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Biomedical subjects

R W Chan

Publications and source records attributed to R W Chan.

At least 19 recordsLinked to original sources

A quantitative output-cost ratio in voice production.

A quantitative output-cost ratio (OCR) is proposed for objective use in voice production and is defined as the ratio of the acoustic output intensity to the collision intensity of the vocal folds. Measurement of the OCR is demonstrated in a laboratory experiment using 5 excised larynges and a transducer designed for use on human subjects. Data were gathered at constant fundamental frequency (150 Hz). Subglottal pressure was varied from 1.0 to 1.6 kPa, and glottal width at the vocal processes was varied from a pressed condition to a 2-mm gap. The OCR was plotted as a function of glottal width. With no vocal tract, the excised larynx experiments yielded a broad maxima in the OCR curves, across all subglottal pressure conditions, at about 0.6 mm. Computer simulations indicate that sharper maxima may occur when the influence of the vocal tract is taken into account. The potential clinical utility of the OCR is discussed for treatment of a wide range of voice disorders, including those involving both hyper- and hypoadduction.

Acoustics↗

Estimation of viscoelastic shear properties of vocal-fold tissues based on time-temperature superposition.

Empirical data on the viscoelastic shear properties of human vocal-fold mucosa (cover) were recently reported at relatively low frequency (0.01-15 Hz). For the data to become relevant to voice production, attempts have been made to parametrize and extrapolate the data to higher frequencies using constitutive modeling [Chan and Titze, J. Acoust. Soc. Am. 107, 565-580 (2000)]. This study investigated the feasibility of an alternative approach for data extrapolation, namely the principle of time-temperature superposition (TTS). TTS is a hybrid theoretical-empirical approach widely used by rheologists to estimate the viscoelastic properties of polymeric systems at time or frequency scales not readily accessible experimentally. It is based on the observation that for many polymers, the molecular configurational changes that occur in a given time scale at a low temperature correspond to those that occur in a shorter time scale at a higher temperature. Using a rotational rheometer, the elastic shear modulus (G') and viscous shear modulus (G'') of vocal-fold cover (superficial layer of lamina propria) tissue samples were measured at 0.01-15 Hz at relatively low temperatures (5 degrees-37 degrees C). Data were empirically shifted according to TTS, yielding composite "master curves" for predicting the magnitude of the shear moduli at higher frequencies at 37 degrees C. Results showed that TTS may be a feasible approach for estimating the viscoelastic shear properties of vocal-fold tissues at frequencies of phonation (on the order of 100-1000 Hz).

Elasticity↗

Geometric characterization of the laryngeal cartilage framework for the purpose of biomechanical modeling.

Some new anatomic data on the laryngeal cartilage framework have been obtained for the biomechanical modeling of the larynx. This study attempted to define and measure some biomechanically important morphometric features of the laryngeal framework, including both the human and the canine laryngeal frameworks, because the canine larynx has been frequently used as an animal model in gross morphology and in physiological experiments. The larynges of 9 men, 7 women, and 9 dogs were harvested and dissected after death. Linear and angular geometric measurements on the thyroid cartilage, the cricoid cartilage, and the arytenoid cartilage were made with a digital caliper and a protractor, respectively. The results are useful for constructing quantitative biomechanical models of vocal fold vibration and posturing (abduction and adduction), eg, continuum mechanical models and finite-element models of the vocal folds.

Adult↗

The importance of hyaluronic acid in vocal fold biomechanics.

