scholarly journals Thoracic shape changes in newborns due to their position

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Serena de Gelidi ◽  
Andy Bardill ◽  
Nima Seifnaraghi ◽  
Yu Wu ◽  
Andreas Demosthenous ◽  
...  
Keyword(s):  
Chest Wall ◽  
Cross Section ◽  
Supine Position ◽  
Respiratory Diseases ◽  
Morphological Changes ◽  
Premature Neonate ◽  
Smart Measurement ◽  
Shape Changes

AbstractThe highly compliant nature of the neonatal chest wall is known to clinicians. However, its morphological changes have never been characterized and are especially important for a customised monitoring of respiratory diseases. Here, we show that a device applied on newborns can trace their chest boundary without the use of radiation. Such technology, which is easy to sanitise between patients, works like a smart measurement tape drawing also a digital cross section of the chest. We also show that in neonates the supine position generates a significantly different cross section compared to the lateral ones. Lastly, an unprecedented comparison between a premature neonate and a child is reported.

Relationships among pressure, tension, and shape of the diaphragm

1983 ◽  
Vol 55 (6) ◽  
pp. 1899-1905 ◽  
Author(s):  
W. A. Whitelaw ◽  
L. E. Hajdo ◽  
J. A. Wallace
Keyword(s):  
Cross Section ◽  
Radius Of Curvature ◽  
Transdiaphragmatic Pressure ◽  
Rib Cage ◽  
Residual Capacity ◽  
Best Fitting ◽  
Pressure Generator ◽  
Free Membrane ◽  
Relationship Of ◽  
Shape Changes

The shape of the diaphragm dome was calculated from transdiaphragmatic pressure and tension in the diaphragm. It was assumed that the muscle acts as a free membrane, attached at its edges to the inside of a vertical rib cage circular in cross section, that the attachments are inferior to the point at which the dome makes contract with the rib cage, and that the abdomen is filled with fluid with a hydrostatic gradient in pressure. The shape is different from a section of a sphere, with a radius of curvature substantially greater at the apex of the dome than at the sides. Observed shapes of human hemidiaphragm domes at functional residual capacity are not spherical but closely match the calculated shapes. Best-fitting shapes correspond to transdiaphragmatic pressures of about 3 cmH2O transdiaphragmatic pressure, suggesting that such a pressure and corresponding tension are present in the human diaphragm when it is at rest in an erect subject. In this model; as lung volume increases and the diaphragm shortens, its shape changes in such a way that the ratio between transdiaphragmatic pressure and tension in the diaphragm remains nearly constant, rather than increasing with volume. Such a model can explain the observation that the length-tension relationship of the muscle is much more important than curvature in determining the effectiveness of the diaphragm as a pressure generator.

scholarly journals Selection for increased tibia length in mice alters skull shape through parallel changes in developmental mechanisms

2020 ◽  
Author(s):  
Colton M. Unger ◽  
Jay Devine ◽  
Benedikt Hallgrímsson ◽  
Campbell Rolian
Keyword(s):  
Endochondral Ossification ◽  
Morphological Changes ◽  
Cranial Base ◽  
Direct Selection ◽  
Micro Ct ◽  
Growth Plates ◽  
History Of ◽  
Selection For ◽  
Tibia Length ◽  
Shape Changes

AbstractBones in the vertebrate cranial base and limb skeleton grow by endochondral ossification, under the control of growth plates. Mechanisms of endochondral ossification are conserved across growth plates, which increases covariation in size and shape among bones, and in turn may lead to correlated changes in skeletal traits not under direct selection. We used micro-CT and geometric morphometrics to characterize shape changes in the cranium of the Longshanks mouse, which was selectively bred for longer tibiae. We show that Longshanks skulls became longer, flatter, and narrower in a stepwise process. Moreover, we show that these morphological changes likely resulted from developmental changes in the growth plates of the Longshanks cranial base, mirroring changes observed in its tibia. Thus, indirect and non-adaptive morphological changes can occur due to developmental overlap among distant skeletal elements, with important implications for interpreting the evolutionary history of vertebrate skeletal form.

scholarly journals DIAGNOSTIC VALUE OF MORPHOLOGICAL CHANGES IN GASTROESOPHAGEAL REFLUX DISEASE IN BIOPSY MATERIAL OF THE DISTAL ESOPHAGUS IN ADOLESCENTS SICKLY WITH ACUTE RESPIRATORY DISEASES

