Effect of a hydrostatic pleural pressure gradient on mechanical behavior of lung lobes

1983 ◽  
Vol 55 (2) ◽  
pp. 453-461 ◽  
Author(s):  
B. G. Murphy ◽  
F. Plante ◽  
L. A. Engel
Keyword(s):  
Pressure Gradient ◽  
Volume Change ◽  
Vital Capacity ◽  
Transpulmonary Pressure ◽  
Pleural Pressure ◽  
Stress Components ◽  
Regional Compliance ◽  
The Mean ◽  
The Vertical Distribution ◽  
Lung Lobes

Using 133Xe, the vertical distribution of regional volume (Vr) was measured in three regions of excised canine lobes both in air and when completely submerged in saline at 40, 60, 70, and 80% lobar vital capacity (VC). The estimated pleural pressure gradient, derived from values of Vr, distance between regions, and the lobar pressure-volume (PV) curve, underestimated the true gradient by 45%. Conversely, the gradient of Vr was substantially less than predicted. From the mean depth of each region below the waterline, pleural, and hence transpulmonary, pressure (PL) was computed. The values of Vr-PL for each region at 40, 60, and 80% lung volume (VL) were related to the lobar PV curve. Slopes of lines joining initial VL-PL points on the lobar PV curve to corresponding Vr-PL points in submerged lobes represent an effective regional compliance of a lobe undergoing deformation. With one exception this was less than the corresponding homogeneous compliance, indicating a stiffening of the lobe during deformation. Slopes of lines joining Vr-PL points of each region at the three lobar volumes represent effective regional compliance of a deformed lobe undergoing volume change. This was not significantly different from the homogeneous compliance. However, effective compliance can only be an approximate indicator of the forces required for a given volume change due to the inadequacy of PL to represent the unequal stress components induced by lobe deformation.

Regional differences in alveolar density in the human lung are related to lung height

2015 ◽  
Vol 118 (11) ◽  
pp. 1429-1434 ◽  
Author(s):  
John E. McDonough ◽  
Lars Knudsen ◽  
Alexander C. Wright ◽  
W. Mark Elliott ◽  
Matthias Ochs ◽  
...  
Keyword(s):  
Pressure Gradient ◽  
Regional Differences ◽  
Volume Fraction ◽  
Transpulmonary Pressure ◽  
Pleural Pressure ◽  
Lung Inflation ◽  
Residual Capacity ◽  
Alveolar Duct ◽  
The Difference

The gravity-dependent pleural pressure gradient within the thorax produces regional differences in lung inflation that have a profound effect on the distribution of ventilation within the lung. This study examines the hypothesis that gravitationally induced differences in stress within the thorax also influence alveolar density in terms of the number of alveoli contained per unit volume of lung. To test this hypothesis, we measured the number of alveoli within known volumes of lung located at regular intervals between the apex and base of four normal adult human lungs that were rapidly frozen at a constant transpulmonary pressure, and used microcomputed tomographic imaging to measure alveolar density (number alveoli/mm3) at regular intervals between the lung apex and base. These results show that at total lung capacity, alveolar density in the lung apex is 31.6 ± 3.4 alveoli/mm3, with 15 ± 6% of parenchymal tissue consisting of alveolar duct. The base of the lung had an alveolar density of 21.2 ± 1.6 alveoli/mm3 and alveolar duct volume fraction of 29 ± 6%. The difference in alveolar density can be negated by factoring in the effects of alveolar compression due to the pleural pressure gradient at the base of the lung in vivo and at functional residual capacity.

scholarly journals Use and success evaluation of percutaneous aortic balloon valvuloplasty in different hemodynamic entities of severe aortic stenosis in the TAVR era

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Piayda ◽  
A Wimmer ◽  
H Sievert ◽  
K Hellhammer ◽  
S Afzal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Pressure Gradient ◽  
Severe Aortic Stenosis ◽  
Primary Treatment ◽  
Low Flow ◽  
Mean Pressure ◽  
The Mean

