Biomedical subjects

H Larsson

Publications and source records attributed to H Larsson.

At least 19 recordsLinked to original sources

PubMed2006

Risk of bacteraemia and mortality in patients with haematological malignancies.

This study examined the association between type of haematological malignancy, risk of bacteraemia and risk of mortality, with emphasis on the impact of bacteraemia type on mortality. A population-based cohort design was used, and all patients aged > or = 15 years with an incident haematological malignancy who were living in North Jutland County, Denmark, during 1992-2002 were included in the study. Among 1666 patients with an incident haematological malignancy, 358 (21%) suffered an episode of bacteraemia during a median follow-up period of 1.1 years (quartile 0.2-3.4) from the date of cancer diagnosis (overall incidence rate of 96/1000 person-years). In comparison to Hodgkin's disease, adjusted incidence rate ratios (IRRs) were 23.3 (95% CI, 10.0-54.5) for acute myeloid leukaemia, 3.8 (95% CI, 1.5-9.3) for multiple myeloma, and 2.2 (95% CI, 0.9-5.1) for non-Hodgkin's lymphoma or chronic lymphatic leukaemia. Overall cumulative 30-day mortality was 32% (95% CI, 27-37), and 90-day mortality was 50% (95% CI, 44-55). In comparison with acute myeloid leukaemia, adjusted mortality rate ratios (MRRs) were close to 1.0 for other haematological malignancies. In comparison to bacteraemia caused by Gram-positive bacteria, adjusted MRRs were 1.0 (95% CI, 0.6-1.5) for Gram-negative bacteraemia, and 1.9 (95% CI, 1.1-3.3) for polymicrobial bacteraemia or fungaemia. Thus, the risk of bacteraemia varied greatly according to the type of malignancy, while mortality rates were similar for these diseases, although dependent on the type of bacteraemia. Polymicrobial bacteraemia or fungaemia was associated with higher mortality.

Adolescent↗

PubMed2001

Wheelchair seating intervention. Results from a client-centred approach.

PURPOSE: The aim of this study was to analyse the effects of wheelchair intervention from a client-centred perspective. METHOD: Results from 38 consecutive active wheelchair users visiting the wheelchair-seating department at the University Hospital in Linköping, Sweden, were analysed and described. All clients had defined problems related to wheelchair seating. Back pain was estimated before intervention and at follow-up, using a Visual Analogue Scale. The effect of intervention on different aspects of wheelchair functionality, seating and occupational performance was estimated by the clients at follow-up. RESULTS: Two initial main problem areas were identified among the group; seating discomfort (87%) and back pain (63%). Back pain was significantly reduced at follow-up (p<0.001). Problems initially defined by the clients, e.g. seating discomfort, were affected positively, in 79% of all clients, as estimated by the clients at follow-up. No significant correlation was found between the initial cause of intervention or the highest ranked wheelchair functionality aspect and final acceptance of intervention. CONCLUSIONS: The results from this study confirm the possibility of reducing, or even eliminating, common secondary problems such as back pain and discomfort, related to wheelchair seating by individually adjusted measures. Further research and development in this field is both necessary and cost-effective.

Adult↗

PubMed2001

A novel anti-angiogenic form of antithrombin with retained proteinase binding ability and heparin affinity.

Latent antithrombin, an inactive antithrombin form with low heparin affinity, has previously been shown to efficiently inhibit angiogenesis and tumor growth. We now show that heat treatment similar to that used for preparation of latent antithrombin also transforms antithrombin to another form, which we denote prelatent, with potent anti-angiogenic and anti-tumor activity but with retained proteinase- and heparin-binding properties. The ability of prelatent antithrombin to inhibit angiogenesis is presumably due to a limited conformational change, which may partially resemble that in latent antithrombin. Such a change is evidenced by a different cleavage pattern of prelatent than of native antithrombin by nontarget proteinases. Prelatent antithrombin exerts its anti-angiogenic effect by a similar mechanism as latent antithrombin, i.e. by inhibiting focal adhesion formation and focal adhesion kinase activity, thereby leading to decreased proliferation of endothelial cells. The proteinase inhibitory fractions in commercial antithrombin preparations, which have been heat treated during production, also have anti-angiogenic activity, comparable with that of the prelatent antithrombin form.

