An image processing technique with associated hardware was developed to quantitatively extract hy... more An image processing technique with associated hardware was developed to quantitatively extract hyoid bone motion from real time submandibular ultrasound images recorded during the swallowing act. Videofluorographi c imaging, the "gold standard" of swallowing studies, was recorded simultaneo usly and synchronized to the ultrasound. Hyoid position obtained from the ultrasound was validated based on the videofluorography using personal computer-based image processing methods.
A three-dimensional ultrasound imaging system was developed for studying tongue configurations du... more A three-dimensional ultrasound imaging system was developed for studying tongue configurations during speech and swallowing. A sequence of two-dimensional ultrasound B- mode images was acquired by moving the ultrasound transducer under the subject's chin. A six-degree-of-freedom electromagnetic position sensor was used in order to determine the spatial position and orientation of the ultrasound transducer during the scanning. Registration of image slices was achieved by using a time code generator to synchronize ultrasound images with the spatial information. Techniques were developed for 3D reconstruction of the tongue surface from multi-planar ultrasound scans using both commercial software and NIH- developed programs for PC and Macintosh computers. The system demonstrated its potential to quickly acquire and reconstruct 3D tongue images, and to assist speech pathologists and radiologists in speech and swallowing disorder diagnosis.
Otolaryngologic Clinics of North America, Nov 1, 1988
A description of the variety of diagnostic techniques used to study dysphagia is presented. The a... more A description of the variety of diagnostic techniques used to study dysphagia is presented. The advantages and limitations of each are discussed along with a description of how each procedure evaluates the actual components of swallowing, both normal and abnormal. Diagnostic decision points in the course of diagnosis and treatment and discussed.
OBJECTIVES To determine the characteristics of swallowing and speech disturbances in patients wit... more OBJECTIVES To determine the characteristics of swallowing and speech disturbances in patients with corticobasal syndrome (CBS) compared to healthy controls, and whether a subjective swallowing questionnaire, the NIH-Speech Pathology swallowing questionnaire (NIH-SQ), can predict swallowing impairment. METHODS Twenty-four consecutive CBS patients underwent a swallowing assessment comprised of the NIH-SQ, ultrasound swallow study (US) and modified barium swallow (MBS) study. Healthy controls (n = 28) completed the NIH-SQ and the US. RESULTS Ninety-six percent of the patients with CBS reported at least one complaint in the NIH-SQ, 59% had abnormal dry swallow duration and 10% abnormal wet swallow duration. Twenty-three patients with CBS had some abnormality on the MBS. The MBS category "piecemeal deglutition" (excessive lingual gestures causing multiple swallows required to clear a single bolus) was characteristic of CBS patients. No aspiration was detected. No NIH-SQ cutoff score or combination of subjective complaints predicted an abnormal MBS. Fifty-two percent of the patients had speech apraxia. CONCLUSIONS Swallowing and speech disturbances are common in patients with CBS and differ from those previously reported in patients with PSP syndrome. Piecemeal deglutition and speech apraxia are characteristic features of our CBS patients. Although the NIH-SQ cannot predict the results of the more objective MBS in this population, it characterizes the patients' major subjective swallowing complaints.
