Mosquitoes drink using a pair of in-line muscular pumps in the head that draw liquid food through a long drinking channel termed as proboscis. Experimental investigations of mosquito drinking using synchrotron x-ray indicate two modes of drinking, a predominantly occurring continuous mode in which the anterior cibarial and posterior pharyngeal pumps expand cyclically at a constant phase difference and an isolated burst mode in which the pharyngeal pump expansion is several orders of magnitude larger than in the continuous mode. The objective of this thesis is to explain the mechanics and functional implication of this two-pump dual mode drinking of a mosquito. A reduced order mathematical model suggests that the primary role of the pharyngeal pump is in the burst mode. Since the precise geometry of the pump during drinking is yet not known, the drinking mechanism is modeled using different pump geometries based on morphological constraints in the animal. The model shows the continuous mode as being more effective in terms of energy expenditure, while the burst mode creates a large pressure difference across the proboscis which might be used to clear an obstruction in the channel or prime the channel. The hypothesis regarding the ability of a mosquito to self-clear an obstruction is analyzed by modeling the presence of an air bubble inside the system. The model indicates that air bubbles maybe able to stop flow during continuous mode drinking, and these same bubbles can be cleared by switching temporarily to burst mode drinking. / Master of Science

No description available.

Head and neck cancer patients often experience swallowing disorders placing them at risk for aspiration and malnutrition. This study examined the effects of electrical stimulation to the pharyngeal wall on swallowing function in post-surgical head and neck cancer patients. Swallowing of liquid, pudding, and cookie consistencies was examined using videofluoroscopy before, and 30 minutes after, a ten minute application of electrical stimulation the pharyngeal wall in 5 male patients experiencing moderate-severe dysphagia. A total of ten measures of swallowing function were obtained from pre- and post-videofluoroscopy studies. Changes were observed post-stimulation in duration of posterior pharyngeal wall to base of tongue contact, total number of swallows, cricopharyngeal opening durations, and pharyngeal transit time. Preliminary findings indicate that electrical stimulation of the pharynx may impact certain features of swallowing in head and neck cancer patients who experience dysphagia. However, further studies are required to confirm the present findings, explore the mechanisms responsible for these changes, and investigate the effect on swallowing function as a result of manipulating stimulus frequencies, intensities and durations. / Speech-Language Pathology

Background and Aims The accurate differentiation between a delayed pharyngeal swallow (sensory impairment) and premature spillage secondary to poor oro-lingual control (motor impairment) is essential to effective dysphagia management. However both physiologic abnormalities result in an identical radiographic sign, that of pre-swallow pooling of the bolus in the pharynx. The dysphagia literature does not provide satisfactory guidelines for making this distinction on videofluoroscopy. The purpose of this study was to assess the validity of a three-part rating scale for differentiating between these two impairments. Methods Videofluoroscopy was used to evaluate the swallowing of 29 participants presenting with dysphagia following stroke. Sensory thresholds for these participants were established by electrical stimulation of the anterior faucial pillars. The videofluoroscopic swallowing studies were analysed using the three-part rating scale and results from this were compared to sensory thresholds using Pearson's product moment correlation. Results There was no significant correlation between the three-part criteria and sensory thresholds. Inter-rater reliability for some measures was poor. Conclusions The three-part criteria was not shown to be a valid measure for differentiating between delayed pharyngeal swallow and premature spillage secondary to poor oro-lingual control. Possible explanations for these findings are discussed, including the relevance of faucial pillar sensation to swallowing.

