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Sample records for line tree swallow

  1. Gamma radiation effects on nestling Tree Swallows

    International Nuclear Information System (INIS)

    Zach, R.; Mayoh, K.R.

    1984-01-01

    The sensitivity of Tree Swallows (Tachycineta bicolor) to the stress of ionizing radiation was investigated with growth analysis. Freshly hatched nestlings were temporarily removed from nests, taken to the laboratory and acutely exposed to 0.9, 2.7, or 4.5 Gy gamma radiation. Some of the unirradiated control nestlings were also taken to the laboratory whereas others were left in the nests. Growth of all the nestlings was measured daily and analyzed by fitting growth models. There was no detectable radiation-induced mortality up to fledgling, approx. = 20 d after irradiation. Radiation exposure did not affect the basic growth pattern; the logistic growth model was most suitable for body mass and foot length, and the von Bertalanffy model for primary-feather length, irrespective of treatment. Parameter values from these models indicated pronounced growth depression in the 2.7-Gy and 4.5-Gy groups, particularly for body mass. Radiation also affected the timing of development. The growth depression of the 2.7-Gy group was similar to that caused by hatching asynchrony in unirradiated nestlings. The 4.5-Cy nestlings grew as well as unexposed nestlings that died from natural causes. Chronic irradiation at approx. = 1.0 Cy/d caused more severe growth effects than acute exposure to 4.5 Gy and may have caused permanent stunting. Growth analysis is a potent tool for assessing man-made environmental stresses. Observed body-mass statistics and model parameters seem to be most sensitive to environmental stresses, but coefficients of variation are not necessarily correlated with sensitivity. 34 references, 2 figures, 4 tables

  2. Innate immune response development in nestling tree swallows

    Science.gov (United States)

    Stambaugh, T.; Houdek, B.J.; Lombardo, M.P.; Thorpe, P.A.; Caldwell, Hahn D.

    2011-01-01

    We tracked the development of innate immunity in nestling Tree Swallows (Tachycineta bicolor) and compared it to that of adults using blood drawn from nestlings during days 6, 12, and 18 of the ???20-day nestling period and from adults. Innate immunity was characterized using an in vitro assay of the ability of whole blood to kill Escherichia coli. The ability of whole blood to kill E. coli increased as nestlings matured. Neither this component of innate immunity nor right wing chord length on day18 were as developed as in adults indicating that development of the innate immune system and growth both continued after fledging. Narrow sense heritability analyses suggest that females with strong immune responses produced nestlings with strong immune responses. These data suggest nestling Tree Swallows allocated sufficient energy to support rapid growth to enable fledging by day 18, but that further development of innate immunity occurred post-fledging. ?? 2011 by the Wilson Ornithological Society.

  3. Mercury Contamination in Tree Swallows Nesting at Northern Wisconsin Inland Lakes that Differ in Methylation Potential

    Science.gov (United States)

    Tree swallows (Tachycineta bicolor) are a useful species to assess the bioavailability and effects of trace elements, including mercury, because they will nest in boxes in relatively close proximity to one another. Because tree swallows feed on the aerial stages of benthic aquat...

  4. Species trees for the tree swallows (Genus Tachycineta): an alternative phylogenetic hypothesis to the mitochondrial gene tree.

    Science.gov (United States)

    Dor, Roi; Carling, Matthew D; Lovette, Irby J; Sheldon, Frederick H; Winkler, David W

    2012-10-01

    The New World swallow genus Tachycineta comprises nine species that collectively have a wide geographic distribution and remarkable variation both within- and among-species in ecologically important traits. Existing phylogenetic hypotheses for Tachycineta are based on mitochondrial DNA sequences, thus they provide estimates of a single gene tree. In this study we sequenced multiple individuals from each species at 16 nuclear intron loci. We used gene concatenated approaches (Bayesian and maximum likelihood) as well as coalescent-based species tree inference to reconstruct phylogenetic relationships of the genus. We examined the concordance and conflict between the nuclear and mitochondrial trees and between concatenated and coalescent-based inferences. Our results provide an alternative phylogenetic hypothesis to the existing mitochondrial DNA estimate of phylogeny. This new hypothesis provides a more accurate framework in which to explore trait evolution and examine the evolution of the mitochondrial genome in this group. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Breeding biology of Tree Swallows and House Wrens in a gradient of gamma radiation

    International Nuclear Information System (INIS)

    Zach, R.; Mayoh, K.R.

    1982-01-01

    In a gradient of gamma radiation from 38.7 mC kg - 1 .d - 1 to background levels of 0.05 μC. kg - 1 . d - 1 to background levels of 0.05 μC . kg - 1 . d - 1 , Tree Swallows (Iridoprocne bicolor) and House Wrens (Troglodytes aedon) avoided nesting in areas of high radiation. Nest boxes selected by swallows and wrens had a mean exposure rate of only 9.3 and 6.6 μC . kg - 1 . d - 1 , respectively. Lateral and canopy vegetation indices and nest hole height and direction could not explain the observed pattern of box selection. Of the boxes with low exposure rates, swallows selected those with little vegetation cover, whereas wrens chose boxes and heavy cover. It appears that the birds responded to radiation levels as low as 100 times background, but it is not clear whether they actually detected radiation or simply responded to secondary clues. The number of swallows and wrens fledged per box was unrelated to radiation exposure. The same was true for number of eggs, hatching success, fledging success, incubation time, and nestling time. Breeding success was reduced because of infertile eggs, eggs with dead embryos, cracked eggs, predation, adverse weather, abandonment, and parasites. The logistic model was ideally suited for describing gains in mass in nestling swallows and wrens. Growth of nestlings was not related to radiation exposure as indicated by the growth rate constant, asymptotic mass, and the proportion of variation explained by the logistic model. Breeding and growth performance were similar in studies not involving experimental radiation

  6. Breeding biology of tree swallows and house wrens in a gradient of gamma radiation

    International Nuclear Information System (INIS)

    Zach, R.; Mayoh, K.R.

    1982-01-01

    In a gradient of gamma radiation ranging from 38.7 mC.kg -1 .d -1 to background levels of 0.05 μC.kg -1 .d -1 , Tree Swallows (Iridoprocne bicolor) and House Wrens (Troglodytes aedon) avoided nesting in areas of high radiation. Nest boxes selected by swallows and wrens had a mean exposure rate of only 9.3 and 6.6 μC.kg -1 .d -1 , respectively. Lateral and canopy vegetation indices and nest hole height and direction could not explain the observed pattern of box selection. Of the boxes with low exposure rates, swallows selected those with little vegetation cover, whereas wrens chose boxes with heavy cover. It appears that the birds responded to radiaton levels as low as 100 times background but it is not clear whether they actually detected radiation or simply responded to secondary clues. The number of swallows and wrens fledged per box was unrelated to radiation exposure. The same was true for number of eggs, hatching success, fledging success, incubation time, and nestling time. Breeding success was reduced because of infertile eggs, eggs with dead embryos, cracked eggs, predation, adverse weather, abandonment, and parasites. The logistic model was ideally suited for describing gains in mass in nestling swallows and wrens. Growth of nestlings was not related to radiation exposure as indicated by the growth rate constant, asymptotic mass, and the proportion of variation explained by the logistic model. The data show that birds avoided adverse effects of radiation by judicious box selection. However, there were indications that at higher breeding densities birds may use high-exposure boxes, where breeding success or growth of nestlings may become reduced due to radiation

  7. Mercury and other element exposure in tree swallows nesting at low pH and neutral pH lakes in northern Wisconsin USA

    International Nuclear Information System (INIS)

    Custer, Thomas W.; Custer, Christine M.; Thogmartin, Wayne E.; Dummer, Paul M.; Rossmann, Ronald; Kenow, Kevin P.; Meyer, Michael W.

    2012-01-01

    The primary objective of this study was to determine whether tree swallows (Tachycineta bicolor) demonstrate similar responses to lake pH and mercury (Hg) contamination in northern Wisconsin as do common loons (Gavia immer). Similar to common loons, Hg concentrations in the blood of tree swallow nestlings were higher, Hg concentrations in eggs tended to be higher, and egg size tended to be smaller at low (<6.2) pH lakes. In contrast to common loons, tree swallow nestling production was not lower at low pH lakes. Based on modeling associations, Hg concentrations in tree swallow eggs and nestling blood can be used to predict Hg concentrations in common loons without the invasive or destructive sampling of loons. Mean concentrations of cadmium, manganese, and mercury in nestling livers were higher at low pH lakes than neutral pH lakes. Concentrations of cadmium, chromium, mercury, selenium, and zinc were not at toxic levels. - Highlights: ► Mercury concentrations in tree swallow nestling livers were higher in low than neutral pH lakes. ► Tree swallow eggs were smaller at low than neutral pH lakes. ► Tree swallow hatching success was not correlated with mercury concentrations in eggs. ► Mercury concentrations in tree swallows can be used to predict common loon exposure. - Mercury concentrations in tree swallows were higher at low pH lakes.

  8. Mercury and other element exposure to tree swallows (Tachycineta bicolor) nesting on Lostwood National Wildlife Refuge, North Dakota

    International Nuclear Information System (INIS)

    Custer, Thomas W.; Custer, Christine M.; Johnson, Kevin M.; Hoffman, David J.

    2008-01-01

    Elevated mercury concentrations in water were reported in the prairie wetlands at Lostwood National Wildlife Refuge, ND. In order to determine whether wildlife associated with these wetlands was exposed to and then accumulated higher mercury concentrations than wildlife living near more permanent wetlands (e.g. lakes), tree swallow (Tachycineta bicolor) eggs and nestlings were collected from nests near seasonal wetlands, semi-permanent wetlands, and lakes. Mercury concentrations in eggs collected near seasonal wetlands were higher than those collected near semi-permanent wetlands or lakes. In contrast, mercury concentrations in nestling livers did not differ among wetland types. Mercury and other element concentrations in tree swallow eggs and nestlings collected from all wetlands were low. As suspected from these low concentrations, mercury concentrations in sample eggs were not a significant factor explaining the hatching success of the remaining eggs in each clutch. - Mercury concentrations in tree swallows nesting in the prairie wetlands at Lostwood National Wildlife Refuge were not elevated

  9. Innate immunity is not related to the sex of adult Tree Swallows during the nestling period

    Science.gov (United States)

    Houdek, Bradley J.; Lombardo, Michael P.; Thorpe, Patrick A.; Hahn, D. Caldwell

    2011-01-01

    Evolutionary theory predicts that exposure to more diverse pathogens will result in the evolution of a more robust immune response. We predicted that during the breeding season the innate immune function of female Tree Swallows (Tachycineta bicolor) should be more effective than that of males because (1) the transmission of sexually transmitted microbes during copulation puts females at greater risk because ejaculates move from males to females, (2) females copulate with multiple males, exposing them to the potentially pathogenic microbes in semen, and (3) females spend more time in the nest than do males so may be more exposed to nest microbes and ectoparasites that can be vectors of bacterial and viral pathogens. In addition, elevated testosterone in males may suppress immune function. We tested our prediction during the 2009 breeding season with microbicidal assays in vitro to assess the ability of the innate immune system to kill Escherichia coli. The sexes did not differ in the ability of their whole blood to kill E. coli. We also found no significant relationships between the ability of whole blood to kill E. coli and the reproductive performance or the physical condition of males or females. These results indicate that during the nestling period there are no sexual differences in this component of the innate immune system. In addition, they suggest that there is little association between this component of innate immunity and the reproductive performance and physical condition during the nestling period of adult Tree Swallows.

  10. Using tree swallows to monitor impacts of aquatic contamination in Great Lakes areas of concern

    International Nuclear Information System (INIS)

    Patnode, K.A.; Bodenstein, B.; Hetzel, R.; Pearson, S.

    1995-01-01

    Tree swallows were used to evaluate movement and potential impacts of contaminants from sediments in Newton Creek (diesel range organics: DROs) and Sheboygan River (PCBs), tributaries to Lake Superior and Lake Michigan, respectively. Contaminated sites occurred along the course of each river, while reference sites were located upstream or on a nearby river. Productivity was monitored and eggs, day 1 nestlings, and day 12 nestlings were collected from each nest. Whole body or egg homogenates were analyzed for PCBs or DROs. EROD activity in livers from day 12 nestlings is being determined for both PCB and DRO exposures. In the Newton Creek study, hatching success was similar for DRO and reference sites. DROs were detected in gastrointestinal tracts of 1 nestling from the reference and 1 from the contaminated site. DROs were not detected in any egg samples. In the Sheboygan River study, hatching success rates differed between 1 reference and 1 contaminated river segment. PCB daily accumulation rates from day 1 to day 12 nestlings were computed for Sheboygan River. All nestlings at reference nests had negative rates due to growth dilution effects. Preliminary analyses indicate the average rate for nestlings from contaminated segments of the river was 220.3 ng/g/day. These 1995 findings will be combined with 1996 data to evaluate the effectiveness of tree swallows for monitoring ecosystem impacts of aquatic contaminants in Wisconsin

  11. Reproductive success and contaminant associations in tree swallows (Tachycineta bicolor) used to assess a beneficial use impairment in U.S. and Binational Great Lakes’ Areas of Concern

    Science.gov (United States)

    During 2010-2014, tree swallow (Tachycineta bicolor) reproductive success was monitored at 68 sites across all 5 Great Lakes, including 58 sites located within Great Lakes Areas of concern (AOCs) and 10 non-AOCs. Sample eggs were collected from tree swallow clutches and analyzed ...

  12. Adult tree swallow survival on the polychlorinated biphenyl-contaminated Hudson River, New York, USA, between 2006 and 2010

    Science.gov (United States)

    Custer, Christine M.; Custer, Thomas W.; Hines, James E.

    2012-01-01

    The upper Hudson River basin in east central New York, USA, is highly contaminated, primarily with polychlorinated biphenyls (PCBs). Reduced adult survival has been documented in tree swallows (Tachycineta bicolor) at a similarly PCB-contaminated river system in western Massachusetts. The purpose of the present study was to assess whether adult survival of tree swallows was likewise affected in the Hudson River basin. Between 2006 and 2010, a total of 521 female tree swallows were banded, of which 148 were retrapped at least once. The authors used Program MARK and an information theoretic approach to test the hypothesis that PCB contamination reduced annual survival of female tree swallows. The model that best described the processes that generated the capture history data included covariate effects of year and female plumage coloration on survival but not PCB/river. Annual survival rates of brown-plumaged females (mostly one year old) were generally lower (mean phi = 0.39) than those of blue-plumaged females (mean phi = 0.50, one year or older). Poor early spring weather in 2007 was associated with reduced survival in both plumage-color groups compared to later years. Models with the effects of PCB exposure on survival (all ΔAICc values >5.0) received little support.

  13. Relating zoobenthic and emergent terrestrial insect production to tree swallow (Tachycineta bicolor) nestling diet in oil sands wetlands

    Energy Technology Data Exchange (ETDEWEB)

    Thoms, J.L.; Martin, J.P.; Ciborowski, J.J. [Windsor Univ., Windsor, ON (Canada); Harms, N.J.; Smits, J.E. [Saskatchewan Univ., Saskatoon, SK (Canada)

    2009-07-01

    This study examined the influence of oil sands process materials (OSPM) on wetland macroinvertebrate community composition and production. Tree swallows are known to inhabit constructed nest boxes and forage near their nest on flying insects of terrestrial and aquatic origin. Therefore, this study evaluated the structure of wetland food webs and how it relates to the transfer of production from aquatic sediments to nestling tree swallows. The study involved 2 reference and 2 oil sands affected wetlands. Exuviae of emerging aquatic and flying insects from floating and sticky traps were collected every 3 days during the tree swallow nestling period in order to estimate benthic invertebrate composition and production. The tree swallow nest boxes, placed around the perimeter of the wetlands in spring were monitored during egg laying and incubation. Diets of the 10-14 day-old nestlings were determined by placing a ligature around the neck of each nestling, preventing the passage of food into the esophagus for 45 min. Food boluses were collected from nestlings fed by the parents during that time. The study showed that although oil sands-affected wetlands had lower aerial insect abundance, they represented over half of the total boluses collected. It was concluded that this study will help determine the ecological viability of oil sands-affected wetlands and their capability of supporting terrestrial predators that rely on zoobenthos.

  14. Differences in size between first and replacement clutches match the seasonal decline in single clutches in Tree Swallows

    NARCIS (Netherlands)

    Karagicheva, J.; Liebers, M.; Rakhimberdiev, E.; Hallinger, K.; Saveliev, A.; Winkler, D.W.

    2016-01-01

    The seasonal decline in clutch size in birds can be a response to the environmentallyconditioned decrease in prospects for offspring or a consequence of a lower physical abilityof late-breeding females. To find out which of the explanations apply in Tree SwallowsTachycineta bicolor, we assessed

  15. The effects of experimental reservoir creation on the bioaccumulation of methylmercury and reproductive success of tree swallows (Tachycineta bicolor).

    Science.gov (United States)

    Gerrard, P M; St Louis, V L

    2001-04-01

    Reservoir creation results in decomposition of flooded organic matter and increased rates of mercury methylation. Methylmercury (MeHg), the most toxic form of mercury, bioaccumulates through aquatic food webs. Our objective was to quantify the transfer of MeHg from aquatic food webs into terrestrial organisms. We examined rates of MeHg bioaccumulation in an insectivorous songbird, the tree swallow, breeding near an experimentally created reservoir. We also determined the impact of flooding and MeHg bioaccumulation on the reproductive success of these birds. Mean MeHg burdens in nestling swallows from near the experimental reservoir increased from 1,210 +/- 150 ng before flooding to 2,200 +/- 102 ng after flooding. Postflood MeHg concentrations in both the body and feathers of the birds were significantly greater than preflood MeHg concentrations. Although MeHg burdens in swallows were elevated in postflood years, we found no overt toxicological affects. An increase in dipteran productivity (the primary food source of tree swallows) after reservoir creation resulted in earlier nest initiation, larger eggs, and faster growth rates of wing and bill length in nestlings raised during postflood years.

  16. Health assessment of tree swallows (Tachycineta bicolor) on the oil sands using stress, immune function and growth indicators

    Energy Technology Data Exchange (ETDEWEB)

    Harms, N.J.; Smits, J.E. [Saskatchewan Univ., Saskatoon, SK (Canada)

    2009-07-01

    Oil sand mining companies in Alberta continue to explore reclamation strategies for tailings water and are evaluating the ecological effectiveness of constructed wetlands for the bioremediation of liquid and solid tailings contaminated with naphthenic acids, polycyclic aromatic hydrocarbons, and dissolved inorganic ions. The success of reclaimed sites and ecosystem health can be measured by examining health variables in wild tree swallows (Tachycineta bicolor) nesting on experimental wetlands receiving tailings or water from tailings ponds. This presentation reported on a study that measured clutch size, egg mass, and hatching and fledging success of 40 breeding pairs of tree swallows on 3 experimental wetlands on Suncor Energy Inc. and Syncrude Canada Ltd. oil sands leases. The Shallow Wetlands/Demonstration Pond (Syncrude), Consolidated Tailings and Natural Wetlands (Suncor) represent sites of different ages and different categories of wetland reclamation, notably mature, maturing, and newly reclaimed. Due to lack of nesting success on the selected reference site, the Shallow Wetlands/Demonstration Pond was selected as the reference site because it has undergone nearly complete bioremediation and had a very low level of contamination. Nestling growth and survival were measured in 199 tree swallows nestlings on the 3 experimental wetlands. Two mid-weight nestlings from 12 nest boxes on each study site were also examined for feather corticosterone levels and adaptive immune function.

  17. Organic contamination in tree swallow (Tachycineta bicolor) nestlings at United States and binational great Lakes Areas of Concern

    Science.gov (United States)

    Custer, Thomas W.; Custer, Christine M.; Dummer, Paul; Goldberg, Diana R.; Franson, J. Christian; Erickson, Richard A.

    2017-01-01

    Contaminant exposure of tree swallows, Tachycineta bicolor, nesting in 27 Areas of Concern (AOCs) in the Great Lakes basin was assessed from 2010 to 2014 to assist managers and regulators in their assessments of Great Lakes AOCs. Contaminant concentrations in nestlings from AOCs were compared with those in nestlings from nearby non-AOC sites. Polychlorinated biphenyl (PCB) and polybrominated diphenyl ether concentrations in tree swallow nestling carcasses at 30% and 33% of AOCs, respectively, were below the mean concentration for non-AOCs. Polycyclic aromatic hydrocarbon (PAH) concentrations in nestling stomach contents and perfluorinated compound concentrations in nestling plasma at 67% and 64% of AOCs, respectively, were below the mean concentration for non-AOCs. Concentrations of PCBs in nestling carcasses were elevated at some AOCs but modest compared with highly PCB-contaminated sites where reproductive effects have been documented. Concentrations of PAHs in diet were sufficiently elevated at some AOCs to elicit a measurable physiological response. Among AOCs, concentrations of the perfluorinated compound perfluorooctane sulfonate in plasma were the highest on the River Raisin (MI, USA; geometric mean 330 ng/mL) but well below an estimated toxicity reference value (1700 ng/mL). Both PAH and PCB concentrations in nestling stomach contents and PCBs in carcasses were significantly correlated with concentrations in sediment previously reported, thereby reinforcing the utility of tree swallows to assess bioavailability of sediment contamination.

  18. Certainty of paternity and paternal investment in eastern bluebirds and tree swallows

    Science.gov (United States)

    Kempenaers, Bart; Lanctot, Richard B.; Robertson, Raleigh J.

    1998-01-01

    Extra-pair paternity is common in many socially monogamous passerine birds with biparental care. Thus, males often invest in offspring to which they are not related. Models of optimal parental investment predict that, under certain assumptions, males should lower their investment in response to reduced certainty of paternity. We attempted to reduce certainty of paternity experimentally in two species, the eastern bluebird, Sialia sialis, and the tree swallow, Tachycineta bicolor, by temporarily removing fertile females on two mornings during egg laying. In both species, experimental males usually attempted to copulate with the female immediately after her reappearance, suggesting that they experienced the absence of their mate as a threat to their paternity. Experimental males copulated at a significantly higher rate than control males. However, contrary to the prediction of the model, experimental males did not invest less than control males in their offspring. There was no difference between experimental and control nests in the proportion of male feeds, male and female feeding rates, nestling growth and nestling condition and size at age 14 days. We argue that females might have restored the males’ confidence in paternity after the experiment by soliciting or accepting copulations. Alternatively, males may not reduce their effort, because the fitness costs to their own offspring may outweigh the benefits for the males, at least in populations where females cannot fully compensate for reduced male investment.

  19. Eggshell bacterial load is related to antimicrobial properties of feathers lining barn swallow nests.

    Science.gov (United States)

    Peralta-Sánchez, Juan Manuel; Soler, Juan José; Martín-Platero, Antonio Manuel; Knight, Rob; Martínez-Bueno, Manuel; Møller, Anders Pape

    2014-02-01

    The use of feathers to line bird's nests has traditionally been interpreted as having a thermoregulatory function. Feather-degrading bacteria growing on feathers lining nests may have antimicrobial properties, which may provide an additional benefit to lining nests with feathers. We test the hypothesis that the production of antimicrobial substances by feather bacteria affects the microbiological environment of the nest, and therefore the bacterial density on eggshells and, indirectly, hatching success. These effects would be expected to differ between nests lined with pigmented and white feathers, because bacteria grow differently on feathers of different colors. We experimentally manipulated the composition of pigmented and unpigmented feathers in nests of the barn swallow (Hirundo rustica) and studied the antimicrobial properties against the keratin-degrading bacterium Bacillus licheniformis of bacteria isolated from feathers of each color. Analyzed feathers were collected at the end of the incubation period, and antimicrobial activity was defined as the proportion of bacteria from the feathers that produce antibacterial substances effective against B. licheniformis. Our experimental manipulation affected antimicrobial activity, which was higher in nests with only white feathers at the beginning of incubation. Moreover, white feathers showed higher antimicrobial activity than black ones. Interestingly, antimicrobial activity in feathers of one of the colors correlated negatively with bacterial density on feather of the opposite color. Finally, antimicrobial activity of white feathers was negatively related to eggshell bacterial load. These results suggest that antimicrobial properties of feathers in general and of white feathers in particular affect the bacterial environment in nests. This environment in turn affects the bacterial load on eggshells, which may affect hatching success.

  20. Reproductive performance and neonatal development of tree swallows (Tachycineta bicolor) on reclaimed mine sites on the Athabasca oil sands

    Energy Technology Data Exchange (ETDEWEB)

    Keshwani, H.; Hersikorn, B.; Smits, J.E. [Saskatchewan Univ., Regina, SK (Canada)

    2007-07-01

    The ability of reclaimed wetlands created from oil sand tailings to support populations of tree swallows was examined. Nests were provided on the sites of interest to allow swallows to breed, raise their young and feed on flying insects from local wetlands. In order to determine if the bird's health was affected by stressors such as contaminants accumulated through the diet, this study examined reproductive performance and neonatal development of the birds. Two experimental wetlands differing in age were used in this study, notably a 15 year old and 3 year old wetland. Reproduction was measured by clutch size, egg mass, hatchability and offspring survival. Neonatal development was assessed through body measurements, taken on 12 day old nestlings. It was shown that the reproductive success of the adults, and clutch size did not differ between the sites. However, initiation of breeding was earlier at the younger reclamation site. Neonatal development was different between sites, but body mass was not. Birds at the younger site exhibited accelerated tail and wing feather maturation, but birds on the mature site had a larger skeletal size. These findings may be attributed to different dietary, nutritional, and/or endocrine modulating substances moving through the food chain. It was noted that insect density and diversity may have been influenced by different altitudes and vegetation cover at the 2 sites.

  1. PCBs and DDE in Tree Swallow (Tachycineta bicolor) Eggs and Nestlings from an Estuarine PCB Superfund Site, New Bedford Harbor, MA, U.S.A.

    Science.gov (United States)

    While breeding tree swallows (Tachycineta bicolor) have been used as biomonitors for freshwater sites, we report the first use of this species to assess the transfer of breeding ground contaminants from an estuarine system. Eggs and nestlings were collected from nest boxes locat...

  2. Mercury concentrations in eggs of red-winged blackbirds and tree swallows breeding in Voyageurs National Park, Minnesota

    Science.gov (United States)

    Tyser, Robin W.; Rolfhus, Kristofer R.; Wiener, James G.; Windels, Steve K.; Custer, Thomas W.; Dummer, Paul

    2016-01-01

    Most investigations of the environmental effects of mercury (Hg) have focused on aquatic food webs that include piscivorous fish or wildlife. However, recent investigations have shown that other species, including passerine songbirds, may also be at risk from exposure to methylmercury (MeHg). We quantified Hg concentrations in eggs of two species of songbirds, red-winged blackbirds (Agelaius phoeniceus) and tree swallows (Tachycineta bicolor), nesting in Voyageurs National Park, Minnesota, USA. Geometric mean concentrations of total Hg (THg) were lower in red-winged blackbird eggs [218 and 107 ng/g dry weight (dw) for 2012 and 2013, respectively] than in tree swallow eggs (228 and 300 ng/g dw for 2012 and 2013, respectively), presumably reflecting differences in the trophic positions of these two species. Concentrations of MeHg averaged 98.4 % of THg in red-winged blackbird eggs. Levels of THg observed in this study were well below critical toxicological benchmarks commonly applied to eggs of avian species, suggesting these breeding populations were not adversely affected by exposure to MeHg. In red-winged blackbirds, concentrations of THg in eggs collected in 2012 were twice those in eggs collected in 2013. Hg levels in eggs of both species increased with date of clutch initiation. In red-winged blackbirds, for example, temporal patterns showed that a 3-week delay in clutch initiation increased egg THg by 60 %. These observations indicate that in ovo exposure of wetland birds to MeHg can vary significantly within nesting season as well as between years.

  3. Synthesis of tree swallow (Tachycineta bicolor) data for Beneficial Use Impairment (BUI) assessment at Wisconsin Areas of Concern

    Science.gov (United States)

    Custer, Christine M.; Custer, Thomas W.; Dummer, Paul

    2018-03-20

    Assessment of the “Bird or Animal Deformities or Reproductive Problems” Beneficial Use Impairment (BUI) can be accomplished by (1) comparing tissue concentrations to established background and Lowest Observable Effect Level (LOEL) for reproductive effects, or (2) directly measuring reproductive success at Areas of Concern (AOCs) and statistically comparing those rates to minimally impacted reference locations (non-AOCs). Results from recent tree swallow (Tachycineta bicolor) publications were used to evaluate this BUI based on both approaches. For both endpoints, a 95-percent confidence interval (CI) was used to test for significant differences. Additional information on BUIs, AOCs, and the program in general can be found in the Great Lakes Water Quality Agreement (2012).For the first metric, there are good background and reproductive effect threshold LOELs for tree swallow egg concentrations for polychlorinated biphenyls (PCBs), dioxins and furans (PCDD/Fs), and mercury, as well as, for some other organic and inorganic contaminants. For the second assessment, comparisons were made between AOC and non-AOC sites for reproductive success, which was measured as the daily probability of egg failure and the percentage of eggs laid that hatched. Multistate modeling was used to assess whether there was an association between the daily probability of egg failure and a suite of contaminants, including PCBs, but also whether there was an association with ecological variables, such as female age and date within season. Both of these ecological variables are known to affect hatching success in birds. The objective of this report is to synthesize the previously published information to assist in the assessment of the “Bird or Animal Deformities or Reproductive Problems” BUI at 16 sites within the 5 Wisconsin AOCs (table 1). The logic behind this interpretation is applicable to other AOCs as well.

  4. Polychlorinated biphenyl congener patterns in tree swallows (Tachycineta bicolor) nesting in the Housatonic River watershed, western Massachusetts, USA, using a novel statistical approach

    International Nuclear Information System (INIS)

    Custer, Christine M.; Read, Lorraine B.

    2006-01-01

    A novel application of a commonly used statistical approach was used to examine differences in polychlorinated biphenyl (PCB) congener patterns among locations and sample matrices in tree swallows (Tachycineta bicolor) nesting in the Housatonic River watershed in western Massachusetts, USA. The most prevalent PCB congeners in tree swallow tissue samples from the Housatonic River watershed were Ballsmitter Zell numbers 153, 138, 180, 187, 149, 101, and 170. These congeners were seven of the eight most prevalent congeners in Aroclor[reg] 1260, the PCB mixture that was the primary source of contamination in the Housatonic River system. Using paired-Euclidean distances and tolerance limits, it was demonstrated that congener patterns in swallow tissues from sites on the main stem of the Housatonic River were more similar to one another than to two sites upstream of the contamination or from a nearby reference area. The congener patterns also differed between the reference area and the two upstream tributaries and between the two tributaries. These pattern differences were the same in both pipper (eggs or just hatched nestlings) and 12-day-old nestling samples. Lower-chlorinated congeners appeared to be metabolized in nestlings and pippers compared to diet, and metabolized more in pippers compared to nestlings. Euclidean distances and tolerance limits provide a simple and statistically valid method to compare PCB congener patterns among groups. - Polychlorinated biphenyl congener patterns in swallows differed between the main stem of the Housatonic River, MA and other locations in the watershed

  5. Annual variation in polychlorinated biphenyl (PCB) exposure in tree swallow (Tachycineta bicolor) eggs and nestlings at Great Lakes Restoration Initiative (GLRI) study sites

    Science.gov (United States)

    Custer, Christine M.; Custer, Thomas W.; Dummer, Paul; Goldberg, Diana R.; Franson, J. Christian

    2018-01-01

    Tree swallow (Tachycineta bicolor) eggs and nestlings were collected from 16 sites across the Great Lakes to quantify normal annual variation in total polychlorinated biphenyl (PCB) exposure and to validate the sample size choice in earlier work. A sample size of five eggs or five nestlings per site was adequate to quantify exposure to PCBs in tree swallows given the current exposure levels and variation. There was no difference in PCB exposure in two randomly selected sets of five eggs collected in the same year, but analyzed in different years. Additionally, there was only modest annual variation in exposure, with between 69% (nestlings) and 73% (eggs) of sites having no differences between years. There was a tendency, both statistically and qualitatively, for there to be less exposure in the second year compared to the first year.

  6. PCBs and DDE in tree swallow (Tachycineta bicolor) eggs and nestlings from an estuarine PCB superfund site, New Bedford Harbor, MA, U.S.A.

    Science.gov (United States)

    Jayaraman, Saro; Nacci, Diane E.; Champlin, Denise M.; Pruell, Richard J.; Rocha, Kenneth J.; Custer, Christine M.; Custer, Thomas W.; Cantwell, Mark

    2009-01-01

    While breeding tree swallows (Tachycineta bicolor) have been used as biomonitors for freshwater sites, we report the first use of this species to assess contaminant bioaccumulation from estuarine breeding grounds into these aerial insectivores. Eggs and nestlings were collected from nest boxes in a polychlorinated biphenyl (PCB) contaminated estuary, the New Bedford Harbor Superfund site (NBH, Massachusetts, USA), and a reference salt marsh, Fox Hill (FH, Jamestown, Rhode Island, USA). Sediments, eggs, and nestlings were compared on a ng g−1 wet weight basis for total PCBs and DDE (1,1-bis-(4-chlorophenyl)-2,2-dichloroethene), metabolite of DDT (1,1,1-trichloro-2,2-bis-(p-chlorophenyl)ethane). NBH samples contained high concentrations of PCBs compared to FH for sediment (36,500 and 0.2), eggs (11,200 and 323), and nestlings (16,800 and 26). PCB homologue patterns linked tree swallow contamination to NBH sediment. NBH samples were also contaminated with DDE compared to FH for sediment (207 and 0.9) and nestlings (235 and 30) but not for eggs (526 and 488), suggesting both NBH and nonbreeding ground sources for DDE. The relationships between sediment and tree swallow egg and nestling PCBs were similar to those reported for freshwater sites. Like some highly contaminated freshwater sites, NBH PCB bioaccumulation had little apparent effect on reproductive success.

  7. Changes in polychlorinated biphenyl (PCB) exposure in tree swallows (Tachycineta bicolor) nesting along the Sheboygan River, WI, USA

    Science.gov (United States)

    Custer, Christine M.; Custer, Thomas W.; Strom, Sean M.; Patnode, Kathleen A.; Franson, J. Christian

    2014-01-01

    Exposure to polychlorinated biphenyls (PCBs) in tree swallow (Tachycineta bicolor) eggs on the Sheboygan River, Wisconsin in the 1990s was higher at sites downstream (geometric means = 3.33–8.69 μg/g wet wt.) of the putative PCB source in Sheboygan Falls, Wisconsin than it was above the source (1.24 μg/g) with the exposure declining as the distance downstream of the source increased. A similar pattern of declining exposure was present in the 2010s as well. Although exposure to PCBs in eggs along the Sheboygan River at sites downstream of Sheboygan Falls has declined by ~60 % since the mid-1990s (8.69 down to 3.27 μg/g) there still seems to be residual pockets of contamination that are exposing some individuals (~25 %) to PCB contamination, similar to exposure found in the 1990s. The exposure patterns in eggs and nestlings among sites, and the changes between the two decades, are further validated by accumulation rate information.

  8. Tissue Mercury Concentrations and Survival of Tree Swallow Embryos, Nestlings and Young Adult Females on a Contaminated Site.

    Science.gov (United States)

    Taylor, Capwell E; Cristol, Daniel A

    2015-10-01

    Tree swallows nesting on mercury-contaminated sites along the South River in Virginia, USA were monitored for reproductive success. The bodies of nestlings found deceased in their nest boxes were collected, along with blood and feather samples from the adult parents and surviving siblings. We also measured hatching and fledging success of the clutches and the annual recapture rate of adults. We found that the body feathers of deceased nestlings contained significantly higher concentrations of mercury (12.89 ± 8.42 μg/g, n = 15) than those of nestlings that survived to fledge (7.41 ± 4.79 μg/g, n = 15). However, mothers of more successful clutches (>75 % hatching) did not differ in mercury concentrations from females with less successful clutches (<50 % hatching). Additionally, adult females breeding for the first time that returned to breed the following year did not differ in blood mercury from females of the same age that bred once but never returned. Our results suggest that mercury had its greatest effect on these songbirds during the nestling stage, whereas for embryos or first-time breeding females, other factors likely played larger roles in mortality.

  9. Detoxification, endocrine, and immune responses of tree swallow nestlings naturally exposed to air contaminants from the Alberta oil sands.

    Science.gov (United States)

    Cruz-Martinez, Luis; Fernie, Kim J; Soos, Catherine; Harner, Tom; Getachew, Fitsum; Smits, Judit E G

    2015-01-01

    Changes in environmental and wildlife health from contaminants in tailings water on the Canadian oil sands have been well-studied; however, effects of air contaminants on wildlife health have not. A field study was conducted to assess biological costs of natural exposure to oil sands-related air emissions on birds. Nest boxes for tree swallows (Tachycineta bicolor) were erected at two sites; within 5 km of active oil sands mining and extraction, and ≥ 60 km south, at one reference site. Passive air monitors were deployed at the nest boxes to measure nitrogen dioxide, sulfur dioxide, ozone, volatile organic compounds, and polycyclic aromatic hydrocarbons (PAHs). Nestlings were examined at day 9 post hatching to assess T cell function and morphometry. At day 14 post hatching, a subset of nestlings was euthanized to measure detoxification enzymes, endocrine changes, and histological alterations of immune organs. Except for ozone, all air contaminants were higher at the two oil sands sites than the reference site (up to 5-fold). Adult birds had similar reproductive performance among sites (p>0.05). Nestlings from industrial sites showed higher hepatic ethoxyresorufin O-dealkylase (EROD) induction (pfeather corticosterone (p>0.6), and no histological alterations in the spleen or bursa of Fabricius (p>0.05). This is the first report examining toxicological responses in wild birds exposed to air contaminants from industrial activity in the oil sands. It is also the first time that small, individual air contaminant monitors have been used to determine local contaminant levels in ambient air around nest boxes of wild birds. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Dirt - swallowing

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002840.htm Dirt - swallowing To use the sharing features on this ... article is about poisoning from swallowing or eating dirt. This article is for information only. DO NOT ...

  11. Mercury in tree swallow food, eggs, bodies, and feathers at Acadia National Park, Maine, and an EPA superfund site, Ayer, Massachusetts.

    Science.gov (United States)

    Longcore, Jerry R; Haines, Terry A; Halteman, William A

    2007-03-01

    We monitored nest boxes during 1997-1999 at Acadia National Park, Mt. Desert Island, ME and at an old-field site in Orono, ME to determine mercury (Hg) uptake in tree swallow (Tachycineta bicolor) eggs, tissues, and food boluses. Also, in 1998-1999 we monitored nest boxes at Grove Pond and Plow Shop Pond at a U.S. Environmental Protection Agency Superfund site in Ayer, MA. We recorded breeding success at all locations. On average among locations, total mercury (THg) biomagnified 2 to 4-fold from food to eggs and 9 to 18-fold from food to feathers. These are minimum values because the proportion of transferable methyl mercury (MeHg) of the THg in insects varies (i.e., 35%-95% of THg) in food boluses. THg was highest in food boluses at Aunt Betty Pond at Acadia, whereas THg in eggs was highest at the Superfund site. A few eggs from nests at each of these locations exceeded the threshold (i.e., 800-1,000 ng/g, wet wt.) of embryotoxicity established for Hg. Hatching success was 88.9% to 100% among locations, but five eggs failed to hatch from 4 of the 11 clutches in which an egg exceeded this threshold. MeHg in feathers was highest in tree swallows at Aunt Betty Pond and the concentration of THg in bodies was related to the concentration in feathers. Transfer of an average of 80%-92% of the Hg in bodies to feathers may have enhanced nestling survival. Residues of Hg in tissues of tree swallows in the Northeast seem higher than those of the Midwest.

  12. Current and potential tree locations in tree line ecotone of Changbai Mountains, Northeast China: the controlling effects of topography.

    Science.gov (United States)

    Zong, Shengwei; Wu, Zhengfang; Xu, Jiawei; Li, Ming; Gao, Xiaofeng; He, Hongshi; Du, Haibo; Wang, Lei

    2014-01-01

    Tree line ecotone in the Changbai Mountains has undergone large changes in the past decades. Tree locations show variations on the four sides of the mountains, especially on the northern and western sides, which has not been fully explained. Previous studies attributed such variations to the variations in temperature. However, in this study, we hypothesized that topographic controls were responsible for causing the variations in the tree locations in tree line ecotone of the Changbai Mountains. To test the hypothesis, we used IKONOS images and WorldView-1 image to identify the tree locations and developed a logistic regression model using topographical variables to identify the dominant controls of the tree locations. The results showed that aspect, wetness, and slope were dominant controls for tree locations on western side of the mountains, whereas altitude, SPI, and aspect were the dominant factors on northern side. The upmost altitude a tree can currently reach was 2140 m asl on the northern side and 2060 m asl on western side. The model predicted results showed that habitats above the current tree line on the both sides were available for trees. Tree recruitments under the current tree line may take advantage of the available habitats at higher elevations based on the current tree location. Our research confirmed the controlling effects of topography on the tree locations in the tree line ecotone of Changbai Mountains and suggested that it was essential to assess the tree response to topography in the research of tree line ecotone.

  13. Variation in immune function, body condition, and feather corticosterone in nestling Tree Swallows (Tachycineta bicolor) on reclaimed wetlands in the Athabasca oil sands, Alberta, Canada

    International Nuclear Information System (INIS)

    Jane Harms, N.; Fairhurst, Graham D.; Bortolotti, Gary R.; Smits, Judit E.G.

    2010-01-01

    In the Athabasca oil sands region of northern Alberta, mining companies are evaluating reclamation using constructed wetlands for integration of tailings. From May to July 2008, reproductive performance of 40 breeding pairs of tree swallows (Tachycineta bicolor), plus growth and survival of nestlings, was measured on three reclaimed wetlands on two oil sands leases. A subset of nestlings was examined for i) feather corticosterone levels, ii) delayed-type hypersensitivity response, and iii) innate immune function. Nestlings on one of two wetlands created with oil sands process affected material (OSPM) were heavier and had greater wing-lengths, and mounted a stronger delayed-type hypersensitivity response compared those on the reference wetland. Corticosterone was significantly higher in male nestlings on one of two OSPM-containing wetland compared to the reference wetland. Body condition of 12-day-old female nestlings was inversely related to feather corticosterone. Under ideal weather conditions, reclaimed wetlands can support healthy populations of aerially-insectivorous birds. - Under ideal weather conditions, tree swallow nestlings on reclaimed OSPM-affected wetlands are in good body condition and mount strong cell-mediated immune responses.

  14. Health of tree swallows (Tachycineta bicolor) nesting in pesticide-sprayed apple orchards in Ontario, Canada. II. Sex and thyroid hormone concentrations and testes development.

    Science.gov (United States)

    Bishop, C A; Van Der Kraak, G J; Ng, P; Smits, J E; Hontela, A

    1998-12-25

    To investigate the effects of pesticides on wild birds, sex (17beta-estradiol; testosterone) and thyroid (triiodothyronine (T3) hormone concentrations, body mass, and testes mass were measured and the development of testes was evaluated in wild tree swallows (Tachycineta bicolor) nesting in four sprayed apple orchards and three nonsprayed sites in southern Ontario, Canada, in 1995-1996. In orchards, birds were exposed to asmany as 11 individual spray events and five sprays of mixtures of chemicals. Residues of organochlorine pesticides, PCBs, lead, and arsenic concentrations were low and not variable among sites except p,p'-DDE concentrations, which ranged from 0.36 to 2.23 microg/g wet weight in eggs. These persistent compounds were not correlated with any endocrine response measured in tree swallows. In 16-d-old male tree swallow chicks, body mass and concentrations of 17beta-estradiol (estradiol), testosterone, and T3 in plasma showed no significant differences between sprayed and nonsprayed groups and among sites within those groups. However, T3 concentrations were slightly elevated in the sprayed group compared to the nonsprayed group, and there was a significant and positive correlation between T3 and the number of mixtures of sprays applied during egg incubation through chick rearing. In 16-d-old female chicks, there were no significant differences among spray treatments or sites and no correlations with spray exposure for testosterone, estradiol, or T3 in plasma. Body mass was correlated positively with T3 and negatively with estradiol but showed no differences among spray exposure groups or sites. Histology of testes of 16-d-old male chicks indicated there were no significant differences among sprayed and nonsprayed birds in testes mass, area, or diameter, or the presence of Leydig cells in the interstitium, the distribution of the Sertoli cells, or the occurrence of heterophils in the testicular interstitium. For the percentage of spermatogonia present on

  15. Swallowing Trouble

    Science.gov (United States)

    ... throat discomfort in the throat or chest (when gastro esophageal reflux is present) a sensation of a foreign body ... to the particular cause of the swallowing disorder. Gastro esophageal reflux can often be treated by changing eating and ...

  16. Reproductive success and contaminant associations in tree swallows (Tachycineta bicolor) used to assess a Beneficial Use Impairment in U.S. and Binational Great Lakes’ Areas of Concern

    Science.gov (United States)

    Custer, Christine M.; Custer, Thomas W.; Etterson, Matthew A.; Dummer, Paul; Goldberg, Diana R.; Franson, J. Christian

    2018-01-01

    During 2010-2014, tree swallow (Tachycineta bicolor) reproductive success was monitored at 68 sites across all 5 Great Lakes, including 58 sites located within Great Lakes Areas of Concern (AOCs) and 10 non-AOCs. Sample eggs were collected from tree swallow clutches and analyzed for contaminants including polychlorinated biphenyls (PCBs), dioxins and furans, polybrominated diphenyl ethers, and 34 other organic compounds. Contaminant data were available for 360 of the clutches monitored. Markov chain multistate modeling was used to assess the importance of 5 ecological variables and 11 of the dominant contaminants in explaining the pattern of egg and nestling failure rates. Four of 5 ecological variables (Female Age, Date within season, Year, and Site) were important explanatory variables. Of the 11 contaminants, only total dioxin and furan toxic equivalents (TEQs) explained a significant amount of the egg failure probabilities. Neither total PCBs nor PCB TEQs explained the variation in egg failure rates. In a separate analysis, polycyclic aromatic hydrocarbon exposure in nestling diet, used as a proxy for female diet during egg laying, was significantly correlated with the daily probability of egg failure. The 8 sites within AOCs which had poorer reproduction when compared to 10 non-AOC sites, the measure of impaired reproduction as defined by the Great Lakes Restoration Initiative, were associated with exposure to dioxins and furan TEQs, PAHs, or depredation. Only 2 sites had poorer reproduction than the poorest performing non-AOC. Using a classic (non-modeling) approach to estimating reproductive success, 82% of nests hatched at least 1 egg, and 75% of eggs laid, excluding those collected for contaminant analyses, hatched.

  17. Current and Potential Tree Locations in Tree Line Ecotone of Changbai Mountains, Northeast China: The Controlling Effects of Topography

    OpenAIRE

    Zong, Shengwei; Wu, Zhengfang; Xu, Jiawei; Li, Ming; Gao, Xiaofeng; He, Hongshi; Du, Haibo; Wang, Lei

    2014-01-01

    Tree line ecotone in the Changbai Mountains has undergone large changes in the past decades. Tree locations show variations on the four sides of the mountains, especially on the northern and western sides, which has not been fully explained. Previous studies attributed such variations to the variations in temperature. However, in this study, we hypothesized that topographic controls were responsible for causing the variations in the tree locations in tree line ecotone of the Changbai Mountain...

  18. The Prediction and Prevention of Dysphagia After Occipitospinal Fusion by Use of the S-line (Swallowing Line).

    Science.gov (United States)

    Kaneyama, Shuichi; Sumi, Masatoshi; Takabatake, Masato; Kasahara, Koichi; Kanemura, Aritetsu; Hirata, Hiroaki; Darden, Bruce V

    2017-05-15

    Clinical case series and risk factor analysis of dysphagia after occipitospinal fusion (OSF). The aim of this study was to develop new criteria to avoid postoperative dysphagia by analyzing the relationship among the craniocervical alignment, the oropharyngeal space, and the incidence of dysphagia after OSF. Craniocervical malalignment after OSF is considered to be one of the primary triggers of postoperative dysphagia. However, ideal craniocervical alignment has not been confirmed. Thirty-eight patients were included. We measured the O-C2 angle (O-C2A) and the pharyngeal inlet angle (PIA) on the lateral cervical radiogram at follow-up. PIA is defined as the angle between McGregor's line and the line that links the center of the C1 anterior arch and the apex of cervical sagittal curvature. The impact of these two parameters on the diameter of pharyngeal airway space (PAS) and the incidence of the dysphagia were analyzed. Six of 38 cases (15.8%) exhibited the dysphagia. A multiple regression analysis showed that PIA was significantly correlated with PAS (β = 0.714, P = 0.005). Receiver-operating characteristic curves showed that PIA had a high accuracy as a predictor of the dysphagia with an AUC (area under the curve) of 0.90. Cases with a PIA less than 90 degrees showed significantly higher incidence of dysphagia (31.6%) than those with a 90 or more degrees of PIA (0.0%) (P = 0.008). Our results indicated that PIA had the high possibility to predict postoperative dysphagia by OSF with the condition of PIA dysphagia. 4.

  19. Analysis of the Optimal Duration of Behavioral Observations Based on an Automated Continuous Monitoring System in Tree Swallows (Tachycineta bicolor: Is One Hour Good Enough?

    Directory of Open Access Journals (Sweden)

    Ádám Z Lendvai

    Full Text Available Studies of animal behavior often rely on human observation, which introduces a number of limitations on sampling. Recent developments in automated logging of behaviors make it possible to circumvent some of these problems. Once verified for efficacy and accuracy, these automated systems can be used to determine optimal sampling regimes for behavioral studies. Here, we used a radio-frequency identification (RFID system to quantify parental effort in a bi-parental songbird species: the tree swallow (Tachycineta bicolor. We found that the accuracy of the RFID monitoring system was similar to that of video-recorded behavioral observations for quantifying parental visits. Using RFID monitoring, we also quantified the optimum duration of sampling periods for male and female parental effort by looking at the relationship between nest visit rates estimated from sampling periods with different durations and the total visit numbers for the day. The optimum sampling duration (the shortest observation time that explained the most variation in total daily visits per unit time was 1h for both sexes. These results show that RFID and other automated technologies can be used to quantify behavior when human observation is constrained, and the information from these monitoring technologies can be useful for evaluating the efficacy of human observation methods.

  20. Effects of in ovo exposure to 3,3',4,4'-tetrachlorobiphenyl (PCB 77) on heart development in tree swallow (Tachycineta bicolor).

    Science.gov (United States)

    Carro, Tiffany; Walker, Mary K; Dean, Karen M; Ottinger, Mary Ann

    2018-01-01

    Tree swallow (Tachycineta bicolor) eggs from 2 uncontaminated sites, the Patuxent Research Refuge (Laurel, MD, USA) and the Cobleskill Reservoir (Cobleskill, NY, USA) were dosed with polychlorinated biphenyl (PCB) 77 to evaluate effects on the developing cardiovascular system. To ensure embryonic viability, treatments were administered into the air cell at embryonic day 2.5 including: untreated (control), vehicle (filtered sterilized fatty acid mixture), 100 ng/g and 1000 ng/g egg. Eggs were dosed in the field with 0.2 μL/egg, returned to the nest, collected at embryonic day 13, hatched in the laboratory, and necropsied. The PCB 77-treated hatchlings were compared with uninjected, vehicle-injected, and environmentally exposed hatchlings collected from a PCB-contaminated Upper Hudson River (NY, USA) site. The PCB 77-treated embryos showed no effects on hatching success or hatchling mortality, heart index, or morphological measures of 4 distinct heart layers (heart width, length, septal thickness, total and ventricular cavity area) compared with controls. Hatchlings that had received PCB 77 exhibited increased incidence of a cardiomyopathy and absence of the ventricular heart wall compact layer (Chi square test; p PCB 77 resulted in distinct cardiomyopathy has implications for long-term individual fitness. Environ Toxicol Chem 2018;37:116-125. © 2017 SETAC. © 2017 SETAC.

  1. Effects of oil sands tailings compounds and harsh weather on mortality rates, growth and detoxification efforts in nestling tree swallows (Tachycineta bicolor)

    Energy Technology Data Exchange (ETDEWEB)

    Gentes, Marie-Line [Department of Veterinary Pathology, University of Saskatchewan, 52 Campus Dr., Saskatoon, SK S7N 5B4 (Canada)]. E-mail: marie-line.gentes@usask.ca; Waldner, Cheryl [Department of Large Animal Clinical Sciences, University of Saskatchewan, 52 Campus Dr., Saskatoon, SK S7N 5B4 (Canada)]. E-mail: cheryl.waldner@usask.ca; Papp, Zsuzsanna [Toxicology Research Centre, 44 Campus Dr., Saskatoon, SK S7N 5B3 (Canada)]. E-mail: zsp127@duke.usask.ca; Smits, Judit E.G. [Department of Veterinary Pathology, University of Saskatchewan, 52 Campus Dr., Saskatoon, SK S7N 5B4 (Canada)]. E-mail: judit.smits@usask.ca

    2006-07-15

    Oil sands mining companies in Alberta, Canada, are evaluating the feasibility of using wetlands to detoxify oil sands process material (OSPM) as a reclamation strategy. Reproductive success, nestling growth, survival and ethoxyresorufin-o-deethylase (EROD) activity were measured in tree swallows (Tachycineta bicolor) on experimental wetlands. In 2003, harsh weather triggered a widespread nestling die-off. Mortality rates on the control site reached 48% while they ranged from 59% to 100% on reclaimed wetlands. The odds of dying on the most process-affected sites were more than ten times higher than those on the control site. In 2004, weather was less challenging. Mortality rates were low, but nestlings on reclaimed wetlands weighed less than those on the control site, and had higher EROD activity. These results indicate that compared with reference birds, nestlings from OSPM-impacted wetlands may be less able to withstand additional stressors, which could decrease their chances of survival after fledging. - Under natural stress caused by harsh weather, birds exposed to chemicals from the oil sands extraction process suffered higher mortality than those in control areas.

  2. Effects of oil sands tailings compounds and harsh weather on mortality rates, growth and detoxification efforts in nestling tree swallows (Tachycineta bicolor)

    International Nuclear Information System (INIS)

    Gentes, Marie-Line; Waldner, Cheryl; Papp, Zsuzsanna; Smits, Judit E.G.

    2006-01-01

    Oil sands mining companies in Alberta, Canada, are evaluating the feasibility of using wetlands to detoxify oil sands process material (OSPM) as a reclamation strategy. Reproductive success, nestling growth, survival and ethoxyresorufin-o-deethylase (EROD) activity were measured in tree swallows (Tachycineta bicolor) on experimental wetlands. In 2003, harsh weather triggered a widespread nestling die-off. Mortality rates on the control site reached 48% while they ranged from 59% to 100% on reclaimed wetlands. The odds of dying on the most process-affected sites were more than ten times higher than those on the control site. In 2004, weather was less challenging. Mortality rates were low, but nestlings on reclaimed wetlands weighed less than those on the control site, and had higher EROD activity. These results indicate that compared with reference birds, nestlings from OSPM-impacted wetlands may be less able to withstand additional stressors, which could decrease their chances of survival after fledging. - Under natural stress caused by harsh weather, birds exposed to chemicals from the oil sands extraction process suffered higher mortality than those in control areas

  3. Tree and shrub expansion over the past 34 years at the tree-line near Abisko, Sweden.

    Science.gov (United States)

    Rundqvist, Sara; Hedenås, Henrik; Sandström, Anneli; Emanuelsson, Urban; Eriksson, Håkan; Jonasson, Christer; Callaghan, Terry V

    2011-09-01

    Shrubs and trees are expected to expand in the sub-Arctic due to global warming. Our study was conducted in Abisko, sub-arctic Sweden. We recorded the change in coverage of shrub and tree species over a 32- to 34-year period, in three 50 x 50 m plots; in the alpine-tree-line ecotone. The cover of shrubs and trees (tree stems (> or =3.5 cm) were noted and positions determined. There has been a substantial increase of cover of shrubs and trees, particularly dwarf birch (Betula nana), and mountain birch (Betula pubescens ssp. czerepanovii), and an establishment of aspen (Populus tremula). The other species willows (Salix spp.), juniper (Juniperus communis), and rowan (Sorbus aucuparia) revealed inconsistent changes among the plots. Although this study was unable to identify the causes for the change in shrubs and small trees, they are consistent with anticipated changes due to climate change and reduced herbivory.

  4. EROD activity, chromosomal damage, and oxidative stress in response to contaminants exposure in tree swallow (Tachycineta bicolor) nestlings from Great Lakes Areas of Concern

    Science.gov (United States)

    Custer, Thomas W.; Custer, Christine M.; Dummer, Paul; Bigorgne, Emilie; Oziolor, Elias; Karouna-Renier, Natalie K.; Schultz, Sandra; Erickson, Richard A.; Aagaard, Kevin; Matson, Cole W.

    2017-01-01

    Tree swallow, Tachycineta bicolor, nestlings were collected from 60 sites in the Great Lakes, which included multiple sites within 27 Areas of Concern (AOCs) and six sites not listed as AOCs from 2010 to 2014. Nestlings, approximately 12 days-of-age, were evaluated for ethoxyresorufin-O-dealkylase (EROD) activity, chromosomal damage, and six measures of oxidative stress. Data on each of these biomarkers were divided into four equal numbered groups from the highest to lowest values and the groups were compared to contaminant concentrations using multivariate analysis. Contaminant concentrations, from the same nestlings, included polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), perfluorinated compounds (PFCs), and 17 elements. Alkylated polycyclic aromatic hydrocarbons (aPAHs) and parent PAHs (pPAHs) were measured in pooled nestling dietary samples. Polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans, and pesticides were measured in sibling eggs. Concentrations of aPAHs, pPAHs, chlordane, dieldrin, heptachlor, and PCBs, in that order, were the major contributors to the significant differences between the lowest and highest EROD activities; PFCs, PBDEs, the remaining pesticides, and all elements were of secondary importance. The four categories of chromosomal damage did not separate out well based on the contaminants measured. Concentrations of aPAHs, pPAHs, heptachlor, PCBs, chlordane, and dieldrin were the major contributors to the significant differences between the lowest and highest activities of two oxidative stress measures, total sulfhydryl (TSH) activity and protein bound sulfhydryl (PBSH) activity. The four categories of thiobarbituric acid reacting substances (TBARS), oxidized glutathione (GSSG), reduced glutathione (GSH), and the ratio of GSSG/GSH did not separate well based on the contaminants measured.

  5. Speech and Swallowing

    Science.gov (United States)

    ... like stuttering. The term for swallowing difficulty is dysphagia. It affects the mechanics of swallowing and quality ... as dining with friends or family. More importantly, dysphagia can lead to malnutrition, dehydration and aspiration (when ...

  6. Most Recent Match Queries in On-Line Suffix Trees

    DEFF Research Database (Denmark)

    Larsson, N. Jesper

    2014-01-01

    A suffix tree is able to efficiently locate a pattern in an indexed string, but not in general the most recent copy of the pattern in an online stream, which is desirable in some applications. We study the most general version of the problem of locating a most recent match: supporting queries...

  7. Investigation of Tree Spectral Reflectance Characteristics Using a Mobile Terrestrial Line Spectrometer and Laser Scanner

    Directory of Open Access Journals (Sweden)

    Eetu Puttonen

    2013-07-01

    Full Text Available In mobile terrestrial hyperspectral imaging, individual trees often present large variations in spectral reflectance that may impact the relevant applications, but the related studies have been seldom reported. To fill this gap, this study was dedicated to investigating the spectral reflectance characteristics of individual trees with a Sensei mobile mapping system, which comprises a Specim line spectrometer and an Ibeo Lux laser scanner. The addition of the latter unit facilitates recording the structural characteristics of the target trees synchronously, and this is beneficial for revealing the characteristics of the spatial distributions of tree spectral reflectance with variations at different levels. Then, the parts of trees with relatively low-level variations can be extracted. At the same time, since it is difficult to manipulate the whole spectrum, the traditional concept of vegetation indices (VI based on some particular spectral bands was taken into account here. Whether the assumed VIs capable of behaving consistently for the whole crown of each tree was also checked. The specific analyses were deployed based on four deciduous tree species and six kinds of VIs. The test showed that with the help of the laser scanner data, the parts of individual trees with relatively low-level variations can be located. Based on these parts, the relatively stable spectral reflectance characteristics for different tree species can be learnt.

  8. Temperature, precipitation and biotic interactions as determinants of tree seedling recruitment across the tree line ecotone.

    Science.gov (United States)

    Tingstad, Lise; Olsen, Siri Lie; Klanderud, Kari; Vandvik, Vigdis; Ohlson, Mikael

    2015-10-01

    Seedling recruitment is a critical life history stage for trees, and successful recruitment is tightly linked to both abiotic factors and biotic interactions. In order to better understand how tree species' distributions may change in response to anticipated climate change, more knowledge of the effects of complex climate and biotic interactions is needed. We conducted a seed-sowing experiment to investigate how temperature, precipitation and biotic interactions impact recruitment of Scots pine (Pinus sylvestris) and Norway spruce (Picea abies) seedlings in southern Norway. Seeds were sown into intact vegetation and experimentally created gaps. To study the combined effects of temperature and precipitation, the experiment was replicated across 12 sites, spanning a natural climate gradient from boreal to alpine and from sub-continental to oceanic. Seedling emergence and survival were assessed 12 and 16 months after sowing, respectively, and above-ground biomass and height were determined at the end of the experiment. Interestingly, very few seedlings were detected in the boreal sites, and the highest number of seedlings emerged and established in the alpine sites, indicating that low temperature did not limit seedling recruitment. Site precipitation had an overall positive effect on seedling recruitment, especially at intermediate precipitation levels. Seedling emergence, establishment and biomass were higher in gap plots compared to intact vegetation at all temperature levels. These results suggest that biotic interactions in the form of competition may be more important than temperature as a limiting factor for tree seedling recruitment in the sub- and low-alpine zone of southern Norway.

  9. Soil warming and CO2 enrichment induce biomass shifts in alpine tree line vegetation.

    Science.gov (United States)

    Dawes, Melissa A; Philipson, Christopher D; Fonti, Patrick; Bebi, Peter; Hättenschwiler, Stephan; Hagedorn, Frank; Rixen, Christian

    2015-05-01

    Responses of alpine tree line ecosystems to increasing atmospheric CO2 concentrations and global warming are poorly understood. We used an experiment at the Swiss tree line to investigate changes in vegetation biomass after 9 years of free air CO2 enrichment (+200 ppm; 2001-2009) and 6 years of soil warming (+4 °C; 2007-2012). The study contained two key tree line species, Larix decidua and Pinus uncinata, both approximately 40 years old, growing in heath vegetation dominated by dwarf shrubs. In 2012, we harvested and measured biomass of all trees (including root systems), above-ground understorey vegetation and fine roots. Overall, soil warming had clearer effects on plant biomass than CO2 enrichment, and there were no interactive effects between treatments. Total plant biomass increased in warmed plots containing Pinus but not in those with Larix. This response was driven by changes in tree mass (+50%), which contributed an average of 84% (5.7 kg m(-2) ) of total plant mass. Pinus coarse root mass was especially enhanced by warming (+100%), yielding an increased root mass fraction. Elevated CO2 led to an increased relative growth rate of Larix stem basal area but no change in the final biomass of either tree species. Total understorey above-ground mass was not altered by soil warming or elevated CO2 . However, Vaccinium myrtillus mass increased with both treatments, graminoid mass declined with warming, and forb and nonvascular plant (moss and lichen) mass decreased with both treatments. Fine roots showed a substantial reduction under soil warming (-40% for all roots soil depth) but no change with CO2 enrichment. Our findings suggest that enhanced overall productivity and shifts in biomass allocation will occur at the tree line, particularly with global warming. However, individual species and functional groups will respond differently to these environmental changes, with consequences for ecosystem structure and functioning. © 2014 John Wiley & Sons Ltd.

  10. Widespread Amazon forest tree mortality from a single cross-basin squall line event

    Science.gov (United States)

    Negrón-Juárez, Robinson I.; Chambers, Jeffrey Q.; Guimaraes, Giuliano; Zeng, Hongcheng; Raupp, Carlos F. M.; Marra, Daniel M.; Ribeiro, Gabriel H. P. M.; Saatchi, Sassan S.; Nelson, Bruce W.; Higuchi, Niro

    2010-08-01

    Climate change is expected to increase the intensity of extreme precipitation events in Amazonia that in turn might produce more forest blowdowns associated with convective storms. Yet quantitative tree mortality associated with convective storms has never been reported across Amazonia, representing an important additional source of carbon to the atmosphere. Here we demonstrate that a single squall line (aligned cluster of convective storm cells) propagating across Amazonia in January, 2005, caused widespread forest tree mortality and may have contributed to the elevated mortality observed that year. Forest plot data demonstrated that the same year represented the second highest mortality rate over a 15-year annual monitoring interval. Over the Manaus region, disturbed forest patches generated by the squall followed a power-law distribution (scaling exponent α = 1.48) and produced a mortality of 0.3-0.5 million trees, equivalent to 30% of the observed annual deforestation reported in 2005 over the same area. Basin-wide, potential tree mortality from this one event was estimated at 542 ± 121 million trees, equivalent to 23% of the mean annual biomass accumulation estimated for these forests. Our results highlight the vulnerability of Amazon trees to wind-driven mortality associated with convective storms. Storm intensity is expected to increase with a warming climate, which would result in additional tree mortality and carbon release to the atmosphere, with the potential to further warm the climate system.

  11. Holocene tree-line variability in the Kauner Valley, Central Eastern Alps, indicated by dendrochronological analysis of living trees and subfossil logs

    NARCIS (Netherlands)

    Nicolussi, Kurt; Kaufmann, Matthias; Patzelt, Gernot; van der Plicht, Johannes; Thurner, Andrea

    2005-01-01

    The altitude of the Alpine tree-line has often been used as proxy for the climatic conditions in the Holocene epoch. The usual approach for establishing a record for this proxy is the analysis of pollen and macro remains. We analysed living trees and subfossil logs from the timberline ecotone in the

  12. Biodiversity and climate change: consequences for upper tree line in Slovakia

    Directory of Open Access Journals (Sweden)

    Minďaš Jozef

    2016-09-01

    Full Text Available Study of the effects of climate change on upper tree limit has mainly focused on the diversity of tree species as a result of the ability of species to tolerate temperature and moisture changes as well as some effects of disturbance regime changes. The tree species diversity changes due to climate change has been analysed via gap model and biodiversity indices. Gap models are individually based on simulations of establishment, growth, and mortality of each tree on the forest plot. Input ecological data for model calculations have been taken from the permanent research plots located in primeval forests in mountainous regions in Slovakia. The results of regional scenarios of the climatic change for the territory of Slovakia have been used, from which the values according to the CGCM3.1 (global model, KNMI and MPI (regional models. Model results for conditions of the climate change scenarios suggest a shift of the upper forest limit to the region of the present subalpine zone, in supramontane zone. The most significant tree species diversity changes have been identified for the upper tree line and current belt of dwarf pine (Pinus mugo occurrence. Hill’s index of biodiversity in the upper forest line increased by 30 – 35% for horizon of 2050, resp. by 45 – 50% modeled for the horizon of 2075. Calculated values of Shannon’s index show an even higher increase due to climate change. For horizon 2050 is a roughly of three fold increase and horizon for 2075 by almost fivefold increase in the value of the index. Results from the gap model indicate the increase of tree species diversity 2 – 2,5 times.

  13. [Dysphagia and swallowing rehabilitation].

    Science.gov (United States)

    Shigematsu, Takashi; Fujishima, Ichiro

    2015-02-01

    Dysphagia is a life-threatening disorder caused by many medical conditions such as stroke, neurological disorders, tumors, etc. The symptoms of dysphagia are quite variable and diagnosed by observation or through screening involving instrumental swallowing examinations such as video-fluoroscopy and video-endoscopy, to determine functional severity and treatment-prognosis. Direct- and indirect-therapy is used with and without food, respectively. Swallowing rehabilitation is very effective, and could be used in conjunction with compensatory techniques. Here we present an overview of dysphagia and swallowing rehabilitation.

  14. Tree Line Structure and Dynamics at the Northern Limit of the Larch Forest: Anabar Plateau, Siberia, Russia

    Science.gov (United States)

    Kharuk, Viacheslav I.; Ranson, Kenneth J.; Im, Sergey T.; Oskorbin, Pavel A.; Dvinskaya, Maria L.; Ovchinnikov, Dmitriy V.

    2013-01-01

    The goal of the study was to provide an analysis of climate impact before, during, and after the Little Ice Age (LIA) on the larch (Larix gmelinii) tree line at the northern extreme of Siberian forests. Recent decadal climate change impacts on the tree line, regeneration abundance, and age structure were analyzed. The location of the study area was within the forest-tundra ecotone (elevation range 170-450 m) in the Anabar Plateau, northern Siberia. Field studies were conducted along elevational transects. Tree natality/mortality and radial increment were determined based on dendrochronology analyses. Tree morphology, number of living and subfossil trees, regeneration abundance, and age structure were studied. Locations of pre-LIA, LIA, and post-LIA tree lines and refugia boundaries were established. Long-term climate variables and drought index were included in the analysis. It was found that tree mortality from the 16th century through the beginning of the 19th century caused a downward tree line recession. Sparse larch stands experienced deforestation, transforming into tundra with isolated relict trees. The maximum tree mortality and radial growth decrease were observed to have occurred at the beginning of 18th century. Now larch, at its northern boundary in Siberia, is migrating into tundra areas. Upward tree migration was induced by warming in the middle of the 19th century. Refugia played an important role in repopulation of the forest-tundra ecotone by providing a seed source and shelter for recruitment of larch regeneration. Currently this ecotone is being repopulated mainly by tree cohorts that were established after the 1930s. The last two decades of warming did not result in an acceleration of regeneration recruitment because of increased drought conditions. The regeneration line reached (but did not exceed) the pre-LIA tree line location, although contemporary tree heights and stand densities are comparatively lower than in the pre-LIA period. The mean

  15. Soil N mineralization profiles of co-existing woody vegetation islands at the alpine tree line

    Czech Academy of Sciences Publication Activity Database

    Wang, L.; Godbold, Douglas

    2017-01-01

    Roč. 136, 5-6 (2017), s. 881-892 ISSN 1612-4669 R&D Projects: GA MŠk(CZ) LO1415 Institutional support: RVO:67179843 Keywords : Tree line * Soil N mineralization * in situ field incubation * Soil N availability * Resin capsule * Woody vegetation islands Subject RIV: DF - Soil Science OBOR OECD: Soil science Impact factor: 2.017, year: 2016

  16. Decision support for mitigating the risk of tree induced transmission line failure in utility rights-of-way.

    Science.gov (United States)

    Poulos, H M; Camp, A E

    2010-02-01

    Vegetation management is a critical component of rights-of-way (ROW) maintenance for preventing electrical outages and safety hazards resulting from tree contact with conductors during storms. Northeast Utility's (NU) transmission lines are a critical element of the nation's power grid; NU is therefore under scrutiny from federal agencies charged with protecting the electrical transmission infrastructure of the United States. We developed a decision support system to focus right-of-way maintenance and minimize the potential for a tree fall episode that disables transmission capacity across the state of Connecticut. We used field data on tree characteristics to develop a system for identifying hazard trees (HTs) in the field using limited equipment to manage Connecticut power line ROW. Results from this study indicated that the tree height-to-diameter ratio, total tree height, and live crown ratio were the key characteristics that differentiated potential risk trees (danger trees) from trees with a high probability of tree fall (HTs). Products from this research can be transferred to adaptive right-of-way management, and the methods we used have great potential for future application to other regions of the United States and elsewhere where tree failure can disrupt electrical power.

  17. Ecology Art Education On-Line: A World Community of Old Trees, A Story of the Research

    Science.gov (United States)

    Julian, June

    1997-01-01

    "A World Community of Old Trees," http://www.nyu.edu/projects/julian/, is the Internet research component of the doctoral dissertation, "Ecology Art Education On-Line: A World Community of Old Trees." It is the first study in the discipline of Art Education to use the World Wide Web to transmit and receive data for doctoral…

  18. Difficulty Swallowing After Stroke (Dysphagia)

    Science.gov (United States)

    ... Stroke Heroes Among Us Difficulty Swallowing After Stroke (Dysphagia) Updated:Nov 15,2016 Excerpted and adapted from "Swallowing Disorders After a Stroke," Stroke Connection Magazine July/August ...

  19. Swallowing Disorders in Schizophrenia.

    Science.gov (United States)

    Kulkarni, Deepika P; Kamath, Vandan D; Stewart, Jonathan T

    2017-08-01

    Disorders of swallowing are poorly characterized but quite common in schizophrenia. They are a source of considerable morbidity and mortality in this population, generally as a result of either acute asphyxia from airway obstruction or more insidious aspiration and pneumonia. The death rate from acute asphyxia may be as high as one hundred times that of the general population. Most swallowing disorders in schizophrenia seem to fall into one of two categories, changes in eating and swallowing due to the illness itself and changes related to psychotropic medications. Behavioral changes related to the illness are poorly understood and often involve eating too quickly or taking inappropriately large boluses of food. Iatrogenic problems are mostly related to drug-induced extrapyramidal side effects, including drug-induced parkinsonism, dystonia, and tardive dyskinesia, but may also include xerostomia, sialorrhea, and changes related to sedation. This paper will provide an overview of common swallowing problems encountered in patients with schizophrenia, their pathophysiology, and management. While there is a scarcity of quality evidence in the literature, a thorough history and examination will generally elucidate the predominant problem or problems, often leading to effective management strategies.

  20. Trees

    Science.gov (United States)

    Al-Khaja, Nawal

    2007-01-01

    This is a thematic lesson plan for young learners about palm trees and the importance of taking care of them. The two part lesson teaches listening, reading and speaking skills. The lesson includes parts of a tree; the modal auxiliary, can; dialogues and a role play activity.

