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At least 937 records · Page 52Linked to original sources

PubMed1993

Pharyngeal fat in obstructive sleep apnea.

Although most patients with obstructive sleep apnea (OSA) are obese, it is not known how obesity contributes to airway collapse during sleep. The purpose of this study was to determine whether the volume of adipose tissue adjacent to the pharyngeal airway in humans is related to the degree of OSA. We studied 30 subjects, nine without OSA and 21 with OSA; two subjects were studied before and after weight loss. Adipose tissue was detected with magnetic resonance imaging using T1-weighted spin echo sequences. The volume of adipose tissue adjacent to the upper airway was determined by measuring the volume of all pixels in the intensity range of adipose tissue within the region bounded by the ramus of the mandible, the spine, the anterior border of the soft palate, and the hard palate. Polysomnography was performed with conventional techniques. All subjects had a collection of adipose tissue adjacent to the upper airway; the volume of this adipose tissue correlated with the number of apneas plus hypopneas per hour of sleep (r = 0.59, p < 0.001). Both patients who lost weight and had fewer apneas and hypopneas had a marked decrease in the pharyngeal adipose tissue volume. We conclude that adipose tissue is deposited adjacent to the pharyngeal airway in patients with OSA and that the volume of this tissue is related to the presence and degree of OSA.

Adipose Tissue↗

PubMed1989

Motor unit regulation of mammalian pharyngeal dilator muscle activity.

The present study examined the cellular regulation of one of the pharyngeal dilator muscles, the geniohyoid, by assessing its motor unit (MU) behavior in anesthetized cats. During spontaneous breathing, MU that (a) were active during inspiration only (I-MU) and (b) were active during both inspiration and expiration (I/E-MU) were identified. I-MU had a later inspiratory onset time and a shorter duration of inspiratory firing than did I/E-MU (P less than 0.002 and P less than 0.0001, respectively). I-MU were usually quiescent whereas I/E-MU were usually active during the last 20% of inspiration. I/E-MU fired more rapidly (P less than 0.00001) and for relatively longer periods of time (P less than 0.00001) during inspiration than during expiration. End-expiratory airway occlusion (preventing lung expansion during inspiration) augmented the inspiratory activity of both I-MU and I/E-MU. Conversely, end-expiratory airway occlusion reduced the absolute and relative firing durations (P less than 0.002 and P less than 0.00002, respectively) and the firing frequency (P less than 0.001) of I/E-MU activity during expiration. These results indicate that (a) the complex pattern of pharyngeal dilator muscle activity is due to the integrated activity of a heterogeneous group of MU, (b) changes in the degree to which pharyngeal dilator muscles are active result from combinations of MU recruitment/decruitment and modulations of the frequency and duration of MU firing, and (c) gating of lung-volume afferent information occurs during the respiratory cycle.

Anesthesia↗

PubMed2001

Quantitative assessment of the pharyngeal airway by dynamic magnetic resonance imaging in obstructive sleep apnea syndrome.

Dynamic changes in the pharyngeal airway of patients with obstructive sleep apnea syndrome (OSAS) were evaluated by quantitating the findings of real-time imaging performed during wakefulness and spontaneous sleep by means of dynamic magnetic resonance imaging (MRI). Six patients with OSAS and 3 non-OSAS subjects, selected prospectively and randomly, underwent polysomnography and dynamic MRI. The cross-sectional areas of the soft palate and oropharynx and the anterior-posterior airway dimensions seen during wakefulness and spontaneous sleep were calculated by US National Institutes of Health imaging software. On the basis of a case control study, comparisons were made with age-matched and body mass index-matched obese non-OSAS snorers. Spontaneous sleep caused significant obstruction and narrowing of various sites of the pharyngeal airway in the OSAS patients, but not in the non-OSAS subjects. During wakefulness, the non-OSAS subjects showed no marked narrowing of the pharyngeal airways, whereas a transient but significant narrowing was observed in the OSAS patients. The mean values of both the cross-sectional area and the anterior-posterior diameter at the soft palate were significantly reduced by spontaneous sleep in the OSAS patients. Dynamic MRI in awake OSAS patients shows promise as a routine diagnostic tool for localizing the upper airway collapse for appropriate selection of surgical therapy.

Adult↗

PubMed2003

Extraction of minute pharyngeal foreign bodies with the videoendoscope.