Angiogenesis Inhibitors↗

PubMed2001

Impaired glucose tolerance (IGT) is associated with reduced insulin-induced suppression of glucagon concentrations.

AIMS/HYPOTHESIS: We aimed to examine whether impaired glucose tolerance is associated with reduced suppression of glucagon concentrations. METHODS: Eighty-four non-diabetic women of Caucasian origin and 61 years of age, of whom 48 had normal glucose tolerance (NGT) and 36 had IGT, underwent a 75 g OGTT and a hyperinsulinaemic, euglycaemic clamp with measurement of glucagon, insulin and glucose concentrations. RESULTS: At 2 h after 75 g oral glucose, glucagon concentrations were reduced by 7.1 +/- 1.1 ng/l in NGT vs 8.0 +/- 1.4 ng/l in IGT, (NS). However, the 2 h reductions in glucagon per mmol/l increase in 2 h glucose or per pmol/l increase in 2 h insulin were both impaired in IGT (p = 0.002 and p = 0.043, respectively) because the 2 h increases in glucose and insulin were higher in IGT than in NGT. Furthermore, suppression of glucagon concentrations during a euglycaemic clamp at hyperinsulinaemic concentrations (NGT: 607 +/- 19 pmol/l, IGT: 561 +/- 21 pmol/l) was lower in IGT (13.6 +/- 1.6 ng/l) than in NGT (23.1 +/- 1.2 ng/l; p < 0.001). The suppression of glucagon concentrations during the hyperinsulinaemic, euglycaemic clamp correlated with insulin sensitivity (r = 0.24, p = 0.027) and with the 2 h glucose value during the OGTT (r = -0.52, p < 0.001). CONCLUSION/INTERPRETATION: Impaired glucose tolerance is associated with reduced insulin-induced suppression of glucagon secretion, which could be caused by A-cell insulin resistance. Inappropriately high glucagon secretion could therefore contribute to the metabolic perturbations in IGT.

Area Under Curve↗

PubMed2001

Semitendinosus muscle in anterior cruciate ligament surgery: Morphology and function.

PURPOSE: To evaluate the fate of the hamstring muscles in general and the semitendinosus muscle in particular, after anterior cruciate ligament (ACL) reconstruction with an autologous semitendinosus tendon graft from the ipsilateral side. TYPE OF STUDY: Prospective consecutive case series investigation. METHODS: Included were 16 consecutive patients, 14 male and 2 female, with a mean age of 26 years. The inclusion criterion was chronic unilateral ACL insufficiency with no concomitant knee ligament injuries. ACL reconstruction was performed with a quadruple semitendinosus tendon graft using the EndoButton technique (Acufex, Mansfield, MA). Intraoperatively, muscle specimens were taken from the semitendinosus muscle on the harvested side. Follow-up at a minimum of 6 months included clinical examination, isokinetic strength performance, magnetic resonance imaging (MRI) of the thigh and knee, and ultrasound-guided muscle biopsy procurement from the semitendinosus muscle for histochemical and enzymatic analyses. RESULTS: Of the patients, 75% showed regeneration of their semitendinosus tendons. The neotendons all inserted below the knee joint where they had fused with the gracilis tendon to a conjoined tendon inserting in the pes anserinus. The semitendinosus muscle had a smaller cross-sectional area on the operated side but none showed total atrophy. Less atrophy was present in the patients with a regenerated semitendinosus neotendon compared with those without regeneration (P =.029). In the latter group the semimembranosus muscle seemed to compensate for this with hypertrophy (P =.019). Cross-sectional muscle fiber areas, the relative number of each fiber type and oxidative potential as estimated by citrate synthase activity, showed no significant differences between the operated and nonoperated legs. The isokinetic strength of the hamstrings and quadriceps was significantly lower in the operated leg than in the nonoperated leg. CONCLUSIONS: With this surgical technique, the semitendinosus muscle can recover and the tendon has, according to the MRI images, a great potential to regenerate after its removal.

