[Eosinophilic esophagitis: a rare cause of dysphagia]. / Œsophagite à éosinophiles: une cause rare de dysphagie.

Eosinophilic esophagitis is an unrecognized and emerging entity. Its incidence increases with allergic disorders. A 29-year-old man presented with a 4-year history of intermittent and paroxysmal dysphagia. The triad including allergy, young age, and impaction of foreign bodies, combined with a chronic dysphagia is almost pathognomonic of eosinophilic esophagitis. Endoscopic esophageal features can be diverse, so systematic esophageal biopsies are required. Diagnosis is established with the demonstration of an eosinophilic infiltrate with a cell count exceeding 15 eosinophils per high power field (×400). First line therapy includes swallowed topical corticosteroids and removal of an allergic cause, when it could be identified.

[Vocal effectiveness in speech and singing: acoustical, physiological and perceptive aspects. applications in speech therapy]. / L'efficacité vocale dans la parole et le chant lyrique : aspects acoustique, physiologique et perceptif. applications orthophoniques.

OBJECTIVE: What is vocal effectiveness in lyrical singing in comparison to speech? Our study tries to answer this question, using vocal efficiency and spectral vocal effectiveness. MATERIAL AND METHODS: Vocal efficiency was mesured for a trained and untrained subject. RESULTS: According to these invasive measures, it appears that the trained singer uses her larynx less efficiently. Efficiency of the larynx in terms of energy then appears to be secondary to the desired voice quality. The acoustic measures of spectral vocal effectiveness of vowels and sentences, spoken and sung by 23 singers, reveal two complementary markers: The "singing power ratio" and the difference in amplitude between the singing formant and the spectral minimum that follows it. Magnetic resonance imaging and simulations of [a], [i] and [o] spoken and sung show laryngeal lowering and the role of the piriform sinuses as the physiological foundations of spectral vocal effectiveness, perceptively related to carrying power. CONCLUSION: These scientifical aspects allow applications in voice therapy, such as physiological and perceptual foundations allowing patients to recuperate voice carrying power with or without background noise.

A detailed mapping of the histamine H(3) receptor and its gene transcripts in rat brain.

The detailed distribution of histamine H(3) receptor mRNAs in rat brain was analyzed by in situ hybridization using a 33P-labelled riboprobe and was combined for the first time with the detailed autoradiographic distribution of the receptor determined in the same animals with [(125)I]iodoproxyfan, a selective radioligand. The signals generated on adjacent brain sections by each probe were quantified and/or rated and were compared in order to identify neuronal populations expressing the receptor. In addition, the cellular localization of the transcripts within various brain structures was analyzed in sections dipped in a photographic emulsion. In the cerebral cortex, the strong mRNA expression in intermediate and deep layers indicates the presence of H(3) receptors on several types of neurons. The binding is dense except in layer V, suggesting that H(3) receptors are located on granule cells and apical dendrites of pyramidal cells. In addition to their localization on monoaminergic afferents, the dense binding in layer IV and strong mRNA expression in thalamic nuclei suggest the presence of heteroreceptors on thalamocortical projections. In the hippocampus, the strong mRNA expression but low binding in pyramidal layers of the CA1 and ventral CA3 fields suggest that H(3) receptors are abundant on efferent projections of pyramidal cells. In the dentate gyrus, some binding sites in the molecular layer may correspond to H(3) receptors synthesized in granule cells and coexpressed with H(1) and H(2) receptors in their dendrites. In the basal ganglia, H(3) receptors are highly expressed in the striatal complex and olfactory tubercles but not in islands of Calleja. Some of the striatal binding sites may correspond to presynaptic receptors present on afferents. The mRNAs in cortical layer V may encode for heteroreceptors on corticostriatal neurons. The presence of mRNAs in the substantia nigra pars compacta suggests that H(3) receptors are located upon nigrostriatal afferents. However, the absence of any signal in the ventral tegmental area indicates that some but not all dopaminergic neurons express H(3) receptors. In addition, the homogeneous mRNA expression within the caudate putamen and nucleus accumbens suggests that many striatal H(3) receptors are present on medium-sized, spiny projection neurons of both the direct and indirect movement pathways. In agreement, a dense binding, but low mRNA expression, is observed in external and internal pallidum and in substantia nigra pars reticulata. In the amygdala, the dense binding and mRNA expression indicate the presence of receptors on both afferents and projections. In the thalamus, the binding in some association nuclei may correspond to receptors present on neurons emanating from the deep cortical layers that strongly express the mRNAs, as well as receptors on the visual systems. However, the low binding and high mRNA expression in most nuclei indicate that many receptors are present upon thalamic projections. In the hypothalamus, the mRNA expression parallels the density of binding sites and is the highest in the tuberomammillary nucleus. Further investigation is needed to know if the dense binding and mRNA expression observed in other nuclei such as the paraventricular, ventromedial and medial tuberal nuclei correspond to pre- and/or postsynaptic receptors. mRNAs are also observed in several areas projecting to the tuberomammillary nucleus, such as the ventrolateral preoptic nucleus. In the lower brainstem, the high mRNA expression and very low binding in the locus coeruleus and raphe nuclei indicate that presynaptic rather than somatodendritic receptors regulate noradrenaline and serotonin release, respectively. A similar pattern in vestibular nuclei suggests that receptors located on projections account for the anti-vertigo properties of H(3) receptor antagonists. In the cerebellum, binding is hardly detectable but a strong mRNA expression is found in most, if not all, Purkinje cells as well as in several central cerebellar nuclei, suggesting the presence of H(3) receptors on efferent projections. The present study reports the first detailed quantification and/or rating of H(3) receptor mRNAs in the brain. The comparison, performed in the same animals, with the distribution of the H(3) receptor protein provides evidence for the presence of H(3) receptors on many neuronal perikarya, dendrites and projections. Although some localizations, mainly as auto- or heteroreceptors, are consistent with previous functional studies, the physiological role, if any, of most of these presynaptic or postsynaptic receptors remains to be established.

