Biomedical subjects

A van der Bilt

Publications and source records attributed to A van der Bilt.

At least 37 records · Page 2Linked to original sources

PubMed2000

Tongue force in patients with myasthenia gravis.

OBJECTIVES: The aim was to study tongue force in patients with bulbar myasthenia gravis and compare it with that of patients with ocular myasthenia gravis, patients in clinical remission who previously suffered from bulbar myasthenia gravis, and healthy subjects. MATERIAL AND METHODS: Tongue force was measured with a tongue force transducer in cranial and lateral directions, which coincide with the directions in which the tongue exerts force during swallowing, speech, and mastication. RESULTS: Tongue force in lateral direction was significantly decreased in patients with bulbar myasthenia gravis. In addition, our findings suggest an incomplete recovery of lateral tongue force in the patients of the remission group. CONCLUSION: Our tongue force measurements may be useful for longitudinal evaluation of therapy in individual patients and also in studies of therapy efficacy in matched groups of patients if the influence of factors such as age, dental state, and sex is taken into account.

Adult↗

PubMed2000

Evaluation of the VX2 rabbit auricle carcinoma as a model for head and neck cancer in humans.

INTRODUCTION: This study investigates whether the VX2 carcinoma cell line, transplanted into the rabbit auricle, can be used as a head and neck cancer model. The biologic behaviour of this model is evaluated, comparing tumour transplantation with either tissue pieces or cell suspensions. MATERIAL: Thirty-six adult NZW rabbits received s.c. injections of VX2-suspensions (Group S) and 11 rabbits received solid VX2-pieces (Group P) into both auricles. METHODS: In Group S, 16 rabbits were sacrificed at various days before (S1) and 15 after (S2) the 28th day following transplantation. In the other five rabbits transplantation failed. Animals from Group P were sacrificed every 2 weeks after the 28th day. At autopsy the size of the primary tumours and of lymph node, lung and other metastases were assessed. If transplantation failed, the maximal tumour size and the time at which regression took place were recorded. Exponential trend lines were used to create growth curves of metastases. Differences between groups were evaluated with the chi2 test, correlations between parameters with Kendall's tau. RESULTS: The tumour take-rate in Groups S and P was 78% and 59% respectively. The maximal size and time at which regression occurred was significantly different, amounting to 83 +/- 7 mm2 at 10.4 +/- 1.6 days (Group S) and 243 +/- 30 mm2 at 20.9 +/- 2.0 days (Group P), respectively. Development of lymph node metastases was not different. In Groups P and S2, over 90% of the necks contained lymph node metastases. There was a higher incidence of lung metastases in Group S2 when compared to Group P (47% vs. 14%) but it was not statistically significant. A significant correlation (p<0.05) between weight loss and the size of lung metastases was found. CONCLUSION: Transplantation of the VX2-tumour with cell suspensions produces a useful head and neck cancer model for locoregional disease in which anti-tumour regimens against both the primary and lymph node metastases can be tested. Transplantation with tumour pieces is not advised as the take-rate is low and spontaneous remissions occur at a late stage.

Animals↗

PubMed1999

Comparison of external load compensation during rhythmic arm movements and rhythmic jaw movements in humans.

Experiments were performed on human elbow flexor and extensor muscles and jaw-opening and -closing muscles to observe the effect on rhythmic movements of sudden loading. The load was provided by an electromagnetic device, which simulated the appearance of a smoothly increasing spring-like load. The responses to this loading were compared in jaw and elbow movements and between expected and unexpected disturbances. All muscles showed electromyographic responses to unexpected perturbations, with latencies of approximately 65 ms in the arm muscles and 25 ms in the jaw. When loading was predictable, anticipatory responses started in arm muscles approximately 200 ms before and in jaw muscles 100 ms before the onset of loading. The reflex responses relative to the anticipatory responses were smaller for the arm muscles than for the jaw muscles. The reflex responses in the arm muscles were the same with unexpected and expected perturbations, whereas anticipation increased the reflex responses in the jaw muscles. Biceps brachii and triceps brachii showed similar sensory-induced responses and similar anticipatory responses. Jaw muscles differed, however, in that the reflex response was stronger in masseter than in digastric. It was concluded that reflex responses in the arm muscles cannot overcome the loading of the arm adequately, which is compensated by a large centrally programmed response when loading is predictable. The jaw muscles, particularly the jaw-closing muscles, tend to respond mainly through reflex loops, even when loading of the jaw is anticipated. The differences between the responses of the arm and the jaw muscles may be related to physical differences. For example, the jaw was decelerated more strongly by the load than the heavier arm. The jaw was decelerated strongly but briefly, <30 ms during jaw closing, indicating that muscle force increased before the onset of reflex activity. Apparently, the force-velocity properties of the jaw muscles have a stabilizing effect on the jaw and have this effect before sensory induced responses occur. The symmetrical responses in biceps and triceps indicate similar motor control of both arm muscles. The differences in reflex activity between masseter and digastric muscle indicate fundamental differences in sensory feedback to the jaw-closing muscle and jaw-opening muscle.

