Regenerative medicine was a breakthrough in the late 20th century which provided potential to resolve refractory diseases. Research on regeneration of the larynx has also been carried out for the vocal fold, muscle, cartilage, and the recurrent laryngeal nerve. The present manuscript reviews the clinical application of regenerative medicine to the vocal fold. The target is irreversible diseases including vocal fold atrophy, scar, and sulcus that causes the vocal fold mucosa to be stiff. The chief pathology is atrophy and/or fibrosis of the superficial layer of the lamina propria (SLP). "Scaffolding" is a strategy in which the altered SLP is replaced with a regenerative scaffold such as atelocollagen or gelatin sponge, expecting creation of new healthy tissue in the scaffold. Atelocollagen implant into the scarred vocal fold has produced positive regenerative effects, but the effects were not consistent possibly because of lack of induction power of regeneration. Growth factors are strong tools that induce regeneration of several tissues. Basic fibroblast growth factor (bFGF) is a promising factor for vocal fold regeneration, and a commercial drug of bFGF is available in Japan. A clinical study of injection of bFGF into the vocal fold with atrophy or scar has demonstrated regenerative effects on the volume and viscoelastic property of the vocal fold.
This study investigated development of narrative abilities through contents and structures in telling stories. The participants were 118 typically developing children (4: 01-6: 11). Two stories and two tasks were prepared. Each child was presented with 10 pages of a wordless picture book extracted from a story entitled, "Frog, Where Are You?" (Mayer, 1969). The other was an original picture story entitled, "A little elephant goes back home with his mother." The children conducted spontaneous speech and retelling tasks. All narratives were recorded with an IC recorder and transcribed for analysis. The results showed that the stories produced by the 4-year-old group contained fewer words and poorer content compared to the over-5-year-old group in both materials and tasks. There were some individual differences in relation to story lengths within the same age group. These findings suggest that children develop contents and structures in telling stories at the same time. Narrative skills have no relation to the materials and tasks. As a group, children from 5 years old and above produce stories rich in structures and contents. The results indicated different narrative skills for each age in preschool.
The present study investigated the relationship between working memory capacity (WMC) and shadowing latency in 21 people who stutter (PWS) and 15 people who do not stutter (PWNS). WMC was measured using the Reading Span Test (RST). The mean RST score of the PWS group was significantly lower than that of the PWNS group. The PWS group also showed significantly shorter shadowing latency than the PWNS group. In terms of the relationship between WMC and shadowing latency, the PWS group had a significant positive correlation, whereas the PWNS group showed a significant negative correlation. These results suggest that PWS and PWNS employ different processing strategies in verbal working memory and shadowing tasks.
We analyzed the word sound finding abilities of Japanese children with developmental dyslexia, with and without developmental language disorder, using word fluency tasks. We evaluated the number of correct words in alliteration fluency tasks with the given sounds /a/ and /ka/ of 151 children in regular classes and 63 children with developmental dyslexia (13 with and 50 without specific language impairment) who were in the first, third and fifth grades of elementary school. Only the children with developmental dyslexia and specific language impairment had lower scores in the alliteration fluency tasks than the children in regular classes, for all grades. These results suggest that scores in word fluency tasks connect with spoken language development and do not decrease in Japanese children with developmental dyslexia without developmental language disorder.
We investigated the effects of age of acquisition (AOA), consistency, familiarity and imageability on reading accuracy for Kanji words in 245 typically developing sixth-graders. The children took a reading aloud test (STRAW-R) of 126 Kanji words. We analyzed error rates for the Kanji words chosen from the 126 so that their word attributes were controlled, in order to investigate the four target effects. Consistency, familiarity and imageability interacted with AOA significantly. These interactions indicated that 1) effects of consistency and familiarity were larger for high AOA words than low AOA words, 2) imageabiltiy effect was significant for high AOA words but not for low AOA words, and 3) no AOA effect was observed for high-imageability words. From these results we surmised that development of the sub-lexical and lexical processes can be known by investigating the effects of consistency, familiarity imageability respectively for low and high AOA words.
We built a skull vibration detection system and attempted to detect direct bone-conducted sounds with skin penetration via a bone-anchored pick-up which consisted of a bone-anchored titanium implant and a piezoelectric acceleration meter. This study clarified the following. 1) In the oscillation experiment on the skull, the output level almost linearly increased more than 20 dBHL above the input level in the direct bone-conducted sounds. In comparison with non-direct bone-conducted sounds, there was no severe attenuation of output level in the high frequency band, from 1000 to 4000 Hz, in the direct bone-conducted sounds. 2) In long-term average spectrum (LTAS) analysis (sentence readings of 28 sec), decreasing of output power was shown at more than 1000 Hz in the non-direct bone-conducted sounds. However, few differences in output power (approximately 0-10 dB) were seen between direct bone-conducted sounds and air-conducted sounds. 3) In the monosyllable speech discrimination test, there was a significant difference (p<.01) in the percentages of correct answers for vowel sounds between non-direct and direct bone-conducted sounds. In comparison with non-direct bone-conducted sounds, there was no tendency to confuse vowel sounds in the case of direct bone-conducted sounds.
This article reported the application of the auditory method to a child with severe hearing impairment who complained of difficulties in Kanji writing. The child showed poor phonological abilities and poor visual memory, although her verbal long-term memory was good. We compared the efficacy of two types of learning methods for Kanji writing. One method called for the subject to memorize Kanji characters by writing them many times (visual method), and with the other method she memorized the construction of Kanji characters orally (auditory method). With both methods, compared to before the practice sessions she was able to write many more Kanji characters both immediately and again two weeks after the practice session. Significant effect was also shown four months after the practice session for the auditory method as compared to that with the visual method, indicating significant long-term outcome with the auditory method. These results suggest that the auditory method for Kanji writing is efficient for children with hearing impairment and difficulties in Kanji writing when they have good verbal long-term memory.
This article reported a child with developmental dyslexia who had been suspected by school personnel of having a hearing impairment. We discussed the underlying cognitive mechanisms of her developmental dyslexia as well as cognitive factors behind the suspected hearing impairment, based on the results of tests and reading/writing training. She showed reading and writing deficits in spite of normal general intellectual functions and language development. Visual cognitive deficits and severe phonological deficits were thought to underlie her developmental dyslexia. She was suspected of having a hearing impairment because of phonological deficits caused by poor phonological representation, leading to otolaryngological examination. In light of the possibility that a child with developmental dyslexia may undergo otolaryngological examination due to suspected hearing impairment, it seems to be needed that an expert in developmental dyslexia cooperate with an otorhinolaryngologist for early detection of developmental dyslexia.
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