Abstract Background In the era of transcatheter aortic valve replacement (TAVR), there is renewed interest in percutaneous balloon aortic valvuloplasty (BAV), which may qualify as the primary treatment option of choice in special clinical situations. Success of BAV is commonly defined as a significant mean pressure gradient reduction after the procedure. Purpose To evaluate the correlation of the mean pressure gradient reduction and increase in the aortic valve area (AVA) in different flow and gradient patterns of severe aortic stenosis (AS). Methods Consecutive patients from 01/2010 to 03/2018 undergoing BAV were divided into normal-flow high-gradient (NFHG), low-flow low-gradient (LFLG) and paradoxical low-flow low-gradient (pLFLG) AS. Baseline characteristics, hemodynamic and clinical information were collected and compared. Additionally, the clinical pathway of patients (BAV as a stand-alone procedure or BAV as a bridge to aortic valve replacement) was followed-up. Results One-hundred-fifty-six patients were grouped into NFHG (n=68, 43.5%), LFLG (n=68, 43.5%) and pLFLG (n=20, 12.8%) AS. Underlying reasons for BAV and not TAVR/SAVR as the primary treatment option are displayed in Figure 1. Spearman correlation revealed that the mean pressure gradient reduction had a moderate correlation with the increase in the AVA in patients with NFHG AS (r: 0.529, p<0.001) but showed no association in patients with LFLG (r: 0.145, p=0.239) and pLFLG (r: 0.030, p=0.889) AS. Underlying reasons for patients to undergo BAV and not TAVR/SAVR varied between groups, however cardiogenic shock or refractory heart failure (overall 46.8%) were the most common ones. After the procedure, independent of the hemodynamic AS entity, patients showed a functional improvement, represented by substantially lower NYHA class levels (p<0.001), lower NT-pro BNP levels (p=0.003) and a numerical but non-significant improvement in other echocardiographic parameters like the left ventricular ejection fraction (p=0.163) and tricuspid annular plane systolic excursion (TAPSE, p=0.066). An unplanned cardiac re-admission due to heart failure was necessary in 23.7% patients. Less than half of the patients (44.2%) received BAV as a bridge to TAVR/SAVR (median time to bridge 64 days). Survival was significantly increased in patients having BAV as a staged procedure (log-rank p<0.001). Conclusion In daily clinical practice, the mean pressure gradient reduction might be an adequate surrogate of BAV success in patients with NFHG AS but is not suitable for patients with other hemodynamic entities of AS. In those patients, TTE should be directly performed in the catheter laboratory to correctly assess the increase of the AVA. BAV as a staged procedure in selected clinical scenarios increases survival and is a considerable option in all flow states of severe AS. (NCT04053192) Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Continuous borehole optical televiewing reveals variable englacial debris concentrations at Khumbu Glacier, Nepal

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Katie E. Miles ◽  
Bryn Hubbard ◽  
Evan S. Miles ◽  
Duncan J. Quincey ◽  
Ann V. Rowan ◽  
...  
Keyword(s):  
Vertical Distribution ◽  
Water Supply ◽  
Depth Profile ◽  
Variable Thickness ◽  
Surface Melting ◽  
High Mountain ◽  
Ablation Area ◽  
The Mean ◽  
Surface Melt ◽  
The Vertical Distribution

AbstractSurface melting of High Mountain Asian debris-covered glaciers shapes the seasonal water supply to millions of people. This melt is strongly influenced by the spatially variable thickness of the supraglacial debris layer, which is itself partially controlled by englacial debris concentration and melt-out. Here, we present measurements of deep englacial debris concentrations from debris-covered Khumbu Glacier, Nepal, based on four borehole optical televiewer logs, each up to 150 m long. The mean borehole englacial debris content is ≤ 0.7% by volume in the glacier’s mid-to-upper ablation area, and increases to 6.4% by volume near the terminus. These concentrations are higher than those reported for other valley glaciers, although those measurements relate to discrete samples while our approach yields a continuous depth profile. The vertical distribution of englacial debris increases with depth, but is also highly variable, which will complicate predictions of future rates of surface melt and debris exhumation at such glaciers.