Bichirs, Polypteriformes, are a basal group of vertebrates with many unique characters as ganoid scales, fleshy pectoral fin, spiraculum or paired lung originated from ventral outpocketing from floor of pharynx. Among the most notable is also the dentition, which contatin teeth among whole area of oropharyngeal cavity. This arrangement is not easily call oral and pharyngeal, what is recently used e.g. for medaka, because it is only one dention with teeth on majority of oral as well as pharyngeal elements. This diploma thesis utilizes expression patterns of Dlx genes to visualize morphogenesis of dentition and pharyngeal arches in the Senegal Bichir (Polypterus senegalus). The very first developing teeth of oral dentition, as well as its further patterning were detected and accurately located using gene expression analyses. It was also discovered an interesting histological context connected with unique mouth opening mechanism during early development of teeth in oral cavity. Another discussion point is establishment of dorsoventral polarization in pharyngeal arches development of bichir based on results from Dlx gene expression analysis. Powered by TCPDF (www.tcpdf.org)

Le développement cranio-facial est un processus complexe qui implique interactions tissulaires et différenciations cellulaires. La façon dont ces processus sont coordonnés lors de l'embryogenèse reste évasive. Perturber ce développement coordonné provoque un large éventail de malformations. Afin de trouver de nouveaux gènes impliqués dans le développement de la tête, un criblage phénotypique a été réalisé par mutagenèse. L'une des lignées de souris obtenues montre des malformations au niveau des arches pharyngées (AP), qui sont les précurseurs de la tête. Ces mutants meurent à mi gestation, due à des problèmes vasculaires. La mutation ponctuelle générée a été localisé dans le gène Mortalin. Mon travail de thèse vise à comprendre comment Mortalin contrôle le développement embryonnaire. Mortalin est exprimée de manière ubiquitaire, puis son expression augmente au niveau des AP, dans les tissus musculaires et nerveux. Pour déterminer les mécanismes moléculaires affectées chez ce mutant, un profil d'expression génique a révélé l'induction de gènes impliqués dans la réponse au stress du réticulum endoplasmique (RE), appelée UPR, dont le rôle est de rétablir l'homéostasie du RE. Mortalin est impliqué dans le contrôle de l'UPR en interagissant avec BiP, un régulateur direct de cette voie. L'activation soutenue de l'UPR entraîne l'apoptose, ce que nous observons chez nos mutants. De plus, l'analyse du cycle cellulaire indique que la phase S est plus longue chez le mutant, suggérant que Mortalin régule le cycle cellulaire. Ainsi, l'ensemble des données suggère que Mortalin est nécessaire pour la survie des cellules au cours du développement. / The development of the head is a complex process that involves tissue interaction and cellular differentiation. Precisely how these processes are coordinated during embryogenesis remains elusive. Disruption of this coordinated development causes a wide range of malformations. In order to find new genes involved in the development of the head, a phenotype-driven ENU screen was performed. One of the mouse lines generated exhibits small pharyngeal arches (PAs), which are the main precursors of the head. Mutant embryos die around mid-gestation, most likely as a result of defective vasculature. We mapped the ENU-mediated point mutation within Mortalin. My thesis work aims to understand how Mortalin controls embryonic development. Mortalin is ubiquitously expressed before mid-gestation. Then its expression increases in the PAs and cranial ganglia. In older embryos, mortalin is expressed in muscle and nervous tissue. To determine which molecular mechanisms are affected in the mutant, gene expression profil revealed the induction of genes involved in the response to endoplasmic reticulum (ER) stress, called UPR. The role of the UPR is to restore homeostasis in the ER. I found that Mortalin regulates the UPR by interacting with BiP, a direct regulator of this pathway. Sustained activation of UPR leads to apoptosis, which is observed in our mutant. Cell cycle has been analyzed to investigate the cause of the reduced embryonic size in our mutant. The length of the S phase was found longer in the mutant, indicating that Mortalin also regulates cell cycle. All together, these data suggest that Mortalin is required for cell survival during development, in part by controlling the UPR.