Adolescent↗

PubMed2001

Comparison of starch branching enzyme I and II from potato.

The in vitro activities of purified potato starch branching enzyme (SBE) I and II expressed in Escherichia coli were compared using several assay methods. With the starch-iodine method, it was found that SBE I was more active than SBE II on an amylose substrate, whereas SBE II was more active than SBE I on an amylopectin substrate. Both enzymes were stimulated by the presence of phosphate. On a substrate consisting of linear dextrins (chain length 8-200 glucose residues), no significant net increase in molecular mass was seen on gel-permeation chromatography after incubation with the enzymes. This indicates intrachain branching of the substrate. After debranching of the products, the majority of dextrins with a degree of polymerization (dp) greater than 60 were absent for SBE I and those with a dp greater than 70 for SBE II. To study the shorter chains, the debranched samples were also analysed by high-performance anion-exchange chromatography. The products of SBE I showed distinct populations at dp 11-12 and dp 29-30, whereas SBE II products had one, broader, population with a peak at dp 13-14. An accumulation of dp 6-7 chains was seen with both isoforms.

1,4-alpha-Glucan Branching Enzyme↗

PubMed2001

The semitendinosus tendon regenerates after resection: a morphologic and MRI analysis in 6 patients after resection for anterior cruciate ligament reconstruction.

Recently, the surprising observation has been made, supported by clinical and MRI findings, that the semitendinosus tendon can regenerate after being harvested in its whole length and thickness for anterior cruciate ligament reconstruction. We studied 6 patients with previous anterior cruciate ligament reconstruction, using a quadruple semitendinosus tendon autograft. In 5 of these, physical examination and MRI showed that the tendond had regenerated. In all 6 patients, the findings were documented macroscopically by open surgical exploration and in the 5 regenerated tendons, also morphologically by biopsies. Macroscopically, histologically and immunohistochemically the regenerated tendons closely resembled normal ones with focal scar-like areas. Our present findings and earlier studies show that full length and thickness harvesting of the semitendinosus tendon in most cases result in full-length tendon regeneration with tissue closely resembling the normal tendon.

Adolescent↗

PubMed2001

Echocardiographic assessment of arrhythmogenic right ventricular cardiomyopathy.

OBJECTIVE: To evaluate new echocardiographic modes in the diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC). DESIGN: Prospective observational study. SETTING: University Hospital. SUBJECTS: 15 patients with ARVC and a control group of 25 healthy subjects. METHODS: Transthoracic echocardiography included cross sectional measurements of the right ventricular outflow tract, right ventricular inflow tract, and right ventricular body. Wall motion was analysed subjectively. M mode and pulsed tissue Doppler techniques were used for quantitative measurement of tricuspid annular motion at the lateral, septal, posterior, and anterior positions. Doppler assessment of tricuspid flow and systemic venous flow was also performed. RESULTS: Assessed by M mode, the total amplitude of the tricuspid annular motion was significantly decreased in the lateral, septal, and posterior positions in the patients compared with the controls. The tissue Doppler velocity pattern showed decreased early diastolic peak annular (E(A)) velocity and an accompanying decrease in early (E(A)) to late diastolic (A(A)) velocity ratio in all positions; the systolic annular velocity was significantly decreased only in the lateral position. Four patients had normal right ventricular dimensions and three were judged to have normal right ventricular wall motion. The patient group had also a significantly decreased tricuspid flow E:A ratio. CONCLUSIONS: Tricuspid annular measurements are valuable, easy to obtain, and allow quantitative assessment of right ventricular function. ARVC patients showed an abnormal velocity pattern that may be an early but non-specific sign of the disease. Normal right ventricular dimensions do not exclude ARVC, and subjective detection of early changes in wall motion may be difficult.

