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At least 613 records · Page 34Linked to original sources

Mouth pressure curve on abrupt interruption of airflow during forced expiration.

The mouth pressure curve after abrupt interruption during forced expiratory maneuver was investigated to evaluate the collapsing state of the airway downstream to the choke point. Immediately after the airflow interruption at the mouth by means of the electromagnetic valve, the mouth pressure suddenly increased (1st phase), followed by a slower rise (2nd phase) within about 100 msec until the pressure reaches the alveolar pressure. The pleural and alveolar pressures remained constant during this process. It was evidenced that, from point of view of mean flow, the airflow flowed at a rate of Vmax through the choke point during the second phase. Thus, it is strongly suggested that the choke point remained at the same point during the 2nd phase. From these results, the 2nd phase of the mouth pressure is expected to represent the specific characteristics for the downstream airway.

Forced Expiratory Flow Rates↗

Superselective intraarterial infusion of cisplatin for squamous cell carcinoma of the mouth: preliminary clinical experience.

OBJECTIVE: The purpose of this study was to assess the initial clinical response to superselective intraarterial infusion of cisplatin for treating stage III and stage IV squamous cell carcinoma of the mouth. SUBJECTS AND METHODS: Thirteen patients received intraarterial cisplatin therapy. The tumors were located in the tongue (n = 7), gingiva (n = 3), buccal mucosa (n = 1), hard palate (n = 1), and floor of the mouth (n = 1). A coaxial technique was used to place microcatheters in the lingual, facial, inferior alveolar, buccinator, and distal internal maxillary arteries, depending on tumor location. The feeding vessels were identified by staining the tumor with infusion of indigocarmine dye in the selected vessel. Relatively low-dose cisplatin (30-40 mg/m2) was injected at the rate of 50 mg/hr. Two or three injections were performed, with a 1-week interval between injections. After chemotherapy, eight patients underwent surgery, four had radiation therapy, and one had both. RESULTS: Thirty-four intraarterial infusions were done successfully without any complications. Arterial infusion of indigocarmine dye was useful for exact identification of feeding vessels, especially when the tumor was extensive, at the margin of the arterial supply, or near the midline. The overall response rate was 92% (complete response [tumor completely resolved], 38%; partial response [tumor reduction > or = 50%], 54%). Ten of 13 patients had no recurrence from 4 to 19 months (mean, 10 months) after treatment. Two patients died of metastatic diseases 6 months after surgery or radiation therapy. One patient had local recurrence 8 months after surgery and postoperative irradiation. No systemic toxicity such as renal failure, liver dysfunction, or bone marrow suppression was observed. Mild and transient local toxicity such as edema or mucositis of the infused area was relatively common. Trigeminal neuralgialike symptoms and reduced mouth opening occurred in two cases and one case, respectively, probably due to direct toxicity to the peripheral trigeminal nerve and masticatory muscles, respectively. CONCLUSION: Superselective intraarterial infusion of low-dose cisplatin is feasible and safe and may have important applications in treating advanced carcinoma of the mouth.

Aged↗

Studies on the nicotine exposure of individual smokers. I. Changes in mouth-level exposure to nicotine on switching to lower nicotine cigarettes.

Twenty-four subjects smoked two brands of filter-tipped cigarettes delivering different amounts of nicotine, on the following 4-week schedule: 1. Smoking their usual brand for 1 week. 2. Smoking another brand similar in size, but delivering less nicotine, for 2 weeks. 3. Reverting to their usual brand for 1 week. The amount of nicotine entering the mouth, defined as the mouth-level exposure, was estimated from a determination of the amount of nicotine trapped in the filter of each cigarette smoked. The results indicate a substantial variation in mouth-level exposure for the subjects studied, even among smokers of cigarettes that deliver similar amounts of nicotine when smoked on a machine under standard conditions. For the majority of subjects, however, changing to a lower nicotine cigarette reduced the total daily mouth-level exposure to nicotine and, therefore, presumably the total tar intake.

Adult↗

Mouth stick design for the client with spinal cord injury.