Objetivos: Investigar a prevalência de obstrução respiratória em indivíduos com fissura de palato submetidos à cirurgia de retalho faríngeo para a correção de insuficiência velofaríngea (estudo 1). Analisar a qualidade do sono e sintomas respiratórios relacionados a apnéia obstrutiva do sono (AOS) de adultos de meia-idade com fissura de palato previamente operada e retalho faríngeo, comparativamente a indivíduos com fissura de palato operada sem retalho faríngeo e indivíduos sem fissura (estudo 2). Determinar a gravidade dos sintomas respiratórios relacionados a AOS e sua correlação com o grau de obstrução velofaríngea provocada pelo retalho (estudo 3). Modelo/Participantes: O estudo 1 foi realizado por meio de revisão sistemática da literatura. O estudo 2 foi realizado, prospectivamente, em 15 indivíduos controles sem fissura (grupo C) e 38pacientes com fissura operada, não sindrômicos, sendo 20 sem retalho (grupo SR) e 18 com retalho (grupo CR), com idade entre 40 e 66 anos. A qualidade do sono e os sintomas de AOS foram avaliados por meio dos questionários de Pittsburgh, Epworth e Berlin. O estudo 3 foi realizado em 12 dos pacientes do grupo CR. A gravidade dos sintomas relacionados a AOS foi avaliada por meio da escala de Trindade e os achados foram correlacionados com o grau de obstrução velofaríngea provocada pelo retalho, avaliado por meio de rinomanometria modificada de Warren. Local de Execução: Laboratório de Fisiologia, HRAC-USP. Resultados: A prevalência de obstrução respiratória durante o sono em indivíduos com retalho faríngeo alcançou percentuais variáveis nos 28 estudos analisados, chegando a ser observada em até 95% dos casos, incluindo sintomas como hiponasalidade, ronco, obstrução nasal e eventos relacionados a apnéia obstrutiva do sono (estudo 1). Os escores aferidos nos questionários de Pittsburgh, Epworth e Berlin não diferiram entre os três grupos analisados, notando-se, contudo, tendência a piores escores no grupo com retalho, indicativos de sonolência excessiva diurna e alto risco para AOS (estudo 2). Sintomas respiratórios relacionados a AOS de maior gravidade foram observados com maior frequência no grupo de indivíduos com retalho. Não foi constatada relação entre a gravidade dos sintomas e o grau de obstrução velofaríngea provocada pelo retalho (estudo 3). Conclusão: Esses achados demonstram que o retalho faríngeo, usado com sucesso para o tratamento dos distúrbios de fala secundários à insuficiência velofaríngea, está associado a um potencial significativo de comprometimento das vias aéreas na meia-idade, exigindo condutas efetivas de triagem e de diagnóstico. / Objectives: To investigate the prevalence of airway obstruction in individuals with cleft palate who underwent pharyngeal flap surgery for the treatment of velopharyngeal insufficiency (study 1). To assess the quality of sleep and respiratory symptoms related to obstructive sleep apnea (OSA) in middle-aged adults with repaired cleft palate and pharyngeal flap, as compared to individuals with repaired cleft palate without pharyngeal flap and individuals without cleft (study 2). To determine the severity of respiratory symptoms related to OSA and its correlation with the degree of obstruction caused by flap (study 3). Model/Participants: Study 1 was conducted through a systematic review of the literature. Study 2 was performed prospectively in 15 control subjects without cleft (group C) and 38 non-syndromic patients with a repaired cleft, 20 of them without flap (NF group) and 18 with a flap (WF group), aged from 40 to 66 years. Quality of sleep and OSA symptoms were assessed by means of Pittsburgh, Epworth and Berlin questionnaires. Study 3 was conducted in 12 patients of the CR group. The severity of OSA-related symptoms was assessed by the Trindade scale and the findings were correlated to the degree of velopharyngeal obstruction caused by flap, assessed by Warrens modified rhinomanometry. Setting: Laboratory of Physiology, HRAC-USP. Results: The prevalence of airway obstruction during sleep in patients with pharyngeal flap achieved variable percentages in the 28 studies analyzed, being observed in up to 95% of cases, including symptoms such as hyponasality, snoring, nasal obstruction and sleep apnea- related events (study 1). Scores obtained in the Pittsburgh, Epworth and Berlin questionnaires did not differ among the three groups. However, the worst scores were seen in the WF group, suggesting excessive daytime sleepiness and high risk for OSA (study 2). More severe OSA relatedrespiratory symptoms were most frequently observed in the WF group. No relation was found between the severity of symptoms and the degree of velopharyngeal obstruction caused by flap (study 3). Conclusion: These findings demonstrate that pharyngeal flap surgery, successfully used for the management of speech disorders secondary to velopharyngeal insufficiency, is associated to a significant potential for airway impairment in the middle age, requiring effective approaches of screening and diagnosis.

