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Sample records for expiratory resistor arterial

  1. Low forced expiratory flow rates and forceful exhalation as a cause for arterial gas embolism during submarine escape training: a case report.

    Science.gov (United States)

    Hartge, Francis J; Bennett, Thomas L

    2015-01-01

    A 26-year-old male U.S. Navy submariner suffered an arterial gas embolism during pressurized submarine escape training. Routine pretraining medical screening revealed no history of asthma, pneumothorax or recent respiratory infection. Pulmonary function testing and posterioranterior/lateral chest X-ray were normal. He forcefully exhaled at the start of his ascent and developed neurological abnormalities including lightheadedness with lower extremity weakness and paresthesias after surfacing. He fully recovered after a U.S. Navy Treatment Table 6. This case represents the first report of an arterial gas embolism since the U.S. Navy resumed pressurized submarine escape training utilizing the Submarine Escape and Immersion Equipment suit. We discuss possible contributing factors and propose that his AGE was caused by pulmonary barotrauma due to a combination of low forced expiratory flow rates and an overly forceful exhalation during his ascent.

  2. Positive end expiratory pressure during one-lung ventilation: Selecting ideal patients and ventilator settings with the aim of improving arterial oxygenation

    Directory of Open Access Journals (Sweden)

    Hoftman Nir

    2011-01-01

    Full Text Available The efficacy of positive end-expiratory pressure (PEEP in treating intraoperative hypoxemia during one-lung ventilation (OLV remains in question given conflicting results of prior studies. This study aims to (1 evaluate the efficacy of PEEP during OLV, (2 assess the utility of preoperative predictors of response to PEEP, and (3 explore optimal intraoperative settings that would maximize the effects of PEEP on oxygenation. Forty-one thoracic surgery patients from a single tertiary care university center were prospectively enrolled in this observational study. After induction of general anesthesia, a double-lumen endotracheal tube was fiberoptically positioned and OLV initiated. Intraoperatively, PEEP = 5 and 10 cmH 2 O were sequentially applied to the ventilated lung during OLV. Arterial oxygenation, cardiovascular performance parameters, and proposed perioperative variables that could predict or enhance response to PEEP were analysed. T-test and c2 tests were utilized for continuous and categorical variables, respectively. Multivariate analyses were carried out using a classification tree model of binary recursive partitioning. PEEP improved arterial oxygenation by ≥20% in 29% of patients (n = 12 and failed to do so in 71% (n = 29; however, no cardiovascular impact was noted. Among the proposed clinical predictors, only intraoperative tidal volume per kilogram differed significantly between responders to PEEP and non-responders (mean 6.6 vs. 5.7 ml/kg, P = 0.013; no preoperative variable predicted response to PEEP. A multivariate analysis did not yield a clinically significant model for predicting PEEP responsiveness. PEEP improved oxygenation in a subset of patients; larger, although still protective tidal volumes favored a positive response to PEEP. No preoperative variables, however, could be identified as reliable predictors for PEEP responders.

  3. Babylonian Resistor Networks

    Science.gov (United States)

    Mungan, Carl E.; Lipscombe, Trevor C.

    2012-01-01

    The ancient Babylonians had an iterative technique for numerically approximating the values of square roots. Their method can be physically implemented using series and parallel resistor networks. A recursive formula for the equivalent resistance R[subscript eq] is developed and converted into a nonrecursive solution for circuits using…

  4. Farey sequences and resistor networks

    Indian Academy of Sciences (India)

    In principle, there can be more than two resistors in series in the beginning, ... estimating |A(n)| thus translates to the problem of counting the number of relevant proper fractions whose denominators are .... The parallel combination of one basic unit resistor, with 1i for i = 4 and i ≥ 6 results in an equivalent resistance of 1/2.

  5. 30 CFR 77.801 - Grounding resistors.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Grounding resistors. 77.801 Section 77.801...-Voltage Distribution § 77.801 Grounding resistors. The grounding resistor, where required, shall be of the proper ohmic value to limit the voltage drop in the grounding circuit external to the resistor to not...

  6. Dual design resistor for high voltage conditioning and transmission lines

    Science.gov (United States)

    Siggins, Timothy Lynn [Newport News, VA; Murray, Charles W [Hayes, VA; Walker, Richard L [Norfolk, VA

    2007-01-23

    A dual resistor for eliminating the requirement for two different value resistors. The dual resistor includes a conditioning resistor at a high resistance value and a run resistor at a low resistance value. The run resistor can travel inside the conditioning resistor. The run resistor is capable of being advanced by a drive assembly until an electrical path is completed through the run resistor thereby shorting out the conditioning resistor and allowing the lower resistance run resistor to take over as the current carrier.

  7. Remote Experiments in Resistor Measurement

    Directory of Open Access Journals (Sweden)

    Popescu Viorel

    2009-10-01

    Full Text Available The paper describes blended learningapproach to teaching resistor measurement. It is basedon “Learning by Doing” paradigm: interacticesimulation, laboratory plants, real experimentsaccessed by Web Publishing Tools under LabVIEW.Studying and experimenting access is opened for 24hours a day, 7 days a week under Moodle bookingsystem.

  8. 30 CFR 75.801 - Grounding resistors.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Grounding resistors. 75.801 Section 75.801... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Underground High-Voltage Distribution § 75.801 Grounding resistors. The grounding resistor, where required, shall be of the proper ohmic value to limit the voltage...

  9. Reliability growth of thin film resistors contact

    Directory of Open Access Journals (Sweden)

    Lugin A. N.

    2010-10-01

    Full Text Available Necessity of resistive layer growth under the contact and in the contact zone of resistive element is shown in order to reduce peak values of current flow and power dissipation in the contact of thin film resistor, thereby to increase the resistor stability to parametric and catastrophic failures.

  10. Resistor Networks based on Symmetrical Polytopes

    National Research Council Canada - National Science Library

    Moody, Jeremy; Aravind, P.K

    2015-01-01

    This paper shows how a method developed by Van Steenwijk can be generalized to calculate the resistance between any two vertices of a symmetrical polytope all of whose edges are identical resistors...

  11. Thermal Characterization of the Overload Carbon Resistors

    Directory of Open Access Journals (Sweden)

    Ivana Kostić

    2013-01-01

    Full Text Available In many applications, the electronic component is not continuously but only intermittently overloaded (e.g., inrush current, short circuit, or discharging interference. With this paper, we provide insight into carbon resistors that have to hold out a rarely occurring transient overload. Using simple electrical circuit, the resistor is overheating with higher current than declared, and dissipation is observed by a thermal camera.

  12. Inspiratory vs. expiratory pressure-volume curves to set end-expiratory pressure in acute lung injury.

    Science.gov (United States)

    Albaiceta, Guillermo M; Luyando, Luis H; Parra, Diego; Menendez, Rafael; Calvo, Juan; Pedreira, Paula Rodríguez; Taboada, Francisco

    2005-10-01

    To study the effects of two levels of positive end-expiratory pressure (PEEP), 2 cm H(2)O above the lower inflection point of the inspiratory limb and equal to the point of maximum curvature on the expiratory limb of the pressure-volume curve, in gas exchange, respiratory mechanics, and lung aeration. Prospective clinical study in the intensive care unit and computed tomography ward of a university hospital. Eight patients with early acute lung injury. Both limbs of the static pressure-volume curve were traced and inflection points calculated using a sigmoid model. During ventilation with a tidal volume of 6 ml/kg we sequentially applied a PEEP 2 cm H(2)O above the inspiratory lower inflection point (15.5+/-3.1 cm H(2)O) and a PEEP equal to the expiratory point of maximum curvature (23.5+/-4.1 cmH(2)O). Arterial blood gases, respiratory system compliance and resistance and changes in lung aeration (measured on three computed tomography slices during end-expiratory and end-inspiratory pauses) were measured at each PEEP level. PEEP according to the expiratory point of maximum curvature was related to an improvement in oxygenation, increase in normally aerated, decrease in nonaerated lung volumes, and greater alveolar stability. There was also an increase in PaCO(2), airway pressures, and hyperaerated lung volume. High PEEP levels according to the point of maximum curvature of the deflation limb of the pressure-volume curve have both benefits and drawbacks.

  13. Voltage-Controlled Floating Resistor Using DDCC

    Directory of Open Access Journals (Sweden)

    M. Kumngern

    2011-04-01

    Full Text Available This paper presents a new simple configuration to realize the voltage-controlled floating resistor, which is suitable for integrated circuit implementation. The proposed resistor is composed of three main components: MOS transistor operating in the non-saturation region, DDCC, and MOS voltage divider. The MOS transistor operating in the non-saturation region is used to configure a floating linear resistor. The DDCC and the MOS transistor voltage divider are used for canceling the nonlinear component term of MOS transistor in the non-saturation region to obtain a linear current/voltage relationship. The DDCC is employed to provide a simple summer of the circuit. This circuit offers an ease for realizing the voltage divider circuit and the temperature effect that includes in term of threshold voltage can be compensated. The proposed configuration employs only 16 MOS transistors. The performances of the proposed circuit are simulated with PSPICE to confirm the presented theory.

  14. Multiple High Voltage Pulse Stressing of Polymer Thick Film Resistors

    Directory of Open Access Journals (Sweden)

    Busi Rambabu

    2014-01-01

    Full Text Available The purpose of this paper is to study high voltage interactions in polymer thick film resistors, namely, polyvinyl chloride- (PVC- graphite thick film resistors, and their applications in universal trimming of these resistors. High voltages in the form of impulses for various pulse durations and with different amplitudes have been applied to polymer thick film resistors and we observed the variation of resistance of these resistors with high voltages. It has been found that the resistance of polymer thick film resistors decreases in the case of higher resistivity materials and the resistance of polymer thick film resistor increases in the case of lower resistivity materials when high voltage impulses are applied to them. It has been also found that multiple high voltage pulse (MHVP stressing can be used to trim the polymer thick film resistors either upwards or downwards.