This paper reviews literature on mouth sticks and presents information from a survey of occupational therapists specializing in the treatment of persons with spinal cord injuries. The review discusses the standards of mouth-stick design that have been established by dentists, but the survey suggests that occupational therapy practice is widely discrepant from these standards. The author suggests increased education for occupational therapists to provide knowledge of the key elements of oral safety, and increased collaboration between occupational therapists and dentists in mouth-stick design, fabrication, and training to assure quality care for all persons who require a mouth stick.

Equipment Design↗

A comparative study of effects of mouth breathing and normal breathing on gingival health in children.

The present study was conducted to assess the effects of mouth breathing, lip seal and upper lip coverage on gingival health of children. 240 school children aged 10-14 years were selected irrespective of sex race and socioeconomic status. They were divided into two major groups i.e. mouth breathers and normal breathers. These groups were further subdivided into six sub-groups or categories on the basis of lip seal and upper incisor coverage. Gingival index was found to be higher in the mouth breathers than in the normal breathers in the subjects with incompetent lip seal. Increased lip separation and decreased upper lip coverage were all associated with higher levels of Plaque index and Gingival index. No statistical difference existed between mouth breathers and normal breathers with respect to Plaque index.

Adolescent↗

[Multiple skin and mouth squamous cell carcinomas related to long-term treatment with hydroxyurea].

INTRODUCTION: Cutaneous side-effects of hydroxyurea treatment are frequently observed. Squamous cell carcinomas are the most severe among them. We report a patient with skin and mouth carcinomas after hydroxyurea treatment. To the best of our knowledge, this is the first case reported. OBSERVATION: A 83-year-old woman had been treated with hydroxyurea from 1985 to 1998 for polycythemia vera. She was referred to our institution in 1998 for painful erosions of both hands. Clinical examination revealed a squamous cell carcinoma leading to amputation of a finger. Hydroxyurea was stopped at this time, and the patient underwent treatment with pipobroman. From May 1998 to March 2000, the patient developed numerous skin keratoses and four squamous cell carcinomas on both hands. In September 2000 and October 2000, two additional skin carcinomas and two mouth carcinomas were diagnosed. DISCUSSION: Cutaneous carcinomas are severe side effects of hydroxyurea therapy. They usually occur after several years of treatment and their outcome may be lethal. The chronology and clinical signs are in favour of implicating hydroxyurea in the development of skin and mouth carcinomas. Despite a bibliographic research using Medline and Embase data bases, we could not find another case-report with simultaneous occurrence of skin and mouth carcinomas after hydroxyurea therapy. This observation emphasizes the need of a long term follow-up in patients receiving hydroxyurea.

Aged↗

Surgical treatment of 150 cases of squamous cell carcinoma of the mouth.

A series of 150 commando operations performed for squamous cell carcinoma of the mouth has been presented. This series is analyzed according to a staging which differs from the TNM standard classification of the Joint Committee. Our criteria of staging are based on local invasion by the primary lesion more than on the size of the lesion alone. The five-year survival for the 50 patients with lesions in the anterior part of the mouth was 62%; for the middle mouth group, 48%; and for the posterior mouth group, 24%.

Carcinoma, Squamous Cell↗

Human repercussions of foot and mouth disease and other similar viral diseases.

Foot and mouth disease is a frequent viral zoonosis in livestock that may occasionally also affect humans. Transmission to man usually occurs as a result of the consumption of unprocessed milk. The clinical manifestations include fever, headache, weakness, muscle pain, and the development of vesicles and ulcers throughout the oral mucosa. Vesicular stomatitis is another zoonosis similar to foot and mouth disease that can likewise affect humans with similar clinical manifestations, in which the presence of aphthae is highly suggestive. In turn, hand, foot and mouth disease and herpangina are two exclusively human diseases caused by different enteroviruses, with a special predilection for children under five years of age, and characterized by the presence of vesicles and ulcerations in the oral cavity. The present study provides a brief review of the salient characteristics of foot and mouth disease and of other similar viral diseases with which the differential diagnosis should be established.

