scholarly journals Pathological disease in the lung periphery after acute COVID-19

2021 ◽  
Author(s):  
Salman Siddiqui ◽  
Christopher E Brightling
Keyword(s):  
Lung Periphery ◽  
Pathological Disease

38. Max Brodel (1870-1941): His artistic influence on surgical learning at John Hopkins Medical School

2007 ◽  
Vol 30 (4) ◽  
pp. 47
Author(s):  
P. Pace-Asciak ◽  
T. Gelfand
Keyword(s):  
New York ◽  
Neck Surgery ◽  
The United States ◽  
Spoken Word ◽  
Medical Illustration ◽  
3 Dimensional ◽  
Teaching Anatomy ◽  
Computer Based ◽  
Pathological Disease

Medical students depend on illustration to learn anatomical facts and details that may be too subtle for the written or spoken word. For surgical disciplines, learners rely on tools such as language, 2-dimensional illustrations, and 3-dimensional models to pass on important concepts. Although a photograph can convey factual information, illustration can highlight and educate the pertinent details for understanding surgical procedures, neurovascular structures, and the pathological disease processes. In order to understand the current role of medical illustration in education, one needs to look to the past to see how art has helped solve communication dilemmas when learning medicine. This paper focuses on Max Brodel (1870-1941), a German-trained artist who eventually immigrated to the United States to pursue his career as a medical illustrator. Shortly after his arrival in Baltimore, Brodel made significant contributions to medical illustration in Gynecology at John Hopkins University, and eventually in other fields of medicine such as Urology and Otolaryngology. Brodel is recognized as one of America’s most distinguished medical illustrators for creating innovative artistic techniques and founding the profession of medical illustration. Today, animated computer based art is synergistically used with medical illustration to educate students about anatomy. Some of the changes that have occurred with the advancement of computer technology will be highlighted and compared to a century ago, when illustrations were used for teaching anatomy due to the scarcity of cadavers. Schultheiss D, Udo J. Max Brodel (1870-1941) and Howard A.Kelly (1858-1943) – Urogynecology and the birth of modern medical illustration. European Journal of Obstetrics & gynecology and Reproductive Biology 1999; 86:113-115. Crosby C. Max Brodel: the man who put art into medicine. New York: Springer-Verlag, 1991. Papel ID. Max Brodel’s contributions to otolaryngology – Head and Neck surgery. The American Journal of Otology 1986; 7(6):460-469.

Perfusion of lung periphery: effects of local exposures to ozone and pressure

1986 ◽  
Vol 61 (2) ◽  
pp. 640-646
Author(s):  
A. N. Freed ◽  
U. A. Scheffel ◽  
L. J. Kelly ◽  
B. Bromberger-Barnea ◽  
H. A. Menkes
Keyword(s):  
High Pressure ◽  
Pulmonary Perfusion ◽  
Alveolar Pressure ◽  
Anesthetized Dogs ◽  
Lung Periphery ◽  
Airways Reactivity ◽  
Collateral System

Following ozone (O3) exposure, airways reactivity increases. We investigated the possibility that exposure to O3 causes a decrease in pulmonary perfusion, and that this decrease is associated with the increase in reactivity. Perfusion was measured with radiolabeled microspheres. A wedged bronchoscope was used to isolate sublobar segments in the middle and lower lobes of anesthetized dogs. Isolated segments were exposed to either O3 or an elevated alveolar pressure. Although increased alveolar pressure decreased microsphere density, exposure to 1 ppm O3 did not. Collateral system resistance rose significantly following exposure to O3 and to high pressure. These studies do not support the hypothesis that pulmonary perfusion is decreased following O3 exposure and is associated with subsequent increases in reactivity.

Airway pressures in an asymmetrically branched airway model of the dog respiratory system

1984 ◽  
Vol 57 (4) ◽  
pp. 1222-1230 ◽  
Author(s):  
Andrew C. Jackson ◽  
Mehrdad Tabrizi ◽  
Michael I. Kotlikoff ◽  
Jon R. Voss
Keyword(s):  
Respiratory System ◽  
High Frequency ◽  
High Frequency Ventilation ◽  
Tissue Properties ◽  
Pressure Distributions ◽  
Lumped Parameter ◽  
Airway Opening ◽  
Frequency Ventilation ◽  
Lung Periphery ◽  
Airway Model

