MEDICAL LITERATURE has been deluged during the past few years with books and papers on penicillin; but a book which has been produced under the general editorship of Sir Alexander Fleming himself represents a complete and authoritative summary of penicillin therapy as it stands today.' The book contains a series of independent contributions by \"experienced and eminent men who have worked with penicillin in Great Britain\". Their opinions and practical methods differ slightly, and there is some overlapping; but these are not disadvantageous, comparison and contrast lending interest to the reading. In the first or general section of the book Fleming contributes two chapters, one on the history and development of penicillin, introducing some interesting sidelights in the romance of discovery, the other on the bacteriological control of penicillin therapy. In both chapters the information is set out in meticulous detail and with a clarity and simplicity which can be enjoyed by all readers. Fleming also gives the right perspective to the place of penicillin amongst the antibiotics and lays down the principles of treatment. Both chapters are well illustrated and are the most outstanding in the book. Included in this first section also are chapters on the chemistry and manufacture of penicillin and its pharmacy, pharmacology and methods of administration. The second section of the book is entirely clinical, giving each author's view on the use of penicillin therapy in a disease or an infection of some particular region of the body. The entire range of peniCillin-sensitive conditions is considered in twenty authoritative and clearly written chapters; these contain many references and illustrations. Dental and veterinary diseases are also given fairly full consideration. The final section is a condensed resume of much of the preceding chapters and is written for. the general practttioner. This chapter is superttuous: it does not contain enough detall to be of much practical value. The book as a Whole, however, will undoubtedly be considered a classical contribution to medical literature and is strongly recommended, not only because of the general interest of its topic, but as a reference book on penicillin therapy of hitherto unequalled excellence. The typography, although conforming to war economy standards, is clear and the paper is good. There is an excellent list of references and the index is satisfactory.

Gray's Anatomy

Stage models have been influential in characterizing infant vocalizations in the first year of life. These models are basically descriptive and do not explain why certain types of vocal behaviors occur within a particular stage or why successive patterns of vocalization occur. This review paper summarizes and elaborates a theory of Developmental Functional Modules (DFMs) and discusses how maturational gradients in the DFMs explain age typical vocalizations as well as the transitions between successive stages or other static forms. Maturational gradients are based on biological processes that effect the reconfiguration and remodeling of the respiratory, laryngeal, and craniofacial systems during infancy. From a dynamic systems perspective, DFMs are part of a complex system with multiple degrees of freedom that can achieve stable performance with relatively few control variables by relying on principles such as synergies, self-organization, nonlinear performance, and movement variability. 

The maturational gradient of infant vocalizations: Developmental stages and functional modules

The present study was designed to clarify the role of the motor nerves in velopharyngeal movements. Experiments were carried out on 15 anesthetized rhesus monkeys on the assumption that their velopharyngeal structures are similar to those of human beings. The pattern and degree of velopharyngeal movements with stimulation to the facial, glossopharyngeal, and vagus nerves in the petrosal area were analyzed by means of fiberscopic observations. The results obtained were as follows: 1. Velopharyngeal movements were most active with stimulation to the vagus, then the glossopharyngeal, and, finally, the facial nerve. 2. Complete closure by unilateral stimulation was elicited only by the vagus nerve and not the facial or glossopharyngeal nerves. 3. The pattern of velopharyngeal movements observed when stimulating the facial nerve was quite different from those seen when the glossopharyngeal or the vagus nerve was stimulated. That is, movements in a plane at the upper part of the nasopharynx were observed on stimulating the facial nerve while upward movements from all of the velopharyngeal structures were seen when the glossopharyngeal or vagus nerve was stimulated. 4. Combined stimulation to the nerves sometimes resulted in additive effects on velopharyngeal movements, but these could be recognized in only a few cases. This study reveals that the motor nerves innervating the velopharyngeal muscles play different roles in velopharyngeal movements.

