Evaluation of the difficulty in deglutition and the development of thickening agents for dysphagia

在本工作中，研究了医院和家庭使用的各种多糖和商业增稠剂的流变性。研究发现，黄原胶-木葡聚糖和木聚糖-凝胶的混合物形成凝胶，但在稀释区每个单独的多糖都不能形成凝胶。用视频荧光法研究了对比剂和增稠剂混合物的饮料量、粘度和屈服应力对吞咽过程的影响，发现粘度太低时会导致无声吸入，而太高的屈服应力会使饮料残留在口咽上。在吞咽过程中，从肌电角度阐明腭帆提肌和腭舌肌的调节是很重要的。当用水作为受试食物时，两个肌肉的活动与…中的吞食量有关更多针对每个受试者的范围，这是根据每个受试者的最佳吞食量单独确定的。当使用相对较高粘度的液体作为试验食物时，吞食量随粘度的变化而发生统计变化。黏度与吞食量呈显著正相关。当被试食物的粘度发生变化时，肌肉活动与粘度和吞食量的关系都发生了显著变化。腭帆提肌活动与粘度和吞食量的变化相关，复相关系数在0.795~0.869之间。然而，舌腭肌活动的复相关系数在0.562到0.745之间。通过稳态剪切粘度、动态粘弹性测定和感官评定，研究了黄原胶(0.6、1.2、2.0%)和不同特性粘度(15.6、16.0、16.5、20.0 dl/g)的黄原胶的流变特性与胡萝卜碎与黄原胶的适口性之间的关系。添加黄原胶减少了胡萝卜碎的数量和咀嚼时间。陈化小组认为，添加黄原胶的胡萝卜碎(特性粘度：15.6dl/g，浓度：0.6%)口感更好，易于吞咽，比不添加黄原胶的胡萝卜碎和切好的胡萝卜块更容易下咽。拥有完整假牙的年龄小组判断，切好的胡萝卜最适合咀嚼，因为胡萝卜碎太小了，不能咀嚼。较少

In the present work, rheological properties of various polysaccharides and commercially available thickening agents used in hospitals and homes have been studied. It was found that the mixtures of xanthan-xyloglucan and xyloglucan-gellan form a gel although each individual polysaccharide does not form a gel in dilute regime. Effects of the quantity of drinks, viscosity and yield stress of the mixture of contrast medium and thickening agent on the swallowing process was examined by videofluorography, and it was found that silent aspiration is induced when the viscosity is too low, and that the too high yield stress of the drinks tend to make remain the drinks on the vallecula.It is important to electromyographically clarify the aspect of regulation of the levator veli palatini and the palatoglossus muscles during transition from the oral to the pharyngeal phases during swallowing. When water was used as tested food, activity of both muscles changed in relation to swallowing volume in a … More range specific to each subject, which was determined on the basis of optimum swallowing volume individually. When liquid with relatively greater viscosity was used as a test food, swallowing volume was statistically changed in relation to change in viscosity. There was significant correlation between viscosity and swallowing volume. When viscosity of test food was changed, both muscle activities were significantly changed in relation to both viscosity and swallowing volume. Levator veli palatini muscle activity was correlated with changes in viscosity and swallowing volume with multiple correlation coefficients ranged from 0.795 to 0.869. However, the multiple correlation coefficients for palatoglossus muscle activity were ranged from 0.562 to 0.745. Therefore, it can be supposed that activity of the palatoglossus muscle could be regulated with other factors as well as two factors tested here.The relationship between the rheological properties of xanthan gum(0.6, 1.2, 2.0%) with different intrinsic viscosities(15.6, 16.0, 16.5, 20.0 dl/g) and the palatabilities of the minced carrots with the xanthan gum was examined by steady shear viscosity, dynamic viscoelasticity measurements, and sensory evaluation. Adding xanthan gum reduced the number and the time for chewing of minced carrots. The aged panel judged that minced carrots with xanthan gum (intrinsic viscosity : 15.6dl/g, concentration : 0.6%) were of better mouthfeel and easy to swallow than minced carrots without xanthan gum and cut carrots without xanthan gum. The age panel with full dentures judged that cut carrots were best to masticate, because minced carrots were too small to masticate. Less