Obstructive sleep apnea (OSA) is associated with major morbidity and daytime somnolence.1 Locatio... more Obstructive sleep apnea (OSA) is associated with major morbidity and daytime somnolence.1 Location of the obstruction cannot be determined by polysomnography, thereby contributing to variance in cure rates for surgical procedures such as uvulopalatopharyngoplasty (UPPP).2,3 There is no clinically accepted, comfortable, and noninvasive method for visualizing the airway during sleep. Ultrasonic imaging of the airway is an established method used in the evaluation of swallowing.4,5 It is a dynamic, safe method, permitting the noninvasive visualization of soft-tissue structures of the pharynx.5 Ultrasound has never been used in the evaluation of OSA. Five male subjects age 35 to 57 years with OSA underwent this procedure. All subjects had apnea indices greater than 35. One subject had undergone unsuccessful UPPP in the past, and all subjects were using continuous positive airway pressure (CPAP) at home. Video output from …
To study the effects of the adenine analog, fludarabine, on patients with refractory dermatomyosi... more To study the effects of the adenine analog, fludarabine, on patients with refractory dermatomyositis and polymyositis, and to assess variables used in following myositis patients during medical intervention. Patients whose myositis was not controlled by prednisone and at least one other immunosuppressive medication were entered into a pilot study during which they received 6 monthly cycles of intravenous fludarabine. Patients were assessed at baseline, every other month, and at month 7 for primary outcome measures of strength and function. Other measurements including peripheral blood cell subsets, muscle enzymes, and various assessments of disease activity were followed monthly during the fludarabine infusion period and for up to 6 months post therapy. Of 16 patients who entered the study, 4 patients were classified as improved, and 7 patients were classified as unchanged. Five patients who withdrew before month 7 were classified as treatment failures. Fludarabine caused a signific...
Our investigation of fetal swallowing has identified potential limitations in the use of color Do... more Our investigation of fetal swallowing has identified potential limitations in the use of color Doppler imaging for detection of amniotic fluid flow and discrimination of respiratory from ingestive activity. The objective of this study was to evaluate an alternative imaging modality, power Doppler sonography, as a technique to enhance detection of amniotic fluid flow in the upper aerodigestive tract. We applied a standardized 4-axis sonographic examination of upper aerodigestive structures and used power Doppler imaging to document amniotic fluid flow. Normal aerodigestive activities from 62 healthy control subjects were compared with 4 abnormal cases. Our longitudinal experience with 66 subjects showed that a directed evaluation of the fetal upper aerodigestive tract with power Doppler imaging provided a systematic approach for studying the physiologic development of this region in both healthy and at-risk fetuses. A standardized 4-axis examination with power Doppler imaging is a useful adjunct in addressing ingestive and respiratory functions in the developing fetus.
Shinichi Abe Muhammad Bilal Abid B Adeleye Joan Arvedson James Barthel Peter Belafsky Mark Bianch... more Shinichi Abe Muhammad Bilal Abid B Adeleye Joan Arvedson James Barthel Peter Belafsky Mark Bianchi Joel Blumin Leonardo Bonilha Heather Bonilha Worth Boyce S Brady Daniel Brasnu James G. Brasseur Deanna Britton Martin Brodsky Margareta Bulow Margareta Bülow Adam Burbidge Susan Butler Giselle Carnaby Danielle Carneiro Chin-wen Chang Ratanapat Chanubol Julie Cichero Naomi Cocks Ian Cook James Coyle MIchael Crary Marinos C. Dalakas Stephanie K. Daniels Paul Davenport Tom R. DeMeester Numan Demir Pamela Dodrill Kulwinder Dua Caryn Easterling Olle Ekberg Cumhur Ertekin Louise Gallagher Rebecca German Marion Boyd Gillespie Michael Groher Roxann Gross Lucinda Halstead Shaheen Hamdy Kozo Hanayama Gady Har-El Dana Hartl Bas Heijnen Maggie-Lee Huckabee Ianessa Humbert Kate Hutcheson Sudarshan Jadcherla Peter Kahrilas Jun Kayashita Mark Kern HyangHee Kim Youngsun Kim Motoi Kobashi Gintas Krisciunas Hitoshi Kurabayashi Ivan Lang Patricia Langdon Susan Langmore Chantal Lau Cathy Lazarus Steven B. Leder Christian Ledl Maureen Lefton-Greif Rebecca Leonard Norman A. Leopold Jeri Logemann Fernanda Loureiro Donna Lundy Ruth E. Martin Rosemary Martino Benson Massey Timothy McCulloch Gary H. McCullough David McFarland Betty McMicken Albert Merati Ray Merrill Krisztina Mészáros Arthur Miller Robert M. Miller Lori Morgan Joseph Murray Elizabeth Musto Lisa Newman Mark A. Nicosia Sonoko Nozaki
An image processing technique with associated hardware was developed to quantitatively extract hy... more An image processing technique with associated hardware was developed to quantitatively extract hyoid bone motion from real time submandibular ultrasound images recorded during the swallowing act. Videofluorographi c imaging, the "gold standard" of swallowing studies, was recorded simultaneo usly and synchronized to the ultrasound. Hyoid position obtained from the ultrasound was validated based on the videofluorography using personal computer-based image processing methods.