2019 ◽  
Vol 1 ◽  
pp. 15-23
Author(s):  
Olena Zhuravel ◽  
Tetyana Pochinok ◽  
Tamara Zadorozhna ◽  
Tetyana Archakova ◽  
Valentyna Zamula
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Mucous Membrane ◽  
Reflux Disease ◽  
Respiratory Diseases ◽  
Morphological Changes ◽  
Diagnostic Value ◽  
Distal Esophagus ◽  
Biopsy Material ◽  
Acute Respiratory Diseases

The article dedicated to the problem of the diagnostic value of morphological changes in gastroesophageal reflux disease in the biopsy of the distal esophagus in pubertal children of childbearing age. Aim of the research is to investigate the diagnostic value of morphological changes in gastroesophageal reflux disease in esophageal biopsy material in adolescents sickly with acute respiratory diseases. Methodology. The objective of the study was achieved through examination of 90 adolescents (10 to 16 years old, average age 13.1±3.54 years) kept under observation at the Children’s Clinical Hospital No. 9 of Kyiv and on the basis of the Department of Pediatrics No. 1 Center of Primary Health Care No. 4 of the Desnianskyi district of Kyiv. All adolescents belonged to the group of sickly with a number of respiratory diseases averaging 6-8 times a year, lasting from 8 to 18 days (on average 12.8±5.41 days). All children have undergone endoscopic examination of the esophagus, stomach and duodenum with the esophagus mucosa biopsy using the OLYMPUS GIF-P3 flexible fiberscope. Results. It was found that the least valuable diagnostic feature in the morphological examination of the mucous membrane of the distal esophagus in the pain-causing children with GERD was thickening of the epithelium with a sensitivity of 13,0 %, a specificity of 96.0 %, and total value of 65.0 %. It has been proved that hyperplasia of cells of the basal layer of the mucous membrane of the distal esophagus at the GERD in the infected children is 46.7 % (specificity – 93.3 %, the total value is 75.6 %). Increase in the number of papillae and their prolongation in 33.3 % cases (sensitivity – 33.3 %, specificity – 93.3 %, overall diagnostic value – 70.8 %). Conclusion. The peculiarity of the morphological manifestations of GERD in childbearing children is dystrophic changes in keratocytes in the superficial parts of the multilayer squamous epithelium, which are detected at 100.0 % of patients (specificity is 93.3 %, total value is 96.8 %), with parakeratosis centers at 13.3 % of cases. It has been shown that a frequent and diagnostically valuable indication is inflammatory infiltration of the esophageal mucosa, which are verified in all cases (100.0 %, with dilatation and hyperemia in 46.7 % of patients (specificity – 40.0 %, total value – 81.3 %).

scholarly journals An asymmetric junctional mechanoresponse coordinates mitotic rounding with epithelial integrity

2021 ◽  
Vol 220 (5) ◽  
Author(s):  
Jooske L. Monster ◽  
Lisa Donker ◽  
Marjolein J. Vliem ◽  
Zaw Win ◽  
Helen K. Matthews ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Morphological Changes ◽  
Mitotic Cell ◽  
Cell Junctions ◽  
Actin Binding ◽  
Epithelial Barrier ◽  
Epithelial Integrity ◽  
Tensile Forces ◽  
Shape Changes ◽  
Mitotic Cells

Epithelia are continuously self-renewed, but how epithelial integrity is maintained during the morphological changes that cells undergo in mitosis is not well understood. Here, we show that as epithelial cells round up when they enter mitosis, they exert tensile forces on neighboring cells. We find that mitotic cell–cell junctions withstand these tensile forces through the mechanosensitive recruitment of the actin-binding protein vinculin to cadherin-based adhesions. Surprisingly, vinculin that is recruited to mitotic junctions originates selectively from the neighbors of mitotic cells, resulting in an asymmetric composition of cadherin junctions. Inhibition of junctional vinculin recruitment in neighbors of mitotic cells results in junctional breakage and weakened epithelial barrier. Conversely, the absence of vinculin from the cadherin complex in mitotic cells is necessary to successfully undergo mitotic rounding. Our data thus identify an asymmetric mechanoresponse at cadherin adhesions during mitosis, which is essential to maintain epithelial integrity while at the same time enable the shape changes of mitotic cells.