Foot-and-Mouth Disease↗

Effects of a betaine-containing toothpaste on subjective symptoms of dry mouth: a randomized clinical trial.

Our aim was to study the effects of mildly flavoured sodium lauryl sulphate (SLS)-containing and detergent-free toothpastes with and without betaine (BET) on subjective symptoms of dry mouth in a randomised clinical trial. BET is an osmoprotectant that reacts with molecules to supply the surface with a water coating that protects cells from surfactants. Twenty-seven xerostomic patients and 18 healthy controls took part in the randomised, double-blind clinical trial with a crossover design. Three mildly flavoured toothpastes: (1) 4% BET, (2) 1% SLS and 4% BET, and (3) 1% SLS were used for six weeks each. The reference or washout paste contained neither SLS nor BET. The subjects' dental appointments were at the beginning of the trial and before and after the use of each toothpaste. At each appointment, the subjects were interviewed about subjective sensations of dry mouth (Visual Assessment Scoring (VAS) Index). The subjects did not report any adverse effects in connection with the use of the toothpastes. The VAS scores for lip dryness and eating difficulties were significantly lower for the BET paste (lip dryness: BET<BET+SLS; p < 0.005 and eating difficulties: BET<BET+SLS; p = 0.02; BET<reference; p = 0.003). The BET paste relieved dry mouth symptoms in 44% of the xerostomic patients, the corresponding figures for the other pastes being BET+SLS 22% (p = 0.002 as compared with BET), SLS 18% (p = 0.022), and reference 7% (p = 0.000). In conclusion, all the mildly flavoured toothpastes used in this study were well accepted by the xerostomic subjects. Thus, other toothpaste components may be more mucosa-irritating than just SLS, or else they enhance the effect of SLS. The detergent-free, BET-containing toothpaste appeared to be associated with relief of some symptoms of dry mouth.

Analysis of Variance↗

Hand, foot and mouth disease.

BACKGROUND: Hand, foot and mouth disease is a common viral illness of infants and children. OBJECTIVE: This article aims to describe the cause, presentation, management and infectivity of this virus. DISCUSSION: Hand, foot and mouth disease is characterised by fever and vesicles in the mouth and on distal extremities. It is usually caused by coxsackie A virus and less commonly by coxsackie B and enterovirus 71. Hand, foot and mouth disease usually affects children under 10 years of age. Enteroviruses may also cause more serious disease such as meningoencephalitis and myocarditis. Treatment is symptomatic. Children are particularly infectious until the blisters have disappeared. Exclusion from school or childcare is not practical as the virus may be present in the faeces for several weeks.

Child↗

The elimination rate of mouth alcohol: mathematical modeling and implications in breath alcohol analysis.

Mouth alcohol, if present in high enough concentrations, can falsely bias the accurate measurement of end-expiratory breath alcohol. Mouth alcohol will be eliminated over time, however, and can be modeled with a single term decaying exponential of the form: B0e-kt + C. It is important, however, to determine the model and its parameters when alcohol is already present within the biologic system. Using three individuals as their own controls, mouth alcohol was administered both before and after alcohol consumption followed by breath alcohol analysis performed at approximately 0.5 min intervals. The results showed that both model parameters (B0 and k) are effected and that the asymptotic value (C) is reached much sooner when alcohol already exists in the end-expiratory breath. Considering only three individuals were involved, the forensic-science importance appears to be that, as the end-expiratory breath alcohol concentration increases, the time necessary for the mouth alcohol to decrease to unbiased levels is decreased. Fifteen min of observation time prior to breath alcohol analysis appears to be more than adequate at forensically relevant concentrations.

Breath Tests↗

[An island pectoralis major myocutaneous flap for the reconstruction of tongue and floor of mouth].

