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71.
72.
OBJECTIVE: To evaluate the efficacy of voice therapy in the management of vocal fold polyps and cysts. STUDY DESIGN AND SETTING: Retrospective review of vocal fold cysts and polyps undergoing voice therapy in a tertiary care center. Symptom resolution or persistence resulting in surgical intervention was the main outcome measure. RESULTS: Fifty-seven patients were identified, of which 49.1% achieved symptom resolution with voice therapy alone. Patients with complete glottal closure and muscle tension dysphonia did not have a better response than those with incomplete glottal closure and without muscle tension dysphonia (P = 0.1, chi(2), respectively). Patients with translucent polyps more commonly responded to voice therapy than fibrotic, hyaline, or hemorrhagic polyps, 81.8% versus 15.4% and 25.0% response rate, respectively (P = 0.002, chi(2)). CONCLUSIONS: Voice therapy is an effective treatment modality for vocal fold polyps and cysts. SIGNIFICANCE: A multidisciplinary approach including a trial of voice therapy is warranted. 相似文献
73.
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75.
Osteogenic differentiation of human bone marrow stromal cells on partially demineralized bone scaffolds in vitro 总被引:11,自引:0,他引:11
Mauney JR Blumberg J Pirun M Volloch V Vunjak-Novakovic G Kaplan DL 《Tissue engineering》2004,10(1-2):81-92
Tissue engineering has been used to enhance the utility of biomaterials for clinical bone repair by the incorporation of an osteogenic cell source into a scaffold followed by the in vitro promotion of osteogenic differentiation before host implantation. In this study, three-dimensional, partially demineralized bone scaffolds were investigated for their ability to support osteogenic differentiation of human bone marrow stromal cells (BMSCs) in vitro. Dynamic cell seeding resulted in homogeneous cell attachment and infiltration within the matrix and produced significantly higher seeding efficiencies when compared with a conventional static seeding method. Dynamically seeded scaffolds were cultured for 7 and 14 days in the presence of dexamethasone and evaluated on biochemical, molecular, and morphological levels for osteogenic differentiation. Significant elevation in alkaline phosphatase activity was observed versus controls over the 14-day culture, with a transient peak indicative of early mineralization on day 7. On the basis of RT-PCR, dexamethasone-treated samples showed elevations in alkaline phosphatase and osteocalcin expression levels at 7 and 14 days over nontreated controls, while bone sialoprotein was produced only in the presence of dexamethasone at 14 days. Scanning electron microscopy evaluation of dexamethasone-treated samples at 14 days revealed primarily cuboidal cells indicative of mature osteoblasts, in contrast to nontreated controls displaying a majority of cells with a fibroblastic cell morphology. These results demonstrate that partially demineralized bone can be successfully used with human BMSCs to support osteogenic differentiation in vitro. This osseous biomaterial may offer new potential benefits as a tool for clinical bone replacement. 相似文献
76.
77.
Rats with lesions of the area postrema (APX) are known to exhibit an enhanced intake of highly palatable foods such as sweetened condensed milk and cookies. These observations suggest the possibility that APX rats find these foods more rewarding and will work harder to obtain these foods. Sham and APX rats were tested on fixed ratio (FR) and progressive ratio (PR) schedules. APX rats consistently pressed more times to receive sucrose solution and attained both FR 3 and FR 5 criteria significantly faster than sham-lesioned control rats. Furthermore, rats with APX had significantly higher break points than sham-lesioned control rats on a progressive ratio schedule. These results support the hypothesis that rats with lesions of the area postrema will consistently work harder to obtain a highly palatable food reward. 相似文献
78.
Dutta Roy T Simon JL Ricci JL Rekow ED Thompson VP Parsons JR 《Journal of biomedical materials research. Part A》2003,67(4):1228-1237
The current study analyzes the in vivo performance of porous sintered hydroxyapatite (HA) bone repair scaffolds fabricated using the TheriForm solid freeform fabrication process. Porous HA scaffolds with engineered macroscopic channels had a significantly higher percentage of new bone area compared with porous HA scaffolds without channels in a rabbit calvarial defect model at an 8-week time point. An unexpected finding was the unusually large amount of new bone within the base material structure, which contained pores less than 20 microm in size. Compared with composite scaffolds of 80% polylactic-co-glycolic acid and 20% beta-tricalcium phosphate with the same macroscopic architecture as evaluated in a previous study, the porous HA scaffolds with channels had a significantly higher percentage of new bone area. Therefore, the current study indicates that scaffold geometry, as determined by the fabrication process, can enhance the ability of a ceramic material to accelerate healing of calvarial defects. 相似文献
79.