scholarly journals PNEUMOTHORAX AND POSTURE

1909 ◽  
Vol 11 (3) ◽  
pp. 444-452 ◽  
Author(s):  
Charles A. Elsberg
Keyword(s):  
Chest Wall ◽  
Prone Position ◽  
Supine Position ◽  
Anterior Chest Wall ◽  
Anterior Wall ◽  
Open Side ◽  
Sound Side ◽  
Posterior Mediastinal ◽  
Respiratory Movements ◽  
Anterior Septum

The last mentioned fact may perhaps find its explanation in the following statements: the two pleural cavities are separated by the layers of the anterior and posterior mediastinal septa. Between the two lies the heart. In the dog, the posterior seems to be somewhat tougher than the anterior septum, and somewhat more fixed and tense. With violent respiratory movements, it is the anterior septum which more especially flaps to and fro and bulges when an opening in the pleura has been made, and it is the anterior septum which is so apt to rupture and thus cause double pneumothorax and the death of the animal. When the dog is on its back, the heart falls backward and the bulging of the anterior mediastinal septum is made more easy. It is different when the animal is on its belly. The heart falls toward the anterior chest wall and thus supports the anterior septum: hence the flapping of the septum, the interference with the respiration of the lung on the sound side, the bulging on expiration on the open side, can not so readily occur. The danger of the open pneumothorax is greatly lessened when the animal is in the prone position. In the supine position the danger of the pneumothorax is due to the falling back of the heart and thus facilitating the rupture of the fragile anterior mediastinal septum; the danger is therefore obviated by fixing the pericardium to the anterior wall of the thorax.

scholarly journals Pervasive White Matter Fiber Degeneration in Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (5) ◽  
pp. 1507-1513 ◽  
Author(s):  
Natalia Egorova ◽  
Thijs Dhollander ◽  
Mohamed Salah Khlif ◽  
Wasim Khan ◽  
Emilio Werden ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Cross Section ◽  
Corticospinal Tract ◽  
Brain Volume ◽  
Morphological Changes ◽  
Axonal Loss ◽  
Fiber Density ◽  
Whole Brain ◽  
Brain Volume Loss

Background and Purpose— We examined if ischemic stroke is associated with white matter degeneration predominantly confined to the ipsi-lesional tracts or with widespread bilateral axonal loss independent of lesion laterality. Methods— We applied a novel fixel-based analysis, sensitive to fiber tract–specific differences within a voxel, to assess axonal loss in stroke (N=104, 32 women) compared to control participants (N=40, 15 women) across the whole brain. We studied microstructural differences in fiber density and macrostructural (morphological) changes in fiber cross-section. Results— In participants with stroke, we observed significantly lower fiber density and cross-section in areas adjacent, or connected, to the lesions (eg, ipsi-lesional corticospinal tract). In addition, the changes extended beyond directly connected tracts, independent of the lesion laterality (eg, corpus callosum, bilateral inferior fronto-occipital fasciculus, right superior longitudinal fasciculus). Conclusions— We conclude that ischemic stroke is associated with extensive neurodegeneration that significantly affects white matter integrity across the whole brain. These findings expand our understanding of the mechanisms of brain volume loss and delayed cognitive decline in stroke.

Effect of the chest wall and blood volume on pulmonary distensibility

1992 ◽  
Vol 72 (1) ◽  
pp. 186-193 ◽  
Author(s):  
H. J. Colebatch ◽  
C. K. Ng ◽  
N. Berend ◽  
F. J. Maccioni
Keyword(s):  
Chest Wall ◽  
Blood Volume ◽  
Surface Pressure ◽  
Supine Position ◽  
Transpulmonary Pressure ◽  
Esophageal Pressure ◽  
Relative Increase ◽  
Alveolar Volume ◽  
Pulmonary Blood Volume ◽  
Gas Volume

To determine the reason for increased pulmonary distensibility in excised lungs, we performed deflation pressure-volume (PV) studies in 24 dogs. Exponential analysis of PV data gave K, an index of distensibility. Lung volume was measured by dilution of neon. Compared with measurements obtained in the supine position, with the chest closed, and with esophageal pressure (Pes) to obtain transpulmonary pressure, K was not changed significantly with the chest strapped, with pleural pressure to obtain transpulmonary pressure, or with the chest open. From displacement of PV curves obtained in the supine position and with the chest closed or open, we estimated that Pes was 0.18 kPa greater than average lung surface pressure. An increase in K in the prone and head-up positions was attributed to a traction artifact decreasing Pes. Exsanguination increased K and produced a relative increase in gas volume. These results show that overall pulmonary distensibility is unaffected by an intact chest wall. An increase in K and gas volume after exsanguination probably reflects a decreased pulmonary blood volume, with collapse of capillaries increasing the alveolar volume-to-surface ratio.