A three-dimensional ultrasound imaging system was developed for studying tongue configurations du... more A three-dimensional ultrasound imaging system was developed for studying tongue configurations during speech and swallowing. A sequence of two-dimensional ultrasound B- mode images was acquired by moving the ultrasound transducer under the subject's chin. A six-degree-of-freedom electromagnetic position sensor was used in order to determine the spatial position and orientation of the ultrasound transducer during the scanning. Registration of image slices was achieved by using a time code generator to synchronize ultrasound images with the spatial information. Techniques were developed for 3D reconstruction of the tongue surface from multi-planar ultrasound scans using both commercial software and NIH- developed programs for PC and Macintosh computers. The system demonstrated its potential to quickly acquire and reconstruct 3D tongue images, and to assist speech pathologists and radiologists in speech and swallowing disorder diagnosis.
Otolaryngologic Clinics of North America, Nov 1, 1988
A description of the variety of diagnostic techniques used to study dysphagia is presented. The a... more A description of the variety of diagnostic techniques used to study dysphagia is presented. The advantages and limitations of each are discussed along with a description of how each procedure evaluates the actual components of swallowing, both normal and abnormal. Diagnostic decision points in the course of diagnosis and treatment and discussed.
OBJECTIVES To determine the characteristics of swallowing and speech disturbances in patients wit... more OBJECTIVES To determine the characteristics of swallowing and speech disturbances in patients with corticobasal syndrome (CBS) compared to healthy controls, and whether a subjective swallowing questionnaire, the NIH-Speech Pathology swallowing questionnaire (NIH-SQ), can predict swallowing impairment. METHODS Twenty-four consecutive CBS patients underwent a swallowing assessment comprised of the NIH-SQ, ultrasound swallow study (US) and modified barium swallow (MBS) study. Healthy controls (n = 28) completed the NIH-SQ and the US. RESULTS Ninety-six percent of the patients with CBS reported at least one complaint in the NIH-SQ, 59% had abnormal dry swallow duration and 10% abnormal wet swallow duration. Twenty-three patients with CBS had some abnormality on the MBS. The MBS category "piecemeal deglutition" (excessive lingual gestures causing multiple swallows required to clear a single bolus) was characteristic of CBS patients. No aspiration was detected. No NIH-SQ cutoff score or combination of subjective complaints predicted an abnormal MBS. Fifty-two percent of the patients had speech apraxia. CONCLUSIONS Swallowing and speech disturbances are common in patients with CBS and differ from those previously reported in patients with PSP syndrome. Piecemeal deglutition and speech apraxia are characteristic features of our CBS patients. Although the NIH-SQ cannot predict the results of the more objective MBS in this population, it characterizes the patients' major subjective swallowing complaints.