Adult↗

PubMed2000

Antiangiogenic effects of latent antithrombin through perturbed cell-matrix interactions and apoptosis of endothelial cells.

Antithrombin is a plasma protein of the serpin superfamily that may occur as several conformational variants. The native form of antithrombin is a major regulator of blood clotting. In the present study, we have identified the mechanism underlying the antiangiogenic action of a heat-denatured form, denoted latent antithrombin. Fibroblast growth factor (FGF)-induced angiogenesis in the chick embryo and angiogenesis in mouse fibrosarcoma tumors were inhibited by treatment with latent antithrombin at 1 mg/kg/day. Thermolysin-cleaved and native antithrombin were less efficient in these respects. Treatment with latent antithrombin induced apoptosis of cultured endothelial cells and inhibited cell migration toward FGF-2. Under these conditions, FGF-2-stimulated FGF receptor kinase activity was unaffected. However, actin reorganization, activation of focal adhesion kinase, and focal adhesion formation were disturbed by latent antithrombin treatment of FGF-2-stimulated endothelial cells. These data indicate that latent antithrombin induces apoptosis of endothelial cells by disrupting cell-matrix interactions through uncoupling of focal adhesion kinase.

Allantois↗

PubMed2000

Endostatins derived from collagens XV and XVIII differ in structural and binding properties, tissue distribution and anti-angiogenic activity.

Endostatin is a fragment of the C-terminal domain NC1 of collagen XVIII that inhibits angiogenesis and tumor growth. We report the characterization of a collagen XV endostatin analogue and its parent NC1 domain, obtained by recombinant expression in mammalian cells. Both NC1 domains contain a trimerization domain, a hinge region that is more sensitive to proteolysis in collagen XVIII and the endostatin domain. Unlike endostatin-XVIII, endostatin-XV does not bind zinc or heparin, which is explained by the crystal structure of endostatin-XV. The collagen XV and XVIII fragments inhibited chorioallantoic membrane angiogenesis induced by basic fibroblast growth factor (FGF-2) or vascular endothelial growth factor (VEGF), but there are striking differences depending on which cytokine is used and whether free endostatins or NC1 domains are applied. The collagen XV and XVIII fragments showed a similar binding repertoire for extracellular matrix proteins. Differences were found in the immunohistological localization in vessel walls and basement membrane zones. Together, these data indentify endostatin-XV as an angiogenesis inhibitor, which differs from endostatin-XVIII in several important functional details.

Amino Acid Sequence↗

PubMed2000

Selectively desulfated heparin inhibits fibroblast growth factor-induced mitogenicity and angiogenesis.

Fibroblast growth factors (FGFs) are known to induce formation of new blood vessels, angiogenesis. We show that FGF-induced angiogenesis can be modulated using selectively desulfated heparin. Chinese hamster ovary cells (CHO677) deficient in heparan sulfate biosynthesis were employed to assess the function of heparin/heparan sulfate in FGF receptor-1 (FGFR-1) signal transduction and biological responses. In the presence of FGF-2, FGFR-1 kinase and subsequent mitogen-activated protein kinase Erk2 activities were augmented in a dose-dependent manner, whereas high concentrations of heparin resulted in decreased activity. The length of the heparin oligomer, minimally an 8/10-mer, was critical for the ability to enhance FGFR-1 kinase activity. The N- and 2-O-sulfate groups of heparin were essential for binding to FGF-2, whereas stimulation of FGFR-1 and Erk2 kinases by FGF-2 also required the presence of 6-O-sulfate groups. Sulfation at 2-O- and 6-O-positions was moreover a prerequisite for binding of heparin to a lysine-rich peptide corresponding to amino acids 160-177 in the extracellular domain of FGFR-1. Selectively 6-O-desulfated heparin, which binds to FGF-2 but fails to bind the receptor, decreased FGF-2-induced proliferation of CHO677 cells, presumably by displacing intact heparin. Furthermore, FGF-2-induced angiogenesis in chick embryos was inhibited by 6-O-desulfated heparin. Thus, formation of a ternary complex of FGF-2, heparin, and FGFR-1 appears critical for the activation of FGFR-1 kinase and downstream signal transduction. Preventing complex formation by modified heparin preparations may allow regulation of FGF-2 functions, such as induction of angiogenesis.