  15. Resistor assemblies, their development and performance

    Science.gov (United States)

    Weisser, D. C.

    1993-04-01

    A survey of 17 electrostatic accelerator installations reporting on 39 resistor grading systems is presented. The synthesis of desirable features, identifiable in the 1986 review by Noé, is shown to provide entirely successful solutions to resistance drift and complete failure for both HVEC and Pelletron accelerators.

  16. Slew Rate Induced Distortion in Switched-Resistor Integrators

    NARCIS (Netherlands)

    Jiraseree-Amornkun, A.; Jiraseree-amornkun, A.; Worapishet, A.; Klumperink, Eric A.M.; Nauta, Bram; Surakampontorn, W.

    2006-01-01

    Abstract—OPAMP-RC integrators built with linear resistors and capacitors can achieve very high linearity. By means of a switched resistor, tuning of the RC time-constant is possible via the duty-cycle of the clock controlling the switched resistor. This paper analyzes the effect of OPAMP slew rate

  17. Zinc oxide varistors and/or resistors

    Science.gov (United States)

    Arnold, Jr., Wesley D.; Bond, Walter D.; Lauf, Robert J.

    1993-01-01

    Varistors and/or resistors that includes doped zinc oxide gel microspheres. The doped zinc oxide gel microspheres preferably have from about 60 to about 95% by weight zinc oxide and from about 5 to about 40% by weight dopants based on the weight of the zinc oxide. The dopants are a plurality of dopants selected from silver salts, boron oxide, silicon oxide and hydrons oxides of aluminum, bismuth, cobalt, chromium, manganese, nickel, and antimony.

  18. Resistor Networks based on Symmetrical Polytopes

    Directory of Open Access Journals (Sweden)

    Jeremy Moody

    2015-03-01

    Full Text Available This paper shows how a method developed by Van Steenwijk can be generalized to calculate the resistance between any two vertices of a symmetrical polytope all of whose edges are identical resistors. The method is applied to a number of cases that have not been studied earlier such as the Archimedean polyhedra and their duals in three dimensions, the regular polytopes in four dimensions and the hypercube in any number of dimensions.

  19. Efeitos da manobra de hiperinsuflação manual associada à pressão positiva expiratória final em pacientes submetidos à cirurgia de revascularização miocárdica Effects of manual hyperinflation maneuver associated with positive end expiratory pressure in patients within coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Laura Jurema dos Santos

    2010-03-01

    Full Text Available OBJETIVO: Verificar os efeitos da manobra de hiperinsuflação manual associada à pressão positiva expiratória final em pacientes submetidos à cirurgia de revascularização do miocárdio. MÉTODOS: Ensaio clínico randomizado realizado entre agosto de 2007 e julho de 2008 na unidade de terapia intensiva do Hospital Luterano (ULBRA. Os pacientes foram divididos em grupo intervenção, no qual foi aplicada a manobra de hiperinsuflação manual associada à pressão positiva expiratória final, e grupo controle. As variáveis ventilatórias foram mensuradas em dois momentos: pré-manobra e pós-manobra. Foram utilizados os testes t de Student para amostras independentes e pareadas, bem como os testes exato de Fisher e o qui-quadrado de McNemar. RESULTADOS: Foram incluídos 18 pacientes durante o período de estudo, com idade média de 64±11 anos, sendo que houve predomínio do sexo feminino (55,6%. O volume corrente inspirado foi de 594± 112 ml no grupo intervenção e 487± 51 ml no grupo controle (p=0,024 e o volume corrente expirado de 598± 105 ml no grupo intervenção e 490± 58 ml no grupo controle (p=0,02. A média da complacência pulmonar estática no grupo intervenção pré-manobra foi de 41,6± 12,1 ml/cmH2O e pós-manobra de 47,4± 16,6 ml/cmH2O (p=0,03. Não houve diferença significativa entre os grupos nas seguintes variáveis: saturação periférica de oxigênio, pressão arterial de oxigênio, tempo de extubação e alterações radiológicas. CONCLUSÃO: Os resultados demonstram uma tendência da manobra de hiperinsuflação manual associada à pressão positiva expiratória final promover aumento dos volumes pulmonares e da complacência estática, entretanto estes achados necessitam confirmação.OBJECTIVE: To verify the effects of manual hyperinflation maneuver associated with positive end expiratory pressure in coronary artery bypass grafting patients. METHODS: This was a randomized trial, conducted from August 2007

  20. Expiratory rib cage compression in mechanically ventilated adults: systematic review with meta-analysis

    Science.gov (United States)

    Borges, Lúcia Faria; Saraiva, Mateus Sasso; Saraiva, Marcos Ariel Sasso; Macagnan, Fabrício Edler; Kessler, Adriana

    2017-01-01

    Objective To review the literature on the effects of expiratory rib cage compression on ventilatory mechanics, airway clearance, and oxygen and hemodynamic indices in mechanically ventilated adults. Methods Systematic review with meta-analysis of randomized clinical trials in the databases MEDLINE (via PubMed), EMBASE, Cochrane CENTRAL, PEDro, and LILACS. Studies on adult patients hospitalized in intensive care units and under mechanical ventilation that analyzed the effects of expiratory rib cage compression with respect to a control group (without expiratory rib cage compression) and evaluated the outcomes static and dynamic compliance, sputum volume, systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, peripheral oxygen saturation, and ratio of arterial oxygen partial pressure to fraction of inspired oxygen were included. Experimental studies with animals and those with incomplete data were excluded. Results The search strategy produced 5,816 studies, of which only three randomized crossover trials were included, totaling 93 patients. With respect to the outcome of heart rate, values were reduced in the expiratory rib cage compression group compared with the control group [-2.81 bpm (95% confidence interval [95%CI]: -4.73 to 0.89; I2: 0%)]. Regarding dynamic compliance, there was no significant difference between groups [-0.58mL/cmH2O (95%CI: -2.98 to 1.82; I2: 1%)]. Regarding the variables systolic blood pressure and diastolic blood pressure, significant differences were found after descriptive evaluation. However, there was no difference between groups regarding the variables secretion volume, static compliance, ratio of arterial oxygen partial pressure to fraction of inspired oxygen, and peripheral oxygen saturation. Conclusion There is a lack of evidence to support the use of expiratory rib cage compression in routine care, given that the literature on this topic offers low methodological quality and is inconclusive. PMID

  1. Rancang Bangun Aplikasi Pendeteksi Tipe Dan Nilai Resistor Berbasis Android

    Directory of Open Access Journals (Sweden)

    I Putu Pratama Andika

    2015-11-01

    Full Text Available Android can be identified as the phone with the ability a high degree resembling computer, by making use of technological progress, an error in the determination of type and value of obstruction from resistors led a series of electronics result of the damage can be avoided, this is because of a resistor having the function of as parapet an electric current or as voltage divider of the series, detection so that the application of type and value of resistor able to contribute to the introduction of a resistor, by using processing tecnology digital image that is a method of hsv ( hue saturation value . Hsv useful as a limit of a color become a reference of the rings of color resistor, by applying this method application can do the introduction of against resistors diinputkan, to then give them the information relating to a type and value of a resistor. It has the percentage research success in the introduction of the value and type resistor by 57 %, to misidentified 30 % and not being recognized of 13 % .

  2. Ultrathin microwave metamaterial absorber utilizing embedded resistors

    Science.gov (United States)

    Kim, Young Ju; Hwang, Ji Sub; Yoo, Young Joon; Khuyen, Bui Xuan; Rhee, Joo Yull; Chen, Xianfeng; Lee, YoungPak

    2017-10-01

    We numerically and experimentally studied an ultrathin and broadband perfect absorber by enhancing the bandwidth with embedded resistors into the metamaterial structure, which is easy to fabricate in order to lower the Q-factor and by using multiple resonances with the patches of different sizes. We analyze the absorption mechanism in terms of the impedance matching with the free space and through the distribution of surface current at each resonance frequency. The magnetic field, induced by the antiparallel surface currents, is formed strongly in the direction opposite to the incident electromagnetic wave, to cancel the incident wave, leading to the perfect absorption. The corresponding experimental absorption was found to be higher than 97% in 0.88-3.15 GHz. The agreement between measurement and simulation was good. The aspects of our proposed structure can be applied to future electronic devices, for example, advanced noise-suppression sheets in the microwave regime.

  3. Peak expiratory flow rate and Pulse Pressure values during the ...

    African Journals Online (AJOL)

    This study assessed the peak expiratory flow rate and pulse pressure during the luteal and menstruation phases of the menstrual cycle. The peak expiratory flow rate and pulse pressure were measured using the Wright's Peak Flow Meter and Mercury Sphygmomanometer respectively. The peak expiratory flow rate and ...

  4. End-expiratory lung volume during mechanical ventilation: a comparison with reference values and the effect of positive end-expiratory pressure in intensive care unit patients with different lung conditions.

    Science.gov (United States)

    Bikker, Ido G; van Bommel, Jasper; Reis Miranda, Dinis; Bakker, Jan; Gommers, Diederik

    2008-01-01

    Functional residual capacity (FRC) reference values are obtained from spontaneous breathing patients, and are measured in the sitting or standing position. During mechanical ventilation FRC is determined by the level of positive end-expiratory pressure (PEEP), and it is therefore better to speak of end-expiratory lung volume. Application of higher levels of PEEP leads to increased end-expiratory lung volume as a result of recruitment or further distention of already ventilated alveoli. The aim of this study was to measure end-expiratory lung volume in mechanically ventilated intensive care unit (ICU) patients with different types of lung pathology at different PEEP levels, and to compare them with predicted sitting FRC values, arterial oxygenation, and compliance values. End-expiratory lung volume measurements were performed at PEEP levels reduced sequentially (15, 10 and then 5 cmH2O) in 45 mechanically ventilated patients divided into three groups according to pulmonary condition: normal lungs (group N), primary lung disorder (group P), and secondary lung disorder (group S). In all three groups, end-expiratory lung volume decreased significantly (P ventilator settings.