NERVOUS SYSTEM: Roles of the facial, glossopharyngeal and vagus nerves in velopharyngeal movement

The present study attempted to clarify the motor nerve supply of the velopharyngeal muscles. Experiments were carried out on 20 anesthetized rhesus monkeys. Evoked EMG responses of the levator veli palatini, uvula, and superior constrictor pharyngeus muscles, which seem to contribute to velopharyngeal closure, were analyzed by stimulating the cranial nerves within the skull. Results were as follows: 1. Muscle action potentials (M-waves) from the selected muscles could be recognized on stimulating the facial, glossopharyngeal, and vagus nerves at the petrosal area of the temporal bone but were not noted upon accessory nerve stimulation. 2. At maximal stimulation, the vagus gave a greater increase in muscle amplitude than the other nerves studied. This was followed by the glossopharyngeal with the facial nerve producing the least increase in amplitude. 3. Also at maximal stimulation, latencies in the response of the levator veli palatini and uvula muscles were reduced to the greatest degree by stimulation of the vagus, to a lesser extent for the glossopharyngeal, and least for the facial nerve. 4. On stimulating the facial nerve below the stylomastoid foramen, M-waves could not be recognized. From the present study, it was concluded that the levator veli palatini, uvula, and superior constrictor pharyngeus muscles are double innervated by the facial nerve and branches of the pharyngeal plexus derived from the glossopharyngeal and vagus nerves and that the facial nerve plays an important role as one of the motor nerves in movements responsible for velopharyngeal closure.

The motor nerve supply of the velopharyngeal muscles

For the individual tongue muscles, relatively little quantification of uniaxial force, fatigue, and fiber type-specific properties has been documented. Here, we assessed uniaxial-specific force gen...

Tongue muscle contractile, fatigue, and fiber type properties in rats.

Our objective was to determine the branching and distribution of the motor nerves supplying the human soft palate muscles. Six adult specimens of the soft palate in continuity with the pharynx, larynx, and tongue were processed with Sihler's stain, a technique that can render large specimens transparent while counterstaining their nerves. The cranial nerves were identified and dissection followed their branches as they divided into smaller divisions toward their terminations in individual muscles. The results showed that both the glossopharyngeal (IX) and vagus (X) nerves have three distinct branches, superior, middle, and inferior. Only the middle branches of each nerve contributed to the pharyngeal plexus to which the facial nerve also contributed. The pharyngeal plexus was divided into two parts, a superior innervating the palatal and neighboring muscles and an inferior innervating pharyngeal constrictors. The superior branches of the IX and X nerves contributed innervation to the palatoglossus, whereas their middle branches innervated the palatopharyngeus. The palatoglossus and palatopharyngeus muscles appeared to be composed of at least two neuromuscular compartments. The lesser palatine nerve not only supplied the palatal mucosa and palatine glandular tissue but also innervated the musculus uvulae, palatopharyngeus, and levator veli palatine. The latter muscle also received its innervation from the superior branch of X nerve. The findings would be useful for better understanding the neural control of the soft palate and for developing novel neuromodulation therapies to treat certain upper airway disorders such as obstructive sleep apnea.

Innervation of human soft palate muscles

The human soft palate plays an important role in respiration, swallowing, and speech. These motor activities depend on reflexes mediated by sensory nerve endings. To date, the details of human sensory innervation to the soft palate have not been demonstrated. In this study, eight adult human whole-mount (soft palate-tongue-pharynx-larynx-upper esophagus) specimens were obtained from autopsy. Each specimen was bisected in the midline, forming two equal and symmetrical halves. Eight hemi-specimens were processed with Sihler's stain, a whole-mount nerve staining technique. The remaining eight hemi-soft palates were used for immunohistochemical study. The soft palatal mucosa was dissected from the oral and nasal sides and prepared for neurofilament staining. Our results showed that the sensory nerve fibers formed a dense nerve plexus in the lamina propria of the soft palatal mucosa. There was a significant difference in the innervation density between both sides. Specifically, the oral side had higher density of sensory nerve fibers than the nasal side of the soft palate. The mean number and percent area of the sensory nerve fibers in the mucosa of the nasal side was 78% and 72% of those in the mucosa of the oral side, respectively (P < 0.0001). The data presented here could be helpful for further investigating the morphological and quantitative alterations in the sensory nerves in certain upper airway disorders involving the soft palate such as obstructive sleep apnea (OSA) and for designing effective therapeutic strategies to treat OSA. Anat Rec, 301:1861-1870, 2018. © 2018 Wiley Periodicals, Inc.

Sensory Innervation of the Human Soft Palate

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Innervation of human soft palate muscles

Sensory Innervation of the Human Soft Palate