  1. Catchment features controlling nitrogen dynamics in running waters above the tree line (central Italian Alps

    Directory of Open Access Journals (Sweden)

    R. Balestrini

    2013-03-01

    Full Text Available The study of nitrogen cycling in mountain areas has a long tradition, as it was applied to better understand and describe ecosystem functioning, as well as to quantify long-distance effects of human activities on remote environments. Nonetheless, very few studies, especially in Europe, have considered catchment features controlling nitrogen dynamics above the tree line with focus on running waters. In this study, relationships between some water chemistry descriptors – including nitrogen species and dissolved organic carbon (DOC – and catchment characteristics were evaluated for a range of sites located above the tree line (1950–2650 m a.s.l. at Val Masino, in the central Italian Alps. Land cover categories as well as elevation and slope were assessed at each site. Water samples were collected during the 2007 and 2008 snow free periods, with a nearly monthly frequency. In contrast to dissolved organic nitrogen, nitrate concentrations in running waters showed a spatial pattern strictly connected to the fractional extension of tundra and talus in each basin. Exponential models significantly described the relationships between maximum NO3 and the fraction of vegetated soil cover (negative relation and talus (positive relation, explaining almost 90% of nitrate variation in running waters. Similarly to nitrate but with an opposite behavior, DOC was positively correlated with vegetated soil cover and negatively correlated with talus. Therefore, land cover can be considered one of the most important factors affecting water quality in high-elevation catchments with contrasting effects on N and C pools.

  2. BuddySuite: Command-Line Toolkits for Manipulating Sequences, Alignments, and Phylogenetic Trees.

    Science.gov (United States)

    Bond, Stephen R; Keat, Karl E; Barreira, Sofia N; Baxevanis, Andreas D

    2017-06-01

    The ability to manipulate sequence, alignment, and phylogenetic tree files has become an increasingly important skill in the life sciences, whether to generate summary information or to prepare data for further downstream analysis. The command line can be an extremely powerful environment for interacting with these resources, but only if the user has the appropriate general-purpose tools on hand. BuddySuite is a collection of four independent yet interrelated command-line toolkits that facilitate each step in the workflow of sequence discovery, curation, alignment, and phylogenetic reconstruction. Most common sequence, alignment, and tree file formats are automatically detected and parsed, and over 100 tools have been implemented for manipulating these data. The project has been engineered to easily accommodate the addition of new tools, is written in the popular programming language Python, and is hosted on the Python Package Index and GitHub to maximize accessibility. Documentation for each BuddySuite tool, including usage examples, is available at http://tiny.cc/buddysuite_wiki. All software is open source and freely available through http://research.nhgri.nih.gov/software/BuddySuite. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution 2017. This work is written by US Government employees and is in the public domain in the US.

  3. Variability of the tree-rings structure of Gmelin’s larch at northern tree line (peninsula of Taymyr

    Directory of Open Access Journals (Sweden)

    V. V. Fakhrutdinova

    2017-04-01

    Full Text Available The study of tree-ring cell structure changes as the result of tree adaptation to varying environmental conditions becomes increasingly important to predict future vegetation shifts under projected climate changes. The estimate of intrapopulation annual variability of wood anatomy characteristics is particularly informative. It helps to divide the contribution of different ecological factors to total features dispersion. In this work, a comparative analysis of individual and climatic variability of tree ring structure characteristics of Gmelin’s larch Larix gmelinii (Rupr. growth within northernmost forest was carried out. The trees from forest-tundra boundary has greater radial growth intensity, forms the bigger conductive zone in rings with wider mean lumen area in comparison with trees from closed forest. This result can be explained by adaptive features and height ecological xylem plasticity of larch. The tree rings structure of larch from boundary with tundra is determined by largely current weather conditions. Is because these ones evince high adaptive plasticity on the level of xylem structure. The xylem reflects joint changes of climate factors and local ecological conditions. The trees from closed forest are characterized by larger individual variability. The local conditions in oldest forest (for example, bad hydrothermal soil conditions inhibit the radial growth and sensitivity to environmental factors. In this case, the trees on individual level are tended to save the normal functioning of water-transport system. The significant differences in ratio individual to climate variability of tree ring structure characteristics can be caused by the different in the level of ecological habitat heterogeneity or the different in the level genetic within-population heterogeneity.

  4. Dynamic imaging of oropharyngeal swallowing

    International Nuclear Information System (INIS)

    Fanucci, A.; Cerro, P.; Diotallevi, P.; Metastasio, F.; Fanucci, E.

    1991-01-01

    Oropharyngeal swallowing is too fast and complex a motion for the human eye to seize its various phases and subsequently evaluate morphology and function of the anatomical structures involved. A chronological subdivision of the swallowing act is needed for e step-by-step analysis. Dinamic evaluation of oropharyngeal swallowing by means of fluoroscopic and US videorecording proved to be a reliable method. Echovideorecording allowed tongue movements to be depicted, together with bolus formation and propulsion. Fluorovideorecording (U-Matic Sony unit, 25-30 images/sec) demonstrated pharyngeal and esophageal phases. A series of chronological and morphological reference points, which characterize oropharyngeal swallowing, were employed to analyze videorecorded images. Slowmotion mode, 'freezed' images, and rewinding allowed an easy and accurate evaluation of swallowing details. Combined chronological and morphological pieces of information allow a comprehensive evaluation of the swallowing act

  5. Holocene Tree Line and Climate Change on the Queen Charlotte Islands, Canada

    Science.gov (United States)

    Pellatt, Marlow G.; Mathewes, Rolf W.

    1997-07-01

    Palynological study of two subalpine ponds on the Queen Charlotte Islands reveals changes in tree line and climate during the Holocene. The findings agree with previous reconstructions, from nearby Louise Pond on the Queen Charlotte Islands, that suggest a warmer-than-present climate and higher-than-present tree lines in the early Holocene (ca. 9600-6600 14C yr B.P.). Basal ages at SC1 Pond and Shangri-La Bog indicate that the basins did not hold permanent water before 7200 14C yr B.P., consistent with a warmer and drier early Holocene previously inferred from Louise Pond. Pollen and plant macrofossils indicate the initial establishment of subalpine conditions by 6090 ± 90 14C yr B.P., similar to the 5790 ± 130 14C yr B.P. age for cooling inferred from Louise Pond. Conditions similar to present were established at SC1 Pond by 3460 ± 100 14C yr B.P., confirming the previous estimate of 3400 14C yr B.P. at Louise Pond. This 3400 14C yr B.P. vegetation shift on the Queen Charlotte Islands corresponds with the beginning of the Tiedemann glacial advance in the south-coastal mountains of British Columbia (ca. 3300 14C yr B.P.), the Peyto and Robson glacial advances between 3300 and 2800 14C yr B.P. in the Rocky Mountains, and climatic cooling inferred from palynological studies throughout southern British Columbia, northern Washington, and southeast Alaska. These findings confirm that changes in regional climate influenced changes in vegetation in coastal British Columbia.

  6. Comparison of optical properties of chromophoric dissolved organic matter (CDOM) in alpine lakes above or below the tree line: insights into sources of CDOM.

    Science.gov (United States)

    Su, Yaling; Chen, Feizhou; Liu, Zhengwen

    2015-05-01

    Here we investigated absorption and fluorescence properties of chromophoric dissolved organic matter (CDOM) in 15 alpine lakes located below or above the tree line to determine its source and composition. The results indicate that the concentrations of CDOM in below-tree-line lakes are significantly higher than in above-tree-line lakes, as evidenced from the absorption coefficients of a250 and a365. The intensities of the protein-like and humic-like fluorescence in below-tree-line lakes are higher than in above-tree-line lakes as well. Three fluorescent components were identified using parallel factor analysis (PARAFAC) modelling. Component 1 is probably associated with biological degradation of terrestrial humic component. The terrestrial humic-like component 2 is only found in below-tree-line lakes. The protein-like or phenolic component 3 is dominant in above-tree-line lakes, which is probably more derived from autochthonous origin. In this study, (1) higher a250/a365 and S275-295 values indicate smaller molecular weights of CDOM in above-tree-line lakes than in below-tree-line lakes, and smaller molecular weights at the surface than at 2.0 m depth; (2) SUVA254 and FI255 results provide evidence of lower percent aromaticity of CDOM in above-tree-line lakes; and (3) FI310 and FI370 suggest a strong allochthonous origin at the surface in below-tree-line lakes, and more contribution from autochthonous biological and aquatic bacterial origin in above-tree-line lakes.

  7. Modeling a two-layer flow system at the subarctic, subalpine tree line during snowmelt

    Science.gov (United States)

    Leenders, Erica E.; Woo, Ming-Ko

    2002-10-01

    In the subarctic it is common to encounter a two-layer flow system consisting of a porous organic cover overlying frozen or unfrozen mineral soils with much lower hydraulic conductivities. The "simple lumped reservoir parametric," or "semidistributed land-use-based runoff processes" (SLURP), model was adapted to simulate runoff generated by such a flow system from an upland shrub land to an open woodland downslope. A subalpine site in Wolf Creek, Yukon, Canada, was subdivided into two aggregated simulation areas (ASA), each being a unit characterized by a set of parameters. The model computes the vertical water balance and flow generation from several storages, and then routes the water out of the ASA. When applied to the 1999 snowmelt season, the model simulated the very low lateral flow and a large increase in storage in the mineral soil, as was observed in the field. The model was used to assess the sensitivity of the two-layer flow system under a range of temperature, snow cover, and frost conditions. Results show that within the range of possible climatic conditions, the hydrologic system is unlikely to yield significant runoff across the subalpine tree line, but if ground ice is abundant in the soil pores, percolation will be limited and fast flow from the surface layer is enhanced.

  8. Partial diagnosis of street tree under power lines in West Regional of Minas Gerais

    Directory of Open Access Journals (Sweden)

    Altamir Fernandes de Oliveira

    2016-03-01

    Full Text Available This work aimed to present a partial diagnosis of street tree under power grid in five cities in the West Region of Minas Gerais, which had more power outages because of conflicts with trees. We identified 186 trees, belonging to 17 species of exotic origin and 30 species of native origin. The most frequent species were Poincianella pluviosa (30.43%, Ligustrum lucidum (10.86%, Michelia champaca (6.52% and Schinus molle (4.89%, which together amounted to 52.7% of the assessed trees. Most trees (84.78% were located in streets wider than 7 m, and 36.55% of the trees were planted in sidewalks with a minimum of 2 m wide. Those trees present ther first bifurcation at over 1.80 m above ground level. The pruning performed due to conflicts with the grid amounted 40.22%. Trees with height equal or over 6 m represents 72.83% of the sampled population. It was observed that there is not an appropriate management plan of urban trees under the grid, as the trees frequency is concentrate on few species that were mostly medium and large size.

  9. Bank Swallow - Monitoring [ds6

    Data.gov (United States)

    California Natural Resource Agency — The data set represents the annual count of bank swallow burrows at nesting colonies located along the Sacramento River. The data set contains two databases which...

  10. Roosts and migrations of swallows

    OpenAIRE

    Winkler, David W.

    2006-01-01

    Swallows of the north temperate zone display a wide variety of territorial behaviour during the breeding season, but as soon as breeding is over, they all appear to adopt a pattern of independent diurnal foraging interleaved with aggregation every night in dense roosts. Swallows generally migrate during the day, feeding on the wing. On many stretches of their annual journeys, their migrations can thus be seen as the simple spatial translation of nocturnal roost sites with foraging routes stra...

  11. The Growth of Bosnian Pine (Pinus hedreichii Christ.) at Tree-Line Locations from Kosovo and its Response to Climate

    OpenAIRE

    Bojaxhi, Faruk; Toromani, Elvin

    2016-01-01

    Background and Purpose: Pinus heldreichii Christ. is a sub-endemic species occurring at tree-line locations in Kosovo and covering an area of 2500 ha. In high elevation sites radial growth is mainly controlled by low temperatures. The main purpose of this study was the analysis of radial growth of P. heldreichii and its response to local climate conditions. Materials and Methods: Research sites comprise of three high elevation stands of P. heldreichii with specific site conditions. Core sa...

  12. Evaluation of swallowing ability using swallowing sounds in maxillectomy patients.

    Science.gov (United States)

    Kamiyanagi, A; Sumita, Y; Ino, S; Chikai, M; Nakane, A; Tohara, H; Minakuchi, S; Seki, Y; Endo, H; Taniguchi, H

    2018-02-01

    Maxillectomy for oral tumours often results in debilitating oral hypofunction, which markedly decreases quality of life. Dysphagia, in particular, is one of the most serious problems following maxillectomy. This study used swallowing sounds as a simple evaluation method to evaluate swallowing ability in maxillectomy patients with and without their obturator prosthesis placed. Twenty-seven maxillectomy patients (15 men, 12 women; mean age 66.0 ± 12.1 years) and 30 healthy controls (14 men, 16 women; mean age 44.9 ± 21.3 years) were recruited for this study. Participants were asked to swallow 4 mL of water, and swallowing sounds were recorded using a throat microphone. Duration of the acoustic signal and duration of peak intensity (DPI) were measured. Duration of peak intensity was significantly longer in maxillectomy patients without their obturator than with it (P maxillectomy patients without their obturator than in healthy controls (P maxillectomy patients who had undergone soft palate resection than in those who had not (P maxillectomy patients could be improved by wearing an obturator prosthesis, particularly during the oral stage. However, it is difficult to improve the oral stage of swallowing in patients who have undergone soft palate resection even with obturator placement. © 2017 John Wiley & Sons Ltd.

  13. Swallowing disorders after ischemic stroke

    Directory of Open Access Journals (Sweden)

    Gabriela Camargo Remesso

    2011-10-01

    Full Text Available OBJECTIVE: To investigate occurrences of swallowing disorders after ischemic stroke. METHOD: This was a retrospective study on 596 medical files. The inclusion criterion was that the patients needed to have been hospitalized with a diagnosis of ischemic stroke; the exclusion criteria were the presence of associated cardiac problems and hospital stay already more than 14 days. RESULTS: 50.5% were men and 49.5% women; mean age 65.3 years (SD=±11.7 (p<0.001. Among the risk factors, 79.4% had hypertension, 36.7% had diabetes (p<0.001 and 42.7% were smokers. 13.3% of the patients died. Swallowing disorders occurred in 19.6%, among whom 91.5% had mild difficulty and 8.5% had severe difficulty. 87.1% had spontaneous recovery after a mean of 2.4 months. A lesion in the brainstem region occurred in 6.8% (p<0.001. CONCLUSION: Swallowing disorders occurred in almost 20% of the population and most of the difficulty in swallowing found was mild. The predictors for swallowing disorders were older age, diabetes mellitus and lesions in the brainstem region.

  14. Swallowing disorders in Parkinson's disease.

    Science.gov (United States)

    Mamolar Andrés, Sandra; Santamarina Rabanal, María Liliana; Granda Membiela, Carla María; Fernández Gutiérrez, María José; Sirgo Rodríguez, Paloma; Álvarez Marcos, César

    Parkinson's disease is a type of chronic neurodegenerative pathology with a typical movement pattern, as well as different, less studied symptoms such as dysphagia. Disease-related disorders in efficacy or safety in the process of swallowing usually lead to malnutrition, dehydration or pneumonias. The aim of this study was identifying and analyzing swallowing disorders in Parkinson's disease. The initial sample consisted of 52 subjects with Parkinson's disease to whom the specific test for dysphagia SDQ was applied. Nineteen participants (36.5%) with some degree of dysphagia in the SDQ test were selected to be evaluated by volume-viscosity clinical exploration method and fiberoptic endoscopic evaluation of swallowing. Disorders in swallowing efficiency and safety were detected in 94.7% of the selected sample. With regards to efficiency, disorders were found in food transport (89.5%), insufficient labial closing (68.4%) and oral residues (47.4%), relating to duration of ingestion. Alterations in security were also observed: pharynx residues (52.7%), coughing (47.4%), penetration (31.64%), aspiration and decrease of SaO 2 (5.3%), relating to the diagnosis of respiratory pathology in the previous year. The SDQ test detected swallowing disorders in 36.5% of the subjects with Parkinson's disease. Disorders in swallowing efficiency and safety were demonstrated in 94.7% of this subset. Disorders of efficiency were more frequent than those of safety, establishing a relationship with greater time in ingestion and the appearance of respiratory pathology and pneumonias. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  15. Does Barium Influence Tongue Behaviors during Swallowing?

    Science.gov (United States)

    Steele, Catriona M.; van Lieshout, Pascal H. H. M.

    2005-01-01

    The validity of videofluoroscopic swallowing assessments rests on the understanding that thin, nectar-, honey-, and spoon-thick radiopaque liquids resemble nonopaque liquids, both in their consistency and in the variations in swallowing that they elicit. Tongue movements during sequential swallows of opaque and nonopaque liquids were studied in 8…

  16. Effect of posture on swallowing.

    African Journals Online (AJOL)

    Ertekin C, Keskin A, Kiylioglu N, Kirazli Y, On AY,. Tarlaci S, et al. The effect of head and neck positions on oropharyngeal swallowing: a clinical and electrophysio- logic study. Archives of physical medicine and rehabilita- tion. 2001;829:1255-60. Epub 2001/09/12. 17. Logemann JA, Pauloski BR, Rademaker AW, Kahrilas.

  17. CO2 enrichment alters diurnal stem radius fluctuations of 36-yr-old Larix decidua growing at the alpine tree line.

    Science.gov (United States)

    Dawes, Melissa A; Zweifel, Roman; Dawes, Nicholas; Rixen, Christian; Hagedorn, Frank

    2014-06-01

    To understand how trees at high elevations might use water differently in the future, we investigated the effects of CO2 enrichment and soil warming (separately and combined) on the water relations of Larix decidua growing at the tree line in the Swiss Alps. We assessed diurnal stem radius fluctuations using point dendrometers and applied a hydraulic plant model using microclimate and soil water potential data as inputs. Trees exposed to CO2 enrichment for 9 yr showed smaller diurnal stem radius contractions (by 46 ± 16%) and expansions (42 ± 16%) compared with trees exposed to ambient CO2 . Additionally, there was a delay in the timing of daily maximum (40 ± 12 min) and minimum (63 ± 14 min) radius values for trees growing under elevated CO2 . Parameters optimized with the hydraulic model suggested that CO2 -enriched trees had an increased flow resistance between the xylem and bark, representing a more buffered water supply system. Soil warming did not alter diurnal fluctuation dynamics or the CO2 response. Elevated CO2 altered the hydraulic water flow and storage system within L. decidua trees, which might have contributed to enhanced growth during 9 yr of CO2 enrichment and could ultimately influence the future competitive ability of this key tree-line species. © 2014 WSL Institute for Snow and Avalanche Research - SLF. New Phytologist © 2014 New Phytologist Trust.

  18. Climate change and population dynamics at the tree line: the importance of long-term studies

    Directory of Open Access Journals (Sweden)

    Anfodillo T

    2007-01-01

    Full Text Available Temperature-limited ecosystems are believed to be extremely sensitive to global warming and the upward treeline migration is one of the most relevant phenomenon. Long term monitoring of demographic trends appears essential in order to understand possible effects of higher temperatures on cold ecosystems. Long-term monitoring of natality and mortality of a Pinus sylvestris population in the Swedish Scandes from 1973 to 2005 (Kullman 2007 showed that number of trees increased in the study plots due to higher natality rate, especially in the last decade. This reverses a natural trend of treeline decline and recession occurred in the past.

  19. The Growth of Bosnian Pine (Pinus hedreichii Christ. at Tree-Line Locations from Kosovo and its Response to Climate

    Directory of Open Access Journals (Sweden)

    Faruk Bojaxhi

    2016-12-01

    Full Text Available Background and Purpose: Pinus heldreichii Christ. is a sub-endemic species occurring at tree-line locations in Kosovo and covering an area of 2500 ha. In high elevation sites radial growth is mainly controlled by low temperatures. The main purpose of this study was the analysis of radial growth of P. heldreichii and its response to local climate conditions. Materials and Methods: Research sites comprise of three high elevation stands of P. heldreichii with specific site conditions. Core samples were collected from 98 healthy dominant and co-dominant trees at breast height using increment borer. They were prepared and cross-dated using standard dendrochronological methods, while tree-ring widths were measured to the nearest 0.001 mm using the TSAP software. The ARSTAN program was used to standardize the tree-ring widths and to calculate dendrochronological statistical parameters. The growth-climate relationship was investigated using bootstrapped correlation function analysing the residual chronologies of each sampled site as a dependent variable and the climatic data from May of the (n-1 year up to the October of the n year for the common period 1951-2013 as an independent variable. Results: The length of Bosnian pine chronologies ranged from 175 to 541 years. All chronologies had high values of first-order autocorrelation indicating that radial growth of P. heldreichii is affected by the climate conditions of the previous growing year. Koritnik chronology had the highest values of the mean sensitivity due to the influence of drought stress. This conclusion is also supported by the result of growth-climate relationship where radial growth is negatively correlated with June temperatures and positively associated with July and August precipitation. We found that radial growth of young trees from Koritnik site is limited by the combined effect of temperatures and summer drought stress. In high elevation sites, temperature is expected to control the

  20. SWALLOWING IN PATIENTS WITH LARYNGITIS

    Directory of Open Access Journals (Sweden)

    Isabela MODA

    Full Text Available ABSTRACT BACKGROUND: Dysphagia is described as a complaint in 32% of patients with laryngitis. OBJECTIVE: The objective of this investigation was to evaluate oral and pharyngeal transit of patients with laryngitis, with the hypothesis that alteration in oral-pharyngeal bolus transit may be involved with dysphagia. METHODS: Videofluoroscopic evaluation of the swallowing of liquid, paste and solid boluses was performed in 21 patients with laryngitis, 10 of them with dysphagia, and 21 normal volunteers of the same age and sex. Two swallows of 5 mL liquid bolus, two swallows of 5 mL paste bolus and two swallows of a solid bolus were evaluated in a random sequence. The liquid bolus was 100% liquid barium sulfate and the paste bolus was prepared with 50 mL of liquid barium and 4 g of food thickener (starch and maltodextrin. The solid bolus was a soft 2.2 g cookie coated with liquid barium. Durations of oral preparation, oral transit, pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement and oral-pharyngeal transit were measured. All patients performed 24-hour distal esophageal pH evaluation previous to videofluoroscopy. RESULTS: The evaluation of 24-hour distal esophageal pH showed abnormal gastroesophageal acid reflux in 10 patients. Patients showed longer oral preparation for paste bolus and a faster oral transit time for solid bolus than normal volunteers. Patients with laryngitis and dysphagia had longer preparation for paste and solid boluses, and a faster oral transit time with liquid, paste and solid boluses. CONCLUSION: A longer oral preparation for paste and solid boluses and a faster transit through the mouth are associated with dysphagia in patients with laryngitis.

  1. SWALLOWING IN PATIENTS WITH LARYNGITIS.

    Science.gov (United States)

    Moda, Isabela; Ricz, Hilton Marcos Alves; Aguiar-Ricz, Lilian Neto; Dantas, Roberto Oliveira

    2018-01-01

    Dysphagia is described as a complaint in 32% of patients with laryngitis. The objective of this investigation was to evaluate oral and pharyngeal transit of patients with laryngitis, with the hypothesis that alteration in oral-pharyngeal bolus transit may be involved with dysphagia. Videofluoroscopic evaluation of the swallowing of liquid, paste and solid boluses was performed in 21 patients with laryngitis, 10 of them with dysphagia, and 21 normal volunteers of the same age and sex. Two swallows of 5 mL liquid bolus, two swallows of 5 mL paste bolus and two swallows of a solid bolus were evaluated in a random sequence. The liquid bolus was 100% liquid barium sulfate and the paste bolus was prepared with 50 mL of liquid barium and 4 g of food thickener (starch and maltodextrin). The solid bolus was a soft 2.2 g cookie coated with liquid barium. Durations of oral preparation, oral transit, pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement and oral-pharyngeal transit were measured. All patients performed 24-hour distal esophageal pH evaluation previous to videofluoroscopy. The evaluation of 24-hour distal esophageal pH showed abnormal gastroesophageal acid reflux in 10 patients. Patients showed longer oral preparation for paste bolus and a faster oral transit time for solid bolus than normal volunteers. Patients with laryngitis and dysphagia had longer preparation for paste and solid boluses, and a faster oral transit time with liquid, paste and solid boluses. A longer oral preparation for paste and solid boluses and a faster transit through the mouth are associated with dysphagia in patients with laryngitis.

  2. Swallowing Dysfunctions in Parkinson's Disease.

    Science.gov (United States)

    Simons, Janine A

    2017-01-01

    Dysphagia is a very frequent and highly relevant symptom in Parkinson's disease (PD) for quality of life, morbidity, and remaining lifetime, which is unfortunately widely underdiagnosed and underestimated regarding patients' centered care. Especially in early stages, the causal association between disease and swallowing disabilities remains unnoticed, which may be accounted for by the inability of caregivers and physicians to detect subtle swallowing problems and by the low self-awareness among PD patients. In order to prevent patients from serious negative consequences for health issues (e.g., aspiration pneumonia or malnutrition) as well as for negative impact on their quality of life, it is on the highest importance of managing dysphagia timely and working closely together in a multidisciplinary team, who all are involved in the patients' care system. This chapter includes background information on epidemiology, pathophysiology, and symptomatology of swallowing disorders in PD. This is followed by a summary of the clinical course and health treats, adequate diagnostic procedures for early identification of dysphagia as well as effective treatment strategies. The conclusion provides recommendations for clinical practice routine. © 2017 Elsevier Inc. All rights reserved.

  3. Pediatric feeding and swallowing rehabilitation: An overview.

    Science.gov (United States)

    van den Engel-Hoek, Lenie; Harding, Celia; van Gerven, Marjo; Cockerill, Helen

    2017-05-16

    Children with neurological disabilities frequently have problems with feeding and swallowing. Such problems have a significant impact on the health and well-being of these children and their families. The primary aims in the rehabilitation of pediatric feeding and swallowing disorders are focused on supporting growth, nutrition and hydration, the development of feeding activities, and ensuring safe swallowing with the aim of preventing choking and aspiration pneumonia. Pediatric feeding and swallowing disorders can be divided into four groups: transient, developmental, chronic or progressive.This article provides an overview of the available literature about the rehabilitation of feeding and swallowing disorders in infants and children. Principles of motor control, motor learning and neuroplasticity are discussed for the four groups of children with feeding and swallowing disorders.

  4. A semi-automatic method for extracting thin line structures in images as rooted tree network

    Energy Technology Data Exchange (ETDEWEB)

    Brazzini, Jacopo [Los Alamos National Laboratory; Dillard, Scott [Los Alamos National Laboratory; Soille, Pierre [EC - JRC

    2010-01-01

    This paper addresses the problem of semi-automatic extraction of line networks in digital images - e.g., road or hydrographic networks in satellite images, blood vessels in medical images, robust. For that purpose, we improve a generic method derived from morphological and hydrological concepts and consisting in minimum cost path estimation and flow simulation. While this approach fully exploits the local contrast and shape of the network, as well as its arborescent nature, we further incorporate local directional information about the structures in the image. Namely, an appropriate anisotropic metric is designed by using both the characteristic features of the target network and the eigen-decomposition of the gradient structure tensor of the image. Following, the geodesic propagation from a given seed with this metric is combined with hydrological operators for overland flow simulation to extract the line network. The algorithm is demonstrated for the extraction of blood vessels in a retina image and of a river network in a satellite image.

  5. Annual increments of juniper dwarf shrubs above the tree line on the central Tibetan Plateau: a useful climatic proxy

    Science.gov (United States)

    Liang, Eryuan; Lu, Xiaoming; Ren, Ping; Li, Xiaoxia; Zhu, Liping; Eckstein, Dieter

    2012-01-01

    Background and Aims Dendroclimatology is playing an important role in understanding past climatic changes on the Tibetan Plateau. Forests, however, are mainly confined to the eastern Tibetan Plateau. On the central Tibetan Plateau, in contrast, shrubs and dwarf shrubs need to be studied instead of trees as a source of climate information. The objectives of this study were to check the dendrochronological potential of the dwarf shrub Wilson juniper (Juniperus pingii var. wilsonii) growing from 4740 to 4780 m a.s.l. and to identify the climatic factors controlling its radial growth. Methods Forty-three discs from 33 stems of Wilson juniper were sampled near the north-eastern shore of the Nam Co (Heavenly Lake). Cross-dating was performed along two directions of each stem, avoiding the compression-wood side as far as possible. A ring-width chronology was developed after a negative exponential function or a straight line of any slope had been fit to the raw measurements. Then, correlations were calculated between the standard ring-width chronology and monthly climate data recorded by a weather station around 100 km away. Key Results Our study has shown high dendrochronological potential of Wilson juniper, based on its longevity (one individual was 324 years old), well-defined growth rings, reliable cross-dating between individuals and distinct climatic signals reflected by the ring-width variability. Unlike dwarf shrubs in the circum-arctic tundra ecosystem which positively responded to above-average temperature in the growing season, moisture turned out to be growth limiting for Wilson juniper, particularly the loss of moisture caused by high maximum temperatures in May–June. Conclusions Because of the wide distribution of shrub and dwarf shrub species on the central Tibetan Plateau, an exciting prospect was opened up to extend the presently existing tree-ring networks far up into one of the largest tundra regions of the world. PMID:22210848

  6. Annual increments of juniper dwarf shrubs above the tree line on the central Tibetan Plateau: a useful climatic proxy.

    Science.gov (United States)

    Liang, Eryuan; Lu, Xiaoming; Ren, Ping; Li, Xiaoxia; Zhu, Liping; Eckstein, Dieter

    2012-03-01

    Dendroclimatology is playing an important role in understanding past climatic changes on the Tibetan Plateau. Forests, however, are mainly confined to the eastern Tibetan Plateau. On the central Tibetan Plateau, in contrast, shrubs and dwarf shrubs need to be studied instead of trees as a source of climate information. The objectives of this study were to check the dendrochronological potential of the dwarf shrub Wilson juniper (Juniperus pingii var. wilsonii) growing from 4740 to 4780 m a.s.l. and to identify the climatic factors controlling its radial growth. Forty-three discs from 33 stems of Wilson juniper were sampled near the north-eastern shore of the Nam Co (Heavenly Lake). Cross-dating was performed along two directions of each stem, avoiding the compression-wood side as far as possible. A ring-width chronology was developed after a negative exponential function or a straight line of any slope had been fit to the raw measurements. Then, correlations were calculated between the standard ring-width chronology and monthly climate data recorded by a weather station around 100 km away. Our study has shown high dendrochronological potential of Wilson juniper, based on its longevity (one individual was 324 years old), well-defined growth rings, reliable cross-dating between individuals and distinct climatic signals reflected by the ring-width variability. Unlike dwarf shrubs in the circum-arctic tundra ecosystem which positively responded to above-average temperature in the growing season, moisture turned out to be growth limiting for Wilson juniper, particularly the loss of moisture caused by high maximum temperatures in May-June. Because of the wide distribution of shrub and dwarf shrub species on the central Tibetan Plateau, an exciting prospect was opened up to extend the presently existing tree-ring networks far up into one of the largest tundra regions of the world.

  7. How do tablet properties influence swallowing behaviours?

    Science.gov (United States)

    Yamamoto, Shinya; Taniguchi, Hiroshige; Hayashi, Hirokazu; Hori, Kazuhiro; Tsujimura, Takanori; Nakamura, Yuki; Sato, Hideaki; Inoue, Makoto

    2014-01-01

    Behavioural performance of tablet swallowing was evaluated with different tablet conditions in terms of size, number and surface coating. Four different types of tablets were prepared: small or large, and with or without a surface coating. Fourteen normal male adults were instructed to swallow the prepared tablets with 15 ml of water. The number of tablets in one trial was changed from one to three. To evaluate swallowing and tablet transport, electromyographic activity was recorded in the left suprahyoid muscles, and videofluorographic images were examined. All tablet conditions (size, number and surface coating) affected the swallowing performance in terms of total number of swallows, electromyographic burst patterns and location of remaining tablets. Increases in the size and number of tablets increased the number of swallows and electromyographic burst area and duration. In addition, all of these parameters increased while swallowing tablets without a coating compared with tablets with a coating. Location of the remaining tablets was mainly within the mouth. This study only clarified the normal pattern of tablet swallowing under several conditions in healthy subjects, but the results may facilitate comprehensive evaluation and treatment planning in terms of administering medication to dysphagic patients. © 2013 Royal Pharmaceutical Society.

  8. Using an implicit min/max KD-Tree for doing efficient terrain line of sight calculations

    CSIR Research Space (South Africa)

    Duvenhage, B

    2009-02-01

    Full Text Available -dimensional tree (kd-tree) based raytracing approach, to calculating LOS information, is efficient. A new implicit min/max kd-tree algorithm is discussed for evaluating LOS queries on large scale spherical terrain. In particular the value of low resolution boundary...

  9. Tundra shrubification and tree-line advance amplify arctic climate warming: results from an individual-based dynamic vegetation model

    Science.gov (United States)

    Zhang, Wenxin; Miller, Paul A.; Smith, Benjamin; Wania, Rita; Koenigk, Torben; Döscher, Ralf

    2013-09-01

    One major challenge to the improvement of regional climate scenarios for the northern high latitudes is to understand land surface feedbacks associated with vegetation shifts and ecosystem biogeochemical cycling. We employed a customized, Arctic version of the individual-based dynamic vegetation model LPJ-GUESS to simulate the dynamics of upland and wetland ecosystems under a regional climate model-downscaled future climate projection for the Arctic and Subarctic. The simulated vegetation distribution (1961-1990) agreed well with a composite map of actual arctic vegetation. In the future (2051-2080), a poleward advance of the forest-tundra boundary, an expansion of tall shrub tundra, and a dominance shift from deciduous to evergreen boreal conifer forest over northern Eurasia were simulated. Ecosystems continued to sink carbon for the next few decades, although the size of these sinks diminished by the late 21st century. Hot spots of increased CH4 emission were identified in the peatlands near Hudson Bay and western Siberia. In terms of their net impact on regional climate forcing, positive feedbacks associated with the negative effects of tree-line, shrub cover and forest phenology changes on snow-season albedo, as well as the larger sources of CH4, may potentially dominate over negative feedbacks due to increased carbon sequestration and increased latent heat flux.

  10. Tundra shrubification and tree-line advance amplify arctic climate warming: results from an individual-based dynamic vegetation model

    International Nuclear Information System (INIS)

    Zhang Wenxin; Miller, Paul A; Smith, Benjamin; Wania, Rita; Koenigk, Torben; Döscher, Ralf

    2013-01-01

    One major challenge to the improvement of regional climate scenarios for the northern high latitudes is to understand land surface feedbacks associated with vegetation shifts and ecosystem biogeochemical cycling. We employed a customized, Arctic version of the individual-based dynamic vegetation model LPJ-GUESS to simulate the dynamics of upland and wetland ecosystems under a regional climate model–downscaled future climate projection for the Arctic and Subarctic. The simulated vegetation distribution (1961–1990) agreed well with a composite map of actual arctic vegetation. In the future (2051–2080), a poleward advance of the forest–tundra boundary, an expansion of tall shrub tundra, and a dominance shift from deciduous to evergreen boreal conifer forest over northern Eurasia were simulated. Ecosystems continued to sink carbon for the next few decades, although the size of these sinks diminished by the late 21st century. Hot spots of increased CH 4 emission were identified in the peatlands near Hudson Bay and western Siberia. In terms of their net impact on regional climate forcing, positive feedbacks associated with the negative effects of tree-line, shrub cover and forest phenology changes on snow-season albedo, as well as the larger sources of CH 4 , may potentially dominate over negative feedbacks due to increased carbon sequestration and increased latent heat flux. (letter)

  11. Stuttered swallowing: Electric stimulation of the right insula interferes with water swallowing. A case report

    Directory of Open Access Journals (Sweden)

    Shoemaker J

    2011-02-01

    Full Text Available Abstract Background Various functional resonance imaging, magnetoencephalographic and lesion studies suggest the involvement of the insular cortex in the control of swallowing. However, the exact location of insular activation during swallowing and its functional significance remain unclear. Case presentation Invasive electroencephalographic monitoring was performed in a 24-year-old man with medically intractable stereotyped nocturnal hypermotor seizures due to a ganglioglioma. During stimulation of the right inferior posterior insular cortex with depth electrodes the patient spontaneously reported a perception of a "stutter in swallowing". Stimulation of the inferior posterior insular cortex at highest intensity (4 mA was also associated with irregular and delayed swallows. Swallowing was not impaired during stimulation of the superior posterior insular cortex, regardless of stimulation intensity. Conclusions These results indicate that the right inferior posterior insular cortex is involved in the neural circuitry underlying the control of swallowing.

  12. Identification of Swallowing Tasks from a Modified Barium Swallow Study That Optimize the Detection of Physiological Impairment

    Science.gov (United States)

    Hazelwood, R. Jordan; Armeson, Kent E.; Hill, Elizabeth G.; Bonilha, Heather Shaw; Martin-Harris, Bonnie

    2017-01-01

    Purpose: The purpose of this study was to identify which swallowing task(s) yielded the worst performance during a standardized modified barium swallow study (MBSS) in order to optimize the detection of swallowing impairment. Method: This secondary data analysis of adult MBSSs estimated the probability of each swallowing task yielding the derived…

  13. Interjudge agreement in videofluoroscopic studies of swallowing.

    Science.gov (United States)

    Wilcox, F; Liss, J M; Siegel, G M

    1996-02-01

    Videofluoroscopic swallowing examinations of 3 patients with dysphagia were reviewed independently by 10 speech-language pathologists. Prior to viewing each video, clinicians were provided with information about the patient's history, the results of a bedside swallow examination, and oral-facial and oral motor control examinations. Clinicians completed a swallowing observation protocol as they viewed each video. They then recommended, from a list of treatment strategies, intervention techniques that would be most appropriate for each patient. Interjudge agreement was calculated by determining how many clinicians observed a given swallowing event or deficit, and how many recommended a given treatment strategy. Results suggest that the level of interjudge agreement for videofluoroscopic evaluations is not encouragingly high.

  14. Pharyngoesophageal swallowing disorders in Parkinson disease

    International Nuclear Information System (INIS)

    Laurent, F.; Dumas, F.; Miremont, F.; Ferrer, X.; Amouretti, M.; Drouillard, J.

    1990-01-01

    This paper evaluates pharyngeal and esophageal swallowing disorders in Parkinson disease. Clinical, videofluorographic and manometric investigations were performed prospectively in 12 control subjects (eight men and four women; mean age, 60 years) and 21 patients with Parkinson disease (10 men and 11 women; mean age, 64 years) to study oral, pharyngeal, and esophageal motoricity. Seventeen patients (81%) complained of swallowing disorders: buccal bolus retention (48%), split swallowing (48%), and saliva buccal outflow (57%). Videofluorography was normal in control subjects and in eight patients (40%). Abnormal findings included vallecular and piriform recesses retention (60%) and split swallowing (35%). Manometry showed a nonperistaltic pharyngeal motoricity with simultaneous contraction in 14 patients (67%) and incomplete upper esophageal sphincter relaxation in three patients (14%). Body esophageal motoricity disorders indicated achalasia in five patients (24%), diffuse esophageal spasm in six (29%), and nonspecific esophageal motility disorder in five (24%)

  15. The Andean Swallow (Orochelidon andecola) in Argentina

    OpenAIRE

    Mazar Barnett, Juan; Pugnali, Germán D.; Pearman Morrison, Mark; Bodrati, Alejandro; Moschione, Flavio; Clark, Ricardo; Roesler, Carlos Ignacio; Monteleone, Diego; Casañas, Hernán; Burgos Gallardo, Freddy; Segovia, José; Pagano, Luis; Povedano, Hernán; Areta, Juan Ignacio

    2016-01-01

    During ornithological studies in the provinces of Jujuy, Salta, and San Juan, we recorded the Andean Swallow Orochelidon andecola at 40 localities. These are the first records in Argentina, and also represent the southernmost for the species. Some of these localities are up to 1500 m lower than the previously known elevational limit (now 800 masl), and up to 1100 km southwards. This is a relatively poorly known swallow, and we present novel natural history data. We found evidence of breeding ...

  16. Fluid mechanics of eating, swallowing and digestion - overview and perspectives.

    Science.gov (United States)

    Engmann, Jan; Burbidge, Adam S

    2013-02-26

    From a very simplistic viewpoint, the human digestive system can be regarded as a long tube (with dramatic variations in diameter, cross-section, wall properties, pumping mechanisms, regulating valves and in-line sensors). We single out a few fluid mechanical phenomena along the trajectory of a food bolus from the mouth to the small intestine and discuss how they influence sensorial perception, safe transport, and nutrient absorption from a bolus. The focus is on lubrication flows between the tongue and palate, the oropharyngeal stage of swallowing and effects of flow on absorption in the small intestine. Specific challenges and opportunities in this research area are highlighted.

  17. Smartphone-Based Real-time Assessment of Swallowing Ability From the Swallowing Sound

    Science.gov (United States)

    Ueno, Tomoyuki; Teramoto, Yohei; Nakai, Kei; Hidaka, Kikue; Ayuzawa, Satoshi; Eguchi, Kiyoshi; Matsumura, Akira; Suzuki, Kenji

    2015-01-01

    Dysphagia can cause serious challenges to both physical and mental health. Aspiration due to dysphagia is a major health risk that could cause pneumonia and even death. The videofluoroscopic swallow study (VFSS), which is considered the gold standard for the diagnosis of dysphagia, is not widely available, expensive and causes exposure to radiation. The screening tests used for dysphagia need to be carried out by trained staff, and the evaluations are usually non-quantifiable. This paper investigates the development of the Swallowscope, a smartphone-based device and a feasible real-time swallowing sound-processing algorithm for the automatic screening, quantitative evaluation, and the visualisation of swallowing ability. The device can be used during activities of daily life with minimal intervention, making it potentially more capable of capturing aspirations and risky swallow patterns through the continuous monitoring. It also consists of a cloud-based system for the server-side analyzing and automatic sharing of the swallowing sound. The real-time algorithm we developed for the detection of dry and water swallows is based on a template matching approach. We analyzed the wavelet transformation-based spectral characteristics and the temporal characteristics of simultaneous synchronised VFSS and swallowing sound recordings of 25% barium mixed 3-ml water swallows of 70 subjects and the dry or saliva swallowing sound of 15 healthy subjects to establish the parameters of the template. With this algorithm, we achieved an overall detection accuracy of 79.3% (standard error: 4.2%) for the 92 water swallows; and a precision of 83.7% (range: 66.6%–100%) and a recall of 93.9% (range: 72.7%–100%) for the 71 episodes of dry swallows. PMID:27170905

  18. Smartphone-Based Real-time Assessment of Swallowing Ability From the Swallowing Sound.

    Science.gov (United States)

    Jayatilake, Dushyantha; Ueno, Tomoyuki; Teramoto, Yohei; Nakai, Kei; Hidaka, Kikue; Ayuzawa, Satoshi; Eguchi, Kiyoshi; Matsumura, Akira; Suzuki, Kenji

    2015-01-01

    Dysphagia can cause serious challenges to both physical and mental health. Aspiration due to dysphagia is a major health risk that could cause pneumonia and even death. The videofluoroscopic swallow study (VFSS), which is considered the gold standard for the diagnosis of dysphagia, is not widely available, expensive and causes exposure to radiation. The screening tests used for dysphagia need to be carried out by trained staff, and the evaluations are usually non-quantifiable. This paper investigates the development of the Swallowscope, a smartphone-based device and a feasible real-time swallowing sound-processing algorithm for the automatic screening, quantitative evaluation, and the visualisation of swallowing ability. The device can be used during activities of daily life with minimal intervention, making it potentially more capable of capturing aspirations and risky swallow patterns through the continuous monitoring. It also consists of a cloud-based system for the server-side analyzing and automatic sharing of the swallowing sound. The real-time algorithm we developed for the detection of dry and water swallows is based on a template matching approach. We analyzed the wavelet transformation-based spectral characteristics and the temporal characteristics of simultaneous synchronised VFSS and swallowing sound recordings of 25% barium mixed 3-ml water swallows of 70 subjects and the dry or saliva swallowing sound of 15 healthy subjects to establish the parameters of the template. With this algorithm, we achieved an overall detection accuracy of 79.3% (standard error: 4.2%) for the 92 water swallows; and a precision of 83.7% (range: 66.6%-100%) and a recall of 93.9% (range: 72.7%-100%) for the 71 episodes of dry swallows.

  19. Worldwide survey of damage from swallowing multiple magnets

    Energy Technology Data Exchange (ETDEWEB)

    Oestreich, Alan E. [Cincinnati Children' s Hospital Medical Center, Radiology Department 5031, Cincinnati, OH (United States)

    2009-02-15

    It is increasingly recognized that in children swallowed multiple magnets cause considerable damage to the gastrointestinal tract. To emphasize that complications from swallowed magnets are extensive worldwide and throughout childhood. The author surveyed radiologists and researched cases of magnet swallowing in the literature and documented age and gender, numbers of magnets, nature of the magnets, reasons for swallowing, and clinical course. A total of 128 instances of magnet swallowing were identified, one fatal. Cases from 21 countries were found. Magnet swallowing occurred throughout childhood, with most children older than 3 years of age. Numbers of swallowed magnets ranged up to 100. Twelve children were known to be autistic. Many reasons were given for swallowing magnets, and a wide range of gastrointestinal damage was encountered. Considerable delay before seeking medical assistance was frequent, as was delay before obtaining radiographs or US imaging. Damage from swallowing multiple magnets is a considerable worldwide problem. More educational and preventative measures are needed. (orig.)

  20. Worldwide survey of damage from swallowing multiple magnets

    International Nuclear Information System (INIS)

    Oestreich, Alan E.

    2009-01-01

    It is increasingly recognized that in children swallowed multiple magnets cause considerable damage to the gastrointestinal tract. To emphasize that complications from swallowed magnets are extensive worldwide and throughout childhood. The author surveyed radiologists and researched cases of magnet swallowing in the literature and documented age and gender, numbers of magnets, nature of the magnets, reasons for swallowing, and clinical course. A total of 128 instances of magnet swallowing were identified, one fatal. Cases from 21 countries were found. Magnet swallowing occurred throughout childhood, with most children older than 3 years of age. Numbers of swallowed magnets ranged up to 100. Twelve children were known to be autistic. Many reasons were given for swallowing magnets, and a wide range of gastrointestinal damage was encountered. Considerable delay before seeking medical assistance was frequent, as was delay before obtaining radiographs or US imaging. Damage from swallowing multiple magnets is a considerable worldwide problem. More educational and preventative measures are needed. (orig.)

  1. Effects of pharyngeal electrical stimulation on swallowing performance.

    Science.gov (United States)

    Takeishi, Ryosuke; Magara, Jin; Watanabe, Masahiro; Tsujimura, Takanori; Hayashi, Hirokazu; Hori, Kazuhiro; Inoue, Makoto

    2018-01-01

    Pharyngeal electrical stimulation (PEStim) has been found to facilitate voluntary swallowing. This study investigated how PEStim contributed to modulation of swallowing function in 15 healthy humans. In the involuntary swallowing test, water was injected onto the pharynx at 0.05 ml/s and the onset latency of the first swallow was measured. In the voluntary swallowing test, subjects swallowed their own saliva as quickly as possible for 30 s and the number of swallows was counted. Voluntary and involuntary swallowing was evaluated before (baseline), immediately after, and every 10 min after 10-min PEStim for 60 min. A voluntary swallowing test with simultaneous 30-s PEStim was also conducted before and 60 min after 10-min PEStim. The number of voluntary swallows with simultaneous PEStim significantly increased over 60 min after 10-min PEStim compared with the baseline. The onset latency of the first swallow in the involuntary swallowing test was not affected by 10-min PEStim. The results suggest that PEStim may have a long-term facilitatory effect on the initiation of voluntary swallowing in healthy humans, but not on peripherally-evoked swallowing. The physiological implications of this modulation are discussed.

  2. Posture of the head and pharyngeal swallowing

    International Nuclear Information System (INIS)

    Ekberg, O.

    1986-01-01

    Closure of the laryngeal vestibule during swallowing is important for protection of the airways. The present investigation included 53 patients with dysphagia examined cineradiographically with the head held in resting posture, flexion and extension. The ability to protect the airways by the downward movement of the epiglottis and by obliteration of the laryngeal vestibule was studied in different postures of the head. Of 35 patients with normal laryngeal obliteration with the head in resting position 10 showed a defective closure at swallowing in extension. In 18 patients with defective closure of the laryngeal vestibule in resting position 9 were improved on flexion and two on extension of the head. In one patient with defectie closure of the laryngeal vestibule in resting position swallowing in flexion showed an aggravated dysfunction. In our other patients the defective closure became more marked on extension. Four patients had less effective downward movement of the epiglottis with the head in extension. Of 10 patients with defective epiglottic movement with the head in resting position two were improved on tilting the head forwards. The results show that the position of the head influences the closure of the airways during swallowing. Patients with defective protection of the laryngeal vestibule should be instructed to swallow with the head tilted forwards. (orig.)

  3. Chemical Sensing Regulates Mastication/Swallowing.

    Science.gov (United States)

    Yamamura, Kensuke; Kurose, Masayuki; Okamoto, Keiichiro

    2016-01-01

    Mastication and swallowing are the first stage of digestion involving several motor processes such as food intake, intra-oral food transport, bolus formation and chewing and swallowing reflex. These complicated motor functions are accomplished by the well-coordinated activities in the jaw, hyoid, tongue, facial and pharyngeal muscles. Although the basic activity patterns of these movements are controlled by the brainstem pattern generators, these movements generate various peripheral sensory inputs. Among the sensory inputs, it is well-known that somatic sensory inputs play important roles in reflexively modulating the movements so that the final motor outputs fit the environmental demand. However, little is known about the effects of chemical sensory inputs such as taste and olfaction originating from the ingested foods by these movements. A possible reason could be raised that cognition of the chemical sensory inputs at the higher brain also influences the movements, so it is difficult to discuss the neural mechanisms underlying the observed effect. In this review, we focus on the effects of chemical sensory inputs on the masticatory movements and initiation of swallowing. We first summarize chemical sensory inputs occurring during mastication and swallowing, and their receptive mechanisms. In addition, we will introduce the effect of application of monosodium L-glutamate (MSG) solution as an umami taste to the oropharynx on the swallow initiation which is involuntary controlled and the possible neural mechanisms underlying this effect is discussed.

  4. Seed germination behavior of swallow wort

    Directory of Open Access Journals (Sweden)

    amir hosein pahlavani

    2009-06-01

    Full Text Available The exotic plant, Swallow- wort, a twining perennial of the Milkweed family, has become increasingly invasive in some place of Iran, especially orchards. Increased knowledge of wort germination biology would facilitate development of an optimum control program. Germination of Swallow wort seeds as affected by environmental factors was studied under controlled-environment growth chamber conditions. The following studies were conducted in plant Pests & Diseases Research Institute during the years 2003-4: 1- Effect of constant temperature on germination that including 10, 15, 18, 20, 25, 30, 35 and 40˚C; 2- Effect of light on constant germination; 3- Effect of temperature fluctuations on seed germination: 15/7, 20/12, 25/17 and 30/22˚C. All experiments were conducted with 8 replications. Swallow wort seeds showed no dormancy when detachment from mother plant. Seed germination was strongly influenced by temperature. Light did not play a crucial role on seed germination of this weed. Therefore Swallow wort seeds were not photoblastic and temperature fluctuations did not increase seed germination of Swallow wort. The above characteristics are very important in making swallowwort an invasive weed. Having precise information of these traits enables us to a better management and control of this troublesome weed.

  5. EFFECT OF GUM CHEWING ON AIR SWALLOWING, SALIVA SWALLOWING AND BELCHING

    Directory of Open Access Journals (Sweden)

    Ana Cristina Viana da SILVA

    2015-09-01

    Full Text Available BackgroundEructation is a physiologic event which allows gastric venting of swallowed air and most of the time is not perceived as a symptom. This is called gastric belching. Supragastric belching occurs when swallowed air does not reach the stomach and returns by mouth a short time after swallowing. This situation may cause discomfort, life limitations and problems in daily life.ObjectiveOur objective in this investigation was to evaluate if gum chewing increases the frequency of gastric and/or supragastric belches.MethodsEsophageal transit of liquid and gas was evaluated by impedance measurement in 16 patients with complaint of troublesome belching and in 15 controls. The Rome III criteria were used in the diagnosis of troublesome belching. The esophageal transit of liquid and gas was measured at 5 cm, 10 cm, 15 cm and 20 cm from the lower esophageal sphincter. The subjects were evaluated for 1 hour which was divided into three 20-minute periods: (1 while sitting for a 20-minute base period; (2 after the ingestion of yogurt (200 mL, 190 kcal, in which the subjects were evaluated while chewing or not chewing gum; (3 final 20-minute period in which the subjects then inverted the task of chewing or not chewing gum. In gastric belch, the air flowed from the stomach through the esophagus in oral direction and in supragastric belch the air entered the esophagus rapidly from proximal and was expulsed almost immediately in oral direction. Air swallows were characterized by an increase of at least 50% of basal impedance and saliva swallow by a decrease of at least 50% of basal impedance, that progress from proximal to distal esophagus.ResultsIn base period, air swallowing was more frequent in patients than in controls and saliva swallowing was more frequent in controls than in patients. There was no difference between the medians of controls and patients in the number of gastric belches and supragastric belches. In six patients, supragastric belches

  6. Growth dynamics of tree-line and lake-shore Scots pine (Pinus sylvestris L. in the central Scandinavian Mountains during the Medieval Climate Anomaly and the early Little Ice Age

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    Hans W Linderholm

    2014-05-01

    Full Text Available Trees growing at their altitudinal or latitudinal distribution in Fennoscandia have been widely used to reconstruct warm season temperatures, and the region hosts some of the world’s longest tree-ring chronologies. These multi-millennial long chronologies have mainly been built from tree remains found in lakes (subfossil wood from lake-shore trees. We used a unique dataset of Scots pine tree-ring data collected from wood remains found on a mountain slope in the central Scandinavian Mountains, yielding a chronology spanning over much of the last 1200 years. This data was compared with a local subfossil wood chronology with the aim to 1 describe growth variability in two environments during the Medieval Climate Anomaly (MCA and the early Little Ice Age (LIA, and 2 investigate differences in growth characteristics during these contrasting periods. It was shown that the local tree-line during both the MCA and early LIA was almost 150 m higher that at present. Based on living pines from the two environments, tree-line pine growth was strongly associated with mid-summer temperatures, while the lake-shore trees showed an additional response to summer precipitation. During the MCA, regarded to be a period of favourable climate in the region, the tree-ring data from both environments showed strong coherency and moderate growth variability. In the early LIA, the two chronologies were less coherent, with the tree-line chronology showing more variability, suggesting different growth responses in the two environments during this period of less favourable growing conditions. Our results indicate that tree-ring width chronologies mainly based on lake-shore trees may need to be re-evaluated.

  7. Alterations to Swallowing Physiology as the Result of Effortful Swallowing in Healthy Seniors.

    Science.gov (United States)

    Molfenter, Sonja M; Hsu, Chuan-Ya; Lu, Ying; Lazarus, Cathy L

    2018-06-01

    A significant proportion of healthy seniors report difficulty swallowing, thought to result from age-related decline in muscle bulk/function. Effortful Swallowing (ES) is used both as a compensatory maneuver to improve pharyngeal propulsion/clearance and has been proposed as an exercise to improve pharyngeal strength. This study sought to quantify the immediate kinematic, temporal, and functional changes during an ES maneuver to quantify its exercise potential to combat age-related changes in swallowing. Videofluoroscopy data were collected from 44 healthy seniors (21 male) over 65 years old (mean = 76.9, SD = 7.1). Each participant swallowed six 5 ml boluses of Varibar nectar-thick liquids: three with regular effort and three using ES. Individual swallows (n = 260) were measured on pharyngeal constriction, pharyngeal shortening, laryngeal closure duration, hyoid movement duration, UES opening duration, stage transition duration, pharyngeal transit time, pharyngeal response duration, Normalized Residue Ratio Scale (NRRS), and the Penetration-Aspiration Scale (PAS). Non-parametric Wilcoxon Rank Sum for repeated measures tested the effect of ES on each outcome. Exact p-values were calculated based on permutation methods, individual p values < 0.008 was deemed to be significant. The ES maneuver significantly prolonged all temporal variables. While we found no significant differences for pharyngeal constriction, significantly less (i.e., worse) pharyngeal shortening was observed in ES condition compared with regular effort swallows. Further, significantly worse pyriform sinus residue (NRRSv) was observed in the ES condition. No differences between ES and regular effort swallows were noted for pharyngeal constriction, NRRSv or PAS. We speculate that these negative manifestations of worse kinematics (less pharyngeal shortening) and function (increase in NRRSp) may be the result of forced volitional manipulation of swallowing in the ES condition in an otherwise

  8. LINES

    Directory of Open Access Journals (Sweden)

    Minas Bakalchev

    2015-10-01

    Full Text Available The perception of elements in a system often creates their interdependence, interconditionality, and suppression. The lines from a basic geometrical element have become the model of a reductive world based on isolation according to certain criteria such as function, structure, and social organization. Their traces are experienced in the contemporary world as fragments or ruins of a system of domination of an assumed hierarchical unity. How can one release oneself from such dependence or determinism? How can the lines become less “systematic” and forms more autonomous, and less reductive? How is a form released from modernistic determinism on the new controversial ground? How can these elements or forms of representation become forms of action in the present complex world? In this paper, the meaning of lines through the ideas of Le Corbusier, Leonidov, Picasso, and Hitchcock is presented. Spatial research was made through a series of examples arising from the projects of the architectural studio “Residential Transformations”, which was a backbone for mapping the possibilities ranging from playfulness to exactness, as tactics of transformation in the different contexts of the contemporary world.

  9. Effects of pollution on swallowing: how little we know

    Energy Technology Data Exchange (ETDEWEB)

    Palmer, J.B.; Silver, K.H. (Division of Rehabilitation Medicine, Johns Hopkins University, Baltimore, MD (United States))

    1992-06-01

    Swallowing is an essential function of the upper alimentary tract. It is highly complex, requiring precise coordination of numerous nerves and muscles of the oral cavity, pharynx, larynx, and esophagus. Swallowing is integrated with other physiologic functions, including mastication and respiration. Impairments of swallowing may result from many different structural or physiologic disorders. Little is currently known about the direct effects of pollution on swallowing. Structures critical to swallowing, however, are vulnerable to damage by environmental hazards such as exposure to ionizing radiation or intake of toxins by ingestion or inhalation. The relationship of swallowing to environmental lung disease is an area of particular interest because impaired swallowing may result in aspiration of food particles into the lung, and because pollutants may hamper airway defense mechanisms. In this article, we discuss the possible impact of selected environmental agents on swallowing and suggest future directions for research.26 references.

  10. Methods for excluding cliff swallows from nesting on highway structures.

    Science.gov (United States)

    2009-08-01

    Cliff swallows (Petrochelidon pyrrhonota) are colonially breeding migratory birds that frequently nest on highway : structures. Protected by the Migratory Bird Treaty Act of 1918, nesting control methods cannot harm swallows or active : nests. This c...

  11. Swallowing difficulties in Duchenne muscular dystrophy: indications for feeding assessment and outcome of videofluroscopic swallow studies

    DEFF Research Database (Denmark)

    Aloysius, A.; Born, P.; Kinali, M.

    2008-01-01

    were performed. Prolonged chewing and effortful bolus transport for solids increased with age. Swallow trigger was normal in the majority of cases. All patients had some post-swallow pharyngeal residue around the laryngeal inlet increasing in volume with age. Although this residue did not result...... on VFSS. It is the oral phase of swallowing that is most significantly affected in DMD. The pharyngeal phase is well triggered but is weak with incomplete pharyngeal clearance leaving pharyngeal residue. Insufficient or effortful chewing coupled with weak clearance may predispose them to choking episodes...

  12. ANALYSIS OF THE WOODY VEGETATION DYNAMICS IN THE AREA OF TREE LINE ECOTONE ON THE BASIS OF PHOTO MONITORING DATA AND USING GIS

    Directory of Open Access Journals (Sweden)

    A. P. Mikhailovich

    2016-01-01

    Full Text Available A method of processing and presentation of the repeated landscape photographs for analysis of spatio-temporal dynamics of woody vegetation in tree line ecotone the Polar Urals (mountain Rai-Iz was developed. It is intended to solve problems with the use of such photographs so as to help the researcher to gain an integral representation of the space under study, obtain additional information about the region of interest, create and update annotation to photographs, and develop thematic maps using repeated landscape photography.

  13. The Neurobiology of Swallowing and Dysphagia

    Science.gov (United States)

    Miller, Arthur J.

    2008-01-01

    The neurobiological study of swallowing and its dysfunction, defined as dysphagia, has evolved over two centuries beginning with electrical stimulation applied directly to the central nervous system, and then followed by systematic investigations that have used lesioning, transmagnetic stimulation, magnetoencephalography, and functional magnetic…

  14. VIDEOFLUOROSCOPIC EVALUATION OF SWALLOWS IN ANOREXIA NERVOSA.

    Science.gov (United States)

    Santos, Carla Manfredi; Cassiani, Rachel Aguiar; Dantas, Roberto Oliveira

    2016-01-01

    There are some studies in the literature about the feeding behavior and masticatory process in patients with feeding disorders; however, it is not very well known if there are alterations in oral-pharyngeal swallowing dynamics in subjects with anorexia nervosa. To evaluate the oral and pharyngeal bolus transit in patients with anorexia nervosa. The study was conducted with 8 individuals clinically diagnosed and in treatment for restricting-type anorexia nervosa (seven women and one man), and 14 healthy individuals with no digestive or neurological symptoms (10 women, 4 men). Swallows were evaluated by videofluoroscopy with three swallows of 5 mL liquid bolus and three swallows of 5 mL paste bolus consistency, given in a random sequence. The participants were asked after each swallow about the sensation of the bolus passage. In the analysis of oral-pharyngeal transit duration, the mean duration of pharyngeal transit with paste bolus in patients with anorexia was shorter than in healthy volunteers (P=0.02). In the duration of movement of the hyoid bone, longer movement was observed in anorexia than in healthy volunteers with liquid bolus (P=0.01). With liquid bolus, five (62.5%) patients and one (7.1%) control had sensation of the bolus passage (Panorexia nervosa, although the results suggest that pharyngeal transit has shorter duration than that seen in healthy volunteers and the hyoid movement duration is longer in patients than in healthy volunteers. Fast pharyngeal transit may be the cause of bolus transit perception in patients with anorexia nervosa.

  15. Senescent Swallowing: Impact, Strategies and Interventions

    Science.gov (United States)

    Ney, Denise; Weiss, Jennifer; Kind, Amy; Robbins, JoAnne

    2010-01-01

    The risk for disordered oropharyngeal swallowing (dysphagia) increases with age. Loss of swallowing function can have devastating health implications including dehydration, malnutrition, and pneumonia, as well as reduced quality of life. Age-related changes place older adults at risk for dysphagia for two major reasons: One is that natural, healthy aging takes its toll on head and neck anatomy and physiologic and neural mechanisms underpinning swallowing function. This progression of change contributes to alterations in the swallowing in healthy older adults and is termed presbyphagia, naturally diminishing functional reserve. Second, disease prevalence increases with age and dysphagia is a co-morbidity of many age-related diseases and/or their treatments. Sensory changes, medication, sarcopenia and age-related diseases are discussed herein. Relatively recent findings that health complications are associated with dysphagia are presented. Nutrient requirements, fluid intake and nutritional assessment for older adults are reviewed relative to their relations to dysphagia. Dysphagia screening and the pros and cons of tube feeding as a solution are discussed. Optimal intervention strategies for elders with dysphagia ranging from compensatory interventions to more rigorous exercise approaches are presented. Compelling evidence of improved functional swallowing and eating outcomes resulting from active rehabilitation focusing on increasing strength of head and neck musculature is provided. In summary, while oropharyngeal dysphagia may be life-threatening, so are some of the traditional alternatives, particularly for frail, elderly patients. While the state of the evidence calls for more research, this review indicates the behavioral, dietary and environmental modifications emerging in this past decade are compassionate, promising and in many cases preferred alternatives to the always present option of tube feeding. PMID:19483069

  16. Pulmonary function in infants with swallowing dysfunction.

    Directory of Open Access Journals (Sweden)

    James D Tutor

    Full Text Available Swallowing dysfunction can lead to recurring aspiration and is frequently associated with chronic symptoms such as cough and wheezing in infants. Our objective was to describe the characteristics of infants with swallowing dysfunction, determine if pulmonary function abnormalities are detectable, and if they improve after therapy.We studied 38 infants with a history of coughing and wheezing who had pulmonary function tests performed within two weeks of their diagnosis of swallowing dysfunction. The raised lung volume rapid thoracoabdominal compression technique was used. After 6 months of therapy, 17 of the infants repeated the tests.Initially, 25 had abnormal spirometry, 18 had abnormal plethysmography, and 15 demonstrated bronchodilator responsiveness. Six months later test were repeated for seventeen patients. Ten patients had continued abnormal spirometry, two patients remained normal, three patients' abnormal spirometry had normalized, and two patients' previously normal studies became abnormal. Eight of the 17 patients had continued abnormal plethysmography, six had continued normal plethysmography, and three patients' normal plethysmography became abnormal. After 6 months of treatment, eight patients demonstrated bronchodilator responsiveness, of which five continued to demonstrate bronchodilator responsiveness and three developed responsiveness. The remainder either continued to be non- bronchodilator responsive (two or lost responsiveness (three. The findings of the abnormal tests in most infants tested is complicated by frequent occurrence of other co-morbidities in this population, including gastroesophageal reflux in 23 and passive smoke exposure in 13 of the infants.The interpretation of lung function changes is complicated by the frequent association of swallowing dysfunction with gastroesophageal reflux and passive smoke exposure in this population. Six months of medical therapy for swallowing dysfunction/gastroesophageal reflux

  17. Activity of Maly Aktru Glacier (Сentral Altai and changes tree line fluctuations in its basin for a historical period

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    A. N. Nazarov

    2016-01-01

    Full Text Available Major problems of dating of the glaciers activity from the wood residues found in moraines are discussed by the example of Maly Aktru Glacier. First of all, these are the underestimation of the glacier development features, the age of the sample itself and its content as well as losses of some outer rings. The study proves that disagreements between dendrochronological and radiocarbon ages of the samples are caused by manifestation of the Suess effect and contents of the wood cells. The reconstruction of June–July temperatures in the Aktru valley for two thousand years was used to reconstruct the altitudinal variability of the tree line thermal potential. Existence of a climatic optimum (I–IV A.D. had been revealed that brought to the higher position of the tree line in mid ages than its thermal potential could enable. On the basis of variability of growth indices for Siberian larch, it is shown that the medieval optimum stands out against a background of solely strong temperature depressions separating it from ancient and modern times, and the climate’s natural history is evidence that the current climate warming is an ordinary phenomenon.

  18. Effect of body posture on involuntary swallow in healthy volunteers.

    Science.gov (United States)

    Shiino, Yoshitaka; Sakai, Shogo; Takeishi, Ryosuke; Hayashi, Hirokazu; Watanabe, Masahiro; Tsujimura, Takanori; Magara, Jin; Ito, Kayoko; Tsukada, Tetsu; Inoue, Makoto

    2016-03-01

    Clinically, reclining posture has been reported to reduce risk of aspiration. However, during involuntary swallow in reclining posture, changes in orofacial and pharyngeal movement before and during pharyngeal swallow should be considered. Further, the mechanisms underlying the effect of body posture on involuntary swallow remain unclear. The aim of the present study was to determine the effect of body posture on activity patterns of the suprahyoid muscles and on patterns of bolus transport during a natural involuntary swallow. Thirteen healthy male adults participated in a water infusion test and a chewing test. In the water infusion test, thickened water was delivered into the pharynx at a very slow rate until the first involuntary swallow was evoked. In the chewing test, subjects were asked to eat 10 g of gruel rice. In both tests, the recording was performed at four body postures between upright and supine positions. Results showed that reclining changed the location of the bolus head at the start of swallow and prolonged onset latency of the swallowing initiation. Muscle burst duration and whiteout time measured by videoendoscopy significantly increased with body reclining and prolongation of the falling time. In the chewing test, reclining changed the location of the bolus head at the start of swallow, and the frequency of bolus residue after the first swallow increased. Duration and area of EMG burst and whiteout time significantly increased with body reclining. These data suggest that body reclining may result in prolongation of pharyngeal swallow during involuntary swallow. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Transnasal endoscopic evaluation of swallowing: a bedside technique to evaluate ability to swallow pureed diets in elderly patients with dysphagia.

    Science.gov (United States)

    Sakamoto, Torao; Horiuchi, Akira; Nakayama, Yoshiko

    2013-08-01

    Endoscopic evaluation of swallowing (EES) is not commonly used by gastroenterologists to evaluate swallowing in patients with dysphagia. To use transnasal endoscopy to identify factors predicting successful or failed swallowing of pureed foods in elderly patients with dysphagia. EES of pureed foods was performed by a gastroenterologist using a small-calibre transnasal endoscope. Factors related to successful versus unsuccessful swallowing of pureed foods were analyzed with regard to age, comorbid diseases, swallowing activity, saliva pooling, vallecular residues, pharyngeal residues and airway penetration⁄aspiration. Unsuccessful swallowing was defined in patients who could not eat pureed foods at bedside during hospitalization. Logistic regression analysis was used to identify independent predictors of swallowing of pureed foods. During a six-year period, 458 consecutive patients (mean age 80 years [range 39 to 97 years]) were considered for the study, including 285 (62%) men. Saliva pooling, vallecular residues, pharyngeal residues and penetration⁄aspiration were found in 240 (52%), 73 (16%), 226 (49%) and 232 patients (51%), respectively. Overall, 247 patients (54%) failed to swallow pureed foods. Multivariate logistic regression analysis demonstrated that the presence of pharyngeal residues (OR 6.0) and saliva pooling (OR 4.6) occurred significantly more frequently in patients who failed to swallow pureed foods. Pharyngeal residues and saliva pooling predicted impaired swallowing of pureed foods. Transnasal EES performed by a gastroenterologist provided a unique bedside method of assessing the ability to swallow pureed foods in elderly patients with dysphagia.

  20. Speech, language and swallowing in Huntington’ Disease

    Directory of Open Access Journals (Sweden)

    Maryluz Camargo-Mendoza

    2017-04-01

    Full Text Available Huntington’s disease (HD has been described as a genetic condition caused by a mutation in the CAG (cytosine-adenine-guanine nucleotide sequence. Depending on the stage of the disease, people may have difficulties in speech, language and swallowing. The purpose of this paper is to describe these difficulties in detail, as well as to provide an account on speech and language therapy approach to this condition. Regarding speech, it is worth noticing that characteristics typical of hyperkinetic dysarthria can be found due to underlying choreic movements. The speech of people with HD tends to show shorter sentences, with much simpler syntactic structures, and difficulties in tasks that require complex cognitive processing. Moreover, swallowing may present dysphagia that progresses as the disease develops. A timely, comprehensive and effective speech-language intervention is essential to improve the quality of life of people and contribute to their communicative welfare.

  1. 決策樹形式知識之線上預測系統架構 | An On-Line Decision Tree-Based Predictive System Architecture

    Directory of Open Access Journals (Sweden)

    馬芳資、林我聰 Fang-Tz Ma、Woo-Tsong Lin

    2003-10-01

    ="font-size: small;">This paper presents an on-line decision tree-based predictive system architecture. The architecture contains nine components, including a database of the examples, a learning system of the decision trees, a knowledge base, a historical knowledge base, a maintaining interface of the decision trees, an interface to upload training and testing examples, a PMML (Predictive Model Markup Language translator, an on-line predictive system, and a merging optional decision trees system. There are three channels to import knowledge in the architecture; the developers can upload the examples to the learning system to induce the decision tree, directly input the information of decision trees through the user interface, or import the decision trees in PMML format. In order to integrate the knowledge of the decision trees, we added the merging optional decision trees system into this architecture. The merging optional decision trees system can combine multiple decision trees into a single decision tree to integrate the knowledge of the trees. In the future research, we will implement this architecture as a real system in the web-based platform to do some empirical analyses. And in order to improve the performance of the merging decision trees, we will also develop some pruning strategies in the merging optional decision trees system.

  2. Prefrontal cortex activity during swallowing in dysphagia patients.

    Science.gov (United States)

    Lee, Jun; Yamate, Chisato; Taira, Masato; Shinoda, Masamichi; Urata, Kentaro; Maruno, Mitsuru; Ito, Reio; Saito, Hiroto; Gionhaku, Nobuhito; Iinuma, Toshimitsu; Iwata, Koichi

    2018-05-24

    Prefrontal cortex activity is modulated by flavor and taste stimuli and changes during swallowing. We hypothesized that changes in the modulation of prefrontal cortex activity by flavor and taste were associated with swallowing movement and evaluated brain activity during swallowing in patients with dysphagia. To evaluate prefrontal cortex activity in dysphagia patients during swallowing, change in oxidized hemoglobin (z-score) was measured with near-infrared spectroscopy while dysphagia patients and healthy controls swallowed sweetened/unsweetened and flavored/unflavored jelly. Total z-scores were positive during swallowing of flavored/unsweetened jelly and negative during swallowing of unflavored/sweetened jelly in controls but negative during swallowing of sweetened/unsweetened and flavored/unflavored jelly in dysphagia patients. These findings suggest that taste and flavor during food swallowing are associated with positive and negative z-scores, respectively. Change in negative and positive z-scores may be useful in evaluating brain activity of dysphagia patients during swallowing of sweetened and unsweetened food.