Adult↗

PubMed1999

Speed-dependent control of cyclic open-close movements of the human jaw with an external force counteracting closing.

Previous work with open-close movements of the jaw in which food resistance was simulated by an external force has shown that additional activity of the jaw-closing muscles to overcome the force is mainly of sensory origin. When the force was expected, a small anticipatory response was also observed, starting before the onset of the force. The movement rates in these experiments corresponded to natural chewing rates of about 60 cycles per minute. Our aim was to investigate how anticipatory and peripherally induced muscle activity change with movement speed. Peripheral feedback to the muscles may increase at higher movement speed, possibly resulting in stronger reflex activity. On the other hand, when the force is expected, more preprogrammed muscle activity may be generated with faster movements, in anticipation of the force. Three movement rates were studied: 30 cpm (slow), 60 cpm (normal speed), and 120 cpm (fast). The results show that muscle activity to move the jaw increases sharply with movement speed. Extra muscle activity needed to overcome the force also increases with movement speed. However, the contribution by peripherally triggered muscle activity does not increase. In contrast, preprogrammed extra muscle activity in anticipation of the force increases sharply with movement speed. It is concluded that the control strategy for these movements is speed-dependent, with a shift to relatively more anticipatory muscle activity at higher movement speeds, making the movement more ballistic.

Adult↗

PubMed1998

Oral functions of patients with myasthenia gravis.

With the use of the methods developed to quantify oral dysfunctions in bulbar MG patients, our results indicate that we can distinguish the patients from their matched controls. These results can add to our knowledge of myasthenia gravis and these methods may improve diagnosis and therapy evaluation in individual patients. In addition, these methods may be used in future pharmacological research.

Deglutition↗

PubMed1998

A comparison of jaw-opener and jaw-closer muscle activity in humans to overcome an external force counteracting jaw movement.

In contrast to the jaw-closer muscles, no or very few spindles are present in the jaw-opening digastric muscle. Therefore sensory feedback to the digastric muscle may be different from feedback to the jaw-closer muscles, resulting in a different reaction when jaw movement is perturbed. This possible difference was investigated by comparing the reaction of the digastric muscle when jaw opening is perturbed, with the reaction of the masseter muscle when jaw closing is perturbed. Subjects made rhythmic, 1-Hz open-close movements of the jaw under control of a metronome. During jaw opening (digastric muscle) or, in the other experiments, during jaw closing (masseter muscle), an external force counteracting jaw movement could appear. Series of movements without the force were unexpectedly alternated by series with the force. In both muscles sensory induced activity started approximately 25 ms after the onset of the force and consisted of two phases. In the masseter muscle the maximum of the first increase was reached significantly sooner (37 +/- 2 ms SEM) than in the digastric muscle (54 +/- 3 ms). The second increase appeared much sooner in the masseter muscle (73 +/- 4 ms) than in the digastric muscle (159 +/- 10 ms). When the force was expected, in both muscles an increase in preprogrammed muscle activity was observed. Also an increase in reflex activity, generated before 120 ms after the onset of the force, was observed, compared with when the force appeared unexpectedly. The relative increase in reflex activity was approximately 2 times larger than the relative increase in preprogrammed activity. Therefore, the increase in reflex activity when the force was expected may have been caused not only by an increase in recruitment, but also by an increase in the gain of the reflex loops. Reflex activity relative to preprogrammed activity was on average 4 times larger in the masseter muscle than in the digastric muscle. This indicates that the masseter muscle can react more adequately to disturbances of jaw movement than the digastric muscle.

Adult↗

PubMed1998

Detection of onset and termination of muscle activity in surface electromyograms.