scholarly journals Determinants of the esophageal-pleural pressure relationship in humans

2020 ◽  
Vol 128 (1) ◽  
pp. 78-86 ◽  
Author(s):  
Iacopo Pasticci ◽  
Paolo Cadringher ◽  
Lorenzo Giosa ◽  
Michele Umbrello ◽  
Paolo Formenti ◽  
...  
Keyword(s):  
Tidal Volume ◽  
Chest Wall ◽  
Supine Position ◽  
Body Position ◽  
Esophageal Pressure ◽  
Lateral Position ◽  
Pleural Pressure ◽  
Absolute Value ◽  
Gravitational Forces ◽  
Chest Wall Elastance

Esophageal pressure has been suggested as adequate surrogate of the pleural pressure. We investigate after lung surgery the determinants of the esophageal and intrathoracic pressures and their differences. The esophageal pressure (through esophageal balloon) and the intrathoracic/pleural pressure (through the chest tube on the surgery side) were measured after surgery in 28 patients immediately after lobectomy or wedge resection. Measurements were made in the nondependent lateral position (without or with ventilation of the operated lung) and in the supine position. In the lateral position with the nondependent lung, collapsed or ventilated, the differences between esophageal and pleural pressure amounted to 4.4 ± 1.6 and 5.1 ± 1.7 cmH2O. In the supine position, the difference amounted to 7.3 ± 2.8 cmH2O. In the supine position, the estimated compressive forces on the mediastinum were 10.5 ± 3.1 cmH2O and on the iso-gravitational pleural plane 3.2 ± 1.8 cmH2O. A simple model describing the roles of chest, lung, and pneumothorax volume matching on the pleural pressure genesis was developed; modeled pleural pressure = 1.0057 × measured pleural pressure + 0.6592 ( r2 = 0.8). Whatever the position and the ventilator settings, the esophageal pressure changed in a 1:1 ratio with the changes in pleural pressure. Consequently, chest wall elastance (Ecw) measured by intrathoracic (Ecw = ΔPpl/tidal volume) or esophageal pressure (Ecw = ΔPes/tidal volume) was identical in all the positions we tested. We conclude that esophageal and pleural pressures may be largely different depending on body position (gravitational forces) and lung-chest wall volume matching. Their changes, however, are identical. NEW & NOTEWORTHY Esophageal and pleural pressure changes occur at a 1:1 ratio, fully justifying the use of esophageal pressure to compute the chest wall elastance and the changes in pleural pressure and in lung stress. The absolute value of esophageal and pleural pressures may be largely different, depending on the body position (gravitational forces) and the lung-chest wall volume matching. Therefore, the absolute value of esophageal pressure should not be used as a surrogate of pleural pressure.

Effect of position on the mechanical interaction between the rib cage and abdomen in preterm infants

1992 ◽  
Vol 72 (3) ◽  
pp. 1032-1038 ◽  
Author(s):  
M. R. Wolfson ◽  
J. S. Greenspan ◽  
K. S. Deoras ◽  
J. L. Allen ◽  
T. H. Shaffer
Keyword(s):  
Pulmonary Function ◽  
Chest Wall ◽  
Preterm Infants ◽  
Prone Position ◽  
Phase Angle ◽  
Supine Position ◽  
Pulmonary Mechanics ◽  
Rib Cage ◽  
Lissajous Figures ◽  
Significant Difference

To determine the influence of body position on chest wall and pulmonary function, we studied the ventilatory, pulmonary mechanics, and thoracoabdominal motion profiles in 20 preterm infants recovering from respiratory disease who were positioned in both the supine and prone position. Thoracoabdominal motion was assessed from measurements of relative rib cage and abdominal movement and the calculated phase angle (an index of thoracoabdominal synchrony) of the rib and abdomen Lissajous figures. The ventilatory and pulmonary function profiles were assessed from simultaneous measurements of transpulmonary pressure, airflow, and tidal volume. The infants were studied in quiet sleep, and the order of positioning was randomized across patients. The results demonstrated no significant difference in ventilatory and pulmonary function measurements as a function of position. In contrast, there was a significant reduction (-49%) in the phase angle of the Lissajous figures and an increase (+66%) in rib cage motion in prone compared with the supine position. In addition, the degree of improvement in phase angle in the prone position was correlated to the severity of asynchrony in the supine position. We speculate that the improvement in thoracoabdominal synchrony in the prone position is related to alterations of chest wall mechanics and respiratory muscle tone mediated by a posturally related shift in the area of apposition of the diaphragm to the anterior inner rib cage wall and increase in passive tension of the muscles of the rib cage. This study suggests that the mechanical advantage associated with prone positioning may confer a useful alternative breathing pattern to the preterm infant in whom elevated respiratory work loads and respiratory musculoskeletal immaturity may predispose to respiratory failure.