A faringe é um órgão muscular que se sustenta nos ossos da face e crânio. Dividindo-se em naso, oro e hipofaringe, pode ser considerada um tubo colabável que atende aos sistemas respiratório e digestivo, participando da respiração, deglutição e fonação. Sua conformação anatômica permite que fatores como obesidade, hipotonia muscular e deficiência mandibular favoreçam sua obstrução, podendo gerar a Síndrome da Apnéia Obstrutiva do Sono (SAOS). Para os pacientes portadores de deficiência mandibular, o tratamento deve desobstruir a faringe por meio de avanço mandibular, aumentando as dimensões faríngeas. A determinação do local de obstrução é fundamental para o adequado tratamento, sendo a análise cefalométrica convencional ou computadorizada, ferramenta útil nesse processo. Da mesma forma que o avanço mandibular aumenta o espaço aéreo faríngeo, espera-se que o recuo de mandíbula reduza-o. Com o objetivo de avaliar as alterações cefalométricas do espaço aéreo faríngeo frente aos procedimentos de cirurgia ortognática para correção de prognatismo mandibular, realizou-se a análise cefalométrica pré e pós-operatória de 19 pacientes submetidos a recuo de mandíbula pela técnica da osteotomia sagital de mandíbula bilateral associada a avanço de maxila por meio de osteotomia Le Fort I, utilizando-se o Programa Dolphin Imaging 10.0. Os resultados obtidos com base nas características do grupo de pacientes estudado não evidenciaram alterações estatisticamente significativas nos espaços aéreos faríngeos superior ou nasofaríngeo, médio ou orofaríngeo e inferior ou hipofaríngeo, o que permitiu concluir que o Programa Dolphin Imaging 10.0 pode ser utilizado como ferramenta para análise cefalométrica do espaço aéreo faríngeo e que a cirurgia ortognática maxilo/mandibular, para correção de prognatismo mandibular, parece não alterar os espaços aéreos faríngeos. / Pharynx is a muscular organ with is sustained by craniofacial bones. It is divided into nasal, oral and hipopharynx, and can be considered as a tube that can be closed serving both respiratory and digestive systems, participating of breathing, swallowing and speech. Its anatomical morphology permits that factors such as obesity, muscular hipotony, and mandibular deficiency, among others, facilitate its obstruction, leading to the sleep apnea syndrome (OAS). The treatment consists of surgical mandibular advancement for the desobstruction of the pharynx, once this procedure increases pharyngeal dimensions. In this context, the determination of the site of the obstruction is essential for an adequate treatment, and conventional or digital cephalometries are useful tools for this diagnosis. If mandible advancement increases pharyngeal air space it is expected that mandible setback decreases such space. In order to evaluate cephalometric alterations of pharyngeal air space after orthognatic surgeries for the correction of mandibular prognatism, cephalometric analysis of 18 patients before and after surgical correction were performed using Dolphin Imaging 10.0 Program. The surgical technique consisted of bilateral mandibular sagital osteotomy associated to maxilla advancement and mentoplasty. Results did not reveal statistical differences for 142 the superior (naso), medium (oral), and inferior (hypopharynx) pharyngeal air spaces, leading to the conclusion that Dolphin Imaging 10.0 Program can be used for the analysis of the pharyngeal air space and that the surgical procedure seems not to interfere in the airway space.