Obstructive sleep apnea (OSA) is associated with major morbidity and daytime somnolence.1 Locatio... more Obstructive sleep apnea (OSA) is associated with major morbidity and daytime somnolence.1 Location of the obstruction cannot be determined by polysomnography, thereby contributing to variance in cure rates for surgical procedures such as uvulopalatopharyngoplasty (UPPP).2,3 There is no clinically accepted, comfortable, and noninvasive method for visualizing the airway during sleep. Ultrasonic imaging of the airway is an established method used in the evaluation of swallowing.4,5 It is a dynamic, safe method, permitting the noninvasive visualization of soft-tissue structures of the pharynx.5 Ultrasound has never been used in the evaluation of OSA. Five male subjects age 35 to 57 years with OSA underwent this procedure. All subjects had apnea indices greater than 35. One subject had undergone unsuccessful UPPP in the past, and all subjects were using continuous positive airway pressure (CPAP) at home. Video output from …
To study the effects of the adenine analog, fludarabine, on patients with refractory dermatomyosi... more To study the effects of the adenine analog, fludarabine, on patients with refractory dermatomyositis and polymyositis, and to assess variables used in following myositis patients during medical intervention. Patients whose myositis was not controlled by prednisone and at least one other immunosuppressive medication were entered into a pilot study during which they received 6 monthly cycles of intravenous fludarabine. Patients were assessed at baseline, every other month, and at month 7 for primary outcome measures of strength and function. Other measurements including peripheral blood cell subsets, muscle enzymes, and various assessments of disease activity were followed monthly during the fludarabine infusion period and for up to 6 months post therapy. Of 16 patients who entered the study, 4 patients were classified as improved, and 7 patients were classified as unchanged. Five patients who withdrew before month 7 were classified as treatment failures. Fludarabine caused a signific...
Our investigation of fetal swallowing has identified potential limitations in the use of color Do... more Our investigation of fetal swallowing has identified potential limitations in the use of color Doppler imaging for detection of amniotic fluid flow and discrimination of respiratory from ingestive activity. The objective of this study was to evaluate an alternative imaging modality, power Doppler sonography, as a technique to enhance detection of amniotic fluid flow in the upper aerodigestive tract. We applied a standardized 4-axis sonographic examination of upper aerodigestive structures and used power Doppler imaging to document amniotic fluid flow. Normal aerodigestive activities from 62 healthy control subjects were compared with 4 abnormal cases. Our longitudinal experience with 66 subjects showed that a directed evaluation of the fetal upper aerodigestive tract with power Doppler imaging provided a systematic approach for studying the physiologic development of this region in both healthy and at-risk fetuses. A standardized 4-axis examination with power Doppler imaging is a useful adjunct in addressing ingestive and respiratory functions in the developing fetus.
Shinichi Abe Muhammad Bilal Abid B Adeleye Joan Arvedson James Barthel Peter Belafsky Mark Bianch... more Shinichi Abe Muhammad Bilal Abid B Adeleye Joan Arvedson James Barthel Peter Belafsky Mark Bianchi Joel Blumin Leonardo Bonilha Heather Bonilha Worth Boyce S Brady Daniel Brasnu James G. Brasseur Deanna Britton Martin Brodsky Margareta Bulow Margareta Bülow Adam Burbidge Susan Butler Giselle Carnaby Danielle Carneiro Chin-wen Chang Ratanapat Chanubol Julie Cichero Naomi Cocks Ian Cook James Coyle MIchael Crary Marinos C. Dalakas Stephanie K. Daniels Paul Davenport Tom R. DeMeester Numan Demir Pamela Dodrill Kulwinder Dua Caryn Easterling Olle Ekberg Cumhur Ertekin Louise Gallagher Rebecca German Marion Boyd Gillespie Michael Groher Roxann Gross Lucinda Halstead Shaheen Hamdy Kozo Hanayama Gady Har-El Dana Hartl Bas Heijnen Maggie-Lee Huckabee Ianessa Humbert Kate Hutcheson Sudarshan Jadcherla Peter Kahrilas Jun Kayashita Mark Kern HyangHee Kim Youngsun Kim Motoi Kobashi Gintas Krisciunas Hitoshi Kurabayashi Ivan Lang Patricia Langdon Susan Langmore Chantal Lau Cathy Lazarus Steven B. Leder Christian Ledl Maureen Lefton-Greif Rebecca Leonard Norman A. Leopold Jeri Logemann Fernanda Loureiro Donna Lundy Ruth E. Martin Rosemary Martino Benson Massey Timothy McCulloch Gary H. McCullough David McFarland Betty McMicken Albert Merati Ray Merrill Krisztina Mészáros Arthur Miller Robert M. Miller Lori Morgan Joseph Murray Elizabeth Musto Lisa Newman Mark A. Nicosia Sonoko Nozaki
Uploads
Papers