A method of automated detection of onset and termination of rhythmic muscle activity in electromyograms (EMGs) is presented. A threshold level in the EMG is computed, such that amplitudes in the EMG signal exceeding this level indicate muscle activity. The threshold level is determined using a statistical criterion based on the amplitude distribution of the entire EMG signal. The working of the method is illustrated with EMG signals recorded from chewing muscles. EMG signals with a good as well as a worse signal-to-noise ratio are presented. The method can be used for any EMG signal containing cyclic bursts of activity and thus may be applied in studies on rhythmic movements, such as chewing, walking and breathing. An automated method of EMG burst detection has the advantage that large amounts of EMG data can be easily and objectively processed.

Electromyography↗

PubMed1998

[Masticatory muscles. Part VIII. Reflexes in the masticatory system].

A reflex is an involuntary response on a specific nerve stimulus. Several types of receptors are present in the masticatory system which can be involved in reflex activity. A short mechanical tap on an incisor, for example, evokes a specific pattern of several so-called exteroceptive reflexes in the electromyographic (EMG) activity of jaw-closing muscles, which includes periods with decreased activity (inhibitory reflex) as well as increased activity (excitatory reflex). In this case, periodontal mechanoreceptors are detecting the stimulus. The second type of reflex that is dealt with is the jaw-jerk reflex as an example of a proprioceptive reflex. A transient increase in length of a jaw-closing muscle, detected by length sensors (muscle spindles), evokes an excitatory reflex in the EMG. Dependent on the motor task, the amplitude of both reflexes is modified. The various reflex mechanisms play an important role in normal physiological functions such as posture control and chewing.

Electromyography↗

PubMed1998

[Masticatory muscles. Part VII. Masticatory muscles and mastication. How do we get small pieces of food?].

One of the functions of the masticatory system is to prepare food for swallowing by crushing it into small pieces to be moistened with saliva. The degree of fragmentation of the food particles depends on factors like the chewing force generated by the closer muscles, the jaw movement, and the morphological aspects of the teeth. The jaw movement is the result of a precise neuromuscular control of the various chewing muscles. Experimental research showed that the muscle activity needed to crush the food particles exists of two components: an anticipating component and a component evoked by the food resistance. The anticipating muscle activity is observed only if food resistance is expected. The muscle activity evoked by the food starts on average 25 ms after food contact. The amount of peripherally induced muscle activity linearly increases as a function of the food resistance. This part of the muscle activity is controlled by sensory information of the masticatory system.

Bite Force↗

PubMed1997

Modulation of the mandibular stretch reflex sensitivity during various phases of rhythmic open-close movements in humans.

The muscle spindles of the jaw elevator muscles provide positive feedback to the alpha motoneurons. It is generally assumed that the feedback is modulated during chewing so that counterproductive forces of the jaw elevator muscles can be avoided during jaw opening. Our aim was to investigate the modulation of the muscle spindle input to the alpha motoneurons during various phases of open-close movements in man. To that end, subjects made rhythmic open-close movements at their natural chewing frequency. A force impulse (5 N, 10 ms), eliciting a jaw-jerk reflex, was unexpectedly applied. The impulse was applied to the mandible at 8 different phases during an open-close cycle, but only 1 impulse per cycle. Jaw movement and surface EMG of the masseter and temporal muscles on both sides were recorded during 3 cycles without an impulse and 3 succeeding cycles with an impulse. To examine whether the modulation of the mandibular stretch reflex sensitivity depends on the food resistance, we applied an additional external force on the mandible, counteracting closing of the jaw each cycle. Two experimental sessions were performed in random order, i.e., without force and with an additional force of 20 N. We observed pronounced reflexes at the onset of jaw closing, during the closing phase, and at occlusion. No or only weak jaw-jerk reflexes were present during jaw opening. The reflex amplitudes at occlusion were larger when an external force was present. This increase in reflex amplitude may be the result of an adjusted gamma motoneuron activity, from pre-motor inhibition, or from both. The reflex amplitudes elicited during jaw closing were not correlated with the phase of the movement.

Adult↗

PubMed1996

An analytic probability density for particle size in human mastication.

In previous studies the distribution of particles sizes of chewed food has been described by an empirical function. However, at the beginning of the chewing process, when many unbroken food particles are still present in the mixture, this function failed to give a good description. In the present study, formulae were derived to characterize the distribution of chewed food particles by size as a function of the number of chewing cycles. The reduction of food particle sizes was considered to be the composite result of a selection and a breakage process. Both processes were described by simple functions. The probability density Pn + 1(x) of finding a particle of size x after n + 1 chewing cycles was computed from Pn(x) by selecting a proportion of particles of size y from Pn to be converted to particles of size x < y by a breakage function. Measures of central tendency--average, median and most probable size--were obtained as a function of the number of chewing cycles. The measures of central tendency characterize the degree of food comminution during the chewing process and so can be used to quantify chewing performance. The comminution of food is described in terms of the selection and breakage functions in a convenient, efficient, analytic way, valid for all phases of the chewing process.

