Abstract Background Individuals with spinocerebellar ataxia type 3 (SCA3) present communication and swallowing disorders, and consequent deterioration in quality of life (QOL). Objective To evaluate the impact of a speech therapy rehabilitation program on the QOL of patients with SCA3. Methods All participants were randomly assigned to two groups, an intervention group receiving speech therapy (STG) and a control group (CG). The International Cooperative Ataxia Rating Scale scores were 32.4 ± 20.2, and the Scale for the Assessment and Rating of Ataxia scores were 11.8 ± 8.0. The intervention consisted of a 12-session speech therapy rehabilitation program with oral, pharyngeal, and laryngeal strengthening exercises—the so-called ATAXIA–Myofunctional Orofacial and Vocal Therapy (A-MOVT). They all were submitted to pre- and postintervention evaluations using the World Health Organization's Quality of Life (WHOQOL-BREF) assessment, as well as the Living with Dysarthria (LwD), Quality of Life in Swallowing Disorders (SWAL-QOL), and Food Assessment Tool (EAT-10). Results The study sample consisted of 48 patients with SCA3 (STG = 25; CG = 23), mean age was 47.1 ± 11.4 years; mean age at symptom onset was 36.9 ± 11.3 years; disease duration was 11.9 ± 13.3 years. After the 3-month intervention, there were significant changes in the QOL in the STG compared with the CG, when assessed by the LwD (179.12 ± 62.55 vs. 129.88 ± 51.42, p < 0.001), SWAL-QOL (869.43 ± 153.63 vs. 911.60 ± 130.90, p = 0.010), and EAT-10 (5.16 ± 7.55 vs. 2.08 ± 3.85, p = 0.018). Conclusions Patients with SCA3 should receive continuous speech therapy as part of the A-MOVT program, because therapy helps to improve difficulty swallowing and dysarthria.

Resumo Antecedentes Indivíduos com ataxia espinocerebelar tipo 3 (AEC3) apresentam distúrbios da comunicação e deterioração da deglutição e, consequentemente, na qualidade de vida (QV). Objetivo Avaliar o impacto de um programa de reabilitação fonoaudiológica na QV em pacientes com AEC3. Métodos Todos os participantes foram alocados aleatoriamente em dois grupos, um grupo intervenção que recebeu terapia fonoaudiológica (GTF) e um grupo controle (GC). As pontuações das escalas: International Cooperative Ataxia Rating Scale (ICARS) foram 32,4 ± 20,2 e da Scale for the Assessment and Rating of Ataxia (SARA) foram 11,8 ± 8,0. A intervenção consistiu em um programa de reabilitação fonoaudiológica de 12 sessões composto por exercícios de fortalecimento oral, faríngeo e laríngeo - denominados ATAXIA - Terapia Miofuncional Orofacial e Vocal (A-TMOV). Todos foram submetidos a avaliações pré e pós-intervenção por meio dos protocolos World Health Organization's Quality of Life (WHOQOL-BREF), Vivendo com Disartria (VcD), Quality of Life in Swallowing Disorders (SWAL-QOL) e Food Assessment Tool (EAT-10). Resultados A amostra foi composta por 48 pacientes com AEC3 (25 no GTF e 23 no GC), média de idade 47,1 ± 11,4anos; média de idade de início dos sintomas 36,9 ± 11,3anos; duração da doença 11,9 ± 13,3anos. Após intervenção de três meses, houve mudanças significativas na QV no GTF em comparação com o GC quando avaliado pelo VcD (179,12 ± 62,55 versus129,88 ± 51,42, p < 0,001), SWAL-QOL (869,43 ± 153,63 versus 911,60 ± 130,90, p = 0,010), EAT-10 (5,16 ± 7,55 versus 2,08 ± 3,85, p = 0,018). Conclusões Pacientes com AEC3 devem receber terapia fonoaudiológica contínua como parte do programa A-TMOV, pois a terapia ajuda a melhorar a dificuldade de deglutição e a disartria.