OBJECTIVE: This study examined the influence of hyaluronic acid (HA) on the biomechanical properties of the human vocal fold cover (the superficial layer of the lamina propria). STUDY DESIGN: Vocal fold tissues were freshly excised from 5 adult male cadavers and were treated with bovine testicular hyaluronidase to selectively remove HA from the lamina propria extracellular matrix (ECM). Linear viscoelastic shear properties (elastic shear modulus and dynamic viscosity) of the tissue samples before and after enzymatic treatment were quantified as a function of frequency (0.01 to 15 Hz) by a parallel-plate rotational rheometer at 37 degrees C. RESULTS: On removing HA from the vocal fold ECM, the elastic shear modulus (G' ) or stiffness of the vocal fold cover decreased by an average of around 35%, while the dynamic viscosity (eta') increased by 70% at higher frequencies (>1 Hz). CONCLUSION: The results suggested that HA plays an important role in determining the biomechanical properties of the vocal fold cover. As a highly hydrated glycosaminoglycan in the vocal fold ECM, it likely contributes to the maintenance of an optimal tissue viscosity that may facilitate phonation, and an optimal tissue stiffness that may be important for vocal fundamental frequency control. SIGNIFICANCE: HA has been proposed as a potential bioimplant for the surgical repair of vocal fold ECM defects (eg, vocal fold scarring and sulcus vocalis). Our results suggested that such clinical use may be potentially optimal for voice production from a biomechanical perspective.

Adult↗

Viscoelastic shear properties of human vocal fold mucosa: theoretical characterization based on constitutive modeling.

The viscoelastic shear properties of human vocal fold mucosa (cover) were previously measured as a function of frequency [Chan and Titze, J. Acoust. Soc. Am. 106, 2008-2021 (1999)], but data were obtained only in a frequency range of 0.01-15 Hz, an order of magnitude below typical frequencies of vocal fold oscillation (on the order of 100 Hz). This study represents an attempt to extrapolate the data to higher frequencies based on two viscoelastic theories, (1) a quasilinear viscoelastic theory widely used for the constitutive modeling of the viscoelastic properties of biological tissues [Fung, Biomechanics (Springer-Verlag, New York, 1993), pp. 277-292], and (2) a molecular (statistical network) theory commonly used for the rheological modeling of polymeric materials [Zhu et al., J. Biomech. 24, 1007-1018 (1991)]. Analytical expressions of elastic and viscous shear moduli, dynamic viscosity, and damping ratio based on the two theories with specific model parameters were applied to curve-fit the empirical data. Results showed that the theoretical predictions matched the empirical data reasonably well, allowing for parametric descriptions of the data and their extrapolations to frequencies of phonation.

Biomechanical Phenomena↗

Hyaluronic acid (with fibronectin) as a bioimplant for the vocal fold mucosa.

OBJECTIVES: To measure the viscoelastic shear properties of hyaluronic acid, with and without fibronectin, and to compare them with those of the human vocal fold mucosa and other phonosurgical biomaterials. METHODS: Viscoelastic shear properties of various implantable biomaterials (Teflon, gelatin, collagen, fat, hyaluronic acid, and hyaluronic acid with fibronectin) were measured with a parallel-plate rotational rheometer. Elastic and viscous shear properties were quantified as a function of oscillation frequency (0.01-15 Hz) at 37 degrees C. RESULTS: The shear properties of hyaluronic acid were relatively close to those of human vocal fold mucosal tissues reported previously. Hyaluronic acid at specific concentrations (0.5%-1%), with or without fibronectin, was found to exhibit viscous shear properties (viscous shear modulus and dynamic viscosity) similar to those of the average male and female vocal fold mucosa. CONCLUSIONS: According to a theory that establishes the effects of tissue shear properties on vocal fold oscillation, phonation threshold pressure (a measure of the ease of phonation) is directly related to the viscous shear modulus of the vibrating vocal fold mucosa. Therefore, our findings suggest that hyaluronic acid, either by itself or mixed with fibronectin, may be a potentially optimal bioimplant for the surgical management of vocal fold mucosal defects and lamina propria deficiencies (e.g., scarring) from a biomechanical standpoint.

Biocompatible Materials↗

Viscoelastic shear properties of human vocal fold mucosa: measurement methodology and empirical results.