scholarly journals POS0853 DECREASE IN ANTI-TOPOISOMERASE-1 ANTIBODY TITER IN PATIENTS WITH SYSTEMIC SCLEROSIS DURING LONG-TERM RITUXIMAB THERAPY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 681.1-681
Author(s):  
L. Garzanova ◽  
L. P. Ananyeva ◽  
O. Koneva ◽  
O. Desinova ◽  
O. Ovsyannikova ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
B Lymphocytes ◽  
Vital Capacity ◽  
Clinical Parameters ◽  
Diffusion Capacity ◽  
Positive Group ◽  
Topoisomerase 1 ◽  
The Mean

Background:Rituximab (RTX) is a new option in the treatment of systemic sclerosis (SSc) [1]. There is not enough data on changes in the level of autoantibodies and their clinical significance during RTM therapy. There are only a few reports on the higher efficiency of RTX in patients (pts) with SSc positive for anti-topoisomerase-1 antibodies (a-Topo-1), therefore the study of this issue might be interested.Objectives:To compare clinical parameters and B-lymphocytes (B-lymph) level in SSc pts depending on the presence or absence of a-Topo-1 during RTX therapy with prospective long-term follow-up.Methods:This study included 88 pts with SSc. The mean follow-up period was 26,3±10,7 months. The mean age was 47years (17-71), female-73 pts (83%), the diffuse cutaneous subset of the disease had 50 pts (57%). Symptoms of the interstitial lung disease (ILD) were observed in 70 pts (80%). The mean disease duration was 5,9±4,8 years. The cumulative mean dose of RTX was 2,9±1,1 grams. All patients received prednisone at a dose of 11,7±4,4 mg, immunosuppressants received 42% of them. There were 63 pts positive for a-Topo-1 and 25 pts - negative. The pts of the compared groups did not differ in the main demographic and clinical parameters, excepting lung involvement. In a-Topo-1 positive group 55 (87%) pts had ILD and only 15 (60%) – in a-Topo-1-negative group (p=0,02). The results at baseline and at the end of the follow up are presented in the form of mean values and changes in parameters (delta).Results:Considering the entire cohort, an improvement of almost all outcome parameters was found. When a-Topo-1 positive and a-Topo-1-negative pts were analyzed separately, we observed a significantly higher decrease in the activity score, depletion of B-lymph, an increase in forced vital capacity (FVC) and diffusion capacity for carbon monoxide (DLCO) in a-Topo-1 positive group of pts (table 1).Table 1.Changes of the main outcome parameters depending on the presence of a-Topo-1 on RTX therapy.Parametersa-Topo-1positive ptsa-Topo-1negative ptsPDelta Activity score (EScSG-AI)1,790,90,001Delta Rodnan skin score (mRSS)4,95,2NSDelta B-lymphocytes (absolute count)0,2120,1930,001Delta FVC*, %8,646,460,001Delta DLCO**, %2,860,0320,001*FVC - forced vital capacity % predicted, **DLCO - diffusion capacity for carbon monoxide % predictedThe a-Тopo-1 level decreased from 174,2±50,1 to 148,1±66,1 units/ml (p=0,0009). In this group, a-Тopo-1 became negative in 5 pts (7,9%). The disappearance of a-Topo-1 positivity was accompanied by a more pronounced decrease in mRSS (delta mRSS=7,4) and a higher depletion of B-lymph. There was a higher cumulative dose of RTX (4±1,4grams) in this 5 pts compared with the pts who sustained a-Topo-1 positivity. There was a moderate negative statistically significant correlation between the a-Topo-1 and the total dose of RTX (r=-0,298, p=0,017). A moderate negative statistically significant correlation was found between the a-Topo-1 and FVC (r=-0,322, p=0,009).Conclusion:In our study, the a-Topo-1 level significantly decreased during RTX therapy in Russian pts. The decrease in a-Topo-1 titers correlated with the total dose of RTX and was accompanied by a decrease in mRSS, disease activity index and an increase in FVC and DLCO. A higher efficacy of RTX in the a-Topo-1 positive group with prevalence of ILD was revealed, therefore a-Topo-1 positivity could be considered as a predictor of a better response to RTX therapy.References:[1]Jordan S, et al. Effects and safety of rituximab in systemic sclerosis: an analysis from the European Scleroderma Trial and Research (EUSTAR) group. Ann Rheum Dis.2015;74:1188–94.Doi:10.1136/annrheumdis-2013-204522.[2]Ebata S, Yoshizaki A, et.al. Rituximab therapy is more effective than cyclophosphamide therapy for Japanese patients with anti-topoisomerase I-positive systemic sclerosis-associated interstitial lung disease. J Dermatol.2019.Nov;46(11):1006-1013.doi:10.1111/1346-8138.15079.Disclosure of Interests:None declared