scholarly journals Caracterización de la gestión de residuos hospitalarios y similares en cami vista hermosa, Bogota

Respuestas ◽  
2016 ◽  
Vol 21 (1) ◽  
pp. 6
Author(s):  
Juan Carlos Hernández-Criado
Keyword(s):  
Environmental Management ◽  
Cross Section ◽  
Waste Disposal ◽  
Respiratory Diseases ◽  
Processes Of Change ◽  
Hospital Waste ◽  
The Public ◽  
Comprehensive Management ◽  
Politica Publica ◽  
Section Type

Antecedentes. La gestión ambiental de los residuos, se enmarca en la política pública, la cual involucra los residuos de carácter peligroso de una forma generalizada. Solo hasta el año 2000, se establecen los lineamientos reglamentarios para la gestión integral de los residuos hospitalarios y similares en Colombia. Objetivo. Caracterizar la gestión de residuos hospitalarios y similares en CAMI VISTA HERMOSA Bogotá. Métodos. La investigación se desarrolló en la Institución Prestadora de Servicios de Salud de primer nivel CAMI VISTA HERMOSA, correspondiente a una Empresa Social del Estado. Se desarrolló un estudio tipo corte transversal, donde se caracterizaron cuantitativa y cualitativamente los residuos generados por día, a través de la consolidación de la información en el formato RH1, establecido por el Manual para la Gestión Integral de los Residuos Sólidos Hospitalarios y Similares. Resultados. Se identificaron residuos como, Biosanitarios, Cortopunzantes, Fármacos, Metales Pesados, Ordinarios, Reciclables y Anatomopatológicos por medio del formato RH1, así mismo fueron cuantificados en cada una de las áreas involucradas en el proceso de prestación del servicio, mostrando la fluctuación en el comportamiento referente a pesos y tipos de estos, determinados por distintos factores, entre los que se tienen: la creciente asistencia a los servicios por consultas de enfermedades respiratorias, asociadas a las temporadas de lluvia y por la inadecuada segregación de los residuos en distinta áreas. Conclusiones. La recolección de la información, sirvió como herramienta para identificar los puntos críticos, donde se realiza una segregación inadecuada de los residuos. Información que además fue útil como estrategia para reorganizar los procesos de cambio desde la óptica del Plan de Gestión de Residuos Hospitalarios y Similares.Abstract Background: The environmental management of residues is defined within the public policy, which involves the hazardous waste from a general standpoint. Only until 2000, the mandatory guidelines were established for the comprehensive management of hospital waste and similar in Colombia. Objective. To characterize the management of hospital and similar waste in CAMI VISTA HERMOSA, Bogotá. Methods. Research was performed at the first level healthcare provider CAMI VISTA HERMOSA, a public social company. A cross – section type study was performed, where the daily-base generated waste was characterized qualitatively and quantitatively, through the consolidation of the information in the RH1 form, established by the Manual for the Comprehensive Management of Hospital Solid Waste and Similar. Results. Biosanitary, sharps, drug, heavy metal, ordinary, recyclable and anatomic-pathological wastes were identified by using the RH1 form; similarly, they were quantified in each of the areas involved in the service providing process, showing the fluctuation in the behavior related to weights and each of their classes, determined by several factors including: the increasing number of medical appointments regarding respiratory diseases associated with raining seasons and the inappropriate waste disposal in different areas. Conclusions. Data collection was a tool that allowed to identify critical points such as the inappropriate waste disposal. Besides, the information was useful as a strategy to reorganize processes of change according to the Plan of Management of Hospital Waste and Similar.Palabras Clave: Bioseguridad, Centro de Atención Medico Integral (CAMI), Gestión de Residuos, Impacto Ambiental, Salud Pública

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