Food↗

PubMed1996

Effects of remote noxious stimulation on exteroceptive reflexes in human jaw-closing muscles.

Reflexes evoked by applying non-painful taps to an incisor tooth were recorded from the jaw closing masseter and temporal muscles of 21 human subjects. A series of inhibitory, excitatory, inhibitory and excitatory waves (the 'Q, R, S and T' waves of the post-stimulus electromyographic complex (PSEC)) occurred in full-wave rectified and averaged electromyograms. Conditioning by remote noxious stimulation (RNS; application of 3 degrees C water to a hand) usually produced increases in activity at the Q-R and S-T transitions of the PSEC (at mean latencies of 24 and 54 ms respectively), which resulted principally from a shortening of the inhibitory Q and S waves. Changes in the amplitudes of the excitatory R and T waves were also found. The effects of RNS were quantified by integrating records of the difference between conditioned and control PSECs. The RNS-induced effect on the entire PSEC was significantly (P < 0.01) greater when the reflexes were evoked by applying hard (7.4 mN.s) as opposed to soft (3.4 mN.s) taps to the tooth. However the ratio between the effects on the ST and QR segments did not differ significantly between these two intensities of tap stimuli. RNS-induced sensations of pain and increases in systemic arterial blood pressure were not correlated with the RNS-induced effects on the different segments of the PSEC. The results suggest that RNS may affect particularly those elements of the PSEC evoked by higher threshold afferents and that the effects are mediated by mechanisms acting directly at the brainstem level and are not secondary to pain or autonomic responses.

Adult↗

PubMed1996

Sensitivity of the jaw-jerk reflex in patients with myogenous temporomandibular disorder.

Changes in the activity of human jaw-elevator muscles related to the mandibular stretch (jaw-jerk) reflex could be involved in the aetiology of temporomandibular disorders (TMD). In order to investigate whether there are differences in the sensitivity of the jaw-jerk reflex between myogenous TMD patients (n = 10) and gender- and age-matched controls (n = 10), jaw-jerk reflexes were elicited under standardized conditions. By measuring the reflex with bipolar surface electromyography (EMG), reflex sensitivity was determined from relations between reflex amplitude and jaw displacement from the masseter and the anterior temporalis muscles. Reflex amplitude and background EMG activity were normalized with respect to the maximal voluntary contraction (MVC) to correct for differences in the thickness of soft tissues overlying the muscle or in electrode placement. In addition to normalization with respect to MVC, for the patients, normalization was also applied with respect to a MVC that was scaled by multiplying values by the ratio of the mean MVC of controls to the mean MVC of patients. At a constant level of background EMG activity, the reflex sensitivity can be determined from the slope (reflex gain) and x-intercept (reflex threshold) of the reflex amplitude-jaw displacement relation. No significant differences between patients and controls were found for the gain or threshold values of either the masseter or the anterior temporalis muscles with a univariate analysis of variance. It is concluded that jaw-jerk reflex sensitivity is not significantly changed in myogenous TMD patients. Therefore, the fusimotor system probably does not play a part in the perpetuating myogenous TMD.

Action Potentials↗

PubMed1996

The relationship between jaw elevator muscle surface electromyogram and simulated food resistance during dynamic condition in humans.

In six human subjects, electromyograms (EMGs) of the masseter and temporal muscles were recorded bilaterally during experiments in which the subjects made rhythmic open-close movements. The closing phase was counteracted by a variable external force on the mandible. Variables of the force (amplitude, time integral and work) and variables of the corresponding EMG bursts (duration, peak amplitude and time integral) were computed for each open-close cycle. Linear regression analyses were used to determine the strength of the relationship between each EMG variable and each force variable. By step-wise multiple regression analysis the EMG variables predicting the force variables were determined. Although there was a highly significant and positive correlation (P < 0.0005), the average coefficients of linear correlation varied from 0.46 to 0.82. The strongest relationship was observed between the time integrals of the force and EMG in the interval between the onset of the burst and the onset of occlusion. It was suggested that to assess muscle force during chewing, the time integral of EMG bursts should be computed.