Allantois↗

PubMed2000

Endostatin-induced tyrosine kinase signaling through the Shb adaptor protein regulates endothelial cell apoptosis.

Endostatin, which corresponds to the C-terminal fragment of collagen XVIII, is a potent inhibitor of angiogenesis. Fibroblast growth factor-2 (FGF-2)-induced angiogenesis in the chicken chorioallantoic membrane was inhibited by endostatin, but not by an endostatin mutant R158/270A, lacking heparin-binding ability. Endostatin was internalized by endothelial cells, but not by mouse fibroblasts. Treatment of murine brain endothelial (IBE) cells with endostatin reduced the proportion of cells in S phase, whereas growth-arrested IBE cells in collagen gels treated with endostatin displayed enhanced tubular morphogenesis. IBE cells overexpressing Shb, an adaptor protein implicated in angiostatin-induced apoptosis, displayed elevated apoptosis and decreased tubular morphogenesis in collagen gels in response to endostatin when added together with FGF-2. Induction of apoptosis was dependent on the heparin-binding ability of endostatin and the expression of Shb with a functional Src homology 2 (SH2)-domain. Endostatin treatment for 10 minutes or 24 hours induced tyrosine phosphorylation of Shb and formation of multiprotein complexes. An Shb SH2 domain fusion protein precipitated a 125-kd phosphotyrosyl protein in endostatin-treated cells. The 125-kd component either contained intrinsic tyrosine kinase activity or occurred in complex with a tyrosine kinase. In conclusion, our data show that endostatin induces tyrosine kinase activity and enhanced apoptosis in FGF-treated endothelial cells.

Adaptor Proteins, Signal Transducing↗

PubMed2000

Glucose intolerance is predicted by low insulin secretion and high glucagon secretion: outcome of a prospective study in postmenopausal Caucasian women.

AIMS/HYPOTHESIS: To study the pathophysiological importance of changes in insulin sensitivity and islet function over time for alterations in glucose tolerance in a randomly selected large group of non-diabetic women aged 57-59 years over a 3-year period. METHODS: At baseline and at the 3-year follow-up, glucose tolerance (WHO 75 g oral glucose), insulin sensitivity (euglycaemic, hyperinsulinaemic clamp) and insulin and glucagon secretion (2 to 5-min responses to 5 g i.v. arginine at fasting, 14 and > 25 mmol/l glucose) were measured. RESULTS: At baseline, women with impaired glucose tolerance (IGT, n = 28) had lower insulin sensitivity (p = 0.048) than normal women (NGT, n = 58). The arginine-induced insulin responses (AIR) were inversely associated with insulin sensitivity (r > or = -0.55, p < 0.001). When related to the 3-year follow-up, the baseline product of AIR at 14 mmol/l glucose times insulin sensitivity, insulin effect index (IE) (r = -0.40, p < 0.001) and the arginine-induced glucagon response at 14 mmol/l glucose (AGR, r = 0.28, p = 0.009) both correlated with follow-up 2-h glucose. In a multiple regression model, baseline 2-h glucose, insulin effect index and arginine-induced glucagon response independently predicted 2-h glucose at follow-up (total r = 0.668, p < 0.001). Furthermore, delta insulin sensitivity (i. e. follow-up minus baseline) correlated with delta insulin secretion (r = -0.30, p = 0.006), whereas delta glucagon secretion correlated with delta2-h glucose (r = 0.30, p = 0.006) over the 3 years. In a multiple regression, alterations in 2-h glucose over the 3 years were independently determined by changes in fasting insulin and glucagon secretion (r = 0.424, p < 0.001). CONCLUSION/INTERPRETATION: Low insulin secretion, when judged in relation to insulin sensitivity, and high glucagon secretion, determine glucose tolerance over time in the individual subject. These processes are therefore potential targets for prevention of deterioration in glucose tolerance.