  3. Aspirating and Nonaspirating Swallow Sounds in Children: A Pilot Study.

    Science.gov (United States)

    Frakking, Thuy; Chang, Anne; O'Grady, Kerry; David, Michael; Weir, Kelly

    2016-12-01

    Cervical auscultation (CA) may be used to complement feeding/swallowing evaluations when assessing for aspiration. There are no published pediatric studies that compare the properties of sounds between aspirating and nonaspirating swallows. To establish acoustic and perceptual profiles of aspirating and nonaspirating swallow sounds and determine if a difference exists between these 2 swallowing types. Aspiration sound clips were obtained from recordings using CA simultaneously undertaken with videofluoroscopic swallow study. Aspiration was determined using the Penetration-Aspiration Scale. The presence of perceptual swallow/breath parameters was rated by 2 speech pathologists who were blinded to the type of swallow. Acoustic data between groups were compared using Mann Whitney U-tests, while perceptual differences were determined by a test of 2 proportions. Combinations of perceptual parameters of 50 swallows (27 aspiration, 23 no aspiration) from 47 children (57% male) were statistically analyzed using area under a receiver operating characteristic (aROC), sensitivity, specificity, and positive and negative predictive values to determine predictors of aspirating swallows. The combination of post-swallow presence of wet breathing and wheeze and absence of GRS and normal breathing was the best predictor of aspiration (aROC = 0.82, 95% CI, 0.70-0.94). There were no significant differences between these 2 swallow types for peak frequency, duration, and peak amplitude. Our pilot study has shown that certain characteristics of swallow obtained using CA may be useful in the prediction of aspiration. However, further research comparing the acoustic swallowing sound profiles of normal children to children with dysphagia (who are aspirating) on a larger scale is required. © The Author(s) 2016.

  4. Prevalence of atypical swallowing: a kinesiographic study.

    Science.gov (United States)

    Monaco, A; Cattaneo, R; Spadaro, A; Marchetti, E; Barone, A

    2006-12-01

    The aim of this study was to investigate the prevalence of kinesiographic coincidence between the most cranial position during deglutition of mandible and habitual occlusal position and to evaluate the distribution of clinical diagnosis according to the kinesiographic pattern of deglutition. 201 random patients in waiting list for dental treatment and classified as orthodontic patients, prosthetic patients, TMD patients and control patients, were evaluated. Kinesiographic records were acquired using K7I and positioning a magnetic sensor frame integral with the head and with the sensory field balanced on an artificial magnet adhering to the mucosa covering the roots of the lower mandibular incisors. The kinesiographic occlusal position was compared to the kinesiographic most cranial position of the mandible during swallowing. 99 patients displayed a discrepancy between the most cranial position during swallowing and the occlusal position. 102 patients did not show any discrepancy. In this group the kinesiographic most cranial position during swallowing coincided with the occlusal position. The finding suggests that computerised kinesiography could be useful to study deglutition, detecting in a reliable way the movement pattern. Atypical deglutition seems to be less atypical than previously though in dental patient population and, despite these data confirm its correlation with malocclusion, we noted an inverse correlation with necessity of prosthetic treatment and no higher prevalence in TMD patients.

  5. Diagnosis of Spasmodic Dysphonia Manifested by Swallowing Difficulty in Videofluoroscopic Swallowing Study

    Science.gov (United States)

    Yeo, Han Gyeol; Lee, Seong Jae; Hyun, Jung Keun

    2015-01-01

    Spasmodic dysphonia is defined as a focal laryngeal disorder characterized by dystonic spasms of the vocal cord during speech. We described a case of a 22-year-old male patient who presented complaining of idiopathic difficulty swallowing that suddenly developed 6 months ago. The patient also reported pharyngolaryngeal pain, throat discomfort, dyspnea, and voice change. Because laryngoscopy found no specific problems, an electrodiagnostic study and videofluoroscopic swallowing study (VFSS) were performed to find the cause of dysphagia. The VFSS revealed continuous twitch-like involuntary movement of the laryngeal muscle around the vocal folds. Then, he was diagnosed with spasmodic dysphonia by VFSS, auditory-perceptual voice analysis, and physical examination. So, we report the first case of spasmodic dysphonia accompanied with difficulty swallowing that was confirmed by VFSS. PMID:25932430

  6. Effects of Barium Concentration on Oropharyngeal Swallow Timing Measures

    OpenAIRE

    Stokely, Shauna L.; Molfenter, Sonja M.; Steele, Catriona M.

    2013-01-01

    Videofluoroscopy is commonly used for evaluating oropharyngeal swallowing but requires radiopaque contrast (typically barium). Prior studies suggest that some aspects of swallowing, including timing measures of oral and pharyngeal bolus transit, vary depending on barium concentration. The aim of our study was to identify timing differences in healthy swallowing between “thin” (40 % w/v concentration) and “ultrathin” (22 % w/v concentration) barium solutions. Twenty healthy adults (Ten women; ...

  7. Prophylactic Swallowing Exercises in Head and Neck Cancer Radiotherapy

    DEFF Research Database (Denmark)

    Mortensen, H R; Jensen, Kenneth; Aksglæde, K

    2015-01-01

    Many head and neck cancer (HNC) survivors experience reduced quality of life due to radiotherapy (RT)-related dysphagia. The aim of this prospective randomized trial was to evaluate the impact of prophylactic swallowing exercises on swallowing-related outcomes in HNC patients treated with curative...... of the dysphagia outcomes during and after treatment. Adherence to exercises was poor and dropouts due to especially fatigue were very frequent in both groups. Systematic swallowing exercises had no impact on swallowing outcomes within the first year after RT. Despite repeated supervised sessions, adherence...

  8. Diagnosis of Swallowing Disorders: How We Interpret Pharyngeal Manometry.

    Science.gov (United States)

    Cock, Charles; Omari, Taher

    2017-03-01

    We provide an overview of the clinical application of novel pharyngeal high-resolution impedance manometry (HRIM) with pressure flow analysis (PFA) in our hands with example cases. In our Centre, we base our interpretation of HRIM recordings upon a qualitative assessment of pressure-impedance waveforms during individual swallows, as well as a quantitative assessment of averaged PFA swallow function variables. We provide a description of two global swallowing efficacy measures, the swallow risk index (SRI), reflecting global swallowing dysfunction (higher SRI = greater aspiration risk) and the post-swallow impedance ratio (PSIR) detecting significant post-swallow bolus residue. We describe a further eight swallow function variables specific to the hypopharynx and upper esophageal sphincter (UES), assessing hypo-pharyngeal distension pressure, contractility, bolus presence and flow timing, and UES basal tone, relaxation, opening and contractility. Pharyngeal HRIM has now come of age, being applicable for routine clinical practice to assess the biomechanics of oropharyngeal swallowing dysfunction. In the future, it may guide treatment strategies and allow more objective longitudinal follow-up on clinical outcomes.

  9. Variability of the pharyngeal phase of swallow in the cat.

    Directory of Open Access Journals (Sweden)

    Daniel G Spearman

    Full Text Available The pharyngeal phase of swallow has been thought to be a stereotypical motor behavior.This is a prospective, preclinical, hypothesis driven, one group by three-task design.We sought to compare the effects of pharyngeal swabbing, water only, and water plus punctate mechanical stimulation on the spatiotemporal features of the pharyngeal phase of swallow in the cat. Swallow was elicited under these three conditions in six anaesthetized cats. Electromyographic activity was recorded from seven muscles used to evaluate swallow: mylohyoid, geniohyoid, thyrohyoid, thyroarytenoid, thyropharyngeus, cricopharyngeus, and parasternal.Pharyngeal swabbing in comparison to the other stimulus conditions, results in decreases in post-swallow cricopharyngeus activity (upper esophageal sphincter; a significant increase in parasternal (schluckatmung; swallow breath activity; and increases in thyrohyoid (laryngeal elevator, thyroarytenoid (laryngeal adductor and parasternal muscles burst duration. Pearson correlations were found of moderate strength between 19% of burst duration comparisons and weak to moderate relationships between 29% of burst amplitude comparisons. However, there were no positive significant relationships between phase durations and electromyogram amplitudes between any of the muscles studied during swallow.The results support the concept that a stereotypical behavior, such as pharyngeal swallowing in animal models, can be modified by sensory feedback from pharyngeal mucosal mechanoreceptors. Furthermore, differences in swallow phase durations and amplitudes provide evidence that separate regulatory mechanisms exist which regulate spatial and temporal aspects of the behavior.

  10. STAMPS: development and verification of swallowing kinematic analysis software.

    Science.gov (United States)

    Lee, Woo Hyung; Chun, Changmook; Seo, Han Gil; Lee, Seung Hak; Oh, Byung-Mo

    2017-10-17

    Swallowing impairment is a common complication in various geriatric and neurodegenerative diseases. Swallowing kinematic analysis is essential to quantitatively evaluate the swallowing motion of the oropharyngeal structures. This study aims to develop a novel swallowing kinematic analysis software, called spatio-temporal analyzer for motion and physiologic study (STAMPS), and verify its validity and reliability. STAMPS was developed in MATLAB, which is one of the most popular platforms for biomedical analysis. This software was constructed to acquire, process, and analyze the data of swallowing motion. The target of swallowing structures includes bony structures (hyoid bone, mandible, maxilla, and cervical vertebral bodies), cartilages (epiglottis and arytenoid), soft tissues (larynx and upper esophageal sphincter), and food bolus. Numerous functions are available for the spatiotemporal parameters of the swallowing structures. Testing for validity and reliability was performed in 10 dysphagia patients with diverse etiologies and using the instrumental swallowing model which was designed to mimic the motion of the hyoid bone and the epiglottis. The intra- and inter-rater reliability tests showed excellent agreement for displacement and moderate to excellent agreement for velocity. The Pearson correlation coefficients between the measured and instrumental reference values were nearly 1.00 (P software is expected to be useful for researchers who are interested in the swallowing motion analysis.

  11. Mastication and swallowing in patients with postirradiation xerostomia

    International Nuclear Information System (INIS)

    Hamlet, Sandra; Faull, Jennifer; Klein, Barbara; Aref, Amr; Fontanesi, James; Stachler, Robert; Shamsa, Falah; Jones, Lewis; Simpson, Mark

    1997-01-01

    Purpose: Very little objective data has been reported on mastication and swallowing in xerostomic patients, which would substantiate presumed causal relationships between xerostomia and patient complaints. The purpose was to elucidate which components of mastication and swallowing were abnormal, and most directly related to xerostomia, and which appeared unaffected. Methods and Materials: A retrospective analysis of timing events in mastication and swallowing was done using videofluoroscopic data for 15 cancer patients with xerostomia, and 20 normal controls. Scintigraphy was also used to determine oropharyngeal residue after a water swallow. Cancer treatment modalities included radiation therapy or chemoradiation therapy. Results: For barium liquid and paste substances, timing measures were equivalent for controls and patients. Xerostomic patients took 46% longer to masticate a shortbread cookie, and timing for the initiation of swallowing was shorter, but duration of swallowing appeared unaffected. Oral and pharyngeal residues following the swallow were greater in the patient group. Conclusions: Xerostomia primarily affected mastication and oral manipulation of a dry, absorbent food material. Increased oral and pharyngeal residues after a water swallow are ambiguously related to xerostomia. The initiation and duration of the pharyngeal swallow was not abnormal

  12. A simple bedside test to assess the swallowing dysfunction in Parkinson′s disease

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    S Vinoth Kanna

    2014-01-01

    Full Text Available Background: Swallowing changes are common in Parkinson′s disease (PD. Early identification is essential to avoid complications of aspiration. Objectives: To evaluate the swallowing ability of the PD patients and to correlate it with the indicators of disease progression. Materials and Methods: A total of 100 PD patients (70 males and 30 females aged between 50 years and 70 years with varying stage, duration, and severity were enrolled in a cross-sectional study carried out between January and May 2012. A simple bedside water swallowing test was performed using standard 150 ml of water. Swallowing process was assessed under three categories-swallowing speeds (ml/s, swallowing volume (ml/swallow and swallowing duration (s/swallow. Equal number of age and sex matched controls were also evaluated. Results: All of them completed the task of swallowing. A mean swallowing speed (27.48 ml/s, swallowing volume (28.5 ml/s, and swallowing duration (1.05 s/swallow was established by the control group. The PD patients showed decreased swallowing speed (7.15 ml/s in males and 6.61 ml/s in females, decreased swallowing volume (14.59 ml/swallow and 14 ml/swallow in females, and increased swallowing duration (2.37 s/swallow and 2.42 s/swallow which are statistically significant. There was a significant positive correlation between the severity, duration, and staging of the disease with the swallowing performance and a poor correlation between the subjective reports of dysphagia and the objective performance on water swallow test. Conclusion: The water swallowing test is a simple bedside test to identify the swallowing changes early in PD. It is recommended to do the test in all PD Patients to detect dysphagia early and to intervene appropriately.

  13. Characteristics of cones and seeds of Pinus sibirica Du Tour at tree line in the Central Altai

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    E. O. Filimonova

    2016-02-01

    Full Text Available We studied the cones of Siberian stone pine (Pinus sibirica Du Tour at its treeline in the forest tundra ecotone in the Severo-Chuisky Range, the Altai Mountains, Russia. We have registered length, diameter and form of apophysis, the number of sterile and fertile scales in the cones, the number of ovules and the number of seeds, including developed and underdeveloped seeds, and the developed seeds/ovules ratio. The cones and seeds are produced below 2350 m a. s. l under arid conditions (east-south-eastern slope and below 2390 m a. s. l. under more humid conditions (west-north-western slope. These altitudes are reproductive line of Siberian stone pine. The predominant forms of the cones near this line are cone-like, spherical and cylindrical. Apophyses are mostly tuberous, hook-like and flat. The most (50% of the sampled cones have the cylindrical form. The number of ovules varied from 84.6 to 102.4 per cone, the number of seeds were from 76.7 to 98.9 per cone, and the developed seeds were 74.5 to 95.7 per cone. The lowest proportion of developed seeds was registered for cones sampled on arid east-south-eastern slope in 2011. The cones with tuberous apophysis have the highest number of seeds (up to 103.6–110 per cone under more humid and 87.3–104.4 per cone under more arid conditions. Cones gathered at 2235–2390 m a. s. l. have low presence of underdeveloped seeds (1.0 to 3.2 % and high developed seeds/ovules ratio (87.2 to 93.7 %.

  14. Swallowing dysfunction as a factor that should be remembered in recurrent pneumonia: videofluoroscopic swallow study.

    Science.gov (United States)

    Kaymaz, Nazan; Özçelik, Uğur; Demir, Numan; Cinel, Güzin; Yalçin, Ebru; Ersöz, Deniz D; Kiper, Nural

    2017-10-01

    The swallow function is one of the strong defense mechanism against aspiration. Aspiration and pneumonia are unavoidable in patients with defective mechanism of swallowing. The aim of this study was to evaluate patients with recurrent pneumonia in terms of videofluoroscopic examination results. The study comprised fifty pediatric cases (22 boys, 28 girls) with an average age of 2.9 years (2 months-7.5 years) who were referred to our clinic due to suffering from recurrent pneumonia. The videofluoroscopic swallow study (VFSS) was performed on all patients. The presence of a correlation with pneumonia was investigated. In 45 of the children, VFSS results were not normal. Of the children, 41 had mental-motor retardation. The results of the videofluoroscopic study show that silent aspiration was the most common pathology in participants with the percentage of 40 (27.5% mild, 17.5% severe). Patients in the study had pneumonia with an incidence of 2.6 illnesses per year. Having one than more results on VFSS was found to be associated with more number of annual pneumonia episodes. Children with neurological impairments are at risk of recurrent acute pneumonia due to aspiration. Disturbances of swallowing phases should be remembered as a cause of pneumonia in these patients.

  15. Derangement of swallowing in children with myelomeningocele

    International Nuclear Information System (INIS)

    Fernbach, S.K.; McLone, D.G.

    1985-01-01

    Barium esophagrams performed in 13 children with myelomeningocele demonstrated a variety of swallowing disorders: difficulty in bolus formation, nasopharyngeal reflux, tracheobronchial aspiration. Cricopharyngeal spasm was not identified in this group. Antegrade peristalsis in the distal two-thirds of the esophagus was normal. Gastroesophageal reflux was demonstrated in 8 of the children. Vocal cord paralysis (8/13) and death in early child-hood (6/13) occurred with greater frequency than in the general myelomeningocele population. Correct management of these children may require tracheostomy, gastrostomy, and fundoplication. (orig.)

  16. Derangement of swallowing in children with myelomeningocele

    Energy Technology Data Exchange (ETDEWEB)

    Fernbach, S.K.; McLone, D.G.

    1985-07-01

    Barium esophagrams performed in 13 children with myelomeningocele demonstrated a variety of swallowing disorders: difficulty in bolus formation, nasopharyngeal reflux, tracheobronchial aspiration. Cricopharyngeal spasm was not identified in this group. Antegrade peristalsis in the distal two-thirds of the esophagus was normal. Gastroesophageal reflux was demonstrated in 8 of the children. Vocal cord paralysis (8/13) and death in early child-hood (6/13) occurred with greater frequency than in the general myelomeningocele population. Correct management of these children may require tracheostomy, gastrostomy, and fundoplication.

  17. Hyolaryngeal excursion as the physiological source of swallowing accelerometry signals

    International Nuclear Information System (INIS)

    Zoratto, D C B; Chau, T; Steele, C M

    2010-01-01

    Swallowing dysfunction, or dysphagia, is a serious condition that can result from any structural or neurological impairment (such as stroke, neurodegenerative disease or brain injury) that affects the swallowing mechanism. The gold-standard method of instrumental swallowing assessment is an x-ray examination known as the videofluoroscopic swallowing study, which involves radiation exposure. Consequently, there is interest in exploring the potential of less invasive methods, with lesser risks of biohazard, to accurately detect swallowing abnormalities. Accelerometry is one such technique, which measures the epidermal vibration signals on a patient's neck during swallowing. Determining the utility of accelerometry signals for detecting dysphagia requires an understanding of the physiological source of the vibrations that are measured on the neck during swallowing. The purpose of the current study was to determine the extent to which movement of the hyoid bone and larynx contributes to the vibration signal that is registered during swallowing accelerometry. This question was explored by mapping the movement trajectories of the hyoid bone and the arytenoid cartilages from lateral videofluoroscopy recordings collected during thin liquid swallowing, and comparing these trajectories to time-linked signals obtained from a dual-axis accelerometer placed on the neck, just anterior to the cricoid cartilage. Participants for this study included 43 adult patients referred for videofluoroscopic swallowing studies to characterize the nature and severity of suspected neurogenic dysphagia. A software program was created to allow frame-by-frame tracking of structural movement on the videofluoroscopy recordings. These movement data were then compared to the integrated acceleration data using multiple linear regressions. The results concur with previous studies, implicating hyolaryngeal excursion as the primary physiological source of swallowing accelerometry signals, with both

  18. Swallowing frequency in elderly people during daily life.

    Science.gov (United States)

    Tanaka, N; Nohara, K; Kotani, Y; Matsumura, M; Sakai, T

    2013-10-01

    Disuse atrophy of swallowing-related organs due to an excessive decrease in swallowing frequency is suspected to occur in patients with poor oral intake, especially elderly people. However, swallowing frequency in daily life has not previously been examined in the elderly. This study examined swallowing frequency in elderly people and compared these findings to those in a younger population and differences in the degree of activity in daily life. (i) We compared swallowing frequency in 20 elderly people (82·0 ± 8·3 year) and 15 healthy young people (26·5 ± 3·5 year). (ii) 20 elderly people were divided into two groups according to the degree of activity in daily life: a semi-bedridden group and bedridden group; the swallowing frequency was compared between these groups. (i) The swallowing frequency in the elderly people was 2-19 times per hour and the mean was 9·4 ± 4·9, and that in the healthy young people was 16-76 times per hour and the mean was 40·7 ± 19·5. Swallowing frequency in elderly people was significantly lower than that in young healthy people (P bedridden group was 2-11 times per hour and the mean was 6·8 ± 3·3, and that in semi-bedridden group was 3-19 times per hour and the mean was 11·9 ± 5·1. Swallowing frequency in bedridden group was significantly lower than that in semi-bedridden group (P elderly people tend to swallow less frequently than young people. In addition, swallowing frequency was lower in elderly subjects with a low degree of activity in daily life. © 2013 John Wiley & Sons Ltd.

  19. Do Dysphagic Patients with an Absent Pharyngeal Swallow Have a Shorter Survival than Dysphagic Patients with Pharyngeal Swallow? Prognostic Importance of a Therapeutic Videoradiographic Swallowing Study (TVSS)

    International Nuclear Information System (INIS)

    Buelow, M.; Olsson, R.; Ekberg, O.

    2005-01-01

    Purpose: To study survival in two groups of dysphagic patients - one group unable to elicit the pharyngeal stage of swallow (APS) and another group with pharyngeal swallow (WPS) - and to compare recommendations regarding nutrition and therapeutic strategies based on the therapeutic swallowing study. Material and Methods: In this retrospective study, the records of dysphagic patients who have undergone a therapeutic videoradiographic swallowing study (TVSS) were reviewed. Forty patients without pharyngeal swallow were matched for age and gender with 40 patients with pharyngeal swallow; altogether 80 patients were included in the study. Survival was registered at 3, 12, and 72 months after the TVSS. Results: In this study, the APS group had a significantly shorter survival time compared to the WPS group when followed-up at 12 months. In the APS group, most patients (37.5% (15/40)) died within the 3 months after TVSS. At 72 months, 62.5% (25/40) of the patients in the APS group had died. In the WPS group, 5% (2/40) had died within 3 months and 47.4% (19/40) after 12 months. At 72 months, 52.5% (21/40) of the patients in the WPS group had died. Regarding nutritional and therapeutic recommendations based on TVSS, 34/40 in the APS group were recommended no oral intake. Eighteen naso-gastric tubes were placed directly after TVSS. The therapeutic strategies recommended were head-positioning, thermal tactile stimulation, and tongue exercises (in 8 patients). In the WPS group, all patients were recommended oral intake. Diet modification was recommended in 29 patients. The therapeutic strategies recommended were head-positioning, thermal tactile stimulation, tongue exercises, supraglottic swallow, and effortful swallow (in 24 patients). Conclusion: Patients unable to elicit the pharyngeal stage of swallow had a shorter survival time than patients with pharyngeal swallow, probably due to a more severe underlying disease. Tube feeding was more frequent in the APS group. Fewer

  20. IMPLICATIONS OF MOUTH BREATHING AND ATYPICAL SWALLOWING IN BODY POSTURE

    Directory of Open Access Journals (Sweden)

    Veronique Sousa

    2017-07-01

    Conclusion: Statistically significant associations were established between the breathing pattern and the horizontal alignment of acromions, as well as the horizontal and vertical alignment of the head; between the pattern of breathing and swallowing with occlusal relationship anteroposterior and occlusal relationship vertical and also between breathing pattern and swallowing with digital sucking habits and pacifier use.

  1. Swallow Characteristics in Patients with Oculopharyngeal Muscular Dystrophy

    Science.gov (United States)

    Palmer, Phyllis M.; Neel, Amy T.; Sprouls, Gwyneth; Morrison, Leslie

    2010-01-01

    Purpose: This prospective investigation evaluates oral weakness and its impact on swallow function, weight, and quality of life in patients with oculopharyngeal muscular dystrophy (OPMD). Method: Intraoral pressure, swallow pressure, and endurance were measured using an Iowa Oral Performance Instrument in participants with OPMD and matched…

  2. Current distribution and population size of the Blue Swallow Hirundo ...

    African Journals Online (AJOL)

    , the crops, natural pastures, livestock and their dung possibly provide the food source for the aerial arthropods on which the Blue Swallows feed. In total, 151 Blue Swallows were recorded consisting of 62 males, 68 females and 21 unsexed ...

  3. Swallowing in moderate and severe phases of Alzheimer's disease

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    Sheilla de Medeiros Correia

    2010-12-01

    Full Text Available OBJECTIVE: To characterize the problems of feeding and swallowing in individuals with moderate and severe Alzheimer´s disease (AD and to correlate these with functional aspects. METHOD: Fifty patients with AD and their caregivers participated in this study. The instruments used were: Clinical Dementia Rating (CDR, Mini-Mental State Examination, Index of Activities of Daily Living, Assessment of Feeding and Swallowing Difficulties in Dementia, Functional Outcome Questionnaire for Aphasia, and Swallowing Rating Scale. RESULTS: Problems with passivity, distraction and refusal to eat were encountered in the CDR2 group. Distraction, passivity and inappropriate feeding velocity were predominant in the CDR3 group. The problems were correlated with communication, swallowing severity of AD individuals and caregiver schooling. CONCLUSION: Given the inexorable functional alterations during the course of the disease, it is vital to observe these in patients with a compromised feeding and swallowing mechanism. The present study supplies the instruments to orient caregivers and professionals.

  4. Involvement of hypoglossal and recurrent laryngeal nerves on swallowing pressure.

    Science.gov (United States)

    Tsujimura, Takanori; Suzuki, Taku; Yoshihara, Midori; Sakai, Shogo; Koshi, Naomi; Ashiga, Hirokazu; Shiraishi, Naru; Tsuji, Kojun; Magara, Jin; Inoue, Makoto

    2018-05-01

    Swallowing pressure generation is important to ensure safe transport of an ingested bolus without aspiration or leaving residue in the pharynx. To clarify the mechanism, we measured swallowing pressure at the oropharynx (OP), upper esophageal sphincter (UES), and cervical esophagus (CE) using a specially designed manometric catheter in anesthetized rats. A swallow, evoked by punctate mechanical stimulation to the larynx, was identified by recording activation of the suprahyoid and thyrohyoid muscles using electromyography (EMG). Areas under the curve of the swallowing pressure at the OP, UES, and CE from two trials indicated high intrasubject reproducibility. Effects of transecting the hypoglossal nerve (12N) and recurrent laryngeal nerve (RLN) on swallowing were investigated. Following bilateral hypoglossal nerve transection (Bi-12Nx), OP pressure was significantly decreased, and time intervals between peaks of thyrohyoid EMG bursts and OP pressure were significantly shorter. Decreased OP pressure and shortened times between peaks of thyrohyoid EMG bursts and OP pressure following Bi-12Nx were significantly increased and longer, respectively, after covering the hard and soft palates with acrylic material. UES pressure was significantly decreased after bilateral RLN transection compared with that before transection. These results suggest that the 12N and RLN play crucial roles in OP and UES pressure during swallowing, respectively. We speculate that covering the palates with a palatal augmentation prosthesis may reverse the reduced swallowing pressure in patients with 12N or tongue damage by the changes of the sensory information and of the contact between the tongue and a palates. NEW & NOTEWORTHY Hypoglossal nerve transection reduced swallowing pressure at the oropharynx. Covering the hard and soft palates with acrylic material may reverse the reduced swallowing function caused by hypoglossal nerve damage. Recurrent laryngeal nerve transection reduced upper

  5. Motor imagery and swallowing: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Ada Salvetti Cavalcanti Caldas

    Full Text Available ABSTRACT Objetive: to identify, in the literature, studies that address the use of motor imagery of swallowing. Methods: a systematic review in SCOPUS databases, Science Direct and Medline, with descriptors and free terms "Motor Imagery"; "Swallow"; "Feeding"; "Stomatognathic System"; "mastication ", "Chew "; "Deglutition "; "Deglutition Disorders "; and "Mental Practice". Original articles using the motor imagery of swallowing were included, while reviews were excluded. For data analysis, at the first and second steps, the reading of titles and abstracts of the studies was carried out. In the third step, all studies that were not excluded were read in full. Results: four manuscripts were selected. The use of motor imagery in the rehabilitation of swallowing shows to be a recent proposal (2014-2015. The sample was reduced and comprised mainly healthy individuals. The EMG of the supra-hyoid muscles was used in two manuscripts. The most used neuroimaging technique was the Near-Infrared Spectroscopy, demonstrating the occurrence of hemodynamic changes during motor imagery and motor execution of swallowing. Conclusion: the motor imagery produces brain response in the motor area of the brain, suggesting that mentalization of actions related to swallowing is effective. However, further studies are needed for the application of this approach in the swallowing rehabilitation.

  6. Risk factors for swallowing dysfunction in stroke patients

    Directory of Open Access Journals (Sweden)

    Anna Flávia Ferraz Barros Baroni

    2012-06-01

    Full Text Available CONTEXT: Stroke is a frequent cause of dysphagia. OBJECTIVE: To evaluate in a tertiary care hospital the prevalence of swallowing dysfunction in stroke patients, to analyze factors associated with the dysfunction and to relate swallowing dysfunction to mortality 3 months after the stroke. METHODS: Clinical evaluation of deglutition was performed in 212 consecutive patients with a medical and radiologic diagnosis of stroke. The occurrence of death was determined 3 months after the stroke. RESULTS: It was observed that 63% of the patients had swallowing dysfunction. The variables gender and specific location of the lesion were not associated with the presence or absence of swallowing dysfunction. The patients with swallowing dysfunction had more frequently a previous stroke, had a stroke in the left hemisphere, motor and/or sensitivity alterations, difficulty in oral comprehension, alteration of oral expression, alteration of the level of consciousness, complications such as fever and pneumonia, high indexes on the Rankin scale, and low indexes on the Barthel scale. These patients had a higher mortality rate. CONCLUSIONS: Swallowing evaluation should be done in all patients with stroke, since swallowing dysfunction is associated with complications and an increased risk of death.

  7. Effects of barium concentration on oropharyngeal swallow timing measures.

    Science.gov (United States)

    Stokely, Shauna L; Molfenter, Sonja M; Steele, Catriona M

    2014-02-01

    Videofluoroscopy is commonly used for evaluating oropharyngeal swallowing but requires radiopaque contrast (typically barium). Prior studies suggest that some aspects of swallowing, including timing measures of oral and pharyngeal bolus transit, vary depending on barium concentration. The aim of our study was to identify timing differences in healthy swallowing between "thin" (40 % w/v concentration) and "ultrathin" (22 % w/v concentration) barium solutions. Twenty healthy adults (Ten women; mean age = 31 years) each performed a series of three noncued 5-ml swallows each of ultrathin and thin liquid barium solutions in videofluoroscopy. Timing measures were compared between barium concentrations using a mixed-model ANOVA. The measures of interest were stage transition duration, pharyngeal transit time, and duration of upper esophageal sphincter opening. Significant differences were observed in the timing measures of swallowing with respect to barium concentration. In all cases, longer durations were seen with the higher barium concentration. Barium concentration influences timing parameters in healthy swallowing, even between ultrathin and thin concentrations. Clinicians need to understand and control for the impact of different barium stimuli on swallowing physiology.

  8. Ginger Orally Disintegrating Tablets to Improve Swallowing in Older People.

    Science.gov (United States)

    Hirata, Ayumu; Funato, Hiroki; Nakai, Megumi; Iizuka, Michiro; Abe, Noriaki; Yagi, Yusuke; Shiraishi, Hisashi; Jobu, Kohei; Yokota, Junko; Hirose, Kahori; Hyodo, Masamitsu; Miyamura, Mitsuhiko

    2016-01-01

    We previously prepared and pharmaceutically evaluated ginger orally disintegrating (OD) tablets, optimized the base formulation, and carried out a clinical trial in healthy adults in their 20 s and 50s to measure their effect on salivary substance P (SP) level and improved swallowing function. In this study, we conducted clinical trials using the ginger OD tablets in older people to clinically evaluate the improvements in swallowing function resulting from the functional components of the tablet. The ginger OD tablets were prepared by mixing the excipients with the same amount of mannitol and sucrose to a concentration of 1% ginger. Eighteen healthy older adult volunteers aged 63 to 90 were included in the swallowing function test. Saliva was collected before and 15 min after administration of the placebo and ginger OD tablets. Swallowing endoscopy was performed by an otolaryngologist before administration and 15 min after administration of the ginger OD tablets. A scoring method was used to evaluate the endoscopic swallowing. Fifteen minutes after taking the ginger OD tablets, the salivary SP amount was significantly higher than prior to ingestion or after taking the placebo (pginger OD tablets. Our findings showed that the ginger OD tablets increased the salivary SP amount and improved swallowing function in older people with appreciably reduced swallowing function.

  9. Tactile thermal oral stimulation increases the cortical representation of swallowing

    Directory of Open Access Journals (Sweden)

    Suntrup Sonja

    2009-06-01

    Full Text Available Abstract Background Dysphagia is a leading complication in stroke patients causing aspiration pneumonia, malnutrition and increased mortality. Current strategies of swallowing therapy involve on the one hand modification of eating behaviour or swallowing technique and on the other hand facilitation of swallowing with the use of pharyngeal sensory stimulation. Thermal tactile oral stimulation (TTOS is an established method to treat patients with neurogenic dysphagia especially if caused by sensory deficits. Little is known about the possible mechanisms by which this interventional therapy may work. We employed whole-head MEG to study changes in cortical activation during self-paced volitional swallowing in fifteen healthy subjects with and without TTOS. Data were analyzed by means of synthetic aperture magnetometry (SAM and the group analysis of individual SAM data was performed using a permutation test. Results Compared to the normal swallowing task a significantly increased bilateral cortical activation was seen after oropharyngeal stimulation. Analysis of the chronological changes during swallowing suggests facilitation of both the oral and the pharyngeal phase of deglutition. Conclusion In the present study functional cortical changes elicited by oral sensory stimulation could be demonstrated. We suggest that these results reflect short-term cortical plasticity of sensory swallowing areas. These findings facilitate our understanding of the role of cortical reorganization in dysphagia treatment and recovery.

  10. Clock gene variation in Tachycineta swallows.

    Science.gov (United States)

    Dor, Roi; Cooper, Caren B; Lovette, Irby J; Massoni, Viviana; Bulit, Flor; Liljesthrom, Marcela; Winkler, David W

    2012-01-01

    Many animals use photoperiod cues to synchronize reproduction with environmental conditions and thereby improve their reproductive success. The circadian clock, which creates endogenous behavioral and physiological rhythms typically entrained to photoperiod, is well characterized at the molecular level. Recent work provided evidence for an association between Clock poly-Q length polymorphism and latitude and, within a population, an association with the date of laying and the length of the incubation period. Despite relatively high overall breeding synchrony, the timing of clutch initiation has a large impact on the fitness of swallows in the genus Tachycineta. We compared length polymorphism in the Clock poly-Q region among five populations from five different Tachycineta species that breed across a hemisphere-wide latitudinal gradient (Fig. 1). Clock poly-Q variation was not associated with latitude; however, there was an association between Clock poly-Q allele diversity and the degree of clutch size decline within breeding seasons. We did not find evidence for an association between Clock poly-Q variation and date of clutch initiation in for any of the five Tachycineta species, nor did we found a relationship between incubation duration and Clock genotype. Thus, there is no general association between latitude, breeding phenology, and Clock polymorphism in this clade of closely related birds.Figure 1Photos of Tachycineta swallows that were used in this study: A) T. bicolor from Ithaca, New York, B) T. leucorrhoa from Chascomús, Argentina, C) T. albilinea from Hill Bank, Belize, D) T. meyeni from Puerto Varas, Chile, and E) T. thalassina from Mono Lake, California, Photographers: B: Valentina Ferretti; A, C-E: David Winkler.

  11. Isometric and swallowing tongue strength in healthy adults.

    Science.gov (United States)

    Todd, J Tee; Lintzenich, Catherine Rees; Butler, Susan G

    2013-10-01

    The tongue contributes to a safe swallow. It facilitates bolus control during mastication, maintains a bolus in the oral cavity to prevent premature entry of the bolus into the hypopharynx, and helps generate pressure in the hypopharynx during swallowing. This study examined isometric tongue strength and tongue pressure measured during swallowing in healthy young and older adults. Prospective group design. One hundred twenty-six healthy individuals who were recruited as part of a larger study on swallowing participated in this study. Participants were divided into three age groups: 20 to 40 years, 41 to 60 years, and ≥61 years. A KayPentax Digital Swallowing Workstation with an air-filled bulb array was placed on the tongue of each participant (anterior to posterior). Participants completed three isometric tongue presses and three swallows. Repeated measures analyses of variance revealed a significant main effect of age (P = .01) and gender by tongue bulb location interaction (P = .02) for isometric tongue strength. That is, older adults had lower isometric tongue strength than young adults, and females had a greater difference between anterior and posterior tongue strength than males. Tongue strength during swallowing yielded significantly greater anterior versus posterior tongue pressure. This study comprises one of the largest in terms of number of healthy participants reported to date and confirms previous findings that isometric tongue strength decreases with age. Furthermore, given young and older adults generate similar swallowing pressures, swallowing is a submaximal strength activity, yet older adults have less functional reserve. 4. Copyright © 2013 The American Laryngological, Rhinological, and Otological Society, Inc.

  12. Riparian swallows as integrators of landscape change in a multiuse river system: implications for aquatic-to-terrestrial transfers of contaminants.

    Science.gov (United States)

    Alberts, Jeremy M; Sullivan, S Mažeika P; Kautza, A

    2013-10-01

    Recent research has highlighted the transfer of contaminants from aquatic to terrestrial ecosystems via predation of aquatic emergent insects by riparian consumers. The influence of adjacent land use and land cover (LULC) on aquatic-to-terrestrial contaminant transfer, however, has received limited attention. From 2010 to 2012, at 11 river reaches in the Scioto River basin (OH, USA), we investigated the relationships between LULC and selenium (Se) and mercury (Hg) concentrations in four species of riparian swallows. Hg concentrations in swallows were significantly higher at rural reaches than at urban reaches (t=-3.58, Pemergent insects. For example, tree swallows (Tachycineta bicolor) at urban reaches exhibited a higher proportion of aquatic prey in their diet, fed at a higher trophic level, and exhibited elevated Se levels. We also found that both Se and Hg concentrations in adult swallows were significantly higher than those observed in nestlings at both urban and rural reaches (Se: t=-2.83, P=0.033, df=3; Hg: t=-3.22, P=0.024, df=3). Collectively, our results indicate that riparian swallows integrate contaminant exposure in linked aquatic-terrestrial systems and that LULC may strongly regulate aquatic contaminant flux to terrestrial consumers. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Cervical auscultation as an adjunct to the clinical swallow examination: a comparison with fibre-optic endoscopic evaluation of swallowing.

    Science.gov (United States)

    Bergström, Liza; Svensson, Per; Hartelius, Lena

    2014-10-01

    This prospective, single-blinded study investigated the validity and reliability of cervical auscultation (CA) under two conditions; (1) CA-only, using isolated swallow-sound clips, and (2) CSE + CA, using extra clinical swallow examination (CSE) information such as patient case history, oromotor assessment, and the same swallow-sound clips as condition one. The two CA conditions were compared against a fibre-optic endoscopic evaluation of swallowing (FEES) reference test. Each CA condition consisted of 18 swallows samples compiled from 12 adult patients consecutively referred to the FEES clinic. Patients' swallow sounds were simultaneously recorded during FEES via a Littmann E3200 electronic stethoscope. These 18 swallow samples were sent to 13 experienced dysphagia clinicians recruited from the UK and Australia who were blinded to the FEES results. Samples were rated in terms of (1) if dysphagic, (2) if the patient was safe on consistency trialled, and (3) dysphagia severity. Sensitivity measures ranged from 83-95%, specificity measures from 50-92% across the conditions. Intra-rater agreement ranged from 69-97% total agreement. Inter-rater reliability for dysphagia severity showed substantial agreement (rs = 0.68 and 0.74). Results show good rater reliability for CA-trained speech-language pathologists. Sensitivity and specificity for both CA conditions in this study are comparable to and often better than other well-established CSE components.

  14. Role of Basal Ganglia in Swallowing Process: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Hamideh Ghaemi

    2016-12-01

    Discussion: Swallowing is a multifaceted performance that needs contribution of the tongue, larynx, pharynx, and esophagus as well as the neurological structures such as neocortex and subcortical regions - BG and brainstem.

  15. Swallowing rehabilitation before and during concurrent chemoradiotherapy for oropharyngeal cancer

    International Nuclear Information System (INIS)

    Tsuneyuki, Miki; Yonezawa, Kouichiro; Morimoto, Koichi; Tanimoto, Hitoshi; Saito, Miki; Otsuki, Naoki; Nibu, Ken-ichi

    2011-01-01

    Recently, oropharyngeal cancer is more frequently being managed with concurrent chemoradiotherapy (CCRT). As more patients receive CCRT, there is increasing attention on dysphagia. Since 2009, speech therapists in our hospital have performed swallowing rehabilitation for dysphagia associated with CCRT. We evaluated dysphagia after CCRT and examined the relationship between swallowing rehabilitation and swallowing disability. A total of 26 patients (22 males and 4 females) with a mean age of 63 years (range, 41 to 79), underwent CCRT between March 2008 and March 2010. Dysphagia after treatment was graded at the end of CCRT and discharge according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 and Fujishima dysphagia grade. Ten of the 26 patients underwent swallowing rehabilitation, exercise and education on muscle strengthening programs before and during CCRT. They tended not to have severe dysphagia, but there were no significant differences. (author)

  16. Changes in Swallowing Symptoms and Esophageal Motility After Thyroid Surgery

    DEFF Research Database (Denmark)

    Sorensen, Jesper Roed; Markoew, Simone; Døssing, Helle

    2018-01-01

    INTRODUCTION: Swallowing difficulties, the pathophysiology behind which is incompletely understood, have been reported in 47-83% of goiter patients referred for thyroidectomy. We aimed at examining the influence of thyroid surgery on swallowing symptoms and esophageal motility. METHODS: Thirty-th...... to esophageal motility disturbances. This information is essential when interpreting dysphagia in patients with nodular goiter, and when balancing patients' expectations to surgical goiter therapy. REGISTRATION NUMBER: NCT03100357 ( www.clinicaltrials.org ).......INTRODUCTION: Swallowing difficulties, the pathophysiology behind which is incompletely understood, have been reported in 47-83% of goiter patients referred for thyroidectomy. We aimed at examining the influence of thyroid surgery on swallowing symptoms and esophageal motility. METHODS: Thirty......-three patients with benign nodular goiter undergoing thyroid surgery were included. All completed high-resolution esophageal manometry examinations and the goiter symptom scale score, assessed by the thyroid-specific patient-reported outcome measure. The evaluations were performed before and 6 months after...

  17. Fiberoptic endoscopic evaluation of swallowing (FEES): proposal for informed consent

    OpenAIRE

    Nacci, A; Ursino, F; La Vela, R; Matteucci, F; Mallardi, V; Fattori, B

    2008-01-01

    Fiberoptic endoscopic evaluation of swallowing (FEES) is now a first choice method for studying swallowing disorders on account of the various advantages it offers: easy to use, very well tolerated, allows bedside examination and is economic. Nevertheless, this diagnostic procedure is not without risks, the most probable consequences of which include discomfort, gagging and/or vomiting, vasovagal syncope, epistaxis, mucosal perforation, adverse reactions to topical anaesthetics and laryngospa...

  18. Occurrences of yawn and swallow are temporally related.

    Science.gov (United States)

    Abe, Kimiko; Weisz, Sarah E M; Dunn, Rachelle L; DiGioacchino, Martina C; Nyentap, Jennifer A; Stanbouly, Seta; Theurer, Julie A; Bureau, Yves; Affoo, Rebecca H; Martin, Ruth E

    2015-02-01

    Yawning is a stereotyped motor behavior characterized by deep inhalation and associated dilation of the respiratory tract, pronounced jaw opening, and facial grimacing. The frequency of spontaneous yawning varies over the diurnal cycle, peaking after waking and before sleep. Yawning can also be elicited by seeing or hearing another yawn, or by thinking about yawning, a phenomenon known as "contagious yawning". Yawning is mediated by a distributed network of brainstem and supratentorial brain regions, the components of which are shared with other airway behaviors including respiration, swallowing, and mastication. Nevertheless, the possibility of behavioral coordination between yawning and other brainstem-mediated functions has not been examined. Here we show, with a double-blind methodology, a greater-than-fivefold increase in rest (saliva) swallowing rate during the 10-s period immediately following contagious yawning elicited in 14 adult humans through the viewing of videotaped yawn stimuli. Sixty-five percent of yawns were followed by a swallow within 10 s and swallows accounted for 26 % of all behaviors produced during this post-yawn period. This novel finding of a tight temporal coupling between yawning and swallowing provides preliminary evidence that yawning and swallowing are physiologically related, thus extending current models of upper airway physiology and neurophysiology. Moreover, our finding suggests the possibility that yawning plays a role in eliciting rest swallowing, a view not considered in previous theories of yawning. As such, the present demonstration of a temporal association between yawning and swallowing motivates a re-examination of the longstanding question, "Why do we yawn?".

  19. Evidence for adaptive cortical changes in swallowing in Parkinson's disease.

    Science.gov (United States)

    Suntrup, Sonja; Teismann, Inga; Bejer, Joke; Suttrup, Inga; Winkels, Martin; Mehler, David; Pantev, Christo; Dziewas, Rainer; Warnecke, Tobias

    2013-03-01

    Dysphagia is a relevant symptom in Parkinson's disease, whose pathophysiology is poorly understood. It is mainly attributed to degeneration of brainstem nuclei. However, alterations in the cortical contribution to deglutition control in the course of Parkinson's disease have not been investigated. Here, we sought to determine the patterns of cortical swallowing processing in patients with Parkinson's disease with and without dysphagia. Swallowing function in patients was objectively assessed with fiberoptic endoscopic evaluation. Swallow-related cortical activation was measured using whole-head magnetoencephalography in 10 dysphagic and 10 non-dysphagic patients with Parkinson's disease and a healthy control group during self-paced swallowing. Data were analysed applying synthetic aperture magnetometry, and group analyses were done using a permutation test. Compared with healthy subjects, a strong decrease of cortical swallowing activation was found in all patients. It was most prominent in participants with manifest dysphagia. Non-dysphagic patients with Parkinson's disease showed a pronounced shift of peak activation towards lateral parts of the premotor, motor and inferolateral parietal cortex with reduced activation of the supplementary motor area. This pattern was not found in dysphagic patients with Parkinson's disease. We conclude that in Parkinson's disease, not only brainstem and basal ganglia circuits, but also cortical areas modulate swallowing function in a clinically relevant way. Our results point towards adaptive cerebral changes in swallowing to compensate for deficient motor pathways. Recruitment of better preserved parallel motor loops driven by sensory afferent input seems to maintain swallowing function until progressing neurodegeneration exceeds beyond the means of this adaptive strategy, resulting in manifestation of dysphagia.

  20. Parameters of Instrumental Swallowing Evaluations: Describing a Diagnostic Dilemma.

    Science.gov (United States)

    Pisegna, Jessica M; Langmore, Susan E

    2016-06-01

    The aim of this study was to compare selected parameters of two swallow evaluations: fiberoptic endoscopic evaluation of swallowing (FEES) and the modified barium swallow (MBS) study. This was a cross-sectional, descriptive study. Fifty-five clinicians were asked to watch video recordings of swallow evaluations of 2 patients that were done using fluoroscopy and endoscopy simultaneously. In a randomized order, clinicians viewed 4 edited videos from simultaneous evaluations: the FEES and MBS videos of patient 1 and 2 each taking one swallow of 5 mL applesauce. Clinicians filled out a questionnaire that asked (1) which anatomical sites they could visualize on each video, (2) where they saw pharyngeal residue after a swallow, (3) their overall clinical impression of the pharyngeal residue, and (4) their opinions of the evaluation styles. Clinicians reported a significant difference in the visualization of anatomical sites, 11 of the 15 sites were reported as better-visualized on the FEES than on the MBS video (p < 0.05). Clinicians also rated residue to be present in more locations on the FEES than on the MBS. Clinicians' overall impressions of the severity of residue on the same exact swallow were significantly different depending on the evaluation type (FEES vs. MBS for patient 1 χ(2) = 20.05, p < 0.0001; patient 2 χ(2) = 7.52, p = 0.006), with FEES videos rated more severely. FEES advantages were: more visualization of pharyngeal and laryngeal swallowing anatomy and residue. However, as a result, clinicians provided more severe impressions of residue amount on FEES. On one hand, this suggests that FEES is a more sensitive tool than MBS studies, but on the other hand, clinicians might provide more severe interpretations on FEES.

  1. Swallow Event Sequencing: Comparing Healthy Older and Younger Adults.

    Science.gov (United States)

    Herzberg, Erica G; Lazarus, Cathy L; Steele, Catriona M; Molfenter, Sonja M

    2018-04-23

    Previous research has established that a great deal of variation exists in the temporal sequence of swallowing events for healthy adults. Yet, the impact of aging on swallow event sequence is not well understood. Kendall et al. (Dysphagia 18(2):85-91, 2003) suggested there are 4 obligatory paired-event sequences in swallowing. We directly compared adherence to these sequences, as well as event latencies, and quantified the percentage of unique sequences in two samples of healthy adults: young ( 65). The 8 swallowing events that contribute to the sequences were reliably identified from videofluoroscopy in a sample of 23 healthy seniors (10 male, mean age 74.7) and 20 healthy young adults (10 male, mean age 31.5) with no evidence of penetration-aspiration or post-swallow residue. Chi-square analyses compared the proportions of obligatory pairs and unique sequences by age group. Compared to the older subjects, younger subjects had significantly lower adherence to two obligatory sequences: Upper Esophageal Sphincter (UES) opening occurs before (or simultaneous with) the bolus arriving at the UES and UES maximum distention occurs before maximum pharyngeal constriction. The associated latencies were significantly different between age groups as well. Further, significantly fewer unique swallow sequences were observed in the older group (61%) compared with the young (82%) (χ 2  = 31.8; p < 0.001). Our findings suggest that paired swallow event sequences may not be robust across the age continuum and that variation in swallow sequences appears to decrease with aging. These findings provide normative references for comparisons to older individuals with dysphagia.

  2. Swallow syncope caused by third-degree atrioventricular block

    DEFF Research Database (Denmark)

    Roust Aaberg, Anne Marie; Eriksson, Anna Elin; Madsen, Per Lav

    2015-01-01

    We report a case of a patient with more than 30 years of repeated syncopes, always following food intake. The patient was diagnosed with a swallow-related third-degree atrioventricular block and successfully treated with an artificial pacemaker.......We report a case of a patient with more than 30 years of repeated syncopes, always following food intake. The patient was diagnosed with a swallow-related third-degree atrioventricular block and successfully treated with an artificial pacemaker....

  3. Changes in the frequency of swallowing during electrical stimulation of superior laryngeal nerve in rats.

    Science.gov (United States)

    Tsuji, Kojun; Tsujimura, Takanori; Magara, Jin; Sakai, Shogo; Nakamura, Yuki; Inoue, Makoto

    2015-02-01

    The aim of the present study was to investigate the adaptation of the swallowing reflex in terms of reduced swallowing reflex initiation following continuous superior laryngeal nerve stimulation. Forty-four male Sprague Dawley rats were anesthetized with urethane. To identify swallowing, electromyographic activity of the left mylohyoid and thyrohyoid muscles was recorded. To evoke the swallowing response, the superior laryngeal nerve (SLN), recurrent laryngeal nerve, or cortical swallowing area was electrically stimulated. Repetitive swallowing evoked by continuous SLN stimulation was gradually reduced, and this reduction was dependent on the resting time duration between stimulations. Prior SLN stimulation also suppressed subsequent swallowing initiation. The reduction in evoked swallows induced by recurrent laryngeal nerve or cortical swallowing area stimulation was less than that following superior laryngeal nerve stimulation. Decerebration had no effect on the reduction in evoked swallows. Prior subthreshold stimulation reduced subsequent initiation of swallowing, suggesting that there was no relationship between swallowing movement evoked by prior stimulation and the subsequent reduction in swallowing initiation. Overall, these data suggest that reduced sensory afferent nerve firing and/or trans-synaptic responses, as well as part of the brainstem central pattern generator, are involved in adaptation of the swallowing reflex following continuous stimulation of swallow-inducing peripheral nerves and cortical areas. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Quality of life related to swallowing in Parkinson's disease.

    Science.gov (United States)

    Carneiro, Danielle; das Graças Wanderley de Sales Coriolano, Maria; Belo, Luciana Rodrigues; de Marcos Rabelo, Aneide Rocha; Asano, Amdore Guescel; Lins, Otávio Gomes

    2014-10-01

    Swallowing difficulties in Parkinson's disease can result in decreased quality of life. The swallowing quality of life questionnaire (SWAL-QOL) is an instrument for specifically assessing quality of life with respect to swallowing, which has been little explored in patients with Parkinson's disease (PD). The goal of this study was to evaluate the quality of life with respect to swallowing in persons with PD compared to controls and at several stages of the disease using the SWAL-QOL. The experimental group was composed of 62 persons with PD at stages 1-4. Forty-one age-matched healthy subjects constituted the control group. The SWAL-QOL scores were significantly lower for the patients with PD than for the controls in all SWAL-QOL domains. Eating duration had the largest difference in score between persons with PD and the controls and the lowest mean score, followed by communication, fatigue, fear, sleep, and food selection. The scores of most domains were lower at later stages of the disease. The scores for eating duration, symptom frequency, and sleep were significantly lower at stage 4 than stages 1 and 2. In conclusion, patients with PD have significantly lower scores in all domains of the SWAL-QOL than normal controls. This means swallowing difficulties occurring in patients with PD negatively affect their QOL. Progression of the disease worsens swallowing QOL, more specifically in the domains of eating duration, symptom frequency, and sleep. This occurs mostly at later stages of the disease.

  5. Swallowing Quality of Life After Zona Incerta Deep Brain Stimulation.

    Science.gov (United States)

    Sundstedt, Stina; Nordh, Erik; Linder, Jan; Hedström, Johanna; Finizia, Caterina; Olofsson, Katarina

    2017-02-01

    The management of Parkinson's disease (PD) has been improved, but management of signs like swallowing problems is still challenging. Deep brain stimulation (DBS) alleviates the cardinal motor symptoms and improves quality of life, but its effect on swallowing is not fully explored. The purpose of this study was to examine self-reported swallowing-specific quality of life before and after caudal zona incerta DBS (cZI DBS) in comparison with a control group. Nine PD patients (2 women and 7 men) completed the self-report Swallowing Quality of Life questionnaire (SWAL-QOL) before and 12 months after cZI DBS surgery. The postoperative data were compared to 9 controls. Median ages were 53 years (range, 40-70 years) for patients and 54 years (range, 42-72 years) for controls. No significant differences were found between the pre- or postoperative scores. The SWAL-QOL total scores did not differ significantly between PD patients and controls. The PD patients reported significantly lower scores in the burden subscale and the symptom scale. Patients with PD selected for cZI DBS showed good self-reported swallowing-specific quality of life, in many aspects equal to controls. The cZI DBS did not negatively affect swallowing-specific quality of life in this study.

  6. A Targeted Swallow Screen for the Detection of Postoperative Dysphagia.

    Science.gov (United States)

    Gee, Erica; Lancaster, Elizabeth; Meltzer, Jospeh; Mendelsohn, Abie H; Benharash, Peyman

    2015-10-01

    Postoperative dysphagia leads to aspiration pneumonia, prolonged hospital stay, and is associated with increased mortality. A simple and sensitive screening test to identify patients requiring objective dysphagia evaluation is presently lacking. In this study, we evaluated the efficacy of a novel targeted swallow screen evaluation. This was a prospective trial involving all adult patients who underwent elective cardiac surgery with cardiopulmonary bypass at our institution over an 8-week period. Within 24 hours of extubation and before the initiation of oral intake, all postsurgical patients were evaluated using the targeted swallow screen. A fiberoptic endoscopic evaluation of swallowing was requested for failed screenings. During the study, 50 postcardiac surgery patients were screened. Fifteen (30%) failed the targeted swallow screen, and ten of the fifteen (66%) failed the subsequent fiberoptic endoscopic evaluation of swallowing exam and were confirmed to have dysphagia. The screening test had 100 per cent sensitivity for detecting dysphagia in our patient population, and a specificity of 87.5 per cent. The overall incidence of dysphagia was 20 per cent. We have shown that a targeted swallow evaluation can efficiently screen patients during the postcardiac surgery period. Furthermore, we have shown that the true incidence of dysphagia after cardiac surgery is significantly higher than previously recognized in literature.

  7. Swallowing difficulties for cerebellar stroke may recover beyond three years.

    Science.gov (United States)

    Périé, S; Wajeman, S; Vivant, R; St Guily, J L

    1999-01-01

    Swallowing disorders after stroke or skull base surgery can be life threatening. Although late recovery can occur, it remains poorly documented. We report a case of a 54-year-old woman with dysphagia resulting from a cerebellar stroke with hemorrhage that was evacuated through craniotomy. Swallowing difficulties were assessed by a videoendoscopic swallowing study. She presented with disruption of swallow initiation and impairment of the pharyngeal stage, resulting in hypopharyngeal stasis and penetration with aspiration. Supportive swallowing therapy was conducted with careful reeducation to assist initiation of the pharyngeal stage as well as development of compensatory postural technique. Initial improvement was very slow but became rapidly progressive from the 31st month after the stroke. By the 34th month, oral feeding was possible without aspiration. This case demonstrates that improvement in swallowing function can be expected even 3 years after stroke or skull base surgery. Determination of predictive factors for late functional recovery is of great importance and should be the focus of further investigation.

  8. Solid bolus swallowing in the radiologic evaluation of dysphagia

    International Nuclear Information System (INIS)

    Westen, D. van; Ekberg, O.

    1993-01-01

    Patients with dysphagia, heartburn and chest pain are regularly referred for radiologic evaluation of swallowing. The liquid barium swallow has been of great value for the biphasic evaluation of the pharynx and esophagus. Though many patients complain of dysphagia specifically for solids, solid bolus swallow is ususally not part of the evaluation. For the present study we therefore included the use of a solid bolus with a diameter of 13 mm and interviewed the patients carefully for any symptoms during this tablet swallow. Of 200 patients examined, the tablet passed through the esophagus without delay in 102. In the 98 patients with delayed passage, the solid bolus arrest occurred in the pharynx in 5 and in the esophagus in 93. Arrest in the esophagus was due to esophageal dysmotility in 48 patients. Twenty of these were symptomatic during the tablet swallow. A narrowing was the cause in 45, of whom 9 had symptoms. In 18 patients (9%) the solid bolus added key information to the radiologic evaluation. We therefore recommend that the solid bolus is included in the routine radiologic work-up of patients with dysphagia. Careful attention to symptoms during the tablet swallow is important. (orig.)

  9. Solid bolus swallowing in the radiologic evaluation of dysphagia

    Energy Technology Data Exchange (ETDEWEB)

    Westen, D. van (Dept. of Diagnostic Radiology, Malmoe General Hospital, Univ. Lund (Sweden)); Ekberg, O. (Dept. of Diagnostic Radiology, Malmoe General Hospital, Univ. Lund (Sweden))

    1993-07-01

    Patients with dysphagia, heartburn and chest pain are regularly referred for radiologic evaluation of swallowing. The liquid barium swallow has been of great value for the biphasic evaluation of the pharynx and esophagus. Though many patients complain of dysphagia specifically for solids, solid bolus swallow is ususally not part of the evaluation. For the present study we therefore included the use of a solid bolus with a diameter of 13 mm and interviewed the patients carefully for any symptoms during this tablet swallow. Of 200 patients examined, the tablet passed through the esophagus without delay in 102. In the 98 patients with delayed passage, the solid bolus arrest occurred in the pharynx in 5 and in the esophagus in 93. Arrest in the esophagus was due to esophageal dysmotility in 48 patients. Twenty of these were symptomatic during the tablet swallow. A narrowing was the cause in 45, of whom 9 had symptoms. In 18 patients (9%) the solid bolus added key information to the radiologic evaluation. We therefore recommend that the solid bolus is included in the routine radiologic work-up of patients with dysphagia. Careful attention to symptoms during the tablet swallow is important. (orig.).

  10. Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Luciana Almeida Moreira da Paz Oliveira

    2015-06-01

    Full Text Available INTRODUCTION: Upper airway nerve and muscle damage associated with obstructive sleep apnea may impair the strength and dynamics of pharyngeal and esophageal contractions during swallowing. OBJECTIVE: To evaluate the presence of alterations in pharyngoesophageal manometry in patients with obstructive sleep apnea with and without oropharyngeal dysphagia. METHODS: This study prospectively evaluated 22 patients with obstructive sleep apnea without spontaneous complaints of dysphagia, using a questionnaire, fiberoptic endoscopic evaluation of swallowing, and pharyngoesophageal manometry, including measurement of the upper and lower esophageal sphincter pressures and mean pharyngeal pressures at three levels during swallowing. RESULTS: The dysphagia group consisted of 17 patients (77.3% in whom swallowing abnormalities were detected on fiberoptic endoscopic evaluation of swallowing (n = 15; 68.2% and/or in the questionnaire (n = 7; 31.8%. The five remaining cases comprised a control group without oropharyngeal dysphagia. In all cases of abnormalities on fiberoptic endoscopic evaluation of swallowing, there was premature bolus leakage into the pharynx. There was no statistically significant difference between the groups regarding any of the pharyngoesophageal manometry measurements, age, or severity of obstructive sleep apnea. CONCLUSION: Pharyngoesophageal manometry detected no statistically significant difference between the groups with and without oropharyngeal dysphagia.

  11. [Telemonitoring of swallowing function: technologies in speech therapy practice.

    Science.gov (United States)

    Tedesco, Angela; Lavermicocca, Valentina; Notarnicola, Marilina; De Francesco, Luca; Dellomonaco, Anna Rita

    2018-02-01

    The process of medical-healthcare technological revolution represents an advantage for the patient and for the care provider, in terms of costs and distances reduction. The telehomecare approach could be useful for monitoring the swallowing disorder in neurodegenerative diseases, preventing complications. In this study the applicability of telemedicine techniques for the monitoring of swallowing function, in patients affected by Huntington's disease (HD), was evaluated through the acquisition and analysis of the sound of swallowing. Two patients with HD were outpatient screened for dysphagia through the Bedside Swallowing Assessment Scale (BSAS) sensitized with pulse oximetry and cervical auscultation. Subsequently, the swallowing functionality was telemonitored for three months with Skype. The swallowing sounds were acquired with a detection microphone attached to the lateral edge of the trachea during fluid intake. The sounds were instantly processed and graphically represented through the Praat software. The analysis of the acoustic signal acquired remotely has made it possible to identify the situations that required immediate speech therapy intervention, suggesting to the patients further modifications of food consistencies, and saving frequent moving to the hospital even in the absence of critical situations. Remote assistance applied to speech therapy could represent a benefit for patients and their carers and a more efficient use of medical and health resources.

  12. Observation the swallowing mechanism in elderly patients with pharyngeal dysphagia

    Directory of Open Access Journals (Sweden)

    Claudia Ximena Campo-Cañar

    2010-09-01

    Full Text Available Observation of the swallowing dynamics is an issue that demands close attention by the health professionals involved in the diagnosis and management of patients with dysphagia. This article is a review of the literature aimed to enhance the knowledge regarding the speech therapy assessment of pharyngeal dysphagia in elder adults. The disorder of the swallowing is called dysphagia and it is defined as difficulty swallowing. The dysphagia is often caused by affectation of mechanical or neuromuscular components of the swallowing mechanism. This type of disorder is likely to impact the the oral, pharyngeal and esophageal phases of the swallowing. The speech therapist should take into account assessing aspects such as level of consciousness, vital signs, whether or not the patient is ventilator dependent, means of feeding, if intubated what type of cannula, whether or not the patient uses a speaking valve (if a trach tube is present, nutritional status, the patient’s expressive and receptive language, the anatomical and physiological state of the oral motor structures. When assessing swallowing clinicians should also make sure to develop an adequate beside clinical, voice assessment and videofluoroscopy.

  13. Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea.

    Science.gov (United States)

    Oliveira, Luciana Almeida Moreira da Paz; Fontes, Luiz Henrique de Souza; Cahali, Michel Burihan

    2015-01-01

    Upper airway nerve and muscle damage associated with obstructive sleep apnea may impair the strength and dynamics of pharyngeal and esophageal contractions during swallowing. To evaluate the presence of alterations in pharyngoesophageal manometry in patients with obstructive sleep apnea with and without oropharyngeal dysphagia. This study prospectively evaluated 22 patients with obstructive sleep apnea without spontaneous complaints of dysphagia, using a questionnaire, fiberoptic endoscopic evaluation of swallowing, and pharyngoesophageal manometry, including measurement of the upper and lower esophageal sphincter pressures and mean pharyngeal pressures at three levels during swallowing. The dysphagia group consisted of 17 patients (77.3%) in whom swallowing abnormalities were detected on fiberoptic endoscopic evaluation of swallowing (n=15; 68.2%) and/or in the questionnaire (n=7; 31.8%). The five remaining cases comprised a control group without oropharyngeal dysphagia. In all cases of abnormalities on fiberoptic endoscopic evaluation of swallowing, there was premature bolus leakage into the pharynx. There was no statistically significant difference between the groups regarding any of the pharyngoesophageal manometry measurements, age, or severity of obstructive sleep apnea. Pharyngoesophageal manometry detected no statistically significant difference between the groups with and without oropharyngeal dysphagia. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  14. Árvore de decisão aplicada em dados de incubação de matrizes de postura Hy-Line W36 Decision tree applied to hatchery databases of Hy-Line W-36

    Directory of Open Access Journals (Sweden)

    Marcelo Gomes Ferreira Lima

    2010-12-01

    Full Text Available Incubatório de ovos é um setor de grande importância na Avicultura de postura. Com a redução dos custos dos equipamentos de informática cresce o armazenamento de dados para gerenciamento do processo produtivo. A Mineração de Dados surge como uma técnica para identificar conhecimentos novos e úteis nos bancos de dados. Objetivou-se, neste trabalho, explorar a técnica Arvore de Decisão em banco de dados de incubatórios de matrizes de postura, visando a elaboração de padrões de incubação. Foram disponibilizados, pela empresa Hy-Line do Brasil Ltda, dados de incubação entre os anos de 2002 e 2006 da linhagem Hy-Line W-36. Dois experimentos foram realizados. Em um deles, valores acima dos estabelecidos pela empresa como desejado para o índice "fêmeas nascidas vendáveis" foram identificados como relevantes para a geração das regras. No outro, valores abaixo dos estabelecidos pela empresa foram identificados como relevantes para a geração das regras. Foi utilizado o algoritmo Entropia C 4.5 e o software SAS-Enterprise Miner como ferramenta de análise . Como conclusão deste estudo, foi possível observar que com a técnica estudada, os dados utilizados no gerenciamento de produção são suficientes para identificar conhecimentos novos, úteis e aplicáveis a fim de melhorar a produtividade das empresas incubadoras, atendendo à demanda com diminuição do desperdício.Hatchery is a very important sector in egg production. As computers become cheaper, there is an increase in data storage for the production management process. Data Mining has appeared as a technique to identify new and useful knowledge in databases. The objective of this work was to explore the Decision Tree technique in hatchery databases to identify the best standards of the incubation process. The data set used in this research was supplied by Hy-Line do Brasil Ltda., corresponding to the incubation period of 2002-2006, from the strain Hy-line W-36. Two

  15. Dosimetric assessment of swallowing examinations with videofluoroscopy

    International Nuclear Information System (INIS)

    Costa, M.M.B.; Canevaro, L.V.; Azevedo, A.C.P.

    2001-01-01

    Dosimetric analysis measurements of the Dose-Area-Product (DAP) of 7 individuals were estimated for the deglutition dynamic using the videofluoroscopic method. The aim of this study is to establish in a preliminary way, typical DAP values for this kind of study. The DAP values were obtained attaching to the X ray tube exit, an ionization chamber from PTW and a Diamentor M4 meter. The typical DAP values obtained during the videofluoroscopic evaluation of the deglutition dynamic, including its three phases, was: 4101 ± 881 cGy.cm 2 and the typical DAP rate was 577 ± 94 cGy.cm 2 /min. These values refer to a standard patient (1.57 cm height, 56 kg. weight) and a protocol that can be performed in about 7 minutes. The values, defined herein as typical refer to the used protocol. To our knowledge, the mean DAP rate is a good parameter to estimate radiation exposure from videofluoroscopic study of swallowing process. (author)

  16. Climate change and tree-line ecosystems in the Sierra Nevada: Habitat suitability modelling to inform high-elevation forest dynamics monitoring

    Science.gov (United States)

    Moore, Peggy E.; Alvarez, Otto; McKinney, Shawn T.; Li, Wenkai; Brooks, Matthew L.; Guo, Qinghua

    2017-01-01

    Whitebark pine and foxtail pine serve foundational roles in the subalpine zone of the Sierra Nevada. They provide the dominant structure in tree-line forests and regulate key ecosystem processes and community dynamics. Climate change models suggest that there will be changes in temperature regimes and in the timing and magnitude of precipitation within the current distribution of these species, and these changes may alter the species’ distributional limits. Other stressors include the non-native pathogen white pine blister rust and mountain pine beetle, which have played a role in the decline of whitebark pine throughout much of its range. The National Park Service is monitoring status and trends of these species. This report provides complementary information in the form of habitat suitability models to predict climate change impacts on the future distribution of these species within Sierra Nevada national parks.We used maximum entropy modeling to build habitat suitability models by relating species occurrence to environmental variables. Species occurrence was available from 328 locations for whitebark pine and 244 for foxtail pine across the species’ distributions within the parks. We constructed current climate surfaces for modeling by interpolating data from weather stations. Climate surfaces included mean, minimum, and maximum temperature and total precipitation for January, April, July, and October. We downscaled five general circulation models for the 2050s and the 2090s from ~125 km2 to 1 km2 under both an optimistic and an extreme climate scenario to bracket potential climatic change and its influence on projected suitable habitat. To describe anticipated changes in the distribution of suitable habitat, we compared, for each species, climate scenario, and time period, the current models with future models in terms of proportional change in habitat size, elevation distribution, model center points, and where habitat is predicted to expand or contract

  17. Videofluoroscopic evaluation of mastication and swallowing in individuals with TMD.

    Science.gov (United States)

    Maffei, Carla; Mello, Marçal Motta de; Biase, Noemi Grigoletto de; Pasetti, Lilian; Camargo, Paulo A Monteiro; Silvério, Kelly Cristina Alves; Gonçalves, Maria Inês Rebelo

    2012-01-01

    To study mastication and swallowing disorders in patients with temporomandibular disorders (TMD). To investigate mastication and swallowing disorders in patients with severe TMD referred to surgery. Clinical and experimental study involving ten individuals with TMD submitted to deglutition videofluoroscopy. These patients did not have posterior teeth, mastication pain and food replacement in favor of pasty consistence food. The assessment of the oral and pharyngeal phases approached the following aspects: side of onset and preferential side for chewing, premature escape, remains of food residues in the oral cavity or in the pharyngeal recesses, number of necessary swallowing efforts, laryngeal penetration and/or tracheal aspiration. During mastication and the oral phase we observed tongue compensatory movements upon chewing (n = 7; 70%), premature escape (n = 4; 40%), food remains in the cavity after swallowing (n = 5; 50%) and an excessive number of deglutition efforts (n = 5; 50%). On the pharyngeal phase we observed food remains in the valleculae (n = 6; 60%), in the pyriform sinuses (n = 4; 40%); laryngeal penetration (n = 1; 10%) and tracheal aspiration (n = 4; 40%). TMD patients may have alterations in their chewing and swallowing patterns, with laryngeal penetration and/or tracheal aspiration. The study indicates the need for a multidisciplinary assessment because of dysphagia in TMD patients.

  18. The Videofluorographic Swallowing Study in Rheumatologic Diseases: A Comprehensive Review

    Science.gov (United States)

    Di Piazza, Ambra; Costanzo, Massimo; Scopelliti, Laura; Salvaggi, Francesco; Cupido, Francesco; Salerno, Sergio; Lo Casto, Antonio; Midiri, Massimo; Lo Re, Giuseppe; Lagalla, Roberto

    2017-01-01

    Autoimmune connective tissue diseases are a heterogeneous group of pathologies that affect about 10% of world population with chronic evolution in 20%–80%. Inflammation in autoimmune diseases may lead to serious damage to other organs including the gastrointestinal tract. Gastrointestinal tract involvement in these patients may also due to both a direct action of antibodies against organs and pharmacological therapies. Dysphagia is one of the most important symptom, and it is caused by failure of the swallowing function and may lead to aspiration pneumonia, malnutrition, dehydration, weight loss, and airway obstruction. The videofluorographic swallowing study is a key diagnostic tool in the detection of swallowing disorders, allowing to make an early diagnosis and to reduce the risk of gastrointestinal and pulmonary complications. This technique helps to identify both functional and structural anomalies of the anatomic chain involved in swallowing function. The aim of this review is to systematically analyze the basis of the pathological involvement of the swallowing function for each rheumatological disease and to show the main features of the videofluorographic study that may be encountered in these patients. PMID:28706536

  19. Swallowing in patients with Parkinson's disease: a surface electromyography study.

    Science.gov (United States)

    Ws Coriolano, Maria das Graças; R Belo, Luciana; Carneiro, Danielle; G Asano, Amdore; Al Oliveira, Paulo José; da Silva, Douglas Monteiro; G Lins, Otávio

    2012-12-01

    Our goal was to study deglutition of Parkinson's disease (PD) patients and normal controls (NC) using surface electromyography (sEMG). The study included 15 patients with idiopathic PD and 15 age-matched normal controls. Surface electromyography was collected over the suprahyoid muscle group. Conditions were the following: swallow at once 10 and 20 ml of water and 5 and 10 ml of yogurt of firm consistency, and freely drink 100 ml of water. During swallowing, durations of sEMG were significantly longer in PD patients than in normal controls but no significant differences of amplitudes were found. Eighty percent of the PD patients and 20 % of the NC needed more than one swallow to consume 20 ml of water, while 70 % of the PD patients and none of the NC needed more than one swallow to consume 5 ml of yogurt. PD patients took significantly more time and needed significantly more swallows to drink 100 ml of water than normal controls. We conclude that sEMG might be a simple and useful tool to study and monitor deglutition in PD patients.

