleeding time in mouse, and prolonged the prothrombin time in rabbits. 2. The drug extract increased the tail volume by capillary dilation in rats. 3. The drug extract inhibited the increase of intracranial pressure and arterial blood pressure in rabbits. 4. At the early time, the increase of arterial blood pressure by the drug extract significantly inhibited by pretreated atropin and regitine in rabbits. 5. The drug extract relaxed the smooth muscle by stimulating the Mg2+-Ca2+-ATPase activities of gastric sarcoplasmic reticulum isolated from rabbit stomach. 6. The drug extract stimulated the heart contraction by inhibiting the $Mg^{2+}-Ca^{2+}-ATPase$ activities of cardiac sarcoplasmic reticulum isolated from rabbit heart. The inhibitory mechanism was reversible and noncompatitive. 7. The drug extract increased the hepatic blood volume by stimulating the hepatic total ATPase activities and hepatic metabolism. 8. The drug extract acted as a tranquilizer by inhibiting the neural Na+-K+-ATPase activity. According to the results, Sagungsan water extract dilated the capillaries, stimulated the heart beat, and thus increased the blood flow with decreasing the intracranial pressure and blood pressure. These effects stanches the epistaxis collectively.
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