Analysis of Variance↗

PubMed2000

Prediction of diabetes using ADA or WHO criteria in post-menopausal women: a 10-year follow-up study.

AIMS/HYPOTHESIS: To study the risk of women with impaired fasting glucose (IFG) as against impaired glucose tolerance (IGT) developing diabetes. METHODS: Oral glucose tolerance tests (75 g) were done in 265 women selected at random at baseline (age 55-57 years) and at a 10-year follow-up. Of the women 42 had IFG/NGT (fasting glucose 6.1-6.9 mmol/l, 2-h glucose < 7.8 mmol/l), 66 IGT/ NFG (2-h glucose 7.8-11.0 mmol/l, fasting glucose < 6.1 mmol/1), 30 IGT/IFG and 127 NFG/NGT. RESULTS: The 10-year progression to diabetes was similar in IGT/NFG (12.1%) and IFG/NGT groups (11.9%, p = 0.97). In IGT/IFG, 20.0% had developed diabetes, which was not significantly higher than in IFG/NGT and IGT/NFG (p = 0.53). In NFG/ NGT at baseline, only 3.9 % had developed diabetes, which was lower than in the other groups (p = 0.023). CONCLUSION/INTERPRETATION: Fasting and 2-h glucose concentrations are equally good in predicting diabetes development over a 10-year period in Caucasian postmenopausal women. Because IGT is more common than IFG, measuring only fasting glucose concentrations would, however, result in missing a prediabetic stage in a large group of people at risk for diabetes and cardiovascular diseases.

Blood Glucose↗

PubMed2000

Overexpression of VEGF 121 in immortalized endothelial cells causes conversion to slowly growing angiosarcoma and high level expression of the VEGF receptors VEGFR-1 and VEGFR-2 in vivo.

Vascular endothelial growth factor (VEGF or vascular permeability factor) is an important angiogenic factor that is up-regulated in numerous benign and malignant disorders, including angiosarcoma, hemangiomas, and solid tumors. To determine the functional role of VEGF in the development of endothelial tumors, we expressed primate VEGF 121 in an endothelial cell line, MS1, derived from primary murine cells by immortalization with a temperature-sensitive SV40 large T antigen. This cell line expresses the VEGFR-2 (Flk-1/Kdr) receptor for VEGF. Expression of VEGF 121 led to the development of slowly growing endothelial tumors, which were histologically well-differentiated angiosarcomas. The angiosarcomas generated from MS1 VEGF cells demonstrated up-regulation of the VEGF receptors VEGFR-2 and VEGFR-1 (Flt-1) in vivo compared with benign hemangiomas generated from MS1 cells. Treatment of these cells with the VEGFR-2 tyrosine kinase inhibitor SU 1498 led to decreased expression of ets-1, a transcription factor which has been shown to be stimulated by VEGF. These results suggest that high level expression of VEGF in endothelial cells may result in malignant transformation. This transformation process likely involves both autocrine and paracrine pathways.

Animals↗

PubMed2000

Measurement of apolipoprotein E (apoE) in cerebrospinal fluid.

