RESUMO
Objectives: This study examined the immediate effects of neuromuscular electrical stimulation (NMES) on the dynamics of oropharyngeal structure and laryngeal vestibular closure (LVC) in healthy subjects. Methods: Ten healthy male volunteers participated in this controlled, before-and-after, videofluoroscopic swallowing pilot study. The study was conducted in four phases (each performed twice): (1) saliva swallow (SS) before evaluation (BEFORE), (2) NMES while at rest with no SS (NMES AT REST), (3) SS during NMES (DURING NMES), and (4) SS to examine the aftereffects of NMES (AFTER). We measured distances that oropharyngeal structures moved in the NMES AT REST phase, and we analyzed the kinematics of saliva swallowing primarily in the BEFORE and AFTER phases. Results: Four changes in the morphology of the oropharyngeal structure caused by NMES AT REST were statistically significant: anterior-upward displacement of the hyoid bone and larynx, stretch of the laryngeal vestibule, and posterior ridge of the tongue root. Regarding the kinematics measured during SS, although there was no significant change in LVC reaction times, LVC duration in the AFTER phase was significantly longer than BEFORE. Regarding maximal displacement of the hyoid bone, there was significantly greater movement AFTER than BEFORE. As additional exploratory outcomes, the velocity of hyoid bone movement was significantly slower, and the hyoid-to-larynx approximation was significantly smaller, DURING NMES than AFTER. Conclusions: Longer duration of LVC might be caused by adaptive learning with NMES-induced structural changes in the oropharynx. Further clinical studies are warranted to determine whether this approach improves dysphagia, which impairs LVC.
RESUMO
A thermoresponsive diblock copolymer, poly(ethyl glycidyl ether)-block-poly(ethylene oxide) (PEGE-b-PEO), is synthesized by successive anionic ring-opening polymerization of ethyl glycidyl ether and ethylene oxide using 2-phenoxyethanol as a starting material, and its solution behavior is elucidated in water. In a dilute 1 wt % solution, the temperature-dependent alteration in the polymer hydrodynamic radius (RH) is measured in the temperature range between 5 and 45 degrees C by pulse-gradient spin-echo NMR and dynamic light scattering. The RH value increased with temperature in two steps, where the first step at 15 degrees C corresponds to the core-shell micelle formation and the second step at 40 degrees C corresponds to the aggregation of the core-shell micelles. The formation of the core-shell micelles is supported by the solubilization of a dye (1,6-diphenyl-1,3,5-hexatriene) in the hydrophobic core, which is recognized for a copolymer solution in the temperature range between 20 and 40 degrees C. In this temperature range, the core-shell micelles and the unimers coexist and the fraction of the former gradually increases with increasing temperature, suggesting equilibrium between the micelles and the unimers. In the concentrated regime (40 wt % solution), the solution forms a gel and the small-angle X-ray scattering measurements reveal the successive formation of hexagonal and lamellar liquid crystal phases with increasing temperature.