The present report describes how minor foreign bodies in the pharynx can be detected and extracted with a videoendoscope. A videoendoscope and biopsy forceps were used for the extraction of minute pharyngeal foreign bodies. The patients were examined and treated in a sitting position. The endoscope was inserted through the nasal passage. Ten minute pharyngeal foreign bodies (all fish bones) were extracted by this method. The advantages of this intervention were that 1) the videoendoscope showed clear dynamic color images of the minute foreign body on a color video monitor and provided excellent resolution and recording, and thus, its diagnostic accuracy was high; 2) minute fish bones located in the pharynx, which are hard to examine, could be well documented; 3) accurate and fine interventions could be performed, and all of the foreign bodies could be extracted quickly; 4) foreign bodies as thin as 0.15 mm could be extracted; 5) the diameter of this videoendoscope was relatively small, resulting in less discomfort for patients, even children; and 6) pernasal endoscopy allowed the physician to examine patients who had a strong gag reflex. Extraction of minute pharyngeal foreign bodies with a videoendoscope is a reliable procedure of office-based endoscopy of the pharynx.

Adolescent↗

PubMedDate not supplied

Attachment of Streptococcus pneumoniae to human pharyngeal epithelial cells in vitro.

The aim of this study has been to develop a test system for attachment of pneumococci to pharyngeal cells. Cells scraped from a healthy person were washed and quantitated, bacteria added and after incubation the suspension was washed and the number of adhering bacteria counted. Among strains from different infectious foci the highest number of strains with adhesive capacity was found in the otitis media group. Capacity to attach to the pharyngeal mucosa might be a virulence factor of pneumococci causing otitis media. There was a lack of distinct relation between capsular serotype and adhesive capacity indicating that the polysaccharide is not primarily responsible for the binding to epithelial cells. If attachment to the pharyngeal mucosa is a first step necessary for colonization and subsequent invasion of the tissues, then antibiotics in the secretions preventing such colonization might be of protective value in otitis-prone children.

Adhesiveness↗

PubMed1990

Velar-pharyngeal status in cleft palate patients with expected adenoidal involution.

This study was designed to provide information about whether cleft palate patients with hypertrophied adenoids maintain velar-pharyngeal contact during the time of expected adenoidal atrophy. Thirty-nine subjects were selected from a large longitudinal study on the basis of availability of lateral still x-ray films taken in series from 5 to 16 years of age. Ratings of velar-pharyngeal contact and ratings of adenoid size were obtained from the films. The obtained data indicated the expected decrease in adenoid size but also, for the group, maintenance of velar-pharyngeal contact. However, three of the 39 subjects were judged to show loss of such contact during the period of study, and an additional four had surgery for velopharyngeal incompetence after the completion of the study. All seven appeared to show significant deterioration of velopharyngeal status in middle or late adolescence. Implications of these findings are discussed.

Adenoids↗

PubMed1996

Pharyngeal hypophysis.

Derived from embryologic remnants of Rathke's pouch and its craniopharyngeal duct, the pharyngeal hypophysis has long been considered to be present in all humans. This thesis has been recently challenged, but the weight of investigative evidence still favors the original premise. The pharyngeal hypophysis is just one product of Rathke's pouch. Others are extracranial pituitary tumors, the very rare craniopharyngioma, pharyngeal hypopharyngeal cysts, and cerebrospinal fluid rhinorrhea.

Craniopharyngioma↗

PubMed1996

Kinematic and dynamic characteristics of solid pellet movement during the pharyngeal phase of swallowing.

Information on solid particle movement through the pharynx, in addition to its physiologic importance, has relevance to the swallowing of medications in pill form. The purpose of this study was to determine the kinematics of a solid particle during the oral-pharyngeal phase of swallowing. We used a concurrent manometric-videofluoroscopic technique and identified two distinct zones of increasing bolus velocity, one at the tongue base and the other at the pharyngo-upper esophageal sphincter (UES) region. Velocity decreased significantly (p < .05), to 9.0 +/- 1.0 cm/s, while the bolus traversed the area located between the tip of the horizontal epiglottis and the pharyngeal wall. The velocity of the liquid barium bolus head was similar to that of the solid barium pellet. The average bolus tail velocity was relatively constant. The acceleration of the barium pellet was temporally associated with development of an incrementally decreasing pressure distal to the location of the pellet in the hypopharynx and across the UES. In conclusion, the kinematics of a solid particle are similar to those of the head of a liquid bolus, but both are different from bolus tail kinematics. During the pharyngeal phase of swallowing, the area located ahead of the bolus exhibits an incrementally decreasing pressure, caudally. This may facilitate bolus transport and contribute to airway protection.

Adult↗

PubMed1982

Changes in aerobic pharyngeal flora related to antibiotic use and the emergence of gram-negative bacilli.

