Biomedical subjects
Publications and source records attributed to R L Plant.
Key anatomic and physiologic features that play an important role in normal and abnormal swallowing in the adult are described. Highlighted topics include the neurologic afferent and efferent control mechanisms, the effect of stroke on these mechanisms, and the upper and lower esophageal sphincters.
This study tested the accuracy of indirect methods of measurement of laryngeal airway resistance in normal subjects and in spasmodic dysphonia (SD). The indirect method assumes that subglottic air pressure remains constant during the voiced segment of a syllable. In this study subglottic air pressure was directly measured via puncture of the cricothyroid membrane in seven normal subjects and seven subjects with SD. The true laryngeal airway resistance was calculated and compared with airway resistance measured using indirect techniques based on intraoral air pressure. In five of the seven normal subjects, subglottic air pressure did not remain constant during the voiced segment. As a result, the error produced using indirect method of calculating average laryngeal resistance for the normal subjects varied from -44% to +50%. For SD subjects the error ranged from -49% to +22%. In general, the indirect technique overestimated laryngeal airway resistance in normal subjects and underestimated the resistance in subjects with SD.
Current techniques for differentiating benign and malignant neck masses in computed tomography scans rely on basic features such as size and image density. Advances in digital imaging have led to development of sophisticated computerized image processing tools. Four different image processing algorithms were used to compare 10 patients with neck masses positive for squamous cell carcinoma and 11 patients with benign neck nodes. Statistically significant differences were seen between the malignant and benign masses for edge analysis and Fourier analysis. Significant differences were also seen in several texture parameters, although these results were considered less reliable. There were no differences between the two groups when compared by histogram analysis. It is concluded that both edge analysis and Fourier analysis can provide additional information to distinguish benign and malignant neck masses.
Objective measurement of vocal quality is difficult in patients with severe voice disorders. Improved success has been reported using a modeling technique known as linear predictive coding. This technique uses an inverse filter to estimate a glottic excitation signal. The pitch amplitude is defined as the height of the first peak of the autocorrelation of the glottic excitation signal. In this study linear predictive coding was used to analyze voice disorders in patients with vocal fold immobility. Voice recordings were made in 16 patients undergoing vocal fold medialization and 10 patients who had no surgical procedure between measurements. The voice quality was rated by three speech pathologists. Five acoustic parameters were calculated from the samples. The best agreement with the listeners' perceptual analysis was achieved using the pitch amplitude. Both pitch amplitude and the perceptual ratings of voice quality improved in patients undergoing vocal fold medialization. Therefore the linear model of speech production and inverse filtering are useful in measuring vocal quality in patients with vocal fold immobility.
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This study examines efficacy and optimal treatment variables of photodynamic therapy (PDT) for human head and neck squamous cancer (HNSC) xenografts in athymic mice. Two and four days after injection of hematoporphyrin derivative (HPD), tumors were illuminated with red light from an argon-dye laser. Sixty-three tumors were treated. With HPD dose and light intensity constant at 7.5 mg/kg and 100 mW/cm2, respectively, the extent of tumor necrosis was strongly dependent on duration of light exposure. There was no substantial difference in results for 30- and 60-minute treatment durations between animals injected with HPD 2 and 4 days before treatment. After 30 minutes treatment time, responses were seen in 8 of 10 mice (2 days post-HPD) and 11 of 12 mice (4 days post-HPD). After 60 minutes treatment time, toxicity was high. We conclude that, in this model, PDT is effective in selective killing of HNSC. For future comparison studies in this model, if the indicated HPD dose and light intensity are used we recommend a 2-day delay after HPD injection and a light exposure duration of 30 minutes.
In rats, lesions were placed in the dorsal/median raphe (DMR), in the ventral raphe (VR: raphe magnus), in both the dorsal/median and ventral raphe (DMVR) or in the reticular formation (RF). The effect of the lesions on the antinociception and catalepsy produced by 3 doses of morphine (3, 10 and 30 mg/kg) was examined. The lesions had no significant effect on the catalepsy produced by any of the doses of morphine tested. DMR lesions produced a partial attentuation of the antinociceptive action of both the 3 and 10 mg doses. VR lesions produced a complete blockade of the 3 mg and only a partial attenuation of the 10 mg dose. In contrast, the combined (DMVR) lesions yielded virtually a total blockade of the 3 and 10 mg. Yet, as with the DMR and VR groups, the DMVR lesions failed to produce a significant antagonism on either of the nociceptive tests at the 30 mg dose. These findings suggest that the ascending and descending fiber systems emanating from the dorsal/median and ventral raphe, respectively, facilitate the expression of morphine-induced analgesia but that neither system alone can be regarded as essential for the manifestation of the antinociceptive effects of systematically administered morphine.
Mechanisms for hematoporphyrin derivative (HPD) localization in malignant tissue and in photodynamic therapy (PDT) have not been established. The authors' experience with human cancer xenografts in nude mice as a tumor system for the experimental study of these mechanisms is described. Human mucosal head and neck squamous cell carcinoma was successfully transplanted to nude mice in 29 per cent of trials and serially passed through multiple generations in three tumor lines. Time required for progressive growth averaged 13.9 days, and 300 mm3 tumors were obtained in four weeks. Take rates per passage varied, in part because of infection, and exponential growth rates varied among the three lines. However, within a single line exponential growth rates were similar. Average growth constants for the period of exponential growth were 0.14, 0.13, and 0.09 for the three lines. Fluorescent microscopy of excised xenografts revealed HPD fluorescence principally in connective tissue cells. Minimal fluorescence was seen in malignant epithelial cells. Spectrophotometric measures of HPD uptake in homogenized tissue showed highest values in liver. Tumor HPD levels were higher than those for either skin or muscle. The authors conclude that this tumor system can be used effectively to study HPD and PDT in head and neck cancer.
PURPOSE: To determine the pullout strength of adaption screws in laryngeal cartilage and its relationship to drill hole and screw diameter. MATERIALS AND METHODS: Screw pullout strength in human cadaver thyroid cartilage was measured using a load cell. Screw sizes of 1.3, 1.5, and 2.0 mm were tested using drill hole diameters of 0.76, 1.1, and 1.5 mm. RESULTS: Maximum pullout strength was achieved using a drill hole diameter of 0.76 mm and a 1.5 mm screw. Pullout strength for this combination was 27.5 N. CONCLUSION: Adaption screws can be used in thyroid cartilage but pullout strengths will be less than in bone. Drill holes for screws in thyroid cartilage should be smaller than those used for cortical bone. Maximum strength will be achieved using a 1.5 mm screw in a 0.76 mm drill hole.