Involuntary cough is superior to voluntary cough for identifying stress urinary incontinence.

Introduction: Voluntary cough (VC) and the laryngeal expiration reflex (LER) provoke stress urinary incontinence (SUI). The aim of this article is to analyze the effectiveness of these stimuli on the timing of urinary leaks.

Material And Methods: Urodynamic testing using pressure catheters was performed on 123 subjects with history of SUI.

Location of the Internal Mammary Vessels for Microvascular Autologous Breast Reconstruction: The "1-2-3 Rule".

Background: Postmastectomy breast reconstruction provides psychosocial benefits in self-esteem, sexuality, and quality of life. Autologous procedures yield the highest overall patient satisfaction compared with implant-based breast reconstruction as the gold standard. The internal mammary vessels are the preferred recipient vessels for free flap breast reconstruction.

What Is the Lobular Branch of the Great Auricular Nerve? Anatomical Description and Significance in Rhytidectomy.

Background: Current literature suggests that preserving the lobular branch of the great auricular nerve has greater impact on sensory function of the auricle than preservation of the posterior branch during rhytidectomy. However, no methodology exists to efficiently and accurately determine the topographic location of the lobular branch. This study describes the branching characteristics of the lobular branch and algorithmic surface markings to assist surgeons in preservation of the great auricular nerve during rhytidectomy flap elevation.

Inspiration closure reflex: the effect of respiration on intrinsic sphincters.

Introduction: The functions of the lower esophageal sphincter (LES) and internal urethral sphincter (IUS) have not been reported during voluntary and involuntary respiratory maneuvers.

Methods: In this study we performed a prospective barium videofluoroscopy study (BSV) of the LES on 4 healthy adult men during voluntary cough (VC), laryngeal expiration reflex (LER), breath-hold maneuvers, and normal inspiration. One subject had fiber-optic pressure catheters placed in the LES and IUS, and electromyographic recording of the right T7-8 intercostals during respiration.

Teaching of anterior cruciate ligament function in osteopathic medical education.

The anterior cruciate ligament (ACL) of the knee and the function of its anteromedial (AM) and posterolateral (PL) bundles are a focus of orthopedic research. Because of the probability that third-year and fourth-year osteopathic medical students will encounter ACL injuries during clinical rotations, it is of paramount importance that students fully understand the functions of the AM and PL bundles as 2 distinct functional components of the ACL. The authors assess the degree to which the AM and PL bundles are discussed within basic science curricula at colleges of osteopathic medicine (COMs).

Anatomic changes related to laryngeal descent from birth to 1 year of age: do they play a role in SIDS?

We conducted a retrospective study to measure laryngeal descent in human infants and to determine if there is any correlation between the associated anatomic changes and the timing of the peak incidence of sudden infant death syndrome (SIDS), which is 2 to 4 months of age. We performed a computerized search of hospital records at our institution to identify magnetic resonance imaging (MRI) scans of the head and neck and plain radiographs of the lateral neck in patients younger than 1 year of age (range: 1 to 357 days). After unusable images were excluded, 79 head and neck MRI scans and 111 lateral neck x-rays were suitable for study.

Intra-abdominal pressures during voluntary and reflex cough.

Background: Involuntary coughing such as that evoked from the larynx, the laryngeal cough reflex (LCR), triggers a coordinated contraction of the thoracic, abdominal and pelvic muscles, which increases intra-abdominal pressure (IAP), displaces the diaphragm upwards and generates the expiratory force for cough and airway clearance. Changes in the IAP during voluntary cough (VC) and the LCR can be measured via a pressure catheter in the bladder. This study evaluated the physiological characteristics of IAP generated during VC and the LCR including peak and mean pressures and calculations of the area under the curve (AUC) values during the time of the cough event or epoch.

Effect of stroke location on the laryngeal cough reflex and pneumonia risk.

Background: The purpose of this study was to evaluate the risk of developing pneumonia in acute stroke patients comparing the early anatomical stroke location and laryngeal cough reflex (LCR) testing.

Methods: A prospective study of 818 consecutive acute stroke patients utilizing a reflex cough test (RCT), which assesses the neurological status of the LCR compared to magnetic resonance imaging or computerized tomography for stroke location and subsequent pneumonia outcome. Stroke diagnosis and stroke location were made by a neurologist and clinical radiologist, respectively; both were blinded to the RCT results.

Effect of acute unilateral middle cerebral artery infarcts on voluntary cough and the laryngeal cough reflex.

Objective: The purpose of this study was to assess the effect of acute unilateral middle cerebral artery (MCA) infarctions in right-handed subjects on their ability to elicit voluntary cough (VC), and separately to assess the laryngeal cough reflex using the reflex cough test.

Design: This prospective, clinical study involved 30 right-handed, alert subjects with no previous history of stroke or asthma and with an infarction of the MCA distribution as seen on computed tomographic or magnetic resonance images. Subjects could follow verbal commands.

Effect of tartaric acid-induced cough on pulmonary function in normal and asthmatic humans.

Objective: The laryngeal cough reflex and the laryngeal cough expiratory reflex are brainstem reflexes that protect the upper airway from significant aspiration. The purpose of this investigation was to examine the effects of tartaric acid-induced cough on pulmonary function in normal healthy and asthmatic individuals.

Design: Twenty healthy and 20 asymptomatic, medicated, asthmatic volunteers engaged in a two-part evaluation of pulmonary function testing.

Electrophysiologic latency to the external obliques of the laryngeal cough expiration reflex in humans.

Objective: The purpose of this study was to trigger the laryngeal cough expiration reflex using inhaled tartaric acid aerosol and to record the latency between the time of initiation of the laryngeal cough expiration reflex component of the laryngeal cough reflex and the onset of electromyographically recorded responses in the external abdominal oblique in humans.

Design: Five male subjects were tested in the seated position, and four latencies were recorded for each subject. The latencies were recorded from laryngeal stimulation to an electromyogram in the muscle belly of the left external abdominal oblique.