  5. Expiratory flow limitation detected by forced oscillation and negative expiratory pressure.

    Science.gov (United States)

    Dellacà, R L; Duffy, N; Pompilio, P P; Aliverti, A; Koulouris, N G; Pedotti, A; Calverley, P M A

    2007-02-01

    The within-breath change in reactance (Delta(rs)) measured by forced oscillation technique (FOT) at 5 Hz reliably detects expiratory flow limitation in chronic obstructive pulmonary disease (COPD). The present study compared this approach to the standard negative expiratory pressure (NEP) method. In total, 21 COPD patients were studied by applying both techniques to the same breath and in 15 patients the measurements were repeated after bronchodilator. For each patient and condition five NEP tests were performed and independently scored by three operators unaware of the FOT results. In 180 tests, FOT classified 53.3% as flow limited. On average, the operators scored 27.6% of tests flow limited and 47.6% non-flow limited, but could not score 24.8%. The methods disagreed in 7.9% of cases; in 78% of these the NEP scores differed between operators. Bronchodilation reduced NEP and DeltaX(rs) scores, with only the latter achieving significance. Averaging the operators' NEP scores, a threshold between 24.6-30.8% of tidal volume being flow limited by NEP produced 94% agreement between methods. In conclusion, when negative expiratory pressure and forced oscillation technique were both available they showed good agreement. As forced oscillation technique is automatic and can measure multiple breaths over long periods, it is suitable for monitoring expiratory flow limitation continuously and identifying patients' breathing close to the onset of expiratory flow limitation, where intermittent sampling may be unrepresentative.

  6. Electrochemical Migration on Electronic Chip Resistors in Chloride Environments

    DEFF Research Database (Denmark)

    Minzari, Daniel; Jellesen, Morten Stendahl; Møller, Per

    2009-01-01

    Electrochemical migration behavior of end terminals on ceramic chip resistors (CCRs) was studied using a novel experimental setup in varying sodium chloride concentrations from 0 to 1000 ppm. The chip resistor used for the investigation was 10-kΩ CCR size 0805 with end terminals made of 97Sn3Pb...... alloy. Anodic polarization behavior of the electrode materials was investigated using a microelectrochemical setup. Material makeup of the chip resistor was investigated using scanning electron microscopy (SEM)/energy dispersive spectroscopy and focused-ion-beam SEM. Results showed that the dissolution...

  7. Transport behaviour of commercially available 100-Omega standard resistors

    CSIR Research Space (South Africa)

    Schumacher, B

    2001-04-01

    Full Text Available Several types of commercial 100-Omega resistors can be used with the cryogenic current comparator to maintain the resistance unit, derived from the Quantized Hall Effect (QHE), and to disseminate this unit to laboratory resistance standards. Up...

  8. Breakdown voltage of metal-oxide resistors in liquid argon

    Energy Technology Data Exchange (ETDEWEB)

    Bagby, L. F. [Fermilab; Gollapinni, S. [Kansas State U.; James, C. C. [Fermilab; Jones, B. J.P. [MIT; Jostlein, H. [Fermilab; Lockwitz, S. [Fermilab; Naples, D. [Pittsburgh U.; Raaf, J. L. [Fermilab; Rameika, R. [Fermilab; Schukraft, A. [Fermilab; Strauss, T. [Bern U., LHEP; Weber, M. S. [Bern U., LHEP; Wolbers, S. A. [Fermilab

    2014-11-07

    We characterized a sample of metal-oxide resistors and measured their breakdown voltage in liquid argon by applying high voltage (HV) pulses over a 3 second period. This test mimics the situation in a HV-divider chain when a breakdown occurs and the voltage across resistors rapidly rise from the static value to much higher values. All resistors had higher breakdown voltages in liquid argon than their vendor ratings in air at room temperature. Failure modes range from full destruction to coating damage. In cases where breakdown was not catastrophic, subsequent breakdown voltages were lower in subsequent measuring runs. One resistor type withstands 131 kV pulses, the limit of the test setup.

  9. Noise characteristics of resistors buried in low-temperature co-fired ceramics

    CERN Document Server

    Kolek, A; Dziedzic, A

    2003-01-01

    The comparison of noise properties of conventional thick film resistors prepared on alumina substrates and resistors embedded in low-temperature co-fired ceramics (LTCCs) is presented. Both types of resistors were prepared from commercially available resistive inks. Noise measurements of LTCC resistors below 1 kHz show Gaussian 1/f noise. This is concluded from the calculations of the second spectra as well as from studying the volume dependence of noise intensity. It has occurred that noise index of LTCC resistors on average is not worse than that of conventional resistors. A detailed study of co-fired surface resistors and co-fired buried resistors show that burying a resistor within LTCC substrate usually leads to (significant) enhancement of resistance but not of noise intensity. We interpret this behaviour as another argument in favour of tunnelling as the dominant conduction mechanism in LTCC resistors.

  10. Levels of maximum end-expiratory carbon monoxide and certain cardiovascular parameters following hubble-bubble smoking.

    Science.gov (United States)

    Shafagoj, Yanal A; Mohammed, Faisal I

    2002-08-01

    The physiological effects of cigarette smoking have been widely studied, however, little is known regarding the effects of smoking hubble-bubble. We examined the acute effects of hubble-bubble smoking on heart rate, systolic, diastolic, and mean arterial blood pressure and maximum end-expiratory carbon monoxide. This study was carried out in the student laboratory, School of Medicine, Department of Physiology, University of Jordan, Amman, Jordan, during the summer of 1999. In 18 healthy habitual hubble-bubble smokers, heart rate, blood pressure, and maximum end-expiratory carbon monoxide was measured before, during and post smoking of one hubble-bubble run (45 minutes). Compared to base line (time zero), at the end of smoking heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, and maximum end-expiratory carbon monoxide were increased 16 2.4 beats per minute, 6.7 2.5 mm Hg, 4.4 1.6 mm Hg, 5.2 1.7 mm Hg, and 14.2 1.8 ppm, (mean standard error of mean, Phubble-bubble smoking elicits a modest increase in heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure and maximum end-expiratory carbon monoxide in healthy hubble-bubble smokers.

  11. Influence of inspiratory resistive loading on expiratory muscle fatigue in healthy humans.

    Science.gov (United States)

    Peters, Carli M; Welch, Joseph F; Dominelli, Paolo B; Molgat-Seon, Yannick; Romer, Lee M; McKenzie, Donald C; Sheel, A William

    2017-09-01

    What is the central question of this study? This study is the first to measure objectively both inspiratory and expiratory muscle fatigue after inspiratory resistive loading to determine whether the expiratory muscles are activated to the point of fatigue when specifically loading the inspiratory muscles. What is the main finding and its importance? The absence of abdominal muscle fatigue suggests that future studies attempting to understand the neural and circulatory consequences of diaphragm fatigue can use inspiratory resistive loading without considering the confounding effects of abdominal muscle fatigue. Expiratory resistive loading elicits inspiratory as well as expiratory muscle fatigue, suggesting parallel coactivation of the inspiratory muscles during expiration. It is unknown whether the expiratory muscles are likewise coactivated to the point of fatigue during inspiratory resistive loading (IRL). The purpose of this study was to determine whether IRL elicits expiratory as well as inspiratory muscle fatigue. Healthy male subjects (n = 9) underwent isocapnic IRL (60% maximal inspiratory pressure, 15 breaths min -1 , 0.7 inspiratory duty cycle) to task failure. Abdominal and diaphragm contractile function was assessed at baseline and at 3, 15 and 30 min post-IRL by measuring gastric twitch pressure (P ga,tw ) and transdiaphragmatic twitch pressure (P di,tw ) in response to potentiated magnetic stimulation of the thoracic and phrenic nerves, respectively. Fatigue was defined as a significant reduction from baseline in P ga,tw or P di,tw . Throughout IRL, there was a time-dependent increase in cardiac frequency and mean arterial blood pressure, suggesting activation of the respiratory muscle metaboreflex. The P di,tw was significantly lower than baseline (34.3 ± 9.6 cmH 2 O) at 3 (23.2 ± 5.7 cmH 2 O, P muscle fatigue. Agonist-antagonist interactions for the respiratory muscles appear to be more important during expiratory versus inspiratory

  12. The Sponge Resistor Model--A Hydrodynamic Analog to Illustrate Ohm's Law, the Resistor Equation R=?l/A, and Resistors in Series and Parallel

    Science.gov (United States)

    Pfister, Hans

    2014-01-01

    Physics students encountering electric circuits for the first time often ask why adding more resistors to a circuit sometimes increases and sometimes decreases the resulting total resistance. It appears that these students have an inadequate understanding of current flow and resistance. Students who do not adopt a model of current, voltage, and…

  13. Physiologic Evaluation of Ventilation Perfusion Mismatch and Respiratory Mechanics at Different Positive End-expiratory Pressure in Patients Undergoing Protective One-lung Ventilation.

    Science.gov (United States)

    Spadaro, Savino; Grasso, Salvatore; Karbing, Dan Stieper; Fogagnolo, Alberto; Contoli, Marco; Bollini, Giacomo; Ragazzi, Riccardo; Cinnella, Gilda; Verri, Marco; Cavallesco, Narciso Giorgio; Rees, Stephen Edward; Volta, Carlo Alberto

    2017-12-06

    Arterial oxygenation is often impaired during one-lung ventilation, due to both pulmonary shunt and atelectasis. The use of low tidal volume (VT) (5 ml/kg predicted body weight) in the context of a lung-protective approach exacerbates atelectasis. This study sought to determine the combined physiologic effects of positive end-expiratory pressure and low VT during one-lung ventilation. Data from 41 patients studied during general anesthesia for thoracic surgery were collected and analyzed. Shunt fraction, high V/Q and respiratory mechanics were measured at positive end-expiratory pressure 0 cm H2O during bilateral lung ventilation and one-lung ventilation and, subsequently, during one-lung ventilation at 5 or 10 cm H2O of positive end-expiratory pressure. Shunt fraction and high V/Q were measured using variation of inspired oxygen fraction and measurement of respiratory gas concentration and arterial blood gas. The level of positive end-expiratory pressure was applied in random order and maintained for 15 min before measurements. During one-lung ventilation, increasing positive end-expiratory pressure from 0 cm H2O to 5 cm H2O and 10 cm H2O resulted in a shunt fraction decrease of 5% (0 to 11) and 11% (5 to 16), respectively (P ventilation, high positive end-expiratory pressure levels improve pulmonary function without increasing high V/Q and reduce driving pressure.