Henry R. Halperin Joshua E. Tsitlik Rafael Beyar Nisha Chandra Alan D. Guerci 《Annals of biomedical engineering》1987,15(3-4):385-403
Whether blood flow during cardiopulmonary resuscitation (CPR) results from intrathoracic pressure fluctuations or direct cardiac
compression remains controversial. We developed a mathematical model that predicts that blood flow due to intrathoracic pressure
fluctuations should be insensitive to compression rate over a wide range but dependent on the applied force and compression
duration. If direct compression of the heart plays a major role, however, the model predicts that flow should be dependent
on compression rate and force, but above a threshold, insensitive to compression duration. These differences in hemodynamics
produced by changes in rate and duration form a basis for determining whether blood flow during CPR results from intrathoracic
pressure fluctuations or from direct cardiac compression. The model was validated for direct cardiac compression by studying
the hemodynamics of cyclic cardiac deformation following thoracotomy in four anesthetized, 21–32-kg dogs. As predicted by
the model, there was no change in myocardial or cerebral perfusion pressures when the duration of compression was increased
from 15% to 45% of the cycle at a constant rate of 60/min. There was, however, a significant increase in perfusion pressures
when rate was increased from 60 to 150/min at a constant duration of 45%. The model was validated for intrathoracic pressure
changes by studying the hemodynamics produced by a thoracic vest (vest CPR) in eight dogs. The vest contained a bladder that
was inflated and deflated. Vest CPR changed intrathoracic pressure without direct cardiac compression, since sternal displacement
was <0.8 cm. As predicted by the model and opposite to direct cardiac compression, there was no change in perfusion pressures
when the rate was increased from 60 to 150/min at a constant duration of 45% of the cycle. Manual CPR was then studied in
eight dogs. There was no surgical manipulation of the chest. Myocardial and cerebral blood flows were determined with radioactive
microspheres and behaved as predicted from the model of intrathoracic pressure, not direct cardiac compression. At nearly
constant peak sternal force (378–426 N), flow was significantly increased when the duration of compression was increased from
short (13%–19% of the cycle) to long (40%–47%), at a rate of 60/min. Flow was unchanged, however, for an increase in rate
from 60 to 150/min at constant compression duration. In addition, myocardial and cerebral flow correlated with their respective
perfusion pressures. Thus vital organ perfusion pressures and flow for manual external chest compression are dependent on
the duration of compression, but not on rates of compression of 60 and 150/min. These data are of course similar to those
produced by vest CPR, where intrathoracic pressure is manipulated without sternal displacement, and to those predicted for
movement of blood by intrathoracic pressure changes. These data are, however, opposite to those produced by cardiac deformation
and to those predicted for movement blood by direct cardiac compression. We conclude that intrathoracic pressure fluctuations
generate blood flow during manual CPR. 相似文献
80.
Leffell MS Fallin MD Hildebrand WH Cavett JW Iglehart BA Zachary AA 《Human immunology》2004,65(1):78-89
Human leukocyte antigen (HLA) class I and II alleles were defined for 302 Lakota Sioux American Indians as part of the American Society for Histocompatibility and Immunogenetics coordinated studies on minority populations. The study group was comprised of adult volunteers from the Cheyenne River and Ogala Sioux tribes residing, respectively, on the Cheyenne River and Pine Ridge Reservations in South Dakota. Of the participants, 263 (87%) claimed full American Indian ancestry through both maternal and paternal grandparents. The study group included 25 nuclear families that were informative for genotyping. HLA phenotypes from 202 adults with no other known first-degree relative included in the study were used for calculation of allele and haplotype frequencies by maximum likelihood estimation. HLA-A, -B, and -Cw alleles were found to be in Hardy Weinberg equilibrium. Deviation from equilibrium was observed for DRB1 alleles (p=0.01), but could be attributed to the sample size and the occurrence of some genotypes with low expected frequencies. Polymorphism among the Sioux was limited with four to seven alleles comprising >80% of those observed at each locus. Several alleles were found at high frequency (0.05-0.30) among the Sioux that are also prevalent in other Native Americans and Alaska Natives, including: A*2402, *3101, and *0206; B*3501,*3901, *5101, and *2705; Cw*0702, *0404, and *03041; DRB1*0407, *0404, *1402, and *16021; and DQB1*0301, *0302, and *0402. DRB1*0811, which has been only previously described in Navajo and Tlingit Indians, was found to occur at a frequency of 0.119 among the Sioux. Two new alleles were defined among the Sioux: Cw*0204 and DRB1*040703, which were found in two and four individuals, respectively. In the haplotype analyses, significant linkage disequilibrium (p<0.00001) was seen in all pairwise comparisons of loci and numerous two and three locus haplotypes were found to have strong, positive linkage disequilibrium values. The two most common extended haplotypes among the Sioux, determined by maximum likelihood estimation and genotyping were: A*31012, B*3501, Cw*0404, DRB1*0407; and A*24021, B*3501, Cw*0404, DRB1*0404. 相似文献