Resumo Introdução: Dificuldades ou limitações na produção de sons agudos durante o canto podem ser decorrentes da técnica vocal utilizada ou de fatores orgânicos. A observação dessa dificuldade ou limitação pelos professores de canto é uma das principais razões pelas quais os indivíduos afetados são encaminhados aos otorrinolaringologistas. Objetivo: Avaliar as alterações laringoestroboscópicas e eletromiográficas no músculo cricotireóideo de cantores com dificuldades ou limitações na produção de sons agudos. Método: Estudo de coorte transversal. Dez cantores com dificuldade de produzir sons agudos foram submetidos a avaliações de voz, laringoestroboscópicas e eletromiográficas. Resultados: Nenhum dos cantores avaliados apresentou sinais de comprometimento do nervo laríngeo superior na laringoestroboscopia. Os achados eletromiográficos para o músculo cricotireóideo foram normais para todos os cantores. Seis cantores apresentaram lesões nas pregas vocais, sete apresentaram sinais sugestivos de refluxo laringofaríngeo e dois apresentaram alterações vasculares. Conclusão: Não foram observados sinais sugestivos de paresia ou paralisia do nervo laríngeo superior na laringoestroboscopia e eletromiografia do músculo cricotireóideo em cantores com dificuldades ou limitações na produção de sons agudos. A presença de lesões nas pregas vocais deve ser investigada nessa população.

Abstract Introduction: Difficulties or limitations in producing high-pitched sounds while singing may be due to the vocal technique used or organic factor. The observation of such difficulty or limitation by singing teachers is one of the main reasons affected individuals are referred to otolaryngologists. Objective: To evaluate the laryngostroboscopic and electromyographic changes in the cricothyroid muscles of singers with difficulties or limitations producing high-pitched sounds. Methods: This is a cross-sectional study. Ten singers with difficulty producing high-pitched sounds underwent voice, laryngostroboscopic, and electromyographic evaluations. Results: None of the evaluated singers presented signs of impairment of the superior laryngeal nerve on laryngostroboscopy. The electromyographic findings for the cricothyroid muscle were normal for all singers. Six singers presented vocal fold lesions, seven had signs suggestive of laryngopharyngeal reflux, and two presented vascular changes. Conclusion: No signs suggestive of superior laryngeal nerve paresis or paralysis were observed on laryngostroboscopy and electromyography of the cricothyroid muscle in singers with difficulties or limitations producing high-pitched sounds. The presence of vocal fold lesions should be investigated in this population.

ABSTRACT “Sasam (沙參)” is a crude drug that is defined in the in Korean Herbal Pharmacopoeia as the root of Adenophora triphylla var. japonica (Regel.) Hara or A. stricta Miq., Campanulaceae. The dried roots of the Adenophora spp. are available in markets, and the roots of various species are similar to each other in shape, making it difficult to distinguish one from another using only the outer morphological appearance. Therefore, the present study aimed to establish quality control parameters for pharmacognostic evaluation and differentiation of five Adenophora species and two varieties grown in Korea. Inner morphological evaluation of the root of these plants was accomplished and preliminary chemical analysis was performed by liquid chromatography-mass spectrometry profiling. As a result, significant differences among samples were found in anatomical characteristics such as number and thickness of cork layer, existence of stone cell in cork layer, frequency of vessels, and area of intercellular space. Significant differences were found among the samples in the content of three components including shashenoside I and a new alkyl glycoside, adenophoroside I. These findings could provide the scientific criteria for the proper identification and establishment of standards for the use of “Sasam”.