  14. Peak Expiratory Flow Rate In Cigarette Smokers | Ukoli | Highland ...

    African Journals Online (AJOL)

    Objective: To compare lung function between smokers and non-smokers using Peak Expiratory Flow Rate (PEFR). Methods: This study examines the peak expiratory flow rate (PEFR) of three hundred and forty cigarette smokers, age and sex-matched with PEFR of equal number of non-smokers. Results: The mean PEFR of ...

  15. Modeling of the expiratory flow pattern of spontaneously breathing cats

    NARCIS (Netherlands)

    Walraven, D; van der Grinten, CPM; Bogaard, JM; van der Ent, CK; Luijendijk, SCM

    2003-01-01

    A mathematical model was developed describing the entire expiratory flow pattern during spontaneous, tidal breathing in the absence of expiratory muscle activity. It provides estimates for the time constants of the respiratory System (tauRS(model)) and of the decay of continuing inspiratory muscle

  16. Ti-Cr-Al-O Thin Film Resistors

    Energy Technology Data Exchange (ETDEWEB)

    Jankowski, A F; Hayes, J P

    2002-03-21

    Thin films of Ti-Cr-Al-O are produced for use as an electrical resistor material. The films are rf sputter deposited from ceramic targets using a reactive working gas mixture of Ar and O{sub 2}. Vertical resistivity values from 10{sup 4} to 10{sup 10} Ohm-cm are measured for Ti-Cr-Al-O films. The film resistivity can be design selected through control of the target composition and the deposition parameters. The Ti-Cr-Al-O thin film resistor is found to be thermally stable unlike other metal-oxide films.

  17. [Cerebral blood flow assessment of preterm infants during respiratory therapy with the expiratory flow increase technique].

    Science.gov (United States)

    Bassani, Mariana Almada; Caldas, Jamil Pedro Siqueira; Netto, Abimael Aranha; Marba, Sérgio Tadeu Martins

    2016-06-01

    To assess the impact of respiratory therapy with the expiratory flow increase technique on cerebral hemodynamics of premature newborns. This is an intervention study, which included 40 preterm infants (≤34 weeks) aged 8-15 days of life, clinically stable in ambient air or oxygen catheter use. Children with heart defects, diagnosis of brain lesion and/or those using vasoactive drugs were excluded. Ultrasonographic assessments with transcranial Doppler flowmetry were performed before, during and after the increase in expiratory flow session, which lasted 5minutes. Cerebral blood flow velocity and resistance and pulsatility indices in the pericallosal artery were assessed. Respiratory physical therapy did not significantly alter flow velocity at the systolic peak (p=0.50), the end diastolic flow velocity (p=0.17), the mean flow velocity (p=0.07), the resistance index (p=0.41) and the pulsatility index (p=0.67) over time. The expiratory flow increase technique did not affect cerebral blood flow in clinically-stable preterm infants. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  18. Cerebral blood flow assessment of preterm infants during respiratory therapy with the expiratory flow increase technique

    Directory of Open Access Journals (Sweden)

    Mariana Almada Bassani

    2016-06-01

    Full Text Available Abstract Objective: To assess the impact of respiratory therapy with the expiratory flow increase technique on cerebral hemodynamics of premature newborns. Methods: This is an intervention study, which included 40 preterm infants (≤34 weeks aged 8-15 days of life, clinically stable in ambient air or oxygen catheter use. Children with heart defects, diagnosis of brain lesion and/or those using vasoactive drugs were excluded. Ultrasonographic assessments with transcranial Doppler flowmetry were performed before, during and after the increase in expiratory flow session, which lasted 5min. Cerebral blood flow velocity and resistance and pulsatility indices in the pericallosal artery were assessed. Results: Respiratory physical therapy did not significantly alter flow velocity at the systolic peak (p=0.50, the end diastolic flow velocity (p=0.17, the mean flow velocity (p=0.07, the resistance index (p=0.41 and the pulsatility index (p=0.67 over time. Conclusions: The expiratory flow increase technique did not affect cerebral blood flow in clinically-stable preterm infants.

  19. 30 CFR 77.901-1 - Grounding resistor; continuous current rating.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Grounding resistor; continuous current rating... OF UNDERGROUND COAL MINES Low- and Medium-Voltage Alternating Current Circuits § 77.901-1 Grounding resistor; continuous current rating. The ground fault current rating of grounding resistors shall meet the...

  20. 30 CFR 77.801-1 - Grounding resistors; continuous current rating.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Grounding resistors; continuous current rating... OF UNDERGROUND COAL MINES Surface High-Voltage Distribution § 77.801-1 Grounding resistors; continuous current rating. The ground fault current rating of grounding resistors shall meet the “extended...

  1. 30 CFR 77.802 - Protection of high-voltage circuits; neutral grounding resistors; disconnecting devices.

    Science.gov (United States)

    2010-07-01

    ... grounding resistors; disconnecting devices. 77.802 Section 77.802 Mineral Resources MINE SAFETY AND HEALTH... of high-voltage circuits; neutral grounding resistors; disconnecting devices. High-voltage circuits... grounded through a suitable resistor at the source transformers, and a grounding circuit, originating at...

  2. SPICE Modeling of Body Bias Effect in 4H-SiC Integrated Circuit Resistors

    Science.gov (United States)

    Neudeck, Philip G.

    2017-01-01

    The DC electrical behavior of n-type 4H-SiC resistors used for realizing 500C durable integrated circuits (ICs) is studied as a function of substrate bias and temperature. Improved fidelity electrical simulation is described using SPICE NMOS model to simulate resistor substrate body bias effect that is absent from the SPICE semiconductor resistor model.

  3. Multi-detector CT evaluation in patients suspected of tracheobronchomalacia: Comparison of end-expiratory with dynamic expiratory volumetric acquisitions

    Energy Technology Data Exchange (ETDEWEB)

    Ferretti, Gilbert R. [Department of Radiology (France)], E-mail: gferretti@chu-grenoble.fr; Jankowski, Adrien [Department of Radiology (France)], E-mail: ajankowski@chu-grenoble.fr; Perrin, Marie Amelie [Department of Radiology (France)], E-mail: maperrin@chu-grenoble.fr; Chouri, Nathalie [Department of Respiratory Diseases (France)], E-mail: nchouri@chu-grenoble.fr; Arnol, Nathalie [Sleep Laboratory and EFCR, University Hospital, Grenoble (France); HP2 Laboratory, INSERM ERI 0017 (Hypoxia: Pathophysiology), Joseph Fourier University, Grenoble (France)], E-mail: narnold@chu-grenoble.fr; Aubaud, Laurent [Department of Radiology (France)], E-mail: laubaud@chu-grenoble.fr; Pepin, Jean-Louis [Sleep Laboratory and EFCR, University Hospital, Grenoble (France); HP2 Laboratory, INSERM ERI 0017 (Hypoxia: Pathophysiology), Joseph Fourier University, Grenoble (France)], E-mail: jlpepin@chu-grenoble.fr

    2008-11-15

    Purpose: The aim of this study was to compare dynamic expiratory imaging and end-expiratory imaging using multi-detector CT (MDCT) of the central airways in patients suspected of tracheobronchomalacia (TBM). Methods: This study had local ethical committee approval. Seventy patients suspected of TBM were prospectively included. All patients underwent evaluation of central airways by three different low-dose MDCT acquisitions: end inspiration, end expiration, and dynamic expiration. Degree of airway collapse was measured by calculating the percentage change in the area and diameter of the airways between inspiratory and the two expiratory techniques at three levels of the trachea and in the sagittal diameter of the right and left main bronchi. Three threshold levels of percentage reduction in diameter or area (30%, 50%, and 70%) for defining TBM were evaluated. Results: In the entire population, the mean percentage of airway collapse was significantly greater with dynamic expiratory imaging than with the end-expiratory imaging at three different levels: lower thoracic trachea (26% vs. 16.6%, p < 0.009), right (25.2% vs. 14%, p < 0.01) and left main (24.7% vs. 13.3%, p < 0.01) bronchus. Whatever the threshold value for defining TBM, dynamic expiratory imaging always resulted in diagnosing TBM in more patients than end-expiratory imaging. Conclusions: Dynamic expiratory imaging shows a significantly greater degree and a significantly greater extent of airway collapse than standard end-expiratory imaging in patients suspected of TBM. Further evaluation of the clinical relevance of such findings is warranted.

  4. variant formula for predicting peak expiratory flow rate in pregnant ...

    African Journals Online (AJOL)

    DR. AMINU

    Accepted: November, 2009. VARIANT FORMULA FOR PREDICTING PEAK EXPIRATORY FLOW RATE IN. PREGNANT WOMEN IN KURA LOCAL GOVERNMENT AREA, KANO STATE,. NIGERIA. A. I. Salisu. Department of Human Physiology, Faculty of Medicine, Bayero University, Kano salisahmedibrahim@yahoo.co.uk;.