  20. A procedure for denoising dual-axis swallowing accelerometry signals

    International Nuclear Information System (INIS)

    Sejdić, Ervin; Chau, Tom; Steele, Catriona M

    2010-01-01

    Dual-axis swallowing accelerometry is an emerging tool for the assessment of dysphagia (swallowing difficulties). These signals however can be very noisy as a result of physiological and motion artifacts. In this note, we propose a novel scheme for denoising those signals, i.e. a computationally efficient search for the optimal denoising threshold within a reduced wavelet subspace. To determine a viable subspace, the algorithm relies on the minimum value of the estimated upper bound for the reconstruction error. A numerical analysis of the proposed scheme using synthetic test signals demonstrated that the proposed scheme is computationally more efficient than minimum noiseless description length (MNDL)-based denoising. It also yields smaller reconstruction errors than MNDL, SURE and Donoho denoising methods. When applied to dual-axis swallowing accelerometry signals, the proposed scheme exhibits improved performance for dry, wet and wet chin tuck swallows. These results are important for the further development of medical devices based on dual-axis swallowing accelerometry signals. (note)

  1. ColorTree: a batch customization tool for phylogenic trees.

    Science.gov (United States)

    Chen, Wei-Hua; Lercher, Martin J

    2009-07-31

    Genome sequencing projects and comparative genomics studies typically aim to trace the evolutionary history of large gene sets, often requiring human inspection of hundreds of phylogenetic trees. If trees are checked for compatibility with an explicit null hypothesis (e.g., the monophyly of certain groups), this daunting task is greatly facilitated by an appropriate coloring scheme. In this note, we introduce ColorTree, a simple yet powerful batch customization tool for phylogenic trees. Based on pattern matching rules, ColorTree applies a set of customizations to an input tree file, e.g., coloring labels or branches. The customized trees are saved to an output file, which can then be viewed and further edited by Dendroscope (a freely available tree viewer). ColorTree runs on any Perl installation as a stand-alone command line tool, and its application can thus be easily automated. This way, hundreds of phylogenic trees can be customized for easy visual inspection in a matter of minutes. ColorTree allows efficient and flexible visual customization of large tree sets through the application of a user-supplied configuration file to multiple tree files.

  2. Nonimaging clinical assessment of impaired swallowing in community-dwelling older adults in Taiwan.

    Science.gov (United States)

    Chen, Miao-Yen; Lin, Li-Chan

    2012-12-01

    Impaired swallowing is common in elderly patients as well as those with neurological disorders and degenerative diseases. Convenient and accurate assessments should be available to community-dwelling older adults to diagnose and provide early management and care of swallowing difficulties, an important factor of influence on elderly life quality. This study used convenient nonimaging methods to assess swallowing functions in community-dwelling older adults and estimated the prevalence of swallowing difficulties. The study adopted a survey method and recruited 216 community-dwelling older adults over 65 years old in northern Taiwan. Researchers used tools including a swallowing test, questionnaire, water test, peripheral arterial pulse oximeter, and laryngeal S-EMG to assess participant swallowing functions and the prevalence of impaired swallowing. We found a 9.5% prevalence of impaired swallowing based on swallow questionnaire and water test results. Age correlated negatively with swallowing speed. A one-way ANOVA showed a significant difference in swallowing speed among the four age groups (F = 6.478, p < .00). A post hoc Scheffe comparison showed significant differences in swallowing time between the 60- to 69- and 70- to 79-year-old groups and 60- to 69- and 80- to 89-year-old groups. Multiple regression of impaired swallowing on various independent variables showed a significant standardized coefficient of 0.163 for age (t = 2.328, p = .021). Logistic regression showed a significant Wals test value for age (p = .007). The Kappa value was 0.307 for agreement analysis between impaired swallowing and SaO(2) value reduction of more than 2%. Swallowing function deteriorates with age. Results of this study provide an assessment of the prevalence of impaired swallowing in community-dwelling older adults in Taiwan. Results can help guide clinical nurses to enhance their objective assessment of impaired swallowing to improve patient quality of life.

  3. Prevalence of swallowing dysfunction screened in Swedish cohort of COPD patients

    Science.gov (United States)

    Gonzalez Lindh, Margareta; Blom Johansson, Monica; Jennische, Margareta; Koyi, Hirsh

    2017-01-01

    Background COPD is a common problem associated with morbidity and mortality. COPD may also affect the dynamics and coordination of functions such as swallowing. A misdirected swallow may, in turn, result in the bolus entering the airway. A growing body of evidence suggests that a subgroup of people with COPD is prone to oropharyngeal dysphagia. The aim of this study was to evaluate swallowing dysfunction in patients with stable COPD and to determine the relation between signs and symptoms of swallowing dysfunction and lung function (forced expiratory volume in 1 second percent predicted). Methods Fifty-one patients with COPD in a stable phase participated in a questionnaire survey, swallowing tests, and spirometry. A post-bronchodilator ratio of the forced expiratory volume in 1 second/best of forced vital capacity and vital capacity <0.7 was used to define COPD. Swallowing function was assessed by a questionnaire and two swallowing tests (water and cookie swallow tests). Results Sixty-five percent of the patients reported subjective signs and symptoms of swallowing dysfunction in the questionnaire and 49% showed measurable ones in the swallowing tests. For the combined subjective and objective findings, 78% had a coexisting swallowing dysfunction. No significant difference was found between male and female patients. Conclusion Swallowing function is affected in COPD patients with moderate to severe airflow limitation, and the signs and symptoms of this swallowing dysfunction were subjective, objective, or both. PMID:28176891

  4. A rare cause of gastric obstruction: Lighters swallowing.

    Science.gov (United States)

    Aday, Ulas; Tardu, Ali; Yagci, Mehmet Ali; Yonder, Huseyin

    2015-01-01

    The majority of swallowed foreign bodies are thrown spontaneously without causing complications in the digestive system. Multiple number of foreign bodies may be swallowed by psychiatric patients which delay diagnosis and increase the complication rate. Long and hard objects cannot pass through the pylorus, and may cause obstruction, ulceration, bleeding and perforation. Endoscopy is used as an effective method in such cases. An exploratory laparatomy was performed after unsuccessful endoscopic foreign object removal in a 28-year-old schizophrenic patient with gastric outlet obstruction due to multiple cigarette lighter swallowing. Ten lighters were removed from the stomach through gastrotomy and one more lighter was removed from the descending colon by milking through the anus. The aim of this paper is to discuss encountered difficulties in psychiatric patients who underwent surgery due to intake of foreign bodies.

  5. VIDEOFLUOROSCOPIC SWALLOWING STUDY: esophageal alterations in patients with dysphagia

    Directory of Open Access Journals (Sweden)

    Betina SCHEEREN

    2014-09-01

    Full Text Available Context Videofluoroscopic swallowing study is a dynamic exam and allows the evaluation of the complete swallowing process. However, most published studies have only reported alterations in the oropharynx and pharyngoesophageal transition, leaving the analysis of the esophagus as a secondary goal. Objectives The goal of this study was to investigate the prevalence of alterations in the esophageal phase thorough videofluoroscopic swallowing study in patients with dysphagia. Methods Consecutive patients with dysphagia who underwent videofluoroscopic swallowing study including esophageal analysis between May 2010 and May 2012 had their exams retrospectively reviewed. Patients were classified into two groups: Group I - without a pre-established etiological diagnosis and Group II - with neurological disease. During the exam, the patients ingested three different consistencies of food (liquid, pasty and solid contrasted with barium sulfate and 19 items were analyzed according to a protocol. The esophageal phase was considered abnormal when one of the evaluated items was compromised. Results Three hundred and thirty-three (n = 333 consecutive patients were studied - 213 (64% in Group I and 120 (36% in Group II. Esophageal alterations were found in 104 (31% patients, with a higher prevalence in Group I (36.2%, especially on the items esophageal clearance (16.9% and tertiary contractions (16.4%. It was observed that 12% of individuals in Group I only presented alterations on the esophageal phase. Conclusion Evaluation of the esophageal phase of swallowing during videofluoroscopic swallowing study detects abnormalities in patients with cervical dysphagia, especially in the group without pre-established etiological diagnosis.

  6. Cortical recovery of swallowing function in wound botulism

    Directory of Open Access Journals (Sweden)

    Ringelstein Erich B

    2008-05-01

    Full Text Available Abstract Background Botulism is a rare disease caused by intoxication leading to muscle weakness and rapidly progressive dysphagia. With adequate therapy signs of recovery can be observed within several days. In the last few years, brain imaging studies carried out in healthy subjects showed activation of the sensorimotor cortex and the insula during volitional swallowing. However, little is known about cortical changes and compensation mechanisms accompanying swallowing pathology. Methods In this study, we applied whole-head magnetoencephalography (MEG in order to study changes in cortical activation in a 27-year-old patient suffering from wound botulism during recovery from dysphagia. An age-matched group of healthy subjects served as control group. A self-paced swallowing paradigm was performed and data were analyzed using synthetic aperture magnetometry (SAM. Results The first MEG measurement, carried out when the patient still demonstrated severe dysphagia, revealed strongly decreased activation of the somatosensory cortex but a strong activation of the right insula and marked recruitment of the left posterior parietal cortex (PPC. In the second measurement performed five days later after clinical recovery from dysphagia we found a decreased activation in these two areas and a bilateral cortical activation of the primary and secondary sensorimotor cortex comparable to the results seen in a healthy control group. Conclusion These findings indicate parallel development to normalization of swallowing related cortical activation and clinical recovery from dysphagia and highlight the importance of the insula and the PPC for the central coordination of swallowing. The results suggest that MEG examination of swallowing can reflect short-term changes in patients suffering from neurogenic dysphagia.

  7. The effect of dairy farm management regime on swallow (Hirundo rustica) abundance in the Netherlands

    NARCIS (Netherlands)

    Lubbe, S.K.; Snoo, de G.R.

    2007-01-01

    Aim To identify differences in Swallow abundance between organically and conventionally managed dairy farms, by examining three factors: farm buildings, food availability and farmer attitudes to Swallows. Methods Organic and conventional dairy farm holdings were compared in pairwise fashion. On

  8. Role of Basal Ganglia in Swallowing Process: A Systematic Review

    OpenAIRE

    Hamideh Ghaemi; Davood Sobhani-Rad; Ali Arabi; Sadegh Saifpanahi; Zahra Ghayoumi Anaraki

    2016-01-01

    Objectives: The basal ganglia (BG) controls different patterns of behavior by receiving inputs from sensory-motor and pre-motor cortex and projecting it to pre-frontal, pre-motor and supplementary motor areas. As the exact role of BG in swallowing process has not been fully determined, we aimed at reviewing the published data on neurological control in the swallowing technique to have a better understanding of BG’s role in this performance.  Methods: English-language articles, w...

  9. Comparison of endoscopy and barium swallow with marshmallow in dysphagia.

    Science.gov (United States)

    Somers, S; Stevenson, G W; Thompson, G

    1986-06-01

    Forty-four patients with dysphagia were examined both by endoscopy and by barium swallow with a marshmallow bolus. In these patients 36 stenoses were found: 34 by radiology and 30 by endoscopy. The radiologic criteria for stenosis included arrest of the marshmallow in a manner to support a column of barium and reproduction of the patient's symptoms at the time this occurred. Radiologic false negative findings were partly due to an inability by patients to swallow an adequate marshmallow bolus; endoscopic failures were associated with small endoscopes and mild stenoses.

  10. Swallowing function in pediatric patients with bilateral vocal fold immobility.

    Science.gov (United States)

    Hsu, Jeffrey; Tibbetts, Kathleen M; Wu, Derek; Nassar, Michel; Tan, Melin

    2017-02-01

    Infants with bilateral vocal fold immobility (BVFI) often have poor swallow function in addition to potential airway compromise. While there are several reports on BVFI and its effect on patients' airway status, little is known about long term swallow function. We aim to characterize the swallowing function over time in pediatric patients with bilateral vocal fold immobility. A retrospective review of medical records of infants diagnosed with BVFI at a tertiary care children's hospital between 2005 and 2014 was conducted. Patient demographics, nature and etiology of immobility, laryngoscopy findings, comorbidities, and swallow outcomes at diagnosis and follow-up were recorded. Swallowing outcomes as measured by presence or absence of a gastrostomy tube were compared by etiology, vocal fold status, and normal or developmentally delay using the Fisher's exact test. 110 patients with a diagnosis of vocal fold immobility were identified. Twenty-nine (26%) had BVFI and twenty-three had complete medical records. Etiologies of vocal fold immobility include cardiac related in 13% (3/23), idiopathic in 30% (7/23) prolonged intubation in 26% (6/23) central neurologic in 22% (5/23), trauma in 4% (1/23), and infection in 4% (1/23). Average follow-up time was 44 months (range 5-94 months). Ten patients (56.5%) required a gastrostomy tube at time of diagnosis. Of this cohort who received gastrostomy tubes, three (30%) ultimately transitioned to complete oral feeds. Return of vocal fold mobility did not correlate with swallow function. In those with non-neurologic etiologies, the need for gastrostomy tube at end of follow up was unlikely. There was a statistically significant difference in the percentage of gastrostomy tube-free children at most recent follow up in patients who were normally developed (86%) versus those who were developmentally delayed (33%) (p = 0.02). We characterized the swallowing function of 23 pediatric patients with BVFI. Comorbidities are significant

  11. Acoustic analysis of swallowing sounds: a new technique for assessing dysphagia.

    Science.gov (United States)

    Santamato, Andrea; Panza, Francesco; Solfrizzi, Vincenzo; Russo, Anna; Frisardi, Vincenza; Megna, Marisa; Ranieri, Maurizio; Fiore, Pietro

    2009-07-01

    To perform acoustic analysis of swallowing sounds, using a microphone and a notebook computer system, in healthy subjects and patients with dysphagia affected by neurological diseases, testing the positive/negative predictive value of a pathological pattern of swallowing sounds for penetration/aspiration. Diagnostic test study, prospective, not blinded, with the penetration/aspiration evaluated by fibreoptic endoscopy of swallowing as criterion standard. Data from a previously recorded database of normal swallowing sounds for 60 healthy subjects according to gender, age, and bolus consistency was compared with those of 15 patients with dysphagia from a university hospital referral centre who were affected by various neurological diseases. Mean duration of the swallowing sounds and post-swallowing apnoea were recorded. Penetration/aspiration was verified by fibreoptic endoscopy of swallowing in all patients with dysphagia. The mean duration of swallowing sounds for a liquid bolus of 10 ml water was significantly different between patients with dysphagia and healthy patients. We also described patterns of swallowing sounds and tested the negative/positive predictive values of post-swallowing apnoea for penetration/aspiration verified by fibreoptic endoscopy of swallowing (sensitivity 0.67 (95% confidence interval 0.24-0.94); specificity 1.00 (95% confidence interval 0.56-1.00)). The proposed technique for recording and measuring swallowing sounds could be incorporated into the bedside evaluation, but it should not replace the use of more diagnostic and valuable measures.

  12. Disturbance of food ingestion and swallowing due to late toxicity of concurrent chemoradiotherapy

    International Nuclear Information System (INIS)

    Komatsu, Masanori; Ishitoya, Junichi; Ikeda, Youichi; Shiono, Osamu; Kawano, Toshirou; Tsukuda, Mamoru

    2010-01-01

    The aim of this study was to evaluate late disturbance of food ingestion and swallowing in patients with advanced head and neck carcinoma after concurrent chemoradiotherapy (CCRT). Patients answered a questionnaire, the Quality of Life Radiation Therapy Instrument (QOL-RTI) for Japanese, and swallowing function was investigated by videoendoscopy (VE) more than 1 year after treatment. The results of patients after CCRT were compared with normal elderly serving as the control group. The total QOL score of the patient group was significantly lower than that of the control group. In terms of the results of the QOL questionnaires, the QOL scores for quantity of saliva, quality of saliva, taste and food swallowing were significantly lower in the patient group. Regarding the VE findings, the control group exhibited almost normal swallowing function, but pooling in the vallecura, laryngeal palsy and pooling in the hypopharynx were observed in the phase of not swallowing. Furthermore, dysfunction of swallowing using the colored water swallowing test was observed in about 40% of the patients. In addition, the factors associated with disturbance of QOL score and swallowing function were analyzed. All factors, id est (i.e.), age, T and N classification, stage, duration after treatment, acute toxicity of chemoradiotherapy and order of chemotherapy, had not influence on food ingestion or swallowing. Patients after CCRT might have potential dysfunction of swallowing. The colored water swallowing test is useful for diagnosis of swallowing dysfunction in head and neck cancer patients after CCRT. (author)

  13. Treatment of post-stroke dysphagia by vitalstim therapy coupled with conventional swallowing training.

    Science.gov (United States)

    Xia, Wenguang; Zheng, Chanjuan; Lei, Qingtao; Tang, Zhouping; Hua, Qiang; Zhang, Yangpu; Zhu, Suiqiang

    2011-02-01

    To investigate the effects of VitalStim therapy coupled with conventional swallowing training on recovery of post-stroke dysphagia, a total of 120 patients with post-stroke dysphagia were randomly and evenly divided into three groups: conventional swallowing therapy group, VitalStim therapy group, and VitalStim therapy plus conventional swallowing therapy group. Prior to and after the treatment, signals of surface electromyography (sEMG) of swallowing muscles were detected, swallowing function was evaluated by using the Standardized Swallowing Assessment (SSA) and Videofluoroscopic Swallowing Study (VFSS) tests, and swallowing-related quality of life (SWAL-QOL) was evaluated using the SWAL-QOL questionnaire. There were significant differences in sEMG value, SSA, VFSS, and SWAL-QOL scores in each group between prior to and after treatment. After 4-week treatment, sEMG value, SSA, VFSS and SWAL-QOL scores were significantly greater in the VitalStim therapy plus conventional swallowing training group than in the conventional swallowing training group and VitalStim therapy group, but no significant difference existed between conventional swallowing therapy group and VitalStim therapy group. It was concluded that VitalStim therapy coupled with conventional swallowing training was conducive to recovery of post-stroke dysphagia.

  14. Flowering Trees

    Indian Academy of Sciences (India)

    Flowering Trees. Boswellia serrata Roxb. ex Colebr. (Indian Frankincense tree) of Burseraceae is a large-sized deciduous tree that is native to India. Bark is thin, greenish-ash-coloured that exfoliates into smooth papery flakes. Stem exudes pinkish resin ... Fruit is a three-valved capsule. A green gum-resin exudes from the ...

  15. Flowering Trees

    Indian Academy of Sciences (India)

    IAS Admin

    Flowering Trees. Ailanthus excelsa Roxb. (INDIAN TREE OF. HEAVEN) of Simaroubaceae is a lofty tree with large pinnately compound alternate leaves, which are ... inflorescences, unisexual and greenish-yellow. Fruits are winged, wings many-nerved. Wood is used in making match sticks. 1. Male flower; 2. Female flower.

  16. Flowering Trees

    Indian Academy of Sciences (India)

    Flowering Trees. Gyrocarpus americanus Jacq. (Helicopter Tree) of Hernandiaceae is a moderate size deciduous tree that grows to about 12 m in height with a smooth, shining, greenish-white bark. The leaves are ovate, rarely irregularly ... flowers which are unpleasant smelling. Fruit is a woody nut with two long thin wings.

  17. Flowering Trees

    Indian Academy of Sciences (India)

    More Details Fulltext PDF. Volume 8 Issue 8 August 2003 pp 112-112 Flowering Trees. Zizyphus jujuba Lam. of Rhamnaceae · More Details Fulltext PDF. Volume 8 Issue 9 September 2003 pp 97-97 Flowering Trees. Moringa oleifera · More Details Fulltext PDF. Volume 8 Issue 10 October 2003 pp 100-100 Flowering Trees.

  18. Analysing the floral elements of the lost tree of Easter Island: a morphometric comparison between the remaining ex-situ lines of the endemic extinct species Sophora toromiro.

    Science.gov (United States)

    Püschel, Thomas A; Espejo, Jaime; Sanzana, María-José; Benítez, Hugo A

    2014-01-01

    Sophora toromiro (Phil) Skottsb. is a species that has been extinct in its natural habitat Easter Island (Rapa Nui) for over 50 years. However, seed collections carried out before its extinction have allowed its persistence ex-situ in different botanical gardens and private collections around the world. The progenies of these diverse collections have been classified in different lines, most of them exhibiting high similarity as corroborated by molecular markers. In spite of this resemblance observed between the different lines, one of them (Titze) has dissimilar floral elements, thus generating doubts regarding its species classification. The floral elements (wing, standard and keel) belonging to three different S. toromiro lines and two related species were analyzed using geometric morphometrics. This method was applied in order to quantify the floral shape variation of the standard, wing, and keel between the different lines and control species. Geometric morphometrics analyses were able to distinguish the floral elements at both intra (lines) and inter-specific levels. The present results are on line with the cumulative evidence that supports the Titze line as not being a proper member of the S. toromiro species, but probably a hybridization product or even another species of the Edwardsia section. The reintroduction programs of S. toromiro should consider this information when assessing the authenticity and origin of the lines that will be used to repopulate the island.

  19. Analysing the floral elements of the lost tree of Easter Island: a morphometric comparison between the remaining ex-situ lines of the endemic extinct species Sophora toromiro.

    Directory of Open Access Journals (Sweden)

    Thomas A Püschel

    Full Text Available Sophora toromiro (Phil Skottsb. is a species that has been extinct in its natural habitat Easter Island (Rapa Nui for over 50 years. However, seed collections carried out before its extinction have allowed its persistence ex-situ in different botanical gardens and private collections around the world. The progenies of these diverse collections have been classified in different lines, most of them exhibiting high similarity as corroborated by molecular markers. In spite of this resemblance observed between the different lines, one of them (Titze has dissimilar floral elements, thus generating doubts regarding its species classification. The floral elements (wing, standard and keel belonging to three different S. toromiro lines and two related species were analyzed using geometric morphometrics. This method was applied in order to quantify the floral shape variation of the standard, wing, and keel between the different lines and control species. Geometric morphometrics analyses were able to distinguish the floral elements at both intra (lines and inter-specific levels. The present results are on line with the cumulative evidence that supports the Titze line as not being a proper member of the S. toromiro species, but probably a hybridization product or even another species of the Edwardsia section. The reintroduction programs of S. toromiro should consider this information when assessing the authenticity and origin of the lines that will be used to repopulate the island.

  20. Adolescents' struggles with swallowing tablets: barriers, strategies and learning.

    Science.gov (United States)

    Hansen, Dana Lee; Tulinius, Ditte; Hansen, Ebba Holme

    2008-01-01

    To explore adolescents' struggles with taking oral medications. Copenhagen, Denmark. Semi-structured qualitative interviews were conducted with 89 adolescents (33 boys, 56 girls) between the ages of 11 and 20. Adolescents were recruited through four public schools. To identify struggles with taking oral medication, interview transcripts were systematically searched for statements including the terms swallow, chew, crush and eat. Thematic analysis of the identified statements was carried out to reveal dominant themes in the adolescents' accounts. Over one-third of the adolescents spontaneously provided accounts of the difficulties they experienced with taking oral medications, especially with swallowing tablets. Three themes were dominant in their narratives: barriers, strategies and learning. Barriers experienced by the adolescents involved the medications' properties, e.g. taste. Adolescents developed strategies to overcome these barriers, e.g. crushing tablets. Via a process of learning-by-doing and the acquisition of increased experience and autonomy, many adolescents mastered the skill of swallowing tablets. Many adolescents experienced barriers in their attempts to swallow tablets. They developed various strategies to overcome these barriers and gradually mastered taking medicines in a learning-by-doing process.

  1. Swallowing function before and after concurrent chemoradiotherapy for pharyngeal cancer

    International Nuclear Information System (INIS)

    Kiyuna, Asanori; Hasegawa, Masahiro; Higa, Asano; Shinhama, Akihiko; Suzuki, Mikio

    2010-01-01

    Concurrent chemoradiotherapy (CCRT) for patients with advanced head or neck cancer has become popular as an effective treatment that can preserve their organs and functions after treatment. However, severe dysfunctions as the complications related to CCRT, e.g. dysphagia, sometimes appear in spite of preservation of the affected organs. The aim of the present study is to clarify swallowing function during and after CCRT. Medical records of subjects who received CCRT for treatment of oropharyngeal (21 cases) and hypopharyngeal (19 cases) cancer were retrospectively reviewed for mucositis and dysphagia before, during, and after CCRT using National Cancer Institute-Common Toxicity Criteria (NCI-CTC) version 2.0. Severity of mucositis and dysphagia kept deteriorating during CCRT and 27.5% of the subjects required tube feeding at the end of CCRT. The mucositis improved rapidly after treatment, but severe dysphagia still persisted in 7.5% of the subjects 6 months after CCRT. Planned neck dissections were carried out in 14 patients as additional treatment against lymph node involvement. Although severe dysphagia appeared immediately after surgery, swallowing function returned to preoperative condition within 1 month. The majority of patients who receive CCRT recover their swallowing function within 6 months after CCRT. However, since some patients demonstrate prolonged dysphagia after CCRT, we should receive informed consent from patients about their swallowing condition after CCRT. (author)

  2. Mastication and swallowing : influence of fluid addition to foods

    NARCIS (Netherlands)

    Pereira, Luciano Jose; Duarte Gaviao, Maria Beatriz; Engelen, Lina; van der Bilt, Andries

    2007-01-01

    introduction: The production of sufficient saliva is indispensable for good chewing. Recent research has demonstrated that salivary flow rate has little influence on the swallowing threshold. Objectives: The hypothesis examined in the present study was that adding fluids to foods will influence

  3. Evaluation of swallowing disorders with videofluoroscopy in Austria: a survey

    International Nuclear Information System (INIS)

    Eisenhuber, Edith; Schima, Wolfgang; Stadler, Alfred; Schober, Ewald; Schibany, Nadja; Denk, Doris-Maria

    2005-01-01

    Aim: The aim of our study was to assess the availability of videofluoroscopy to examine patients with swallowing disorders in Austria. Materials and methods: A questionnaire was sent to the department heads of the radiology departments of all hospitals (n=143) and to all non-hospital-based radiologic practices (n=226) throughout Austria. The survey focused on the availability of videofluoroscopic swallowing studies and on the studies performed in patients with deglutition disorders. Results: The questionnaire was completed and returned by 134 of 143 radiology departments (94%) and 65 of 226 non-hospital-based radiologists (29%). Videofluoroscopic swallowing studies were performed in 38 of 134 radiology departments (28%) and in 21 of 65 practices (32%). The method is available in all nine Austrian states (100%) and 27 of 99 districts (27%). The number of examinations performed in different states ranged from 0.7 to 19 studies/10,000 population per year. The number of videofluoroscopic examinations per department or practice in the year 2001 ranged between 5 and 690 (median, 100 examinations). To 85% of videofluoroscopy units patients were referred from otorhinolaryngology/phoniatrics-logopedics, to 69% of videofluoroscopy units referrals were also from internal medicine, from neurology in 54%, and from pediatrics in 20%. Conclusion: Despite the widespread availability of videofluoroscopy throughout Austria, its use still varies largely between different states. The data show that in general there is a wide-spread demand for videofluoroscopic swallowing studies

  4. Current conservation status of the Blue Swallow Hirundo ...

    African Journals Online (AJOL)

    The overall probability of extinction of the species in the wild is 3%. Minimum viable population size analysis suggests that a goal for the long-term conservation of the Blue Swallow should be to mitigate current threats that are driving declines such that the population increases to a minimum of 3 600 individuals. This should ...

  5. Quantitative Measures of Swallowing Deficits in Patients With Parkinson's Disease.

    Science.gov (United States)

    Ellerston, Julia K; Heller, Amanda C; Houtz, Daniel R; Kendall, Katherine A

    2016-05-01

    Dysphagia and associated aspiration pneumonia are commonly reported sequelae of Parkinson's disease (PD). Previous studies of swallowing in patients with PD have described prolonged pharyngeal transit time, delayed onset of pharyngeal transit, cricopharyngeal (CP) achalasia, reduced pharyngeal constriction, and slowed hyolaryngeal elevation. These studies were completed using inconsistent evaluation methodology, reliance on qualitative analysis, and a lack of a large control group, resulting in concerns regarding diagnostic precision. The purpose of this study was to investigate swallowing function in patients with PD using a norm-referenced, quantitative approach. This retrospective study includes 34 patients with a diagnosis of PD referred to a multidisciplinary voice and swallowing clinic. Modified barium swallow studies were performed using quantitative measures of pharyngeal transit time, hyoid displacement, CP sphincter opening, area of the pharynx at maximal constriction, and timing of laryngeal vestibule closure relative to bolus arrival at the CP sphincter. Reduced pharyngeal constriction was found in 30.4%, and a delay in airway closure relative to arrival of the bolus at the CP sphincter was the most common abnormality, present in 62% of patients. Previously reported findings of prolonged pharyngeal transit, poor hyoid elevation, and CP achalasia were not identified as prominent features. © The Author(s) 2015.

  6. [Age-related changes in swallowing. Physiology and pathophysiology].

    Science.gov (United States)

    Muhle, P; Wirth, R; Glahn, J; Dziewas, R

    2015-04-01

    The term presbyphagia refers to all changes of swallowing physiology that are manifested with increasing age. Alterations in the pattern of deglutition that are part of healthy aging are called primary presbyphagia. Primary presbyphagia is not an illness in itself but contributes to a more pervasive naturally diminished functional reserve, making older adults more susceptible to dysphagia. If disorders in swallowing occur in the elderly as a comorbidity of a specific disease, for example stroke or neurodegenerative disorders, this is called secondary presbyphagia. Increasing age has an impact on each stage of deglutition. In the oral preparatory phase a diminished input for smell and taste as well as a usually multifactorial cause of dry mouth are the most important influencing factors. Sarcopenia, the degenerative loss of skeletal muscle mass, strength and quality associated with aging, interferes in particular with the oropharyngeal phase. A decreased sensory feedback from the oropharyngeal mucosa leads to a delayed triggering of the swallowing reflex. Finally, a reduction in connective tissue elasticity and changes of the axial skeleton lead to various modifications of the swallowing pattern with advanced age.

  7. Differences in Swallowing between High and Low Concentration Taste Stimuli

    Directory of Open Access Journals (Sweden)

    Ahmed Nagy

    2014-01-01

    Full Text Available Taste is a property that is thought to potentially modulate swallowing behavior. Whether such effects depend on taste, intensity remains unclear. This study explored differences in the amplitudes of tongue-palate pressures in swallowing as a function of taste stimulus concentration. Tongue-palate pressures were collected in 80 healthy women, in two age groups (under 40, over 60, stratified by genetic taste status (nontasters, supertasters. Liquids with different taste qualities (sweet, sour, salty, and bitter were presented in high and low concentrations. General labeled magnitude scale ratings captured perceived taste intensity and liking/disliking of the test liquids. Path analysis explored whether factors of taste, concentration, age group, and/or genetic taste status impacted: (1 perceived intensity; (2 palatability; and (3 swallowing pressures. Higher ratings of perceived intensity were found in supertasters and with higher concentrations, which were more liked/disliked than lower concentrations. Sweet stimuli were more palatable than sour, salty, or bitter stimuli. Higher concentrations elicited stronger tongue-palate pressures independently and in association with intensity ratings. The perceived intensity of a taste stimulus varies as a function of stimulus concentration, taste quality, participant age, and genetic taste status and influences swallowing pressure amplitudes. High-concentration salty and sour stimuli elicit the greatest tongue-palate pressures.

  8. Effect of posture on swallowing | Alghadir | African Health Sciences

    African Journals Online (AJOL)

    Background: Swallowing is a systematic process. Any structural, physiological or neurological disturbance in this process may cause dysphagia. Although there are studies that report head/neck movements during mastication, there are fewer studies that show the effect of different head/neck postures on difficulty while ...

  9. \\'The snake will swallow you': supernatural snakes and the creation ...

    African Journals Online (AJOL)

    \\'The snake will swallow you': supernatural snakes and the creation of the Khotso legend. Felicity Wood. Abstract. No Abstract. Indilinga: African Journal of Indigenous Knowledge Systems (IAJIKS) Vol. 4(1) 2005: 347-359. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  10. Tongue-mandible coupling movements during saliva swallowing.

    Science.gov (United States)

    Bourdiol, P; Mishellany-Dutour, A; Peyron, M-A; Woda, A

    2014-03-01

    The purpose of this study was to measure the tongue and mandible positions and displacements in relation to the maxilla in the midsagittal plane to characterize the different saliva swallowing patterns by recording their kinematics. A 2D electromagnetic articulograph using four transducer coils, three attached to the upper surface of the tongue midline plus one attached to the chin anterior part allowed continuous evaluation of tongue and chin movements in twelve young adults in good general health. During 170 s sequences recorded at a frequency of 100 Hz, subjects were at rest, silently reading a text they had chosen. The subjects were free to swallow during the sequence. Deglutition of accumulated saliva was analysed after averaging all values obtained during successive 250 ms periods. We identified three elementary swallowing patterns. Mean duration of tongue-mandible movements were 1·51 ± 0·17 s, 1·63 ± 0·14 s and 2·00 ± 0·08 s for the first, second and third patterns respectively. In the light of other studies based on intra-oral pressure recordings, our results help to understand the tongue-mandible coupling behaviours involved in managing an in-mouth saliva bolus during the three elementary swallowing patterns identified. © 2014 John Wiley & Sons Ltd.

  11. Swallowing Disorders in Parkinson's Disease: Impact of Lingual Pumping

    Science.gov (United States)

    Argolo, Natalie; Sampaio, Marília; Pinho, Patrícia; Melo, Ailton; Nóbrega, Ana Caline

    2015-01-01

    Background: Lingual pumping (LP) is a repetitive, involuntary, anteroposterior movement of the tongue on the soft palate that is executed prior to transferring the food bolus to the pharynx, but we also observed LP when multiple swallows were taken. LP may be associated with rigidity and bradykinesia in patients with Parkinson's disease (PD). This…

  12. Tree compression with top trees

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li; Landau, Gad M.

    2013-01-01

    We introduce a new compression scheme for labeled trees based on top trees [3]. Our compression scheme is the first to simultaneously take advantage of internal repeats in the tree (as opposed to the classical DAG compression that only exploits rooted subtree repeats) while also supporting fast...

  13. Tree compression with top trees

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li; Landau, Gad M.

    2015-01-01

    We introduce a new compression scheme for labeled trees based on top trees. Our compression scheme is the first to simultaneously take advantage of internal repeats in the tree (as opposed to the classical DAG compression that only exploits rooted subtree repeats) while also supporting fast...

  14. Stricture location predicts swallowing outcomes following endoscopic rendezvous procedures.

    Science.gov (United States)

    Adams, Katherine N; Shah, Rupali N; Buckmire, Robert A

    2017-06-01

    Complete pharyngoesophageal strictures may be encountered by the otolaryngologist as a consequence of radiation/chemoradiotherapy therapies for head and neck cancer. A combined anterograde and retrograde dilation procedure (rendezvous procedure) has proven to be a useful surgical intervention in these cases. We assess the long-term swallowing outcomes of this patient cohort including gastrostomy tube (G-tube) reliance, swallowing quality of life, and variables that contribute to improved swallowing outcomes. Retrospective chart review. A retrospective chart review of 18 consecutive patients treated with rendezvous procedures between April 2007 and May 2015 was carried out. Data were collected from chart review and follow-up telephone calls including demographics, surgical/postoperative course details, and Eating Assessment Tool (EAT-10) (swallowing quality of life) scores. The completion rate of the procedure was 83% (15 completed/3 procedures aborted). Average follow-up was 22 months. Thirteen of 15 (86.7%) achieved an oral diet, and 7/15 (46.7%) had their G-tube removed. G-tube-independent (GTI) patients had an average stricture length of 2.33 cm and an average distance from the incisors of 17.4 cm compared to G-tube dependent-(GTD) patients who had an average stricture length of 2.63 cm and 14.6 cm mean distance from the incisors (P = .66 and .0343, respectively). Final EAT-10 scores averaged 20.1 in GTI patients and 33.8 in GTD patients (P = .022). Stricture/incisor distance and EAT-10 scores demonstrated a moderate to strong negative correlation (r = -0.67). Following the endoscopic rendezvous procedure, swallowing outcomes and G-tube status is related to the distance of the stricture from the incisors. 2b Laryngoscope, 127:1388-1391, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  15. Radiation doses to children during modified barium swallow studies

    International Nuclear Information System (INIS)

    Weir, Kelly A.; McMahon, Sandra M.; Long, Gillian; Bunch, Judith A.; Pandeya, Nirmala; Coakley, Kerry S.; Chang, Anne B.

    2007-01-01

    There are minimal data on radiation doses to infants and children undergoing a modified barium swallow (MBS) study. To document screening times, dose area product (DAP) and effective doses to children undergoing MBS and to determine factors associated with increased screening times and effective dose. Fluoroscopic data (screening time, DAP, kVp) for 90 consecutive MBS studies using pulse fluoroscopy were prospectively recorded; effective dose was calculated and data were analyzed for effects of behavior, number of swallow presentations, swallowing dysfunction and medical problems. Mean effective dose for the entire group was 0.0826 ± 0.0544 mSv, screening time 2.48 ± 0.81 min, and DAP 28.79 ± 41.72 cGy cm 2 . Significant differences were found across three age groups (≤1.0, >1.0-3.0 and >3.0 years) for effective dose (mean 0.1188, 0.0651 and 0.0529 mSv, respectively; P < 0.001), but not for screening time or DAP. Effective dose was correlated with screening time (P 0.007), DAP (P < 0.001), number of swallow presentations (P = 0.007), lower age (P = 0.017), female gender (P = 0.004), and height (P < 0.001). Screening time was correlated with total number of swallow presentations (P < 0.001) and DAP (P < 0.001). Screening times, DAP, effective dose, and child and procedural factors associated with higher effective doses are presented for children undergoing MBS studies. (orig.)

  16. Barn swallows nesting near radioactive leaching ponds in southeastern Idaho

    International Nuclear Information System (INIS)

    Millard, J.B.; Whicker, F.W.; Markham, O.D.

    1978-01-01

    Seasonally occurring populations of barn swallows nest near the Test Reactor Area (TRA) radioactive leaching ponds on the Idaho National Engineering Laboratory (INEL) Site. These birds utilize leaching pond arthropods and are therefore capable of accumulating radioactive materials and exporting them from the INEL Site during migration. The breeding biology is discussed for these swallows and a control group located 100 km away. Total nestling mortality for the controls and a 1977 TRA population was found to be statistically identical. Over 20 fission and activation products have been detected in immature and adult TRA birds. Mean concentrations of detectable radionuclides were used to calculate internal dose rates, and results showed that Na-24 contributed about 72% of the total average of 21.9 mrad/d for adult birds. Concentration factors were also calculated for predominant radionuclides in swallows relative to filtered pond water. Data from LiF dosimeters in swallow nests constructed with contaminated mud indicated average dose rates were 84 mrad/d for eggs and 220 mrad/d for nestlings. Growth curves were constructed for the immature TRA birds and controls. The first clutch of TRA swallows was found to have a significantly lower mean growth rate constant than the first clutch of controls. The statistical difference in growth rate between the control and TRA first clutch populations may have resulted from differences in climate, nesting site habitat, or available food sources, and cannot be solely attributed to radiation exposure as a causative factor. Growth rate parameters for TRA birds were within the range of values reported in the literature

  17. Analysis of vocal and swallowing functions after horizontal glottectomy.

    Science.gov (United States)

    Topaloğlu, İlhan; Bal, Muhlis; Salturk, Ziya; Berkiten, Güler; Atar, Yavuz

    2016-08-01

    We conducted a cross-sectional study to assess vocal and swallowing functions after horizontal glottectomy. Our study population was made up of 22 men aged 45 to 72 years (mean: 58.3) who underwent horizontal glottectomy and completed at least 1 year of follow-up. To compare postoperative results, 20 similarly aged men were included as a control group; all glottectomy patients and all controls were smokers. We used three methods-acoustic and aerodynamic voice analyses, the GRBAS (grade, roughness, breathiness, asthenicity, and strain) scale, and the voice handicap index-30 (VHI-30)-to assess vocal function objectively, perceptually, and subjectively, respectively. We also assessed swallowing function objectively by fiberoptic endoscopic evaluation of swallowing (FEES) and subjectively with the M.D. Anderson dysphagia inventory (MDADI). The 22 patients were also subcategorized into three groups according to the extent of their arytenoid cartilage resection, and their outcomes were compared. Acoustic and aerodynamic analyses showed that the mean maximum phonation time was significantly shorter and the fundamental frequency was significantly lower in the glottectomy group than in the controls (p = 0.001 for both), and that the mean jitter and shimmer values and the mean harmonics-to-noise ratio were all significantly higher (p = 0.001 for all); there were no significant differences among the three arytenoid subgroups. Self-assessments revealed that there were no statistically significant differences among the three subgroups in GRBAS scale scores except for the breathiness score (p = 0.045), which was lower in the arytenoid preservation subgroup than in the total resection subgroup; there were no statistically significant differences among the three subgroups in VHI-30 scores. Finally, swallow testing found no statistically significant differences in FEES scores or MDADI scores. We conclude that horizontal glottectomy caused a deterioration in vocal function, but

  18. Functional MRI study of cerebral cortical activation during volitional swallowing

    International Nuclear Information System (INIS)

    Wakasa, Toru; Aiga, Hideki; Yanagi, Yoshinobu; Kawai, Noriko; Sugimoto, Tomosada; Kuboki, Takuo; Kishi, Kanji

    2002-01-01

    The purpose of this study was to investigate the somatotropic distribution and lateralization of motor and sensory cortical activity during swallowing in healthy adult human subjects using functional MR imaging. Nine healthy right-handed adult volunteers (6 men, 3 women; ages 22-38) were examined. Their cortical activities were evoked by having them swallow, five times, a small bolus of water (3 ml) supplied through a plastic catheter. As a positive control, the subjects performed five repetitions of right-handed grasping tasks. Blood oxygenation level-dependent images were obtained using a 1.5 Tesla MR system (Magnetom Vision, Siemens Germany; repetition time/echo time (TR/TE)=0.96/0.66, flip angle (FA)=90 deg). T1 weighted anatomical images were obtained for the same slices in each subject. Cerebral activity was observed most notably in the primary motor cortex and primary somatosensory cortex, followed by the premotor cortex, anterior cingulate cortex, frontal operculum, and insula. The hand-grasping task activated relatively superior parts of the primary motor and somatosensory cortices. The swallowing task, on the other hand, activated the inferior parts of the pre- and postcentral gyri. The hand-grasping activation of motor and sensory cortices was localized absolutely on the contralateral side, whereas swallowing activated the motor cortex either bilaterally or unilaterally. Swallowing activated the sensory cortex almost always bilaterally. This study suggested that fMRI could be used to identify the specific areas of cortical activation caused by various tasks, and to differentiate the locations of cortical activation between tasks. (author)

  19. Dynamic evaluation of swallowing disorders with electron-beam tomography

    International Nuclear Information System (INIS)

    Raith, J.; Lindbichler, F.; Kern, R.; Groell, R.; Rienmueller, R.

    1996-01-01

    Three cases preselected by videofluorography were studied to evaluate whether electron beam tomography (EBT) permits more detailed dynamic imaging of swallowing disorders focusing on the mesonasopharyngeal segment, the hypopharynx and the upper esophageal sphincter (UES). Immediately after videofluorographic examination of the oropharyngeal deglutition, EBT is performed. The patient is in a supine position and while the patient swallows a 20 ml bolus of water or diluted iodine containing contrast agent, a sequence of 20 images per level is scanned. The levels, which are determined by using the scout view, are oriented parallel to the hard palate either at the level of the hard palate to image the mesonasopharyngel segment or just above the hyoid bone to focus on the hypopharynx or at the location of the USE. The scan technique is a single-slice cinemode with a slice thickness of 3 mm (exposure time 100 ms, interscan delay 16 ms, 130 kV, 620 mA). The following structural interactions that we have so far been unable to image can be clearly demonstrated with EBT: During normal swallowing, the mesonasopharyngeal segment is completely and symmetrically closed by the soft palate and Passavant's cushion; lateral hypopharyngeal pouches can be located more precisely; and disorders of the UES can be differentiated into functional or morphologically caused disorders (e.g., goiter or cervical osteophytes). Videofluorography and cinematography are still the gold standard in functional evaluation of swallowing disorders. However, EBT permits dynamic imaging of pharyngeal deglutition in a preselected transverse plane and can give useful additional information concerning functional anatomical changes in the pharynx during swallowing. Further clinical evaluation is needed. (orig.) [de

  20. Functional MRI study of cerebral cortical activation during volitional swallowing

    Energy Technology Data Exchange (ETDEWEB)

    Wakasa, Toru; Aiga, Hideki; Yanagi, Yoshinobu; Kawai, Noriko; Sugimoto, Tomosada; Kuboki, Takuo; Kishi, Kanji [Okayama Univ. (Japan). Graduate School of Medicine and Dentistry

    2002-12-01

    The purpose of this study was to investigate the somatotropic distribution and lateralization of motor and sensory cortical activity during swallowing in healthy adult human subjects using functional MR imaging. Nine healthy right-handed adult volunteers (6 men, 3 women; ages 22-38) were examined. Their cortical activities were evoked by having them swallow, five times, a small bolus of water (3 ml) supplied through a plastic catheter. As a positive control, the subjects performed five repetitions of right-handed grasping tasks. Blood oxygenation level-dependent images were obtained using a 1.5 Tesla MR system (Magnetom Vision, Siemens Germany; repetition time/echo time (TR/TE)=0.96/0.66, flip angle (FA)=90 deg). T1 weighted anatomical images were obtained for the same slices in each subject. Cerebral activity was observed most notably in the primary motor cortex and primary somatosensory cortex, followed by the premotor cortex, anterior cingulate cortex, frontal operculum, and insula. The hand-grasping task activated relatively superior parts of the primary motor and somatosensory cortices. The swallowing task, on the other hand, activated the inferior parts of the pre- and postcentral gyri. The hand-grasping activation of motor and sensory cortices was localized absolutely on the contralateral side, whereas swallowing activated the motor cortex either bilaterally or unilaterally. Swallowing activated the sensory cortex almost always bilaterally. This study suggested that fMRI could be used to identify the specific areas of cortical activation caused by various tasks, and to differentiate the locations of cortical activation between tasks. (author)

  1. Neural network pattern recognition of lingual-palatal pressure for automated detection of swallow.

    Science.gov (United States)

    Hadley, Aaron J; Krival, Kate R; Ridgel, Angela L; Hahn, Elizabeth C; Tyler, Dustin J

    2015-04-01

    We describe a novel device and method for real-time measurement of lingual-palatal pressure and automatic identification of the oral transfer phase of deglutition. Clinical measurement of the oral transport phase of swallowing is a complicated process requiring either placement of obstructive sensors or sitting within a fluoroscope or articulograph for recording. Existing detection algorithms distinguish oral events with EMG, sound, and pressure signals from the head and neck, but are imprecise and frequently result in false detection. We placed seven pressure sensors on a molded mouthpiece fitting over the upper teeth and hard palate and recorded pressure during a variety of swallow and non-swallow activities. Pressure measures and swallow times from 12 healthy and 7 Parkinson's subjects provided training data for a time-delay artificial neural network to categorize the recordings as swallow or non-swallow events. User-specific neural networks properly categorized 96 % of swallow and non-swallow events, while a generalized population-trained network was able to properly categorize 93 % of swallow and non-swallow events across all recordings. Lingual-palatal pressure signals are sufficient to selectively and specifically recognize the initiation of swallowing in healthy and dysphagic patients.

  2. Dysphagia progression and swallowing management in Parkinson's disease: an observational study.

    Science.gov (United States)

    Luchesi, Karen Fontes; Kitamura, Satoshi; Mourão, Lucia Figueiredo

    2015-01-01

    Dysphagia is relatively common in individuals with neurological disorders. To describe the swallowing management and investigate associated factors with swallowing in a case series of patients with Parkinson's disease. It is a long-term study with 24 patients. The patients were observed in a five-year period (2006-2011). They underwent Fiberoptic Endoscopic Evaluation of Swallowing, Functional Oral Intake Scale and therapeutic intervention every three months. In the therapeutic intervention they received orientation about exercises to improve swallowing. The Chi-square, Kruskal-Wallis and Fisher's tests were used. The period of time for improvement or worsening of swallowing was described by Kaplan-Meier analysis. During the follow-up, ten patients improved, five stayed the same and nine worsened their swallowing functionality. The median time for improvement was ten months. Prior to the worsening there was a median time of 33 months of follow-up. There was no associated factor with improvement or worsening of swallowing. The maneuvers frequently indicated in therapeutic intervention were: chin-tuck, bolus consistency, bolus effect, strengthening-tongue, multiple swallows and vocal exercises. The swallowing management was characterized by swallowing assessment every three months with indication of compensatory and rehabilitation maneuvers, aiming to maintain the oral feeding without risks. There was no associated factor with swallowing functionality in this case series. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  3. Dysphagia progression and swallowing management in Parkinson's disease: an observational study

    Directory of Open Access Journals (Sweden)

    Karen Fontes Luchesi

    2015-02-01

    Full Text Available Introduction: Dysphagia is relatively common in individuals with neurological disorders. Objective: To describe the swallowing management and investigate associated factors with swallowing in a case series of patients with Parkinson's disease. Methods: It is a long-term study with 24 patients. The patients were observed in a five-year period (2006-2011. They underwent Fiberoptic Endoscopic Evaluation of Swallowing, Functional Oral Intake Scale and therapeutic intervention every three months. In the therapeutic intervention they received orientation about exercises to improve swallowing. The Chi-square, Kruskal-Wallis and Fisher's tests were used. The period of time for improvement or worsening of swallowing was described by Kaplan-Meier analysis. Results: During the follow-up, ten patients improved, five stayed the same and nine worsened their swallowing functionality. The median time for improvement was ten months. Prior to the worsening there was a median time of 33 months of follow-up. There was no associated factor with improvement or worsening of swallowing. The maneuvers frequently indicated in therapeutic intervention were: chin-tuck, bolus consistency, bolus effect, strengthening-tongue, multiple swallows and vocal exercises. Conclusion: The swallowing management was characterized by swallowing assessment every three months with indication of compensatory and rehabilitation maneuvers, aiming to maintain the oral feeding without risks. There was no associated factor with swallowing functionality in this case series.

  4. A comparison between swallowing sounds and vibrations in patients with dysphagia

    Science.gov (United States)

    Movahedi, Faezeh; Kurosu, Atsuko; Coyle, James L.; Perera, Subashan

    2017-01-01

    The cervical auscultation refers to the observation and analysis of sounds or vibrations captured during swallowing using either a stethoscope or acoustic/vibratory detectors. Microphones and accelerometers have recently become two common sensors used in modern cervical auscultation methods. There are open questions about whether swallowing signals recorded by these two sensors provide unique or complementary information about swallowing function; or whether they present interchangeable information. The aim of this study is to present a broad comparison of swallowing signals recorded by a microphone and a tri-axial accelerometer from 72 patients (mean age 63.94 ± 12.58 years, 42 male, 30 female), who underwent videofluoroscopic examination. The participants swallowed one or more boluses of thickened liquids of different consistencies, including thin liquids, nectar-thick liquids, and pudding. A comfortable self-selected volume from a cup or a controlled volume by the examiner from a 5ml spoon was given to the participants. A comprehensive set of features was extracted in time, information-theoretic, and frequency domains from each of 881 swallows presented in this study. The swallowing sounds exhibited significantly higher frequency content and kurtosis values than the swallowing vibrations. In addition, the Lempel-Ziv complexity was lower for swallowing sounds than those for swallowing vibrations. To conclude, information provided by microphones and accelerometers about swallowing function are unique and these two transducers are not interchangeable. Consequently, the selection of transducer would be a vital step in future studies. PMID:28495001

  5. Soft-robotic esophageal swallowing as a clinically-inspired bolus rheometry technique

    International Nuclear Information System (INIS)

    Dirven, Steven; Allen, Jacqueline; Xu, Weiliang; Cheng, Leo K

    2017-01-01

    To investigate the impact of viscosity and peristaltic transport parameters on manometric pressure signatures, a reproducible swallowing process is required. Due to inter- and intra-subject variability from swallow to swallow, the human body does not represent an optimal mechanism for such an investigation. A smooth and continuous swallowing soft-robot has been developed to produce biomimetic swallowing trajectories, and is proposed to operate as a bench-top bolus rheometric investigation method. The method compares conventional viscometry and pressure signature findings from robotic swallowing experiments. The robotic aspect of experimentation involved 450 biomimetic swallows (10 repetitions of 45 unique experiments). The method examined swallowing transport in three dimensions: bolus formulation, peristaltic wavelength, and peristaltic velocity, each of which are known to contribute to safe and effective swallowing in vivo . It is found that the pressure gradients and magnitudes are commensurate with clinical reports on biological swallowing, on the order of 100 mmHg peak, however, the relationship between viscosity and pressure signatures is less clear. Bolus transport cannot be predicted as a function of bolus viscosity alone. Traditional viscometric data at 50 s −1 , as used in clinical practice, may not be a strong indicator of swallow effort, safety, or efficacy in vivo . (paper)

  6. Prevalence of swallowing dysfunction screened in Swedish cohort of COPD patients

    Directory of Open Access Journals (Sweden)

    Gonzalez Lindh M

    2017-01-01

    Full Text Available Margareta Gonzalez Lindh,1,2 Monica Blom Johansson,1 Margareta Jennische,1 Hirsh Koyi2,3 1Department of Neuroscience, Speech and Language Pathology, Uppsala University, Uppsala, Sweden; 2Centre for Research and Development (CFUG, Uppsala University, County Council of Gävleborg, Gävle, Sweden; 3Department of Respiratory Medicine, Gävle Hospital, Gävle, Sweden Background: COPD is a common problem associated with morbidity and mortality. COPD may also affect the dynamics and coordination of functions such as swallowing. A misdirected swallow may, in turn, result in the bolus entering the airway. A growing body of evidence suggests that a subgroup of people with COPD is prone to oropharyngeal dysphagia. The aim of this study was to evaluate swallowing dysfunction in patients with stable COPD and to determine the relation between signs and symptoms of swallowing dysfunction and lung function (forced expiratory volume in 1 second percent predicted.Methods: Fifty-one patients with COPD in a stable phase participated in a questionnaire survey, swallowing tests, and spirometry. A post-bronchodilator ratio of the forced expiratory volume in 1 second/best of forced vital capacity and vital capacity <0.7 was used to define COPD. Swallowing function was assessed by a questionnaire and two swallowing tests (water and cookie swallow tests.Results: Sixty-five percent of the patients reported subjective signs and symptoms of swallowing dysfunction in the questionnaire and 49% showed measurable ones in the swallowing tests. For the combined subjective and objective findings, 78% had a coexisting swallowing dysfunction. No significant difference was found between male and female patients.Conclusion: Swallowing function is affected in COPD patients with moderate to severe airflow limitation, and the signs and symptoms of this swallowing dysfunction were subjective, objective, or both. Keywords: deglutition, deglutition disorders, swallowing, COPD, speech

  7. Tree Nut Allergies

    Science.gov (United States)

    ... Blog Vision Awards Common Allergens Tree Nut Allergy Tree Nut Allergy Learn about tree nut allergy, how ... a Tree Nut Label card . Allergic Reactions to Tree Nuts Tree nuts can cause a severe and ...

  8. Swallowing endoscopy findings in Huntington's disease: a case report.

    Science.gov (United States)

    Alves, Thaís Coelho; Cola, Paula Cristina; Santos, Rarissa Rúbia Dallaqua Dos; Motonaga, Suely Mayumi; Silva, Roberta Gonçalves da

    2016-01-01

    Huntington's disease (HD) is a degenerative genetic disorder with autosomal-dominant transmission. The triad of symptoms of this disease consists of psychiatric disorders, jerky movements, and dementia. Oropharyngeal dysphagia, which is more evident with disease progression, is also present. Few studies have addressed the swallowing characteristics using objective analysis in this population. The purpose of this research was to describe the swallowing endoscopic findings of the pharyngeal phase in HD. This is a cross-sectional study addressing a clinical case which included two individuals of the same family, male, 32 and 63 years old, designated as individual A and individual B, with progression of the disease for five and 13 years, respectively. Consistent liquid, nectar, and puree were offered during the evaluation. There was presence of posterior oral spillage in liquid and nectar, small amount of pharyngeal residues, and no laryngeal penetration or aspiration in the individuals with HD in this study.

  9. "Music & Memory" and improved swallowing in advanced dementia.

    Science.gov (United States)

    Cohen, Dan; Post, Stephen G; Lo, Angela; Lombardo, Robin; Pfeffer, Brandon

    2018-01-01

    Background Dysphagia and difficulty with eating affects a significant portion of individuals with advanced dementia. Such problems with oral intake can have serious health consequences including mealtime distress, dehydration and malnutrition, aspiration, reduced quality of life, and increased mortality risk. Design We present the first data indicating that "Music & Memory" interventions improve swallowing in individuals with advanced dementia, thereby making oral feeding easier and potentially diminishing reliance on PEG. Setting Columbia Health Care Center, Wyocena, WI (with Music&Memory.org, Mineola, NY and Stony Brook University). Participants Residents with advanced dementia (N = 5). Observation by eight professional caregivers. Results (1) Enhanced swallowing mechanism with Music & Memory prior to dining; (2) decreased incidents of choking during mealtime; (3) improved nutritional status; (4) reduced weight loss; (5) reduced need for speech interventions; (6) enhanced quality of life. Conclusions The preliminary results call for additional research.

  10. Speech and swallowing outcomes in buccal mucosa carcinoma

    Directory of Open Access Journals (Sweden)

    Sunila John

    2011-01-01

    Full Text Available Buccal carcinoma is one of the most common malignant neoplasms among all oral cancers in India. Understanding the role of speech language pathologists (SLPs in the domains of evaluation and management strategies of this condition is limited, especially in the Indian context. This is a case report of a young adult with recurrent squamous cell carcinoma of the buccal mucosa with no deleterious habits usually associated with buccal mucosa carcinoma. Following composite resection, pectoralis major myocutaneous flap reconstruction, he developed severe oral dysphagia and demonstrated unintelligible speech. This case report focuses on the issues of swallowing and speech deficits in buccal mucosa carcinoma that need to be addressed by SLPs, and the outcomes of speech and swallowing rehabilitation and prognostic issues.

  11. Automated acoustic analysis in detection of spontaneous swallows in Parkinson's disease.

    Science.gov (United States)

    Golabbakhsh, Marzieh; Rajaei, Ali; Derakhshan, Mahmoud; Sadri, Saeed; Taheri, Masoud; Adibi, Peyman

    2014-10-01

    Acoustic monitoring of swallow frequency has become important as the frequency of spontaneous swallowing can be an index for dysphagia and related complications. In addition, it can be employed as an objective quantification of ingestive behavior. Commonly, swallowing complications are manually detected using videofluoroscopy recordings, which require expensive equipment and exposure to radiation. In this study, a noninvasive automated technique is proposed that uses breath and swallowing recordings obtained via a microphone located over the laryngopharynx. Nonlinear diffusion filters were used in which a scale-space decomposition of recorded sound at different levels extract swallows from breath sounds and artifacts. This technique was compared to manual detection of swallows using acoustic signals on a sample of 34 subjects with Parkinson's disease. A speech language pathologist identified five subjects who showed aspiration during the videofluoroscopic swallowing study. The proposed automated method identified swallows with a sensitivity of 86.67 %, a specificity of 77.50 %, and an accuracy of 82.35 %. These results indicate the validity of automated acoustic recognition of swallowing as a fast and efficient approach to objectively estimate spontaneous swallow frequency.

  12. Assessment of the swallowing function in older individuals referred to myocardial revascularization surgery.

    Science.gov (United States)

    Dantas, Mara de Oliveira Rodrigues Luiz; Auler, José Otávio Costa; Andrade, Claudia Regina Furquim de

    2010-01-01

    Swallowing evaluation of older individuals with coronary disease referred to heart surgery. To identify the characteristics of the swallowing function in older individuals referred to myocardial revascularization surgery (MR), using an evaluating protocol composed by a water test, cervical auscultation and pulse oximetry. The Assessment Protocol for Dysphagia Risk through a Combined Swallowing test and Vital Signs monitoring was used (PADTC)--measurements of HR and SpO2 (heart rate and oxygen saturation), water swallowing test with 1, 3, 5, 10, 15 e 20 ml, measurement of respiratory rate and cervical auscultation. The electronic stethoscope was used to analyze the number of swallows, response time and swallowing sound classification. In the Research Group (RG) older individuals with heart disease who were referred to MR were included. In the Control Group (CG) healthy older individuals were included. 38 older individuals were evaluated in the RG (mean age 68 years). In the CG, 30 older individuals were evaluated (mean age 70 years). There was a significant difference for the swallowing response time in older individuals with heart disease who presented HR below 60: swallowing response was shorter for 3 ml, 10 ml, 15 ml e 20 ml. HR was lower for individuals with heart disease. No significant difference was found between the groups for the other analyzed parameters. Older individuals with heart disease presented differences in the swallowing function when compared to healthy older individuals. Older individuals with heart disease presented alterations in the temporal coordination between breathing and swallowing, thus indicating risk for dysphagia.

  13. Volitional chewing with a conscious effort alters and facilitates swallowing during feeding sequence.

    Science.gov (United States)

    Furuya, J; Hara, A; Nomura, T; Kondo, H

    2014-03-01

    The key objective of mastication is to form a food bolus suitable for smooth swallowing. However, chewing is usually performed without a conscious effort. Poor bolus formation can cause pharyngeal residue and suffocation in elderly individuals with reduced swallowing function. Therefore, chewing with a conscious effort may help the bolus to more easily pass the pharynx. This study aimed to clarify the impact of mastication with a conscious effort on the feeding sequence. Subjects included 25 dentulous volunteers who were informed and provided written consent. Lateral videofluoroscopy was performed during the feeding of solid agar jelly under two conditions: chewing naturally in their usual manner (without volition) and chewing with a conscious effort (with volition). Temporal evaluation was performed for mastication, stage II transport (STII), swallow onset and oropharyngeal transit time. Moreover, bolus volume at swallow onset and subjective evaluation of swallowing easiness were measured. Volitional chewing with a conscious effort lengthened the duration of the chewing sequence before and after STII and delayed the swallow onset despite the fact that the bolus volume in the vallecula and hypopharynx (HYP) had significantly increased. Furthermore, with volition, the bolus transit time from swallow onset in the oral cavity, upper oropharynx and HYP was reduced, and subjective evaluation of swallowing easiness demonstrated significant improvement. These results suggest that volitional chewing with a conscious effort can alter bolus transport and swallowing, resulting in easier swallowing. © 2014 John Wiley & Sons Ltd.

  14. Difficult to swallow: patient preferences for alternative valproate pharmaceutical formulations

    Directory of Open Access Journals (Sweden)

    Monali Bhosle

    2009-06-01

    Full Text Available Monali Bhosle,1 Joshua S Benner,1 Mitch DeKoven,1 Jeff Shelton21Health Economics and Outcomes Research, IMS Health Inc, Falls Church, VA, USA; 2Answers and Insights Market Research, Inc, Indianapolis, IN, USAObjective: To determine the degree to which swallowing valproate (VP tablets is an issue, the proportion of patients who would prefer an alternative formulation, and the predictors of preference.Methods: A quantitative telephone survey of eligible adults (n = 400, ≥18 years old who currently take (n = 236 or previously took (n = 164 VP tablets within the past 6 months was conducted.Results: More than half of the patients indicated that VP tablets were ‘uncomfortable to swallow’ (68.5%, n = 274 and were ‘very interested’ (65.8%, n = 263 in medications that were easier to swallow. When choosing conceptually between taking VP tablet once/day or an equally safe and effective but significantly smaller soft gel capsule twice per day, the 82.8%, (n = 331 preferred the soft gel capsule. In the multivariate regression analysis, perceiving soft gel capsules to be easier to swallow (OR = 73.54; 95% CI = 15.01 to 360.40 and taking VP more frequently (OR = 2.02; 95% CI = 1.13 to 3.61 were significant predictors of soft gel capsule treatment preference.Conclusion: VP users would prefer a formulation that is easier to swallow, even if it is needed to be taken twice per day. When choosing between medications with similar efficacy and safety, physicians can consider patient preferences to optimize conditions for medication adherence.Keywords: patient preference, valproate formulations, tablet characteristics

  15. Time budget of South African cliff swallows during breeding

    African Journals Online (AJOL)

    The use of time by the South African cliff swallow was determined and use of energy calculated by using equations for predicting standard metabolic rate and the cost of flight. The highest daily energy expenditur.e was during the feeding of nestlings when 9,22 h were spent foraging. The cost of 127 kJ for building a nest is ...

  16. Immediate effect of laryngeal surface electrical stimulation on swallowing performance.

    Science.gov (United States)

    Takahashi, Keizo; Hori, Kazuhiro; Hayashi, Hirokazu; Fujiu-Kurachi, Masako; Ono, Takahiro; Tsujimura, Takanori; Magara, Jin; Inoue, Makoto

    2018-01-01

    Surface electrical stimulation of the laryngeal region is used to improve swallowing in dysphagic patients. However, little is known about how electrical stimulation affects tongue movements and related functions. We investigated the effect of electrical stimulation on tongue pressure and hyoid movement, as well as suprahyoid and infrahyoid muscle activity, in 18 healthy young participants. Electrical stimulation (0.2-ms duration, 80 Hz, 80% of each participant's maximal tolerance) of the laryngeal region was applied. Each subject swallowed 5 ml of barium sulfate liquid 36 times at 10-s intervals. During the middle 2 min, electrical stimulation was delivered. Tongue pressure, electromyographic activity of the suprahyoid and infrahyoid muscles, and videofluorographic images were simultaneously recorded. Tongue pressure during stimulation was significantly lower than before or after stimulation and was significantly greater after stimulation than at baseline. Suprahyoid activity after stimulation was larger than at baseline, while infrahyoid muscle activity did not change. During stimulation, the position of the hyoid at rest was descended, the highest hyoid position was significantly inferior, and the vertical movement was greater than before or after stimulation. After stimulation, the positions of the hyoid at rest and at the maximum elevation were more superior than before stimulation. The deviation of the highest positions of the hyoid before and after stimulation corresponded to the differences in tongue pressures at those times. These results suggest that surface electrical stimulation applied to the laryngeal region during swallowing may facilitate subsequent hyoid movement and tongue pressure generation after stimulation. NEW & NOTEWORTHY Surface electrical stimulation applied to the laryngeal region during swallowing may facilitate subsequent hyoid movement and tongue pressure generation after stimulation. Tongue muscles may contribute to overshot recovery

  17. The feasibility of magnetic resonance imaging of the dynamic swallowing

    International Nuclear Information System (INIS)

    Yang Jingquan; Gao Mingyong; Luo Suling; Lu Ruiliang; He Xiaohong

    2012-01-01

    Objective: To offer some visual and valuable clinical bases for the pharynx disease diagnosis and treatment by comparing the influence of different scanning sequences on the image quality and scanning time, and studying the application to the dynamic swallowing MRI scanning. Methods: The dynamic swallowing scanning of pharyngeal was performed on 20 nasopharyngeal carcinoma patients without deglutition disorders through GE 3.0 MRI system with fast imaging employing steady state acquisition (FIESTA) and fast gradient recalled echo (Fast GRE) sequences, and combined with the array spatial sensitivity encoding technique (ASSET), which accelerating factors was 2.0 ph, and sixty dynamic images were acquired sequentially. The image quality was graded into three classes:excellent, favorable and poor,which were visually assessed by three senior MRI physician using double-blinded method. The quantitative data were analyzed statistically with the SPSS13.0 software. Results: Under the same parameters,the scanning time with FIESTA, FIESTA+ASSET, Fast GRE and Fast GREA+ASSET sequences were 54 s, 28 s, 49 s and 25 s respectively. The number of excellent images with the four sequences were 44, 52, 52 and 56 respectively. The scanning time was the shortest and the image quality was the best with Fast GRE+ASSET sequence. Conclusions: The dynamic imaging of swallowing in sagittal view was achieved with Fast GRE+ASSET sequence on GE 3.0T MRI system. It could present status of the pharynx well, and the soft tissue of swallowing was showed clearly in the dynamic images. These will provide visual and effective evidence for clinical diagnosis and treatment. (authors)

  18. A Mathematical Model for Swallowing of Concentrated Fluids in Oesophagus

    OpenAIRE

    Pandey, S. K.; Tripathi, Dharmendra

    2011-01-01

    This model investigates particularly the impact of an integral and a non-integral number of waves on the swallowing of food stuff such as jelly, tomato puree, soup, concentrated fruits juices and honey transported peristaltically through the oesophagus. The fluid is considered as a Casson fluid. Emphasis is on the study of the dependence of local pressure distribution on space and time. Mechanical efficiency, reflux limit and trapping are also discussed. The effect of Casson fluid vis-à-vis N...

  19. Flowering Trees

    Indian Academy of Sciences (India)

    medium-sized handsome tree with a straight bole that branches at the top. Leaves are once pinnate, with two to three pairs of leaflets. Young parts of the tree are velvety. Inflorescence is a branched raceme borne at the branch ends. Flowers are large, white, attractive, and fragrant. Corolla is funnel-shaped. Fruit is an ...

  20. Flowering Trees

    Indian Academy of Sciences (India)

    Cassia siamia Lamk. (Siamese tree senna) of Caesalpiniaceae is a small or medium size handsome tree. Leaves are alternate, pinnately compound and glandular, upto 18 cm long with 8–12 pairs of leaflets. Inflorescence is axillary or terminal and branched. Flowering lasts for a long period from March to February. Fruit is ...

  1. Flowering Trees

    Indian Academy of Sciences (India)

    Flowering Trees. Cerbera manghasL. (SEA MANGO) of Apocynaceae is a medium-sized evergreen coastal tree with milky latex. The bark is grey-brown, thick and ... Fruit is large. (5–10 cm long), oval containing two flattened seeds and resembles a mango, hence the name Mangas or. Manghas. Leaves and fruits contain ...

  2. Flowering Trees

    Indian Academy of Sciences (India)

    user

    Flowering Trees. Gliricidia sepium(Jacq.) Kunta ex Walp. (Quickstick) of Fabaceae is a small deciduous tree with. Pinnately compound leaves. Flower are prroduced in large number in early summer on terminal racemes. They are attractive, pinkish-white and typically like bean flowers. Fruit is a few-seeded flat pod.

  3. Flowering Trees

    Indian Academy of Sciences (India)

    Flowering Trees. Acrocarpus fraxinifolius Wight & Arn. (PINK CEDAR, AUSTRALIAN ASH) of. Caesalpiniaceae is a lofty unarmed deciduous native tree that attains a height of 30–60m with buttresses. Bark is thin and light grey. Leaves are compound and bright red when young. Flowers in dense, erect, axillary racemes.

  4. Talking Trees

    Science.gov (United States)

    Tolman, Marvin

    2005-01-01

    Students love outdoor activities and will love them even more when they build confidence in their tree identification and measurement skills. Through these activities, students will learn to identify the major characteristics of trees and discover how the pace--a nonstandard measuring unit--can be used to estimate not only distances but also the…

  5. Drawing Trees

    DEFF Research Database (Denmark)

    Halkjær From, Andreas; Schlichtkrull, Anders; Villadsen, Jørgen

    2018-01-01

    We formally prove in Isabelle/HOL two properties of an algorithm for laying out trees visually. The first property states that removing layout annotations recovers the original tree. The second property states that nodes are placed at least a unit of distance apart. We have yet to formalize three...

  6. Flowering Trees

    Indian Academy of Sciences (India)

    Srimath

    Grevillea robusta A. Cunn. ex R. Br. (Sil- ver Oak) of Proteaceae is a daintily lacy ornamental tree while young and growing into a mighty tree (45 m). Young shoots are silvery grey and the leaves are fern- like. Flowers are golden-yellow in one- sided racemes (10 cm). Fruit is a boat- shaped, woody follicle.

  7. Diet composition of nestlings and adults of the threatened Bolivian Swallow-tailed Cotinga Phibalura flavirostris boliviana (Aves: Passeriformes: Cotingidae in Bolivia

    Directory of Open Access Journals (Sweden)

    Verónica del Rosario Avalos

    2015-08-01

    Full Text Available The qualitative and quantitative composition of the nestling and adult diet of the threatened Swallow-tailed Cotinga Phibalura flavirostris boliviana was studied through the analysis of fecal samples.  Nestling diet consisted of 62% fruit and 38% insects but varied according to the nestling age. The diet of adults was made up of 89% fruit and 11% insects.  The fruit eaten came primarily from the trees Schefflera morototoni, Hyeronima moritziana and Ocotea cuprea.  Most insects in the fecal samples were winged-species of the orders Hymenoptera and Coleoptera.  This species relied mostly on fruiting trees from semi-humid forest fragments and isolated trees on mountain savannas.  Thus, management plans for this bird should consider the conservation of these habitats. 

  8. Cine-MRI swallowing evaluation after tongue reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Hartl, Dana M. [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)], E-mail: dmhartl@aol.com; Kolb, Frederic; Bretagne, Evelyne [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France); Bidault, Francois; Sigal, Robert [Department of Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)

    2010-01-15

    Objective: To determine the feasibility of cine-MRI for non-invasive swallowing evaluation after surgery for lingual carcinoma with reconstruction using microvascular free flaps. Methods: Ten patients with stage IV carcinoma of the mobile tongue and/or tongue base treated by surgical resection and reconstruction with a free flap were evaluated after an average of 4.3 years (range: 1.5-11 years), using cine-MRI in 'single-shot fast spin echo' (SSFSE) mode. Fiberoptic laryngoscopy of swallowing was performed before MRI to detect aspiration. The tolerance and ability to complete the exam were noted. The mobilities of the oral and pharyngeal structures visualized were evaluated as normal, reduced or increased. Results: Cine-MRI was well tolerated in all cases; 'dry' swallow was performed for the 2 patients with clinical aspiration. Tongue base-pharyngeal wall contact was observed in 5 cases. An increased anterior tongue recoil, increased mandibular recoil, increased posterior oropharyngeal wall advancement and an increased laryngeal elevation were observed in 4 cases. One case of a passive 'slide' mechanism was observed. Conclusions: Cine-MRI is a safe, non-invasive technique for the evaluation of the mobility of oral and oropharyngeal structures after free-flap reconstruction of the tongue. For selected cases, it may be complementary to clinical examination for evaluation of dysphagia after surgery and free-flap reconstruction. Further technical advances will be necessary before cine-MRI can replace videofluoroscopy, however.