objetivos: considerando a importância e a eficácia das faringoplastias como cirurgias reabilitadoras da fala e a importância dos aspectos anestésicos para um resultado cirúrgico adequado, este estudo objetiva documentar as intercorrências relativas às cirurgias de retalho faríngeo e seu possível envolvimento com os fatores anestésicos. Método: estudo retrospectivo e descritivo. Foram analisados 2679 prontuários de pacientes submetidos a faringoplastias, no Hospital de Reabilitação de Anomalias Craniofaciais- Universidade se São Paulo (HRAC-USP), entre 1980 e 2003. Foram selecionados os 2299 casos em que a técnica utilizada foi a do retalho faríngeo posterior e foram coletados parâmetros clínicos e sintomas sugestivos de complicações: permeabilidade de via aérea, sangramento, dor, náusea e vômito, agitação psicomotora, temperatura, pressão arterial e saturação de oxigênio. Resultados: dos 2299 procedimentos, 1042 apresentaram complicações. Vômito (16,31%) e dor (14,31%) foram as mais freqüentes. Complicações consideradas mais críticas, como obstrução de via aérea e hemorragia foram menos freqüentes, ocorrendo em 4,78% e 3,87% dos 2299 pacientes operados. As complicações mais críticas foram as determinantes da necessidade de reoperação no período pós-operatório precoce, ocorrendo em 39 pacientes. As menores chances de ocorrência de complicações foram verificadas com o anestésico inalatório sevoflurano, com o agente indutor propofol, com opióides na indução anestésica, com os analgésicos tramadol e nalbufina e com o antiemético ondansetron. Conclusão: houve associação entre medicações administradas na anestesia e ocorrência ou ausência de complicações no período pós-operatório precoce. O esquema medicamentoso, utilizado desde 1995, incluindo sevoflurano, propofol, opióides na indução, tramadol, nalbufina e ondansetron, é o que melhor atende às necessidades dos pacientes e anestesiologistas para cirurgia do retalho faríngeo, no HRAC-USP. / Objectives: considering the valuable and effectiveness of pharyngoplasty like surgical procedure designed to correct velopharyngeal dysfunction and the importance of anesthetic aspects in any surgery outcome, this study aimed to assess complications rates and a possible association with drugs used by anesthetist. Study design: we conducted a 23-year retrospective study at a tertiary craniofacial center: Hospital de Reabilitação de Anomalias Cranifaciais – Universidade de São Paulo (HRACUSP). Two thousand six hundred seventy nine patients charts between 1980 and 2003 were reviewed. Charts were selected when the posterior pharyngeal flap surgery was performed (2299 charts). Clinical parameters and symptoms linked to perioperative complications were collected: airway permeability, bleeding, pain, vomiting, agitation, temperature, arterial pressure and oxygen saturation. Results: from 2299 pharyngeal flaps, 1042 showed early postoperative complications. The most common complications were vomiting (16,31%) and pain (14,31%). Most critical complications were less frequent: airway obstruction occurred in 4,78% of all patients and bleeding occurred at a rate of 3,87%. Just 39 patients needed reoperation to control these critical complications. The best results with a low complications rate were achieved when anesthetist used sevoflurane, propofol, opioids in anesthesia induction, tramadol, nalbufine and ondansetron Conclusions: there was association between anesthetic drugs and early post operative complications. The drugs scheme (sevoflurane, propofol, opioids, tramadol, nalbufine, ondansetron) used by HRAC-USP anesthetists team since 1995 has been proved effective and appropriate.