A computer model of the mechanical properties of the dog respiratory system based on the asymmetrically branching airway model of Horsfield et al. (11) is described. The peripheral ends of this airway model were terminated by a lumped-parameter impedance representing gas compression in the alveoli, and lung and chest wall tissue properties were derived from measurements made in this laboratory. Using this model we predicted the respiratory system impedance and the distribution of pressures along the airways in the dog lung. Predicted total respiratory system impedances for frequencies between 4 and 64 Hz at three lung volumes were found to compare quite closely to measured impedances in dogs. Serial pressure distributions were found to be frequency-dependent and to result in higher pressures in the lung periphery than at the airway opening at some frequencies. The implications of this fading for high-frequency ventilation are discussed. impedance; high-frequency ventilation; central airway resistance; respiratory system resistance; airway pressure distribution; distribution of ventilation Submitted on November 14, 1983 Accepted on May 8, 1984

scholarly journals Cardiac Amyloidosis: A Review of Current Imaging Techniques

2021 ◽  
Vol 8 ◽  
Author(s):  
Yousuf Razvi ◽  
Rishi K. Patel ◽  
Marianna Fontana ◽  
Julian D. Gillmore
Keyword(s):  
Bone Scintigraphy ◽  
Cardiac Amyloidosis ◽  
Tissue Characterization ◽  
Amyloid Fibrils ◽  
Imaging Techniques ◽  
Significant Proportion ◽  
Disease Process ◽  
Heterogenous Group ◽  
Pathological Disease ◽  
Over Time

Systemic amyloidosis is a rare, heterogenous group of diseases characterized by extracellular infiltration and deposition of amyloid fibrils. Cardiac amyloidosis (CA) occurs when these fibrils deposit within the myocardium. Untreated, this inevitably leads to progressive heart failure and fatality. Historically, treatment has remained supportive, however, there are now targeted disease-modifying therapeutics available to patients with CA. Advances in echocardiography, cardiac magnetic resonance (CMR) and repurposed bone scintigraphy have led to a surge in diagnoses of CA and diagnosis at an earlier stage of the disease natural history. CMR has inherent advantages in tissue characterization which has allowed us to better understand the pathological disease process behind CA. Combined with specialist assessment and repurposed bone scintigraphy, diagnosis of CA can be made without the need for invasive histology in a significant proportion of patients. With existing targeted therapeutics, and novel agents being developed, understanding these imaging modalities is crucial to achieving early diagnosis for patients with CA. This will allow for early treatment intervention, accurate monitoring of disease course over time, and thereby improve the length and quality of life of patients with a disease that historically had an extremely poor prognosis. In this review, we discuss key radiological features of CA, focusing on the two most common types; immunoglobulin light chain (AL) and transthyretin (ATTR) CA. We highlight recent advances in imaging techniques particularly in respect of their clinical application and utility in diagnosis of CA as well as for tracking disease change over time.

Unusual thoracic radiographic findings in children treated for Hodgkin's disease.

1986 ◽  
Vol 4 (6) ◽  
pp. 874-882 ◽  
Author(s):  
M S Jochelson ◽  
N J Tarbell ◽  
H J Weinstein
Keyword(s):  
Hodgkin's Disease ◽  
Radiation Pneumonitis ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Radiographic Findings ◽  
Appropriate Treatment ◽  
Mediastinal Widening ◽  
Lung Periphery ◽  
Inflammatory Changes ◽  
Radiographic Changes

Mantle irradiation is often part of the treatment for Hodgkin's disease. Localized pneumonitis and fibrosis are well-known sequelae of this treatment. We report nine patients with unusual thoracic radiographic findings following treatment for Hodgkin's disease. All nine had mediastinal widening. Seven of these patients received combined modality therapy in which prednisone was given with their MOPP. In these seven patients, an increase in mediastinal width developed at the same time as the radiographic changes of radiation pneumonitis. Two patients developed bilateral infiltrates extending beyond the field of radiation to the lung periphery. In one of these patients, a spontaneous pneumomediastinum developed. One patient underwent mediastinal biopsy that revealed inflammatory changes similar to those seen in radiation pneumonitis. All patients either responded to steroids or had spontaneous regression of radiographic abnormalities supporting the presumed diagnosis of treatment related changes. Recognition of these unusual sequelae of mantle irradiation will aid in differentiating them from infection or tumor and lead to prompt, appropriate treatment.