Pharyngeal flora were evaluated semi-quantitatively by counting and differentiating the colonies growing on blood agar plates into four major bacterial groups. In children they consisted mainly of alpha-streptococci, followed by smaller portions of Neisseria, and of gram-positive organisms other than alpha-streptococci. Gram-negative bacilli did not occur under normal conditions. Oral ampicillin in a daily dose of 50 mg/kg caused suppression of the alpha-streptococci, and promoted emergence of gram-negative bacilli. Oral cephalexin in the same dose caused changes in the same direction, but less extensively than ampicillin . Parenteral aminoglycoside antibiotics in usual dosage did not change the pharyngeal flora. Differential counting of the growth is a simple and useful tool to evaluate the ecology of pharyngeal flora. It serves to monitor overgrowth of resistant organisms in the respiratory tract.

Administration, Oral↗

PubMedDate not supplied

Barium and meat. A comparison between pharyngeal swallow of fluid and solid boluses.

The influence of bolus consistency on pharyngeal swallow was radiologically studied in 24 individuals by comparing liquid barium and solid meat after chewing. Pharyngeal function was apparently performed synchronously and symmetrically on both boluses. No definite conclusion about the influence on epiglottic mobility, closure of the laryngeal vestibule and relaxation of the cricopharyngeal muscle could be drawn from this study. There was no difference in the elevation of the pharynx and larynx. The transit time for a solid bolus was shorter compared with that of a fluid bolus. The transit time for the apex of the bolus was shorter than for the tail. A more marked elevation of the pharynx and larynx was followed by a shorter transit time. The width of the pharyngo-esophageal segment was larger in the transverse than in the sagittal diameter during the passage of the bolus and larger on solid compared with fluid swallow. Our results reflect the ability of pharyngeal swallow to be executed with precision and with few alterations due to variable bolus consistency.

Adult↗

PubMed1996

Sleep apnea syndrome. Examination of pharyngeal obstruction with high-speed MR and polysomnography.

PURPOSE: We attempted to determine the usefulness of high-speed MR imaging for evaluating the severity of sleep apnea syndrome (SAS) by comparing findings of pharyngeal obstruction obtained with high-speed MR with those of all-night polysomnography (PSG). SUBJECTS AND METHODS: A total of 33 patients with SAS underwent turbo-FLASH MR examination, while awake and after i.v. injection of hydroxyzine hydrochloride. Serial images were examined by cinemode. Pharyngeal findings on MR were divided into single-site obstruction (SO) at the velopharynx, multiple-site obstruction (MO), and no obstruction (NO). PSG findings were analyzed to determine the predominant type of apnea, severity as evaluated by an apnea index (AI), and the lowest SaO2 value during sleep. RESULTS: Seventy-five percent of the central apnea group had SO, and 70% of the mixed apneas had MO, while only 15% of the obstructed apneas had MO. The percentage of patients with severe SAS (AI of 20% or higher) was 48% for the SO, and 70% for the MO. The lowest SaO2 value tended to be low in the mixed apnea in the case of PSG, and tended to be low in the MO at MR examination. CONCLUSION: Analysis of pharyngeal dynamics using high-speed MR may provide some useful information for evaluating the severity of SAS.

Aged↗

PubMedDate not supplied

Pharyngeal flora in a sexually active population.

During a 7-week period 1141 patients attending the Genitourinary Clinic at Charing Cross Hospital completed a brief questionnaire and had pharyngeal swabs cultured for Neisseria spp, beta-haemolytic streptococci, corynebacterium and yeasts. The study included 397 heterosexual men, 492 heterosexual women, 189 homosexuals, 41 lesbians and 22 bisexual men and women. Four hundred and sixty patients (40%) admitted oro-genital contact in the preceding 2 weeks. The meningococcal carriage rate was 11.6%. Homosexuals had the highest carriage 23.8% and heterosexual females the lowest 5.9%. Significant differences in carriage rates were found between homosexual and heterosexual men (P < 0.0001), heterosexual men and women (P < 0.005) and between lesbian and heterosexual women (P < 0.025). Recent oro-anal contact significantly increased meningococcal isolation (P < 0.001). A significant association between beta-haemolytic streptococci and concomitant meningococcal carriage was also found (P < 0.01). Sexual orientation and oro-genital contact influences both meningococcal and pharyngeal yeast isolation and should be considered when interpreting pharyngeal culture results.

Anti-Bacterial Agents↗

PubMed2004

Non-apneic snoring and the orthodontist: radiographic pharyngeal dimension changes with supine posture and mandibular protrusion.