OBJECTIVE: To evaluate an island pectoralis major myocutaneous flap for immediate reconstruction of the total tongue body and the floor of the mouth after radical resection of bilateral tongue carcinoma involved. METHODS: Form October 2000 to December 2002, seven patients with bilateral tongue carcinoma were selected to treat with salvage surgery, and an island pectoralis major myocutaneous flap were applied for immediate reconstruction of total body of tongue and floor of mouth. RESULTS: Six flaps survived well. Only one flap showed a partial necrosis, with no submandibular fistula, infection, and other complications. The reconstructed tongue and floor of mouth worked well. The speaking and swallowing functions were satisfactory after 2 approximately 16 months' follow-ups. Only one patient died of lung metastasis carcinoma in 9 months after the operation. CONCLUSIONS: The island pectoralis major myocutaneous flap could be an ideal selection for the immediate reconstruction of the total tongue body and the floor of mouth.

Adult↗

[Mouth guard and occlusal force distribution].

Mouth guards are effective to prevent traumatic injury in maxillofacial region during sports activities. This study was conducted to investigate the influence of wearing mouth guards on occlusal force distribution with the T-scan system. With comparison to the value of average occlusal force level per occlusal point (OFL) on natural dentition and wearing conventional full arch bite plane, following results were obtained. 1) Difference of OFL within the same dental arch became smaller when mouth guards were on. 2) Statistically significant difference in OFL was not found between two mouth guards with different hardness. 3) During three seconds clenching, OFL in posterior region changed great deal at the initiation but stayed at about the same level after that.

Bite Force↗

Oropharyngeal mucositis complicating bone marrow transplantation: prognostic factors and the effect of chlorhexidine mouth rinse.

Oral mucosal ulceration complicating bone marrow transplantation interferes with patients' comfort, nutrition and may lead to systemic infection derived from the mouth. The mucosal injury results from epithelial damage due to the cytotoxic effects of chemotherapy and radiation conditioning as well as from superficial oropharyngeal infection. Because chlorhexidine gluconate is a broad spectrum topical antimicrobial which has been demonstrably effective in preventing oral infection and gingivitis, we performed a randomized, placebo controlled, double-blind trial of chlorhexidine as a mouth rinse in BMT recipients to study the severity of oral mucositis and both oral and systemic infectious complications. One hundred patients were randomly assigned to receive either chlorhexidine gluconate 0.12% mouth rinse or placebo three times daily from the initiation (day -8) of chemoradiotherapy conditioning until day +35 post-BMT. Chlorhexidine use resulted in a trend toward improved oral hygiene index (reduced dental plaque) (p = 0.06) but did not modify the oral mucositis. Patients using chlorhexidine developed a maximum ulceration of 18 +/- 22% of their oral mucosa, while placebo patients ulcerated 25 +/- 31% of the mouth. Ulcerative mucositis was significantly worse in adults compared with children, in individuals who received methotrexate for graft-versus-host disease prophylaxis, and was most prominent on non-keratinized epithelium. Overall, there was no clinically demonstrable additional therapeutic advantage to the use of chlorhexidine in either reducing the mucositis, controlling oral pain, facilitating oral nutrition, shortening hospital stay, or reducing oral infection with herpes simplex virus. There was a trend toward diminished oral candidiasis in chlorhexidine users (p = 0.06).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Role of the nose in inspiration in mouth breathing: quantitative determination by analysis of expiratory gases].

It is widely accepted that increased nasal resistance plays a major role in habitual mouth breathing. We investigated oronasal air flow distribution during voluntary mouth breathing in subjects without nasal obstruction. To determine whether nasal air flow contributes to total inspiratory flow, we administered 100% O2 by a nasal mask while the lips were kept apart by a mouth piece. Expired O2 concentrations measured at the mouth were a sensitive indicator of nasal admixture during inspiration. Theoretical considerations predict that mixed expired pO2 from two consecutive steady state periods should allow calculation of nasal admixture. Measurements made on 22 healthy volunteers revealed a very variable degree of nasal contribution to inspiratory air flow (mean +/- SD, 25 +/- 15%, range 3-70%). There was no correlation between this proportion and anthropometric data, smoking habits, nasal resistance, or presence of rhinitis. We suggest that changes in the position of the soft palate, tongue, and/or pharyngeal wall associated with respiration are mainly responsible for the within and between subject variation observed in this study. This explanation is consistent with recent experimental findings on the pharyngeal dilating muscles.