How changes in the serial distribution of bronchoconstriction affect lung mechanics

1993 ◽  
Vol 74 (6) ◽  
pp. 2838-2847 ◽  
Author(s):  
F. M. Robatto ◽  
S. Simard ◽  
M. S. Ludwig
Keyword(s):  
Direct Effect ◽  
Coefficient Of Variation ◽  
Lung Parenchyma ◽  
Lung Mechanics ◽  
Response Curves ◽  
Mechanical Heterogeneity ◽  
Airway Constriction ◽  
Lung Resistance ◽  
Lung Periphery ◽  
Central Airway

It is generally accepted that methacholine (MCh) acts predominantly on the central airways and histamine (H) acts on the lung periphery. We hypothesized therefore that lung mechanics would be affected differently by H and MCh aerosols. In 12 anesthetized paralyzed open-chest mongrel dogs, we obtained MCh (0.1–30 mg/ml, n = 6) and H (0.1–30 mg/ml, n = 6) concentration-response curves. The alveolar capsule technique was used to partition lung resistance (RL) into airway (Raw) and tissue (Rti) components. The degree of mechanical heterogeneity across the lung was assessed by computing the coefficient of variation for five alveolar pressures during relaxed expirations. RL increased 823 +/- 202% after H and 992 +/- 219% after MCh. Rti increased 784 +/- 192% after H and 1,014 +/- 279% after MCh. Raw increased 1,098 +/- 297% after H and 1,275 +/- 332% after MCh. Elastance increased 342 +/- 53% after H and 423 +/- 88% after MCh. The coefficient of variation increased 279 +/- 65% after H and 252 +/- 55% after MCh. The patterns of change were similar throughout the H and MCh concentration-response curves. We conclude that H and MCh have comparable effects on lung mechanics and that the degree and pattern of heterogeneity inside the lung after constriction are the same regardless of the agent used. These data support the hypothesis that H and MCh have some similar direct effect on the lung parenchyma. Parenchymal deformation after MCh-induced central airway constriction alone would be unlikely to explain increases in Rti of this magnitude or changes in lung mechanics so similar to those induced by H.

Diffusivity dependence of multiple-breath washouts of lung periphery

1990 ◽  
Vol 68 (1) ◽  
pp. 76-83 ◽  
Author(s):  
G. G. Berdine ◽  
D. Dale ◽  
J. E. Johnson ◽  
J. L. Lehr
Keyword(s):  
Tidal Volume ◽  
Exponential Decay ◽  
Local Minimum ◽  
Local Maximum ◽  
Inspiratory Flow ◽  
Normal Range ◽  
Lung Periphery ◽  
Kinetics Of ◽  
And Diffusion ◽  
Single Exponential

Subpleural concentrations of He and SF6 were measured during multiple-breath washouts from isolated dog lungs. Tidal volume, inspiratory flow, and frequency were in the normal range of canine ventilation. For each gas, there was a local minimum in concentration during inspiration (Cinsp) and a local maximum in concentration during exhalation (Cexp). SF6 exhibited a deeper inspiratory trough than He for each breath of every washout. For large tidal volumes (10-20 ml/kg), Cexp approximated a single exponential decay and He was cleared more rapidly than SF6. For small tidal volumes (2.5 ml/kg), Cexp was multiexponential and SF6 was cleared more rapidly than He. Cinsp/Cexp (a measure of the depth of the inspiratory trough) and the kinetics of Cexp decay were determined for washouts using a tidal volume of 10 and 20 ml/kg and different inspiratory flows. Under all conditions, an increase of inspiratory flow resulted in a deeper inspiratory trough for both He and SF6. For washouts using 10 ml/kg and 60 breaths/min, an increase of inspiratory flow increased the clearance of both gases. In washouts using lower ventilatory frequencies, gas clearance was independent of inspiratory flow. These findings are contrary to predictions of contemporary models of convection and diffusion in the lung. This study suggests that convective axial mixing and radial diffusion in the airways are important determinants of pulmonary gas transport.

Effects of homogeneous and heterogeneous changes in the lung periphery on spirometry results

2019 ◽  
Vol 173 ◽  
pp. 139-145 ◽  
Author(s):  
Adam G. Polak ◽  
Dariusz Wysoczański ◽  
Janusz Mroczka
Keyword(s):  
Lung Periphery
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