OBJECTIVE: To evaluate the radiographic changes that occur in the pharynx and surrounding structures with alteration of posture from the upright to the supine position and the effect that mandibular protrusion whilst supine has on these dimensions. DESIGN: Prospective cephalometric study. SETTING: University Dental Hospital and School. SUBJECTS AND METHOD: This prospective study involved 35 consecutively referred adults with proven non-apneic snoring. Lateral skull radiographs were obtained with the subjects upright in occlusion, supine in occlusion and supine with the mandible protruded to the maximum comfortable position. Radiographs were traced and digitized, and the pharyngeal dimensional changes and hyoid position were examined. Males and females were examined separately. RESULTS: Radiographic pharyngeal dimensions were changed with altered posture, resulting in significant reductions in the minimum post-palatal (p<0.01) and post-lingual (p<0.05) airway measurements in the supine position. Mandibular protrusion whilst in the supine position produced increases in the functioning space for the tongue. CONCLUSION: A supine posture results in significant reductions in pharyngeal airway measurements of non-apneic snorers. Mandibular protrusion whilst in the supine position produces an increase in the functioning space for the tongue.

Adult↗

PubMed1985

Identification of seven hormone-producing cell types in the human pharyngeal hypophysis.

Eight adult human pharyngeal pituitary glands taken at autopsy were studied by immunocytochemistry to reveal the presence of ACTH-, lipotropin-, FSH-, LH-, TSH-, PRL-, and GH-immunoreactive cells. All of these cell types were found and quantitated in pharyngeal hypophyses from patients with no evidence of endocrine disorder. The percentage of the seven hormone-producing cell types varied from gland to gland from 1-30%; there were no marked histological differences between sexes or attributable to age. The cellular composition of the pharyngeal hypophysis shows that this gland has the capacity to produce at least seven hormones.

Adult↗

PubMed2003

Endothelin 1-mediated regulation of pharyngeal bone development in zebrafish.

Endothelin 1 (Edn1), a secreted peptide expressed ventrally in the primordia of the zebrafish pharyngeal arches, is required for correct patterning of pharyngeal cartilage development. We have studied mutants and morpholino-injected larvae to examine the role of the Edn1 signal in patterning anterior pharyngeal arch bone development during the first week after fertilization. We observe a remarkable variety of phenotypic changes in dermal bones of the anterior arches after Edn1 reduction, including loss, size reduction and expansion, fusion and shape change. Notably, the changes that occur appear to relate to the level of residual Edn1. Mandibular arch dermal bone fusions occur with severe Edn1 loss. In the dorsal hyoid arch, the dermal opercle bone is usually absent when Edn1 is severely reduced and is usually enlarged when Edn1 is only mildly reduced, suggesting that the same signal can act both positively and negatively in controlling development of a single bone. Position also appears to influence the changes: a branchiostegal ray, a dermal hyoid bone normally ventral to the opercle, can be missing in the same arch where the opercle is enlarged. We propose that Edn1 acts as a morphogen; different levels pattern specific positions, shapes and sizes of bones along the dorso-ventral axis. Changes involving Edn1 may have occurred during actinopterygian evolution to produce the efficient gill-pumping opercular apparatus of teleosts.

Animals↗

PubMed1999

Developmental expression of Pax1/9 genes in urochordate and hemichordate gills: insight into function and evolution of the pharyngeal epithelium.

The epithelium of the pharynx contributes to the formation of gills in hemichordates, urochordates, cephalochordates and primitive vertebrates, and is therefore a key structure for understanding developmental mechanisms underlying the establishment of chordate body plans. Pax1- and Pax9-related genes encode transcription factors which are expressed in the pharyngeal region of cephalochordates as well as in the vertebrate pharyngeal pouch epithelium that forms the thymus and parathyroid glands. To explore the molecular basis underlying the occurrence and modifications of the pharyngeal epithelium during evolution, we isolated cDNA clones for Pax1- and Pax9-related genes of urochordates (HrPax1/9 of Halocynthia roretzi and CiPax1/9 of Ciona intestinalis) and a hemichordate (PfPax1/9 of Ptychodera flava) from gill cDNA libraries. Each gene is present as a single copy per haploid genome. All of the cDNAs encode typical paired domains and octapeptides but not a homeodomain, as is also true of other Pax1- and Pax9-related genes. Molecular phylogenetic analysis based on comparison of the paired domain amino-acid sequences suggests that HrPax1/9, CiPax1/9 and PfPax1/9 belong to the Pax1/9 subfamily, and that they are descendants of a single precursor of Pax1/Pax9. Screening of HrPax1/9 cDNA clones yielded six different types of transcripts which were generated by alternative splicing. Northern blot, RT-PCR/Southern and in situ hybridization analyses revealed that HrPax1/9, CiPax1/9 and PfPax1/9 are not expressed during early embryogenesis but are expressed in the epithelia of differentiating gills, suggesting that these genes encode gill-specific transcription factors. The Pax1/9 genes therefore might provide the first developmental genetic corroboration of hypotheses of organ-level homology that unifies hemichordates, urochordates and cephalochordates.