  5. Effects of Inspiratory and Expiratory Muscle Training in Normal Subjects

    OpenAIRE

    Sasaki, Makoto; Kurosawa, Hajime; Kohzuki, Masahiro

    2005-01-01

    The present study aimed to clarify the effects of inspiratory muscle training (IMT) and expiratory muscle training (EMT) on ventilatory muscle strength, pulmonary function and responses during exercise testing. Young healthy women were randomly assigned to 3 groups: IMT (n=16); EMT (n=16); or untrained normal controls (NC, n=8). Subjects in the IMT and EMT groups trained for 15 minutes twice daily over 2 weeks at loads of 30% maximal inspiratory and expiratory muscle strength, respectively. V...

  6. A Random Trimming Approach for Obtaining High-Precision Embedded Resistors

    Science.gov (United States)

    2008-12-01

    target resistance) Fr eq ue nc y Single-Dive/Random Trimming L-Cut Trimming Higher Precision Lower Precision 67 Points 66 Poin ts 0 5 10 15 20 25 30 35 40...layers.1 For a resistor of a given value, the total power dissipated (P) by the resistor is, R VRIP 2 2 == (9) where I is the current flowing...through the resistor, R is the resistance value of the resistor, and V is the voltage across the resistor. The total power dissipated by the

  7. Does Ramadan fasting affect expiratory flow rates in healthy subjects?

    Science.gov (United States)

    Subhan, Mirza M F; Siddiqui, Qamar A; Khan, Mohammed N; Sabir, Salman

    2006-11-01

    To assess whether Ramadan fasting affects the expiratory flow rates in healthy subjects, and to know if these effects correlate to a change in other variables. This unmatched case-control longitudinal study includes 46 non-smoking healthy subjects who undertook lung function testing at the Aga Khan University, Pakistan. Expiratory flow rates and body mass were measured in 3 Islamic months, corresponding to November 2001 to January 2002. There was a significant reduction in body mass in Ramadan compared to pre and post Ramadan. No significant changes in expiratory flows were seen during Ramadan as compared to the pre Ramadan period. However, forced expiratory flow rates at 75% of vital capacity (FEF(75)) and between 75% and 85% of vital capacity (FEF(75-85)) showed a significant increase in the post Ramadan period compared to Ramadan. Changes in FEF(75) were negatively correlated to changes in body mass between Ramadan and post Ramadan. This study shows that Ramadan fasting will not affect expiratory flow rates in healthy subjects. Post Ramadan values did show an increase in FEF(75) and FEF(75-85), possibly due to changes in body water and fat content. The reductions in body mass were most probably due to lack of nutrition and not dehydration as the fasts were performed in winter. Collection of reference values or early phase clinical trials measuring expiratory flow rates should not be affected by Ramadan fasting.

  8. Positive expiratory pressure improves oxygenation in healthy subjects exposed to hypoxia.

    Directory of Open Access Journals (Sweden)

    Hugo Nespoulet

    Full Text Available INTRODUCTION: Positive end-expiratory pressure (PEEP is commonly used in critical care medicine to improve gas exchange. Altitude sickness is associated with exaggerated reduction in arterial oxygenation. We assessed the effect of PEEP and pursed lips breathing (PLB on arterial and tissue oxygenation under normobaric and hypobaric hypoxic conditions. METHODS: Sixteen healthy volunteers were exposed to acute normobaric hypoxia (Laboratory study, FiO₂=0.12. The protocol consisted in 3-min phases with PEEPs of 0, 5 or 10 cmH₂O, PLB or similar ventilation than with PEEP-10, interspaced with 3-min phases of free breathing. Arterial (pulse oximetry and quadriceps (near-infrared spectroscopy oxygenation, ventilation, cardiac function, esophageal and gastric pressures and subjects' subjective perceptions were recorded continuously. In addition, the effect of PEEP on arterial oxygenation was tested at 4,350 m of altitude in 9 volunteers breathing for 20 min with PEEP-10 (Field study. RESULTS: During the laboratory study, PEEP-10 increased arterial and quadriceps oxygenation (arterial oxygen saturation +5.6±5.0% and quadriceps oxyhemoglobin +58±73 µmol.cm compared to free breathing; p0.05 compared to PEEP-0. During the field study, PEEP-10 increased arterial oxygen saturation by +6.7±6.0% after the 3(rd minute with PEEP-10 without further significant increase until the 20(th minute with PEEP-10. Subjects did not report any significant discomfort with PEEP. CONCLUSIONS: These data indicate that 10-cmH₂O PEEP significantly improves arterial and muscle oxygenation under both normobaric and hypobaric hypoxic conditions in healthy subjects. PEEP-10 could be an attractive non-pharmacological tool to limit blood oxygen desaturation and possibly symptoms at altitude.

  9. System and method of modulating electrical signals using photoconductive wide bandgap semiconductors as variable resistors

    Science.gov (United States)

    Harris, John Richardson; Caporaso, George J; Sampayan, Stephen E

    2013-10-22

    A system and method for producing modulated electrical signals. The system uses a variable resistor having a photoconductive wide bandgap semiconductor material construction whose conduction response to changes in amplitude of incident radiation is substantially linear throughout a non-saturation region to enable operation in non-avalanche mode. The system also includes a modulated radiation source, such as a modulated laser, for producing amplitude-modulated radiation with which to direct upon the variable resistor and modulate its conduction response. A voltage source and an output port, are both operably connected to the variable resistor so that an electrical signal may be produced at the output port by way of the variable resistor, either generated by activation of the variable resistor or propagating through the variable resistor. In this manner, the electrical signal is modulated by the variable resistor so as to have a waveform substantially similar to the amplitude-modulated radiation.

  10. Long-term facilitation of expiratory and sympathetic activities following acute intermittent hypoxia in rats.

    Science.gov (United States)

    Lemes, E V; Aiko, S; Orbem, C B; Formentin, C; Bassi, M; Colombari, E; Zoccal, D B

    2016-07-01

    Acute intermittent hypoxia (AIH) promotes persistent increases in ventilation and sympathetic activity, referred as long-term facilitation (LTF). Augmented inspiratory activity is suggested as a major component of respiratory LTF. In this study, we hypothesized that AIH also elicits a sustained increase in expiratory motor activity. We also investigated whether the expiratory LTF contributes to the development of sympathetic LTF after AIH. Rats were exposed to AIH (10 × 6-7% O2 for 45 s, every 5 min), and the cardiorespiratory parameters were evaluated during 60 min using in vivo and in situ approaches. In unanesthetized conditions (n = 9), AIH elicited a modest but sustained increase in baseline mean arterial pressure (MAP, 104 ± 2 vs. 111 ± 3 mmHg, P < 0.05) associated with enhanced sympathetic and respiratory-related variabilities. In the in situ preparations (n = 9), AIH evoked LTF in phrenic (33 ± 12%), thoracic sympathetic (75 ± 25%) and abdominal nerve activities (69 ± 14%). The sympathetic overactivity after AIH was phase-locked with the emergence of bursts in abdominal activity during the late-expiratory phase. In anesthetized vagus-intact animals, AIH increased baseline MAP (113 ± 3 vs. 122 ± 2 mmHg, P < 0.05) and abdominal muscle activity (535 ± 94%), which were eliminated after pharmacological inhibition of the retrotrapezoid nucleus/parafacial respiratory group (RTN/pFRG). These findings indicate that increased expiratory activity is also an important component of AIH-elicited respiratory LTF. Moreover, the development of sympathetic LTF after AIH is linked to the emergence of active expiratory pattern and depends on the integrity of the neurones of the RTN/pFRG. © 2016 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

  11. Short-term effects of positive expiratory airway pressure in patients being weaned from mechanical ventilation

    Directory of Open Access Journals (Sweden)

    Marcelo de Mello Rieder

    2009-05-01

    Full Text Available OBJECTIVE: To investigate the feasibility and the cardiorespiratory effects of using positive expiratory airway pressure, a physiotherapeutic tool, in comparison with a T-tube, to wean patients from mechanical ventilation. METHODS/DESIGN: A prospective, randomized, cross-over study. SETTING: Two intensive care units. PATIENTS AND INTERVENTIONS: We evaluated forty patients who met weaning criteria and had been mechanically-ventilated for more than 48 hours, mean age 59 years, including 23 males. All patients were submitted to the T-tube and Expiratory Positive Airway Pressure devices, at 7 cm H2O, during a 30-minute period. Cardiorespiratory variables including work of breathing, respiratory rate (rr, peripheral oxygen saturation (SpO2, heart rate (hr, systolic, diastolic and mean arterial pressures (SAP, DAP, MAP were measured in the first and thirtieth minutes. The condition was analyzed as an entire sample set (n=40 and was also divided into subconditions: chronic obstructive pulmonary disease (n=14 and non-chronic obstructive pulmonary disease (non- chronic obstructive pulmonary disease (n=26 categories. Comparisons were made using a t-test and Analysis of Variance. The level of significance was p < 0.05. RESULTS: Our data showed an increase in work of breathing in the first and thirtieth minutes in the EPAP condition (0.86+ 0.43 and 1.02+1.3 as compared with the T-tube condition (0.25+0.26 and 0.26+0.35 (p<0.05, verified by the flow-sensor monitor (values in J/L. No statistical differences were observed when comparing the Expiratory Positive Airway Pressure and T-tube conditions with regard to cardiorespiratory measurements. The same result was observed for both chronic obstructive pulmonary disease and non- chronic obstructive pulmonary disease subconditions. CONCLUSIONS: Our study demonstrated that, in weaning patients from mechanical ventilation, the use of a fixed level of Expiratory Positive Airway Pressure caused an increase in work of

  12. Ultra-high-ohmic microstripline resistors for Coulomb blockade devices

    Science.gov (United States)

    Lotkhov, Sergey V.

    2013-06-01

    In this paper, we report on the fabrication and low-temperature characterization of ultra-high-ohmic microstripline resistors made of a thin film of weakly oxidized titanium. Nearly linear voltage-current characteristics were measured at temperatures down to T ˜ 20 mK for films with sheet resistivities as high as ˜7 kΩ, i.e. about an order of magnitude higher than our previous findings for weakly oxidized Cr. Our analysis indicates that such an improvement can help to create an advantageous high-impedance environment for different Coulomb blockade devices. Further properties of the Ti film addressed in this work show the promise of low-noise behavior of the resistors when applied in different realizations of the quantum standard of current.