Resumo Introdução A síndrome da apneia obstrutiva do sono e o refluxo laringofaríngeo são doenças com alta prevalência na população em geral. No entanto, ainda não está claro se são doenças com os mesmos fatores de risco presentes nas mesmas populações ou se há alguma relação entre elas. Objetivo Avaliar e determinar a prevalência de refluxo laringofaríngeo em pacientes com síndrome da apneia obstrutiva moderada e acentuada, bem como determinar os fatores preditivos de refluxo nesses pacientes. Método Estudo de coorte histórica com corte transversal de pacientes entre 18 e 70 anos, encaminhados a um ambulatório de Otorrinolaringologia em serviço terciário, com diagnóstico polissonográfico de síndrome da apneia obstrutiva do sono moderada ou acentuada. Foram aplicados o questionário Reflux Sympton Index e o escore de achados endolaríngeos por meio de videolaringoscopia indireta na população estudada, respeitando os critérios de inclusão e exclusão. Resultados Foram avaliados 56 pacientes, dos quais 64,3% apresentaram refluxo laringofaríngeo (Reflux Sympton Index positivo e/ou Reflux Finding Score positivo). O índice de massa corpórea foi fator preditor da presença de refluxo laringofaríngeo nesse grupo de pacientes com síndrome da apneia obstrutiva do sono moderada e acentuada. Nos pacientes cujos Reflux Sympton Index e o escore de achados endolaríngeos foram positivos (12,3%), houve uma tendência à significância para maior índice de apneia e hipopneia e maior porcentagem do tempo de sono com saturação de oxi-hemoglobina abaixo de 90% (p = 0,05). Conclusão A prevalência de refluxo laringofaríngeo foi alta nesse grupo de pacientes com síndrome da apneia obstrutiva do sono moderada e acentuada e o índice de massa corpórea foi fator preditor de refluxo nesses pacientes. Houve uma tendência a maior dessaturacão de oxi-hemoglobina em pacientes com "índice de sintomas de refluxo" e escore de achados endolaríngeos positivos.

Abstract Introduction Obstructive sleep apnea syndrome and laryngopharyngeal reflux are diseases with a high prevalence in the overall population; however, it remains unclear whether they are diseases with the same risk factors present in the same populations or if there is any association between them. Objectives To evaluate and determine the prevalence of laryngopharyngeal reflux in patients with moderate and severe obstructive apnea syndrome and also to determine its predictive factors. Methods Historical cohort, cross-sectional study of patients aged 18-70 years, referred to a tertiary service Otorhinolaryngology outpatient clinic with a polysomnographic diagnosis of moderate or severe obstructive sleep apnea syndrome. The reflux symptom index questionnaire and the reflux finding score at indirect videolaryngoscopy were applied to the assessed population, considering the inclusion and exclusion criteria. Results Fifty-six patients were evaluated, of which 64.3% had a positive laryngopharyngeal reflux (positive reflux symptom index and/or positive endolaryngeal reflux finding score). Body mass index was a predictor of reflux presence in this group of patients with moderate to severe obstructive sleep apnea syndrome. In patients with positive score for endoscopic findings and reflux symptom index (12.3%), there was a trend toward significance for a higher mean apnea-hypopnea index and a higher percentage of sleep time with oxyhemoglobin saturation below 90% (p = 0.05). Conclusion The prevalence of laryngopharyngeal reflux was higher in this group of patients with moderate to severe obstructive sleep apnea syndrome, and the body mass index was a predictor of laryngopharyngeal reflux in these patients. There was a trend toward greater oxyhemoglobin desaturation in patients with a positive score for reflux symptoms index (RSI) and reflux finding score (RFS).

Abstract Introduction Many recent studies on teachers warn of the adverse effects that voice problems have on work performance. However, only a few of these studies included university teachers. Objective To compare the vocal symptoms and risk factors betweenmale and female university teachers in a private institution within the city of São Paulo. Methods In a cross-sectional survey, a voice self-evaluation form prepared by the Ministry of Labor in Brazil was administered to 846 university teachers at a private institution in the city of São Paulo. Results The percentage of hoarseness, vocal tract discomfort, neck pain and foreign body sensation was significantly higher in female than in male subjects. A significantly higher percentage of males participated in other professional activities in addition to teaching, reported working in a calm environment compared with working in a moderately or severely tense and stressful environment, and rated themselves as calm, slightly stressed and anxious ormoderately stressed and anxious rather than very stressed and anxious. A significantly higher percentage of females spent most of their time teaching compared with performing other professional activities, and rated themselves as chatty or impulsive. Conclusion Among university teachers, a significantly higher percentage of females than males reported hoarseness, vocal tract discomfort, neck pain and foreign body sensation. Some risk factors related to work organization, workplace environment, voice care and quality of life variables were related to this higher prevalence in females.