  9. Cine-MRI swallowing evaluation after tongue reconstruction

    International Nuclear Information System (INIS)

    Hartl, Dana M.; Kolb, Frederic; Bretagne, Evelyne; Bidault, Francois; Sigal, Robert

    2010-01-01

    Objective: To determine the feasibility of cine-MRI for non-invasive swallowing evaluation after surgery for lingual carcinoma with reconstruction using microvascular free flaps. Methods: Ten patients with stage IV carcinoma of the mobile tongue and/or tongue base treated by surgical resection and reconstruction with a free flap were evaluated after an average of 4.3 years (range: 1.5-11 years), using cine-MRI in 'single-shot fast spin echo' (SSFSE) mode. Fiberoptic laryngoscopy of swallowing was performed before MRI to detect aspiration. The tolerance and ability to complete the exam were noted. The mobilities of the oral and pharyngeal structures visualized were evaluated as normal, reduced or increased. Results: Cine-MRI was well tolerated in all cases; 'dry' swallow was performed for the 2 patients with clinical aspiration. Tongue base-pharyngeal wall contact was observed in 5 cases. An increased anterior tongue recoil, increased mandibular recoil, increased posterior oropharyngeal wall advancement and an increased laryngeal elevation were observed in 4 cases. One case of a passive 'slide' mechanism was observed. Conclusions: Cine-MRI is a safe, non-invasive technique for the evaluation of the mobility of oral and oropharyngeal structures after free-flap reconstruction of the tongue. For selected cases, it may be complementary to clinical examination for evaluation of dysphagia after surgery and free-flap reconstruction. Further technical advances will be necessary before cine-MRI can replace videofluoroscopy, however.

  10. Effect of age on proximal esophageal response to swallowing

    Directory of Open Access Journals (Sweden)

    Roberto Oliveira Dantas

    2010-12-01

    Full Text Available CONTEXT: It has been demonstrated that the ageing process affects esophageal motility. OBJECTIVES: To evaluate the effect of the age on the proximal esophageal response to wet swallows. METHOD: We measured the proximal esophageal response to swallows of a 5 mL bolus of water in 69 healthy volunteers, 20 of them aged 18-30 years (group I, 27 aged 31-50 years (group II, and 22 aged 51-74 years (group III. We used the manometric method with continuous perfusion. The proximal esophageal contractions were recorded 5 cm from a pharyngeal recording site located 1 cm above the upper esophageal sphincter. The time between the onset of the pharyngeal and of the proximal esophageal recording (pharyngeal-esophageal time and the amplitude, duration and area under the curve of the proximal esophageal contraction were measured. RESULTS: The pharyngeal-esophageal time was shorter in group I subjects than in group II and III subjects (P<0.05. The duration of proximal esophageal contractions was longer in group I than in groups II and III (P<0.001. There was no differences between groups in the amplitude or area under the curve of contractions. There were no differences between groups II and III for any of the measurements. CONCLUSION: We conclude that the age may affects the response of the proximal esophagus to wet swallows.

  11. Evaluation of Chewing and Swallowing Sensors for Monitoring Ingestive Behavior.

    Science.gov (United States)

    Fontana, Juan M; Sazonov, Edward S

    2013-03-01

    Monitoring Ingestive Behavior (MIB) of individuals is of special importance to identify and treat eating patterns associated with obesity and eating disorders. Current methods for MIB require subjects reporting every meal consumed, which is burdensome and tend to increase the reporting bias over time. This study presents an evaluation of the burden imposed by two wearable sensors for MIB during unrestricted food intake: a strain sensor to detect chewing events and a throat microphone to detect swallowing sounds. A total of 30 healthy subjects with various levels of adiposity participated in experiments involving the consumption of four meals in four different visits. A questionnaire was handled to subjects at the end of the last visit to evaluate the sensors burden in terms of the comfort levels experienced. Results showed that sensors presented high comfort levels as subjects indicated that the way they ate their meal was not considerably affected by the presence of the sensors. A statistical analysis showed that chewing sensor presented significantly higher comfort levels than the swallowing sensor. The outcomes of this study confirmed the suitability of the chewing and swallowing sensors for MIB and highlighted important aspects of comfort that should be addressed to obtain acceptable and less burdensome wearable sensors for MIB.

  12. Swallowing sound detection using hidden markov modeling of recurrence plot features

    International Nuclear Information System (INIS)

    Aboofazeli, Mohammad; Moussavi, Zahra

    2009-01-01

    Automated detection of swallowing sounds in swallowing and breath sound recordings is of importance for monitoring purposes in which the recording durations are long. This paper presents a novel method for swallowing sound detection using hidden Markov modeling of recurrence plot features. Tracheal sound recordings of 15 healthy and nine dysphagic subjects were studied. The multidimensional state space trajectory of each signal was reconstructed using the Taken method of delays. The sequences of three recurrence plot features of the reconstructed trajectories (which have shown discriminating capability between swallowing and breath sounds) were modeled by three hidden Markov models. The Viterbi algorithm was used for swallowing sound detection. The results were validated manually by inspection of the simultaneously recorded airflow signal and spectrogram of the sounds, and also by auditory means. The experimental results suggested that the performance of the proposed method using hidden Markov modeling of recurrence plot features was superior to the previous swallowing sound detection methods.

  13. Swallowing sound detection using hidden markov modeling of recurrence plot features

    Energy Technology Data Exchange (ETDEWEB)

    Aboofazeli, Mohammad [Faculty of Engineering, Department of Electrical and Computer Engineering, University of Manitoba, Winnipeg, Manitoba, R3T 5V6 (Canada)], E-mail: umaboofa@cc.umanitoba.ca; Moussavi, Zahra [Faculty of Engineering, Department of Electrical and Computer Engineering, University of Manitoba, Winnipeg, Manitoba, R3T 5V6 (Canada)], E-mail: mousavi@ee.umanitoba.ca

    2009-01-30

    Automated detection of swallowing sounds in swallowing and breath sound recordings is of importance for monitoring purposes in which the recording durations are long. This paper presents a novel method for swallowing sound detection using hidden Markov modeling of recurrence plot features. Tracheal sound recordings of 15 healthy and nine dysphagic subjects were studied. The multidimensional state space trajectory of each signal was reconstructed using the Taken method of delays. The sequences of three recurrence plot features of the reconstructed trajectories (which have shown discriminating capability between swallowing and breath sounds) were modeled by three hidden Markov models. The Viterbi algorithm was used for swallowing sound detection. The results were validated manually by inspection of the simultaneously recorded airflow signal and spectrogram of the sounds, and also by auditory means. The experimental results suggested that the performance of the proposed method using hidden Markov modeling of recurrence plot features was superior to the previous swallowing sound detection methods.

  14. Phylogenetic trees

    OpenAIRE

    Baños, Hector; Bushek, Nathaniel; Davidson, Ruth; Gross, Elizabeth; Harris, Pamela E.; Krone, Robert; Long, Colby; Stewart, Allen; Walker, Robert

    2016-01-01

    We introduce the package PhylogeneticTrees for Macaulay2 which allows users to compute phylogenetic invariants for group-based tree models. We provide some background information on phylogenetic algebraic geometry and show how the package PhylogeneticTrees can be used to calculate a generating set for a phylogenetic ideal as well as a lower bound for its dimension. Finally, we show how methods within the package can be used to compute a generating set for the join of any two ideals.

  15. DupTree: a program for large-scale phylogenetic analyses using gene tree parsimony.

    Science.gov (United States)

    Wehe, André; Bansal, Mukul S; Burleigh, J Gordon; Eulenstein, Oliver

    2008-07-01

    DupTree is a new software program for inferring rooted species trees from collections of gene trees using the gene tree parsimony approach. The program implements a novel algorithm that significantly improves upon the run time of standard search heuristics for gene tree parsimony, and enables the first truly genome-scale phylogenetic analyses. In addition, DupTree allows users to examine alternate rootings and to weight the reconciliation costs for gene trees. DupTree is an open source project written in C++. DupTree for Mac OS X, Windows, and Linux along with a sample dataset and an on-line manual are available at http://genome.cs.iastate.edu/CBL/DupTree

  16. Spontaneous swallowing frequency has potential to identify dysphagia in acute stroke.

    Science.gov (United States)

    Crary, Michael A; Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael F

    2013-12-01

    Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. In a cohort of 63 acute stroke cases, swallow frequency rates (swallows per minute [SPM]) were compared with stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with versus without clinically significant dysphagia. Receiver operating characteristic curve analysis was used to identify the optimal threshold in SPM, which was compared with a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was used to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. Receiver operating characteristic curve analysis yielded a threshold of SPM≤0.40 that identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5- to 10-minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel.

  17. Spontaneous Swallowing Frequency [Has Potential to] Identify Dysphagia in Acute Stroke

    Science.gov (United States)

    Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael

    2014-01-01

    Background and Purpose Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. Methods In a cohort of 63 acute stroke cases swallow frequency rates (swallows per minute: SPM) were compared to stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with vs. without clinically significant dysphagia. ROC analysis was used to identify the optimal threshold in SPM which was compared to a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was employed to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. Results SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. ROC analysis yielded a threshold of SPM ≤ 0.40 which identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5 to 10 minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Conclusions Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel. PMID:24149008

  18. Aspiration and swallowing in Parkinson disease and rehabilitation with EMST: a randomized trial.

    Science.gov (United States)

    Troche, M S; Okun, M S; Rosenbek, J C; Musson, N; Fernandez, H H; Rodriguez, R; Romrell, J; Pitts, T; Wheeler-Hegland, K M; Sapienza, C M

    2010-11-23

    Dysphagia is the main cause of aspiration pneumonia and death in Parkinson disease (PD) with no established restorative behavioral treatment to date. Reduced swallow safety may be related to decreased elevation and excursion of the hyolaryngeal complex. Increased submental muscle force generation has been associated with expiratory muscle strength training (EMST) and subsequent increases in hyolaryngeal complex movement provide a strong rationale for its use as a dysphagia treatment. The current study's objective was to test the treatment outcome of a 4-week device-driven EMST program on swallow safety and define the physiologic mechanisms through measures of swallow timing and hyoid displacement. This was a randomized, blinded, sham-controlled EMST trial performed at an academic center. Sixty participants with PD completed EMST, 4 weeks, 5 days per week, for 20 minutes per day, using a calibrated or sham, handheld device. Measures of swallow function including judgments of swallow safety (penetration-aspiration [PA] scale scores), swallow timing, and hyoid movement were made from videofluoroscopic images. No pretreatment group differences existed. The active treatment (EMST) group demonstrated improved swallow safety compared to the sham group as evidenced by improved PA scores. The EMST group demonstrated improvement of hyolaryngeal function during swallowing, findings not evident for the sham group. EMST may be a restorative treatment for dysphagia in those with PD. The mechanism may be explained by improved hyolaryngeal complex movement. This intervention study provides Class I evidence that swallow safety as defined by PA score improved post EMST.

  19. Objective Measures of Swallowing Function Applied to the Dysphagia Population: A One Year Experience.

    Science.gov (United States)

    Kendall, Katherine A; Ellerston, Julia; Heller, Amanda; Houtz, Daniel R; Zhang, Chong; Presson, Angela P

    2016-08-01

    Quantitative, reliable measures of swallowing physiology can be made from an modified barium swallowing study. These quantitative measures have not been previously employed to study large dysphagic patient populations. The present retrospective study of 139 consecutive patients with dysphagia seen in a university tertiary voice and swallowing clinic sought to use objective measures of swallowing physiology to (1) quantify the most prevalent deficits seen in the patient population, (2) identify commonly associated diagnoses and describe the most prevalent swallowing deficits, and (3) determine any correlation between objective deficits and Eating Assessment Tool (EAT-10) scores and body mass index. Poor pharyngeal constriction (34.5 %) and airway protection deficits (65.5 %) were the most common swallowing abnormalities. Reflux-related dysphagia (36 %), nonspecific pharyngeal dysphagia (24 %), Parkinson disease (16 %), esophageal abnormality (13 %), and brain insult (10 %) were the most common diagnoses. Poor pharyngeal constriction was significantly associated with an esophageal motility abnormality (p dysphagia symptoms as determined by the EAT-10 did not correlate with swallowing function abnormalities. This preliminary study indicates that reflux disease is common in patients with dysphagia and that associated esophageal abnormalities are common in dysphagic populations and may be associated with specific pharyngeal swallowing abnormalities. However, symptom scores from the EAT-10 did not correspond to swallowing pathophysiology.

  20. The relationship between limit of Dysphagia and average volume per swallow in patients with Parkinson's disease.

    Science.gov (United States)

    Belo, Luciana Rodrigues; Gomes, Nathália Angelina Costa; Coriolano, Maria das Graças Wanderley de Sales; de Souza, Elizabete Santos; Moura, Danielle Albuquerque Alves; Asano, Amdore Guescel; Lins, Otávio Gomes

    2014-08-01

    The goal of this study was to obtain the limit of dysphagia and the average volume per swallow in patients with mild to moderate Parkinson's disease (PD) but without swallowing complaints and in normal subjects, and to investigate the relationship between them. We hypothesize there is a direct relationship between these two measurements. The study included 10 patients with idiopathic PD and 10 age-matched normal controls. Surface electromyography was recorded over the suprahyoid muscle group. The limit of dysphagia was obtained by offering increasing volumes of water until piecemeal deglutition occurred. The average volume per swallow was calculated by dividing the time taken by the number of swallows used to drink 100 ml of water. The PD group showed a significantly lower dysphagia limit and lower average volume per swallow. There was a significantly moderate direct correlation and association between the two measurements. About half of the PD patients had an abnormally low dysphagia limit and average volume per swallow, although none had spontaneously related swallowing problems. Both measurements may be used as a quick objective screening test for the early identification of swallowing alterations that may lead to dysphagia in PD patients, but the determination of the average volume per swallow is much quicker and simpler.

  1. Children with central and peripheral neurologic disorders have distinguishable patterns of dysphagia on videofluoroscopic swallow study.

    Science.gov (United States)

    van den Engel-Hoek, Lenie; Erasmus, Corrie E; van Hulst, Karen C M; Arvedson, Joan C; de Groot, Imelda J M; de Swart, Bert J M

    2014-05-01

    To determine whether findings on videofluoroscopic swallow studies reveal different patterns of dysphagia between children with central and peripheral neurologic disorders, a retrospective study of 118 videofluoroscopic swallow studies was completed. There were 3 groups: cerebral palsy with only spastic features (n = 53), cerebral palsy with dyskinetic features (n = 34), and neuromuscular disorders (myotonic dystrophy I, n = 5; spinal muscular atrophy I-II, n = 8; Duchenne muscular dystrophy, n = 8; other neuromuscular disorder, n = 10). Interpretation of the videofluoroscopic swallow studies was not blinded. The video fluoroscopic swallow study findings were compared dichotomously between the groups. Children with cerebral palsy demonstrated dysphagia in 1 or all phases of swallowing. In neuromuscular disorder, muscle weakness results in pharyngeal residue after swallow. The underlying swallowing problem in neuromuscular disorder is muscle weakness whereas that in cerebral palsy is more complex, having to do with abnormal control of swallowing. This study serves as a first exploration on specific characteristics of swallowing in different neurologic conditions and will help clinicians anticipate what they might expect.

  2. Computational Analysis of Pharyngeal Swallowing Mechanics in Patients with Motor Neuron Disease: A Pilot Investigation.

    Science.gov (United States)

    Garand, K L; Schwertner, Ryan; Chen, Amy; Pearson, William G

    2018-04-01

    Swallowing impairment (dysphagia) is a common sequela in patients with motor neuron disease (MND). The purpose of this retrospective, observational pilot investigation was to characterize how pharyngeal swallowing mechanics are impacted in patients with MND using a comparison with healthy, non-dysphagic control group. Computational analysis of swallowing mechanics (CASM) was used to determine covariate biomechanics of pharyngeal swallowing from videofluoroscopic assessment in 15 patients with MND and 15 age- and sex-matched healthy controls. Canonical variant analysis with post hoc discriminate function analysis (DFA) was performed on coordinate data mapping functional muscle groups underlying pharyngeal swallowing. Differences in swallowing mechanics associated with group (MND; control), motor neuron predominance (upper; lower), onset (bulbar; spinal), and swallow task (thin, pudding) were evaluated and visualized. Pharyngeal swallowing mechanics differed significantly in patients with MND compared with healthy controls (D = 2.01, p mechanics by motor neuron predominance (D = 5.03, p mechanics of patients with MND differ from and are more heterogeneous than healthy controls. These findings suggest patients with MND may compensate reductions in pharyngeal shortening and tongue base retraction by extending the head and neck and increasing hyolaryngeal excursion. This work and further CASM investigations will lead to further insights into development and evaluation of targeted clinical treatments designed to prolong safe and efficient swallowing function in patients with MND.

  3. Central inhibition of initiation of swallowing by systemic administration of diazepam and baclofen in anaesthetized rats.

    Science.gov (United States)

    Tsujimura, Takanori; Sakai, Shogo; Suzuki, Taku; Ujihara, Izumi; Tsuji, Kojun; Magara, Jin; Canning, Brendan J; Inoue, Makoto

    2017-05-01

    Dysphagia is caused not only by neurological and/or structural damage but also by medication. We hypothesized memantine, dextromethorphan, diazepam, and baclofen, all commonly used drugs with central sites of action, may regulate swallowing function. Swallows were evoked by upper airway (UA)/pharyngeal distension, punctate mechanical stimulation using a von Frey filament, capsaicin or distilled water (DW) applied topically to the vocal folds, and electrical stimulation of a superior laryngeal nerve (SLN) in anesthetized rats and were documented by recording electromyographic activation of the suprahyoid and thyrohyoid muscles and by visualizing laryngeal elevation. The effects of intraperitoneal or topical administration of each drug on swallowing function were studied. Systemic administration of diazepam and baclofen, but not memantine or dextromethorphan, inhibited swallowing evoked by mechanical, chemical, and electrical stimulation. Both benzodiazepines and GABA A receptor antagonists diminished the inhibitory effects of diazepam, whereas a GABA B receptor antagonist diminished the effects of baclofen. Topically applied diazepam or baclofen had no effect on swallowing. These data indicate that diazepam and baclofen act centrally to inhibit swallowing in anesthetized rats. NEW & NOTEWORTHY Systemic administration of diazepam and baclofen, but not memantine or dextromethorphan, inhibited swallowing evoked by mechanical, chemical, and electrical stimulation. Both benzodiazepines and GABA A receptor antagonists diminished the inhibitory effects of diazepam, whereas a GABA B receptor antagonist diminished the effects of baclofen. Topical applied diazepam or baclofen was without effect on swallowing. Diazepam and baclofen act centrally to inhibit swallowing in anesthetized rats. Copyright © 2017 the American Physiological Society.

  4. Feeding and Swallowing Disorders in Pediatric Neuromuscular Diseases: An Overview.

    Science.gov (United States)

    van den Engel-Hoek, Lenie; de Groot, Imelda J M; de Swart, Bert J M; Erasmus, Corrie E

    2015-11-20

    Feeding and swallowing problems in infants and children have a great impact on health and wellbeing. The aim of this study was to provide an overview of recognized feeding and swallowing problems in different groups of children with neuromuscular diseases, based on relevant literature and expert opinion, and to propose recommendations for the assessment and treatment of these problems. Almost all pediatric neuromuscular diseases are accompanied by feeding and swallowing problems during the different phases of deglutition, problems that give rise to a wide variety of signs and symptoms, which emphasizes the importance of a comprehensive feeding and swallowing assessment by a speech and language therapist.

  5. Coordination of cough and swallow: a meta-behavioral response to aspiration.

    Science.gov (United States)

    Pitts, Teresa; Rose, Melanie J; Mortensen, Ashley N; Poliacek, Ivan; Sapienza, Christine M; Lindsey, Bruce G; Morris, Kendall F; Davenport, Paul W; Bolser, Donald C

    2013-12-01

    Airway protections is the prevention and/or removal of material by behaviors such as cough and swallow. We hypothesized these behaviors are coordinated to respond to aspiration. Anesthetized animals were challenged with simulated aspiration that induced both coughing and swallowing. Electromyograms of upper airway and respiratory muscles together with esophageal pressure were recorded to identify and evaluate cough and swallow. During simulated aspiration, both cough and swallow intensity increased and swallow duration decreased consistent with rapid pharyngeal clearance. Phase restriction between cough and swallow was observed; swallow was restricted to the E2 phase of cough. These results support three main conclusions: 1) the cough and swallow pattern generators are tightly coordinated so as to generate a protective meta-behavior; 2) the trachea provides feedback on swallow quality, informing the brainstem about aspiration incidences; and 3) the larynx and upper esophageal sphincter act as two separate valves controlling the direction of positive and negative pressures from the upper airway into the thorax. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Self-perception of swallowing by patients with benign nonsurgical thyroid disease.

    Science.gov (United States)

    Pernambuco, Leandro; Silva, Marlisson Pinheiro da; Almeida, Marluce Nascimento de; Costa, Erika Beatriz de Morais; Souza, Lourdes Bernadete Rocha de

    2017-02-23

    To verify the frequency of swallowing complaints in patients with benign nonsurgical thyroid disease and compare the self-perception of swallowing disorder intensity between different types of thyroid disease. The study sample comprised 39 women aged 19-58 years (38.54 ± 10.74) with hypothyroidism (n=22; 56.4%) or thyroid nodules (n=17; 43.6%). Presence and type of swallowing complaint and self-perception of swallowing disorder intensity were investigated by means of self-ratings recorded on a 100-millimeter visual analog scale. The data were analyzed by descriptive measures and the Mann-Whitney nonparametric test was used to compare the self-perception of swallowing disorder intensity between both clinical diagnoses of thyroid disease. The level of 5% was adopted for statistical significance. Twenty-six (66.7%) individuals reported the following swallowing complaints: pharyngolaryngeal stasis sensation (37.15%), chocking (34.29%), and odynophagia (28.57%). The mean value of self-perception of swallowing disorder intensity by the visual analog scale was 59.35 (± 27.38) millimeters. No difference in self-perception was reported between the clinical diagnoses of thyroid disease. In this sample, swallowing complaint was frequently observed in patients with benign nonsurgical thyroid disease. Moderate self-perception of swallowing disorder intensity was reported regardless of the clinical diagnosis of thyroid disease.

  7. Electron Tree

    DEFF Research Database (Denmark)

    Appelt, Ane L; Rønde, Heidi S

    2013-01-01

    The photo shows a close-up of a Lichtenberg figure – popularly called an “electron tree” – produced in a cylinder of polymethyl methacrylate (PMMA). Electron trees are created by irradiating a suitable insulating material, in this case PMMA, with an intense high energy electron beam. Upon discharge......, during dielectric breakdown in the material, the electrons generate branching chains of fractures on leaving the PMMA, producing the tree pattern seen. To be able to create electron trees with a clinical linear accelerator, one needs to access the primary electron beam used for photon treatments. We...... appropriated a linac that was being decommissioned in our department and dismantled the head to circumvent the target and ion chambers. This is one of 24 electron trees produced before we had to stop the fun and allow the rest of the accelerator to be disassembled....

  8. Flowering Trees

    Indian Academy of Sciences (India)

    Srimath

    shaped corolla. Fruit is large, ellipsoidal, green with a hard and smooth shell containing numerous flattened seeds, which are embedded in fleshy pulp. Calabash tree is commonly grown in the tropical gardens of the world as a botanical oddity.

  9. A comparative analysis of DBSCAN, K-means, and quadratic variation algorithms for automatic identification of swallows from swallowing accelerometry signals.

    Science.gov (United States)

    Dudik, Joshua M; Kurosu, Atsuko; Coyle, James L; Sejdić, Ervin

    2015-04-01

    Cervical auscultation with high resolution sensors is currently under consideration as a method of automatically screening for specific swallowing abnormalities. To be clinically useful without human involvement, any devices based on cervical auscultation should be able to detect specified swallowing events in an automatic manner. In this paper, we comparatively analyze the density-based spatial clustering of applications with noise algorithm (DBSCAN), a k-means based algorithm, and an algorithm based on quadratic variation as methods of differentiating periods of swallowing activity from periods of time without swallows. These algorithms utilized swallowing vibration data exclusively and compared the results to a gold standard measure of swallowing duration. Data was collected from 23 subjects that were actively suffering from swallowing difficulties. Comparing the performance of the DBSCAN algorithm with a proven segmentation algorithm that utilizes k-means clustering demonstrated that the DBSCAN algorithm had a higher sensitivity and correctly segmented more swallows. Comparing its performance with a threshold-based algorithm that utilized the quadratic variation of the signal showed that the DBSCAN algorithm offered no direct increase in performance. However, it offered several other benefits including a faster run time and more consistent performance between patients. All algorithms showed noticeable differentiation from the endpoints provided by a videofluoroscopy examination as well as reduced sensitivity. In summary, we showed that the DBSCAN algorithm is a viable method for detecting the occurrence of a swallowing event using cervical auscultation signals, but significant work must be done to improve its performance before it can be implemented in an unsupervised manner. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Unilateral Superior Laryngeal Nerve Lesion in an Animal Model of Dysphagia and Its Effect on Sucking and Swallowing

    Science.gov (United States)

    Campbell-Malone, Regina; Holman, Shaina D.; Lukasik, Stacey L.; Fukuhara, Takako; Gierbolini-Norat, Estela M.; Thexton, Allan J.; German, Rebecca Z.

    2013-01-01

    We tested two hypotheses relating to the sensory deficit that follows a unilateral superior laryngeal nerve (SLN) lesion in an infant animal model. We hypothesized that it would result in (1) a higher incidence of aspiration and (2) temporal changes in sucking and swallowing. We ligated the right-side SLN in six 2–3-week-old female pigs. Using videofluoroscopy, we recorded swallows in the same pre- and post-lesion infant pigs. We analyzed the incidence of aspiration and the duration and latency of suck and swallow cycles. After unilateral SLN lesioning, the incidence of silent aspiration during swallowing increased from 0.7 to 41.5 %. The durations of the suck containing the swallow, the suck immediately following the swallow, and the swallow itself were significantly longer in the post-lesion swallows, although the suck prior to the swallow was not different. The interval between the start of the suck containing a swallow and the subsequent epiglottal movement was longer in the post-lesion swallows. The number of sucks between swallows was significantly greater in post-lesion swallows compared to pre-lesion swallows. Unilateral SLN lesion increased the incidence of aspiration and changed the temporal relationships between sucking and swallowing. The longer transit time and the temporal coordinative dysfunction between suck and swallow cycles may contribute to aspiration. These results suggest that swallow dysfunction and silent aspiration are common and potentially overlooked sequelae of unilateral SLN injury. This validated animal model of aspiration has the potential for further dysphagia studies. PMID:23417250

  11. Clinical investigation on application of water swallowing to MR esophagography

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jinping, E-mail: zjpmri@163.com [Department of Radiology, Tongling People' s Hospital, Bijiashan Road 468, Tongling 244000, Anhui (China); Hu, Weijian; Zang, Lin [Department of Cardiothoracic Surgery, Tongling People' s Hospital, Bijiashan Road 468, Tongling 244000, Anhui (China); Yao, Yibin; Tang, Yongxiang; Qian, Zhen; Gao, Ping; Wu, Xiaoyan; Li, Shijian [Department of Radiology, Tongling People' s Hospital, Bijiashan Road 468, Tongling 244000, Anhui (China); Xie, Zhenlan; Yuan, Xiaoqing [Department of Pathology, Tongling People' s Hospital, Bijiashan Road 468, Tongling 244000, Anhui (China)

    2012-09-15

    Objective: To verify the clinical outcomes of applying water swallowing to MR esophagography. Methods: Thirty patients confirmed postoperatively or histopathologically with thoracic esophageal carcinoma by endoscopic biopsy and 10 healthy volunteers with normal esophagus underwent respectively conventional magnetic resonance imaging (MRI) detection and water swallowing MR esophagography. Of those patients, 4 underwent second examination after radiotherapy. Assessment on imaging effects of MR esophagography was performed. Assessment on definition on MR esophagography of the tumor in both upper and lower ends, specific localization, tumor size finally measured, coincidence with the gross pathologic types and tumor staging were respectively performed by comparison with conventional MRI. Additionally, we evaluated the outcomes of radiotherapy by comparing the previous MR esophagography with the second one with interventional technique. Results: Of the total 44 images of MR esophagography, 97.7% (43/44) were in high resolution by sagittal view and 81.8% (36/44) by cross-section. 93.3% (56/60) of the MR esophagography were clearly defined with the neoplastic lesion ends in the 30 patients with thoracic esophageal carcinoma, compared with 11.7% (7/60) by conventional MRI. The results were totally different in statistics (P < 0.005). Preoperative conventional MRI detection of the 22 cases in 25 undergone radical resection suggested vague diameter of the primary tumor and impossibly identified it at middle-lower thoracic esophagus in 5, and even failed to confirm gross pathologic types in 19 cases. Yet, MR esophagography with water swallowing represented accurate tumor length (graded as excellent) in 88% (22/25), localization in 100% (25/25), exact gross pathologic types in 88% (22/25), and accuracy for tumor staging in 80.8% (21/26) compared to 92.3% (24/26) by conventional MRI. Therapeutic effects achieved in 4 patients with radiotherapy. Conclusions: MR esophagography

  12. Dose-dependent deterioration of swallowing function after induction chemotherapy and definitive chemoradiotherapy for laryngopharyngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Haderlein, M.; Semrau, S.; Ott, O.; Speer, S.; Fietkau, R. [University Hospital Erlangen, Department of Radiation Oncology, Erlangen (Germany); Bohr, C. [University Hospital Erlangen, Department of Otorhinolaryngology, Head and Neck Surgery, Erlangen (Germany)

    2014-02-15

    To evaluate the influence of clinical, treatment- and dose-dependent factors on posttreatment swallowing function after induction chemotherapy and definitive chemoradiotherapy in a group of homogeneously treated laryngopharyngeal cancer patients. From 28 May 2008 to 15 February 2013, 45 patients with borderline inoperable laryngopharyngeal cancer that had responded well to induction chemotherapy were treated with definitive chemoradiotherapy. Median follow-up was 22 months. Swallowing function and clinical data were prospectively analyzed using the EORTC QLQ-C30 questionnaire. Swallowing structures were retrospectively delineated on the original treatment planning CT. Dose-volume histograms were calculated for swallowing structures and D{sub mean}, D{sub max} and V50-V64 values (in 2 Gy increments) were determined for each patient. Tumor volume and infiltration of the swallowing apparatus was defined by CT before induction chemotherapy. Of the 45 patients, 26 (57.8 %) fully regained swallowing function after chemoradiotherapy. A further 12 patients (26.7 %) were able to manage soft, pureed and/or liquid foods; the remaining 7 (15.6 %) were completely dependent on percutaneous endoscopic gastrostomy (PEG). Posttreatment swallowing function was significantly influenced by D{sub mean} to the superior pharyngeal constrictor muscle (PCM, p = 0.041). Correlations between late dysphagia and dose-volume relationships in the superior PCM and soft palate were also observed, which were significant from V60 (p = 0.043) and V58 for the soft palate and superior PCM, respectively. Of the evaluated clinical and tumor-related factors, only alcohol abuse (p = 0.024) had an influence on posttreatment swallowing function. Almost 50 % of patients had deterioration of swallowing function after definitive chemoradiotherapy for laryngopharyngeal cancer. The dose to anatomical structures responsible for swallowing function appears to play a role. Therefore, in selected patients, target

  13. Voice- and swallow-related quality of life in idiopathic Parkinson's disease.

    Science.gov (United States)

    van Hooren, Michel R A; Baijens, Laura W J; Vos, Rein; Pilz, Walmari; Kuijpers, Laura M F; Kremer, Bernd; Michou, Emilia

    2016-02-01

    This study explores whether changes in voice- and swallow-related QoL are associated with progression of idiopathic Parkinson's disease (IPD). Furthermore, it examines the relationship between patients' perception of both voice and swallowing disorders in IPD. Prospective clinical study, quality of life (QoL). One-hundred mentally competent IPD patients with voice and swallowing complaints were asked to answer four QoL questionnaires (Voice Handicap Index, MD Anderson Dysphagia Inventory, Visual Analog Scale [VAS] voice, and Dysphagia Severity Scale [DSS]). Differences in means for the QoL questionnaires and their subscales within Hoehn and Yahr stage groups were calculated using one-way analysis of variance. The relationship between voice- and swallow-related QoL questionnaires was determined with the Spearman correlation coefficient. Scores on both voice and swallow questionnaires suggest an overall decrease in QoL with progression of IPD. A plateau in QoL for VAS voice and the DSS was seen in the early Hoehn and Yahr stages. Finally, scores on voice-related QoL questionnaires were significantly correlated with swallow-related QoL outcomes. Voice- and swallow-related QoL decreases with progression of IPD. A significant association was found between voice- and swallow-related QoL questionnaires. Healthcare professionals can benefit from voice- and swallow-related QoL questionnaires in a multidimensional voice- or swallow-assessment protocol. The patient's perception of his/her voice and swallowing disorders and its impact on QoL in IPD should not be disregarded. 2b. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Effect of transcranial direct current stimulation on swallowing apraxia and cortical excitability in stroke patients.

    Science.gov (United States)

    Yuan, Ying; Wang, Jie; Wu, Dongyu; Huang, Xiaobo; Song, Weiqun

    2017-10-01

    Swallowing apraxia is characterized by impaired volitional swallowing but relatively preserved reflexive swallowing. Few studies are available on the effectiveness of behavioral therapy and management of the condition. This study aimed to investigate the effect of transcranial direct current stimulation (tDCS) on swallowing apraxia and cortical activation in stroke patients. The study included three inpatients (age 48-70 years; 1 male, 2 females; duration of stroke, 35-55 d) with post-stroke swallowing apraxia and six age-matched healthy subjects (age 45-65 years; 3 males, 3 females). Treatments were divided into two phases: Phase A and Phase B. During Phase A, the inpatients received three weeks of sham tDCS and conventional treatments. During Phase B, these patients received three weeks of anodal tDCS over the bilateral primary sensorimotor cortex (S 1 M 1 ) of swallowing and conventional treatments. Swallowing apraxia assessments were measured in three inpatients before Phase A, before Phase B, and after Phase B. The electroencephalography (EEG) nonlinear index of approximate entropy (ApEn) was calculated for three patients and six healthy subjects. After tDCS, scores of swallowing apraxia assessments increased, and ApEn indices increased in both stimulated and non-stimulated areas. Anodal tDCS might provide a useful means for recovering swallowing apraxia, and the recovery could be related to increased excitability of the swallowing cortex. Further investigations should explore the relationship between lesion size and/or lesion site and the prognosis of swallowing apraxia. Clinical trial registry: http://www.chictr.org Registration Number: ChiCTR-TRC-14004955.

  15. The anatomy and physiology of normal and abnormal swallowing in oropharyngeal dysphagia.

    Science.gov (United States)

    Sasegbon, A; Hamdy, S

    2017-11-01

    Eating and drinking are enjoyable activities that positively impact on an individual's quality of life. The ability to swallow food and fluid is integral to the process of eating. Swallowing occupies a dual role being both part of the enjoyment of eating and being a critically important utilitarian activity to enable adequate nutrition and hydration. Any impairment to the process of swallowing can negatively affect a person's perception of their quality of life. The process of swallowing is highly complex and involves muscles in the mouth, pharynx, larynx, and esophagus. The oropharynx is the anatomical region encompassing the oral cavity and the pharynx. Food must be masticated, formed into a bolus and transported to the pharynx by the tongue whereas fluids are usually held within the mouth before being transported ab-orally. The bolus must then be transported through the pharynx to the esophagus without any matter entering the larynx. The muscles needed for all these steps are coordinated by swallowing centers within the brainstem which are supplied with sensory information by afferent nerve fibers from several cranial nerves. The swallowing centers also receive modulatory input from higher centers within the brain. Hence, a swallow has both voluntary and involuntary physiologic components and the term dysphagia is given to difficult swallowing while oropharyngeal dysphagia is difficult swallowing due to pathology within the oropharynx. Problems affecting any point along the complex swallowing pathway can result in dysphagia. This review focuses on the anatomy and physiology behind normal and abnormal oropharyngeal swallowing. It also details the common diseases and pathology causing oropharyngeal dysphagia. © 2017 John Wiley & Sons Ltd.

  16. Dose-dependent deterioration of swallowing function after induction chemotherapy and definitive chemoradiotherapy for laryngopharyngeal cancer

    International Nuclear Information System (INIS)

    Haderlein, M.; Semrau, S.; Ott, O.; Speer, S.; Fietkau, R.; Bohr, C.

    2014-01-01

    To evaluate the influence of clinical, treatment- and dose-dependent factors on posttreatment swallowing function after induction chemotherapy and definitive chemoradiotherapy in a group of homogeneously treated laryngopharyngeal cancer patients. From 28 May 2008 to 15 February 2013, 45 patients with borderline inoperable laryngopharyngeal cancer that had responded well to induction chemotherapy were treated with definitive chemoradiotherapy. Median follow-up was 22 months. Swallowing function and clinical data were prospectively analyzed using the EORTC QLQ-C30 questionnaire. Swallowing structures were retrospectively delineated on the original treatment planning CT. Dose-volume histograms were calculated for swallowing structures and D mean , D max and V50-V64 values (in 2 Gy increments) were determined for each patient. Tumor volume and infiltration of the swallowing apparatus was defined by CT before induction chemotherapy. Of the 45 patients, 26 (57.8 %) fully regained swallowing function after chemoradiotherapy. A further 12 patients (26.7 %) were able to manage soft, pureed and/or liquid foods; the remaining 7 (15.6 %) were completely dependent on percutaneous endoscopic gastrostomy (PEG). Posttreatment swallowing function was significantly influenced by D mean to the superior pharyngeal constrictor muscle (PCM, p = 0.041). Correlations between late dysphagia and dose-volume relationships in the superior PCM and soft palate were also observed, which were significant from V60 (p = 0.043) and V58 for the soft palate and superior PCM, respectively. Of the evaluated clinical and tumor-related factors, only alcohol abuse (p = 0.024) had an influence on posttreatment swallowing function. Almost 50 % of patients had deterioration of swallowing function after definitive chemoradiotherapy for laryngopharyngeal cancer. The dose to anatomical structures responsible for swallowing function appears to play a role. Therefore, in selected patients, target volume

  17. Association between swallow perception and esophageal bolus clearance in patients with globus sensation.

    Science.gov (United States)

    Chen, Chien-Lin; Yi, Chih-Hsun; Liu, Tso-Tsai

    2013-04-01

    Globus sensation is common, but its pathogenesis is not yet clear. Our purpose was to investigate subjective perception of swallowing and esophageal motility by combined multichannel intraluminal impedance and manometry (MII-EM) for patients with globus sensation. Combined MII-EM was performed for 25 globus patients and 15 healthy controls. Swallows were abnormal if hypocontractivity or simultaneous contractions occurred. Esophageal bolus transit was incomplete if bolus exit was not found at one or more of all measurement sites. Perception of each swallow was assessed by use of a standardized scoring system, and was enhanced if the score was >1. Few globus patients reported enhanced perception during viscous or solid swallows. Incomplete bolus transit and enhanced perception occurred similarly between viscous and solid boluses. Agreement between enhanced perception and proximal bolus clearance was greater during solid swallows (κ = 0.45, 95 % CI: 0.32-0.58) than during viscous swallows (κ = 0.13, 95 % CI: 0-0.25) (P perception and total bolus clearance was greater during solid swallows (κ = 0.46, 95 % CI: 0.34-0.58) than during viscous swallows (κ = 0.11, 95 % CI: 0-0.22) (P perception is uncommon in patients with globus sensation, although there is a significant association between enhanced esophageal perception and solid bolus clearance. Application of a solid bolus may help better delineation of the interrelationship between the subjective perception of bolus passage and the objective measurement of bolus clearance.

  18. Demography of invasive black and pale swallow-wort populations in New York

    Science.gov (United States)

    Vincetoxicum nigrum (Black Swallow-wort) and Vincetoxicum rossicum (Pale Swallow-wort) are perennial twining vines introduced from Europe. Both species have become invasive in northeastern North America in a variety of habitats. To develop parameters for a population model for evaluating potential b...

  19. Gum chewing improves swallow frequency and latency in Parkinson patients: a preliminary study.

    Science.gov (United States)

    South, Angela R; Somers, Stephanie M; Jog, Mandar S

    2010-04-13

    Reduced swallowing frequency affects secretion management in Parkinson disease (PD). Gum chewing increases saliva flow and swallow frequency. This study uses chewing gum to modify swallow frequency and latency between swallows in patients with PD. 1) Assess the frequency and latency of swallow at baseline (BL), during gum chewing (GC), and post gum chewing (PGC) for participants with PD (stage 2-4) nonsymptomatic for prandial dysphagia; and 2) assess carryover after gum is expectorated. Twenty participants were studied across 3 tasks, each of 5 minutes in duration: BL, GC, and PGC. Respiratory and laryngeal signals were continuously recorded using PowerLab (version 5.5.5; ADI Instruments, Castle Hill, Australia). Frequency and latency of swallow events were calculated. Differences (analysis of variance) are reported for frequency (p Parkinson disease. This study provides Class III evidence that chewing gum increases swallow frequency and decreases latency of swallowing in an experiment in patients with stage 2 to 4 Parkinson disease who are nonsymptomatic for significant prandial dysphagia.

  20. The Test of Masticating and Swallowing Solids (TOMASS): Reliability, Validity and International Normative Data

    Science.gov (United States)

    Huckabee, Maggie-Lee; McIntosh, Theresa; Fuller, Laura; Curry, Morgan; Thomas, Paige; Walshe, Margaret; McCague, Ellen; Battel, Irene; Nogueira, Dalia; Frank, Ulrike; van den Engel-Hoek, Lenie; Sella-Weiss, Oshrat

    2018-01-01

    Background: Clinical swallowing assessment is largely limited to qualitative assessment of behavioural observations. There are limited quantitative data that can be compared with a healthy population for identification of impairment. The Test of Masticating and Swallowing Solids (TOMASS) was developed as a quantitative assessment of solid bolus…

  1. Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation

    Science.gov (United States)

    Clark, Heather; Lazarus, Cathy; Arvedson, Joan; Schooling, Tracy; Frymark, Tobi

    2009-01-01

    Purpose: To systematically review the literature examining the effects of neuromuscular electrical stimulation (NMES) on swallowing and neural activation. The review was conducted as part of a series examining the effects of oral motor exercises (OMEs) on speech, swallowing, and neural activation. Method: A systematic search was conducted to…

  2. Bilateral Killian-Jamieson diverticula demonstrated by videofluoroscopic swallowing study: case report

    Directory of Open Access Journals (Sweden)

    Betina Scheeren

    2013-06-01

    Full Text Available The authors report the case of a 56-year-old male patient complaining of dysphagia for solids and food impaction, submitted to videofluoroscopic swallowing study that demonstrated the presence of two esophageal diverticula. The videofluoroscopic swallowing study was critical in the identification and diagnosis of the diverticula, an esophageal cause of dysphagia.

  3. Tongue Pressure Modulation during Swallowing: Water versus Nectar-Thick Liquids

    Science.gov (United States)

    Steele, Catriona M.; Bailey, Gemma L.; Molfenter, Sonja M.

    2010-01-01

    Purpose: Evidence of tongue-palate pressure modulation during swallowing between thin and nectar-thick liquids stimuli has been equivocal. This mirrors a lack of clear evidence in the literature of tongue and hyoid movement modulation between nectar-thick and thin liquid swallows. In the current investigation, the authors sought to confirm whether…

  4. Relationships between air swallowing, intragastric air, belching and gastro-oesophageal reflux

    NARCIS (Netherlands)

    Bredenoord, AJ; Weusten, BLAM; Timmer, R; Akkermans, LMA; Smout, AJPM

    Background: With each swallow a certain amount of air is transported to the stomach. The stomach protects itself against excessive distention by swallowed air through belching (gas reflux). The mechanism of belching (transient lower oesophageal sphincter relaxation) is also one of the mechanisms

  5. Relationships between air swallowing, intragastric air, belching and gastro-oesophageal reflux

    NARCIS (Netherlands)

    Bredenoord, A. J.; Weusten, B. L. A. M.; Timmer, R.; Akkermans, L. M. A.; Smout, A. J. P. M.

    2005-01-01

    BACKGROUND: With each swallow a certain amount of air is transported to the stomach. The stomach protects itself against excessive distention by swallowed air through belching (gas reflux). The mechanism of belching (transient lower oesophageal sphincter relaxation) is also one of the mechanisms

  6. Fiberoptic endoscopic evaluation of swallowing (FEES): proposal for informed consent.

    Science.gov (United States)

    Nacci, A; Ursino, F; La Vela, R; Matteucci, F; Mallardi, V; Fattori, B

    2008-08-01

    Fiberoptic endoscopic evaluation of swallowing (FEES) is now a first choice method for studying swallowing disorders on account of the various advantages it offers: easy to use, very well tolerated, allows bedside examination and is economic. Nevertheless, this diagnostic procedure is not without risks, the most probable consequences of which include discomfort, gagging and/or vomiting, vasovagal syncope, epistaxis, mucosal perforation, adverse reactions to topical anaesthetics and laryngospasm. The risks involved with FEES stress the importance of informing the patient of these; this is an important aspect in medicine that necessarily and immediately implies receiving the patient's so-called "informed consent". Informed consent should be obtained not only by means of specific printed forms but also after the patient has had an interview with the physician who will be performing the procedure and who will offer information according to the personal clinical, psychological, cultural and linguistic situation of the patient and in keeping with the type of procedure proposed. In the case of FEES, as with other invasive or non-invasive diagnostic procedures, therefore, routine written and signed consent, together with a patient/physician interview should fulfil what is known as "complete information". In this report, a specific form for informed consent to FEES procedures, is proposed.

  7. A Mathematical Model for Swallowing of Concentrated Fluids in Oesophagus

    Directory of Open Access Journals (Sweden)

    S. K. Pandey

    2011-01-01

    Full Text Available This model investigates particularly the impact of an integral and a non-integral number of waves on the swallowing of food stuff such as jelly, tomato puree, soup, concentrated fruits juices and honey transported peristaltically through the oesophagus. The fluid is considered as a Casson fluid. Emphasis is on the study of the dependence of local pressure distribution on space and time. Mechanical efficiency, reflux limit and trapping are also discussed. The effect of Casson fluid vis-à-vis Newtonian fluid is investigated analytically and numerically too. The result is physically interpreted as that the oesophagus makes more efforts to swallow fluids with higher concentration. It is observed that the pressure is uniformly distributed when an integral number of waves is there in the oesophagus; but it is non-uniform when a non-integral number of waves is present therein. It is further observed that as the plug flow region widens, the pressure difference increases, which indicates that the averaged flow rate will reduce for a Casson fluid. It is also concluded that Casson fluids are more prone to reflux.

  8. Post-operative swallowing in multiple system atrophy.

    Science.gov (United States)

    Ueha, R; Nito, T; Sakamoto, T; Yamauchi, A; Tsunoda, K; Yamasoba, T

    2016-02-01

    Some patients with multiple system atrophy (MSA) require surgical interventions such as tracheostomy and aspiration prevention. Few studies have investigated the postoperative clinical course of MSA patients. The aim of this study was to determine a management strategy for dysphagia and respiratory disorder in MSA. From 2001 to 2014, 18 MSA patients (13 males and 5 females, 52-76 years) underwent tracheostomy (TR, n = 11) or laryngeal closure (LC, n = 12). Five patients underwent LC following TR. Vocal fold impairment, the degree of dysphagia and pre/post-operative oral ingestion, and postoperative survival time were evaluated retrospectively. Swallowing function was assessed using the penetration aspiration scale (PAS). TR was performed due to respiratory disorder in seven patients and due to dysphagia in four patients. PAS scores ranged 1-8 in TR patients and 7-8 in LC patients. Seven of 11 patients who underwent TR displayed worsened PAS scores, and no patients displayed improved PAS scores following TR. All patients who underwent LC regained complete or partial oral intake after surgery. There were no significant differences in postoperative survival time between the two groups. Considering the impacts of TR and LC on survival time, postoperative feeding and swallowing, LC is a good option for treating MSA patients with dysphagia. © 2015 EAN.

  9. Intrarater and interrater reliability for measurements in videofluoroscopy of swallowing

    International Nuclear Information System (INIS)

    Baijens, Laura; Barikroo, Ali; Pilz, Walmari

    2013-01-01

    Objective: Intrarater and interrater reliability is crucial to the quality of diagnostic and therapy-effect studies. This paper reports on a systematic review of studies on intrarater and interrater reliability for measurements in videofluoroscopy of swallowing. The aim of this review was to summarize and qualitatively analyze published studies on that topic. Materials and methods: Those published up to March 2013 were found through a comprehensive electronic database search using PubMed, Embase, and The Cochrane Library. Two reviewers independently assessed the studies using strict inclusion criteria. Results: Nineteen studies were included and then qualitatively analyzed. In several of these, methodological problems were found. Moreover, intrarater and interrater reliability varied with the measure applied. A meta-analysis was not carried out as studies were not of sufficient quality to warrant doing so. Conclusion: In order to achieve reliable measurements in videofluoroscopy of swallowing, it is recommended that raters use well-defined guidelines for the levels of ordinal visuoperceptual variables. Furthermore, in order to make the measurements reliable (intrarater and interrater) it is recommended that, following protocolled pre-experimental training, the raters should have maximum consensus about the definition of the measured variables

  10. Radiological evaluation of swallowing and clinical patterns of systemic sclerosis

    International Nuclear Information System (INIS)

    Montesi, A.; Pesaresi, A.; Cavalli, M.L.; Serri, L.; Salmistraro, D.; Candela, M.; Gabrielli, A.

    1990-01-01

    Fifty-one patients with systemic sclerosis (scleroderma) were studied by means of videofluoroscopy in order to evaluate the abnormalities in the oral-pharyngeal and esophageal phases of deglutition and to correlate the radiological patterns with the clinical features of the disease. Thirteen patients (25.5%) exhibited swallowing disorders such as oral leakage, retention, penetration, mild or moderate aspiration and abnormal upper esophageal sphincter behavior. These dysfunctions were more evident in patients with esophageal motility abnormalities. A normal radiological pattern in the esophagus was not associated with swallowing alterations. Remarkably, patients with oral-pharyngeal disorders had a higher incidence of lung diseases. Forty-five patients (88%) exhibited disorders of the esophageal phase of deglutition, such as mild or severe motility abnormalities or hiatal hernia, gastro-esophageal reflux, reflux esophagitis, and stricture. Radiological findings in the esophagus can be abnormal in the early stages of the disease. On the other hand, the radiological pattern of esophageal motility can be occasionally negative in advanced or extensive disease. This indicates a discrepancy between clinical symptoms and radiological picture of the esophagus. The radiological examination of the oral-pharyngeal and esophageal phases of deglutition is important in patients with scleroderma in order to evaluate visceral involvement, motility disorders, and risk of aspiration. Such radiological information can be useful in preventing esophagitis and pulmonary complications

  11. Intrarater and interrater reliability for measurements in videofluoroscopy of swallowing

    Energy Technology Data Exchange (ETDEWEB)

    Baijens, Laura, E-mail: laura.baijens@mumc.nl [Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht (Netherlands); Barikroo, Ali, E-mail: a.Barikroo@ufl.edu [Swallowing Research Laboratory, Department of Speech, Language and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, FL (United States); Pilz, Walmari, E-mail: walmari.pilz@mumc.nl [Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht (Netherlands)

    2013-10-01

    Objective: Intrarater and interrater reliability is crucial to the quality of diagnostic and therapy-effect studies. This paper reports on a systematic review of studies on intrarater and interrater reliability for measurements in videofluoroscopy of swallowing. The aim of this review was to summarize and qualitatively analyze published studies on that topic. Materials and methods: Those published up to March 2013 were found through a comprehensive electronic database search using PubMed, Embase, and The Cochrane Library. Two reviewers independently assessed the studies using strict inclusion criteria. Results: Nineteen studies were included and then qualitatively analyzed. In several of these, methodological problems were found. Moreover, intrarater and interrater reliability varied with the measure applied. A meta-analysis was not carried out as studies were not of sufficient quality to warrant doing so. Conclusion: In order to achieve reliable measurements in videofluoroscopy of swallowing, it is recommended that raters use well-defined guidelines for the levels of ordinal visuoperceptual variables. Furthermore, in order to make the measurements reliable (intrarater and interrater) it is recommended that, following protocolled pre-experimental training, the raters should have maximum consensus about the definition of the measured variables.

  12. Lead concentrations and reproduction in highway-nesting barn swallows

    Science.gov (United States)

    Grue, C.E.; O'Shea, T.J.; Hoffman, D.J.

    1984-01-01

    Swallows (Hirundo rustica) collected within the right-of-way of a major Maryland highway were greater than those found in Barn Swallows nesting within a rural area. Lead concentrations in the feathers of adults from the highway colony were also greater than Lead concentrations in the carcasses and stomach contents of adult and nestling Barn those of rural adults, but concentrations in the feathers of nestlings from the two locations were similar. Activity of u-aminolevulinic acid dehydratase in red blood cells was lower in highway-nesting adults and their young than in their rural counterparts, although hemoglobin concentrations and hematocrits did not differ. The number of eggs, nestlings, and body weights of the latter at 16-18 days of age were similar in the two colonies, as were body weights of adults from the two areas. These results suggest that contamination of roadside habitats by lead from automotive emissions does not pose a serious hazard to birds that are aerial feeders.

  13. Soft Electronics Enabled Ergonomic Human-Computer Interaction for Swallowing Training

    Science.gov (United States)

    Lee, Yongkuk; Nicholls, Benjamin; Sup Lee, Dong; Chen, Yanfei; Chun, Youngjae; Siang Ang, Chee; Yeo, Woon-Hong

    2017-04-01

    We introduce a skin-friendly electronic system that enables human-computer interaction (HCI) for swallowing training in dysphagia rehabilitation. For an ergonomic HCI, we utilize a soft, highly compliant (“skin-like”) electrode, which addresses critical issues of an existing rigid and planar electrode combined with a problematic conductive electrolyte and adhesive pad. The skin-like electrode offers a highly conformal, user-comfortable interaction with the skin for long-term wearable, high-fidelity recording of swallowing electromyograms on the chin. Mechanics modeling and experimental quantification captures the ultra-elastic mechanical characteristics of an open mesh microstructured sensor, conjugated with an elastomeric membrane. Systematic in vivo studies investigate the functionality of the soft electronics for HCI-enabled swallowing training, which includes the application of a biofeedback system to detect swallowing behavior. The collection of results demonstrates clinical feasibility of the ergonomic electronics in HCI-driven rehabilitation for patients with swallowing disorders.

  14. The Effects of Oral-Motor Exercises on Swallowing in Children: An Evidence-Based Systematic Review

    Science.gov (United States)

    Arvedson, Joan; Clark, Heather; Lazarus, Cathy; Schooling, Tracy; Frymark, Tobi

    2010-01-01

    Aim: The aim of this unregistered evidence-based systematic review was to determine the state and quality of evidence on the effects of oral motor exercises (OME) on swallowing physiology, pulmonary health, functional swallowing outcomes, and drooling management in children with swallowing disorders. Method: A systematic search of 20 electronic…

  15. Flowering Trees

    Indian Academy of Sciences (India)

    deciduous tree with irregularly-shaped trunk, greyish-white scaly bark and milky latex. Leaves in opposite pairs are simple, oblong and whitish beneath. Flowers that occur in branched inflorescence are white, 2–. 3cm across and fragrant. Calyx is glandular inside. Petals bear numerous linear white scales, the corollary.

  16. Flowering Trees

    Indian Academy of Sciences (India)

    Berrya cordifolia (Willd.) Burret (Syn. B. ammonilla Roxb.) – Trincomali Wood of Tiliaceae is a tall evergreen tree with straight trunk, smooth brownish-grey bark and simple broad leaves. Inflorescence is much branched with white flowers. Stamens are many with golden yellow anthers. Fruit is a capsule with six spreading ...

  17. Flowering Trees

    Indian Academy of Sciences (India)

    Canthium parviflorum Lam. of Rubiaceae is a large shrub that often grows into a small tree with conspicuous spines. Leaves are simple, in pairs at each node and are shiny. Inflorescence is an axillary few-flowered cymose fascicle. Flowers are small (less than 1 cm across), 4-merous and greenish-white. Fruit is ellipsoid ...

  18. Flowering Trees

    Indian Academy of Sciences (India)

    sriranga

    Hook.f. ex Brandis (Yellow. Cadamba) of Rubiaceae is a large and handsome deciduous tree. Leaves are simple, large, orbicular, and drawn abruptly at the apex. Flowers are small, yellowish and aggregate into small spherical heads. The corolla is funnel-shaped with five stamens inserted at its mouth. Fruit is a capsule.

  19. Flowering Trees

    Indian Academy of Sciences (India)

    Celtis tetrandra Roxb. of Ulmaceae is a moderately large handsome deciduous tree with green branchlets and grayish-brown bark. Leaves are simple with three to four secondary veins running parallel to the mid vein. Flowers are solitary, male, female and bisexual and inconspicuous. Fruit is berry-like, small and globose ...

  20. Flowering Trees

    Indian Academy of Sciences (India)

    IAS Admin

    Aglaia elaeagnoidea (A.Juss.) Benth. of Meliaceae is a small-sized evergreen tree of both moist and dry deciduous forests. The leaves are alternate and pinnately compound, terminating in a single leaflet. Leaflets are more or less elliptic with entire margin. Flowers are small on branched inflorescence. Fruit is a globose ...

  1. Flowering Trees

    Indian Academy of Sciences (India)

    user

    Flowers are borne on stiff bunches terminally on short shoots. They are 2-3 cm across, white, sweet-scented with light-brown hairy sepals and many stamens. Loquat fruits are round or pear-shaped, 3-5 cm long and are edible. A native of China, Loquat tree is grown in parks as an ornamental and also for its fruits.

  2. Flowering Trees

    Indian Academy of Sciences (India)

    mid-sized slow-growing evergreen tree with spreading branches that form a dense crown. The bark is smooth, thick, dark and flakes off in large shreds. Leaves are thick, oblong, leathery and bright red when young. The female flowers are drooping and are larger than male flowers. Fruit is large, red in color and velvety.

  3. Flowering Trees

    Indian Academy of Sciences (India)

    Andira inermis (wright) DC. , Dog Almond of Fabaceae is a handsome lofty evergreen tree. Leaves are alternate and pinnately compound with 4–7 pairs of leaflets. Flowers are fragrant and are borne on compact branched inflorescences. Fruit is ellipsoidal one-seeded drupe that is peculiar to members of this family.

  4. Flowering Trees

    Indian Academy of Sciences (India)

    narrow towards base. Flowers are large and attrac- tive, but emit unpleasant foetid smell. They appear in small numbers on erect terminal clusters and open at night. Stamens are numerous, pink or white. Style is slender and long, terminating in a small stigma. Fruit is green, ovoid and indistinctly lobed. Flowering Trees.

  5. Flowering Trees

    Indian Academy of Sciences (India)

    Muntingia calabura L. (Singapore cherry) of. Elaeocarpaceae is a medium size handsome ever- green tree. Leaves are simple and alternate with sticky hairs. Flowers are bisexual, bear numerous stamens, white in colour and arise in the leaf axils. Fruit is a berry, edible with several small seeds embedded in a fleshy pulp ...

  6. ~{owering 'Trees

    Indian Academy of Sciences (India)

    . Stamens are fused into a purple staminal tube that is toothed. Fruit is about 0.5 in. across, nearly globose, generally 5-seeded, green but yellow when ripe, quite smooth at first but wrinkled in drying, remaining long on the tree ajier ripening.

  7. Tree Mortality

    Science.gov (United States)

    Mark J. Ambrose

    2012-01-01

    Tree mortality is a natural process in all forest ecosystems. However, extremely high mortality also can be an indicator of forest health issues. On a regional scale, high mortality levels may indicate widespread insect or disease problems. High mortality may also occur if a large proportion of the forest in a particular region is made up of older, senescent stands....

  8. Flowering Trees

    Indian Academy of Sciences (India)

    Guaiacum officinale L. (LIGNUM-VITAE) of Zygophyllaceae is a dense-crowned, squat, knobbly, rough and twisted medium-sized ev- ergreen tree with mottled bark. The wood is very hard and resinous. Leaves are compound. The leaflets are smooth, leathery, ovate-ellipti- cal and appear in two pairs. Flowers (about 1.5.

  9. A Preliminary Videofluoroscopic Investigation of Swallowing Physiology and Function in Individuals with Oculopharyngeal Muscular Dystrophy (OPMD).

    Science.gov (United States)

    Waito, Ashley A; Steele, Catriona M; Peladeau-Pigeon, Melanie; Genge, Angela; Argov, Zohar

    2018-05-03

    Dysphagia is one of the primary symptoms experienced by individuals with Oculopharyngeal Muscular Dystrophy (OPMD). However, we lack understanding of the discrete changes in swallowing physiology that are seen in OPMD, and the resulting relationship to impairments of swallowing safety and efficiency. This study sought to describe the pathophysiology of dysphagia in a small sample of patients with OPMD using a videofluoroscopy examination (VFSS) involving 3 × 5 mL boluses of thin liquid barium (22% w/v). The aim of this study is to extend what is known about the pathophysiology of dysphagia in OPMD, by quantifying changes in swallow timing, kinematics, safety, and efficiency, measured from VFSS. This study is a secondary analysis of baseline VFSS collected from 11 adults (4 male), aged 48-62 (mean 57) enrolled in an industry-sponsored phase 2 therapeutic drug trial. Blinded raters scored the VFSS recordings for safety [Penetration-Aspiration Scale (PAS)], efficiency [Normalized Residue Ratio Scale (NRRS)], timing [Pharyngeal Transit Time (PTT), Swallow Reaction Time (SRT), Laryngeal Vestibule Closure Reaction Time (LVCrt), Upper Esophageal Sphincter Opening Duration (UESD)], and kinematics (hyoid movement, pharyngeal constriction, UES opening width). Impairment thresholds from existing literature were defined to characterize swallowing physiology and function. Further, Fisher's Exact tests and Pearson's correlations were used to conduct a preliminary exploration of associations between swallowing physiology (e.g., kinematics, timing) and function (i.e., safety, efficiency). Compared to published norms, we identified significant differences in the degree of maximum pharyngeal constriction, hyoid movement distance and speed, as well as degree and timeliness of airway closure. Unsafe swallowing (PAS ≥ 3) was seen in only 3/11 patients. By contrast, clinically significant residue (i.e., NRRS scores ≥ 0.09 vallecular; ≥ 0.2 pyriform) was seen in

  10. Evaluating Swallowing Muscles Essential for Hyolaryngeal Elevation by Using Muscle Functional Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    Pearson, William G.; Hindson, David F.; Langmore, Susan E.; Zumwalt, Ann C.

    2013-01-01

    Purpose: Reduced hyolaryngeal elevation, a critical event in swallowing, is associated with radiation therapy. Two muscle groups that suspend the hyoid, larynx, and pharynx have been proposed to elevate the hyolaryngeal complex: the suprahyoid and longitudinal pharyngeal muscles. Thought to assist both groups is the thyrohyoid, a muscle intrinsic to the hyolaryngeal complex. Intensity modulated radiation therapy guidelines designed to preserve structures important to swallowing currently exclude the suprahyoid and thyrohyoid muscles. This study used muscle functional magnetic resonance imaging (mfMRI) in normal healthy adults to determine whether both muscle groups are active in swallowing and to test therapeutic exercises thought to be specific to hyolaryngeal elevation. Methods and Materials: mfMRI data were acquired from 11 healthy subjects before and after normal swallowing and after swallowing exercise regimens (the Mendelsohn maneuver and effortful pitch glide). Whole-muscle transverse relaxation time (T2 signal, measured in milliseconds) profiles of 7 test muscles were used to evaluate the physiologic response of each muscle to each condition. Changes in effect size (using the Cohen d measure) of whole-muscle T2 profiles were used to determine which muscles underlie swallowing and swallowing exercises. Results: Post-swallowing effect size changes (where a d value of >0.20 indicates significant activity during swallowing) for the T2 signal profile of the thyrohyoid was a d value of 0.09; a d value of 0.40 for the mylohyoid, 0.80 for the geniohyoid, 0.04 for the anterior digastric, and 0.25 for the posterior digastric-stylohyoid in the suprahyoid muscle group; and d values of 0.47 for the palatopharyngeus and 0.28 for the stylopharyngeus muscles in the longitudinal pharyngeal muscle group. The Mendelsohn maneuver and effortful pitch glide swallowing exercises showed significant effect size changes for all muscles tested, except for the thyrohyoid. Conclusions

  11. Automatic discrimination between safe and unsafe swallowing using a reputation-based classifier

    Directory of Open Access Journals (Sweden)

    Nikjoo Mohammad S

    2011-11-01

    Full Text Available Abstract Background Swallowing accelerometry has been suggested as a potential non-invasive tool for bedside dysphagia screening. Various vibratory signal features and complementary measurement modalities have been put forth in the literature for the potential discrimination between safe and unsafe swallowing. To date, automatic classification of swallowing accelerometry has exclusively involved a single-axis of vibration although a second axis is known to contain additional information about the nature of the swallow. Furthermore, the only published attempt at automatic classification in adult patients has been based on a small sample of swallowing vibrations. Methods In this paper, a large corpus of dual-axis accelerometric signals were collected from 30 older adults (aged 65.47 ± 13.4 years, 15 male referred to videofluoroscopic examination on the suspicion of dysphagia. We invoked a reputation-based classifier combination to automatically categorize the dual-axis accelerometric signals into safe and unsafe swallows, as labeled via videofluoroscopic review. From these participants, a total of 224 swallowing samples were obtained, 164 of which were labeled as unsafe swallows (swallows where the bolus entered the airway and 60 as safe swallows. Three separate support vector machine (SVM classifiers and eight different features were selected for classification. Results With selected time, frequency and information theoretic features, the reputation-based algorithm distinguished between safe and unsafe swallowing with promising accuracy (80.48 ± 5.0%, high sensitivity (97.1 ± 2% and modest specificity (64 ± 8.8%. Interpretation of the most discriminatory features revealed that in general, unsafe swallows had lower mean vibration amplitude and faster autocorrelation decay, suggestive of decreased hyoid excursion and compromised coordination, respectively. Further, owing to its performance-based weighting of component classifiers, the static

  12. Evaluating Swallowing Muscles Essential for Hyolaryngeal Elevation by Using Muscle Functional Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pearson, William G., E-mail: bp1@bu.edu [Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts (United States); Hindson, David F. [Department of Radiology, Boston Medical Center, Boston, Massachusetts (United States); Langmore, Susan E. [Department of Otolaryngology, Boston Medical Center, Boston, Massachusetts (United States); Speech and Hearing Sciences, Boston University, Boston, Massachusetts (United States); Zumwalt, Ann C. [Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts (United States)

    2013-03-01

    Purpose: Reduced hyolaryngeal elevation, a critical event in swallowing, is associated with radiation therapy. Two muscle groups that suspend the hyoid, larynx, and pharynx have been proposed to elevate the hyolaryngeal complex: the suprahyoid and longitudinal pharyngeal muscles. Thought to assist both groups is the thyrohyoid, a muscle intrinsic to the hyolaryngeal complex. Intensity modulated radiation therapy guidelines designed to preserve structures important to swallowing currently exclude the suprahyoid and thyrohyoid muscles. This study used muscle functional magnetic resonance imaging (mfMRI) in normal healthy adults to determine whether both muscle groups are active in swallowing and to test therapeutic exercises thought to be specific to hyolaryngeal elevation. Methods and Materials: mfMRI data were acquired from 11 healthy subjects before and after normal swallowing and after swallowing exercise regimens (the Mendelsohn maneuver and effortful pitch glide). Whole-muscle transverse relaxation time (T2 signal, measured in milliseconds) profiles of 7 test muscles were used to evaluate the physiologic response of each muscle to each condition. Changes in effect size (using the Cohen d measure) of whole-muscle T2 profiles were used to determine which muscles underlie swallowing and swallowing exercises. Results: Post-swallowing effect size changes (where a d value of >0.20 indicates significant activity during swallowing) for the T2 signal profile of the thyrohyoid was a d value of 0.09; a d value of 0.40 for the mylohyoid, 0.80 for the geniohyoid, 0.04 for the anterior digastric, and 0.25 for the posterior digastric-stylohyoid in the suprahyoid muscle group; and d values of 0.47 for the palatopharyngeus and 0.28 for the stylopharyngeus muscles in the longitudinal pharyngeal muscle group. The Mendelsohn maneuver and effortful pitch glide swallowing exercises showed significant effect size changes for all muscles tested, except for the thyrohyoid. Conclusions

  13. Visualizing Contour Trees within Histograms

    DEFF Research Database (Denmark)

    Kraus, Martin

    2010-01-01

    Many of the topological features of the isosurfaces of a scalar volume field can be compactly represented by its contour tree. Unfortunately, the contour trees of most real-world volume data sets are too complex to be visualized by dot-and-line diagrams. Therefore, we propose a new visualization...... that is suitable for large contour trees and efficiently conveys the topological structure of the most important isosurface components. This visualization is integrated into a histogram of the volume data; thus, it offers strictly more information than a traditional histogram. We present algorithms...... to automatically compute the graph layout and to calculate appropriate approximations of the contour tree and the surface area of the relevant isosurface components. The benefits of this new visualization are demonstrated with the help of several publicly available volume data sets....

  14. Therapeutic singing as an early intervention for swallowing in persons with Parkinson's disease.

    Science.gov (United States)

    Stegemöller, E L; Hibbing, P; Radig, H; Wingate, J

    2017-04-01

    For persons with Parkinson's disease (PD), secondary motor symptoms such as swallow impairment impact the quality of life and are major contributors to mortality. There is a present need for therapeutic interventions aimed at improving swallow function during the early stages of PD. The purpose of this pilot study was to examine the effects of a group therapeutic singing intervention on swallowing in persons with PD with no significant dysphagia symptoms. Cohort study. University in the United States. Twenty-four participants with PD. Eight weeks of group therapeutic singing. Electromyography (EMG) was used to assess muscle activity associated with swallow pre and post the group singing intervention. Swallow quality of life (SWAL-QOL) and the Unified Parkinson's Disease Rating Scale (UPDRS) were also obtained pre- and post-intervention. Participants reported minimal difficulty with swallowing, yet results revealed a significant increase in EMG outcome measures, as well as significant improvement in UPDRS total and UPDRS motor scores. No significant differences were revealed for SWAL-QOL. Increases in EMG timing measures may suggest that group singing results in the prolongation of laryngeal elevation, protecting the airway from foreign material for longer periods of time during swallow. Combined with the improvement in UPDRS clinical measures, therapeutic singing may be an engaging early intervention strategy to address oropharyngeal dysphagia while also benefiting additional clinical symptoms of PD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Dysphagia in Lewy body dementia - a clinical observational study of swallowing function by videofluoroscopic examination.

    Science.gov (United States)

    Londos, Elisabet; Hanxsson, Oskar; Alm Hirsch, Ingrid; Janneskog, Anna; Bülow, Margareta; Palmqvist, Sebastian

    2013-10-07

    Dysphagia, which can result in aspiration pneumonia and death, is a well-known problem in patients with dementia and Parkinson's disease. There are few studies on dysphagia in patients with dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), especially studies objectively documenting the type of swallowing dysfunction. The aim of this study was therefore to investigate the prevalence, and define the actual swallowing dysfunction according to a videofluoroscopic swallowing examination (VFSE) in patients with DLB and PDD. Eighty-two consecutive patients with DLB or PDD in a clinical follow-up program were asked about symptoms of dysphagia. Those experiencing dysphagia were examined with VFSE. Prevalence and type of swallowing dysfunction was recorded. Twenty-six patients (32%) reported symptoms of dysphagia such as swallowing difficulties or coughing. Twenty-four (92%) of these had a documented swallowing dysfunction on VFSE. Eighty-eight percent suffered from pharyngeal dysfunction. Almost all DLB or PDD patients with subjective signs of dysphagia had pathologic results on VFSE, the majority of pharyngeal type. This type of dysphagia has not been reported in DLB before. The results have clinical implications and highlight the importance of asking for and examining swallowing function to prevent complications such as aspiration.

  16. Swallowing and deep brain stimulation in Parkinson’s disease: A systematic review

    Science.gov (United States)

    Troche, Michelle S.; Brandimore, Alexandra E.; Foote, Kelly D.; Okun, Michael S.