  13. Review on surface mounting components (wire wound chip resistors) development

    Science.gov (United States)

    Shiota, Shigeo; Nakao, Masahiro; Shimizu, Akira

    1992-08-01

    An overview of the development review on surface mounting components (wire wound chip resistors) is presented. Temperature rise tests were conducted on wire wound chip resistors installing them on substrates made of alumina, glass epoxy resin, or polyimide to determine their temperature rise characteristics, and maximum load factors were determined taking substrate heat resisting temperature and solder melting temperature into consideration. Evaluation tests were conducted on the filters' resistance to environments (thermal shock, anti hydroscopicity, thermal stability, loaded life, shock, random vibration, radiation resistance, out gassing), and the subject filters functioned satisfactory with exception of difficulty of conducting the thermal stability test at 125 C which was lower than the temperature specified in the NASDA's (National Space Development Agency of Japan's) specification due to problems of heat resistance of the molding resin material.

  14. 1/f Noise in Ceramic Superconductors and Granular Resistors

    OpenAIRE

    Takagi, Keiji; Mizunami, Toru; Okayama, Hideyuki; Shiyuan, Yang

    1990-01-01

    The authors have measured the current noise in some components of granular structure. The samples are ceramic superconductors, carbon-black graft-polymer resistors, and positive temperature coefficient(PTe) ceramics. All noise spectra are of the 1/! type. The temperature dependence of the noise level is measured and compared with the temperature dependence of the resistance, It is shown that in these components the temperature coefficient of the resistance is related to the noise level as pre...

  15. Design of a Compact Dump Resistor System for LCD Magnet

    CERN Document Server

    Gaddi, A

    2010-01-01

    In this technical note we suggest a possible solution for the choice of the detector magnet dump resistor. The push-pull scenario for Linear Collider Detectors imposes new solutions for magnet powering and protection lines, else than what developed for LHC detectors. The magnet dump resistor is the protecting equipment that has the function of extracting a significant amount of magnetic stored energy, from the coil winding to a dump. The LCD magnet has to move with the experiment from the garage to the beam position, so it has to be compact and reliable at the same time. We make here a proposal for a passive water-cooled dumper, we calculate the minimum amount of water required, the resistor hot-spot temperature, the overall mechanical design. The electrical part is not covered by this note, as it can be assumed that the solutions adopted by LHC detector magnets, in terms of quench instrumentation, energy extraction and maximum voltage, are not significantly affected by the push-pull scenario.

  16. Defect tolerance in resistor-logic demultiplexers for nanoelectronics.

    Science.gov (United States)

    Kuekes, Philip J; Robinett, Warren; Williams, R Stanley

    2006-05-28

    Since defect rates are expected to be high in nanocircuitry, we analyse the performance of resistor-based demultiplexers in the presence of defects. The defects observed to occur in fabricated nanoscale crossbars are stuck-open, stuck-closed, stuck-short, broken-wire, and adjacent-wire-short defects. We analyse the distribution of voltages on the nanowire output lines of a resistor-logic demultiplexer, based on an arbitrary constant-weight code, when defects occur. These analyses show that resistor-logic demultiplexers can tolerate small numbers of stuck-closed, stuck-open, and broken-wire defects on individual nanowires, at the cost of some degradation in the circuit's worst-case voltage margin. For stuck-short and adjacent-wire-short defects, and for nanowires with too many defects of the other types, the demultiplexer can still achieve error-free performance, but with a smaller set of output lines. This design thus has two layers of defect tolerance: the coding layer improves the yield of usable output lines, and an avoidance layer guarantees that error-free performance is achieved.

  17. Physiological techniques for detecting expiratory flow limitation during tidal breathing

    Directory of Open Access Journals (Sweden)

    N.G. Koulouris

    2011-09-01

    Full Text Available Patients with severe chronic obstructive pulmonary disease (COPD often exhale along the same flow–volume curve during quiet breathing as they do during the forced expiratory vital capacity manoeuvre, and this has been taken as an indicator of expiratory flow limitation at rest (EFLT. Therefore, EFLT, namely attainment of maximal expiratory flow during tidal expiration, occurs when an increase in transpulmonary pressure causes no increase in expiratory flow. EFLT leads to small airway injury and promotes dynamic pulmonary hyperinflation, with concurrent dyspnoea and exercise limitation. In fact, EFLT occurs commonly in COPD patients (mainly in Global Initiative for Chronic Obstructive Lung Disease III and IV stage, in whom the latter symptoms are common, but is not exclusive to COPD, since it can also be detected in other pulmonary and nonpulmonary diseases like asthma, acute respiratory distress syndrome, heart failure and obesity, etc. The existing up to date physiological techniques of assessing EFLT are reviewed in the present work. Among the currently available techniques, the negative expiratory pressure has been validated in a wide variety of settings and disorders. Consequently, it should be regarded as a simple, noninvasive, practical and accurate new technique.

  18. Electrical Switching of Perovskite Thin-Film Resistors

    Science.gov (United States)

    Liu, Shangqing; Wu, Juan; Ignatiev, Alex

    2010-01-01

    Electronic devices that exploit electrical switching of physical properties of thin films of perovskite materials (especially colossal magnetoresistive materials) have been invented. Unlike some related prior devices, these devices function at room temperature and do not depend on externally applied magnetic fields. Devices of this type can be designed to function as sensors (exhibiting varying electrical resistance in response to varying temperature, magnetic field, electric field, and/or mechanical pressure) and as elements of electronic memories. The underlying principle is that the application of one or more short electrical pulse(s) can induce a reversible, irreversible, or partly reversible change in the electrical, thermal, mechanical, and magnetic properties of a thin perovskite film. The energy in the pulse must be large enough to induce the desired change but not so large as to destroy the film. Depending on the requirements of a specific application, the pulse(s) can have any of a large variety of waveforms (e.g., square, triangular, or sine) and be of positive, negative, or alternating polarity. In some applications, it could be necessary to use multiple pulses to induce successive incremental physical changes. In one class of applications, electrical pulses of suitable shapes, sizes, and polarities are applied to vary the detection sensitivities of sensors. Another class of applications arises in electronic circuits in which certain resistance values are required to be variable: Incorporating the affected resistors into devices of the present type makes it possible to control their resistances electrically over wide ranges, and the lifetimes of electrically variable resistors exceed those of conventional mechanically variable resistors. Another and potentially the most important class of applications is that of resistance-based nonvolatile-memory devices, such as a resistance random access memory (RRAM) described in the immediately following article

  19. The Kölliker-Fuse nucleus orchestrates the timing of expiratory abdominal nerve bursting.

    Science.gov (United States)

    Barnett, William H; Jenkin, Sarah E M; Milsom, William K; Paton, Julian F R; Abdala, Ana P; Molkov, Yaroslav I; Zoccal, Daniel B

    2018-02-01

    Coordination of respiratory pump and valve muscle activity is essential for normal breathing. A hallmark respiratory response to hypercapnia and hypoxia is the emergence of active exhalation, characterized by abdominal muscle pumping during the late one-third of expiration (late-E phase). Late-E abdominal activity during hypercapnia has been attributed to the activation of expiratory neurons located within the parafacial respiratory group (pFRG). However, the mechanisms that control emergence of active exhalation, and its silencing in restful breathing, are not completely understood. We hypothesized that inputs from the Kölliker-Fuse nucleus (KF) control the emergence of late-E activity during hypercapnia. Previously, we reported that reversible inhibition of the KF reduced postinspiratory (post-I) motor output to laryngeal adductor muscles and brought forward the onset of hypercapnia-induced late-E abdominal activity. Here we explored the contribution of the KF for late-E abdominal recruitment during hypercapnia by pharmacologically disinhibiting the KF in in situ decerebrate arterially perfused rat preparations. These data were combined with previous results and incorporated into a computational model of the respiratory central pattern generator. Disinhibition of the KF through local parenchymal microinjections of gabazine (GABA A receptor antagonist) prolonged vagal post-I activity and inhibited late-E abdominal output during hypercapnia. In silico, we reproduced this behavior and predicted a mechanism in which the KF provides excitatory drive to post-I inhibitory neurons, which in turn inhibit late-E neurons of the pFRG. Although the exact mechanism proposed by the model requires testing, our data confirm that the KF modulates the formation of late-E abdominal activity during hypercapnia. NEW & NOTEWORTHY The pons is essential for the formation of the three-phase respiratory pattern, controlling the inspiratory-expiratory phase transition. We provide

  20. Platinum thin film resistors as accurate and stable temperature sensors

    Science.gov (United States)

    Diehl, W.

    1984-01-01

    The measurement characteristics of thin-Pt-film temperature sensors fabricated using advanced methods are discussed. The limitations of wound-wire Pt temperature sensors and the history of Pt-film development are outlined, and the commonly used film-deposition, structuring, and trimming methods are presented in a table. The development of a family of sputtered film resistors is described in detail and illustrated with photographs of the different types. The most commonly used tolerances are reported as + or - 0.3 C + 0.5 percent of the temperature measured.

  1. Lung and chest wall mechanics during exercise: effects of expiratory flow limitation.

    Science.gov (United States)

    Aliverti, Andrea

    2008-11-30

    This short review summarizes how lung and chest wall mechanics can be modelled and which are the mechanical constraints imposed on the ventilatory system and its components during exercise. In healthy humans the structural and functional characteristics of the ventilator pump are able to meet the increased demands of ventilation during exercise and it is rare that arterial blood gas is significantly altered up to maximal exercise. In contrast, exercise is frequently limited by the ventilator system in disease, especially when altered mechanical properties of the airway and lung make expiratory flow limitation (EFL) a common feature. EFL is a phenomenon that can be understood in terms of the viscous effects of gas flowing from the alveoli to the airway opening along a collapsible airway which leads during exercise to dynamic hyperflation and several abnormalities of the ventilatory pump. These, in turn, determine a series of secondary manifestations, namely dyspnoea, exercise limitation and hypercapnia that can cause serious morbidity.

