Summary Elevation of the larynx is critical to swallowing function, an observation supported by the fact that radiation therapy-induced dysphagia is associated with reduced laryngeal elevation. We investigated muscles underlying hyolaryngeal elevation by using muscle functional MRI. We acquired scans from 11 healthy subjects to determine whole-muscle T2 signal profiles pre-swallowing, post-swallowing, and after performing swallowing exercises. Results demonstrate muscles essential to laryngeal elevation and exercises that target them. Purpose Reduced hyolaryngeal elevation, a critical event in swallowing, is associated with radiation therapy. Two muscle groups that suspend the hyoid, larynx, and pharynx have been proposed to elevate the hyolaryngeal complex: the suprahyoid and longitudinal pharyngeal muscles. Thought to assist both groups is the thyrohyoid, a muscle intrinsic to the hyolaryngeal complex. Intensity modulated radiation therapy guidelines designed to preserve structures important to swallowing currently exclude the suprahyoid and thyrohyoid muscles. This study used muscle functional magnetic resonance imaging (mfMRI) in normal healthy adults to determine whether both muscle groups are active in swallowing and to test therapeutic exercises thought to be specific to hyolaryngeal elevation. Methods and Materials mfMRI data were acquired from 11 healthy subjects before and after normal swallowing and after swallowing exercise regimens (the Mendelsohn maneuver and effortful pitch glide). Whole-muscle transverse relaxation time (T2 signal, measured in milliseconds) profiles of 7 test muscles were used to evaluate the physiologic response of each muscle to each condition. Changes in effect size (using the Cohen d measure) of whole-muscle T2 profiles were used to determine which muscles underlie swallowing and swallowing exercises. Results Post-swallowing effect size changes (where a d value of >0.20 indicates significant activity during swallowing) for the T2 signal profile of the thyrohyoid was a d value of 0.09; a d value of 0.40 for the mylohyoid, 0.80 for the geniohyoid, 0.04 for the anterior digastric, and 0.25 for the posterior digastric-stylohyoid in the suprahyoid muscle group; and d values of 0.47 for the palatopharyngeus and 0.28 for the stylopharyngeus muscles in the longitudinal pharyngeal muscle group. The Mendelsohn maneuver and effortful pitch glide swallowing exercises showed significant effect size changes for all muscles tested, except for the thyrohyoid. Conclusions Muscles of both the suprahyoid and the longitudinal pharyngeal muscle groups are active in swallowing, and both swallowing exercises effectively target muscles elevating the hyolaryngeal complex. mfMRI is useful in testing swallowing muscle function.
The use of chiral reagents for the derivatization of optically-active amines and alcohols for the purpose of determining their enantiomeric purity or absolute configuration is a tool used by many chemists. Among the techniques used, Mosher's amide and Mosher's ester analyses are among the most reliable and one of the most often used. Despite this, these techniques are rarely introduced in the undergraduate organic laboratory. In this experiment teams of students are given optically-pure amines of known structure but unknown stereochemistry. One half of the team derivatizes a sample of the amine with optically-pure (R)-Mosher's acid chloride and the other half of the team derivatizes a sample of the amine with optically-pure (S)-Mosher's acid chloride. The resulting amide diastereomers can be analyzed by 1H NMR spectroscopy and, using Mosher's model, distinguished from one another. Through careful analysis the students can determine the absolute configuration of their starting amine. Sample reactions are presented as well as spectral data for 18 Mosher amides that have been used in this experiment.
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