    2013-01-01

    The purpose of this review is to assess the current state of the literature on the topic of deep brain stimulation (DBS) and its effects on swallowing function in Parkinson’s disease (PD). Pubmed, Cochrane review, and web of science searches were completed on all articles addressing DBS that contained a swallowing outcome measure. Outcome measures included the penetration/aspiration scale, pharyngeal transit time, oropharyngeal residue, drooling, aspiration pneumonia, death, hyolaryngeal excursion, epiglottic inversion, UPDRS scores, and presence of coughing/throat clearing during meals. The search identified 13 studies specifically addressing the effects of DBS on swallowing. Critical assessment of the 13 identified peer-reviewed publications revealed nine studies employing an experimental design, (e.g. “on” vs. “off”, pre- vs. post-DBS) and four case reports. None of the nine experimental studies were found to identify clinically significant improvement or decline in swallowing function with DBS. Despite these findings, several common threads were identified across experimental studies and will be examined in this review. Additionally, available data demonstrate that, although subthalamic nucleus (STN) stimulation has been considered to cause more impairment to swallowing function than globus pallidus internus (GPi) stimulation, there are no experimental studies directly comparing swallowing function in STN vs. GPi. Moreover, there has been no comparison of unilateral vs. bilateral DBS surgery and the coincident effects on swallowing function. This review includes a critical analysis of all experimental studies and discusses methodological issues that should be addressed in future studies. PMID:23726461

  17. Non-invasive assessment determine the swallowing and respiration dysfunction in early Parkinson's disease.

    Science.gov (United States)

    Wang, Chin-Man; Shieh, Wann-Yun; Weng, Yi-Hsin; Hsu, Yi-Hsuan; Wu, Yih-Ru

    2017-09-01

    Dysphagia is common among patients with Parkinson's disease. Swallowing and its coordination with respiration is extremely important to achieve safety swallowing. Different tools have been used to assess this coordination, however the results have been inconsistent. We aimed to investigate this coordination in patients with Parkinson's disease using a non-invasive method. Signals of submental muscle activity, thyroid cartilage excursion, and nasal airflow during swallowing were recorded simultaneously. Five different water boluses were swallowed three times, and the data were recorded and analyzed. Thirty-seven controls and 42 patients with early-stage Parkinson's disease were included. The rates of non-expiratory/expiratory pre- and post-swallowing respiratory phase patterns were higher in the patients than in the controls (P Parkinson's disease, and safety compensation mechanisms were used more than efficiency during swallowing. The results of this study may serve as a baseline for further research into new treatment regimens and to improve the management of swallowing in patients with Parkinson's disease. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Development of chair-side evaluation system of swallowing discomfort of denture wearers

    Science.gov (United States)

    Matsumoto, Keisuke; Ikuta, Ryuhei; Kataoka, Kanako; Ono, Yumie; Tamaki, Katsushi

    2018-02-01

    We investigated the appropriate hemodynamic parameters of functional near-infrared spectroscopy (fNIRS) to best differentiate the discomfort intensity related to swallowing in healthy subjects wearing different types of simulated dentures. Thirty-one subjects performed 4 sessions of water-swallowing task in a sitting position without or with wearing any one of the 3 simulated dentures under continuous fNIRS monitoring of the prefrontal cortex. The simulated dentures were consisted of a flat maxillary palatal bar and bilateral support attachment to the teeth and gum. The palatal bar positions were arranged along with the anterior, middle, or posterior areas of the upper jaw. The cumulative values of oxyhemoglobin and deoxyhemoglobin concentration changes were calculated for periods of 5 - 10 s from completion of swallowing. Subjective rating of swallowing-discomfort was the lowest without wearing denture and increased along with the palatal bar position placed from anterior to posterior. Cumulated deoxyhemoglobin signals calculated for 10 s post-swallowing event in the left frontopolar prefrontal cortex showed the best correlation with the subjective rating of discomfort in swallowing with dentures. These neurological signatures would be beneficial to detect swallowing discomfort in elderly denture wearers who have difficulty in communicating with dentists.

  19. Characterizing Dysphagia and Swallowing Intervention in the Traumatic Spinal Injury Population

    Science.gov (United States)

    Valenzano, Teresa J.; Waito, Ashley A.; Steele, Catriona M.

    2016-01-01

    Dysphagia is reported to be a common secondary complication for individuals with traumatic spinal injuries. Different etiologies of traumatic spinal injuries may lead to different profiles of swallowing impairment. We conducted a systematic review to determine the characteristics of dysphagia after traumatic spinal injury and to describe interventions currently used to improve swallowing function in this population. A comprehensive multi-engine literature search identified 137 articles of which 5 were judged to be relevant. These underwent review for study quality, rating for level of evidence, and data extraction. The literature describing dysphagia after traumatic spinal injury was comprised predominantly of low level evidence and single case reports. Aspiration, pharyngeal residue, and decreased/absent hyolaryngeal elevation were found to be common characteristics of dysphagia in this population. The most commonly used swallowing interventions included tube feeding, compensatory swallowing strategies, and steroids/antibiotics. Improvement in swallowing function following swallowing intervention was reported in all studies, however there was no control for spontaneous recovery. The results demonstrate a need for high-quality research to profile the pathophysiology of dysphagia after traumatic spinal injury and controlled studies to demonstrate the efficacy of swallowing interventions in this population. PMID:27412004

  20. Routine Use of Contrast Swallow After Total Gastrectomy and Esophagectomy: Is it Justified?

    Science.gov (United States)

    El-Sourani, Nader; Bruns, Helge; Troja, Achim; Raab, Hans-Rudolf; Antolovic, Dalibor

    2017-01-01

    After gastrectomy or esophagectomy, esophagogastrostomy and esophagojejunostomy are commonly used for reconstruction. Water-soluble contrast swallow is often used as a routine screening to exclude anastomotic leakage during the first postoperative week. In this retrospective study, the sensitivity and specificity of oral water-soluble contrast swallow for the detection of anastomotic leakage and its clinical symptoms were analysed. Records of 104 consecutive total gastrectomies and distal esophagectomies were analysed. In all cases, upper gastrointestinal contrast swallow with the use of a water-soluble contrast agent was performed on the 5 th postoperative day. Extravasation of the contrast agent was defined as anastomotic leakage. When anastomotic insufficiency was suspected but no extravasation was present, a computed tomography (CT) scan and upper endoscopy were performed. Oral contrast swallow detected 7 anastomotic leaks. Based on CT-scans and upper endoscopy, the true number of anastomotic leakage was 15. The findings of the oral contrast swallow were falsely positive in 4 and falsely negative in 12 patients, respectively. The sensitivity and specificity of the oral contrast swallow was 20% and 96%, respectively. Routine radiological contrast swallow following total gastrectomy or distal esophagectomy cannot be recommended. When symptoms of anastomotic leakage are present, a CT-scan and endoscopy are currently the methods of choice.

  1. Assessment of swallowing and its disorders—A dynamic MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Vijay Kumar, K.V., E-mail: vijaykumarkv@yahoo.in [Department of Speech, Language and Hearing Sciences, SRU (India); Shankar, V., E-mail: drshankarv@yahoo.co.in [Department of Neurology, SRU (India); Santosham, Roy, E-mail: santoshamroy@yahoo.com [Department of Radiology and Imaging Sciences, SRU (India)

    2013-02-15

    Magnetic resonance imaging overcomes the limitations of videofluoroscopy in assessing without radiation exposure. The clinical utility of dynamic MRI for swallowing disorders is not well documented. This study demonstrates the feasibility of using dynamic MRI in assessment of swallowing disorders. Ten normal and three brainstem lesion patients participated in this study. GE Signa HDxt 1.5 Tesla MRI scanner with head-and-neck coil as a receiver and fast imaging employing steady state acquisition sequence was used. The swallow was analyzed in terms of symmetry and amplitude of movements of velum, faucial pillars, tongue, epiglottis and cricopharyngeous and images from the sagittal, coronal and axial planes. In sagittal plane posterior movement of tongue and its compression on velum, elevation of hyoid bone, elevation of larynx and lid action of epiglottis, in the coronal view the symmetrical movements of the faucial pillars and pharyngeal constrictor muscles and in axial plane three anatomical landmarks were targeted based on their role in swallowing, viz. velum, epiglottis and cricopharyngeous were studied. In brainstem lesion individuals, posterior movement of tongue, and elevation of larynx were not seen. Asymmetrical movements of faucial pillars and cricopharyngeous muscle were appreciated in the dynamic MRI. This demonstrates that, dynamic MRI is an efficient tool to understand the swallowing physiology and helps the speech language pathologist in modifying the swallowing maneuvers. Dynamic MRI is an effective tool in assessing swallowing and its disorders. This muscle specific information is not appreciated in videofluoroscopy and this information is necessary to modify the therapy maneuvers.

  2. Assessment of swallowing and its disorders—A dynamic MRI study

    International Nuclear Information System (INIS)

    Vijay Kumar, K.V.; Shankar, V.; Santosham, Roy

    2013-01-01

    Magnetic resonance imaging overcomes the limitations of videofluoroscopy in assessing without radiation exposure. The clinical utility of dynamic MRI for swallowing disorders is not well documented. This study demonstrates the feasibility of using dynamic MRI in assessment of swallowing disorders. Ten normal and three brainstem lesion patients participated in this study. GE Signa HDxt 1.5 Tesla MRI scanner with head-and-neck coil as a receiver and fast imaging employing steady state acquisition sequence was used. The swallow was analyzed in terms of symmetry and amplitude of movements of velum, faucial pillars, tongue, epiglottis and cricopharyngeous and images from the sagittal, coronal and axial planes. In sagittal plane posterior movement of tongue and its compression on velum, elevation of hyoid bone, elevation of larynx and lid action of epiglottis, in the coronal view the symmetrical movements of the faucial pillars and pharyngeal constrictor muscles and in axial plane three anatomical landmarks were targeted based on their role in swallowing, viz. velum, epiglottis and cricopharyngeous were studied. In brainstem lesion individuals, posterior movement of tongue, and elevation of larynx were not seen. Asymmetrical movements of faucial pillars and cricopharyngeous muscle were appreciated in the dynamic MRI. This demonstrates that, dynamic MRI is an efficient tool to understand the swallowing physiology and helps the speech language pathologist in modifying the swallowing maneuvers. Dynamic MRI is an effective tool in assessing swallowing and its disorders. This muscle specific information is not appreciated in videofluoroscopy and this information is necessary to modify the therapy maneuvers

  3. TreeScaper: Visualizing and Extracting Phylogenetic Signal from Sets of Trees.

    Science.gov (United States)

    Huang, Wen; Zhou, Guifang; Marchand, Melissa; Ash, Jeremy R; Morris, David; Van Dooren, Paul; Brown, Jeremy M; Gallivan, Kyle A; Wilgenbusch, Jim C

    2016-12-01

    Modern phylogenomic analyses often result in large collections of phylogenetic trees representing uncertainty in individual gene trees, variation across genes, or both. Extracting phylogenetic signal from these tree sets can be challenging, as they are difficult to visualize, explore, and quantify. To overcome some of these challenges, we have developed TreeScaper, an application for tree set visualization as well as the identification of distinct phylogenetic signals. GUI and command-line versions of TreeScaper and a manual with tutorials can be downloaded from https://github.com/whuang08/TreeScaper/releases TreeScaper is distributed under the GNU General Public License. © The Author 2016. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. New Swallowing Evaluation Using Piezoelectricity in Normal Individuals.

    Science.gov (United States)

    Sogawa, Yuichiro; Kimura, Shinji; Harigai, Toru; Sakurai, Naoki; Toyosato, Akira; Nishikawa, Taro; Inoue, Makoto; Murasawa, Akira; Endo, Naoto

    2015-12-01

    This study aimed to elucidate the relationship between the piezoelectric waveform latency, hyoid bone movement, surface electromyogram (sEMG), and the pharyngeal transit time (PTT) during swallowing. Forty-one healthy subjects were divided into three age groups: younger (20-39 years, n = 8), middle-aged (40-59 years, n = 9), and older (60-79 years, n = 24). Motion analysis of the hyoid bone using videofluorography (VF), waveform analysis of the front neck using piezoelectric films, and sEMG of the suprahyoid muscle group were performed simultaneously. Latencies of the three movement phases were defined as upward (VFS1), forward (VFS2), and returning to starting position (VFS3). The three phases of the piezoelectric waveform-from wave initiation of the negative wave to the start of the second deep negative wave; from the start of the second deep negative wave to the start of the last positive wave (SLPW); and from the SLPW to the end of the last positive wave-were defined as PS1, PS2, and PS3, respectively. VFS1-3 and PS1-3 were significantly correlated. VFS1 and PS1 latencies were significantly longer with thick liquid than with thin liquid. VFS2, PS1, and PS2 latencies were longer in the older group than in the other two groups. The start of PS1 was nearly equal to those of sEMG and VFS1. Bolus arrival time in the valleculae was statistically equal to the end of the PS1 with both thin and thick liquids. To establish the swallowing screening using Piezoelectric film, further investigation is necessary in the dysphagia patients.

  5. Swallowing function after laryngeal cleft repair: more than just fixing the cleft.

    Science.gov (United States)

    Osborn, Alexander J; de Alarcon, Alessandro; Tabangin, Meredith E; Miller, Claire K; Cotton, Robin T; Rutter, Michael J

    2014-08-01

    To evaluate and describe the swallowing function in children after laryngeal cleft repair. Ten-year (2002-2012) retrospective chart review. Academic tertiary care pediatric otolaryngology practice. Records of 60 children who had surgical repair of laryngeal cleft (ages 2 weeks-14 years) and postoperative functional endoscopic evaluation of swallowing or videofluoroscopic swallow studies were examined retrospectively. Twenty-nine children had one postoperative swallow evaluation, 19 children had two, 4 children had three, 5 children had four, and 3 children had five. Median time to the first evaluation was 10.8 weeks (interquartile range [IQR]: 36.5, 231). On the final swallow evaluation, 34 (57%) children demonstrated normal swallowing parameters, 12 (20%) children showed penetration, and 14 (23%) children showed aspiration. Forty-three (72%) children were able to take everything by mouth normally or with minor behavioral modifications, 11 (18%) children required thickened fluids, and six (10%) children were kept nil per os (NPO). Mean improvement on the penetration-aspiration (pen-asp) scale was 2.13. On multivariable analysis, neurodevelopmental issues and gastronomy tube use were associated with the need for NPO status. Despite a high rate of surgical success, a substantial minority of children have persistent swallowing dysfunction after laryngeal cleft repair. Swallowing dysfunction after repair is multifactorial and arises from concomitant neurologic, anatomic, or other comorbidities that contribute to oropharyngeal and pharyngeal dysphagia. Based on our results, we recommend a testing schedule for postoperative swallowing evaluations after cleft repair. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  6. Differential Response Pattern of Oropharyngeal Pressure by Bolus and Dry Swallows.

    Science.gov (United States)

    Hasegawa, Mana; Kurose, Masayuki; Okamoto, Keiichiro; Yamada, Yoshiaki; Tsujimura, Takanori; Inoue, Makoto; Sato, Taisuke; Narumi, Takatsune; Fujii, Noritaka; Yamamura, Kensuke

    2018-02-01

    The aim of this study was to determine if bolus and dry swallow showed similar pressure changes in the oropharynx using our newly developed device. A unique character of it includes that baropressure can be measured with the sensor being placed in the balloon and can assess the swallowing mechanics in terms of pressure changes in the oropharynx with less influences of direct contacts of boluses and oropharyngeal structures during swallow indirectly. Fifteen healthy subjects swallowed saliva (dry), 15 ml of water, 45 ml of water, and 15 ml of two different types of food in terms of viscosity (potage soup-type and mayonnaise-type foods). Suprahyoid muscle activity was recorded simultaneously. Three parameters, area under the curve (AUC), peak amplitude, and duration of pressure, were analyzed from each swallow. Almost all of the bolus swallowing events had biphasic baropressure responses consisting of an early phase and late phase (99%), whereas 90% of the saliva swallowing events had a single phase. AUC, peak, and duration displayed greater effects during the late phase than during the early phase. Baropressure of the early phase, but not of the late phase, significantly increased with increasing volume; however, small but significant viscosity effects on pressure were seen during both phases. Peak pressure of the late phase was preceded by maximum muscle activity, whereas that of the early phase was seen when muscle activity displayed a peak response. These findings indicated that our device with the ability to measure baropressure has the potential to provide additional parameter to assess the swallow physiology, and biphasic baropressure responses in the early and late phases could reflect functional aspects of the swallowing reflexes.

  7. Involvement of ERK phosphorylation in brainstem neurons in modulation of swallowing reflex in rats

    Science.gov (United States)

    Tsujimura, Takanori; Kondo, Masahiro; Kitagawa, Junichi; Tsuboi, Yoshiyuki; Saito, Kimiko; Tohara, Haruka; Ueda, Koichiro; Sessle, Barry J; Iwata, Koichi

    2009-01-01

    In order to evaluate the neuronal mechanisms underlying functional abnormalities of swallowing in orofacial pain patients, this study investigated the effects of noxious orofacial stimulation on the swallowing reflex, phosphorylated extracellular signal-regulated kinase (pERK) and γ-aminobutyric acid (GABA) immunohistochemical features in brainstem neurons, and also analysed the effects of brainstem lesioning and of microinjection of GABA receptor agonist or antagonist into the nucleus tractus solitarii (NTS) on the swallowing reflex in anaesthetized rats. The swallowing reflex elicited by topical administration of distilled water to the pharyngolaryngeal region was inhibited after capsaicin injection into the facial (whisker pad) skin or lingual muscle. The capsaicin-induced inhibitory effect on the swallowing reflex was itself depressed after the intrathecal administration of MAPK kinase (MEK) inhibitor. No change in the capsaicin-induced inhibitory effect was observed after trigeminal spinal subnucleus caudalis lesioning, but the inhibitory effect was diminished by paratrigeminal nucleus (Pa5) lesioning. Many pERK-like immunoreactive neurons in the NTS showed GABA immunoreactivity. The local microinjection of the GABAA receptor agonist muscimol into the NTS produced a significant reduction in swallowing reflex, and the capsaicin-induced depression of the swallowing reflex was abolished by microinjection of the GABAA receptor antagonist bicuculline into the NTS. The present findings suggest that facial skin–NTS, lingual muscle–NTS and lingual muscle–Pa5–NTS pathways are involved in the modulation of swallowing reflex by facial and lingual pain, respectively, and that the activation of GABAergic NTS neurons is involved in the inhibition of the swallowing reflex following noxious stimulation of facial and intraoral structures. PMID:19124539

  8. Role of Barium Swallow in Diagnosing Clinically Significant Anastomotic Leak following Esophagectomy

    Directory of Open Access Journals (Sweden)

    Simon Roh

    2016-04-01

    Full Text Available Background: Barium swallow is performed following esophagectomy to evaluate the anastomosis for detection of leaks and to assess the emptying of the gastric conduit. The aim of this study was to evaluate the reliability of the barium swallow study in diagnosing anastomotic leaks following esophagectomy. Methods: Patients who underwent esophagectomy from January 2000 to December 2013 at our institution were investigated. Barium swallow was routinely done between days 5–7 to detect a leak. These results were compared to clinically determined leaks (defined by neck wound infection requiring jejunal feeds and or parenteral nutrition during the postoperative period. The sensitivity and specificity of barium swallow in diagnosing clinically significant anastomotic leaks was determined. Results: A total of 395 esophagectomies were performed (mean age, 62.2 years. The indications for the esophagectomy were as follows: malignancy (n=320, high-grade dysplasia (n=14, perforation (n=27, benign stricture (n=7, achalasia (n=16, and other (n=11. A variety of techniques were used including transhiatal (n=351, McKeown (n=35, and Ivor Lewis (n=9 esophagectomies. Operative mortality was 2.8% (n=11. Three hundred and sixty-eight patients (93% underwent barium swallow study after esophagectomy. Clinically significant anastomotic leak was identified in 36 patients (9.8%. Barium swallow was able to detect only 13/36 clinically significant leaks. The sensitivity of the swallow in diagnosing a leak was 36% and specificity was 97%. The positive and negative predictive values of barium swallow study in detecting leaks were 59% and 93%, respectively. Conclusion: Barium swallow is an insensitive but specific test for detecting leaks at the cervical anastomotic site after esophagectomy.

  9. Involvement of ERK phosphorylation in brainstem neurons in modulation of swallowing reflex in rats.

    Science.gov (United States)

    Tsujimura, Takanori; Kondo, Masahiro; Kitagawa, Junichi; Tsuboi, Yoshiyuki; Saito, Kimiko; Tohara, Haruka; Ueda, Koichiro; Sessle, Barry J; Iwata, Koichi

    2009-02-15

    In order to evaluate the neuronal mechanisms underlying functional abnormalities of swallowing in orofacial pain patients, this study investigated the effects of noxious orofacial stimulation on the swallowing reflex, phosphorylated extracellular signal-regulated kinase (pERK) and gamma-aminobutyric acid (GABA) immunohistochemical features in brainstem neurons, and also analysed the effects of brainstem lesioning and of microinjection of GABA receptor agonist or antagonist into the nucleus tractus solitarii (NTS) on the swallowing reflex in anaesthetized rats. The swallowing reflex elicited by topical administration of distilled water to the pharyngolaryngeal region was inhibited after capsaicin injection into the facial (whisker pad) skin or lingual muscle. The capsaicin-induced inhibitory effect on the swallowing reflex was itself depressed after the intrathecal administration of MAPK kinase (MEK) inhibitor. No change in the capsaicin-induced inhibitory effect was observed after trigeminal spinal subnucleus caudalis lesioning, but the inhibitory effect was diminished by paratrigeminal nucleus (Pa5) lesioning. Many pERK-like immunoreactive neurons in the NTS showed GABA immunoreactivity. The local microinjection of the GABA(A) receptor agonist muscimol into the NTS produced a significant reduction in swallowing reflex, and the capsaicin-induced depression of the swallowing reflex was abolished by microinjection of the GABA(A) receptor antagonist bicuculline into the NTS. The present findings suggest that facial skin-NTS, lingual muscle-NTS and lingual muscle-Pa5-NTS pathways are involved in the modulation of swallowing reflex by facial and lingual pain, respectively, and that the activation of GABAergic NTS neurons is involved in the inhibition of the swallowing reflex following noxious stimulation of facial and intraoral structures.

  10. Trees of Our National Forests.

    Science.gov (United States)

    Forest Service (USDA), Washington, DC.

    Presented is a description of the creation of the National Forests system, how trees grow, managing the National Forests, types of management systems, and managing for multiple use, including wildlife, water, recreation and other uses. Included are: (1) photographs; (2) line drawings of typical leaves, cones, flowers, and seeds; and (3)…

  11. Etiology and long-term functional swallow outcomes in pediatric unilateral vocal fold immobility.

    Science.gov (United States)

    Tibbetts, Kathleen M; Wu, Derek; Hsu, Jeffrey V; Burton, William B; Nassar, Michel; Tan, Melin

    2016-09-01

    Unilateral vocal fold immobility (UVFI) results in deficits in phonatory, respiratory, and swallow function of the pediatric patient. Little is known about long-term functional swallow outcomes. Medical records of children diagnosed with UVFI between 2005 and 2014 at a tertiary children's hospital were retrospectively reviewed. Etiology, laryngoscopy findings, and swallow status at diagnosis and follow-up were recorded. Swallow outcomes were compared by etiology using Fisher's exact test. McNemar's test was used to identify correlations between return of mobility and swallow recovery. Rates of pneumonia were compared with initial swallow evaluation results using a two-tailed t-test. Eighty-eight patients with UVFI were identified and 73 patients (47% female, mean age 14.4 months, standard deviation (SD) 26.7 months) had complete medical records. Mean follow up time was 52.7 months (SD 36.8 months). Etiologies included cardiothoracic surgery (68.5%), idiopathic (12.3%), prolonged intubation (11.0%), central nervous system (CNS) abnormality (5.5%), and non-cardiac iatrogenic injury to the recurrent laryngeal nerve (2.7%). Forty-seven patients underwent a follow up laryngoscopy, and recovery of vocal fold (VF) mobility was documented in 42.6% (20/47). At diagnosis, 31.5% fed orally, compared with 79.5% at follow-up. Direct correlation between recovery of VF mobility and swallow recovery was not demonstrated. Cardiac etiologies demonstrated higher rates of swallow recovery than CNS abnormalities (p = 0.0393). Twenty-five children aspirated on initial modified barium swallow (MBS) and 10 children developed pneumonias at some point during the follow up period. There was no significant difference in rates of pneumonia in patients with and without aspiration on MBS. Recovery of swallow in children with UVFI does not directly parallel return of VF mobility. Long-term swallow outcome is favorable in this population. Initial MBS does not indicate ultimate swallow outcome

  12. Surface tree languages and parallel derivation trees

    NARCIS (Netherlands)

    Engelfriet, Joost

    1976-01-01

    The surface tree languages obtained by top-down finite state transformation of monadic trees are exactly the frontier-preserving homomorphic images of sets of derivation trees of ETOL systems. The corresponding class of tree transformation languages is therefore equal to the class of ETOL languages.

  13. Too hard to swallow: a secret secondary defence of an aposematic insect.

    Science.gov (United States)

    Wang, Lu-Yi; Huang, Wen-San; Tang, Hsin-Chieh; Huang, Lung-Chun; Lin, Chung-Ping

    2018-01-25

    Anti-predator strategies are significant components of adaptation in prey species. Aposematic prey are expected to possess effective defences that have evolved simultaneously with their warning colours. This study tested the hypothesis of the defensive function and ecological significance of the hard body in aposematic Pachyrhynchus weevils pioneered by Alfred Russel Wallace nearly 150 years ago. We used predation trials with Japalura tree lizards to assess the survivorship of 'hard' (mature) versus 'soft' (teneral) and 'clawed' (intact) versus 'clawless' (surgically removed) weevils. The ecological significance of the weevil's hard body was evaluated by assessing the hardness of the weevils, the local prey insects, and the bite forces of the lizard populations. The existence of toxins or deterrents in the weevil was examined by gas chromatography-mass spectrometry (GC-MS). All 'hard' weevils were instantly spat out after being bitten once and survived attacks by the lizards. In contrast, the 'soft' weevils were chewed and subsequently swallowed. The results were the same regardless of the presence or absence of the weevil's tarsal claws. The hardness of 'hard' Pachyrhynchus weevils was significantly higher than the average hardness of other prey insects in the same habitat and the mean bite forces of the local lizards. The four candidate compounds of the weevil identified by GC-MS had no known toxic or repellent functions against vertebrates. These results reveal that the hardness of aposematic prey functions as an effective secondary defence, and they provide a framework for understanding the spatio-temporal interactions between vertebrate predators and aposematic insect prey. © 2018. Published by The Company of Biologists Ltd.

  14. Trees are good, but…

    Science.gov (United States)

    E.G. McPherson; F. Ferrini

    2010-01-01

    We know that “trees are good,” and most people believe this to be true. But if this is so, why are so many trees neglected, and so many tree wells empty? An individual’s attitude toward trees may result from their firsthand encounters with specific trees. Understanding how attitudes about trees are shaped, particularly aversion to trees, is critical to the business of...

  15. Lost and found…Tracking a swallowed denture: Role of radiology

    Directory of Open Access Journals (Sweden)

    Yogita Khalekar

    2017-01-01

    Full Text Available Denture ingestion or aspiration is a problem requiring awareness of different specialists including dentists, surgeons, otolaryngologists, and anesthesiologists for prevention, early diagnosis and adequate treatment. Complications of swallowed dentures include hollow viscous necrosis, perforation, and penetration to neighbouring organs leading to fistulae, bleeding and obstruction. Here, we present the case of a 65 year old female patient who swallowed the denture, which was detected by barium swallow and removed by endoscopy. Hence, the management of swallowed denture needs a multidisciplinary approach with the help of a dentist, otolaryngologist and anesthesiologists. Dentists should recommend patients to visit them for planned check ups or revisit them in case of denture dislodgement or loosening as soon as possible to prevent such life threatening events.

  16. Comparison of Masticatory and Swallowing Functional Outcomes in Surgically and Prosthetically Rehabilitated Maxillectomy Patients.

    Science.gov (United States)

    Sreeraj, R; Krishnan, Vinod; V, Manju; Thankappan, Krishnakumar

    This study compared masticatory and swallowing functional outcomes in maxillectomy patients who underwent surgical and prosthetic rehabilitation or prosthetic rehabilitation only following surgical resection. This comparative cross-sectional study involved 20 maxillectomy patients and compared their masticatory and swallowing functions following combined surgical and prosthodontic management vs an exclusively prosthodontic approach. Masticatory performance was measured by an originally modified sieve method using hydrocolloid material, and video fluoroscopic examination was employed for swallowing assessments. Masticatory performance was significantly better in the patient group treated with flaps and removable denture prostheses compared to patients treated with obturator prosthesis alone. Swallowing outcomes were comparable in both groups. Flap reconstruction followed by an obturator prosthesis seems to be a preferable option when planning for functional rehabilitation in maxillectomy patients. Further research is needed to substantiate the functional outcomes noted in this study.

  17. SWALLOWING DISORDERS IN CLINICAL PRACTICE: FUNCTIONAL ANATOMY, ASSESSMENT AND REHABILITATION STRATEGIES

    Directory of Open Access Journals (Sweden)

    STANESCU Ioana

    2014-09-01

    Full Text Available Swallowing is a complex process consisting in transporting food from mouth to the stomach; it involves voluntary and reflex activity of more than 30 nerves and muscles, requiring complex neuromuscular coordination and brainstem and cortical centers for controle. Dysphagia is defined as a alteration in the swallowing process, which cause difficulty in transporting saliva and aliments from the mouth trough the pharynx and esophagus into the stomach . It is a frequent symptom, affecting especially old people, people with neurological diseases, cancers of head and neck or severe reflux . Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus, which could e caused by neurological conditions. Dysphagia carries serious health risks: malnutrition, dehydration, increase risk of infections. Effective dysphagia management requires an interdisciplinary approach; the goal of rehabilitation is to identify and treat abnormalities of swallowing while maintaining safe and efficient nutrition. KEY WORDS: swallowing, dysphagia, functional anatomy, rehabilitation, neuroplasticity

  18. Kinematic MRI using short TR single shot fast spin echo (SSFSE) in evaluating swallowing

    Energy Technology Data Exchange (ETDEWEB)

    Isogai, Satoshi; Takehara, Yasuo; Isoda, Haruo; Kodaira, Nami; Masunaga, Hatsuko; Ozawa, Fukujirou; Kaneko, Masao [Hamamatsu Univ. School of Medicine, Shizuoka (Japan); Nozaki, Atsushi; Kabasawa, Hiroyuki

    1999-03-01

    The utility of short TR single shot fast spin echo (SSFSE) MR imaging for evaluating swallowing was determined. Five healthy volunteers underwent kinematic MR imaging of swallowing with a 1.5 T MR scanner using the short TR (300 ms) SSFSE sequence. Twenty phases of sagittal sections were acquired within 6 sec, where the temporal resolution was 300 ms. For oral contrast medium, we used prune yogurt juice with Fe added. The image contrast of short TR SSFSE was found to be somewhere like that of T1-weighted images. In all cases, both the buccal and pharyngeal stages of swallowing were successfully depicted. The Fe-added prune yogurt juice performed as a positive contrast medium and helped determine anatomical structures in the buccal stage. Short TR (300 ms) SSFSE was useful in evaluating swallowing. The combined use of Fe-added prune yogurt juice was helpful in enhancing the surface of the oropharynx. (author)

  19. Kinematic MRI using short TR single shot fast spin echo (SSFSE) in evaluating swallowing

    International Nuclear Information System (INIS)

    Isogai, Satoshi; Takehara, Yasuo; Isoda, Haruo; Kodaira, Nami; Masunaga, Hatsuko; Ozawa, Fukujirou; Kaneko, Masao; Nozaki, Atsushi; Kabasawa, Hiroyuki

    1999-01-01

    The utility of short TR single shot fast spin echo (SSFSE) MR imaging for evaluating swallowing was determined. Five healthy volunteers underwent kinematic MR imaging of swallowing with a 1.5 T MR scanner using the short TR (300 ms) SSFSE sequence. Twenty phases of sagittal sections were acquired within 6 sec, where the temporal resolution was 300 ms. For oral contrast medium, we used prune yogurt juice with Fe added. The image contrast of short TR SSFSE was found to be somewhere like that of T1-weighted images. In all cases, both the buccal and pharyngeal stages of swallowing were successfully depicted. The Fe-added prune yogurt juice performed as a positive contrast medium and helped determine anatomical structures in the buccal stage. Short TR (300 ms) SSFSE was useful in evaluating swallowing. The combined use of Fe-added prune yogurt juice was helpful in enhancing the surface of the oropharynx. (author)

  20. Swallowing dysfunction in patients with unilateral vocal fold paralysis: aetiology and outcomes.

    Science.gov (United States)

    Ollivere, B; Duce, K; Rowlands, G; Harrison, P; O'Reilly, B J

    2006-01-01

    Although unilateral vocal fold palsy (UVFP) is a common problem, data relating to swallowing dysfunction are sparse. We reviewed the clinical findings (method of presentation, underlying diagnosis and position of the vocal folds) of 30 patients and conducted a follow-up telephone survey. Outcome measures used were direct visualization of fold function, position and compensation. In addition, standardized speech and language assessments for swallowing dysfunction and dysphonia were noted and compared to presentation. Our study indicates that 56 per cent of patients with UVFP have associated dysphagia. Outcome with speech therapy is significant, with 73 per cent showing improvement. These data indicate a significant link between UVFP and swallowing dysfunction. There is a marked therapeutic benefit from voice therapy. Further work is required to evaluate the long-term outcomes and establish the mechanism of swallowing dysfunction in these patients.

  1. Time-Frequency Analysis and Hermite Projection Method Applied to Swallowing Accelerometry Signals

    Directory of Open Access Journals (Sweden)

    Ervin Sejdić

    2010-01-01

    Full Text Available Fast Hermite projections have been often used in image-processing procedures such as image database retrieval, projection filtering, and texture analysis. In this paper, we propose an innovative approach for the analysis of one-dimensional biomedical signals that combines the Hermite projection method with time-frequency analysis. In particular, we propose a two-step approach to characterize vibrations of various origins in swallowing accelerometry signals. First, by using time-frequency analysis we obtain the energy distribution of signal frequency content in time. Second, by using fast Hermite projections we characterize whether the analyzed time-frequency regions are associated with swallowing or other phenomena (vocalization, noise, bursts, etc.. The numerical analysis of the proposed scheme clearly shows that by using a few Hermite functions, vibrations of various origins are distinguishable. These results will be the basis for further analysis of swallowing accelerometry to detect swallowing difficulties.

  2. Swallowing abnormalities in multiple sclerosis: correlation between videofluoroscopy and subjective symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Wiesner, W.; Steinbrich, W. [Institute of Diagnostic Radiology, University Hospital of Basel (Switzerland); Wetzel, S.G.; Radue, E.W. [Institute of Neuroradiology, University Hospital Basel (Switzerland); Kappos, L.; Hoshi, M.M. [Department of Neurology, University Hospital of Basel (Switzerland); Witte, U. [Section of Logopedia, University Hospital of Basel (Switzerland)

    2002-04-01

    The purpose of this study was to evaluate if subjective symptoms indicating an impaired deglutition correlate with videofluoroscopic findings in patients with multiple sclerosis (MS). Videofluoroscopic examinations of 18 MS patients were analyzed by a radiologist and a logopedist and compared with the symptoms of these patients. Four patients complained about permanent dysphagia. Six patients reported mild and intermittent difficulties in swallowing, but were asymptomatic at the time of videofluoroscopy. Eight patients had no symptoms regarding their deglutition. All patients (n=4) who complained of permanent dysphagia showed aspiration. All patients (n=6) with mild and intermittent difficulties in swallowing showed undercoating of the epiglottis and/or laryngeal penetration. Of those 8 patients without any swallowing symptoms, only 2 had a normal videofluoroscopy. Swallowing abnormalities seem to be much more frequent in patients with MS than generally believed and they may easily be missed clinically as long as the patients do not aspirate. (orig.)

  3. Comprehensive swallowing exercises to treat complicated dysphagia caused by esophageal replacement with colon: A case report.

    Science.gov (United States)

    Jiang, Li; Wang, Yujue; Li, Na; Qiu, Weihong; Wu, Huixiang; Huo, Jianshan; Dai, Meng; Yu, Yong; Wan, Guifang; Dou, Zulin; Guo, Weiping

    2017-02-01

    Surgical procedures for colonic replacement of the esophagus are most commonly associated with anastomotic stricture which cause dysphagia. In this report, we describe a rare case of a patient who demonstrated dysphagia resulting from an anastomotic stricture following esophageal replacement with the colon. All the treatments to dilate the anastomotic stricture were ineffective. To investigate the new treatment strategy for a case with complicated dysphagia, clinical dysphagia evaluations, functional oral intake scale (FOIS), videofluoroscopic swallowing study as well as high-resolution manometry were used to evaluate the swallowing function of the patient before and after treatments. Comprehensive swallowing exercises included the protective airway maneuver, tongue pressure resistance feedback exercise, Masako Maneuver swallowing exercise, and the effortful swallowing exercise. Comprehensive swallowing exercises showed good effect in the patient. The FOIS score increased from level 1 to level 7. The videofluoroscopy digital analysis showed that the pharynx constriction rate was 23% and 50%, before and after treatment, respectively. The data from the high-resolution manometry displayed that: the value of the velopharyngeal pressure peak was 82.8 mmHg before treatment and 156.9 mmHg after treatment; the velopharyngeal contraction duration time was 310 milliseconds before treatment and 525 milliseconds after treatment; the value of the hypopharynx pressure peak was 53.7 mmHg before treatment and 103.2 mmHg after treatment; and the hypopharynx contraction duration time was 390 milliseconds before treatment and 1030 milliseconds after treatment. The swallowing visualization illustrated that a bolus could normally pass through the anastomotic stoma, and the bolus leakage was no longer present. The patient was able to eat various consistencies of food independently, and we were able to remove the jejunum nutrient catheter before discharging the patient. For

  4. Aspiration of barium contrast medium in an elderly man with disordered swallowing

    OpenAIRE

    Bağcı Ceyhan, B.; Çelikel, T.; Koç, M.; Ahıskalı, R.; Biren, T.; Ataizi Çelikel, Ç.

    1995-01-01

    The aspiration of contrast medium during the investigation of gastrointestinal diseases is a well recognized hazard, particularly in patients with swallowing disorders. A case is reported in which accidental aspiration of contrast barium occurred owing to disordered swallowing in an elderly man. The infiltration on chest x-ray persisted 2 years after barium contrast aspiration. Inflammatory reaction and retractile, granular material observed in lung biopsy specimens suggested barium-induced p...

  5. Effect of aging on oral and swallowing function after meal consumption

    Directory of Open Access Journals (Sweden)

    Hiramatsu T

    2015-01-01

    Full Text Available Tetsuya Hiramatsu,1,2 Hideyuki Kataoka,3 Mari Osaki,4 Hiroshi Hagino3,4 1Department of Speech Pathology and Audiology, Matsue Co-medical College, Matsue, Japan; 2Graduate School of Medical Sciences, Tottori University, 3School of Health Science, Faculty of Medicine, Tottori University, 4Rehabilitation Division, Tottori University Hospital, Yonago, Japan Background/purpose: Dysphagia may worsen due to fatigue of the infrahyoid and suprahyoid muscle groups as a result of repetitive swallowing during a meal. We investigated the hypothesis that meal consumption may reduce tongue strength and endurance in older adults (OAs.Methods: Tongue–palate pressure, oral diadochokinesis, repetitive saliva swallowing, and surface electromyography activity before and after a meal were measured in 23 young adults (YAs and 23 OA volunteers.Results: There was a statistically significant difference in both tongue pressure and the number of voluntary swallows between YAs and OAs. Peak tongue pressure was significantly lower in OAs than YAs both before and after meal consumption. The most notable finding was that the first time interval (the time from test initiation to the beginning of the first swallow was prolonged after meal consumption only in OAs, whereas the first time interval showed no difference between YAs and OAs before meal consumption with reference to the repetitive saliva swallowing test. The initiation of swallowing was prolonged by both meal consumption and aging; there was a significant interaction between these two factors. The number of repetitions of the monosyllable/pa/was statistically similar between YAs and OAs before meal consumption, but it was significantly lower in OAs after meal consumption.Conclusion: Aging leads to declining tongue pressure and motor function of the lips. It is possible that swallowing function declines in older individuals when meal consumption is prolonged, especially at the end of mealtime, as a result of their

  6. The digastric muscle is less involved in pharyngeal swallowing in rabbits.

    Science.gov (United States)

    Tsujimura, Takanori; Yamada, Aki; Nakamura, Yuki; Fukuhara, Takako; Yamamura, Kensuke; Inoue, Makoto

    2012-06-01

    The swallowing reflex is centrally programmed by the lower brain stem, the so-called swallowing central pattern generator (CPG), and once the reflex is initiated, many muscles in the oral, pharyngeal, laryngeal, and esophageal regions are systematically activated. The mylohyoid (MH) muscle has been considered to be a "leading muscle" according to previous studies, but the functional role of the digastric (DIG) muscle in the swallowing reflex remains unclear. In the present study, therefore, the activities of single units of MH and DIG neurons were recorded extracellularly, and the functional involvement of these neurons in the swallowing reflex was investigated. The experiments were carried out on eight adult male Japanese white rabbits anesthetized with urethane. To identify DIG and MH neurons, the peripheral nerve (either DIG or MH) was stimulated to evoke action potentials of single motoneurons. Motoneurons were identified as such if they either (1) responded to antidromic nerve stimulation of DIG or MH in an all-or-none manner at threshold intensities and (2) followed stimulation frequencies of up to 0.5 kHz. As a result, all 11 MH neurons recorded were synchronously activated during the swallowing reflex, while there was no activity in any of the 7 DIG neurons recorded during the swallowing reflex. All neurons were anatomically localized ventromedially at the level of the caudal portion of the trigeminal motor nucleus, and there were no differences between the MH and DIG neuron sites. The present results strongly suggest that at least in the rabbit, DIG motoneurons are not tightly controlled by the swallowing CPG and, hence, the DIG muscle is less involved in the swallowing reflex.

  7. Role of physical bolus properties as sensory inputs in the trigger of swallowing.

    Science.gov (United States)

    Peyron, Marie-Agnès; Gierczynski, Isabelle; Hartmann, Christoph; Loret, Chrystel; Dardevet, Dominique; Martin, Nathalie; Woda, Alain

    2011-01-01

    Swallowing is triggered when a food bolus being prepared by mastication has reached a defined state. However, although this view is consensual and well supported, the physical properties of the swallowable bolus have been under-researched. We tested the hypothesis that measuring bolus physical changes during the masticatory sequence to deglutition would reveal the bolus properties potentially involved in swallowing initiation. Twenty normo-dentate young adults were instructed to chew portions of cereal and spit out the boluses at different times in the masticatory sequence. The mechanical properties of the collected boluses were measured by a texture profile analysis test currently used in food science. The median particle size of the boluses was evaluated by sieving. In a simultaneous sensory study, twenty-five other subjects expressed their perception of bolus texture dominating at any mastication time. Several physical changes appeared in the food bolus as it was formed during mastication: (1) in rheological terms, bolus hardness rapidly decreased as the masticatory sequence progressed, (2) by contrast, adhesiveness, springiness and cohesiveness regularly increased until the time of swallowing, (3) median particle size, indicating the bolus particle size distribution, decreased mostly during the first third of the masticatory sequence, (4) except for hardness, the rheological changes still appeared in the boluses collected just before swallowing, and (5) physical changes occurred, with sensory stickiness being described by the subjects as a dominant perception of the bolus at the end of mastication. Although these physical and sensory changes progressed in the course of mastication, those observed just before swallowing seem to be involved in swallowing initiation. They can be considered as strong candidates for sensory inputs from the bolus that are probably crucially involved in the triggering of swallowing, since they appeared in boluses prepared in various

  8. Role of physical bolus properties as sensory inputs in the trigger of swallowing.

    Directory of Open Access Journals (Sweden)

    Marie-Agnès Peyron

    Full Text Available BACKGROUND: Swallowing is triggered when a food bolus being prepared by mastication has reached a defined state. However, although this view is consensual and well supported, the physical properties of the swallowable bolus have been under-researched. We tested the hypothesis that measuring bolus physical changes during the masticatory sequence to deglutition would reveal the bolus properties potentially involved in swallowing initiation. METHODS: Twenty normo-dentate young adults were instructed to chew portions of cereal and spit out the boluses at different times in the masticatory sequence. The mechanical properties of the collected boluses were measured by a texture profile analysis test currently used in food science. The median particle size of the boluses was evaluated by sieving. In a simultaneous sensory study, twenty-five other subjects expressed their perception of bolus texture dominating at any mastication time. FINDINGS: Several physical changes appeared in the food bolus as it was formed during mastication: (1 in rheological terms, bolus hardness rapidly decreased as the masticatory sequence progressed, (2 by contrast, adhesiveness, springiness and cohesiveness regularly increased until the time of swallowing, (3 median particle size, indicating the bolus particle size distribution, decreased mostly during the first third of the masticatory sequence, (4 except for hardness, the rheological changes still appeared in the boluses collected just before swallowing, and (5 physical changes occurred, with sensory stickiness being described by the subjects as a dominant perception of the bolus at the end of mastication. CONCLUSIONS: Although these physical and sensory changes progressed in the course of mastication, those observed just before swallowing seem to be involved in swallowing initiation. They can be considered as strong candidates for sensory inputs from the bolus that are probably crucially involved in the triggering of

  9. Deleterious sucking habits and atypical swallowing in children with otitis media with effusion.

    Science.gov (United States)

    Ralli, Giovanni; Ruoppolo, Giovanni; Mora, Renzo; Guastini, Luca

    2011-10-01

    The aim of this study was to investigate the possible correlation between otitis media with effusion, bad sucking habits and atypical swallowing in children affected by otitis media with effusion. 65 children, aged from 7 to 12 years, observed in the ENT Department of the "La Sapienza" University of Rome, were enrolled in the study group (group A). All children were affected by otitis media with effusion for more than 3 months. As control group, 60 healthy children, aged from 7 to 12 years were identified (group B). All the children underwent medical history, with evaluation of the sucking habits, ENT examination, tympanometry, orthodontic examination and evaluation of swallowing. In the orthodontic examination the variables analyzed were: maximum mouth opening, right and left mandibular lateral movements and mandibular protrusion. Atypical swallowing was considered to occur when lip activity produced strong tension in the perioral musculature, and/or the tip of the tongue was placed or pushed against the anterior teeth during swallowing. In the group A, atypical swallowing was found in 33/65 subjects out of the 65 children (50.7%). In the control group (group B) 16/60 children (26.6%) showed atypical swallowing. Compared with group B, deleterious sucking habits were significantly higher (phabits were present in almost all children with atypical swallowing (28/33 in group A and 12/16 in group B). Our data suggest a correlation between otitis media with effusion, deleterious sucking habits and prevalence of atypical swallowing. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. Travel of a mis-swallowed long spoon to the jejunum

    Science.gov (United States)

    Song, Yan; Guo, Hua; Wu, Jian-Yong

    2009-01-01

    Foreign-body ingestion is a relatively common presentation at emergency departments, but long metallic spoon swallowing is an infrequent occurrence. Unlike most cases of foreign-body ingestion, there have been no reported cases of long foreign bodies reaching the jejunum. We report a rare case of a coffee spoon that was swallowed accidentally and passed through the pylorus and duodenal loop and reached the jejunum, with no complications. PMID:19842235

  11. Taste and Temperature in Swallowing Transit Time after Stroke

    Directory of Open Access Journals (Sweden)

    Paula C. Cola

    2012-09-01

    Full Text Available Background: Oropharyngeal dysphagia is common in individuals after stroke. Taste and temperature are used in dysphagia rehabilitation. The influence of stimuli, such as taste and temperature, on swallowing biomechanics has been investigated in both healthy individuals and in individuals with neurological disease. However, some questions still remain unanswered, such as how the sequence of offered stimuli influences the pharyngeal response. The goal of the present study was to determine the influence of the sequence of stimuli, sour taste and cold temperature, on pharyngeal transit time during deglutition in individuals after stroke. Methods: The study included 60 individuals with unilateral ischemic stroke, 29 males and 31 females, aged 41–88 years (mean age: 66.2 years examined 0–50 days after ictus (median: 6 days, with mild to moderate oropharyngeal dysphagia. Exclusion criteria were hemorrhagic stroke patients, patients with decreased level of consciousness, and clinically unstable patients, as confirmed by medical evaluation. The individuals were divided into two groups of 30 individuals each. Group 1 received a nonrandomized sequence of stimuli (i.e. natural, cold, sour, and sour-cold and group 2 received a randomized sequence of stimuli. A videofluoroscopic swallowing study was performed to analyze the pharyngeal transit time. Four different stimuli (natural, cold, sour, and sour-cold were offered. The images were digitalized and specific software was used to measure the pharyngeal transit time. Since the values did not present regular distribution and uniform variances, nonparametric tests were performed. Results: Individuals in group 1 presented a significantly shorter pharyngeal transit time with the sour-cold stimulus than with the other stimuli. Individuals in group 2 did not show a significant difference in pharyngeal transit time between stimuli. Conclusions: The results showed that the sequence of offered stimuli influences

  12. Swallowing Disorders in Sjögren's Syndrome: Prevalence, Risk Factors, and Effects on Quality of Life.

    Science.gov (United States)

    Pierce, Jenny L; Tanner, Kristine; Merrill, Ray M; Miller, Karla L; Kendall, Katherine A; Roy, Nelson

    2016-02-01

    This epidemiological investigation examined the prevalence, risk factors, and quality-of-life effects of swallowing disorders in Sjögren's syndrome (SS). One hundred and one individuals with primary or secondary SS (94 females, 7 males; mean age 59.4, SD = 14.1) were interviewed regarding the presence, nature, and impact of swallowing disorders and symptoms. Associations among swallowing disorders and symptoms, select medical and social history factors, SS disease severity, and the M.D. Anderson Dysphagia Inventory (MDADI) and Short Form 36 Health Survey (SF-36) were examined. The prevalence of a current self-reported swallowing disorder was 64.4 %. SS disease severity was the strongest predictor of swallowing disorders, including significant associations with the following swallow symptoms: taking smaller bites, thick mucus in the throat, difficulty placing food in the mouth, and wheezing while eating (p esophageal reflux, current exposure to secondary tobacco smoke, frequent neck or throat tension, frequent throat clearing, chronic post-nasal drip, and stomach or duodenal ulcers. Swallowing disorders did not differ on the basis of primary or secondary SS. Swallowing disorders and specific swallowing symptoms were uniquely associated with reduced quality of life. Among those with swallowing disorders, 42 % sought treatment, with approximately half reporting improvement. Patient-perceived swallowing disorders are relatively common in SS and increase with disease severity. Specific swallowing symptoms uniquely and significantly reduce swallow and health-related quality of life, indicating the need for increased identification and management of dysphagia in this population.

  13. A model experiment to study swallowing of spherical and elongated particles

    Directory of Open Access Journals (Sweden)

    Marconati Marco

    2017-01-01

    Full Text Available Swallowing disorders are not uncommon among elderly and people affected by neurological diseases. For these patients the ingestion of solid grains, such as pharmaceutical oral solid formulations, could result in choking. This generally results in a low compliance in taking solid medications. The effect of the solid medication size on the real or perceived ease of swallowing is still to be understood from the mechanistic viewpoint. The interplay of the inclusion shape and the rheology of the liquid being swallowed together with the medication is also not fully understood. In this study, a model experiment was developed to study the oropharyngeal phase of swallowing, replicating the dynamics of the bolus flow induced by the tongue (by means of a roller driven by an applied force. Experiments were performed using a wide set of solid inclusions, dispersed in a thick Newtonian liquid. Predictions for a simple theory are compared with experiments. Results show that an increase in the grain size results in a slower dynamics of the swallowing. Furthermore, the experiments demonstrated the paramount role of shape, as flatter and more streamlined inclusions flow faster than spherical. This approach can support the design of new oral solid formulations that can be ingested more easily and effectively also by people with mild swallowing disorders.

  14. Impaired swallowing mechanics of post radiation therapy head and neck cancer patients: A retrospective videofluoroscopic study.

    Science.gov (United States)

    Pearson, William G; Davidoff, Alisa A; Smith, Zachary M; Adams, Dorothy E; Langmore, Susan E

    2016-02-28

    To determine swallowing outcomes and hyolaryngeal mechanics associated with post radiation therapy head and neck cancer (rtHNC) patients using videofluoroscopic swallow studies. In this retrospective cohort study, videofluoroscopic images of rtHNC patients (n = 21) were compared with age and gender matched controls (n = 21). Penetration-aspiration of the bolus and bolus residue were measured as swallowing outcome variables. Timing and displacement measurements of the anterior and posterior muscular slings elevating the hyolaryngeal complex were acquired. Coordinate data of anatomical landmarks mapping the action of the anterior muscles (suprahyoid muscles) and posterior muscles (long pharyngeal muscles) were used to calculate the distance measurements, and slice numbers were used to calculate time intervals. Canonical variate analysis with post-hoc discriminant function analysis was performed on coordinate data to determine multivariate mechanics of swallowing associated with treatment. Pharyngeal constriction ratio (PCR) was also measured to determine if weak pharyngeal constriction is associated with post radiation therapy. The rtHNC group was characterized by poor swallowing outcomes compared to the control group in regards to: Penetration-aspiration scale (P time of displacement was abbreviated (P = 0.002) and distance of excursion was reduced (P = 0.02) in the rtHNC group. A canonical variate analysis shows a significant reduction in pharyngeal mechanics in the rtHNC group (P clearance. Using videofluoroscopy, this study shows rtHNC patients have worse swallowing outcomes associated with reduced hyolaryngeal mechanics and pharyngeal constriction compared with controls.

  15. The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats.

    Directory of Open Access Journals (Sweden)

    Anne Abysique

    Full Text Available Deoxynivalenol (DON, one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bolus from the mouth to the esophagus. To better understand DON effects on ingestive behaviour, we have studied its effects on rhythmic swallowing in the rat, after intravenous and central administration. Repetitive electrical stimulation of the superior laryngeal nerve or of the tractus solitarius, induces rhythmic swallowing that can be recorded using electromyographic electrodes inserted in sublingual muscles. Here we provide the first demonstration that, after intravenous and central administration, DON strongly inhibits the swallowing reflex with a short latency and in a dose dependent manner. Moreover, using c-Fos staining, a strong neuronal activation was observed in the solitary tract nucleus which contains the central pattern generator of swallowing and in the area postrema after DON intravenous injection. Our data show that DON modifies swallowing and interferes with central neuronal networks dedicated to food intake regulation.

  16. Contemporary management of voice and swallowing disorders in patients with advanced lung cancer.

    Science.gov (United States)

    Brady, Grainne C; Carding, Paul N; Bhosle, Jaishree; Roe, Justin W G

    2015-06-01

    Advanced lung cancer can cause changes to swallowing and communication function. Direct tumour invasion, dyspnoea and deconditioning can all impact on swallowing function and communication. Cancer treatment, if administered, may cause or compound symptoms. In this study, the nature of swallowing and communication difficulties in patients with advanced lung cancer will be discussed, and management options including medical management, speech and language therapy (SLT) intervention, and surgical interventions will be considered. Advanced lung cancer can result in voice and swallowing difficulties, which can increase symptom burden and significantly impact on quality of life (QOL). There is a growing evidence base to support the use of injection laryngoplasty under local anaesthetic to offer immediate improvement in voice, swallowing and overall QOL. There is limited literature on the nature and extent of voice and swallowing impairment in patients with lung cancer. Well designed studies with robust and sensitive multidimensional dysphagia and dysphonia assessments are required. Outcome studies examining interventions with clearly defined treatment goals are required. These studies should include both functional and patient-reported outcome measures to develop the evidence base and to ensure that interventions are both timely and appropriate.

  17. Effect of peripherally and cortically evoked swallows on jaw reflex responses in anesthetized rabbits.

    Science.gov (United States)

    Suzuki, Taku; Yoshihara, Midori; Sakai, Shogo; Tsuji, Kojun; Nagoya, Kouta; Magara, Jin; Tsujimura, Takanori; Inoue, Makoto

    2018-05-03

    This study aimed to investigate whether the jaw-opening (JOR) and jaw-closing reflexes (JCR) are modulated during not only peripherally, but also centrally, evoked swallowing. Experiments were carried out on 24 adult male Japanese white rabbits. JORs were evoked by trigeminal stimulation at 1 Hz for 30 sec. In the middle 10 sec, either the superior laryngeal nerve (SLN) or cortical swallowing area (Cx) was simultaneously stimulated to evoke swallowing. The peak-to-peak JOR amplitude was reduced during the middle and late 10-sec periods (i.e., during and after SLN or Cx stimulation), and the reduction was dependent on the current intensity of SLN/Cx stimulation: greater SLN/Cx stimulus current resulted in greater JOR inhibition. The reduction rate was significantly greater during Cx stimulation than during SLN stimulation. The amplitude returned to baseline 2 min after 10-sec SLN/Cx stimulation. The effect of co-stimulation of SLN and Cx was significantly greater than that of SLN stimulation alone. There were no significant differences in any parameters of the JCR between conditions. These results clearly showed that JOR responses were significantly suppressed, not only during peripherally evoked swallowing but also during centrally evoked swallowing, and that the inhibitory effect is likely to be larger during centrally compared with peripherally evoked swallowing. The functional implications of these results are discussed. Copyright © 2018. Published by Elsevier B.V.

  18. Impacts and limitations of medialization thyroplasty on swallowing function of patients with unilateral vocal fold paralysis.

    Science.gov (United States)

    Tateya, Ichiro; Hirano, Shigeru; Kishimoto, Yo; Suehiro, Atsushi; Kojima, Tsuyohi; Ohno, Satoshi; Ito, Juichi

    2010-11-01

    Medialization thyroplasty was effective in improving swallowing function as well as vocal function in most cases with unilateral vocal fold paralysis. The impact of medialization thryoplasty was insufficient for the case with severe atrophy and that in which the vocal fold was fixed in the lateral position. To evaluate the impacts and limitations of medialization thyroplasty on swallowing function of the patients with unilateral vocal fold paralysis. Eight cases (mean age 68.5 years) with unilateral vocal fold paralysis chiefly complaining of swallowing disturbance were studied. All patients underwent thyroplasty type I. The causes of the paralysis were lung cancer in four cases, esophageal cancer in one case, aortic aneurysm in one case, subarachnoid hemorrhage in one case, and unknown in one case. Subjective swallowing function score, maximum phonation time (MPT), mean flow rate (MFR), amplitude perturbation quotient (APQ), and pitch perturbation quotient (PPQ) were examined pre- and postoperatively. The swallowing score improved in all except two cases. However, bilateral thryoplasty was necessary for the case with severe vocal fold atrophy and arytenoid adduction was needed for the case in which the vocal fold was fixed in the lateral position. The swallowing score, MPT, and MFR showed significant improvement after surgery.

  19. Modular tree automata

    DEFF Research Database (Denmark)

    Bahr, Patrick

    2012-01-01

    Tree automata are traditionally used to study properties of tree languages and tree transformations. In this paper, we consider tree automata as the basis for modular and extensible recursion schemes. We show, using well-known techniques, how to derive from standard tree automata highly modular...

  20. Simple street tree sampling

    Science.gov (United States)

    David J. Nowak; Jeffrey T. Walton; James Baldwin; Jerry. Bond

    2015-01-01

    Information on street trees is critical for management of this important resource. Sampling of street tree populations provides an efficient means to obtain street tree population information. Long-term repeat measures of street tree samples supply additional information on street tree changes and can be used to report damages from catastrophic events. Analyses of...

  1. Values for rooted-tree and sink-tree digraphs games and sharing a river

    NARCIS (Netherlands)

    Khmelnitskaya, Anna Borisovna

    We introduce values for rooted-tree and sink-tree digraph games axiomatically and provide their explicit formula representation. These values may be considered as natural extensions of the lower equivalent and upper equivalent solutions for line-graph games studied in Brink, Laan, and Vasil'ev

  2. Swallowable fluorometric capsule for wireless triage of gastrointestinal bleeding.

    Science.gov (United States)

    Nemiroski, A; Ryou, M; Thompson, C C; Westervelt, R M

    2015-12-07

    Real-time detection of gastrointestinal bleeding remains a major challenge because there does not yet exist a minimally invasive technology that can both i) monitor for blood from an active hemorrhage and ii) uniquely distinguish it from blood left over from an inactive hemorrhage. Such a device would be an important tool for clinical triage. One promising solution, which we have proposed previously, is to inject a fluorescent dye into the blood stream and to use it as a distinctive marker of active bleeding by monitoring leakage into the gastrointestinal tract with a wireless fluorometer. This paper reports, for the first time to our knowledge, the development of a swallowable, wireless capsule with a built-in fluorometer capable of detecting fluorescein in blood, and intended for monitoring gastrointestinal bleeding in the stomach. The embedded, compact fluorometer uses pinholes to define a microliter sensing volume and to eliminate bulky optical components. The proof-of-concept capsule integrates optics, low-noise analog sensing electronics, a microcontroller, battery, and low power Zigbee radio, all into a cylindrical package measuring 11 mm × 27 mm and weighing 10 g. Bench-top experiments demonstrate wireless fluorometry with a limit-of-detection of 20 nM aqueous fluorescein. This device represents a major step towards a technology that would enable simple, rapid detection of active gastrointestinal bleeding, a capability that would save precious time and resources and, ultimately, reduce complications in patients.

  3. Swallowing performance after radiation therapy for carcinoma of the esophagus

    International Nuclear Information System (INIS)

    O'Rourke, I.C.; Tiver, K.; Bull, C.; Gebski, V.; Langlands, A.O.

    1988-01-01

    The purpose of the study reported in this article was to tabulate the incidence and etiologic factors of importance in the development of strictures after radiotherapy for carcinoma of the esophagus and to analyze the outcome of patients who develop such strictures. Eighty patients were treated with radiotherapy, 50 having radical and 30 having palliative treatment. Sixty-nine patients had squamous cell carcinoma, four had adenocarcinoma, one had sarcoma, one had mucoepidermoid carcinoma, and five had undifferentiated tumors. Forty percent developed no stricture, 30% had benign fibrotic stricture, and 28% developed malignant stricture. The etiologic factors analysed included age, pretreatment swallowing score, histology and length (size) of tumor; stage of disease, dose of radiotherapy, and use of chemotherapy. None of these factors were shown to be of etiologic importance. The survival of patients who developed benign strictures was found to be significantly longer (1-year survival 88%) than those who developed no stricture (50%) or malignant stricture (19%). Using a success score for palliation of dysphagia, it was found that the majority of patients (71%) who developed a benign stricture had a moderately successful outcome--they were able to tolerate a full or soft diet and required dilatation with a median duration between dilatations of 5 months. Patients who developed a malignant stricture were palliated poorly by dilatation alone, and most required esophageal intubation

  4. City of Pittsburgh Trees

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Trees cared for and managed by the City of Pittsburgh Department of Public Works Forestry Division. Tree Benefits are calculated using the National Tree Benefit...

  5. SU-D-BRA-01: Feasibility Study for Swallowing Prediction Using Pressure Sensors

    International Nuclear Information System (INIS)

    Cho, M; Kim, T; Kim, D; Kang, S; Kim, K; Shin, D; Noh, Y; Suh, T; Kim, S

    2016-01-01

    Purpose: To develop a swallowing prediction system (SPS) using force sensing sensors and evaluate its feasibility. Methods: The SPS developed consists of force sensing sensor units, a thermoplastic mask, a signal transport device and a control PC installed with an in-house software. The SPS is designed to predict the pharyngeal stage of swallowing because it is known that internal organ movement occurs in pharyngeal stage. To detect prediction signal in the SPS, the force sensing sensor units were attached on both the submental muscle region and thyroid cartilage region of the thermoplastic mask. While the signal from the thyroid cartilage region informs the action of swallowing, the signal from the submental muscle region is utilized as a precursor for swallowing. Since the duration of swallowing is relatively short, using such precursor (or warning) signals for machine control is considered more beneficial. A volunteer study was conducted to evaluate the feasibility of the system. In this volunteer study, we intended to verify that the system could predict the pharyngeal stage of the swallowing. We measured time gaps between obtaining the warning signals in the SPS and starting points of the pharyngeal stage of swallowing. Results: The measured data was examined whether the time gaps were in reasonable order to be easily utilized. The mean and standard deviation values of these time gaps were 0.550 s ± 0.183 s. in 8 volunteers. Conclusion: The proposed method was able to predict the on-set of swallowing of human subjects inside the thermoplastic mask, which has never been possible with other monitoring systems such as camera-based monitoring system. With the prediction ability of swallowing incorporated into the machine control mechanism (in the future), beam delivery can be controlled to skip swallowing periods and significant dosimetric gain is expected in head & neck cancer treatments. This work was supported by the Radiation Technology R&D program (No. 2015M

  6. SU-D-BRA-01: Feasibility Study for Swallowing Prediction Using Pressure Sensors

    Energy Technology Data Exchange (ETDEWEB)

    Cho, M; Kim, T; Kim, D; Kang, S; Kim, K; Shin, D; Noh, Y; Suh, T [The Catholic University of Korea College of Medicine, Department of Biomedical Engineering, Research Institute of Biomedical Engineering, Seoul (Korea, Republic of); Kim, S [Virginia Commonwealth University, Richmond, VA (United States)

    2016-06-15

    Purpose: To develop a swallowing prediction system (SPS) using force sensing sensors and evaluate its feasibility. Methods: The SPS developed consists of force sensing sensor units, a thermoplastic mask, a signal transport device and a control PC installed with an in-house software. The SPS is designed to predict the pharyngeal stage of swallowing because it is known that internal organ movement occurs in pharyngeal stage. To detect prediction signal in the SPS, the force sensing sensor units were attached on both the submental muscle region and thyroid cartilage region of the thermoplastic mask. While the signal from the thyroid cartilage region informs the action of swallowing, the signal from the submental muscle region is utilized as a precursor for swallowing. Since the duration of swallowing is relatively short, using such precursor (or warning) signals for machine control is considered more beneficial. A volunteer study was conducted to evaluate the feasibility of the system. In this volunteer study, we intended to verify that the system could predict the pharyngeal stage of the swallowing. We measured time gaps between obtaining the warning signals in the SPS and starting points of the pharyngeal stage of swallowing. Results: The measured data was examined whether the time gaps were in reasonable order to be easily utilized. The mean and standard deviation values of these time gaps were 0.550 s ± 0.183 s. in 8 volunteers. Conclusion: The proposed method was able to predict the on-set of swallowing of human subjects inside the thermoplastic mask, which has never been possible with other monitoring systems such as camera-based monitoring system. With the prediction ability of swallowing incorporated into the machine control mechanism (in the future), beam delivery can be controlled to skip swallowing periods and significant dosimetric gain is expected in head & neck cancer treatments. This work was supported by the Radiation Technology R&D program (No. 2015M

  7. Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises

    NARCIS (Netherlands)

    Kraaijenga, Sophie A. C.; van der Molen, Lisette; Jacobi, Irene; Hamming-Vrieze, Olga; Hilgers, Frans J. M.; van den Brekel, Michiel W. M.

    2015-01-01

    Concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer (HNC) is associated with substantial early and late side effects, most notably regarding swallowing function, but also regarding voice quality and quality of life (QoL). Despite increased awareness/knowledge on acute dysphagia in

  8. Results of fiberoptic endoscopic evaluation of swallowing vs. radiation dose in the swallowing muscles after radiotherapy of cancer in the oropharynx

    International Nuclear Information System (INIS)

    Teguh, David N.; Levendag, Peter C.; Sewnaik, Aniel; Hakkesteegt, Marieke M.; Noever, Inge; Voet, Peter; Est, Henrie van der; Sipkema, Dick; Rooij, Peter van; Baatenburg de Jong, Robert Jan; Schmitz, Paul I.M.

    2008-01-01

    Background and purpose: Dysphagia is a serious complaint but frequently underreported. This paper assesses for oropharyngeal cancer (OPC) the relationship between the dose received by the swallowing structures, and the findings of a fiberoptic endoscopic evaluation of the swallowing process (FEES). Materials and methods: Between 2000 and 2005, 60 of 67 OPC patients local-regionally NED for at least one year following treatment responded to three types of QoL questionnaires; i.e. Performance Status Scales, EORTC H and N35, and M.D. Anderson Dysphagia Inventory. Twenty-four patients agreed to the FEES procedure. The main swallowing muscles were delineated, with the mean dose per muscle calculated using the original 3D CT-based treatment plans. Regression analysis was performed between FEES variables and the doses in the different swallowing muscles and the dysphagia related questionnaires. Results: A significant relationship was found between the results of FEES and the mean dose in the superior constrictor muscle (SCM). Some of the subjective dysphagia complaints were significantly correlated with the FEES variables in this retrospectively study. Conclusion: A higher dose in the SCM generally results in worsening of the findings obtained by the FEES examination

  9. TreeRipper web application: towards a fully automated optical tree recognition software

    Directory of Open Access Journals (Sweden)

    Hughes Joseph

    2011-05-01

    Full Text Available Abstract Background Relationships between species, genes and genomes have been printed as trees for over a century. Whilst this may have been the best format for exchanging and sharing phylogenetic hypotheses during the 20th century, the worldwide web now provides faster and automated ways of transferring and sharing phylogenetic knowledge. However, novel software is needed to defrost these published phylogenies for the 21st century. Results TreeRipper is a simple website for the fully-automated recognition of multifurcating phylogenetic trees (http://linnaeus.zoology.gla.ac.uk/~jhughes/treeripper/. The program accepts a range of input image formats (PNG, JPG/JPEG or GIF. The underlying command line c++ program follows a number of cleaning steps to detect lines, remove node labels, patch-up broken lines and corners and detect line edges. The edge contour is then determined to detect the branch length, tip label positions and the topology of the tree. Optical Character Recognition (OCR is used to convert the tip labels into text with the freely available tesseract-ocr software. 32% of images meeting the prerequisites for TreeRipper were successfully recognised, the largest tree had 115 leaves. Conclusions Despite the diversity of ways phylogenies have been illustrated making the design of a fully automated tree recognition software difficult, TreeRipper is a step towards automating the digitization of past phylogenies. We also provide a dataset of 100 tree images and associated tree files for training and/or benchmarking future software. TreeRipper is an open source project licensed under the GNU General Public Licence v3.

  10. Functional connectivity and laterality of the motor and sensory components in the volitional swallowing network.

    Science.gov (United States)

    Lowell, Soren Y; Reynolds, Richard C; Chen, Gang; Horwitz, Barry; Ludlow, Christy L

    2012-05-01

    Functional neuroimaging has shown that multiple brain regions are active during volitional swallowing. Little is known, however, about which regions integrate motor execution and sensory feedback in the swallowing system. Although unilateral brain lesions in either hemisphere can produce swallowing deficits, some functional neuroimaging studies indicate that the left hemisphere has greater activation in certain sensory and motor-related swallowing regions. In this study, correlation coefficients were computed for five seed regions during volitional saliva swallowing to determine the functional relationships of these regions with the rest of the brain: the anterior and posterior insula, inferior frontal gyrus (BA44), primary sensory cortex (S1), and primary motor cortex (M1). A laterality index (LI) was derived that accounts for relative differences in total, positive connected voxels for the left/right hemisphere seeds. Clusters of significantly connected voxels were greater from the anterior and posterior insula than from the other three seed regions. Interactions of the insula with other brain regions were greater on the left than on the right during volitional swallowing. Group means showed laterality in the anterior insula (LI = 0.25) and the posterior insula (LI = 0.33). BA44 showed a lesser degree of difference in left versus right hemisphere interactions (LI = 0.12) while S1 did not show lateralization (LI = 0.02) and M1 showed some predominance of interactions in the right hemisphere (LI = -0.19). The greater connectivity from the left hemisphere insula to brain regions within and across hemispheres suggests that the insula is a primary integrative region for volitional swallowing in humans.

  11. Characterization of swallow modulation in response to bolus volume in healthy subjects accounting for catheter diameter.

    Science.gov (United States)

    Ferris, Lara; Schar, Mistyka; McCall, Lisa; Doeltgen, Sebastian; Scholten, Ingrid; Rommel, Nathalie; Cock, Charles; Omari, Taher

    2018-06-01

    Characterization of the pharyngeal swallow response to volume challenges is important for swallowing function assessment. The diameter of the pressure-impedance recording catheter may influence these results. In this study, we captured key physiological swallow measures in response to bolus volume utilizing recordings acquired by two catheters of different diameter. Ten healthy adults underwent repeat investigations with 8- and 10-Fr catheters. Liquid bolus swallows of volumes 2.5, 5, 10, 20, and 30 mL were recorded. Measures indicative of distension, contractility, and flow timing were assessed. Pressure-impedance recordings with pressure-flow analysis were used to capture key distension, contractility, and pressure-flow timing parameters. Larger bolus volumes increased upper esophageal sphincter distension diameter (P < .001) and distension pressures within the hypopharynx and upper esophageal sphincter (P < .05). Bolus flow timing measures were longer, particularly latency of bolus propulsion ahead of the pharyngeal stripping wave (P < .001). Use of a larger-diameter catheter produced higher occlusive pressures, namely upper esophageal sphincter basal pressure (P < .005) and upper esophageal sphincter postdeglutitive pressure peak (P < .001). The bolus volume swallowed changed measurements indicative of distension pressure, luminal diameter, and pressure-flow timing; this is physiologically consistent with swallow modulation to accommodate larger, faster-flowing boluses. Additionally, catheter diameter predominantly affects lumen occlusive pressures. Appropriate physiological interpretation of the pressure-impedance recordings of pharyngeal swallowing requires consideration of the effects of volume and catheter diameter. NA. Laryngoscope, 128:1328-1334, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Standardization of a Videofluoroscopic Swallow Study Protocol to Investigate Dysphagia in Dogs.

    Science.gov (United States)

    Harris, R A; Grobman, M E; Allen, M J; Schachtel, J; Rawson, N E; Bennett, B; Ledyayev, J; Hopewell, B; Coates, J R; Reinero, C R; Lever, T E

    2017-03-01

    Videofluoroscopic swallow study (VFSS) is the gold standard for diagnosis of dysphagia in veterinary medicine but lacks standardized protocols that emulate physiologic feeding practices. Age impacts swallow function in humans but has not been evaluated by VFSS in dogs. To develop a protocol with custom kennels designed to allow free-feeding of 3 optimized formulations of contrast media and diets that address limitations of current VFSS protocols. We hypothesized that dogs evaluated by a free-feeding VFSS protocol would show differences in objective swallow metrics based on age. Healthy juvenile, adult, and geriatric dogs (n = 24). Prospective, experimental study. Custom kennels were developed to maintain natural feeding behaviors during VFSS. Three food consistencies (thin liquid, pureed food, and dry kibble) were formulated with either iohexol or barium to maximize palatability and voluntary prehension. Dogs were evaluated by 16 swallow metrics and compared across age groups. Development of a standardized VFSS protocol resulted in successful collection of swallow data in healthy dogs. No significant differences in swallow metrics were observed among age groups. Substantial variability was observed in healthy dogs when evaluated under these physiologic conditions. Features typically attributed to pathologic states, such as gastric reflux, were seen in healthy dogs. Development of a VFSS protocol that reflects natural feeding practices may allow emulation of physiology resulting in clinical signs of dysphagia. Age did not result in significant changes in swallow metrics, but additional studies are needed, particularly in light of substantial normal variation. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  13. Effect of acid swallowing on esophageal contraction in patients with heartburn related to hypersensitivity.