  2. Peak Expiratory Flow Rate in Petroleum Depot Workers and Petrol ...

    African Journals Online (AJOL)

    Peak Expiratory Flow Rate (PEFR) values in litres per minute were determined in petrol depot loaders, petrol station attendants and in control subjects. The PEFR values were 315 ± 94, 386 + 91 and 529 + 94 litres/min. in depot workers, petrol attendants and control subjects respectively. The value in the control subjects ...

  3. Peak expiratory flow rate and respiratory symptoms following ...

    African Journals Online (AJOL)

    Peak expiratory flow rate (PEFR) of 350 rural women aged (20-70 years) in Edo State, Nigeria who actively used wood as a source of fuel for cooking was measured. The height, chest circumference, weight and blood pressure of the women were also measured. Respiratory symptoms of cough with sputum production, ...

  4. Factors influencing peak expiratory flow in teenage boys | van ...

    African Journals Online (AJOL)

    Background. Peak expiratory flow (PEF) is a useful measure of pulmonary health status and is frequently utilised in asthm, management. Reduction in PEF is usually indicative of onset (of asthma symptoms. However, use can be made of PEF values only if normal values are known. The definition of normal range is always ...

  5. variations of peak expiratory flow rate with anthropometric

    African Journals Online (AJOL)

    admin

    Summary: PEFR was measured in 300 healthy adult male and female staff and students of the. University of Benin, Benin City, and the College of Education, Ekiadolor, near Benin. The variations of. Peak Expiratory Flow Rate (PEFR) with respect to height (ht), weight (wt) and chest circumference (cc) were determined in ...

  6. Changes in Peak Expiratory Flow Rate, Blood Pressure and Pulse ...

    African Journals Online (AJOL)

    Changes in Peak Expiratory Flow Rate, Blood Pressure and Pulse Rate Following Ingestion of Increased Coffee Concentrations in Healthy Male Adults. ... It further indicates that, mild doses of coffee confer benefits on airflow in the lungs. While higher doses are also beneficial in improving airflow in the airway, such doses ...

  7. Changes in Peak Expiratory Flow Rate, Blood Pressure and Pulse ...

    African Journals Online (AJOL)

    We studied the effect of different concentrations of coffee on peak expiratory flow rate (PEFR), blood pressure and pulse rate in an attempt to determine some physiological effects of coffee intake. 18 apparently healthy adult males, age range 20 to 30 years, were recruited for the study over a three day period. Varying ...

  8. Knowledge, attitude and practice of nurses toward peak expiratory ...

    African Journals Online (AJOL)

    The lowest individual mean percent score was that of procedures and steps of measuring peak expiratory flow rate (39.0 ± 24.1%). The highest percent knowledge score was that of benefits of use and content instructions for teaching patients (78.3 ± 19.5% and 78.1 ±12.0%, respectively). Sociodemographic factors did not ...

  9. Light-induced EMF in silver-palladium film resistors

    Science.gov (United States)

    Mikheev, G. M.; Zonov, R. G.; Aleksandrov, V. A.

    2010-07-01

    We have studied the generation of nanosecond emf pulses in silver-palladium film resistors under the action of radiation of a Q-switched laser. The samples were fabricated using the technology of thick film resistors on dielectric substrates, based on fusing a resistive paste that contains palladium, silver oxide, glass, and an organic binder into the substrate at 880 K. The amplitude of detected pulses exhibits linear growth with the power of incident laser radiation, depends on the angle of light incidence (vanishes at the normal incidence) onto the film and the angle of film rotation about the normal to its surface, and changes its sign with that of the incidence angle. The duration of the generated emf pulses is several times that of the incident laser pulses. The signal is not of a thermoelectric nature and can be related to the current generation by means of the surface photogalvanic effect and the photon quasi-momentum transfer to charge carriers during light absorption by the film material.

  10. Characteristics and Breakdown Behaviors of Polysilicon Resistors for High Voltage Applications

    Directory of Open Access Journals (Sweden)

    Xiao-Yu Tang

    2015-01-01

    Full Text Available With the rapid development of the power integrated circuit technology, polysilicon resistors have been widely used not only in traditional CMOS circuits, but also in the high voltage applications. However, there have been few detailed reports about the polysilicon resistors’ characteristics, like voltage and temperature coefficients and breakdown behaviors which are critical parameters of high voltage applications. In this study, we experimentally find that the resistance of the polysilicon resistor with a relatively low doping concentration shows negative voltage and temperature coefficients, while that of the polysilicon resistor with a high doping concentration has positive voltage and temperature coefficients. Moreover, from the experimental results of breakdown voltages of the polysilicon resistors, it could be deduced that the breakdown of polysilicon resistors is thermally rather than electrically induced. We also proposed to add an N-type well underneath the oxide to increase the breakdown voltage in the vertical direction when the substrate is P-type doped.

  11. Expiratory Flow Limitation Definition, Mechanisms, Methods, and Significance

    Directory of Open Access Journals (Sweden)

    Claudio Tantucci

    2013-01-01

    Full Text Available When expiratory flow is maximal during tidal breathing and cannot be increased unless operative lung volumes move towards total lung capacity, tidal expiratory flow limitation (EFL is said to occur. EFL represents a severe mechanical constraint caused by different mechanisms and observed in different conditions, but it is more relevant in terms of prevalence and negative consequences in obstructive lung diseases and particularly in chronic obstructive pulmonary disease (COPD. Although in COPD patients EFL more commonly develops during exercise, in more advanced disorder it can be present at rest, before in supine position, and then in seated-sitting position. In any circumstances EFL predisposes to pulmonary dynamic hyperinflation and its unfavorable effects such as increased elastic work of breathing, inspiratory muscles dysfunction, and progressive neuroventilatory dissociation, leading to reduced exercise tolerance, marked breathlessness during effort, and severe chronic dyspnea.

  12. Standard-resistor compounds with adjustable operating temperature

    Science.gov (United States)

    Oe, T.; Urano, C.; Kaneko, N.; Hadano, M.; Takenaka, K.

    2013-10-01

    The broad peak of the temperature-resistivity curve ρ(T) in antiperovskite Mn3AgN can potentially be used to develop materials with temperature coefficients of resistance as low as that of the widely used standard-resistor material Manganin. By partially replacing Ag by In or Mn by Fe, we suppressed the peak height of ρ(T) in Mn3AgN to levels that in some cases were lower than that of Manganin, and by co-doping with Cu and In or Fe, the peak temperature could be controlled over a temperature width of at least 50 K around room temperature while retaining the broadness of ρ(T) curve.

  13. Resistor-less charge sensitive amplifier for semiconductor detectors

    Energy Technology Data Exchange (ETDEWEB)

    Pelczar, K., E-mail: krzysztof.pelczar@doctoral.uj.edu.pl; Panas, K.; Zuzel, G.

    2016-11-01

    A new concept of a Charge Sensitive Amplifier without a high-value resistor in the feedback loop is presented. Basic spectroscopic parameters of the amplifier coupled to a coaxial High Purity Germanium detector (HPGe) are discussed. The amplifier signal input is realized with an n-channel J-FET transistor. The feedback capacitor is discharged continuously by the second, forward biased n-channel J-FET, driven by an RC low–pass filter. Both the analog—with a standard spectroscopy amplifier and a multi-channel analyzer—and the digital—by applying a Flash Analog to Digital Converter—signal readouts were tested. The achieved resolution in the analog and the digital readouts was 0.17% and 0.21%, respectively, at the Full Width at Half Maximum of the registered {sup 60}Co 1332.5 keV gamma line.

  14. Circular photogalvanic effect observed in silver-palladium film resistors

    Science.gov (United States)

    Mikheev, G. M.; Aleksandrov, V. A.; Saushin, A. S.

    2011-06-01

    The surface circular photogalvanic effect (CPGE) at a laser wavelength of 1064 nm was observed for the first time in silver-palladium resistors fabricated by a thick-film technology. The CPGE response was detected using the electrodes oriented parallel to the radiation incidence plane, for the laser beam obliquely incident onto the sample surface. The coefficient of the pulsed laser radiation power conversion into light-induced emf (with the polarity depending on the sign of the circular polarization) amounted to about 80 mV/MW for film dimensions of 0.02 × 20 × 20 mm and a load resistance of 50 Ω. The maximum absolute value of the conversion coefficient was observed for the angles of light incidence of ±60°.

  15. Indium Tin Oxide Resistor-Based Nitric Oxide Microsensors

    Science.gov (United States)

    Xu, Jennifer C.; Hunter, Gary W.; Gonzalez, Jose M., III; Liu, Chung-Chiun

    2012-01-01

    A sensitive resistor-based NO microsensor, with a wide detection range and a low detection limit, has been developed. Semiconductor microfabrication techniques were used to create a sensor that has a simple, robust structure with a sensing area of 1.10 0.99 mm. A Pt interdigitated structure was used for the electrodes to maximize the sensor signal output. N-type semiconductor indium tin oxide (ITO) thin film was sputter-deposited as a sensing material on the electrode surface, and between the electrode fingers. Alumina substrate (250 m in thickness) was sequentially used for sensor fabrication. The resulting sensor was tested by applying a voltage across the two electrodes and measuring the resulting current. The sensor was tested at different concentrations of NO-containing gas at a range of temperatures. Preliminary results showed that the sensor had a relatively high sensitivity to NO at 450 C and 1 V. NO concentrations from ppm to ppb ranges were detected with the low limit of near 159 ppb. Lower NO concentrations are being tested. Two sensing mechanisms were involved in the NO gas detection at ppm level: adsorption and oxidation reactions, whereas at ppb level of NO, only one sensing mechanism of adsorption was involved. The NO microsensor has the advantages of high sensitivity, small size, simple batch fabrication, high sensor yield, low cost, and low power consumption due to its microsize. The resistor-based thin-film sensor is meant for detection of low concentrations of NO gas, mainly in the ppb or lower range, and is being developed concurrently with other sensor technology for multispecies detection. This development demonstrates that ITO is a sensitive sensing material for NO detection. It also provides crucial information for future selection of nanostructured and nanosized NO sensing materials, which are expected to be more sensitive and to consume less power.