Resumo Introdução: A distribuição, concentração e função dos glicosaminoglicanos nos diversos tecidos da prega vocal ainda não está esclarecida. Objetivo: Avaliar a distribuição e concentração dos glicosaminoglicanos sulfatados nas diferentes camadas da prega vocal humana de acordo com o sexo e a idade. Método: Foram usadas 11 pregas vocais obtidas de cadáveres (sete homens e quatro mulheres) sem lesão de laringe, com menos de 12 horas de óbito e entre 35 e 98 anos. As pregas foram submetidas à extração de glicosaminoglicanos da cobertura e ligamento e leitura pós-eletroforese. Os dados foram comparados segundo camada, idade e sexo. Resultados: A concentração de dermatan sulfato foi significativamente maior em todas as camadas. Não foram observadas diferenças nas concentrações totais de glicosaminoglicanos nas camadas estudadas quanto ao gênero. É significantemente menor em indivíduos abaixo de 60 anos na cobertura. Conclusão: Dermatam sulfato, condroitim sulfato e heparam sulfato foram observados na cobertura e no ligamento de pregas vocais humanas, de ambos os sexos, sendo a concentração de dermatam sulfato foi significativamente maior em todas as camadas. A concentração de glicosaminoglicanos na cobertura é significativamente menor em indivíduos abaixo de 60 anos em comparação com idosos.

Abstract Introduction: The distribution, concentration and function of glycosaminoglycans in the various vocal fold tissues are still unclear. Objective: To evaluate the distribution and concentration of sulfated glycosaminoglycans in different layers of the human vocal fold according to gender and age. Methods: We used 11 vocal folds obtained from cadavers (7 men and 4 women) with no laryngeal lesion, less than 12 h after death, and aged between 35 and 98 years. The folds underwent glycosaminoglycans extraction from the cover and ligament, and post-electrophoresis analysis. Data were compared according to the layer, age and gender. Results: The concentration of dermatan sulfate was significantly higher in all layers. No differences were observed in the total concentrations of glycosaminoglycans in layers studied according to gender. It is significantly lower in the cover of individuals aged below 60 years. Conclusion: Dermatan sulfate, chondroitin sulfate, and heparan sulfate were observed in the human vocal folds cover and ligament of both genders, with the concentration of dermatan sulfate being significantly higher in all layers. Glycosaminoglycans concentration on the cover is significantly lower in individuals below 60 years compared with elderly.

ABSTRACT Mori folium, the leaf of Morus alba L. (Moraceae), has been traditionally used for various medicinal purposes from ancient times to the present. In this study, we examined the effects of water extract of Mori folium (WEMF) on the production of inflammatory mediators, such as nitric oxide (NO) and prostaglandin E2 (PGE2), and reactive oxygen species (ROS) in lipopolysaccharide (LPS)-stimulated murine RAW 264.7 macrophages. Our data indicated that WEMF significantly suppressed the secretion of NO and PGE2 in RAW 264.7 macrophages without any significant cytotoxicity. The protective effects were accompanied by a marked reduction in their regulatory gene expression at the transcription level. WEMF attenuated LPS-induced intracellular ROS production in RAW 264.7 macrophages. It inhibited the nuclear translocation of the nuclear factor-kappa B p65 subunit and the activation of mitogen-activated protein kinases in LPS-treated RAW 264.7 macrophages. Furthermore, WEMF reduced LPS-induced NO production and ROS accumulation in zebrafish. Although more efforts are needed to fully understand the critical role of WEMF in the inhibition of inflammation, the findings of the present study may provide insights into the approaches for Mori folium as a potential therapeutic agent for inflammatory and antioxidant disorders.

Background: The melanocortin-4 receptor gene (MC4R) plays an important role in regulating food intake and body weight in mammals. In the present study, we identified the MC4R gene in native Korean brown, brindle, and black cattle by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP), and investigated its association with economic traits. A total of 413 cattle from the three breeds were tested for backfat thickness, carcass weight, longissimus muscle area, and marbling score, and statistical data were analyzed using the SAS program. Results: The C allele had the highest frequency in brown and brindle cattle, and the G allele frequency was highest in black cattle. The C1069G SNP was significantly (p < 0.05) associated with only marbling scores in brown and brindle cattle but no significant association was detected between the marbling scores and polymorphism in black cattle. Conclusions: These results suggest that a C1069G SNP of the MC4R gene may be useful as a genetic marker for marbling scores in Korean brown and brindle cattle.