    Science.gov (United States)

    Lee, Hyuk; Lee, Sang Kil; Park, Jun Chul; Shin, Sung Kwan; Lee, Yong Chan

    2013-01-01

    There are heterogeneous subgroups among those with heartburn, and data on these individuals are relatively scant. We aimed to evaluate the effect of acid challenge on the segmental contractions of esophageal smooth muscle in endoscopy-negative patients with normal esophageal acid exposure. High-resolution esophageal manometry (HRM) was performed on 30 endoscopy-negative patients with heartburn accompanied by normal esophageal acid exposure using 10 water swallows followed by 10 acidic pomegranate juice swallows. Patients were classified into functional heartburn (FH) and hypersensitive esophagus (HE) groups based on the results of 24-hr impedance pH testing. HRM topographic plots were analyzed and maximal wave amplitude and pressure volumes were measured for proximal and distal smooth muscle segments. The pressure volume of the distal smooth muscle segment in the HE group measured during acidic swallows was higher than during water swallows (2224.1 ± 68.2 mmHg/cm per s versus 2105.6 ± 66.4 mmHg/cm per s, P = 0.027). A prominent shift in the pressure volume to the distal smooth muscle segment was observed in the HE group compared with the FH group (segmental ratio: 2.72 ± 0.08 versus 2.39 ± 0.07, P = 0.005). Manometric measurements during acidic swallows revealed that this shift was augmented in the HE group. The optimal ratio of pomegranate juice swallowing for discrimination of FH from HE was 2.82, with a sensitivity of 88.9% and a specificity of 100%. Hypercontractile response of distal smooth muscle segment to acid swallowing was more prominent in the HE group than the FH group. © 2012 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  14. Use of fiberoptic endoscopic evaluation of swallowing (FEES) in the management of psychogenic dysphagia in children.

    Science.gov (United States)

    Thottam, Prasad John; Silva, Rodrigo C; McLevy, Jennifer D; Simons, Jeffrey P; Mehta, Deepak K

    2015-02-01

    To describe the use of fiberoptic endoscopic evaluation of swallowing (FEES) as an adjunct in the management of children presenting with psychogenic dysphagia, defined as food avoidance and excessive fear of eating without identifiable anatomic or functional swallowing abnormalities. Case series of patients presenting to the otolaryngology clinic of a tertiary pediatric teaching hospital between 2007 and 2008 that were evaluated and managed with the utilization of FEES. The outcomes measured were age, gender, duration of symptoms, findings of FEES, additional work-up and resolution of symptoms at follow-up. Five patients (4 males, 1 female) with ages ranging from 5 to 13 years old (mean=8.6). The median duration of symptoms before presentation was 3 weeks. Four families described refusal of solids starting after choking episode and variable estimated weight loss (mean 2.8kg). One child presented with vague complaints of intermittent odynophagia and food refusal. Fiberoptic endoscopic evaluation of swallowing was performed on all patients. No abnormalities of the oropharyngeal swallow were appreciated. Additional management included different combinations of modified barium swallow study, esophagastroduodenoscopy (EGD), upper GI series, antibiotics, and psychotherapy. Mean follow-up with clinic visit was 4.2 months. Three of the five children reported complete resolution of symptoms after FEES at follow-up visit. Fiberoptic endoscopic evaluation of swallowing can be a useful management tool in children with psychogenic dysphagia as it provides direct visualization of the oropharyngeal swallowing mechanism. This can be used to provide visual reassure and biofeedback to patients and parents. Additional workup should be decided on an individual basis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Cannabinoids facilitate the swallowing reflex elicited by the superior laryngeal nerve stimulation in rats.

    Science.gov (United States)

    Mostafeezur, Rahman Md; Zakir, Hossain Md; Takatsuji, Hanako; Yamada, Yoshiaki; Yamamura, Kensuke; Kitagawa, Junichi

    2012-01-01

    Cannabinoids have been reported to be involved in affecting various biological functions through binding with cannabinoid receptors type 1 (CB1) and 2 (CB2). The present study was designed to investigate whether swallowing, an essential component of feeding behavior, is modulated after the administration of cannabinoid. The swallowing reflex evoked by the repetitive electrical stimulation of the superior laryngeal nerve in rats was recorded before and after the administration of the cannabinoid receptor agonist, WIN 55-212-2 (WIN), with or without CB1 or CB2 antagonist. The onset latency of the first swallow and the time intervals between swallows were analyzed. The onset latency and the intervals between swallows were shorter after the intravenous administration of WIN, and the strength of effect of WIN was dose-dependent. Although the intravenous administration of CB1 antagonist prior to intravenous administration of WIN blocked the effect of WIN, the administration of CB2 antagonist did not block the effect of WIN. The microinjection of the CB1 receptor antagonist directly into the nucleus tractus solitarius (NTS) prior to intravenous administration of WIN also blocked the effect of WIN. Immunofluorescence histochemistry was conducted to assess the co-localization of CB1 receptor immunoreactivity to glutamic acid decarboxylase 67 (GAD67) or glutamate in the NTS. CB1 receptor was co-localized more with GAD67 than glutamate in the NTS. These findings suggest that cannabinoids facilitate the swallowing reflex via CB1 receptors. Cannabinoids may attenuate the tonic inhibitory effect of GABA (gamma-aminobuteric acid) neurons in the central pattern generator for swallowing.

  16. Cannabinoids facilitate the swallowing reflex elicited by the superior laryngeal nerve stimulation in rats.

    Directory of Open Access Journals (Sweden)

    Rahman Md Mostafeezur

    Full Text Available Cannabinoids have been reported to be involved in affecting various biological functions through binding with cannabinoid receptors type 1 (CB1 and 2 (CB2. The present study was designed to investigate whether swallowing, an essential component of feeding behavior, is modulated after the administration of cannabinoid. The swallowing reflex evoked by the repetitive electrical stimulation of the superior laryngeal nerve in rats was recorded before and after the administration of the cannabinoid receptor agonist, WIN 55-212-2 (WIN, with or without CB1 or CB2 antagonist. The onset latency of the first swallow and the time intervals between swallows were analyzed. The onset latency and the intervals between swallows were shorter after the intravenous administration of WIN, and the strength of effect of WIN was dose-dependent. Although the intravenous administration of CB1 antagonist prior to intravenous administration of WIN blocked the effect of WIN, the administration of CB2 antagonist did not block the effect of WIN. The microinjection of the CB1 receptor antagonist directly into the nucleus tractus solitarius (NTS prior to intravenous administration of WIN also blocked the effect of WIN. Immunofluorescence histochemistry was conducted to assess the co-localization of CB1 receptor immunoreactivity to glutamic acid decarboxylase 67 (GAD67 or glutamate in the NTS. CB1 receptor was co-localized more with GAD67 than glutamate in the NTS. These findings suggest that cannabinoids facilitate the swallowing reflex via CB1 receptors. Cannabinoids may attenuate the tonic inhibitory effect of GABA (gamma-aminobuteric acid neurons in the central pattern generator for swallowing.

  17. Voluntary Modulation of Hemodynamic Responses in Swallowing Related Motor Areas: A Near-Infrared Spectroscopy-Based Neurofeedback Study.

    Directory of Open Access Journals (Sweden)

    Silvia Erika Kober

    Full Text Available In the present study, we show for the first time that motor imagery of swallowing, which is defined as the mental imagination of a specific motor act without overt movements by muscular activity, can be successfully used as mental strategy in a neurofeedback training paradigm. Furthermore, we demonstrate its effects on cortical correlates of swallowing function. Therefore, N = 20 healthy young adults were trained to voluntarily increase their hemodynamic response in swallowing related brain areas as assessed with near-infrared spectroscopy (NIRS. During seven training sessions, participants received either feedback of concentration changes in oxygenated hemoglobin (oxy-Hb group, N = 10 or deoxygenated hemoglobin (deoxy-Hb group, N = 10 over the inferior frontal gyrus (IFG during motor imagery of swallowing. Before and after the training, we assessed cortical activation patterns during motor execution and imagery of swallowing. The deoxy-Hb group was able to voluntarily increase deoxy-Hb over the IFG during imagery of swallowing. Furthermore, swallowing related cortical activation patterns were more pronounced during motor execution and imagery after the training compared to the pre-test, indicating cortical reorganization due to neurofeedback training. The oxy-Hb group could neither control oxy-Hb during neurofeedback training nor showed any cortical changes. Hence, successful modulation of deoxy-Hb over swallowing related brain areas led to cortical reorganization and might be useful for future treatments of swallowing dysfunction.

  18. Dysphagia management: an analysis of patient outcomes using VitalStim therapy compared to traditional swallow therapy.

    Science.gov (United States)

    Kiger, Mary; Brown, Catherine S; Watkins, Lynn

    2006-10-01

    This study compares the outcomes using VitalStim therapy to outcomes using traditional swallowing therapy for deglutition disorders. Twenty-two patients had an initial and a followup videofluoroscopic swallowing study or fiberoptic endoscopic evaluation of swallowing and were divided into an experimental group that received VitalStim treatments and a control group that received traditional swallowing therapy. Outcomes were analyzed for changes in oral and pharyngeal phase dysphagia severity, dietary consistency restrictions, and progression from nonoral to oral intake. Results of chi(2) analysis showed no statistically significant difference in outcomes between the experimental and control groups.

  19. Swallowable capsule with air channel for improved image-guided cancer detection in the esophagus

    Science.gov (United States)

    Seibel, Eric J.; Melville, C. David; Lung, Jonathan K. C.; Babchanik, Alexander P.; Lee, Cameron M.; Johnston, Richard S.; Dominitz, Jason A.

    2009-02-01

    A new type of endoscope has been developed and tested in the human esophagus, a tethered-capsule endoscope (TCE) that requires no sedation for oral ingestion and esophageal inspection. The TCE uses scanned red, green, and blue laser light to image the upper digestive tract using a swallowable capsule of 6.4mm in diameter and 18mm in length on a 1.4mm diameter tether. The TCE has been modified for image-guided interventions in the lower esophagus, specifically for more effective detection and measurement of the extent of Barrett's esophagus, a precursor to esophageal cancer. Three modifications have been tested in vivo: (1) weighting the capsule so it is negatively buoyant in water, (2) increasing the frame rate of 500-line images to 30 Hz (video rate), and (3) adding a 1.0mm inner diameter working channel alongside the tether for distending the lower esophagus with air pressure during endoscopy. All three modifications proved effective for more clearly visualizing the lower esophagus in the first few human subjects. The air channel was especially useful because it did not change tolerability in the first subject for unsedated endoscopy and the air easily removed bubbles obscuring tissue from the field of view. The air provided a non-invasive intervention by stimulating the mechanosensor of the lower esophageal sphincter at the precise time that the TCE was positioned for most informative imaging. All three TCE modifications proved successful for improved visualization of esophageal pathology, such as suspected Barrett's esophagus, without the use of sedation.

  20. Nitric Oxide - Its Importance in Swallowing, Inflammatory Bowel Disease and Cirrhotic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    ABR Thomson

    2001-01-01

    Full Text Available Nitric oxide is a neurotransmitter found in the central and peripheral nervous systems. Nitric oxide synthase (NOS is localized in the central nervous system, including the nucleus of the solitary tract, nucleus ambiguus and dorsal motor nucleus of the vagus. These are regions that are implicated in the central control of swallowing and esophageal motility. In rats and rabbits, NOS has been shown to be present in the nucleus subcentralis of the nucleus of the solitary tract, and is thought to be responsible for the central programming of the striated muscle component of esophageal peristalsis. Beyak and co-workers from the University of Toronto, Toronto, Ontario provided evidence that the L-arginine-nitric oxide pathway is implicated in the central control of swallowing and esophageal motility. They studied oropharyngeal swallowing as well as esophageal peristalsis, and determined the functional role of brain stem nitric oxide by examining the effects of blockade of central nervous system NOS on swallowing, and on primary and secondary peristalsis. Administering NOS inhibitors intravenously or intracerebroventricularly into the fourth ventricle produced a number of oropharyngeal swallows and induced primary peristalsis in the smooth muscle portion of the esophageal body. NOS reduced the number of oropharyngeal swallows and the incidence of primary peristalsis in both smooth and striated muscle, and reduced the amplitude of peristalsis and smooth muscle contraction. This suggests that nitric oxide is a functional neurotransmitter in the central pattern generator responsible for swallowing and the central control of esophageal peristalsis. Peripherally administered NOS inhibitor can access structures within the blood-brain barrier to affect neuronal activity and physiological function. The central pattern generated for swallowing and esophageal peristalsis is suggested to be a serial network of linked neurons within the nucleus of the solitary

  1. Swallowing disorders in nursing home residents: how can the problem be explained?

    Directory of Open Access Journals (Sweden)

    Nogueira D

    2013-02-01

    Full Text Available Dália Nogueira,1 Elizabeth Reis21Speech Therapy Department, Escola Superior de Saúde de Alcoitão, Estoril, Portugal; 2Department of Quantitative Methods, Lisbon University Institute ISCTE/IUL, Lisbon, PortugalBackground: The swallowing mechanism changes significantly as people age, even in the absence of chronic diseases. Presbyphagia, a term that refers to aging-related changes in the swallowing mechanism, may be linked to many health conditions and presents itself in distinct ways. Swallowing disorders are also identified as a major problem amongst the elderly population living in nursing homes.Methods: The study sought to determine the prevalence of swallowing disorders in nursing home residents, to identify the relationship between self-perceived swallowing disorders, cognitive functions, autonomy, and depression, and also to analyze which variables explain the score of the Dysphagia Self-Test (DST. For this purpose, the researchers chose to apply a survey conveying questions on demographic aspects, general health, eating and feeding, as well as instruments to assess functional performance and the 3 ounce Water Swallow Test.Results: The sample consisted of 272 elderly people living in eight nursing homes in Portugal. Six did not sign the informed consent form. Of the total, 29% were totally dependent, 33% were depressed, 45% had cognitive impairment, and 38% needed help with feeding. About 43% of the individuals reported having problems related to eating. Regarding the DST, 40% showed signs of dysphagia. With respect to the 3 ounce Water Swallow Test, 38% revealed at least one of the symptoms, wet voice being the most prevalent. Correlation measures showed that age had no linear association with the DST score although correlation with the Barthel Index and Mini Mental State Examination was found to be significant. A linear regression model was estimated with the DST score as the dependent variable and the MMSE and BI scores, gender, age

  2. Impacts of palatal coverage on bolus formation during mastication and swallowing and subsequent adaptive changes.

    Science.gov (United States)

    Sato, T; Furuya, J; Tamada, Y; Kondo, H

    2013-10-01

    Palatal coverage is often required for elderly edentulous patients with complete dentures. The purpose of this study was to clarify impacts of palatal coverage on bolus formation and subsequent adaptive changes. Subjects were 18 healthy young dentulous adults who wore 1·5-mm-thick palatal plates. Subjects were asked to feed 12 g of bicoloured rice as usual, and the bolus formation by mastication and swallowing in the pharynx was observed using a nasal videoendoscopy. The bolus formation index (BFI), number of mastication strokes until swallowing, visual analogue scale about swallowing easiness and masticatory performance using colour-changeable gum were measured under three conditions: before placement of the palatal plate (day 0), immediately after placement (day 1) and after 7 days of wearing the plate (day 7). BFI and visual analogue scale on day 1 were significantly lower than those on day 0, but those on day 7 significantly recovered to the level of day 0. The number of mastication strokes did not change from day 0 to day 1, however, that on day 7 was significantly higher. Masticatory performance on days 1 and 7 was significantly lower than that on day 0. Although palatal coverage inhibits bolus formation during feeding, subjects increased the number of mastication strokes until swallowing threshold as they adapted to palatal coverage over time. This adaptive change was due to compensate for the lowered masticatory performance to achieve bolus formation for comfortable swallowing. © 2013 John Wiley & Sons Ltd.

  3. Esophageal Transit, Contraction and Perception of Transit After Swallows of Two Viscous Boluses.

    Science.gov (United States)

    Dalmazo, Jucileia; Aprile, Lilian Rose Otoboni; Dantas, Roberto Oliveira

    2015-10-01

    There have been results showing the influence of bolus viscosities and consistency on esophageal motility and transit. However, there is no description about the influence of two different viscous boluses on esophageal contractions, bolus transit and perception of transit. Our objective in this investigation was to evaluate the esophageal transit and contraction after swallows of two viscous boluses. By impedance and manometric methods, we measured the esophageal transit and contraction after swallows of two viscous boluses of 5 mL volume, 100% barium sulfate and yogurt, swallowed in duplicate in the supine and upright positions. The bolus transit, esophageal contractions and the perception of bolus transit through the esophagus were evaluated in both positions. Impedance and contraction were measured at 5, 10, 15 and 20 cm from the lower esophageal sphincter. After each swallow, the volunteers were asked about the sensation of bolus transit through the esophagus. In supine position, the yogurt had a less frequent complete bolus transit than barium. Also in the supine position, the esophageal transit was longer with yogurt than with barium. Esophageal contractions after swallows were similar between barium and yogurt boluses. There was no difference in perception of transit between the two boluses. Although both 100% barium sulfate and yogurt are viscous boluses and have similar viscosities, the transit through the esophagus is slower with yogurt bolus than with barium bolus, which suggests that viscosity may be not the sole factor to determine transit.

  4. Experimental infection of cliff swallows (Petrochelidon pyrrhonota) with varying doses of West Nile virus

    Science.gov (United States)

    Oesterle, P.T.; Nemeth, N.M.; VanDalen, Kaci K.; Sullivan, H.; Bentler, K.T.; Young, G.R.; McLean, R.G.; Clark, L.; Smeraski, C.; Hall, Jeffrey S.

    2009-01-01

    Cliff swallows (Petrochelidon pyrrhonota) were inoculated with differing doses of West Nile virus (WNV) to evaluate their potential role as reservoir hosts in nature. Swallows often nest in large colonies in habitats and months associated with high mosquito abundance and early WNV transmission in North America. Additionally, cliff swallow diet consists of insects, including mosquitoes, leading to an additional potential route of WNV infection. The average peak viremia titer among infected cliff swallows was 106.3 plaque-forming units (PFU)/mL serum and the reservoir competence index was 0.34. There was no correlation between dose and probability of becoming infected or viremia peak and duration. Oral shedding was detected from 2 to 14 days post-inoculation with an average peak titer of 1044 PFU/swab. These results suggest that cliff swallows are competent reservoir hosts of WNV and therefore, they may play a role in early seasonal amplification and maintenance of WNV. Copyright ?? 2009 by The American Society of Tropical Medicine and Hygiene.

  5. Swallowing impairment and pulmonary dysfunction in Parkinson's disease: the silent threats.

    Science.gov (United States)

    Monteiro, Larissa; Souza-Machado, Adelmir; Pinho, Patrícia; Sampaio, Marília; Nóbrega, Ana Caline; Melo, Ailton

    2014-04-15

    Swallowing disorders and respiratory impairment are frequent in Parkinson's disease (PD) patients, and aspiration pneumonia remains the leading cause of death among these subjects. The objective of this study was to investigate whether there is an association between pulmonary impairment and swallowing dysfunction in PD patients. A cross-sectional study with a comparison group was conducted with PD patients. Subjects were submitted to demographic questionnaires and underwent spirometric and videofluorographic assessments. Significance level was considered at 95% (p<0.05). Among 35 PD patients, 40% presented with swallowing complaints. However, 22% of the clinically asymptomatic patients presented airway food penetration when submitted to videofluoroscopy. In 20% of PD patients material entered the airways and there was contact with the vocal folds in 7%. However, there was an efficient cleaning with residue deglutition in almost all patients. No penetration/aspiration was detected among the controls. Respiratory parameters were below the normal predicted values in PD patients when compared to the healthy controls. These data suggest an association between pulmonary dysfunction and swallowing impairment in PD patients; even in patients without swallowing complaints, impaired pulmonary function can be detected. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Analysis of oropharyngeal dysphagia through fibroendoscopy evaluation of swallowing in patients with Parkinson's disease.

    Science.gov (United States)

    Correa-Flores, Melissa; Arch-Tirado, Emilio; Villeda-Miranda, Alicia; Rocha-Cacho, Karina Elizabeth; Verduzco-Mendoza, Antonio; Hernández-López, Xochiquetzal

    2012-01-01

    Parkinson's disease (PD) has a high incidence in Mexico and is estimated at approximately 500,000 patients. One of the main clinical manifestations of PD is dysphagia, which is the difficult passage of food from the mouth to the stomach. The aim of this study was to assess oropharyngeal dysphagia through fibroendoscopy evaluation of swallowing in patients with PD. We conducted a census sample of patients with PD: 17 males and 10 females, aged >49 years. Clinical history, physical examination and neurological evaluation of swallowing fibroendoscopy were carried out. Of the symptomatic patients, 16 patients (59.25%) reported dysphagia. Fibroendoscopic evaluation demonstrated swallowing disorders in 25 patients (92.59%). The main findings were poor bolus control in 19 patients (70.37%), deficits in bolus propulsion in 25 patients (92.59%), impaired swallowing in 14 patients (51.85%), fractional swallowing in 11 patients (40.74%), reduced epiglottic tilting in 11 patients (48.14%), food residue in vallecula in 24 patients (88.88%) and piriform sinus in 19 patients (70.37%). There was no correlation between duration of PD and degree of involvement of oropharyngeal dysphagia. Oropharyngeal dysphagia in patients with PD is a common symptom and can range from the oral cavity to the upper esophageal sphincter. Early onset of severe dysphagia is exceptional in this disease and should alert the clinician to the diagnostic possibility of parkinsonism.

  7. Deglutitive inhibition, latency between swallow and esophageal contractions and primary esophageal motor disorders.

    Science.gov (United States)

    Sifrim, Daniel; Jafari, Jafar

    2012-01-01

    Swallowing induces an inhibitory wave that is followed by a contractile wave along the esophageal body. Deglutitive inhibition in the skeletal muscle of the esophagus is controlled in the brain stem whilst in the smooth muscle, an intrinsic peripheral control mechanism is critical. The latency between swallow and contractions is determined by the pattern of activation of the inhibitory and excitatory vagal pathways, the regional gradients of inhibitory and excitatory myenteric nerves, and the intrinsic properties of the smooth muscle. A wave of inhibition precedes a swallow-induced peristaltic contraction in the smooth muscle part of the human oesophagus involving both circular and longitudinal muscles in a peristaltic fashion. Deglutitive inhibition is necessary for drinking liquids which requires multiple rapid swallows (MRS). During MRS the esophageal body remains inhibited until the last of the series of swallows and then a peristaltic contraction wave follows. A normal response to MRS requires indemnity of both inhibitory and excitatory mechanisms and esophageal muscle. MRS has recently been used to assess deglutitive inhibition in patients with esophageal motor disorders. Examples with impairment of deglutitive inhibition are achalasia of the LES and diffuse esophageal spasm.

  8. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough

    Directory of Open Access Journals (Sweden)

    Carlos Shuler Nin

    2013-12-01

    Full Text Available OBJECTIVE: To assess the routine use of barium swallow study in patients with chronic cough.METHODS: Between October of 2011 and March of 2012, 95 consecutive patients submitted to chest X-ray due to chronic cough (duration > 8 weeks were included in the study. For study purposes, additional images were obtained immediately after the oral administration of 5 mL of a 5% barium sulfate suspension. Two radiologists systematically evaluated all of the images in order to identify any pathological changes. Fisher's exact test and the chi-square test for categorical data were used in the comparisons.RESULTS: The images taken immediately after barium swallow revealed significant pathological conditions that were potentially related to chronic cough in 12 (12.6% of the 95 patients. These conditions, which included diaphragmatic hiatal hernia, esophageal neoplasm, achalasia, esophageal diverticulum, and abnormal esophageal dilatation, were not detected on the images taken without contrast. After appropriate treatment, the symptoms disappeared in 11 (91.6% of the patients, whereas the treatment was ineffective in 1 (8.4%. We observed no complications related to barium swallow, such as contrast aspiration.CONCLUSIONS: Barium swallow improved the detection of significant radiographic findings related to chronic cough in 11.5% of patients. These initial findings suggest that the routine use of barium swallow can significantly increase the sensitivity of chest X-rays in the detection of chronic cough-related etiologies.

  9. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough.

    Science.gov (United States)

    Nin, Carlos Shuler; Marchiori, Edson; Irion, Klaus Loureiro; Paludo, Artur de Oliveira; Alves, Giordano Rafael Tronco; Hochhegger, Daniela Reis; Hochhegger, Bruno

    2013-01-01

    To assess the routine use of barium swallow study in patients with chronic cough. Between October of 2011 and March of 2012, 95 consecutive patients submitted to chest X-ray due to chronic cough (duration > 8 weeks) were included in the study. For study purposes, additional images were obtained immediately after the oral administration of 5 mL of a 5% barium sulfate suspension. Two radiologists systematically evaluated all of the images in order to identify any pathological changes. Fisher's exact test and the chi-square test for categorical data were used in the comparisons. The images taken immediately after barium swallow revealed significant pathological conditions that were potentially related to chronic cough in 12 (12.6%) of the 95 patients. These conditions, which included diaphragmatic hiatal hernia, esophageal neoplasm, achalasia, esophageal diverticulum, and abnormal esophageal dilatation, were not detected on the images taken without contrast. After appropriate treatment, the symptoms disappeared in 11 (91.6%) of the patients, whereas the treatment was ineffective in 1 (8.4%). We observed no complications related to barium swallow, such as contrast aspiration. Barium swallow improved the detection of significant radiographic findings related to chronic cough in 11.5% of patients. These initial findings suggest that the routine use of barium swallow can significantly increase the sensitivity of chest X-rays in the detection of chronic cough-related etiologies.

  10. Sensory and instrumental analysis for slipperiness and compliance of food during swallowing.

    Science.gov (United States)

    Seo, H-S; Hwang, I K; Han, T R; Kim, I S

    2007-11-01

    In spite of its importance, there have been few attempts to evaluate the sensory attributes of the food bolus during swallowing. In the current study, the slipperiness, the degree of slide for the food bolus through the mucosal surface of the oro-pharynx, and the compliance, how easily the shape of a food bolus can be transformed for automatic and comfortable swallowing, were derived among several sensory attributes related to the swallowing. Therefore, the study aims were twofold: (1) to develop the methods of sensory and instrumental analyses for determining the slipperiness and compliance of the food bolus during swallowing and (2) to examine the appropriateness of the newly designed devices by correlating the data between the sensory and instrumental analyses. Six commercial food products were evaluated by 10 trained panelists for each attribute. The devices for assessing each attribute were developed in consideration of the oro-pharyngeal movements. The sensory and instrumental analyses showed high correlation and regression coefficients as well as intensity differences of the 6 samples for each attribute. In conclusion, the slipperiness and the compliance were suitable for acquiring a better understanding of the sensory attributes of the food bolus during swallowing, and the newly developed devices showed a high potential for determining those attributes.

  11. Visual and auditory stimuli associated with swallowing. An fMRI study

    International Nuclear Information System (INIS)

    Kawai, Takeshi; Watanabe, Yutaka; Tonogi, Morio; Yamane, Gen-yuki; Abe, Shinichi; Yamada, Yoshiaki; Callan, Akiko

    2009-01-01

    We focused on brain areas activated by audiovisual stimuli related to swallowing motions. In this study, three kinds of stimuli related to human swallowing movement (auditory stimuli alone, visual stimuli alone, or audiovisual stimuli) were presented to the subjects, and activated brain areas were measured using functional MRI (fMRI) and analyzed. When auditory stimuli alone were presented, the supplementary motor area was activated. When visual stimuli alone were presented, the premotor and primary motor areas of the left and right hemispheres and prefrontal area of the left hemisphere were activated. When audiovisual stimuli were presented, the prefrontal and premotor areas of the left and right hemispheres were activated. Activation of Broca's area, which would have been characteristic of mirror neuron system activation on presentation of motion images, was not observed; however, activation of brain areas related to swallowing motion programming and performance was verified for auditory, visual and audiovisual stimuli related to swallowing motion. These results suggest that audiovisual stimuli related to swallowing motion could be applied to the treatment of patients with dysphagia. (author)

  12. Oropharyngeal and laryngeal sensory innervation in the pathophysiology of swallowing disorders and sensory stimulation treatments.

    Science.gov (United States)

    Alvarez-Berdugo, Daniel; Rofes, Laia; Casamitjana, J Francesc; Padrón, Andreína; Quer, Miquel; Clavé, Pere

    2016-09-01

    Oropharyngeal dysphagia (OD) affects older and neurological patients, causing malnutrition and dehydration and increasing the risk for aspiration pneumonia. There is evidence that sensory deficits in those populations are closely related to swallowing disorders, and several research groups are developing new therapies based on sensory stimulation of this area. More information on the sensory innervation participating in the swallow response is needed to better understand the pathophysiology of OD and to develop new treatments. This review focuses on the sensory innervation of the human oropharynx and larynx in healthy people compared with patients with swallowing disorders in order to unravel the abnormalities that may lead to the loss of sensitivity in patients with OD. We also hypothesize the pathway through which active sensory-enhancement treatments may elicit their therapeutic effect on patients with swallowing dysfunctions. As far as we know, this is the first time a review covers the anatomy, histology, ultrastructure, and molecular biology of the sensory innervation of the swallowing function. © 2016 New York Academy of Sciences.

  13. On the Physiology of Normal Swallowing as Revealed by Magnetic Resonance Imaging in Real Time

    Directory of Open Access Journals (Sweden)

    Arno Olthoff

    2014-01-01

    Full Text Available The aim of this study was to assess the physiology of normal swallowing using recent advances in real-time magnetic resonance imaging (MRI. Therefore ten young healthy subjects underwent real-time MRI and flexible endoscopic evaluations of swallowing (FEES with thickened pineapple juice as oral contrast bolus. MRI movies were recorded in sagittal, coronal, and axial orientations during successive swallows at about 25 frames per second. Intermeasurement variation was analyzed and comparisons between real-time MRI and FEES were performed. Twelve distinct swallowing events could be quantified by real-time MRI (start time, end time, and duration. These included five valve functions: oro-velar opening, velo-pharyngeal closure, glottal closure, epiglottic retroflexion, and esophageal opening; three bolus transports: oro-velar transit, pharyngeal delay, pharyngeal transit; and four additional events: laryngeal ascent, laryngeal descent, vallecular, and piriform sinus filling and pharyngeal constriction. Repetitive measurements confirmed the general reliability of the MRI method with only two significant differences for the start times of the velo-pharyngeal closure (t(8=-2.4, P≤0.046 and laryngeal ascent (t(8=-2.6, P≤0.031. The duration of the velo-pharyngeal closure was significantly longer in real-time MRI compared to FEES (t(8=-3.3, P≤0.011. Real-time MRI emerges as a simple, robust, and reliable tool for obtaining comprehensive functional and anatomical information about the swallowing process.

  14. Genealogy and gene trees.

    Science.gov (United States)

    Rasmuson, Marianne

    2008-02-01

    Heredity can be followed in persons or in genes. Persons can be identified only a few generations back, but simplified models indicate that universal ancestors to all now living persons have occurred in the past. Genetic variability can be characterized as variants of DNA sequences. Data are available only from living persons, but from the pattern of variation gene trees can be inferred by means of coalescence models. The merging of lines backwards in time leads to a MRCA (most recent common ancestor). The time and place of living for this inferred person can give insights in human evolutionary history. Demographic processes are incorporated in the model, but since culture and customs are known to influence demography the models used ought to be tested against available genealogy. The Icelandic data base offers a possibility to do so and points to some discrepancies. Mitochondrial DNA and Y chromosome patterns give a rather consistent view of human evolutionary history during the latest 100 000 years but the earlier epochs of human evolution demand gene trees with longer branches. The results of such studies reveal as yet unsolved problems about the sources of our genome.

  15. Categorizing ideas about trees: a tree of trees.

    Science.gov (United States)

    Fisler, Marie; Lecointre, Guillaume

    2013-01-01

    The aim of this study is to explore whether matrices and MP trees used to produce systematic categories of organisms could be useful to produce categories of ideas in history of science. We study the history of the use of trees in systematics to represent the diversity of life from 1766 to 1991. We apply to those ideas a method inspired from coding homologous parts of organisms. We discretize conceptual parts of ideas, writings and drawings about trees contained in 41 main writings; we detect shared parts among authors and code them into a 91-characters matrix and use a tree representation to show who shares what with whom. In other words, we propose a hierarchical representation of the shared ideas about trees among authors: this produces a "tree of trees." Then, we categorize schools of tree-representations. Classical schools like "cladists" and "pheneticists" are recovered but others are not: "gradists" are separated into two blocks, one of them being called here "grade theoreticians." We propose new interesting categories like the "buffonian school," the "metaphoricians," and those using "strictly genealogical classifications." We consider that networks are not useful to represent shared ideas at the present step of the study. A cladogram is made for showing who is sharing what with whom, but also heterobathmy and homoplasy of characters. The present cladogram is not modelling processes of transmission of ideas about trees, and here it is mostly used to test for proximity of ideas of the same age and for categorization.

  16. Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD).

    Science.gov (United States)

    Newman, Roger; Vilardell, Natàlia; Clavé, Pere; Speyer, Renée

    2016-04-01

    Fluid thickening is a well-established management strategy for oropharyngeal dysphagia (OD). However, the effects of thickening agents on the physiology of impaired swallow responses are not fully understood, and there is no agreement on the degree of bolus thickening. To review the literature and to produce a white paper of the European Society for Swallowing Disorders (ESSD) describing the evidence in the literature on the effect that bolus modification has upon the physiology, efficacy and safety of swallowing in adults with OD. A systematic search was performed using the electronic Pubmed and Embase databases. Articles in English available up to July 2015 were considered. The inclusion criteria swallowing studies on adults over 18 years of age; healthy people or patients with oropharyngeal dysphagia; bolus modification; effects of bolus modification on swallow safety (penetration/aspiration) and efficacy; and/or physiology and original articles written in English. The exclusion criteria consisted of oesophageal dysphagia and conference abstracts or presentations. The quality of the selected papers and the level of research evidence were assessed by standard quality assessments. At the end of the selection process, 33 articles were considered. The quality of all included studies was assessed using systematic, reproducible, and quantitative tools (Kmet and NHMRC) concluding that all the selected articles reached a valid level of evidence. The literature search gathered data from various sources, ranging from double-blind randomised control trials to systematic reviews focused on changes occurring in swallowing physiology caused by thickened fluids. Main results suggest that increasing bolus viscosity (a) results in increased safety of swallowing, (b) also results in increased amounts of oral and/or pharyngeal residue which may result in post-swallow airway invasion, (c) impacts the physiology with increased lingual pressure patterns, no major changes in impaired

  17. Urban tree growth modeling

    Science.gov (United States)

    E. Gregory McPherson; Paula J. Peper

    2012-01-01

    This paper describes three long-term tree growth studies conducted to evaluate tree performance because repeated measurements of the same trees produce critical data for growth model calibration and validation. Several empirical and process-based approaches to modeling tree growth are reviewed. Modeling is more advanced in the fields of forestry and...

  18. Keeping trees as assets

    Science.gov (United States)

    Kevin T. Smith

    2009-01-01

    Landscape trees have real value and contribute to making livable communities. Making the most of that value requires providing trees with the proper care and attention. As potentially large and long-lived organisms, trees benefit from commitment to regular care that respects the natural tree system. This system captures, transforms, and uses energy to survive, grow,...

  19. Factors influencing bird foraging preferences among conspecific fruit trees

    Science.gov (United States)

    Foster, M.S.

    1990-01-01

    The rates at which birds visit fruiting individuals of Allophylus edulis (Sapindaceae) differ substantially among trees. Such avian feeding preferences are well-known, but usually involve fruits and trees of different species. Factors controlling avian preferences for particular trees in a population of conspecifics are generally undocumented. To address this issue, I attempted to correlate rates at which individual birds and species fed in trees of Allophylus with 27 fruit or plant characteristics. Birds that swallow fruits whole were considered separately from those that feed in other ways. Plant characters were selected on the basis of their potential influence on feeding efficiency or predation risk, assuming that birds would select feeding trees so as to maximize the net rate of energy or nutrient intake and to minimize predation. Correlations were found between feeding visits by some groups of birds and percent water in the pulp, milligrams of mineral ash in the pulp, and crop size. No character was correlated with feeding visits by all groups of birds in both years of the study. The correlations with water and mineral ash are unexplained and may be artifacts. The correlation with crop size may represent a tactic to minimize predation.

  20. Classification and regression trees

    CERN Document Server

    Breiman, Leo; Olshen, Richard A; Stone, Charles J

    1984-01-01

    The methodology used to construct tree structured rules is the focus of this monograph. Unlike many other statistical procedures, which moved from pencil and paper to calculators, this text's use of trees was unthinkable before computers. Both the practical and theoretical sides have been developed in the authors' study of tree methods. Classification and Regression Trees reflects these two sides, covering the use of trees as a data analysis method, and in a more mathematical framework, proving some of their fundamental properties.

  1. Computer Tree

    Directory of Open Access Journals (Sweden)

    Onur AĞAOĞLU

    2014-12-01

    Full Text Available It is crucial that gifted and talented students should be supported by different educational methods for their interests and skills. The science and arts centres (gifted centres provide the Supportive Education Program for these students with an interdisciplinary perspective. In line with the program, an ICT lesson entitled “Computer Tree” serves for identifying learner readiness levels, and defining the basic conceptual framework. A language teacher also contributes to the process, since it caters for the creative function of the basic linguistic skills. The teaching technique is applied for 9-11 aged student level. The lesson introduces an evaluation process including basic information, skills, and interests of the target group. Furthermore, it includes an observation process by way of peer assessment. The lesson is considered to be a good sample of planning for any subject, for the unpredicted convergence of visual and technical abilities with linguistic abilities.

  2. Early Identification and Treatment of Communication and Swallowing Deficits in Parkinson Disease

    Science.gov (United States)

    Ciucci, Michelle R.; Grant, Laura M.; Paul Rajamanickam, Eunice S.; Hilby, Breanna L.; Blue, Katherine V.; Jones, Corinne A.; Kelm-Nelson, Cynthia A.

    2015-01-01

    Parkinson disease (PD) is a complex, progressive, neurodegenerative disorder that leads to a wide range of deficits including fine and gross sensorimotor impairment, autonomic dysfunction, mood disorders, and cognitive decline. Traditionally, the focus for diagnosis and treatment has been on sensorimotor impairment related to dopamine depletion. It is now widely recognized, however, that PD-related pathology affects multiple central nervous system neurotransmitters and pathways. Communication and swallowing functions can be impaired even in the early stages, significantly affecting health and quality of life. The purpose of this article is to review the literature on early intervention for communication and swallowing impairment in PD. Overarching themes were that (1) studies and interpretation of data from studies in early PD are limited; (2) best therapy practices have not been established, in part due to the heterogeneous nature of PD; and (3) as communication and swallowing problems are pervasive in PD, further treatment research is essential. PMID:24166192

  3. Comparison of barium swallow and ultrasound in diagnosis of gastro-oesophageal reflux in children.

    Science.gov (United States)

    Naik, D R; Bolia, A; Moore, D J

    1985-01-01

    Fifty one infants and older children with suspected gastro-oesophageal reflux entered a study comparing the diagnostic accuracy of a standard barium swallow examination with that of ultrasound scanning. All children were examined by both techniques. In 40 cases there was unequivocal agreement between the examinations. Of the remaining patients, four had definite reflux by ultrasonic criteria but showed no evidence of reflux on barium swallow examination, four had positive findings on ultrasound but showed only minimal reflux on barium swallow, and one showed minimal reflux on ultrasound but had a negative barium meal result. In two children the ultrasound study was inconclusive. Ultrasound has an important role in the diagnosis and follow up of patients under the age of 5 years with gastro-oesophageal reflux. Images FIG 1 FIG 2 PMID:3924317

  4. Quantifying swallowing function for healthy adults in different age groups using acoustic analysis

    Science.gov (United States)

    Leung, Man-Yin

    Dysphagia is a medical condition that can lead to devastating complications including weight loss, aspiration pneumonia, dehydration, and malnutrition; hence, timely identification is essential. Current dysphagia evaluation tools are either invasive, time consuming, or highly dependent on the experience of an individual clinician. The present study aims to develop a non-invasive, quantitative screening tool for dysphagia identification by capturing acoustic data from swallowing and mastication. The first part of this study explores the feasibility of using acoustic data to quantify swallowing and mastication. This study then further identifies mastication and swallowing trends in a neurotypical adult population. An acoustic capture protocol for dysphagia screening is proposed. Finally, the relationship among speaking, lingual and mastication rates are explored. Results and future directions are discussed.

  5. [Visualization of laryngopharynx during swallowing of negative contrast media (air) with cine mode 64-row MDCT].

    Science.gov (United States)

    Fudeya, Taku; Otake, Shoichiro; Watabe, Hirotaka; Mitsuoka, Takashi; Yoshikawa, Akitoshi

    2010-05-20

    Video fluoroscopic examination of swallowing generally needs a contrast media such as a barium sulfate. Since the examination is usually performed in patients with dysphasia, there is a risk of aspiration. We tried to visualize the laryngopharynx during swallowing of negative contrast media (air) with 64-row multi-detector computed tomography (64-MDCT). Cine mode 64-MDCT was performed to visualize the laryngopharynx in 4 healthy volunteers during swallowing of negative contrast media (air). The data were converted to three-dimensional (3D) images of 2 conditions (air and bone) and sagittal images of the soft tissue condition at a workstation. These images were sent to a personal computer and modeled to 3D cine images with Digital Imaging and Communication in Medicine (DICOM) Viewer and Quick Time Player. 3D cine images demonstrated movements of the epiglottis, vallecula, piriform sinus, tongue, pharyngeal wall, hyoid bone and thyroid cartilage.

  6. Successful treatment of pill-swallowing difficulties with head posture practice.

    Science.gov (United States)

    Kaplan, Bonnie J; Steiger, Roberta A; Pope, Jamie; Marsh, Ashley; Sharp, Maegan; Crawford, Susan G

    2010-05-01

    Clinics often encounter neurologically intact patients who are unable to swallow pills. All of the interventions published previously have used traditional behavioural techniques, which are time consuming and often not helpful. To determine whether children who had never been able to swallow a whole pill could become successful as a result of an intervention based on head posture. A novel intervention was developed based on published research showing that changing head position alters swallowing dynamics. The method was developed in two studies of 240 adults and children, pilot tested in a study of 108 university students with very mild pill-swallowing discomfort, and then evaluated in a study of 41 children who had never successfully swallowed a pill in spite of much instruction and coaxing. Children were recruited from a tertiary paediatric hospital: 34 were clinic patients, four were their siblings or friends, and three were children of hospital staff. The primary intervention involved teaching five head positions (centre, up, down, left and right) followed by a two-week period of daily practice. EIGHT CHILDREN (ALL CLINIC REFERRALS) WITHDREW WITHOUT PRACTICING: four were too ill to practice (primarily due to sedation or nausea) and four simply refused to do the homework practice. All 33 of the children who were able and willing to practice daily were successful. Practice with head posture variations was successful in treating pill-swallowing difficulties in all 33 children who practiced for 14 days. A training video can be viewed at www.ucalgary.ca/research4kids/pillswallowing.

  7. INFLUENCE OF AGE ON SWALLOWS OF A HIGHLY VISCOUS LIQUID BOLUS

    Directory of Open Access Journals (Sweden)

    Weslania Viviane NASCIMENTO

    2015-03-01

    Full Text Available Background Swallow function has a decline with aging, mainly in those over 80 years old. In the population over 69 years, about 11% of subjects reported symptoms indicative of significant dysphagia. Objectives Our objective was to evaluate the hypothesis that older asymptomatic subjects before 80 years old have compensations to sustain a safe and efficient swallow, at least with swallows of liquid bolus. Methods We performed videofluoroscopic evaluation of swallows in 55 normal volunteers, a younger group with 33 subjects (16 men and 17 women aged 19 to 55 years, mean 35.5±9.8 years, and an older group with 22 subjects (15 men and 7 women aged 56 to 77 years, mean 64.8±6.8 years. The subjects swallowed in duplicate 5 mL and 10 mL of liquid barium with a pH of 7.9, density of 1.82 g/cm3, and viscosity of 895 cp. Results The mean duration of pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement and oral-pharyngeal transit were longer in the younger group compared with the older group. The relation between pharyngeal clearance duration and hyoid movement duration was similar in younger and older subjects, for 5 mL and 10 mL bolus volumes. Conclusions On average, a highly viscous liquid bolus crosses the pharynx faster in older subjects (56-77 years old than in younger subjects (19-55 years old, which suggested an adaptation to the aging process to maintain a safe swallow.

  8. Improvement of swallowing function in patients with esophageal cancer treated by radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sugahara, Shinji; Nakajima, Kotaro; Nozawa, Kumiko [Hitachi Ltd., Ibaraki (Japan). Hitachi General Hospital; Ohara, Kiyoshi; Yoshioka, Hiroshi; Tatsuzaki, Hideo; Tanaka, Naomi; Fukao, Katashi; Itai, Yuji

    1996-12-01

    This study investigated the impact of radiotherapy on swallowing function in 152 patients with esophageal cancer. Swallowing function was retrospectively assessed in these patients using a swallowing-function scoring system. Total tumor dose ranged from 22.5 Gy in 14 fractions to 104.4 Gy in 50 fractions. Improvement in dysphagia was noted in 62.3% of these patients, with a median time to improvement of 6 weeks. Improvement rate of patients irradiated with 20.0 to 34.9 Gy, 35.0 to 59.9 Gy and 60.0 Gy or more was 23.1%, 58.3% and 71.6%, respectively. Patients with T1-3 showed, a greater improvement rate than patients with T4 cancer (72.2% versus 54.1%). On multivariate analysis, the initial score, total dose and T factor correlated with improvements in swallowing function. Our results suggest that 35.0 Gy or more is necessary to improve swallowing function. The median duration in which patients could swallow soft or solid foods, was 8 months in patients receiving 60.0 Gy or more and 2 months in patients receiving 50.0 to 59.9 Gy, respectively. There was a significant difference between these periods (p<0.01). Regarding duration of palliation, median duration for patients receiving 60.0 Gy or more was 30 weeks, while it was 22 weeks for patients treated with lesser doses (p=0.053). We recommend 60.0 Gy or more as the optimal dosage for improving dysphagia. (author)

  9. Non-invasive monitoring of chewing and swallowing for objective quantification of ingestive behavior

    International Nuclear Information System (INIS)

    Sazonov, Edward; Schuckers, Stephanie; Lopez-Meyer, Paulo; Makeyev, Oleksandr; Sazonova, Nadezhda; Melanson, Edward L; Neuman, Michael

    2008-01-01

    A methodology of studying of ingestive behavior by non-invasive monitoring of swallowing (deglutition) and chewing (mastication) has been developed. The target application for the developed methodology is to study the behavioral patterns of food consumption and producing volumetric and weight estimates of energy intake. Monitoring is non-invasive based on detecting swallowing by a sound sensor located over laryngopharynx or by a bone-conduction microphone and detecting chewing through a below-the-ear strain sensor. Proposed sensors may be implemented in a wearable monitoring device, thus enabling monitoring of ingestive behavior in free-living individuals. In this paper, the goals in the development of this methodology are two-fold. First, a system comprising sensors, related hardware and software for multi-modal data capture is designed for data collection in a controlled environment. Second, a protocol is developed for manual scoring of chewing and swallowing for use as a gold standard. The multi-modal data capture was tested by measuring chewing and swallowing in 21 volunteers during periods of food intake and quiet sitting (no food intake). Video footage and sensor signals were manually scored by trained raters. Inter-rater reliability study for three raters conducted on the sample set of five subjects resulted in high average intra-class correlation coefficients of 0.996 for bites, 0.988 for chews and 0.98 for swallows. The collected sensor signals and the resulting manual scores will be used in future research as a gold standard for further assessment of sensor design, development of automatic pattern recognition routines and study of the relationship between swallowing/chewing and ingestive behavior

  10. Defining Swallowing-Related Quality of Life Profiles in Individuals with Amyotrophic Lateral Sclerosis

    Science.gov (United States)

    Gaziano, Joy; Watts, Stephanie; Robison, Raele; Plowman, Emily K.

    2016-01-01

    Although it is known that dysphagia contributes to significant malnutrition, pneumonia, and mortality in amyotrophic lateral sclerosis (ALS), it remains unclear how swallowing impairment impacts quality of life in this vulnerable patient population. The aim of the current study was to (1) delineate swallow-related quality of life (SR-QOL) profiles in individuals with ALS and (2) evaluate relationships between SR-QOL, degree of swallowing impairment, and ALS global disease progression. Eighty-one ALS patients underwent a standardized videofluoroscopic swallow study and completed the swallowing quality of life (SWAL-QOL) instrument and ALS functional rating scale-revised (ALSFRS-R). Penetration Aspiration Scale (PAS) scores were derived by a blinded rater. Correlation analyses and a between groups ANOVA (safe vs. penetrators vs. aspirators) were performed. Mean SWAL-QOL score for this cohort was 75.94 indicating a moderate degree of SR-QOL impairment with fatigue, eating duration, and communication representing the most affected domains. Correlations were revealed between the SWAL-QOL and (1) PAS (r = −0.39, p < 0.001) and (2) ALSFRS-R (r = 0.23, p < 0.05). Mean (SD) SWAL-QOL scores for safe versus penetrator versus aspirator groups were 81.2 (2.3) versus 77 (3.4) versus 58.7 (5.9), respectively, with a main effect observed [F(2,78) = 9.71, p < 0.001]. Post hoc testing revealed lower SWAL-QOL scores for aspirators versus safe swallowers (p < 0.001) and aspirators versus penetrators (p < 0.001). Overall, SR-QOL was moderately reduced in this cohort of ALS patients and profoundly impacted in ALS aspirators and individuals with advanced disease. These findings highlight the importance of early multidisciplinary intervention to not only avoid malnutrition, weight loss, and pulmonary sequelae but also the associated reduced QOL seen in these individuals. PMID:26837611

  11. Objective clinical assessment of change in swallowing ability of maxillectomy patients when wearing obturator prostheses.

    Science.gov (United States)

    Matsuyama, Miwa; Tsukiyama, Yoshihiro; Koyano, Kiyoshi

    2005-01-01

    Evaluation of treatment outcome is important in maxillofacial rehabilitation. Although eating is one of the oral functions that most strongly influences patients' quality of life, only a few reports exist on the objective assessment of swallowing for maxillectomy patients. The purpose of this study was to identify changes in the swallowing ability of maxillectomy patients when wearing obturator prostheses through the use of an objective clinical assessment. The swallowing ability of 38 postmaxillectomy patients consecutively treated with obturator prostheses was objectively evaluated with the "water-drinking test" that was developed for the assessment of dysphagia patients after cerebrovascular disease. In this test, the subjects were instructed to drink 30 mL of water in one swallow. The profile was evaluated with the combination of the time required for drinking the water and the incidence of cough reflex. Statistical analysis was performed using the Wilcoxon signed-rank test, the paired t test, and the Chi-square test with StatView 5.0 for the Macintosh. Performance improved significantly when the patients wore prostheses (P = .0026, Wilcoxon signed-rank test). The mean drinking times without and with prostheses were 8.2 +/- 6.3 s and 5.0 +/- 3.5 s, respectively. Drinking time was shortened significantly when the prosthesis was worn (P = .0002, paired t test). The assessment of behavior and episodes revealed that the swallowing ability of the maxillectomy patients was significantly improved when a prosthesis was worn (P = .0002, Chi-square test). The swallowing ability of maxillectomy patients was quantitatively and qualitatively improved with obturator prostheses.

  12. [Evaluation of swallowing function with surface electromyography before and after tonsillectomy].

    Science.gov (United States)

    Gürkan, Emre; Veyseller, Bayram; Açıkalın, Reşit Murat; Elbistanlı, Suphi; Yurtsever, Serveren; Acar, Hürtan

    2011-01-01

    In this study, we evaluated the swallowing function with surface electromyography before and after tonsillectomy. Twenty patients (12 males, 8 females; mean age 23.8 years; range 17 to 30 years) who had tonsillectomy indication as study group, and 10 healthy individuals (8 males, 2 females; mean age 26 years; range 18 to 35 years) as control group were included in this prospective study between October 2008 and February 2009. Due to their significant role on oral and faringeal phases of swallowing; the surface electromyography prosedure is performed on the masseter muscle, the submental-submandibular muscle group and the infrahyoid muscles to measure their electrical activity and duration of contraction. For this purpose, single swallow and continuous drinking of 100 cc water tests were applied to each patient preoperatively and; in the postoperative 1st week and the 1st month. The preoperative duration of drinking periods were significanly longer in the study group compared to the control group (p<0.05). At the end of the first postoperative week the duration of drinking 100 cc water test was significantly longer than the preoperative mean of the study group (p<0.05). After one month single- swallow durations of study group were significantly shorter then the preoperative mean (p<0.05). The electrical activity of the masseter and infrahyoid muscles were significantly higher in study group compared with control group (p<0.05). The close proximity of the surgical area to the muscles affects swallowing after tonsillectomy. The surface electromyography is a simple, non-invasive and reliable method for postoperative evaluation of the swallowing functions of the throat muscles and thereby allows monitoring of the recovery and functional improvement of these muscles.

  13. Non-invasive monitoring of chewing and swallowing for objective quantification of ingestive behavior.

    Science.gov (United States)

    Sazonov, Edward; Schuckers, Stephanie; Lopez-Meyer, Paulo; Makeyev, Oleksandr; Sazonova, Nadezhda; Melanson, Edward L; Neuman, Michael

    2008-05-01

    A methodology of studying of ingestive behavior by non-invasive monitoring of swallowing (deglutition) and chewing (mastication) has been developed. The target application for the developed methodology is to study the behavioral patterns of food consumption and producing volumetric and weight estimates of energy intake. Monitoring is non-invasive based on detecting swallowing by a sound sensor located over laryngopharynx or by a bone-conduction microphone and detecting chewing through a below-the-ear strain sensor. Proposed sensors may be implemented in a wearable monitoring device, thus enabling monitoring of ingestive behavior in free-living individuals. In this paper, the goals in the development of this methodology are two-fold. First, a system comprising sensors, related hardware and software for multi-modal data capture is designed for data collection in a controlled environment. Second, a protocol is developed for manual scoring of chewing and swallowing for use as a gold standard. The multi-modal data capture was tested by measuring chewing and swallowing in 21 volunteers during periods of food intake and quiet sitting (no food intake). Video footage and sensor signals were manually scored by trained raters. Inter-rater reliability study for three raters conducted on the sample set of five subjects resulted in high average intra-class correlation coefficients of 0.996 for bites, 0.988 for chews and 0.98 for swallows. The collected sensor signals and the resulting manual scores will be used in future research as a gold standard for further assessment of sensor design, development of automatic pattern recognition routines and study of the relationship between swallowing/chewing and ingestive behavior.

  14. A Novel Imaging Analysis Method for Capturing Pharyngeal Constriction During Swallowing.

    Science.gov (United States)

    Schwertner, Ryan W; Garand, Kendrea L; Pearson, William G

    2016-01-01

    Videofluoroscopic imaging of swallowing known as the Modified Barium Study (MBS) is the standard of care for assessing swallowing difficulty. While the clinical purpose of this radiographic imaging is to primarily assess aspiration risk, valuable biomechanical data is embedded in these studies. Computational analysis of swallowing mechanics (CASM) is an established research methodology for assessing multiple interactions of swallowing mechanics based on coordinates mapping muscle function including hyolaryngeal movement, pharyngeal shortening, tongue base retraction, and extension of the head and neck, however coordinates characterizing pharyngeal constriction is undeveloped. The aim of this study was to establish a method for locating the superior and middle pharyngeal constrictors using hard landmarks as guides on MBS videofluoroscopic imaging, and to test the reliability of this new method. Twenty de-identified, normal, MBS videos were randomly selected from a database. Two raters annotated landmarks for the superior and middle pharyngeal constrictors frame-by-frame using a semi-automated MATLAB tracker tool at two time points. Intraclass correlation coefficients were used to assess test-retest reliability between two raters with an ICC = 0.99 or greater for all coordinates for the retest measurement. MorphoJ integrated software was used to perform a discriminate function analysis to visualize how all 12 coordinates interact with each other in normal swallowing. The addition of the superior and middle pharyngeal constrictor coordinates to CASM allows for a robust analysis of the multiple components of swallowing mechanics interacting with a wide range of variables in both patient specific and cohort studies derived from common use imaging data.

  15. Correlation of ultrasound imaging of oral swallow with ventilatory alterations in cerebral palsied and normal children: preliminary observations.

    Science.gov (United States)

    Kenny, D J; Casas, M J; McPherson, K A

    1989-01-01

    Preliminary results of an investigation that synchronizes the videotaped output of ultrasound camera and the analog data from physiological measurements of swallowing and ventilation in normal and cerebral palsied (CP) children are presented. Four cerebral palsied children and three control children undertook a single sip-swallow of 5 ml of liquid and a solid mastication-swallow sequence on three occasions according to a defined protocol. The CP children exhibited much more variability and less control of the liquid bolus than did the controls. The ultrasound image clearly demonstrates the lack of control of the posterior of the tongue in many CP children. Some parts of the sequence of oral swallow and the time to achieve maximum anterior displacement of the hyoid bone appear to be slowed. The sequential events of swallowing show less variability as the sip-swallow proceeds from the oral voluntary to pharyngeal and lower involuntary phases. This study also identified a short-latency apnea that appears to accompany a saliva (protective) swallow and a long-latency apnea that accompanies semi-solid or liquid bolus (alimentary) swallows. Further investigations of normal and CP children utilizing a combined diagnostic imaging-physiological measurement approach will follow this initial study.

  16. Auditory Verbal Cues Alter the Perceived Flavor of Beverages and Ease of Swallowing: A Psychometric and Electrophysiological Analysis

    Directory of Open Access Journals (Sweden)

    Aya Nakamura

    2013-01-01

    Full Text Available We investigated the possible effects of auditory verbal cues on flavor perception and swallow physiology for younger and elder participants. Apple juice, aojiru (grass juice, and water were ingested with or without auditory verbal cues. Flavor perception and ease of swallowing were measured using a visual analog scale and swallow physiology by surface electromyography and cervical auscultation. The auditory verbal cues had significant positive effects on flavor and ease of swallowing as well as on swallow physiology. The taste score and the ease of swallowing score significantly increased when the participant’s anticipation was primed by accurate auditory verbal cues. There was no significant effect of auditory verbal cues on distaste score. Regardless of age, the maximum suprahyoid muscle activity significantly decreased when a beverage was ingested without auditory verbal cues. The interval between the onset of swallowing sounds and the peak timing point of the infrahyoid muscle activity significantly shortened when the anticipation induced by the cue was contradicted in the elderly participant group. These results suggest that auditory verbal cues can improve the perceived flavor of beverages and swallow physiology.

  17. Nitric Oxide and Histamine Signal Attempts to Swallow: A Component of Learning that Food Is Inedible in "Aplysia"

    Science.gov (United States)

    Katzoff, Ayelet; Miller, Nimrod; Susswein, Abraham J.

    2010-01-01

    Memory that food is inedible in "Aplysia" arises from training requiring three contingent events. Nitric oxide (NO) and histamine are released by a neuron responding to one of these events, attempts to swallow food. Since NO release during training is necessary for subsequent memory and NO substitutes for attempts to swallow, it was suggested that…

  18. Feasibility and usefulness of using swallow contrast-enhanced ultrasound to diagnose Zenker's diverticulum: preliminary results.

    Science.gov (United States)

    Cui, Xin-Wu; Ignee, Andre; Baum, Ulrich; Dietrich, Christoph F

    2015-04-01

    Zenker's diverticulum (ZD) may be misdiagnosed on conventional ultrasound as a thyroid nodule or other lesion. A barium esophagram is usually used to confirm the diagnosis; however, this procedure exposes the patient to radiation. The aim of this study was to evaluate the feasibility of using swallow contrast-enhanced ultrasound (swallow-CEUS) to diagnose ZD. Ten consecutive patients with ZD (7 men and 3 women, aged 67 ± 11 y) were included in the study. In 4 patients, ZD was incidentally found on head and neck ultrasound, and in 6 patients, ZD was suspected because of dysphagia. All lesions could be detected on conventional ultrasound before swallow-CEUS. Ten healthy volunteers (8 men and 2 women, aged 60 ± 12 y) were chosen as a control group. Written informed consent was obtained. With the patient in the sitting or upright position, conventional ultrasound was performed first to image the lesion, then the patient was asked to swallow ultrasound contrast agent (UCA) (2-4 drops of SonoVue diluted with about 200 mL of tap water). Transity of the contrast agent in the esophagus was imaged with CEUS. Retention of the UCA in the diverticulum was monitored for at least 3 min. All patients underwent a barium esophagram as the gold standard. Swallow-CEUS revealed that in all patients (100%), the UCA was transported from the pharynx to the esophagus while the patient swallowed. ZD appeared as a pouch-shaped structure at the posterior pharyngo-esophageal junction that retained UCA longer than 3 min. The barium esophagram confirmed the diagnosis of ZD in all patients. For the 10 volunteers, no abnormal structure (retaining UCA) was detected during or after swallowing of UCA. With the advantages of no radiation and bedside availability, swallow-CEUS may become a method of choice in confirmation of the diagnosis of ZD, especially when ZD is suspected on conventional ultrasound. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier

  19. A predictive model for swallowing dysfunction after curative radiotherapy in head and neck cancer

    International Nuclear Information System (INIS)

    Langendijk, Johannes A.; Doornaert, Patricia; Rietveld, Derek H.F.; Verdonck-de Leeuw, Irma M.; Rene Leemans, C.; Slotman, Ben J.

    2009-01-01

    Introduction: Recently, we found that swallowing dysfunction after curative (chemo) radiation (CH) RT has a strong negative impact on health-related quality of life (HRQoL), even more than xerostomia. The purpose of this study was to design a predictive model for swallowing dysfunction after curative radiotherapy or chemoradiation. Materials and methods: A prospective study was performed including 529 patients with head and neck squamous cell carcinoma (HNSCC) treated with curative (CH) RT. In all patients, acute and late radiation-induced morbidity (RTOG Acute and Late Morbidity Scoring System) was scored prospectively. To design the model univariate and multivariate logistic regression analyses were carried out with grade 2 or higher RTOG swallowing dysfunction at 6 months as the primary (SWALL 6months ) endpoint. The model was validated by comparing the predicted and observed complication rates and by testing if the model also predicted acute dysphagia and late dysphagia at later time points (12, 18 and 24 months). Results: After univariate and multivariate logistic regression analyses, the following factors turned out to be independent prognostic factors for SWALL 6months : T3-T4, bilateral neck irradiation, weight loss prior to radiation, oropharyngeal and nasopharyngeal tumours, accelerated radiotherapy and concomitant chemoradiation. By summation of the regression coefficients derived from the multivariate model, the Total Dysphagia Risk Score (TDRS) could be calculated. In the logistic regression model, the TDRS was significantly associated with SWALL 6months ((p 6months was 5%, 24% and 46% in case of low-, intermediate- and high-risk patients, respectively. These observed percentages were within the 95% confidence intervals of the predicted values. The TDRS risk group classification was also significantly associated with acute dysphagia (P < 0.001 at all time points) and with late swallowing dysfunction at 12, 18 and 24 months (p < 0.001 at all time points

  20. Fiber-optic endoscopic evaluation of swallowing (FEES): predictor of swallowing-related complications in the head and neck cancer population.

    Science.gov (United States)

    Deutschmann, Michael W; McDonough, Alanna; Dort, Joseph C; Dort, Erika; Nakoneshny, Steve; Matthews, T Wayne

    2013-07-01

    The treatment of head and neck cancer is associated with significant dysphagia and morbidity. Prescribing a safe oral diet in this population is challenging. Data from 116 consecutive patients having 189 fiber-optic endoscopic evaluation of swallowing (FEES) examinations over a 3-year period were analyzed. All patients had been treated for head and neck cancer and subsequently were assessed by FEES. The primary outcome was the incidence of swallowing-related adverse events resulting from the FEES-based dietary recommendations. There were 10 episodes of aspiration pneumonia, 4 episodes of airway obstruction, 3 unanticipated insertions of gastrostomy tubes, and 2 unexplained deaths within the study period. The overall rate of adverse events was 10.1%. The only statistically significant predictor of adverse events was the Rosenbek score (p = .03). Our experience is that FEES guides appropriate and safe diet recommendations in this population. Copyright © 2012 Wiley Periodicals, Inc.

  1. Fault tree handbook

    International Nuclear Information System (INIS)

    Haasl, D.F.; Roberts, N.H.; Vesely, W.E.; Goldberg, F.F.

    1981-01-01

    This handbook describes a methodology for reliability analysis of complex systems such as those which comprise the engineered safety features of nuclear power generating stations. After an initial overview of the available system analysis approaches, the handbook focuses on a description of the deductive method known as fault tree analysis. The following aspects of fault tree analysis are covered: basic concepts for fault tree analysis; basic elements of a fault tree; fault tree construction; probability, statistics, and Boolean algebra for the fault tree analyst; qualitative and quantitative fault tree evaluation techniques; and computer codes for fault tree evaluation. Also discussed are several example problems illustrating the basic concepts of fault tree construction and evaluation

  2. Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises.

    Science.gov (United States)

    Kraaijenga, Sophie A C; van der Molen, Lisette; Jacobi, Irene; Hamming-Vrieze, Olga; Hilgers, Frans J M; van den Brekel, Michiel W M

    2015-11-01

    Concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer (HNC) is associated with substantial early and late side effects, most notably regarding swallowing function, but also regarding voice quality and quality of life (QoL). Despite increased awareness/knowledge on acute dysphagia in HNC survivors, long-term (i.e., beyond 5 years) prospectively collected data on objective and subjective treatment-induced functional outcomes (and their impact on QoL) still are scarce. The objective of this study was the assessment of long-term CCRT-induced results on swallowing function and voice quality in advanced HNC patients. The study was conducted as a randomized controlled trial on preventive swallowing rehabilitation (2006-2008) in a tertiary comprehensive HNC center with twenty-two disease-free and evaluable HNC patients as participants. Multidimensional assessment of functional sequels was performed with videofluoroscopy, mouth opening measurements, Functional Oral Intake Scale, acoustic voice parameters, and (study specific, SWAL-QoL, and VHI) questionnaires. Outcome measures at 6 years post-treatment were compared with results at baseline and at 2 years post-treatment. At a mean follow-up of 6.1 years most initial tumor-, and treatment-related problems remained similarly low to those observed after 2 years follow-up, except increased xerostomia (68%) and increased (mild) pain (32%). Acoustic voice analysis showed less voicedness, increased fundamental frequency, and more vocal effort for the tumors located below the hyoid bone (n = 12), without recovery to baseline values. Patients' subjective vocal function (VHI score) was good. Functional swallowing and voice problems at 6 years post-treatment are minimal in this patient cohort, originating from preventive and continued post-treatment rehabilitation programs.

  3. There's Life in Hazard Trees

    Science.gov (United States)

    Mary Torsello; Toni McLellan

    The goals of hazard tree management programs are to maximize public safety and maintain a healthy sustainable tree resource. Although hazard tree management frequently targets removal of trees or parts of trees that attract wildlife, it can take into account a diversity of tree values. With just a little extra planning, hazard tree management can be highly beneficial...

  4. 77 FR 35366 - Albany-Eugene Transmission Line Rebuild Project

    Science.gov (United States)

    2012-06-13

    ... materials, removing vegetation including danger trees, and revegetating areas disturbed by construction... implement the Proposed Action Alternative, based on the Albany-Eugene Transmission Line Rebuild Project (DOE...

  5. SU-E-J-193: Application of Surface Mapping in Detecting Swallowing for Head-&-Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cao, D; Xie, X; Mehta, V; Shepard, D [Swedish Cancer Institute, Seattle, WA (United States)

    2015-06-15

    Purpose: Recent evidence is emerging that long term swallowing function may be improved after radiotherapy for head-&-neck cancer if doses are limited to certain swallowing structures. Immobilization of patients with head-&-neck cancer is typically done with a mask. This mask, however, doesn’t limit patient swallowing. Patient voluntary or involuntary swallowing may introduce significant tumor motion, which can lead to suboptimal delivery. In this study, we have examined the feasibility of using surface mapping technology to detect patient swallowing during treatment and evaluated its magnitude. Methods: The C-RAD Catalyst system was used to detect the patient surface map. A volunteer lying on the couch was used to simulate the patient under treatment. A virtual marker was placed near the throat and was used to monitor the swallowing action. The target motion calculated by the Catalyst system through deformable registration was also collected. Two treatment isocenters, one placed close to the throat and the other placed posterior to the base-of-tongue, were used to check the sensitivity of surface mapping technique. Results: When the patient’s throat is not in the shadow of the patient’s chest, the Catalyst system can clearly identify the swallowing motion. In our tests, the vertical motion of the skin can reach to about 5mm. The calculated target motion can reach up to 1 cm. The magnitude of this calculated target motion is more dramatic when the plan isocenter is closer to the skin surface, which suggests that the Catalyst motion tracking technique is more sensitive to the swallowing motion with a shallower isocenter. Conclusion: Surface mapping can clearly identify patient swallowing during radiation treatment. This information can be used to evaluate the dosimetric impact of the involuntary swallowing. It may also be used to potentially gate head-&-neck radiation treatments. A prospective IRB approved study is currently enrolling patients in our

  6. Effect of spontaneous saliva swallowing on short-term heart rate variability (HRV) and reliability of HRV analysis.

    Science.gov (United States)

    Yildiz, Metin; Doma, Serian

    2017-09-26

    The effects of effortful swallowing and solid meal ingestions on heart rate variability (HRV) have been examined previously. The effects of spontaneous saliva swallowing on short-term HRV and reliability of HRV analysis have not been studied before. The effect of saliva swallowing on HRV analyses parameters [meanRRI, SDNN (standard deviation of normal-to-normal), LF (low frequency), HF (high frequency) powers, LH/HF] and the reliability of LF and HF powers were investigated by frequency, time-frequency and intraclass correlation coefficient (ICC) analyses. Electrocardiogram and swallowing signal that obtained from an electronic stethoscope placed on the necks of subjects were recorded simultaneously from 30 healthy and young volunteers in sitting position during 15 min. Spontaneous swallowing has been shown to significantly alter some HRV parameters (SDNN, LF power and LF/HF ratio). Time-frequency analysis results showed that the contribution of saliva swallowing to LF (1-58%) and HF (2-42%) powers could change significantly depending on the number of swallowing. The ICC of the LF and HF powers for the successive 5-min signal segments were found 0·89, 0·92, respectively. These values decreased to 0·73 and 0·90 in the subjects with more swallowing rate. When the analyses were made for 2-min signal periods, these values decreased to 0·63 and 0·67. We concluded that spontaneous saliva swallowing can change HRV parameters. We have also seen that changes in swallowing rate and use of short signal segments may reduce the reliability of HRV analyses. © 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  7. Covering tree with stars

    DEFF Research Database (Denmark)

    Baumbach, Jan; Guo, Jiong; Ibragimov, Rashid

    2015-01-01

    We study the tree edit distance problem with edge deletions and edge insertions as edit operations. We reformulate a special case of this problem as Covering Tree with Stars (CTS): given a tree T and a set of stars, can we connect the stars in by adding edges between them such that the resulting...... tree is isomorphic to T? We prove that in the general setting, CST is NP-complete, which implies that the tree edit distance considered here is also NP-hard, even when both input trees having diameters bounded by 10. We also show that, when the number of distinct stars is bounded by a constant k, CTS...

  8. New insights into sucking, swallowing and breathing central generators: A complexity analysis of rhythmic motor behaviors.

    Science.gov (United States)

    Samson, Nathalie; Praud, Jean-Paul; Quenet, Brigitte; Similowski, Thomas; Straus, Christian

    2017-01-18

    Sucking, swallowing and breathing are dynamic motor behaviors. Breathing displays features of chaos-like dynamics, in particular nonlinearity and complexity, which take their source in the automatic command of breathing. In contrast, buccal/gill ventilation in amphibians is one of the rare motor behaviors that do not display nonlinear complexity. This study aimed at assessing whether sucking and swallowing would also follow nonlinear complex dynamics in the newborn lamb. Breathing movements were recorded before, during and after bottle-feeding. Sucking pressure and the integrated EMG of the thyroartenoid muscle, as an index of swallowing, were recorded during bottle-feeding. Nonlinear complexity of the whole signals was assessed through the calculation of the noise limit value (NL). Breathing and swallowing always exhibited chaos-like dynamics. The NL of breathing did not change significantly before, during or after bottle-feeding. On the other hand, sucking inconsistently and significantly less frequently than breathing exhibited a chaos-like dynamics. Therefore, the central pattern generator (CPG) that drives sucking may be functionally different from the breathing CPG. Furthermore, the analogy between buccal/gill ventilation and sucking suggests that the latter may take its phylogenetic origin in the gill ventilation CPG of the common ancestor of extant amphibians and mammals. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. A comparison of swallowing dysfunction in Becker muscular dystrophy and Duchenne muscular dystrophy.