Objetivos: Estabelecer um banco de amostras de fala constituído por gravações representativas do uso de articulação compensatória do tipo (FF), da presença de hipernasalidade e da ausência de hipernasalidade; identificar valores de nasalância (média e desvio padrão) em amostras de fala estudadas; e comparar os valores de nasalância nas diferentes amostras de fala. Método: Um total de 1680 amostras de fala foram fornecidas por 19 indivíduos com fissura labiopalatina (FLP) operada, com ou sem disfunção velofaringea (DVF) e por cinco indivíduos sem DVF e sem histórico de FLP. Os participantes repetiram um conjunto de 14 frases (13 constituídas de sons de alta pressão e uma constituída de um som de baixa pressão), enquanto os sinais de áudio e nasalância foram capturados simultaneamente. Os sinais de áudio foram editados e foram julgados por três juízas experientes por consenso. Após julgamento as amostras foram reagrupadas em quatro grupos distintos: G1 incluiu 255 amostras de fala julgadas como representativas de hipernasalidade (hiper); G2 incluiu 130 amostras de fala julgadas como representativas do uso de FF e hipernasalidade; G3 incluiu 280 amostras de fala julgadas como representativas de fala típica (sem FF e sem hiper) em falantes com histórico de FLP; G4 incluiu 175 amostras de fala julgadas como representativas de fala típicas (sem FF e sem hiper) em falantes sem histórico de FLP. Resultados: Os julgamentos aferidos por consenso pelas três juízas permitiram a identificação de amostras representativas do uso de FF e da presença e ausência de hipernasalidade. As amostras julgadas e redistribuídas nos quatro grupos de interesse permitiram o cálculo dos valores de nasalância para cada grupo e foi realizado estatística inferencial utilizando o teste Kruskal-Wallis para testar a hipótese de que a presença de FF, associada ou não à hipernasalidade, nas amostras de fala de interesse, altera os resultados de nasalância. Quando houve diferença estatisticamente significante foi aplicado o teste Dunn\'s para comparar os grupos aos pares. Após a análise estatística inferencial realizada observa-se que houve diferença estatisticamente significativa entre os grupos com alteração de fala (G1 e G2) e aqueles sem alteração (G3 e G4). A diferença entre o grupo com hipernasalidade (G1) e o grupo com FF (G2) não foi significante Conclusão: O uso de FF não influenciou significativamente os valores de nasalância para a amostra estudada, refutando a hipótese estipulada. / Objective: This study had the objectives of establishing a data bank of speech recordings representative of use of pharyngeal fricative compensatory articulation (PF); presence and absence of hypernasality; identifying nasalance values (mean and standard deviation for the samples studied; and comparing nasalance finding among the different speech samples established. Method: A total of 1680 speech samples were recorded from 19 individuals with cleft lip and palate (CLP), 11 with velopharyngeal dysfunction (VPD) and 8 without VPD, and from 5 individuals without history of CLP. The participants repeated a series of 14 phrases (13 with high pressure consonants and 1 with a low pressure consonant), while audio and nasometric data was simultaneously recorded. The audio signals captures were edited and rated by 3 experienced judges with 100% agreement. After the ratings the samples were distributed into 4 groups (G): G1 included 255 samples rated as representative of presence of hypernasality; G2 included 130 samples rated as representative of use of PF and hypernasality; G3 included 280 samples rated as representative of normal speech (without PF and without hypernasality) for speakers with history of cleft palate; G4 included 175 samples rated as representative of normal speech (without PF and without hypernasality) for speakers without history of cleft palate. Results: The ratings established with agreement by the 3 judges during auditory-perceptual analysis of the recordings responded to objectives this study which proposed to establish samples representative of use of PF and of presence and absence of hypernasality. The samples rated by the judges were distributed into the four groups of interest for calculation of the nasalance scores, The Kruskal-Wallis statistical test was used to test the hypothesis that presence of PF, with or without hypernasality significantly would affect nasalance scores. When significant difference was found Dunns test was used to compared data in group pairs. After inferential statistics we observed that a significant difference was found between nasalance scores for groups G1 and G2 (samples representative of speech errors) with groups G3 and G4 (samples representative of normal speech). The difference between the group with hypernasality (G1) and the group with PF (G2) was not significant. Conclusion: The use of PF did not significantly influence nasalance values for the studied sample, refuting the proposed hypothesis.