Tongue pressure modulation for initial gel consistency in a different oral strategy.

BACKGROUND: In the recent hyper-aged societies of developed countries, the market for soft diets for patients with dysphagia has been growing and numerous jelly-type foods have become available. However, interrelationships between the biomechanics of oral strategies and jelly texture remain unclear. The present study investigated the influence of the initial consistency of jelly on tongue motor kinetics in different oral strategies by measuring tongue pressure against the hard palate. METHODS: Jellies created as a mixture of deacylated gellan gum and psyllium seed gum with different initial consistencies (hard, medium or soft) were prepared as test foods. Tongue pressure production while ingesting 5 ml of jelly using different oral strategies (Squeezing or Mastication) was recorded in eight healthy volunteers using an ultra-thin sensor sheet system. Maximal magnitude, duration and total integrated values (tongue work) of tongue pressure for size reduction and swallowing in each strategy were compared among initial consistencies of jelly, and between Squeezing and Mastication. RESULTS: In Squeezing, the tongue performed more work for size reduction with increasing initial consistency of jelly by modulating both the magnitude and duration of tongue pressure over a wide area of hard palate, but tongue work for swallowing increased at the posterior-median and circumferential parts by modulating only the magnitude of tongue pressure. Conversely, in Mastication, the tongue performed more work for size reduction with increasing initial consistency of jelly by modulating both magnitude and duration of tongue pressure mainly at the posterior part of the hard palate, but tongue work as well as other tongue pressure parameters for swallowing showed no differences by type of jelly. CONCLUSIONS: These results reveal fine modulations in tongue-palate contact according to the initial consistency of jelly and oral strategies.

A novel approach to therapeutic angiogenesis for patients with critical limb ischemia by sustained release of basic fibroblast growth factor using biodegradable gelatin hydrogel: an initial report of the phase I-IIa study.

BACKGROUND: Limb ischemia remains a challenge. To overcome shortcomings or limitations of gene therapy or cell transplantation, a sustained release system of basic fibroblast growth factor (bFGF) using biodegradable gelatin hydrogel has been developed. METHODS AND RESULTS: A phase I-IIa study was performed, in which 7 patients had critical limb ischemia. They were intramuscularly injected with 200 microg of bFGF-incorporated gelatin hydrogel microspheres into the gastrocnemius of the ischemic limb. End-points were safety and feasibility of treatment after 4 and 24 weeks. One patient was excluded from the study for social reasons, but only after symptomatic improvements. In the evaluation of the other 6 patients, significant improvements were observed in the distance walked in 6 min (295+/-42 m vs 491+/-85 m for pretreatment vs after 24 weeks, p=0.023) and in transcutaneous oxygen pressure (53.5+/-5.2 mmHg vs 65.5+/-4.0 mmHg, p=0.03). The rest pain scale also improved (3.5+/-0.2 vs 1.0+/-0.6, p=0.022). The ankle-brachial pressure index improved at 4 weeks but not at 24 weeks. Among 5 patients who had a non-healing foot ulcer, the ulcer was completely healed in 3 patients, reduced in 1, and there was no change in 1 patient at 24 weeks. The blood levels of bFGF were undetected or within the normal level in all patients. CONCLUSIONS: The sustained release of bFGF from gelatin hydrogel might be simple, safe, and effective to achieve therapeutic angiogenesis because it did not need genetic materials or collection of implanted cells, and because it did not have any general effects, which was supported by there being no elevation of the bFGF serum level.