The structure of a highly decelerated axisymmetric turbulent boundary layer

2021 ◽  
Vol 929 ◽  
Author(s):  
N. Agastya Balantrapu ◽  
Christopher Hickling ◽  
W. Nathan Alexander ◽  
William Devenport
Keyword(s):  
Boundary Layer ◽  
Pressure Gradient ◽  
Shear Layer ◽  
Layer Thickness ◽  
Boundary Layer Thickness ◽  
Large Scale ◽  
Convection Velocity ◽  
Mean Flow ◽  
Mean Velocity ◽  
The Mean

Experiments were performed over a body of revolution at a length-based Reynolds number of 1.9 million. While the lateral curvature parameters are moderate ( $\delta /r_s < 2, r_s^+>500$ , where $\delta$ is the boundary layer thickness and r s is the radius of curvature), the pressure gradient is increasingly adverse ( $\beta _{C} \in [5 \text {--} 18]$ where $\beta_{C}$ is Clauser’s pressure gradient parameter), representative of vehicle-relevant conditions. The mean flow in the outer regions of this fully attached boundary layer displays some properties of a free-shear layer, with the mean-velocity and turbulence intensity profiles attaining self-similarity with the ‘embedded shear layer’ scaling (Schatzman & Thomas, J. Fluid Mech., vol. 815, 2017, pp. 592–642). Spectral analysis of the streamwise turbulence revealed that, as the mean flow decelerates, the large-scale motions energize across the boundary layer, growing proportionally with the boundary layer thickness. When scaled with the shear layer parameters, the distribution of the energy in the low-frequency region is approximately self-similar, emphasizing the role of the embedded shear layer in the large-scale motions. The correlation structure of the boundary layer is discussed at length to supply information towards the development of turbulence and aeroacoustic models. One major finding is that the estimation of integral turbulence length scales from single-point measurements, via Taylor's hypothesis, requires significant corrections to the convection velocity in the inner 50 % of the boundary layer. The apparent convection velocity (estimated from the ratio of integral length scale to the time scale), is approximately 40 % greater than the local mean velocity, suggesting the turbulence is convected much faster than previously thought. Closer to the wall even higher corrections are required.

Protein osmotic pressure gradients and microvascular reflection coefficients

1997 ◽  
Vol 273 (2) ◽  
pp. H997-H1002 ◽  
Author(s):  
R. E. Drake ◽  
S. Dhother ◽  
R. A. Teague ◽  
J. C. Gabel
Keyword(s):  
Reflection Coefficient ◽  
Pressure Gradient ◽  
Osmotic Pressure ◽  
Reflection Coefficients ◽  
Pressure Gradients ◽  
Fluid Filtration ◽  
The Mean ◽  
Osmotic Reflection Coefficient ◽  
New Equation ◽  
Osmotic Pressure Gradient

Microvascular membranes are heteroporous, so the mean osmotic reflection coefficient for a microvascular membrane (sigma d) is a function of the reflection coefficient for each pore. Investigators have derived equations for sigma d based on the assumption that the protein osmotic pressure gradient across the membrane (delta II) does not vary from pore to pore. However, for most microvascular membranes, delta II probably does vary from pore to pore. In this study, we derived a new equation for sigma d. According to our equation, pore-to-pore differences in delta II increase the effect of small pores and decrease the effect of large pores on the overall membrane osmotic reflection coefficient. Thus sigma d for a heteroporous membrane may be much higher than previously derived equations indicate. Furthermore, pore-to-pore delta II differences increase the effect of plasma protein osmotic pressure to oppose microvascular fluid filtration.