A standard method for the empirical rheological characterization of viscoelastic materials was adopted to measure the viscoelastic shear properties of human vocal-fold mucosal tissues (the superficial layer of lamina propria). A parallel-plate rotational rheometer was employed to measure shear deformation of viscoelastic tissue samples, which were deformed between two rigid circular plates rotating in small-amplitude sinusoidal oscillations. Elastic and viscous shear moduli of the samples were then quantified as a function of oscillation frequency (0.01 to 15 Hz) based on shear stresses and strains recorded by the rheometer. Data were obtained from 15 excised human larynges (10 male and 5 female). Results showed that the elastic shear modulus mu and the damping ratio zeta of human vocal-fold mucosa were relatively constant across the range of frequencies observed, while the dynamic viscosity eta decreased monotonically with frequency (i.e., shear thinning). Intersubject differences in mu and eta as large as an order of magnitude were observed, part of which may reflect age-related and gender-related differences. Some molecular interpretations of the findings are discussed.

Adult↗

Viscosities of implantable biomaterials in vocal fold augmentation surgery.

Vocal fold vibration depends critically on the viscoelasticity of vocal fold tissues. For instance, phonation threshold pressure, a measure of the "ease" of phonation, has been shown to be directly related to the viscosity of the vibrating mucosa. Various implantable biomaterials have been used in vocal fold augmentation surgery, with implantation sites sometimes close to or inside the mucosa. Yet their viscosities or other mechanical properties are seldom known. This study attempts to provide data on viscosities of commonly used phonosurgical biomaterials. Using a parallel-plate rotational rheometer, oscillatory shear experiments were performed on implantable polytetrafluoroethylene (Teflon or Polytef; Mentor Inc., Hingham, MA), collagen (Zyderm; Collagen Corp., Palo Alto, CA), glutaraldehyde crosslinked (GAX) collagen (Phonagel or Zyplast; Collagen Corp.), absorbable gelatin (Gelfoam; Upjohn Co., Kalamazoo, MI), and human abdominal subcutaneous fat. Samples of human vocal fold mucosal tissues were also tested. Under sinusoidal oscillatory shear at 10 Hz and at 37 degrees C, the dynamic viscosity was 116 Pascal-seconds (Pa-s) for polytetrafluoroethylene, 21 Pa-s for gelatin, 8-13 Pa-s for the two types of collagen, 3 Pa-s for fat, and 1 to 3 Pa-s for vocal fold mucosa. Results extrapolated to 100 Hz also show similar differences among the biomaterials, but all values are an order of magnitude lower because of the typical inverse frequency relation (shear thinning effect) for polymeric and biologic materials. The data suggest that the use of fat for vocal fold augmentation may be more conducive to the "ease" of phonation because of its relatively low viscosity, which is closest to physiologic levels. This implication is probably the most relevant in predicting initial outcome of the postoperative voice before there is any significant assimilation (e.g., resorption and fibrosis) of the implanted biomaterial.

Abdomen↗

Psychosocial adjustment among children conceived via donor insemination by lesbian and heterosexual mothers.

This study examined the relations among family structure (e.g., number of parents, parental sexual orientation), family process (e.g., parents' relationship satisfaction, interparental conflict), and the psychological adjustment of children who had been conceived via donor insemination. The 80 participating families, all of whom had conceived children using the resources of a single sperm bank, included 55 families headed by lesbian and 25 families headed by heterosexual parents. Fifty families were headed by couples and 30 by single parents. Participating children averaged 7 years of age. Results showed that children were developing in normal fashion, and that their adjustment was unrelated to structural variables such as parental sexual orientation or the number of parents in the household. These results held true for teacher reports as well as for parent reports. Variables associated with family interactions and processes were, however, significantly related to indices of children's adjustment. Parents who were experiencing higher levels of parenting stress, higher levels of interparental conflict, and lower levels of love for each other had children who exhibited more behavior problems.

Adaptation, Psychological↗

Further studies of phonation threshold pressure in a physical model of the vocal fold mucosa.