Adolescent↗

Contraction and relaxation of upper airway muscles during expiratory application of negative pressure at the mouth.

Upper airway muscles (UAM) are activated during inspiration, but little is known about their activity during expiration. We studied six healthy volunteers in supine position. Negative pressure (-10 to -30 cm H2O) was applied cyclically at the mouth during expiration. Subjects actively breathed during inspiration and either contracted or relaxed their UAM during expiration. Supraglottic pressure (Psg) was measured with a catheter with the tip at the supraglottic level. During relaxation, but not during contraction, there was expiratory flow limitation (FL) accompanied by high frequency pressure and flow oscillations (70 +/- 5.7 Hz at -30 cm H2O). The average linear supraglottic resistance was higher during relaxation than during contraction at both -10 and -20 cm H2O (p < 0.05), but not at -30 cm H2O. Amplitude of expiratory genioglossus electromyogram was 3.6 +/- 2.5 mm during quiet breathing, 7.0 +/- 3.8 mm during contraction (p < 0.05) and 4.1 +/- 1.8 mm during relaxation. Average mouth pressure, which immediately preceded pressure (and flow) oscillations was -2.1 +/- 0.9 cm H2O. In one subject cineradiography of the neck during expiratory application of -30 cm H2O showed anterior flexion and high frequency oscillations of the soft palate during relaxation. During contraction, the soft palate was close to the posterior pharyngeal wall without oscillations. We conclude that cyclically applied negative pressure at the mouth during expiration produced expiratory flow limitation during relaxation but not during contraction, and that expiratory contraction of UAM stabilizes upper airways during negative pressure application at the mouth.

Adult↗

Epidemiological, virological, and clinical features of an epidemic of hand, foot, and mouth disease in England and Wales.

We describe the epidemiological, virological, and clinical features of an epidemic of hand, foot, and mouth disease, attributed to coxsackie A virus serotype 16, that occurred throughout England and Wales in the last quarter of 1994. Nine hundred and fifty-two cases were reported by spotter practices that make weekly returns to the Royal College of General Practitioners, which made this the largest epidemic of hand, foot, and mouth disease in England and Wales reported to date. Most patients were aged 1 to 4 years and lived in central or southern regions. Clinical features were unavailable from the weekly returns but were described in detail for 39 patients, mostly by means of a questionnaire to general practitioners near the PHLS Coxsackie Reference Laboratory. All cases had a rash on their hands and 23 also had rashes on their feet and in their mouths. Most cases were mild. Severity was associated with the degree of mouth involvement. Secondary cases in family members were rare. Data from the Royal College of General Practitioners since 1963 reveal a period between epidemics of two to three years. The epidemics in 1988 and 1990 also occurred in the last quarters of these years and cases were concentrated in the central and southern regions.

Adolescent↗

Comparative permeability of various chemical markers through human vaginal and buccal mucosa as well as porcine buccal and mouth floor mucosa.

A number of drugs undergo extensive first-pass metabolism after oral administration, necessitating large doses for effective therapeutic responses in the body. Buccal administration of drugs is becoming more popular because the drugs diffuse into the systemic circulation directly, circumventing the first-pass metabolism. Lower concentrations thus need to be administered and side effects may be minimized. In this study, one of the classic models for human buccal permeability, i.e. the porcine buccal mucosal model, is compared with the more recent human vaginal model and both these are in turn further compared to porcine mouth floor mucosa. To determine the permeability of the different markers (arecoline, 17beta-estradiol, water and vasopressin), a continuous flow-through perfusion system was used (20 degrees C, 24h). Mean steady state flux values were compared statistically using a t-test at a significance level of 5%. Porcine buccal mucosa showed a consistently lower permeability towards all the markers than the other mucosae tested. Porcine mouth floor mucosa was found to be more permeable than porcine buccal mucosa. From these studies we concluded that human vaginal and porcine mouth floor mucosae were superior models for human buccal mucosa than porcine buccal mucosa, using in vitro permeability studies with various chemical markers.

Administration, Buccal↗