Apolipoprotein E (apoE) is a protein involved in transport of lipids and has been implicated to play an important role in regeneration after nerve injury. Determination of apoE in cerebrospinal fluid (CSF) thus have a potential interest when studying different forms of brain damage and as a marker of ongoing regenerative processes in the brain. However, previous studies on CSF-ApoE in Alzheimer's disease (AD) have given inconclusive results. Such inconsistent results might be related to confounding factors interfering with sample handling and/or analyses, which have not been fully elucidated. We therefore examined different potential confounding factors for analyses of apoE in CSF and also developed a new enzyme linked immunosorbent assay (ELISA). The hydrophobic character of ApoE resulted in adsorption to different types of test tubes commonly used for collection of CSF at lumbar puncture, resulting in falsely low levels. This makes CSF handling critical, especially if samples are taken in different types of tubes, or is transferred to new tubes. Taking this confounding factors in consideration and analysing patient and control CSF handled in the same way and using the new ELISA, we could confirm our previous finding of reduced levels of ApoE in AD, (3.4 +/- 1.3 mg/l) compared with controls (4.5 +/- 2.7 mg/l) (p = 0.045). Both in the AD and in the control group, higher levels of CSF-ApoE was found in individuals possessing the ApoE4 alleles. Our results support that CSF-ApoE is reduced in AD, and that handling of CSF is a critical factor, which may explain the discrepant results from previous studies. Differences in the amount of patients and controls possessing the ApoE4 allele included might also increase the variance between different studies.

Aged↗

PubMed2000

Revision total hip arthroplasty using third-generation cementing technique.

A total of 83 consecutive first-revision total hip arthroplasties were performed in 83 patients using pressurized vacuum-mixed cement, a third-generation cementing technique. At a median follow-up of 3.6 years (range, 1.5-6.3 years), the overall failure rates (radiographic loosening, re-revision, or both) were 39% for the femoral components and 30% for the acetabular components. With definite radiographic loosening as an endpoint, the cement-bone interface achieved was the only significant factor to predict stem durability, with an adjusted odds ratio of 1.8 (95% confidence interval, 1.1-3.0). On the acetabular side, bone stock was the only significant factor, with an adjusted odds ratio of 5.3 (95% confidence interval, 4.0-27.7). In this retrospective cohort study, femoral cement pressurization per se did not appear to improve the results over those of other studies using second-generation techniques.

Adult↗

PubMed2000

Vocal fold vibrations: high-speed imaging, kymography, and acoustic analysis: a preliminary report.

OBJECTIVES: To evaluate a new analysis system, High-Speed Tool Box (H. Larsson, custom-made program for image analysis, version 1.1, Department of Logopedics and Phoniatrics, Huddinge University Hospital, Huddinge, Sweden, 1998) for studying vocal fold vibrations using a high-speed camera and to relate findings from these analyses to sound characteristics. STUDY DESIGN: A Weinberger Speedcam + 500 system (Weinberger AG, Dietikon, Switzerland) was used with a frame rate of 1,904 frames per second. Images were stored and analyzed digitally. Analysis included automatic glottal edge detection and calculation of glottal area variations, as well as kymography. These signals were compared with acoustic waveforms using the Soundswell program (Hitech Development AB, Stockholm, Sweden). METHODS: The High-Speed Tool Box was applied on two types of high-speed recordings: a diplophonic phonation and a tremor voice. Relations between glottal vibratory patterns and the sound waveform were analyzed. RESULTS: In the diplophonic phonation, the glottal area waveform, as well as the kymogram, showed a specific pattern of repetitive glottal closures, which was also seen in the acoustic waveform. In the tremor voice, fundamental frequency (F0) fluctuations in the acoustic waveform were reflected in slow variations in amplitude in the glottal area waveform. For studying details of mucosal movements during these kinds of abnormal vibrations, the glottal area waveform was particularly useful. CONCLUSIONS: Our results suggest that this combined high-speed acoustic-kymographic analysis package is a promising aid for separating and specifying different voice qualities such as diplophonia and voice tremor. Apart from clinical use, this finding should be of help for specification of the terminology of different voice qualities.

Acoustics↗