    Science.gov (United States)

    Yamada, Yuka; Kawakami, Michiyuki; Wada, Ayako; Otsuka, Tomoyoshi; Muraoka, Kaori; Liu, Meigen

    2018-06-01

    Swallowing dysfunction has been reported in Duchenne muscular dystrophy (DMD), but has not been studied in Becker muscular dystrophy (BMD). The aims of this study were to report the characteristics of swallowing dysfunction in BMD compared with DMD. The study participants were 18 patients with BMD and 18 patients with DMD. All the patients were examined using videofluorography during swallowing of 5 mL of fluid. The penetration-aspiration scale (P-A scale) and the videofluorographic dysphagia scale (VDS) were used to evaluate dysphagia. Swinyard functional ability stage was not significantly different between the BMD and DMD groups. Rate of aspiration, P-A scale score, and total VDS score did not differ across groups, but the VDS item score for laryngeal elevation was lower in the BMD group than in the DMD group (median scores 4.5 and 9, respectively; p Becker muscular dystrophy (BMD) was not well known. Eighteen patients with BMD and 18 patients with Duchenne muscular dystrophy were examined with videofluorography. Patients with BMD have swallowing problems similar to those observed in patients with DMD.

  10. Five days of successful oral alimentation for hospitalized patients based upon passing the Yale Swallow Protocol.

    Science.gov (United States)

    Leder, Steven B; Suiter, Debra M

    2014-09-01

    This study aimed to determine the success of oral alimentation and patient retention rate 1 to 5 days after passing the Yale Swallow Protocol. Participants were 200 consecutive acute care inpatients referred for swallow assessment. Inclusion criteria were adequate cognitive abilities to participate safely, completing an oral mechanism examination, and passing the 3-ounce water swallow challenge. Exclusion criteria were altered mental status, failing the 3-ounce challenge, preadmission dysphagia, head-of-bed restrictions alimentation and retention rate. All patients who remained medically and neurologically stable drank thin liquids and ate successfully 1 to 5 days after passing the protocol. Mean (SD) volume of liquid ingested per day was 474.2 (435.5) cc. Patient retention declined steadily from day of testing (n = 200) through post-testing day 5 (n = 95). Passing the Yale Swallow Protocol allowed for initial determination of aspiration risk followed by successful oral alimentation for 1 to 5 days in medically and neurologically stable acute care hospitalized patients and without the need for instrumental dysphagia testing. The decline in patient retention was expected because of increasingly rapid transit through the acute care setting, which often renders longer follow-up problematic. © The Author(s) 2014.

  11. A VALIDATION STUDY OF THE FACIAL-ORAL TRACT THERAPY SWALLOWING ASSESSMENT OF SALIVA

    DEFF Research Database (Denmark)

    Mortensen, Jesper; Jensen, Ditte; Kjærsgaard, Annette

    Introduction Facial-Oral Tract Therapy (F.O.T.T.) (1) is an approach that provides both clinical assessment and treatment of oropharyngeal dysphagia. In the F.O.T.T. approach, a prerequisite for the initiation of oral intake is safe swallowing of saliva. A recent randomized controlled trial (2...

  12. Movie MRI at five frames a second for evaluation of speech and swallowing

    Science.gov (United States)

    Kumada, Masanobu; Mori, Koichi; Nakajima, Yasoichi; Nozaki, Seiji

    2004-05-01

    Magnetic resonance imaging (MRI) is a noninvasive imaging method that is widely used in the medical field. One of the limitations of MRI is its low time-resolution images of MRI are usually obtained as still images. Here we introduced a newly developed method of ``movie'' MRI with high time-resolution at five images a second. Its good application would include study and evaluation of speech and swallowing. Instrument: MRT-2001 XG with Software ver.5.5. (Toshiba). Coil: head QD coil for the tongue; CTL ARRY coil (3ch) for the neck, Imaging condition: sagital FFE2D; TR=2.8 ms TE=1.2 ms FA=10 deg Matrix=64×128 ST=10 mm NAQ=1 AV FOV=23×35 ; ROAFI; sequential acquisition. Maximum imaging length=51 s. A healthy Japanese male (Tokyo dialect speaker, 39 years). Task: Repetitive utterance of /tenten.../ and intentional swallowing of saliva. Results: In the task of /tenten..../, we could detect, in temporal order, velopharyngeal (VP) closure, opening of the tongue-palate (TP) closure, VP opening, TP closure, VP closure, and so on. In the swallowing task of saliva, we could detect movement of the tongue for conveying saliva to the pharynx, VP closure, backward movement of the tongue root, elevation and descent of the larynx in this temporal order. Our ``Movie MRI'' seemed promising for the noninvasive evaluation of speech and deglutition. Appropriate materials for swallowing evaluation will be presented.

  13. A Continent-Wide Migratory Divide in North American Breeding Barn Swallows (Hirundo rustica.

    Directory of Open Access Journals (Sweden)

    Keith A Hobson

    Full Text Available Populations of most North American aerial insectivores have undergone steep population declines over the past 40 years but the relative importance of factors operating on breeding, wintering, or stopover sites remains unknown. We used archival light-level geolocators to track the phenology, movements and winter locations of barn swallows (Hirdundo rustica; n = 27 from populations across North America to determine their migratory connectivity. We identified an east-west continental migratory divide for barn swallows with birds from western regions (Washington State, USA (n = 8 and Saskatchewan, Canada (n = 5 traveling shorter distances to wintering areas ranging from Oregon to northern Colombia than eastern populations (Ontario (n = 3 and New Brunswick (n = 10, Canada which wintered in South America south of the Amazon basin. A single swallow from a stable population in Alabama shared a similar migration route to eastern barn swallows but wintered farther north in northeast Brazil indicating a potential leap frog pattern migratory among eastern birds. Six of 9 (67% birds from the two eastern populations and Alabama underwent a loop migration west of fall migration routes including around the Gulf of Mexico travelling a mean of 2,224 km and 722 km longer on spring migration, respectively. Longer migration distances, including the requirement to cross the Caribbean Sea and Gulf of Mexico and subsequent shorter sedentary wintering periods, may exacerbate declines for populations breeding in northeastern North America.

  14. Perception of Wet Vocal Quality in Identifying Penetration/Aspiration during Swallowing

    Science.gov (United States)

    Groves-Wright, Kathy Jean; Boyce, Suzanne; Kelchner, Lisa

    2010-01-01

    Purpose: In the present study, the authors investigated the association between wet vocal quality (WVQ) and prandial material in the larynx during phonation. The presence of such material is indicative of oropharyngeal dysphagia and results from entry of material into the laryngeal vestibule during swallowing. The primary aim of the study was to…

  15. Air swallowing, belching, and reflux in patients with gastroesophageal reflux disease

    NARCIS (Netherlands)

    Bredenoord, Albert J.; Weusten, Bas L. A. M.; Timmer, Robin; Smout, André J. P. M.

    2006-01-01

    OBJECTIVES: Belching and gastroesophageal reflux share a common physiological mechanism. The aim of this study was to investigate whether air swallowing leads to both belching and reflux. METHODS: Esophageal impedance, pH, and pressure were measured during two 20-min recording periods in 12 controls

  16. A study of brain networks associated with swallowing using graph-theoretical approaches.

    Directory of Open Access Journals (Sweden)

    Bo Luan

    Full Text Available Functional connectivity between brain regions during swallowing tasks is still not well understood. Understanding these complex interactions is of great interest from both a scientific and a clinical perspective. In this study, functional magnetic resonance imaging (fMRI was utilized to study brain functional networks during voluntary saliva swallowing in twenty-two adult healthy subjects (all females, [Formula: see text] years of age. To construct these functional connections, we computed mean partial correlation matrices over ninety brain regions for each participant. Two regions were determined to be functionally connected if their correlation was above a certain threshold. These correlation matrices were then analyzed using graph-theoretical approaches. In particular, we considered several network measures for the whole brain and for swallowing-related brain regions. The results have shown that significant pairwise functional connections were, mostly, either local and intra-hemispheric or symmetrically inter-hemispheric. Furthermore, we showed that all human brain functional network, although varying in some degree, had typical small-world properties as compared to regular networks and random networks. These properties allow information transfer within the network at a relatively high efficiency. Swallowing-related brain regions also had higher values for some of the network measures in comparison to when these measures were calculated for the whole brain. The current results warrant further investigation of graph-theoretical approaches as a potential tool for understanding the neural basis of dysphagia.

  17. Neurorehabilitation strategies for poststroke oropharyngeal dysphagia: from compensation to the recovery of swallowing function.

    Science.gov (United States)

    Cabib, Christopher; Ortega, Omar; Kumru, Hatice; Palomeras, Ernest; Vilardell, Natalia; Alvarez-Berdugo, Daniel; Muriana, Desirée; Rofes, Laia; Terré, Rosa; Mearin, Fermín; Clavé, Pere

    2016-09-01

    Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for poststroke OD. The pathophysiology of oropharyngeal biomechanics can be assessed by videofluoroscopy, as delayed laryngeal vestibule closure is closely associated with aspiration. Stroke may affect afferent or efferent neuronal circuits participating in deglutition. The integrity of oropharyngeal-cortical afferent pathways can be assessed by electroencephalography through sensory-evoked potentials by pharyngeal electrical stimulation, while corticopharyngeal efferent pathways can be characterized by electromyography through motor-evoked potentials by transcranial magnetic stimulation. Dysfunction in both cortico-mediated evoked responses is associated with delayed swallow response and aspiration. Studies have reported hemispherical asymmetry on motor control of swallowing and the relevance of impaired oropharyngeal sensitivity on aspiration. Advances in treatment include improvements in compensatory strategies but are mainly focused on (1) peripheral stimulation strategies and (2) central, noninvasive stimulation strategies with evidence of their clinical benefits. Characterization of poststroke OD is evolving from the assessment of impaired biomechanics to the sensorimotor integration processes involved in deglutition. Treatment is also changing from compensatory strategies to promoting brain plasticity, both to recover swallow function and to improve brain-related swallowing dysfunction. © 2016 New York Academy of Sciences.

  18. Development of a system to monitor laryngeal movement during swallowing using a bend sensor.

    Directory of Open Access Journals (Sweden)

    Qiang Li

    Full Text Available BACKGROUND: Swallowing dysfunction (also known as dysphagia, which results in a deterioration of nutritional intake, slows rehabilitation and causes aspiration pneumonia, is very common following neurological impairments. Although videofluorographic (VF examination is widely used for detecting aspiration, an objective and non-invasive method for assessing swallowing function has yet to be established because of a lack of adequate devices and protocols. In this paper, a bend sensor whose resistance is altered by bending was introduced to monitor swallowing-related laryngeal movement. METHODS: Six healthy male volunteers were recruited in the present study. Specific time points on the signal waveform produced by the bend sensor were defined to describe laryngeal movement by differential analysis. Additionally, the physiological significance of the obtained waveform was confirmed by analyzing the sequential correlations between the signal waveform from the bend sensor and hyoid bone kinetics simultaneously recorded by VF. RESULTS: Seven time points were successfully defined on the signal waveform to reference laryngeal movement. Each time point was well correlated with certain VF events, with evidence of no significant time lags, and there were positive correlations between waveform time points and matched VF events. Furthermore, obvious similarities were noticed between the duration of each phase on the signal waveform and the duration of the matched hyoid bone activity. CONCLUSIONS: The present monitoring system using a bend sensor might be useful for observing the temporal aspects of laryngeal movement during swallowing, and it was well coordinated with hyoid bone movement.

  19. Time budget of South African cliff swallows during breeding | Earlé ...

    African Journals Online (AJOL)

    The use of time by the South African cliff swallow was determined and use of energy calculated by using equations for predicting standard metabolic rate and the cost of flight. The highest daily energy expenditure was during the feeding of nestlings when 9,22 h were spent foraging. The cost of 127 kJ for building a nest is ...

  20. Lingual Pressure as a Clinical Indicator of Swallowing Function in Parkinson's Disease

    Science.gov (United States)

    Pitts, Laura L.; Morales, Sarah; Stierwalt, Julie A. G.

    2018-01-01

    Purpose: Swallowing impairment, or dysphagia, is a known contributor to reduced quality of life, pneumonia, and mortality in Parkinson's disease (PD). However, the contribution of tongue dysfunction, specifically inadequate pressure generation, to dysphagia in PD remains unclear. Our purpose was to determine whether lingual pressures in PD are (a)…

  1. Family and Cultural Issues in a School Swallowing and Feeding Program

    Science.gov (United States)

    Davis-McFarland, Elise

    2008-01-01

    Purpose: This article presents a rationale for speech-language pathologists (SLPs) to provide culturally competent evaluation, diagnostic, and intervention services for children with oral motor, swallowing, and feeding disorders in school settings. There is also a discussion of how changing American public school demographics necessitate the…

  2. Voice and Swallowing Outcomes after Hyoid Suspension Surgery in Patients with Obstructive Sleep Apnea.

    Science.gov (United States)

    Askar, Sherif M; Quriba, Amal S; Hassan, Elham M; Awad, Ali M; Bessar, Ahmad A

    2018-05-15

    The role of hyoidthyroidpexia (HTP) surgery in the management of patients with obstructive sleep apnea (OSA) is well described with good reported outcomes. The effect of HTP on other laryngeal functions is not well discussed. This study was designed to evaluate voice and swallowing outcomes after HTP. This study was applied on a selected group of OSA patients. HTP (as a sole procedure) was performed in 17 patients and 14 patients had simultaneous palatal procedures (e.g., anterior palatoplasty). Pre- and postoperative assessment of voice and swallowing were done. Comparison between pre- and postoperative results of voice and swallowing measures revealed a nonsignificant difference. HTP (as a sole technique or as part of a multilevel intervention) could help with airway collapse and might be considered a safe, simple, and effective technique in the management of selected patients experiencing OSA. In addition, it seems to have no hazardous effect on either the voice or swallowing function of patients. © 2018 S. Karger AG, Basel.

  3. Variation in sperm morphometry and sperm competition among barn swallow (Hirundo rustica) populations

    Czech Academy of Sciences Publication Activity Database

    Laskemoen, T.; Albrecht, Tomáš; Bonisoli-Alquati, A.; Cepák, J.; De Lope, F.; Hermosell, I. G.; Johannessen, L. E.; Kleven, O.; Marzal, A.; Mousseau, T. A.; Moller, A. P.; Robertson, R. J.; Rudolfsen, G.; Saino, N.; Vortman, Y.; Lifjeld, J. T.

    2013-01-01

    Roč. 67, č. 2 (2013), s. 301-309 ISSN 0340-5443 R&D Projects: GA ČR(CZ) GAP506/12/2472 Institutional support: RVO:68081766 Keywords : Barn swallow * Extrapair paternity * Hirundo rustica * Sperm competition * Sperm size Subject RIV: EG - Zoology Impact factor: 3.049, year: 2013

  4. Swallows Rugby Football Club, South Africa: The story of a century ...

    African Journals Online (AJOL)

    This paper aims to deconstruct and isolate a century-long story of the Swallows RFC from a multifarious Xhosa and black peoplees rugby history and locate it in the epicentre of research in the country. This Club was established in 1911 at the East Bank Location (EBL) of East London, in the present day Eastern Cape ...

  5. Air swallowing, belching, acid and non-acid reflux in patients with functional dyspepsia

    NARCIS (Netherlands)

    Conchillo, J. M.; Selimah, M.; Bredenoord, A. J.; Samsom, M.; Smout, A. J. P. M.

    2007-01-01

    BACKGROUND: Frequent belching is a common symptom in patients with functional dyspepsia with a reported incidence up to 80%. We hypothesized that patients with functional dyspepsia possibly have a higher frequency of belching than healthy subjects secondary to frequent air swallowing. AIM: To assess

  6. Protective Effects of Ferulic Acid against Chronic Cerebral Hypoperfusion-Induced Swallowing Dysfunction in Rats

    Directory of Open Access Journals (Sweden)

    Takashi Asano

    2017-03-01

    Full Text Available Ferulic acid (FA, a phenolic phytochemical, has been reported to exert antioxidative and neuroprotective effects. In this study, we investigated the protective effects of FA against the dysfunction of the swallowing reflex induced by ligation of bilateral common carotid arteries (2VO in rats. In 2VO rats, topical administration of water or citric acid to the pharyngolaryngeal region evoked a diminished number of swallowing events with prolonged latency compared to sham-operated control rats. 2VO rats had an increased level of superoxide anion radical, and decreased dopamine and tyrosine hydroxylase enzyme levels in the striatum, suggesting that 2VO augmented cerebral oxidative stress and impaired the striatal dopaminergic system. Furthermore, substance P (SP expression in the laryngopharyngeal mucosa, which is believed to be positively regulated by dopaminergic signaling in the basal ganglia, was decreased in 2VO rats. Oral treatment with FA (30 mg/kg for 3 weeks (from one week before 2VO to two weeks after improved the swallowing reflex and maintained levels of striatal dopamine and laryngopharyngeal SP expression in 2VO rats. These results suggest that FA maintains the swallowing reflex by protecting the dopamine-SP system against ischemia-induced oxidative damage in 2VO rats.

  7. Clinical Characteristics of Voice, Speech, and Swallowing Disorders in Oromandibular Dystonia

    Science.gov (United States)

    Kreisler, Alexandre; Vepraet, Anne Caroline; Veit, Solène; Pennel-Ployart, Odile; Béhal, Hélène; Duhamel, Alain; Destée, Alain

    2016-01-01

    Purpose: To better define the clinical characteristics of idiopathic oromandibular dystonia, we studied voice, speech, and swallowing disorders and their impact on activities of daily living. Method: Fourteen consecutive patients with idiopathic oromandibular dystonia and 14 matched, healthy control subjects were included in the study. Results:…

  8. Barium versus Nonbarium Stimuli: Differences in Taste Intensity, Chemesthesis, and Swallowing Behavior in Healthy Adult Women

    Science.gov (United States)

    Nagy, Ahmed; Steele, Catriona M.; Pelletier, Cathy A.

    2014-01-01

    Purpose: The authors examined the impact of barium on the perceived taste intensity of 7 different liquid tastant stimuli and the modulatory effect that these differences in perceived taste intensity have on swallowing behaviors. Method: Participants were 80 healthy women, stratified by age group (60) and genetic taste status…

  9. Swallowing thresholds of mandibular implant-retained overdentures with variable portion sizes

    NARCIS (Netherlands)

    Fontijn-Tekamp, F.A.; Slagter, A.P.; Van der Bilt, A.; Van't Hof, M.A.; Kalk, W.; Jansen, J.A.

    2004-01-01

    We analysed the effect of three portion sizes Optocal Plus (small, medium and large) on swallowing thresholds in subjects with either conventional complete dentures or mandibular implant-retained overdentures (transmandibular and permucosal cylindric implants). Tests were carried out in 52 women and

  10. Habitat use by the critically endangered Blue Swallow in KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    James Wakelin

    2018-03-01

    Conclusion: To this end, the stewardship programme spearheaded by local conservation agencies, which aims to formally conserve privately owned patches of untransformed grassland and other natural habitats, may have a strong impact on the long-term persistence of Blue Swallow populations.

  11. Instrumental and sensory quantification of oral coatings retained after swallowing semi-solid foods

    NARCIS (Netherlands)

    Prinz, J.F.; Huntjens, L.; Wijk, de R.A.

    2006-01-01

    After a mouthful of food has been swallowed, some food material is always retained in the mouth. With semi-solid foods this is in the form of a coating that adheres to the oral mucosa. The amount and location of this material may play an important role in food sensations. In this study two

  12. Swallowing assessment in early laryngeal cancer patients treated either with surgery or radiotherapy

    International Nuclear Information System (INIS)

    Celedon L, Carlos; Gambi A, Galo; Royer F, Michel; Esquivel C, Patricia; Arteaga J, Patricia; Valdes P, Constanza

    2008-01-01

    Swallowing is a complex neuromuscular process that requires anatomical indemnity and an adequate coordination of several organs. Laryngeal cancer treatment may cause swallowing disorders. Traditionally, a high frequency of this type of disorder after surgery has been reported, but no actual data concerning its incidence in patients undergoing radiotherapy for early laryngeal cancer has been published. Aim. To compare swallowing disorders frequency posterior to treatment in early laryngeal cancer patients. Material and Method. Two groups of early laryngeal cancer patients were transversally studied, one treated with vertical partial surgery (CP), and the other treated exclusively with radiotherapy. Each patient had otorhinolaryngological, nasofibroscopic and video fluoroscopic evaluations after treatment. Differences between groups were compared using the - square test. Results. Twenty patients per group were entered in this study, predominantly males of similar age. Both groups presented a high incidence of aspiration symptoms (55% in RT and 35% in CP). There were no significant differences between both groups. Discussion and Conclusion. A high incidence of swallowing disorders in patients treated for early laryngeal cancer was found. It should then be considered as a frequent alteration in this group of patients, either treated with RT or CP

  13. Trees and highway safety.

    Science.gov (United States)

    2011-03-01

    To minimize the severity of run-off-road collisions of vehicles with trees, departments of transportation (DOTs) : commonly establish clear zones for trees and other fixed objects. Caltrans clear zone on freeways is 30 feet : minimum (40 feet pref...

  14. Technology-enabled management of communication and swallowing disorders in Parkinson's disease: a systematic scoping review.

    Science.gov (United States)

    Theodoros, Deborah; Aldridge, Danielle; Hill, Anne J; Russell, Trevor

    2018-06-19

    Communication and swallowing disorders are highly prevalent in people with Parkinson's disease (PD). Maintenance of functional communication and swallowing over time is challenging for the person with PD and their families and may lead to social isolation and reduced quality of life if not addressed. Speech and language therapists (SLTs) face the conundrum of providing sustainable and flexible services to meet the changing needs of people with PD. Motor, cognitive and psychological issues associated with PD, medication regimens and dependency on others often impede attendance at a centre-based service. The access difficulties experienced by people with PD require a disruptive service approach to meet their needs. Technology-enabled management using information and telecommunications technologies to provide services at a distance has the potential to improve access, and enhance the quality of SLT services to people with PD. To report the status and scope of the evidence for the use of technology in the management of the communication and swallowing disorders associated with PD. Studies were retrieved from four major databases (PubMed, CINAHL, EMBASE and Medline via Web of Science). Data relating to the types of studies, level of evidence, context, nature of the management undertaken, participant perspectives and the types of technologies involved were extracted for the review. A total of 17 studies were included in the review, 15 of which related to the management of communication and swallowing disorders in PD with two studies devoted to participant perspectives. The majority of the studies reported on the treatment of the speech disorder in PD using Lee Silverman Voice Treatment (LSVT LOUD ® ). Synchronous and asynchronous technologies were used in the studies with a predominance of the former. There was a paucity of research in the management of cognitive-communication and swallowing disorders. Research evidence supporting technology-enabled management of the

  15. Predictive modelling for swallowing dysfunction after primary (chemo)radiation: results of a prospective observational study.

    Science.gov (United States)

    Christianen, Miranda E M C; Schilstra, Cornelis; Beetz, Ivo; Muijs, Christina T; Chouvalova, Olga; Burlage, Fred R; Doornaert, Patricia; Koken, Phil W; Leemans, C René; Rinkel, Rico N P M; de Bruijn, Marieke J; de Bock, G H; Roodenburg, Jan L N; van der Laan, Bernard F A M; Slotman, Ben J; Verdonck-de Leeuw, Irma M; Bijl, Hendrik P; Langendijk, Johannes A

    2012-10-01

    The purpose of this large multicentre prospective cohort study was to identify which dose volume histogram parameters and pre-treatment factors are most important to predict physician-rated and patient-rated radiation-induced swallowing dysfunction (RISD) in order to develop predictive models for RISD after curative (chemo) radiotherapy ((CH) RT). The study population consisted of 354 consecutive head and neck cancer patients treated with (CH) RT. The primary endpoint was grade 2 or more swallowing dysfunction according to the RTOG/EORTC late radiation morbidity scoring criteria at 6 months after (CH) RT. The secondary endpoints were patient-rated swallowing complaints as assessed with the EORTC QLQ-H&N35 questionnaire. To select the most predictive variables a multivariate logistic regression analysis with bootstrapping was used. At 6 months after (CH) RT the bootstrapping procedure revealed that a model based on the mean dose to the superior pharyngeal constrictor muscle (PCM) and mean dose to the supraglottic larynx was most predictive. For the secondary endpoints different predictive models were found: for problems with swallowing liquids the most predictive factors were the mean dose to the supraglottic larynx and radiation technique (3D-CRT versus IMRT). For problems with swallowing soft food the mean dose to the middle PCM, age (18-65 versus >65 years), tumour site (naso/oropharynx versus other sites) and radiation technique (3D-CRT versus IMRT) were the most predictive factors. For problems with swallowing solid food the most predictive factors were the mean dose to the superior PCM, the mean dose to the supraglottic larynx and age (18-65 versus >65 years). And for choking when swallowing the V60 of the oesophageal inlet muscle and the mean dose to the supraglottic larynx were the most predictive factors. Physician-rated and patient-rated RISD in head and neck cancer patients treated with (CH) RT cannot be predicted with univariate relationships between the

  16. Decision-Tree Program

    Science.gov (United States)

    Buntine, Wray

    1994-01-01

    IND computer program introduces Bayesian and Markov/maximum-likelihood (MML) methods and more-sophisticated methods of searching in growing trees. Produces more-accurate class-probability estimates important in applications like diagnosis. Provides range of features and styles with convenience for casual user, fine-tuning for advanced user or for those interested in research. Consists of four basic kinds of routines: data-manipulation, tree-generation, tree-testing, and tree-display. Written in C language.

  17. Minnesota's Forest Trees. Revised.

    Science.gov (United States)

    Miles, William R.; Fuller, Bruce L.

    This bulletin describes 46 of the more common trees found in Minnesota's forests and windbreaks. The bulletin contains two tree keys, a summer key and a winter key, to help the reader identify these trees. Besides the two keys, the bulletin includes an introduction, instructions for key use, illustrations of leaf characteristics and twig…

  18. D2-tree

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Sioutas, Spyros; Pantazos, Kostas

    2015-01-01

    We present a new overlay, called the Deterministic Decentralized tree (D2-tree). The D2-tree compares favorably to other overlays for the following reasons: (a) it provides matching and better complexities, which are deterministic for the supported operations; (b) the management of nodes (peers...

  19. Covering tree with stars

    DEFF Research Database (Denmark)

    Baumbach, Jan; Guo, Jian-Ying; Ibragimov, Rashid

    2013-01-01

    We study the tree edit distance problem with edge deletions and edge insertions as edit operations. We reformulate a special case of this problem as Covering Tree with Stars (CTS): given a tree T and a set of stars, can we connect the stars in by adding edges between them such that the resulting ...

  20. Winter Birch Trees

    Science.gov (United States)

    Sweeney, Debra; Rounds, Judy

    2011-01-01

    Trees are great inspiration for artists. Many art teachers find themselves inspired and maybe somewhat obsessed with the natural beauty and elegance of the lofty tree, and how it changes through the seasons. One such tree that grows in several regions and always looks magnificent, regardless of the time of year, is the birch. In this article, the…

  1. Total well dominated trees

    DEFF Research Database (Denmark)

    Finbow, Arthur; Frendrup, Allan; Vestergaard, Preben D.

    cardinality then G is a total well dominated graph. In this paper we study composition and decomposition of total well dominated trees. By a reversible process we prove that any total well dominated tree can both be reduced to and constructed from a family of three small trees....

  2. Altered Cortical Swallowing Processing in Patients with Functional Dysphagia: A Preliminary Study

    Science.gov (United States)

    Wollbrink, Andreas; Warnecke, Tobias; Winkels, Martin; Pantev, Christo; Dziewas, Rainer

    2014-01-01

    Objective Current neuroimaging research on functional disturbances provides growing evidence for objective neuronal correlates of allegedly psychogenic symptoms, thereby shifting the disease concept from a psychological towards a neurobiological model. Functional dysphagia is such a rare condition, whose pathogenetic mechanism is largely unknown. In the absence of any organic reason for a patient's persistent swallowing complaints, sensorimotor processing abnormalities involving central neural pathways constitute a potential etiology. Methods In this pilot study we measured cortical swallow-related activation in 5 patients diagnosed with functional dysphagia and a matched group of healthy subjects applying magnetoencephalography. Source localization of cortical activation was done with synthetic aperture magnetometry. To test for significant differences in cortical swallowing processing between groups, a non-parametric permutation test was afterwards performed on individual source localization maps. Results Swallowing task performance was comparable between groups. In relation to control subjects, in whom activation was symmetrically distributed in rostro-medial parts of the sensorimotor cortices of both hemispheres, patients showed prominent activation of the right insula, dorsolateral prefrontal cortex and lateral premotor, motor as well as inferolateral parietal cortex. Furthermore, activation was markedly reduced in the left medial primary sensory cortex as well as right medial sensorimotor cortex and adjacent supplementary motor area (pdysphagia - a condition with assumed normal brain function - seems to be associated with distinctive changes of the swallow-related cortical activation pattern. Alterations may reflect exaggerated activation of a widely distributed vigilance, self-monitoring and salience rating network that interferes with down-stream deglutition sensorimotor control. PMID:24586948

  3. Reflex Cough and Disease Duration as Predictors of Swallowing Dysfunction in Parkinson's Disease.

    Science.gov (United States)

    Troche, Michelle S; Schumann, Beate; Brandimore, Alexandra E; Okun, Michael S; Hegland, Karen W

    2016-12-01

    Patients with Parkinson's disease (PD) have progressive and pervasive disorders of airway protection. Recent work has highlighted the relationship between reflex and voluntary cough and swallowing safety. The goal of this study was to test the sensitivity and specificity of several airway protective and disease-specific factors for predicting swallowing safety outcomes in PD. Sixty-four participants (44 males) completed measures of voluntary and reflex cough, and swallowing safety. Clinical predictors included disease severity and duration, and cough airflow and sensitivity measures. ROC and Chi-square analyses identified predictors of swallowing safety (penetration-aspiration score) in PD. Disease duration significantly discriminated between patients with normal and abnormal swallowing safety (p = 0.027, sensitivity: 71 %, specificity: 55.4 %). Cough reflex sensitivity significantly discriminated between patients who penetrated above the level of the vocal folds and those with more severe penetration/aspiration (p = 0.021, sensitivity: 71.0 %, specificity 57.6 %). Urge-to-cough sensitivity (log-log linear slope) was the only variable which significantly discriminated between patients with penetration versus aspiration (p = 0.017, sensitivity: 85.7 %, specificity 73.2 %). It is important to identify the factors which influence airway protective outcomes in PD especially given that aspiration pneumonia is a leading cause of death. Results from this study highlight the ecological validity of reflex cough in the study of airway protection and this study further identifies important factors to consider in the screening of airway protective deficits in PD.

  4. Multiple Rapid Swallow Responses During Esophageal High-Resolution Manometry Reflect Esophageal Body Peristaltic Reserve

    Science.gov (United States)

    Shaker, Anisa; Stoikes, Nathaniel; Drapekin, Jesse; Kushnir, Vladimir; Brunt, L. Michael; Gyawali, C. Prakash

    2014-01-01

    OBJECTIVES Dysphagia may develop following antireflux surgery as a consequence of poor esophageal peristaltic reserve. We hypothesized that suboptimal contraction response following multiple rapid swallows (MRS) could be associated with chronic transit symptoms following antireflux surgery. METHODS Wet swallow and MRS responses on esophageal high-resolution manometry (HRM) were characterized collectively in the esophageal body (distal contractile integral (DCI)), and individually in each smooth muscle contraction segment (S2 and S3 amplitudes) in 63 patients undergoing antireflux surgery and in 18 healthy controls. Dysphagia was assessed using symptom questionnaires. The MRS/wet swallow ratios were calculated for S2 and S3 peak amplitudes and DCI. MRS responses were compared in patients with and without late postoperative dysphagia following antireflux surgery. RESULTS Augmentation of smooth muscle contraction (MRS/wet swallow ratios > 1.0) as measured collectively by DCI was seen in only 11.1% with late postoperative dysphagia, compared with 63.6% in those with no dysphagia and 78.1% in controls (P≤0.02 for each comparison). Similar results were seen with S3 but not S2 peak amplitude ratios. Receiver operating characteristics identified a DCI MRS/wet swallow ratio threshold of 0.85 in segregating patients with late postoperative dysphagia from those with no postoperative dysphagia with a sensitivity of 0.67 and specificity of 0.64. CONCLUSIONS Lack of augmentation of smooth muscle contraction following MRS is associated with late postoperative dysphagia following antireflux surgery, suggesting that MRS responses could assess esophageal smooth muscle peristaltic reserve. Further research is warranted to determine if antireflux surgery needs to be tailored to the MRS response. PMID:24019081

  5. Cortical processing of swallowing in ALS patients with progressive dysphagia--a magnetoencephalographic study.

    Directory of Open Access Journals (Sweden)

    Inga K Teismann

    Full Text Available Amyotrophic lateral sclerosis (ALS is a rare disease causing degeneration of the upper and lower motor neuron. Involvement of the bulbar motor neurons often results in fast progressive dysphagia. While cortical compensation of dysphagia has been previously shown in stroke patients, this topic has not been addressed in patients suffering from ALS. In the present study, we investigated cortical activation during deglutition in two groups of ALS patients with either moderate or severe dysphagia. Whole-head MEG was employed on fourteen patients with sporadic ALS using a self-paced swallowing paradigm. Data were analyzed by means of time-frequency analysis and synthetic aperture magnetometry (SAM. Group analysis of individual SAM data was performed using a permutation test. We found a reduction of cortical swallowing related activation in ALS patients compared to healthy controls. Additionally a disease-related shift of hemispheric lateralization was observed. While healthy subjects showed bilateral cortical activation, the right sensorimotor cortex was predominantly involved in ALS patients. Both effects were even stronger in the group of patients with severe dysphagia. Our results suggest that bilateral degeneration of the upper motor neuron in the primary motor areas also impairs further adjusted motor areas, which leads to a strong reduction of 'swallowing related' cortical activation. While both hemispheres are affected by the degeneration a relatively stronger activation is seen in the right hemisphere. This right hemispheric lateralization of volitional swallowing observed in this study may be the only sign of cortical plasticity in dysphagic ALS patients. It may demonstrate compensational mechanisms in the right hemisphere which is known to predominantly coordinate the pharyngeal phase of deglutition. These results add new aspects to our understanding of the pathophysiology of dysphagia in ALS patients and beyond. The compensational

  6. The study on development of easily chewable and swallowable foods for elderly.

    Science.gov (United States)

    Kim, Soojeong; Joo, Nami

    2015-08-01

    When the functions involved in the ingestion of food occurs failure, not only loss of enjoyment of eating, it will be faced with protein-energy malnutrition. Dysmasesis and difficulty of swallowing occurs in various diseases, but it may be a major cause of aging, and elderly people with authoring and dysmasesis and difficulty of swallowing in the aging society is expected to increase rapidly. In this study, we carried out a survey targeting nutritionists who work in elderly care facilities, and examined characteristics of offering of foods for elderly and the degree of demand of development of easily chewable and swallowable foods for the elderly who can crush foods and take that by their own tongues, and sometimes have difficulty in drinking water and tea. In elderly care facilities, it was found to provide a finely chopped food or ground food that was ground with water in a blender for elderly with dysmasesis. Elderly satisfaction of provided foods is appeared overall low. Results of investigating the applicability of foods for elderly and the reflection will of menus, were showed the highest response rate in a gelification method in molecular gastronomic science technics, and results of investigating the frequent food of the elderly; representative menu of beef, pork, white fish, anchovies and spinach, were showed Korean barbecue beef, hot pepper paste stir fried pork, pan fried white fish, stir fried anchovy, seasoned spinach were the highest offer frequency. This study will provide the fundamentals of the development of easily chewable and swallowable foods, gelification, for the elderly. The study will also illustrate that, in the elderly, food undergone gelification will reduce the risk of swallowing down to the wrong pipe and improve overall food preference.

  7. Radionuclide uptake and growth of barn swallows nesting by radioactive leaching ponds

    International Nuclear Information System (INIS)

    Millard, J.B.; Whicker, F.W.; Markham, O.D.

    1990-01-01

    Populations of barn swallows (Hirundo rustica) nested seasonally near the Test Reactor Area (TRA) radioactive leaching ponds on the Idaho National Engineering Laboratory. These birds utilized leaching pond arthropods as a food source and contaminated mud for nest construction. Over 20 fission and activation products were detected in immature and adult TRA birds. The radionuclide exhibiting the highest mean concentration in adult birds was 51Cr, with 16.1 Bq g-1. Mean concentrations of detectable radionuclides were used to calculate internal dose rates. Approximately 72% of the total dose rate of 219 microGy d-1 (22 mrad d-1) for adult birds was due to 24Na. Swallow thyroids contained a mean 131I concentration of 3330 Bq g-1. An average dose rate to the thyroid was calculated to be 4300 microGy d-1 or 450 mGy (45 rad) for the entire breeding season. Data from LiF-700 thermoluminescent dosimeters in swallow nests indicated that average dose rates were 840 microGy d-1 for eggs and 2200 Gy d-1 for nestlings, for a total of 54 mGy (5.4 rad) during the nesting period. The breeding biology and growth rate were investigated for TRA swallows and comparison group located 15 km and 100 km away. Total mortality rates for the comparison group vs. 1976 and 1977 TRA populations were not found to be significantly (p greater than 0.9) different. Nonlinear regression was used to fit individual growth curves and estimate parameters using a logistic model. First clutch TRA swallows were found to have a significantly lower mean growth rate compared to either the first clutch comparison group or the second clutch of TRA birds. Mean asymptotic weights achieved by immature TRA birds were also found to be significantly lower than those achieved by comparison group birds. Both growth rate and asymptotic weights for TRA birds were within the normal range reported in the literature

  8. Patient-reported symptom questionnaires in laryngeal cancer: voice, speech and swallowing.

    Science.gov (United States)

    Rinkel, R N P M; Verdonck-de Leeuw, I M; van den Brakel, N; de Bree, R; Eerenstein, S E J; Aaronson, N; Leemans, C R

    2014-08-01

    To validate questionnaires on voice, speech, and swallowing among laryngeal cancer patients, to assess the need for and use of rehabilitation services, and to determine the association between voice, speech, and swallowing problems, and quality of life and distress. Laryngeal cancer patients at least three months post-treatment completed the VHI (voice), SHI (speech), SWAL-QOL (swallowing), EORTC QLQ-C30, QLQ-HN35, HADS, and study-specific questions on rehabilitation. Eighty-eight patients and 110 healthy controls participated. Cut off scores of 15, 6, and 14 were defined for the VHI, SHI, and SWAL-QOL (sensitivity > 90%; specificity > 80%). Based on these scores, 56% of the patients reported voice, 63% speech, and 54% swallowing problems. VHI, SHI, and SWAL-QOL scores were associated significantly with quality of life (EORTC QLQ-C30 global quality of life scale) (r = .43 (VHI and SHI) and r = .46 (SWAL-QOL)) and distress (r = .50 (VHI and SHI) and r = .58 (SWAL-QOL)). In retrospect, 32% of the patients indicated the need for rehabilitation at time of treatment, and 81% of these patients availed themselves of such services. Post-treatment, 8% of the patients expressed a need for rehabilitation, and 20% of these patients actually made use of such services. Psychometric characteristics of the VHI, SHI, and SWAL-QOL in laryngeal cancer patients are good. The prevalence of voice, speech, and swallowing problems is high, and clearly related to quality of life and distress. Although higher during than after treatment, the perceived need for and use of rehabilitation services is limited. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Relationships between dysphagia and tongue pressure during swallowing in Parkinson's disease patients.

    Science.gov (United States)

    Minagi, Y; Ono, T; Hori, K; Fujiwara, S; Tokuda, Y; Murakami, K; Maeda, Y; Sakoda, S; Yokoe, M; Mihara, M; Mochizuki, H

    2018-03-25

    Although dysphagia is a life-threatening problem in patients with Parkinson's disease (PD), the pathophysiology of oropharyngeal dysphagia is yet to be understood. This study investigated the tongue motor function during swallowing in relation to dysphagia and the severity of PD. Thirty patients with PD (14 males and 16 females; average age, 69.4 years), Hoehn and Yahr stage II-IV, in Osaka University Hospital are participated in this study. During swallowing 5 ml of water, tongue pressure on the hard palate was measured using a sensor sheet with 5 measuring points. The maximal tongue pressure at each measuring point during swallowing was compared between patients with PD and healthy controls. Subjective assessment of oropharyngeal dysphagia was performed using Swallowing Disturbance Questionnaire-Japanese. The maximal tongue pressure at each measuring point was significantly lower in patients with PD than in healthy controls (8 males and 12 females; average age, 71.6 years). Furthermore, the maximal tongue pressure was significantly lower in dysphagic PD patients than non-dysphagic PD patients. Loss of tongue pressure production at the anterior part of the hard palate was strongly related to dysphagia in the oral phase as well as in the pharyngeal phase. An abnormal pattern of tongue pressure production was more frequently observed in dysphagic PD patients than in non-dysphagic PD patients. The results suggest that tongue pressure measurement might be useful for early and quantitative detection of tongue motor disability during swallowing in patients with PD. © 2018 John Wiley & Sons Ltd.

  10. Diagnostic validity of methods for assessment of swallowing sounds: a systematic review.

    Science.gov (United States)

    Taveira, Karinna Veríssimo Meira; Santos, Rosane Sampaio; Leão, Bianca Lopes Cavalcante de; Neto, José Stechman; Pernambuco, Leandro; Silva, Letícia Korb da; De Luca Canto, Graziela; Porporatti, André Luís

    2018-02-03

    Oropharyngeal dysphagia is a highly prevalent comorbidity in neurological patients and presents a serious health threat, which may lead to outcomes of aspiration pneumonia, ranging from hospitalization to death. This assessment proposes a non-invasive, acoustic-based method to differentiate between individuals with and without signals of penetration and aspiration. This systematic review evaluated the diagnostic validity of different methods for assessment of swallowing sounds, when compared to Videofluroscopic of Swallowing Study (VFSS) to detect oropharyngeal dysphagia. Articles in which the primary objective was to evaluate the accuracy of swallowing sounds were searched in five electronic databases with no language or time limitations. Accuracy measurements described in the studies were transformed to construct receiver operating characteristic curves and forest plots with the aid of Review Manager v. 5.2 (The Nordic Cochrane Centre, Copenhagen, Denmark). The methodology of the selected studies was evaluated using the Quality Assessment Tool for Diagnostic Accuracy Studies-2. The final electronic search revealed 554 records, however only 3 studies met the inclusion criteria. The accuracy values (area under the curve) were 0.94 for microphone, 0.80 for Doppler, and 0.60 for stethoscope. Based on limited evidence and low methodological quality because few studies were included, with a small sample size, from all index testes found for this systematic review, Doppler showed excellent diagnostic accuracy for the discrimination of swallowing sounds, whereas microphone-reported good accuracy discrimination of swallowing sounds of dysphagic patients and stethoscope showed best screening test. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  11. TreePics: visualizing trees with pictures

    Directory of Open Access Journals (Sweden)

    Nicolas Puillandre

    2017-09-01

    Full Text Available While many programs are available to edit phylogenetic trees, associating pictures with branch tips in an efficient and automatic way is not an available option. Here, we present TreePics, a standalone software that uses a web browser to visualize phylogenetic trees in Newick format and that associates pictures (typically, pictures of the voucher specimens to the tip of each branch. Pictures are visualized as thumbnails and can be enlarged by a mouse rollover. Further, several pictures can be selected and displayed in a separate window for visual comparison. TreePics works either online or in a full standalone version, where it can display trees with several thousands of pictures (depending on the memory available. We argue that TreePics can be particularly useful in a preliminary stage of research, such as to quickly detect conflicts between a DNA-based phylogenetic tree and morphological variation, that may be due to contamination that needs to be removed prior to final analyses, or the presence of species complexes.

  12. Esophageal contractions, bolus transit and perception of transit after swallows of liquid and solid boluses in normal subjects

    Directory of Open Access Journals (Sweden)

    Juciléia Dalmazo

    2012-12-01

    Full Text Available CONTEXT: Esophageal dysphagia is the sensation that the ingested material has a slow transit or blockage in its normal passage to the stomach. It is not always associated with motility or transit alterations. OBJECTIVES: To evaluate in normal volunteers the possibility of perception of bolus transit through the esophagus after swallows of liquid and solid boluses, the differences in esophageal contraction and transit with these boluses, and the association of transit perception with alteration of esophageal contraction and/or transit. METHODS: The investigation included 11 asymptomatic volunteers, 4 men and 7 women aged 19-58 years. The subjects were evaluated in the sitting position. They performed swallows of the same volume of liquid (isotonic drink and solid (macaroni boluses in a random order and in duplicate. After each swallow they were asked about the sensation of bolus passage through the esophagus. Contractions and transit were evaluated simultaneously by solid state manometry and impedance. RESULTS: Perception of bolus transit occurred only with the solid bolus. The amplitude and area under the curve of contractions were higher with swallows of the solid bolus than with swallows of the liquid bolus. The difference was more evident in swallows with no perception of transit (n = 12 than in swallows with perception (n = 10. The total bolus transit time was longer for the solid bolus than for the liquid bolus only with swallows followed by no perception of transit. CONCLUSION: The results suggest that the perception of esophageal transit may be the consequence of inadequate adaptation of esophageal transit and contraction to the characteristics of the swallowed bolus.

  13. Absolutely Continuous Spectrum for Random Schrödinger Operators on the Fibonacci and Similar Tree-strips

    Energy Technology Data Exchange (ETDEWEB)

    Sadel, Christian, E-mail: Christian.Sadel@ist.ac.at [University of British Columbia, Mathematics Department (Canada)

    2014-12-15

    We consider cross products of finite graphs with a class of trees that have arbitrarily but finitely long line segments, such as the Fibonacci tree. Such cross products are called tree-strips. We prove that for small disorder random Schrödinger operators on such tree-strips have purely absolutely continuous spectrum in a certain set.

  14. 'Pharyngocise': Randomized Controlled Trial of Preventative Exercises to Maintain Muscle Structure and Swallowing Function During Head-and-Neck Chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Carnaby-Mann, Giselle, E-mail: gmann@phhp.ufl.edu [Department of Behavioral Science and Community Health, University of Florida, Gainesville, FL (United States); Crary, Michael A. [Department of Speech Language and Hearing Sciences, University of Florida, Gainesville, FL (United States); Schmalfuss, Ilona [Department of Radiology, North Florida/South Georgia Veterans Health System, Gainesville, FL (Georgia); Amdur, Robert [Department of Radiation Oncology, University of Florida, Gainesville, FL (United States)

    2012-05-01

    Purpose: Dysphagia after chemoradiotherapy is common. The present randomized clinical trial studied the effectiveness of preventative behavioral intervention for dysphagia compared with the 'usual care.' Methods and Materials: A total of 58 head-and-neck cancer patients treated with chemoradiotherapy were randomly assigned to usual care, sham swallowing intervention, or active swallowing exercises (pharyngocise). The intervention arms were treated daily during chemoradiotherapy. The primary outcome measure was muscle size and composition (determined by T{sub 2}-weighted magnetic resonance imaging). The secondary outcomes included functional swallowing ability, dietary intake, chemosensory function, salivation, nutritional status, and the occurrence of dysphagia-related complications. Results: The swallowing musculature (genioglossus, hyoglossuss, and mylohyoid) demonstrated less structural deterioration in the active treatment arm. The functional swallowing, mouth opening, chemosensory acuity, and salivation rate deteriorated less in the pharyngocise group. Conclusion: Patients completing a program of swallowing exercises during cancer treatment demonstrated superior muscle maintenance and functional swallowing ability.

  15. “Pharyngocise”: Randomized Controlled Trial of Preventative Exercises to Maintain Muscle Structure and Swallowing Function During Head-and-Neck Chemoradiotherapy

    International Nuclear Information System (INIS)

    Carnaby-Mann, Giselle; Crary, Michael A.; Schmalfuss, Ilona; Amdur, Robert

    2012-01-01

    Purpose: Dysphagia after chemoradiotherapy is common. The present randomized clinical trial studied the effectiveness of preventative behavioral intervention for dysphagia compared with the “usual care.” Methods and Materials: A total of 58 head-and-neck cancer patients treated with chemoradiotherapy were randomly assigned to usual care, sham swallowing intervention, or active swallowing exercises (pharyngocise). The intervention arms were treated daily during chemoradiotherapy. The primary outcome measure was muscle size and composition (determined by T 2 -weighted magnetic resonance imaging). The secondary outcomes included functional swallowing ability, dietary intake, chemosensory function, salivation, nutritional status, and the occurrence of dysphagia-related complications. Results: The swallowing musculature (genioglossus, hyoglossuss, and mylohyoid) demonstrated less structural deterioration in the active treatment arm. The functional swallowing, mouth opening, chemosensory acuity, and salivation rate deteriorated less in the pharyngocise group. Conclusion: Patients completing a program of swallowing exercises during cancer treatment demonstrated superior muscle maintenance and functional swallowing ability.

  16. Effects of carbonated liquid on swallowing dysfunction in dementia with Lewy bodies and Parkinson’s disease dementia

    Directory of Open Access Journals (Sweden)

    Larsson V

    2017-08-01

    Full Text Available Victoria Larsson,1 Gustav Torisson,1,2 Margareta Bülow,3 Elisabet Londos1 1Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, 2Department of Infectious Diseases, 3Diagnostic Centre of Imaging and Functional Medicine, Skåne University Hospital, Malmö, Sweden Background: Swallowing dysfunction is an increasingly recognized problem in patients with dementia with Lewy bodies (DLB and Parkinson’s disease dementia (PDD, which can result in aspiration pneumonia and death. Few studies have examined potential ways of improving swallowing function in this fragile patient group. The aim of this study was to evaluate swallowing dysfunction and carbonated liquid using videofluoroscopy in DLB and PDD patients. Methods: A total of 48 patients with DLB and PDD were referred for a clinical examination with videofluoroscopy. Descriptive overall assessments were provided at the time of the examination regarding swallowing function and the effects of different modifications, including carbonated thin liquid (CTL. Additionally, a repeated measures quantitative retrospective analysis has been performed comparing 1 thin liquids; 2 thickened liquids and 3 CTLs, with regard to the quantitative variables 1 pharyngeal transit time (PTT; 2 pharyngeal retention and 3 tracheal penetration. Results: In all, 40/48 (83% of the patients had a swallowing dysfunction, which was confirmed on videofluoroscopy, with 34/40 (85% patients having a pharyngeal-type dysfunction. A total of 14/40 (35% patients with an objective swallowing impairment did not have any subjective swallowing symptoms. Out of the patients with swallowing dysfunction, 87% had an overall improved swallowing function with carbonated liquid. PTT for carbonated liquid (median 633 ms, interquartile range [IQR] 516–786 ms was quicker than for thin liquid (760 ms, IQR 613–940 ms, P=0.014 and thickened liquid (880.0 ms, IQR 600–1,500 ms, P<0.001. No significant effect

  17. Spectra of chemical trees

    International Nuclear Information System (INIS)

    Balasubramanian, K.

    1982-01-01

    A method is developed for obtaining the spectra of trees of NMR and chemical interests. The characteristic polynomials of branched trees can be obtained in terms of the characteristic polynomials of unbranched trees and branches by pruning the tree at the joints. The unbranched trees can also be broken down further until a tree containing just two vertices is obtained. The effectively reduces the order of the secular determinant of the tree used at the beginning to determinants of orders atmost equal to the number of vertices in the branch containing the largest number of vertices. An illustrative example of a NMR graph is given for which the 22 x 22 secular determinant is reduced to determinants of orders atmost 4 x 4 in just the second step of the algorithm. The tree pruning algorithm can be applied even to trees with no symmetry elements and such a factoring can be achieved. Methods developed here can be elegantly used to find if two trees are cospectral and to construct cospectral trees

  18. Refining discordant gene trees.

    Science.gov (United States)

    Górecki, Pawel; Eulenstein, Oliver

    2014-01-01

    Evolutionary studies are complicated by discordance between gene trees and the species tree in which they evolved. Dealing with discordant trees often relies on comparison costs between gene and species trees, including the well-established Robinson-Foulds, gene duplication, and deep coalescence costs. While these costs have provided credible results for binary rooted gene trees, corresponding cost definitions for non-binary unrooted gene trees, which are frequently occurring in practice, are challenged by biological realism. We propose a natural extension of the well-established costs for comparing unrooted and non-binary gene trees with rooted binary species trees using a binary refinement model. For the duplication cost we describe an efficient algorithm that is based on a linear time reduction and also computes an optimal rooted binary refinement of the given gene tree. Finally, we show that similar reductions lead to solutions for computing the deep coalescence and the Robinson-Foulds costs. Our binary refinement of Robinson-Foulds, gene duplication, and deep coalescence costs for unrooted and non-binary gene trees together with the linear time reductions provided here for computing these costs significantly extends the range of trees that can be incorporated into approaches dealing with discordance.

  19. An interactive programme for weighted Steiner trees

    International Nuclear Information System (INIS)

    Do Nascimento, Marcelo Zanchetta; Batista, Valério Ramos; Coimbra, Wendhel Raffa

    2015-01-01

    We introduce a fully written programmed code with a supervised method for generating weighted Steiner trees. Our choice of the programming language, and the use of well- known theorems from Geometry and Complex Analysis, allowed this method to be implemented with only 764 lines of effective source code. This eases the understanding and the handling of this beta version for future developments

  20. An interactive programme for weighted Steiner trees

    Science.gov (United States)

    Zanchetta do Nascimento, Marcelo; Ramos Batista, Valério; Raffa Coimbra, Wendhel

    2015-01-01

    We introduce a fully written programmed code with a supervised method for generating weighted Steiner trees. Our choice of the programming language, and the use of well- known theorems from Geometry and Complex Analysis, allowed this method to be implemented with only 764 lines of effective source code. This eases the understanding and the handling of this beta version for future developments.

  1. Effects of age and viscosity on food transport and breathing-swallowing coordination during eating of two-phase food in nursing home residents.

    Science.gov (United States)

    Yamada, Tsuyoshi; Matsuo, Koichiro; Izawa, Masayuki; Yamada, Shizuru; Masuda, Yuji; Ogasawara, Tadashi

    2017-11-01

    When eating food that contains both liquid and solid phases, the liquid component frequently enters the hypopharynx before swallowing and can increase the risk of aspiration. Thus, we examined whether the initial viscosity of mixed consistency food could alter pre-swallow food transport and breathing-swallowing coordination in older adults. Fiberoptic endoscopy was recorded while 18 healthy young adults and 19 older adults ate 5 g of steamed rice combined with 3 mL of blue-dye water. Liquid viscosity was set at three levels by the addition of a thickening agent (0 wt%, thin; 2 wt%, thicker; 4 wt%, higher-viscosity, respectively). We measured the timing of swallow initiation and its corresponding respiratory phase for each participant. For thin mixed consistency food, whereas the timing of swallow initiation was comparable between young and older participants, swallowing was initiated during inspiration significantly more often in older participants (31.6 %) than in young participants (5.6 %). In contrast, the timing of swallow initiation was delayed in older participants for thicker and higher-viscosity foods, although swallowing was commonly initiated during expiration in both groups. In older adults, we observed that swallow initiation function was preserved for thin mixed consistency samples, but breathing-swallowing coupling was diminished. For higher-viscosity foods, swallow initiation was delayed in this group, but breathing-swallowing coordination was not disturbed, probably as a result of the slow bolus flow into the hypopharynx. Thus, it appears the initial viscosity of mixed consistency food profoundly affects food transport before swallowing as well as breathing-swallowing coordination in nursing home residents. Geriatr Gerontol Int 2017; 17: 2171-2177. © 2017 Japan Geriatrics Society.

  2. Optimal Monotone Drawings of Trees

    OpenAIRE

    He, Dayu; He, Xin

    2016-01-01

    A monotone drawing of a graph G is a straight-line drawing of G such that, for every pair of vertices u,w in G, there exists abpath P_{uw} in G that is monotone in some direction l_{uw}. (Namely, the order of the orthogonal projections of the vertices of P_{uw} on l_{uw} is the same as the order they appear in P_{uw}.) The problem of finding monotone drawings for trees has been studied in several recent papers. The main focus is to reduce the size of the drawing. Currently, the smallest drawi...

  3. Improving swallowing outcomes in patients with head and neck cancer using a theory-based pretreatment swallowing intervention package: protocol for a randomised feasibility study.

    Science.gov (United States)

    Govender, Roganie; Smith, Christina H; Gardner, Benjamin; Barratt, Helen; Taylor, Stuart A

    2017-03-27

    The incidence of head and neck cancer (HNC) in the UK is rising, with an average of 31 people diagnosed daily. Patients affected by HNC suffer significant short-term and long-term post-treatment morbidity as a result of dysphagia, which affects daily functioning and quality of life (QOL). Pretreatment swallowing exercises may provide additional benefit over standard rehabilitation in managing dysphagia after primary HNC treatments, but uncertainty about their effectiveness persists. This study was preceded by an intervention development phase to produce an optimised swallowing intervention package (SIP). The aim of the current study is to assess the feasibility of this new intervention and research processes within a National Health Service (NHS) setting. A two-arm non-blinded randomised controlled feasibility study will be carried out at one tertiary referral NHS centre providing specialist services in HNC. Patients newly diagnosed with stage III and IV disease undergoing planned surgery and/or chemoradiation treatments will be eligible. The SIP will be delivered pre treatment, and a range of swallowing-related and QOL measures will be collected at baseline, 1, 3 and 6 months post-treatment. Outcomes will test the feasibility of a future randomised controlled trial (RCT), detailing rate of recruitment and patient acceptance to participation and randomisation. Salient information relating to protocol implementation will be collated and study material such as the case report form will be tested. A range of candidate outcome measures will be examined for suitability in a larger RCT. Ethical approval was obtained from an NHS Research Ethics Committee. Findings will be published open access in a peer-reviewed journal, and presented at relevant conferences and research meetings. ISRCTN40215425; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Preliminary Evaluation of the Pathomechanisms of Dysphagia After Occipitospinal Fusion: Kinematic Analysis by Videofluoroscopic Swallowing Study.

    Science.gov (United States)

    Kaneyama, Shuichi; Sumi, Masatoshi; Takabatake, Masato; Kasahara, Koichi; Kanemura, Aritetsu; Koh, Akihiro; Hirata, Hiroaki

    2016-12-01

    Kinematic analysis of swallowing function using videofluoroscopic swallowing study (VFSS). The aims of this study were to analyze swallowing process in the patients who underwent occipitospinal fusion (OSF) and elucidate the pathomechanism of dysphagia after OSF. Although several hypotheses about the pathomechanisms of dysphagia after OSF were suggested, there has been little tangible evidence to support these hypotheses since these hypotheses were based on the analysis of static radiogram or CT. Considering that swallowing is a compositive motion of oropharyngeal structures, the etiology of postoperative dysphagia should be investigated through kinematic approaches. Each four patients with or without postoperative dysphagia (group D and N, respectively) participated in this study. For VFSS, all patients were monitored to swallow 5-mL diluted barium solution by fluoroscopy, and then dynamic passing pattern of the barium solution was analyzed. Additionally, O-C2 angle (O-C2A) was measured for the assessment of craniocervical alignment. O-C2A in group D was -7.5 degrees, which was relatively smaller than 10.3 degrees in group N (P = 0.07). In group D, all cases presented smooth medium passing without any obstruction at the upper cervical level regardless of O-C2A, whereas the obstruction to the passage of medium was detected at the apex of mid-lower cervical ocurvature, where the anterior protrusion of mid-lower cervical spine compressed directly the pharyngeal space. In group N, all cases showed smooth passing of medium through the whole process of swallowing. This study presented that postoperative dysphagia did not occur at the upper cervical level even though there was smaller angle of O-C2A and demonstrated the narrowing of the oropharyngeal space towing to direct compression by the anterior protrusion of mid-lower cervical spine was the etiology of dysphagia after OSF. Therefore, surgeon should pay attention to the alignment of mid-cervical spine as well as

  5. Aspiration pneumonia induces muscle atrophy in the respiratory, skeletal, and swallowing systems.

    Science.gov (United States)

    Komatsu, Riyo; Okazaki, Tatsuma; Ebihara, Satoru; Kobayashi, Makoto; Tsukita, Yoko; Nihei, Mayumi; Sugiura, Hisatoshi; Niu, Kaijun; Ebihara, Takae; Ichinose, Masakazu

    2018-05-22

    Repetition of the onset of aspiration pneumonia in aged patients is common and causes chronic inflammation. The inflammation induces proinflammatory cytokine production and atrophy in the muscles. The proinflammatory cytokines induce muscle proteolysis by activating calpains and caspase-3, followed by further degradation by the ubiquitin-proteasome system. Autophagy is another pathway of muscle atrophy. However, little is known about the relationship between aspiration pneumonia and muscle. For swallowing muscles, it is not clear whether they produce cytokines. The main objective of this study was to determine whether aspiration pneumonia induces muscle atrophy in the respiratory (the diaphragm), skeletal (the tibialis anterior, TA), and swallowing (the tongue) systems, and their possible mechanisms. We employed a mouse aspiration pneumonia model and computed tomography (CT) scans of aged pneumonia patients. To induce aspiration pneumonia, mice were inoculated with low dose pepsin and lipopolysaccharide solution intra-nasally 5 days a week. The diaphragm, TA, and tongue were isolated, and total RNA, proteins, and frozen sections were stored. Quantitative real-time polymerase chain reaction determined the expression levels of proinflammatory cytokines, muscle E3 ubiquitin ligases, and autophagy related genes. Western blot analysis determined the activation of the muscle proteolysis pathway. Frozen sections determined the presence of muscle atrophy. CT scans were used to evaluate the muscle atrophy in aged aspiration pneumonia patients. The aspiration challenge enhanced the expression levels of proinflammatory cytokines in the diaphragm, TA, and tongue. Among muscle proteolysis pathways, the aspiration challenge activated caspase-3 in all the three muscles examined, whereas calpains were activated in the diaphragm and the TA but not in the tongue. Activation of the ubiquitin-proteasome system was detected in all the three muscles examined. The aspiration challenge

  6. Stable isotope analysis of migratory connectivity in a threatened intra-African migrant, the Blue Swallow (Hirundo atrocaerulea)

    CSIR Research Space (South Africa)

    Wakelin, J

    2010-07-01

    Full Text Available The Blue Swallow (Hirundo atrocaerulea) is a threatened intra-African migrant with breeding populations in three geographically disjunct regions. We analysed stable hydrogen, nitrogen and carbon isotope ratios in feather keratin to determine whether...

  7. [Aural Stimulation with Capsaicin Ointment Improved the Swallowing Function in Patients with Dysphagia: Evaluation by the SMRC Scale].

    Science.gov (United States)

    Kondo, Eiji; Jinnouchi, Osamu; Ohnishi, Hiroki; Kawata, Ikuji; Takeda, Noriaki

    2015-11-01

    Cough and swallowing reflexes are important airway-protective mechanisms against aspiration. Angiotensin-converting enzyme (ACE) inhibitors, one of the side effects of which is cough, have been reported to reduce the incidence of aspiration pneumonia in hypertensive patients with stroke. ACE inhibitors have also been reported to improve the swallowing function in post-stroke patients. On the other hand, stimulation of the Arnold nerve, the auricular branch of the vagus, triggers the cough reflex (Arnold's ear-cough reflex). Capsaicin, an agonist of Transient Receptor Potential Vanilloid 1 (TRPV1), has been shown to activate the peripheral sensory C-fibers. Stimulation of the sensory branches of the vagus in the laryngotracheal mucosa with capsaicin induces the cough reflex and has been reported to improve the swallowing function in patients with dysphagia. In our previous study, we showed that aural stimulation of the Arnold nerve with 0.025% capsaicin ointment improved the swallowing function, as evaluated by the endoscopic swallowing score, in 26 patients with dysphagia. In the present study, the video images of swallowing recorded in the previous study were re-evaluated using the SMRC scale by an independent otolaryngologist who was blinded to the information about the patients and the endoscopic swallowing score. The SMRC scale is used to evaluate four aspects of the swallowing function: 1) Sensory: the initiation of the swallowing reflex as assessed by the white-out timing; 2) Motion: the ability to hold blue-dyed water in the oral cavity and induce laryngeal elevation; 3) Reflex: glottal closure and the cough reflex induced by touching the epiglottis or arytenoid with the endoscope; 4) Clearance: pharyngeal clearance of the blue-dyed water after swallowing. Accordingly, we demonstrated that a single application of capsaicin ointment to the external auditory canal of patients with dysphagia significantly improved the R, but not the S, M or C scores, and this

  8. Effects of neuromuscular electrical stimulation combined with effortful swallowing on post-stroke oropharyngeal dysphagia: a randomised controlled trial.

    Science.gov (United States)

    Park, J-S; Oh, D-H; Hwang, N-K; Lee, J-H

    2016-06-01

    Neuromuscular electrical stimulation (NMES) has been used as a therapeutic intervention for dysphagia. However, the therapeutic effects of NMES lack supporting evidence. In recent years, NMES combined with traditional swallowing therapy has been used to improve functional recovery in patients with post-stroke dysphagia. This study aimed to investigate the effects of effortful swallowing combined with neuromuscular electrical stimulation on hyoid bone movement and swallowing function in stroke patients. Fifty stroke patients with mild dysphagia who were able to swallow against the resistance applied by using NMES and cooperate actively in training were included. This study was designed as a 6-week single-blind, randomised, controlled study. In the experimental group, two pairs of electrodes were placed horizontally in the infrahyoid region to depress the hyoid bone. The NMES intensity was increased gradually until the participants felt a grabbing sensation in their neck and performed an effortful swallow during the stimulation. In the placebo group, the same procedure was followed except for the intensity, which was increased gradually until the participants felt an electrical sensation. All participants underwent this intervention for 30 min per session, 5 sessions per week, for 6 weeks. Videofluoroscopic swallowing studies (VFSS) were carried out before and after the intervention and kinematics of the hyoid bone and swallowing function were analysed based on the VFSS. The experimental group revealed a significant increase in anterior and superior hyoid bone movement and the pharyngeal phase of the swallowing function. This intervention can be used as a novel remedial approach in dysphagic stroke patients. © 2016 John Wiley & Sons Ltd.

  9. Speech-Language and swallowing manifestations and rehabilitation in an 11-year-old girl with MELAS syndrome.

    Science.gov (United States)

    Vandana, V P; Bindu, Parayil Sankaran; Sonam, Kothari; Taly, Arun B; Gayathri, N; Madhu, N; Sinha, S

    2015-01-01

    Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a rare mitochondrial disease. The available studies on MELAS syndrome are limited to evaluation of radiological, audiological, genetic, and neurological findings. Among the various neurological manifestations, speech-language and swallowing manifestations are less discussed in the literature. This report describes the speech-language and swallowing function in an 11-year-old girl with MELAS syndrome. The intervention over a period of 6 months is discussed.

  10. Rotigotine Transdermal Patch Improves Swallowing in Dysphagic Patients with Parkinson's Disease.

    Science.gov (United States)

    Hirano, Makito; Isono, Chiharu; Sakamoto, Hikaru; Ueno, Shuichi; Kusunoki, Susumu; Nakamura, Yusaku

    2015-08-01

    Abnormal swallowing, dysphagia, is a potentially fatal symptom in Parkinson's disease (PD) and is characterized by frequent silent aspiration, an unrecognized risk of suffocation and aspiration pneumonia. Several studies have reported that the injection of apomorphine, a dopamine agonist, alleviated dysphagia in some patients with PD. The effects of other antiparkinson medications against dysphagia remain controversial. Rotigotine is another dopamine agonist with non-oral administration, i.e., a transdermal patch. Its noninvasiveness seems to render this medicine even more suitable than apomorphine for dysphasic patients. However, no direct evidence has been reported. In the present retrospective open-label study, we for the first time objectively showed that rotigotine improved swallowing on videofluoroscopic examination in dysphagic patients with PD.

  11. The valuative tree

    CERN Document Server

    Favre, Charles

    2004-01-01

    This volume is devoted to a beautiful object, called the valuative tree and designed as a powerful tool for the study of singularities in two complex dimensions. Its intricate yet manageable structure can be analyzed by both algebraic and geometric means. Many types of singularities, including those of curves, ideals, and plurisubharmonic functions, can be encoded in terms of positive measures on the valuative tree. The construction of these measures uses a natural tree Laplace operator of independent interest.

  12. Adding Endoscopist-Directed Flexible Endoscopic Evaluation of Swallowing to the Videofluoroscopic Swallowing Study Increased the Detection Rates of Penetration, Aspiration, and Pharyngeal Residue.

    Science.gov (United States)

    Park, Won Young; Lee, Tae Hee; Ham, Nam Seok; Park, Ji Woong; Lee, Yang Gyun; Cho, Sang Jin; Lee, Joon Seong; Hong, Su Jin; Jeon, Seong Ran; Kim, Hyun Gun; Cho, Joo Young; Kim, Jin Oh; Cho, Jun Hyung; Lee, Ji Sung

    2015-09-23

    Currently, the videofluoroscopic swallowing study (VFSS) is the standard tool for evaluating dysphagia. We evaluated whether the addition of endoscopist-directed flexible endoscopic evaluation of swallowing (FEES) to VFSS could improve the detection rates of penetration, aspiration, and pharyngeal residue, compared the diagnostic efficacy between VFSS and endoscopist-directed FEES and assessed the adverse events of the FEES. In single tertiary referral center, a retrospective analysis of prospectively collected data was conducted. Fifty consecutive patients suspected of oropharyngeal dysphagia were enrolled in this study between January 2012 and July 2012. The agreement in the detection of penetration and aspiration between VFSS and FEES of viscous food (κ=0.34; 95% confidence interval [CI], 0.15 to 0.53) and liquid food (κ=0.22; 95% CI, 0.02 to 0.42) was "fair." The agreement in the detection of pharyngeal residue between the two tests was "substantial" with viscous food (κ=0.63; 95% CI, 0.41 to 0.94) and "fair" with liquid food (κ=0.37; 95% CI, 0.10 to 0.63). Adding FEES to VFSS significantly increased the detection rates of penetration, aspiration, and pharyngeal residue. No severe adverse events were noted during FEES, except for two cases of epistaxis, which stopped spontaneously without requiring any packing. This study demonstrated that the addition of endoscopist-directed FEES to VFSS increased the detection rates of penetration, aspiration, and pharyngeal residue.

  13. Contrast-enhanced swallow study sensitivity for anastomotic leak detection in post-esophagectomy patients.

    Science.gov (United States)

    Mejía-Rivera, S; Pérez-Marroquín, S A; Cortés-González, R; Medina-Franco, H

    2018-03-07

    Esophagectomy is a highly invasive surgery and one of its postoperative complications is anastomotic leakage, occurring in 53% of cases. The aim of the present study was to determine the sensitivity of the contrast-enhanced swallow study as a method for diagnosing anastomotic leak in patients that underwent esophagectomy. The present retrospective study included the case records of patients that underwent esophagectomy with reconstruction and cervical anastomosis at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán within the time frame of January 1, 2000 and May 31, 2006. Demographic, clinical, and laboratory data emphasizing clinical and radiographic anastomotic leak detection were identified. Descriptive statistics were carried out and contrast-enhanced swallow study sensitivity for diagnosing leakage was calculated. Seventy patients were included in the analysis. The mean age of the patients was 50.6 years, 51 of the patients were men (72.86%), and 19 were women (27.14%). Indications for surgery were benign lesion in 29 patients (41.4%) and malignant lesion in 41 (58.6%). A total of 44.3% of the patients presented with a comorbidity, with diabetes mellitus and high blood pressure standing out. Thirty patients (42.85%) presented with anastomotic leak. Contrast-enhanced swallow study sensitivity for leak detection was 43.33%. The diagnostic sensitivity of the contrast-enhanced swallow study was very low. Therefore, we recommend the discontinuation of its routine use as a method for diagnosing anastomotic leaks. Copyright © 2018 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  14. A Timely Intervention: Endoscopic Retrieval of a Swallowed Magnetized Activity Watch

    Directory of Open Access Journals (Sweden)

    Jason S. Radowsky

    2016-01-01

    Full Text Available The accidental ingestion of a foreign object often presents a difficult scenario for the clinician. This includes not only the decision to retrieve the material but also the appropriate technique to use. We present the case of a young asymptomatic girl who swallowed a magnetic activity watch, which was then successfully retrieved with an endoscopic snare. To our knowledge, this is the first documented case of salvaging an operational watch from the stomach using an endoscopic technique.

  15. Prevalence of skeletal muscle mass loss and its association with swallowing function after cardiovascular surgery.

    Science.gov (United States)

    Wakabayashi, Hidetaka; Takahashi, Rimiko; Watanabe, Naoko; Oritsu, Hideyuki; Shimizu, Yoshitaka

    2017-06-01

    The aim of this study was to assess the prevalence of skeletal muscle mass loss and its association with swallowing function in patients with dysphagia after cardiovascular surgery. A retrospective cohort study was performed in 65 consecutive patients with dysphagia after cardiovascular surgery who were prescribed speech therapy. Skeletal muscle index (SMI) was calculated as total psoas muscle area assessed via abdominal computed tomography divided by height squared. Cutoff values were 6.36 cm 2 /m 2 for men and 3.92 cm 2 /m 2 for women. The Food Intake Level Scale (FILS) was used to assess the swallowing function. Univariate and ordered logistic regression analyses were applied to examine the associations between skeletal muscle mass loss and dysphagia. The study included 50 men and 15 women (mean age 73 ± 8 y). The mean SMI was 4.72 ± 1.37 cm 2 /m 2 in men and 3.33 ± 1.42 cm 2 /m 2 in women. Skeletal muscle mass loss was found in 53 (82%) patients. Twelve had tracheostomy cannula. Thirteen were non-oral feeding (FILS levels 1-3), 5 were oral food intake and alternative nutrition (levels 4-6), and 47 were oral food intake alone (levels 7-9) at discharge. The FILS at discharge was significantly lower in patients with skeletal muscle mass loss. Ordered logistic regression analysis of swallowing function showed that skeletal muscle mass loss and tracheostomy cannula were associated independently with the FILS at discharge. The prevalence of skeletal muscle mass loss is very high, and skeletal muscle mass loss is associated with swallowing function. Copyright © 2017 Elsevier Inc. All rights reserved.