Objectives:The aim of the present study was (a) to determine the relationship of videofluoroscopic swallowing study (VFSS) findings of the swallowing musculature with the diagnostic criteria for sarcopenic dysphagia and (b) to examine the usefulness of VFSS for diagnosing sarcopenic dysphagia.
Methods:The participants were 132 patients (mean age, 80.4 ± 8.8 years). Their skeletal muscle mass, nutritional status and swallowing functions as assessed by VFSS findings were measured. Also, the relationship between the VFSS findings and sarcopenia was examined.Results: Of all the participants, 20 men (mean age, 83.2 ± 6.9 years) and 27 women (mean age, 85.3 ± 6.9 years) were diagnosed with sarcopenia. In men, the amount of laryngeal upward movement (ALUM) was significantly lower and the pharyngeal area was significantly wider in the sarcopenia group than in the non-sarcopenia group.In women, the pharyngeal area was significantly wider in the sarcopenia group than in the non-sarcopenia group. In a logistic regression model, ALUM (odds ratio [OR] 1.135, 95% confidence interval [CI] 1.037-1.241, P = .006) and pharyngeal area (OR 0.028, 95% CI 0.001-0.670, P = .027) was a significant independent factor for the presence or absence of sarcopenia.
Conclusions: The decline in swallowing function of sarcopenia patients was characterised by lower laryngeal movement and enlargement of the pharyngeal cavity due to decreased skeletal muscle mass and decreased muscle strength. The present study suggested the usefulness of measuring ALUM during swallowing and measuring the pharyngeal area with VFSS as indicators of decreased swallowing muscle function in sarcopenia. K E Y W O R D S larynx, pharyngeal muscles, sarcopenia, swallowing | 585 MIYASHITA eT Al.
Background
Tongue muscle strength is important for swallowing but decreases with age, in association with reduced skeletal muscle mass. However, the relationships between pharyngeal dynamics and both skeletal muscle mass and tongue muscle strength are unknown.
Objective
To investigate the effect of reductions in tongue muscle strength on pharyngeal movement during swallowing in patients with dysphagia.
Methods
Subjects were selected from male outpatients ≥65 years old who were examined for the main complaint of dysphagia. Patients with history of neurodegenerative disease affecting tongue movement, cerebrovascular disease or oral cancer were excluded. As a result, 82 men (mean age, 80.6 ± 6.8 years) participated. Skeletal muscle mass index (SMI) as physical parameters and maximum tongue pressure (MTP) as tongue muscles strength were measured. Status and dynamics of the pharyngeal organs, including change in posterior pharyngeal wall advancement (PPWA) when swallowing 3.0 mL of moderately thick liquid, were measured by analysing videofluoroscopic images. Simple bivariate correlation and multiple regression analysis were used to statistically analyse correlations between parameters.
Results
MTP showed a significant positive correlation with SMI (r = .43, P < .01). PPWA showed a significant negative correlation with MTP (r = −0.30, P < .01), but no association with SMI.
Conclusions
While tongue muscle strength is affected by skeletal muscle mass, posterior pharyngeal wall advancement is not readily affected by decreases in skeletal muscle mass. Posterior pharyngeal wall advancement may increase to compensate for swallowing function among individuals with reduced tongue muscle strength.
Ultrahigh-repetition-rate lasers will become vital light sources for many future technologies; however, their realization is challenging because the cavity size must be minimized. Whispering-gallery-mode (WGM) microresonators are attractive for this purpose since they allow the strong light–matter interaction usually needed to enable mode locking. However, the optimum parameter ranges are entirely unknown since no experiments have yet been conducted. Here, we numerically investigate pulsed operation in a toroidal WGM microresonator with gain and saturable absorption (SA) to study the experimental feasibility. We show that dispersion is the key parameter for achieving passive mode locking in this system. Moreover, the design guideline provided in this work can apply to any small resonators with gain and SA and is not limited to a specific cavity system.
We numerically investigate the deterministic generation of a perfect soliton crystal (PSC) in an optical microresonator functionalized with a saturable absorber (SA). The SA allows the direct formation of a PSC from an initial, periodic Turing roll. It prevents passage through a chaotic state, which induces a stochastic nature with regard to the number of generated dissipative Kerr solitons. We show that PSCs form deterministically, and the number is controlled by adjusting the input power and SA parameter. Our work provides a simple approach for obtaining a stable PSC that offers an ultrahigh repetition rate and a high comb output power.
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