Alternative Splicing↗

PubMed2006

Evolution of pharyngeal behaviors and neuronal functions in free-living soil nematodes.

To explore the use of Caenorhabditis elegans and related nematodes for studying behavioral evolution, we conducted a comparative study of pharyngeal behaviors and neuronal regulation in free-living soil nematodes. The pharynx is divided into three parts: corpus, isthmus and terminal bulb, and pharyngeal behaviors consist of stereotyped patterns of two motions: pumping and peristalsis. Based on an outgroup species, Teratocephalus lirellus, the ancestral pattern of pharyngeal behaviors consisted of corpus pumping, isthmus peristalsis and terminal bulb pumping, each occurring independently. Whereas corpus pumping remained largely conserved, isthmus and terminal bulb behaviors evolved extensively from the ancestral pattern in the four major free-living soil nematode families. In the Rhabditidae family, which includes Caenorhabditis elegans, the anterior isthmus switched from peristalsis to pumping, and anterior isthmus and terminal bulb pumping became coupled to corpus pumping. In the Diplogasteridae family, the terminal bulb switched from pumping to peristalsis, and isthmus and terminal bulb became coupled for peristalsis. In the Cephalobidae family, isthmus peristalsis and terminal bulb pumping became coupled. And in the Panagrolaimidae family, the posterior isthmus switched from peristalsis to pumping. Along with these behavioral changes, we also found differences in the neuronal regulation of isthmus and terminal bulb behaviors. M2, a neuron that has no detectable function in C. elegans, stimulated anterior isthmus peristalsis in the Panagrolaimidae. Further, M4 was an important excitatory neuron in each family, but its exact downstream function varied between stimulation of posterior isthmus peristalsis in the Rhabditidae, isthmus/terminal bulb peristalsis in the Diplogasteridae, isthmus peristalsis and terminal bulb pumping in the Cephalobidae, and posterior isthmus/terminal bulb pumping in the Panagrolaimidae. In the Rhabditidae family, although M4 normally has no effect on the terminal bulb, we found that M4 can stimulate the terminal bulb in C. elegans if the Ca2+-activated K+ channel SLO-1 is inactivated. C. elegans slo-1 mutants have generally increased neurotransmission, and in slo-1 mutants we found novel electropharyngeogram signals and increased pumping rates that suggested activation of M4-terminal bulb synapses. Thus, we suggest that the lack of M4-terminal bulb stimulations in C. elegans and the Rhabditidae family evolved by changes in synaptic transmission. Altogether, we found behavioral and neuronal differences in the isthmus and terminal bulb of free-living soil nematodes, and we examined potential underlying mechanisms of one aspect of M4 evolution. Our results suggest the utility of Caenorhabditis elegans and related nematodes for studying behavioral evolution.

Animals↗

PubMed1993

Motor neuron M3 controls pharyngeal muscle relaxation timing in Caenorhabditis elegans.

1. Previous work has shown that 12 of the 14 types of neurons in the Caenorhabditis elegans pharyngeal nervous system are collectively but not individually necessary for the trapping and transport of bacteria. The aim of these experiments was to determine the functions of individual neuron types by laser-killing combinations of neurons and looking at the effects on behavior. 2. The motor neuron M3 and the sensory neuron I5 are important in trapping bacteria, as shown by two observations. First, when M3 and I5 are both killed, trapping is inefficient in the isthmus (the middle section of the pharynx). Second, M3 is sufficient in the absence of the other 11 neuron types for normal trapping in the corpus (anterior pharynx). 3. M3 and I5 influence the timing of pharyngeal muscle motions. When M3 is killed, pump duration (the interval from the beginning of pharyngeal contraction to the end of relaxation) increases from 170 to 196 ms. This increase is at least partially due to a slower relaxation. Thus, M3 speeds up relaxation. Pump duration decreases to 159 ms when I5 is killed. When I5 and M3 are both killed, pump durations are long (192 ms), just as when M3 alone is killed. These observations, together with previous electron microscopic work showing synapses from I5 to M3, suggest that I5 slows down relaxation by inhibiting M3. 4. To explain these results, I propose that M3 and I5 promote bacterial trapping by regulating the relative timing of muscle relaxation in different regions of the pharynx.

Animals↗