Expression analysis of the histamine H(3) receptor in developing rat tissues.

Endogenous histamine is involved in tissue growth and cell proliferation. In accordance with a putative function of the H(3) receptor in this mitogenic effect, we show that H(3)-receptor mRNAs are expressed together with those of the histamine-synthesizing enzyme in the embryonic liver and adipose tissue, and in various epithelia. Finally, we show that activation of recombinant H(3) receptors enhances MAP kinase activity.

Cloning and cerebral expression of the guinea pig histamine H3 receptor: evidence for two isoforms.

We cloned the full length guinea pig H3 receptor cDNA using RT-PCR amplification with primers from the human receptor and templates from brain areas. Evidence was obtained for two isoforms, designated H3L and H3S, differing by a 30 amino acid stretch within the third cytosolic loop, presumably generated by alternative splicing. In situ hybridization using a selective cRNA probe showed the gene transcripts to be highly expressed in discrete neuronal populations, e.g. pyramidal cells in the cerebral cortex or cerebellar Purkinje cells, in some instances already known to express other histamine receptor subtypes.

Comparison and evolution of perceptual and acoustic characteristics of voice after supracricoid partial laryngectomy with cricohyoidoepiglottopexy.

The present prospective study, based on a series of 12 male patients managed with supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL-CHEP), was designed i) to compare the perceptual and acoustic parameters before surgery and at 6 months after sugery, ii) to evaluate the evolution of the perceptual and acoustic parameters between 6 and 18 months postoperatively, and iii) to determine the correlations between the perceptual and acoustic parameters preoperatively and at 18 months postoperatively. The roughness was found to be significantly worsened after SCPL-CHEP. The jitter, shimmer, noise-to-harmonic ratio, and degree of voiceless increased significantly after SCPL-CHEP. Neither acoustic nor perceptual parameters varied significantly between 6 and 18 months postoperatively. Preoperatively, a strong statistical correlation was found between grade, roughness and strain and all acoustic parameters but F0. Breathiness was statistically correlated with all acoustic parameters but jitter. Postoperatively the only statistical correlation noted was between roughness and F0.

[Acoustic measurements, perceptive judgements and physiological correlates of the "singing-formant" in male and female opera singers]. / Mesures acoustiques, jugements perceptifs et corrélats physiologiques du singing-formant chez les chanteurs et les chanteuses lyriques.

At the crossroads of speech and music, this research contribute to a description of the "singing-formant" not only in its acoustic aspects, but also in its physiological and perceptive aspects. From systematic spectral analysis of the phenomenon, the singing-formant is firstly redefined and described from an acoustic point of view, as a reinforcement of extra energy at around 2800 Hz in male subjects and up to 4000 Hz in female ones. What is the perceptive significance of such a phenomenon? Taking into account the voicing context of lyrical singing, we then attempt to show the impact of the singing-formant on the sounds perceived through perception tests. Finally, we attempt to explain its characteristics from a physiological point of view. Vibratory phenomena initially favour the emergence of high-pitched harmonics, richer in the larynx spectra of those of our subjects who have the singing-formant. From a resonance point of view from the analysis of the contours of middle sagittal slices of Magnetic Resonance Imaging (MRI) of the French vowels [a], [i] and [o] spoken and sung by a professional bass singer, the area functions and spectra of sounds given out have been elaborated, thanks to the vocal tract acoustic simulation software of S. Maeda. Hypotheses relating to the nature and position of articulators favourable to the production of the singing-formant can then be given out, and are of great interest for the education and reeducation of the singing voice.

[Subjective evaluation of voice and speech after supra-cricoid partial laryngectomy]. / Evaluation subjective de la voix et de la parole après laryngectomie partielle supra-cricoïdienne.

A prospective perceptual evaluation of the voice and speech after supra-cricoid partial laryngectomy over the first post-operative six months was performed. Ten male patients were evaluated at one, three and six months by five listeners. A voice profil was drawn from defined acoustical parameters studied, and a chronology in the voice improvement was observed. Voice therapy aims could be suggested.