This paper reports results of further experimentation on a previously developed physical model of the vocal-fold mucosa [Titze et al., J. Acoust. Soc. Am. 97, 3080-3084 (1995)]. The effects of vocal-fold thickness, epithelial membrane thickness, and prephonatory glottal geometry on phonation threshold pressure were studied. Phonation threshold pressures in the range of 0.13 to 0.34 kPa were observed for an 11-mm-thick vocal fold with a 70-micron-thick "epithelial" membrane for different "mucosal" fluid viscosities. Higher threshold pressure was always obtained for thinner vocal folds and thicker membranes. In another set of experiments, lowest offset threshold pressure was obtained for a rectangular or a near-rectangular prephonatory glottis (with a glottal convergence angle within about +/- 3 degrees). It ranged from 0.07 to 0.23 kPa for different glottal half-widths between 2.0 and 6.0 mm. The threshold for more convergent or divergent glottal geometries was consistently higher. This finding only partially agrees with previous analytical work which predicts a lowest threshold for a divergent glottis. The discrepancy between theory and data is likely to be associated with flow separation from a divergent glottis.

Humans↗

Osseointegrated implants for single tooth replacement in general practice: a 1-year report from a multicentre prospective study.

The single tooth implant is a treatment option for the replacement of missing single teeth and in many cases is the treatment of choice. It is, however, an expensive treatment requiring a co-ordinated approach to the surgical and restorative aspects of treatment. In this study, a group of dentists in general and restorative dental practice and with no previous experience in implant surgery underwent an intensive training course in all aspects of implant treatment for single teeth. Using a system of simplified instrumentation with a strict adherence to protocol, the group installed and restored single tooth implants ad modum Brånemark in a wide range of clinical situations. At the one year follow-up period following crown insertion, the success rate of treatment compared favourably with results reported from centres using the specialist team approach to treatment. The results of this study indicate that further consideration should be given to the training of general dentists so that improved delivery of dental health care can be provided at a more economic level.

Adolescent↗

Does the voice improve with vocal hygiene education? A study of some instrumental voice measures in a group of kindergarten teachers.

This study investigated the efficacy of a program of vocal hygiene education designed for an occupational group at risk for dysphonia, namely, kindergarten teachers. Twelve female teachers explored concepts and knowledge of vocal abuse and vocal hygiene in a workshop session and attempted to practice vocal hygiene for 2 months. They showed significant voice improvement as assessed instrumentally in terms of three acoustic and electroglottographic parameters. There was no significant change of voice in a control group of 13 teachers. The results suggest that teachers were able to improve their voices if they significantly reduced vocal abuses in daily life and practiced specific strategies to maintain classroom order and reduce the use of voice in teaching.

Adult↗

Single tooth replacement--expanded treatment options.

The aim of any prosthesis is to restore function and aesthetics by replacing the missing tooth with minimal risks to adjacent tissues. The options presently available to the patient for the replacement of a missing single tooth include the removable partial denture, partial and full coverage bridgework, resin-bonded bridgework and the single-tooth implant prosthesis. The relative merits and guidelines for successful application of these treatment modalities are presented.

Dental Implantation, Endosseous↗

Computerized pattern recognition of EEG artifact.

Automated artifact classification of quantified EEG (QEEG) epochs from 9 males using linear discriminant analysis showed greater than 85% agreement with judges' opinions. These results were replicated (n = 600 epochs for each sample). Testing the entire sample (n = 5800) illustrated reliable eye artifact (94%) but reduced muscle artifact classification (70%) accuracy. Agreement was lowest in the case of more subtle forms of muscle artifact (i.e., low amplitude muscle), however, less than 4% of these were wrongly classified as non-artifact. Improved data collection techniques retaining high frequency energies are anticipated to improve muscle artifact recognition. Results indicate that low levels of artifact contamination would result when only those epochs classified as non-artifact were accepted for inclusion in further analysis.

Blinking↗