Adult↗

PubMed1996

Influence of the thickness of soft tissues overlying human masseter and temporalis muscles on the electromyographic maximal voluntary contraction level.

Skinfold measurements by means of calipers and the use of linear regression functions, representing relationships between maximal EMG activity and skinfold thickness, provide a simple and non-invasive procedure to diminish the influence of the thickness of the subcutaneous tissues overlying jaw-elevator muscles on electromyographic data of the maximal voluntary contraction (MVC) level. This method, which allows an improved comparison between different subject or muscle groups in terms of neuromuscular capacity, has been applied to MVC values from the masseter and the anterior temporal muscles (surface EMG) of 21 healthy males, 14 healthy females, and 14 females suffering from myogenous temporomandibular disorders (TMD). Non-corrected MVC values from both muscle groups were larger for the male controls than for the female controls. As the skinfold thickness was smaller for males than for females, these MVC levels did not differ significantly after correction for skinfold thickness. As the skinfold thickness was very similar for the female TMD patients and the controls, the correction method did not appreciably change the lower MVC values of the TMD patients.

Adult↗

PubMed1995

Analysis of differences between conditioned and control reflex series in EMG recordings.

Two methods are presented for the data analysis of signals derived by subtracting conditioned from control reflex data in full-wave rectified and averaged electromyographic (EMG) signals. The first method uses the ratios of the mean amplitudes and standard errors of the mean (S.E.M.s) (i.e. Student's t values) of a series of data points in such a difference signal, and deals with the detection of latencies of reflex components which are susceptible to a conditioning stimulus or experimental situation. The second method applies a modified cumulative sum (CUSUM) technique to full-wave rectified difference signals. This modified CUSUM technique determines the magnitude of the effects of the conditioning situation above that expected due to chance fluctuations, taking into account the effect of reflex modulations on such chance fluctuations in a post-stimulus period. The modified CUSUM technique proved particularly useful when various subtle but consistent, opposing changes occurred sequentially in the conditioned series thus yielding a complicated pattern of effects in a difference signal, with a low signal-to-noise ratio.

Conditioning, Classical↗

PubMed1995

The role of sensory information in the control of rhythmic open-close movements in humans.

Chewing requires a low level of muscle activity for jaw movement. Additional muscle activity is required to overcome the resistance of the food. The additional muscle activity consists of two contributions, an anticipating contribution before food contact and a peripherally induced contribution, about 23 ms after food contact. The amounts of both contributions depend on the information about food resistance obtained in preceding chewing cycles. It is not known whether this information is preserved if the resistance is absent during only a limited number of chewing cycles. Our aim was to investigate the extent to which information about food resistance obtained during chewing is used during subsequent cycles to generate anticipating and peripherally induced muscle activity. Subjects made rhythmic open-close movements at their natural chewing frequency, controlled by a metronome. Food resistance was simulated by an external force acting on the jaw in a downward direction during part of the closing movement. Jaw movement and surface EMG of the masseter and suprahyoid muscles were recorded during experiments in which sequences of at least 20 cycles with the force were alternated with a small, random number (from 1 to 10) of cycles without the force. The amount of anticipating muscle activity as well as the peripherally induced muscle activity in the first cycle with the force gradually decreased as a function of the number of preceding forceless cycles. About 30% of the additional muscle activity had an anticipatory origin, whereas the rest of the activity was evoked by the force regardless of the number of preceding forceless cycles.

Adult↗

PubMed1994

A computer-controlled experimental set-up enabling the quantification of motor performance in man, applied to mastication.

This paper describes a computer-controlled experimental set-up, which enables the simulation and manipulation of the resistance of food, the bolus size and reflex evoking events during chewing in man. Food resistance was simulated by an external downward directed force on the mandible during the closing phase. The force was supplied by a magnet-coil system. A coil, rigidly attached to the subject's mandible, was located in a permanent magnetic field. By varying the current through the coil, the force on the coil and thus on the mandible could be adjusted. The current was on line computed as a function of the jaw gape. Food resistance and bolus size could be simulated and manipulated by varying the amplitude of the force and the jaw gape at which the force started, respectively. The possibility of varying these parameters could be used simultaneously and independently. Reflex evoking events were simulated by an additional loading or unloading force pulse, superimposed on the food-simulating force. The set-up has been tested during experiments in which food resistance, bolus size and reflex evoking events were simulated. Examples of these experiments are presented in this paper.

Bite Force↗