Defining recurrent laryngeal nerve injury in a mouse model for regenerative therapeutic investigations

Includes vitaInjury of the recurrent laryngeal nerve (RLN), a branch of the vagus nerve, results in ipsilateral vocal fold (VF) paralysis that contributes to dysphagia, dysphonia, and dyspnea (i.e., swallow, vocal, and respiratory dysfunction, respectively). Unfortunately, there is no clinical intervention that will reliably restore physiologic movement to the VF after an RLN injury. Throughout this work, the effects of RLN injury on murine VF motion, swallowing behavior, vocalization production, and respiratory function are examined. Furthermore, methods for refining the functional assays used to assess these behaviors are developed, allowing for the production of more reliable and translatable results. Therefore, in Chapter 2, the effects of RLN injury are explored to confirm the fidelity of the laryngeal innervation pattern and functional outcomes (for vocal fold motion and swallowing) between mice and humans. In Chapter 3, an automated VF tracking and quantification software is developed to objectively measure dynamic VF motion, which is further refined in Chapter 4. Also in Chapter 4, we expand our translational mouse model to characterize swallow, vocal, and respiratory function in mice with unilateral VF paralysis following RLN injury. Lastly, VNS and its role as a therapeutic intervention for RLN injury is studied (Chapter 2), as well as the potential off-target effects this therapy may have on the many other organ systems provided innervation by the vagus nerve (Chapter 5). In conclusion, this work aims to provide a refined and reproducible animal model for researchers to use to investigate RLN pathophysiology and treatment options.Includes bibliographical reference

Patient-Specific Implants in Musculoskeletal (Orthopedic) Surgery

Most of the treatments in medicine are patient specific, aren’t they? So why should we bother with individualizing implants if we adapt our therapy to patients anyway? Looking at the neighboring field of oncologic treatment, you would not question the fact that individualization of tumor therapy with personalized antibodies has led to the thriving of this field in terms of success in patient survival and positive responses to alternatives for conventional treatments. Regarding the latest cutting-edge developments in orthopedic surgery and biotechnology, including new imaging techniques and 3D-printing of bone substitutes as well as implants, we do have an armamentarium available to stimulate the race for innovation in medicine. This Special Issue of Journal of Personalized Medicine will gather all relevant new and developed techniques already in clinical practice. Examples include the developments in revision arthroplasty and tumor (pelvic replacement) surgery to recreate individual defects, individualized implants for primary arthroplasty to establish physiological joint kinematics, and personalized implants in fracture treatment, to name but a few

PRELIMINARY FINDINGS OF A POTENZIATED PIEZOSURGERGICAL DEVICE AT THE RABBIT SKULL

The number of available ultrasonic osteotomes has remarkably increased. In vitro and in vivo studies have revealed differences between conventional osteotomes, such as rotating or sawing devices, and ultrasound-supported osteotomes (Piezosurgery®) regarding the micromorphology and roughness values of osteotomized bone surfaces. Objective: the present study compares the micro-morphologies and roughness values of osteotomized bone surfaces after the application of rotating and sawing devices, Piezosurgery Medical® and Piezosurgery Medical New Generation Powerful Handpiece. Methods: Fresh, standard-sized bony samples were taken from a rabbit skull using the following osteotomes: rotating and sawing devices, Piezosurgery Medical® and a Piezosurgery Medical New Generation Powerful Handpiece. The required duration of time for each osteotomy was recorded. Micromorphologies and roughness values to characterize the bone surfaces following the different osteotomy methods were described. The prepared surfaces were examined via light microscopy, environmental surface electron microscopy (ESEM), transmission electron microscopy (TEM), confocal laser scanning microscopy (CLSM) and atomic force microscopy. The selective cutting of mineralized tissues while preserving adjacent soft tissue (dura mater and nervous tissue) was studied. Bone necrosis of the osteotomy sites and the vitality of the osteocytes near the sectional plane were investigated, as well as the proportion of apoptosis or cell degeneration. Results and Conclusions: The potential positive effects on bone healing and reossification associated with different devices were evaluated and the comparative analysis among the different devices used was performed, in order to determine the best osteotomes to be employed during cranio-facial surgery

Multislice computed tomography coronary angiography

__Abstract__ Computed Tomography (CT) imaging is also known as "CAT scanning" (Computed Axia

Mechanisms of Respiratory-Swallow Coordination and the Effects of Skill Training on Swallowing Rehabilitation in Parkinson’s Disease

Respiratory-swallow coordination (RSC) is critical for safe and efficient swallowing. In healthy adults, RSC is most frequently characterized by an exhale-swallow-exhale pattern initiated within the mid-lung volume range with a respiratory pause of approximately one second. This combination in RSC behaviors is thought to be most optimal for swallowing-related bolus clearance and airway protection. Deviations from these RSC behaviors are observed at disproportionately higher rates in people with Parkinson’s disease (PD) when compared to non-dysphagic, healthy adults. However, little is known about which variables influence RSC in PD, if the RSC behaviors that are most optimal for swallowing in healthy adults are also most optimal for swallowing in PD, and if respiratory-swallow training can be used to successfully rehabilitate suboptimal RSC, swallowing safety, and swallowing efficiency in PD. This dissertation document includes a series of four studies that address these important clinical research questions. Chapter 1 will begin by reviewing the current body of literature as it relates to dysphagia in PD, RSC in healthy adults and PD, respiratory-swallow training as a skill-based treatment for dysphagia rehabilitation, and motor learning considerations for respiratory-swallow skill training in PD. Chapter 2 will be used to examine the relationships among RSC with patient- and swallowing-specific factors in PD. Chapter 2 will also be used to assess the influence of RSC behaviors on measures of swallowing safety (penetration-aspiration) and swallowing efficiency (pharyngeal residue) in PD. Chapter 3 will then evaluate the effects of verbal cueing on RSC in PD as a method of determining if RSC is stimulable for rehabilitative change. Chapter 4 will explore the effects of respiratory-swallow training on swallowing safety and efficiency rehabilitation in a person with mid-stage PD and severe dysphagia within the context of a single-subject experimental design. Chapter 5 will then examine the effects of respiratory-swallow training on dysphagia and RSC rehabilitation within the context of a cohort study. Chapter 5 will also be used to compare the effects of constant versus variable practice in order to explore how principles of motor learning can be used to enhance respiratory-swallow training outcomes. This document will then conclude by synthesizing the results from Chapters 2-5 and by discussing directions for future research

Elasmobranchs as living resources: Advances in the biology, ecology, systematics, and the status of the fisheries

This report owes its genesis to the foresight and enthusiam of Dr. Kazuhiro Mizue. By happy circumstance, Professor Mizue contacted me in 1983 with his visionary ideas on cooperative programs. He noted that the time was right because the Japan Society for the Promotion of Science and the National Science Foundation had mutually given priority to cooperative programs in marine biology. I therefore agreed to act as the U.S. coordinator and proposed to NSF, a short trip to Japan to negotiate site visits and timing with ten previously appointed Japanese scientists and, if that trip were successful, to negotiate a joint research project, possibly followed by a joint seminar. (PDF file contains 528 pages.

Aplicabilidad clínica de la fibroendoscopia flexible de la deglución en una unidad de cuidados intensivos de un hospital de tercer nivel

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Cirugía. Fecha de lectura: 22-06-201