Inflection point on transpulmonary pressure-volume curves and closing volume

1975 ◽  
Vol 38 (2) ◽  
pp. 228-235 ◽  
Author(s):  
M. Demedts ◽  
J. Clement ◽  
D. C. Stanescu ◽  
K. P. van de Woestijne
Keyword(s):  
Inflection Point ◽  
Vital Capacity ◽  
Transpulmonary Pressure ◽  
Bronchial Obstruction ◽  
Closing Volume ◽  
Lung Volumes ◽  
Nitrogen Washout ◽  
Single Breath ◽  
Space Effect ◽  
Washout Curves

In 20 healthy subjects and 18 patients with bronchial obstruction, closing volume (CV) on single-breath nitrogen washout curves and inflection point (IP) on transpulmonary pressure-volume curves were recorded simultaneously during slow expiratory vital capacity maneuvers. IP and CV did not occur at identical lung volumes, IP being systematically larger than CV for small CV values. This discrepancy could not be attributed to an esophageal or mediastinal artifact. It is suggested that, though CV and IP both express “airway closure,” their sensitivity to closure may differ: CV underestimates closure because of a dead space effect; the latter may vary individually. On the other hand, IP may not reflect the true beginning of closure, particularly when it occurs at higher lung volumes.

Effect of parenchymal shear modulus and lung volume on bronchial pressure-diameter behavior

1978 ◽  
Vol 44 (6) ◽  
pp. 859-868 ◽  
Author(s):  
S. J. Lai-Fook ◽  
R. E. Hyatt ◽  
J. R. Rodarte
Keyword(s):  
Shear Modulus ◽  
Lung Volume ◽  
Pressure Difference ◽  
Transpulmonary Pressure ◽  
Pleural Pressure ◽  
Air Trapping ◽  
Control State ◽  
General Method

A method that interrelates lung pressure-volume behavior, bronchial pressure-diameter behavior, and parenchymal shear modulus is presented. The method was used to predict changes in intraparenchymal bronchial diameter that occurred when lobe pressure-volume behavior and parenchymal shear modulus were markedly changed by inducing air trapping in isolated dog lobes. Predictions agreed with measurements, thereby supporting the general method. Measured values for the shear modulus were approximately 0.7 times the transpulmonary pressure for the control state. Estimated values for the peribronchial pressure difference from pleural pressure during a deflation pressure-volume maneuver for transpulmonary pressures below 12 cmH2O were small, approximately +/- 1 cmH2O, its sign being positive or negative, depending on whether the bronchus was dilated or contricted.

Heat Transfer in a Supersonic Parallel Diffuser

1965 ◽  
Vol 7 (1) ◽  
pp. 1-7 ◽  
Author(s):  
P. J. Baker
Keyword(s):  
Heat Transfer ◽  
Pressure Gradient ◽  
Cross Section ◽  
Static Pressure ◽  
Positive Pressure ◽  
Transfer Coefficients ◽  
Heat Transfer Coefficients ◽  
Pipe Flows ◽  
Pressure Distributions ◽  
The Mean

This paper presents the results of heat transfer measurements taken on a two-dimensional supersonic parallel diffuser. The wall static pressure distributions and the corresponding heat transfer coefficients and fluxes have been measured for a range of initial total pressures. The effects of varying the area of the diffuser cross-section for the same upstream generating nozzle have also been studied. Mach number profiles measured at sections along the diffuser show that in the presence of shock waves and a positive pressure gradient the flow is very much underdeveloped. In general, the mean level of heat transfer is found to be much greater than that predicted by conventional empirical equations for subsonic pipe flows with zero pressure gradient. Further, on comparison between normal and oblique shock diffusion the former is found to give the higher level of heat transfer.

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