  16. Inclusion of Body-Bias Effect in SPICE Modeling of 4H-SiC Integrated Circuit Resistors

    Science.gov (United States)

    Neudeck, Philip G.

    2017-01-01

    The DC electrical behavior of n-type 4H-SiC resistors used for realizing 500 C durable integrated circuits (ICs) is studied as a function of substrate bias and temperature. Improved fidelity electrical simulation is described using SPICE NMOS model to simulate resistor substrate body bias effect that is absent from the SPICE semiconductor resistor model.

  17. A random access memory immune to single event upset using a T-Resistor

    Science.gov (United States)

    Ochoa, A. Jr.

    1987-10-28

    In a random access memory cell, a resistance ''T'' decoupling network in each leg of the cell reduces random errors caused by the interaction of energetic ions with the semiconductor material forming the cell. The cell comprises two parallel legs each containing a series pair of complementary MOS transistors having a common gate connected to the node between the transistors of the opposite leg. The decoupling network in each leg is formed by a series pair of resistors between the transistors together with a third resistor interconnecting the junction between the pair of resistors and the gate of the transistor pair forming the opposite leg of the cell. 4 figs.

  18. Ultrabroadband Microwave Metamaterial Absorber Based on Electric SRR Loaded with Lumped Resistors

    Science.gov (United States)

    Zhao, Jingcheng; Cheng, Yongzhi

    2016-10-01

    An ultrabroadband microwave metamaterial absorber (MMA) based on an electric split-ring resonator (ESRR) loaded with lumped resistors is presented. Compared with an ESRR MMA, the composite MMA (CMMA) loaded with lumped resistors offers stronger absorption over an extremely extended bandwidth. The reflectance simulated under different substrate loss conditions indicates that incident electromagnetic (EM) wave energy is mainly consumed by the lumped resistors. The simulated surface current and power loss density distributions further illustrate the mechanism underlying the observed absorption. Further simulation results indicate that the performance of the CMMA can be tuned by adjusting structural parameters of the ESRR and lumped resistor parameters. We fabricated and measured MMA and CMMA samples. The CMMA yielded below -10 dB reflectance from 4.4 GHz to 18 GHz experimentally, with absorption bandwidth and relative bandwidth of 13.6 GHz and 121.4%, respectively. This ultrabroadband microwave absorber has potential applications in the electromagnetic energy harvesting and stealth fields.

  19. A low-cost DAC BIST structure using a resistor loop.

    Directory of Open Access Journals (Sweden)

    Jaewon Jang

    Full Text Available This paper proposes a new DAC BIST (digital-to-analog converter built-in self-test structure using a resistor loop known as a DDEM ADC (deterministic dynamic element matching analog-to-digital converter. Methods for both switch reduction and switch effect reduction are proposed for solving problems related to area overhead and accuracy of the conventional DAC BIST. The proposed BIST modifies the length of each resistor in the resistor loop via a merging operation and reduces the number of switches and resistors. In addition, the effect of switches is mitigated using the proposed switch effect reduction method. The accuracy of the proposed BIST is demonstrated by the reduction in the switch effect. The experimental results show that the proposed BIST reduces resource usages and the mismatch error caused by the switches.

  20. A low-cost DAC BIST structure using a resistor loop.

    Science.gov (United States)

    Jang, Jaewon; Kim, Heetae; Kang, Sungho

    2017-01-01

    This paper proposes a new DAC BIST (digital-to-analog converter built-in self-test) structure using a resistor loop known as a DDEM ADC (deterministic dynamic element matching analog-to-digital converter). Methods for both switch reduction and switch effect reduction are proposed for solving problems related to area overhead and accuracy of the conventional DAC BIST. The proposed BIST modifies the length of each resistor in the resistor loop via a merging operation and reduces the number of switches and resistors. In addition, the effect of switches is mitigated using the proposed switch effect reduction method. The accuracy of the proposed BIST is demonstrated by the reduction in the switch effect. The experimental results show that the proposed BIST reduces resource usages and the mismatch error caused by the switches.

  1. Prolonged slow expiration technique in infants: effects on tidal volume, peak expiratory flow, and expiratory reserve volume.

    Science.gov (United States)

    Lanza, Fernanda C; Wandalsen, Gustavo; Dela Bianca, Ana Caroline; Cruz, Carolina L; Postiaux, Guy; Solé, Dirceu

    2011-12-01

    Prolonged slow expiration (PSE) is a physiotherapy technique often applied in infants to reduce pulmonary obstruction and clear secretions, but there have been few studies of PSE's effects on the respiratory system. To describe PSE's effects on respiratory mechanics in infants. We conducted a cross-sectional study with 18 infants who had histories of recurrent wheezing. The infants were sedated for lung-function testing, which was followed by PSE. The PSE consisted of 3 sequences of prolonged manual thoraco-abdominal compressions during the expiratory phase. We measured peak expiratory flow (PEF), tidal volume (V(T)), and the frequency of sighs during and immediately after PSE. We described the exhaled volume during PSE as a fraction of expiratory reserve volume (%ERV). We quantified ERV with the raised-volume rapid-thoracic-compression technique. The cohort's mean age was 32.2 weeks, and they had an average of 4.8 previous wheezing episodes. During PSE there was significant V(T) reduction (80 ± 17 mL vs 49 ± 11 mL, P < .001), no significant change in PEF (149 ± 32 mL/s vs 150 ± 32 mL/s, P = .54), and more frequent sighs (40% vs 5%, P = .03), compared to immediately after PSE. The exhaled volume increased in each PSE sequence (32 ± 18% of ERV, 41 ± 24% of ERV, and 53 ± 20% of ERV, P = .03). It was possible to confirm and quantify that PSE deflates the lung to ERV. PSE caused no changes in PEF, induced sigh breaths, and decreased V(T), which is probably the main mechanical feature for mucus clearance.

  2. Thoracoabdominal asynchrony and ratio of time to peak tidal expiratory flow over total expiratory time in adolescents with cystic fibrosis.

    Science.gov (United States)

    Hunter, J M; Sperry, E E; Ravilly, S; Colin, A A

    1999-09-01

    Thoracoabdominal asynchrony (TAA) and the ratio of time to peak tidal expiratory flow over total expiratory time (TME/TE) have been used to assess airway obstruction in infants and adults. We obtained these measurements using calibrated respiratory inductance plethysmography (RIP) on 15 adolescents and young adults with cystic fibrosis (CF) and varying disease severity. The measurements were then compared to 15 normal age-matched controls. TAA was expressed as a phase angle (phi) calculated from the abdominal (AB) and ribcage (RC) signals acquired from scalar strip chart recordings. Using CODAS (DATAQ Instruments, Akron, OH) software, the analog signals were digitized, and the differentiated sum (AB + RC) signal was used to calculate TME/TE. Forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) were obtained using RIP in all subjects. Subjects with CF had a significantly higher mean phi than the control subjects (15 degrees vs. 8 degrees, respectively, P = 0.01). In the CF patients the specificity of a high phi as an indicator of abnormality was 80%, while the sensitivity was 65%. There was no correlation in the magnitude of phi and disease severity as assessed by FVC or FEV1. There was no significant difference in TME/TE between the groups. We conclude that RIP-acquired phi, but not TME/TE, is a simple and useful method to detect the presence of airway obstructive disease. We speculate that the sensitivity of this method will increase in younger patients with more compliant chest walls and less air trapping. Longitudinal studies of phi in infants and young children with lung disease could help in assessing disease severity and progression in this population, in whom repeated measures are few and complex.

  3. Dynamics of end expiratory lung volume after changing positive end-expiratory pressure in acute respiratory distress syndrome patients.

    Science.gov (United States)

    Garnero, Aude; Tuxen, David; Corno, Gaëlle; Durand-Gasselin, Jacques; Hodgson, Carol; Arnal, Jean-Michel

    2015-09-18

    Lung recruitment maneuvers followed by an individually titrated positive end-expiratory pressure (PEEP) are the key components of the open lung ventilation strategy in acute respiratory distress syndrome (ARDS). The staircase recruitment maneuver is a step-by-step increase in PEEP followed by a decremental PEEP trial. The duration of each step is usually 2 minutes without physiologic rationale. In this prospective study, we measured the dynamic end-expiratory lung volume changes (ΔEELV) during an increase and decrease in PEEP to determine the optimal duration for each step. PEEP was progressively increased from 5 to 40 cmH2O and then decreased from 40 to 5 cmH2O in steps of 5 cmH2O every 2.5 minutes. The dynamic of ΔEELV was measured by direct spirometry as the difference between inspiratory and expiratory tidal volumes over 2.5 minutes following each increase and decrease in PEEP. ΔEELV was separated between the expected increased volume, calculated as the product of the respiratory system compliance by the change in PEEP, and the additional volume. Twenty-six early onset moderate or severe ARDS patients were included. Data are expressed as median [25th-75th quartiles]. During the increase in PEEP, the expected increased volume was achieved within 2[2-2] breaths. During the decrease in PEEP, the expected decreased volume was achieved within 1 [1-1] breath, and 95 % of the additional decreased volume was achieved within 8 [2-15] breaths. Completion of volume changes in 99 % of both increase and decrease in PEEP events required 29 breaths. In early ARDS, most of the ΔEELV occurs within the first minute, and change is completed within 2 minutes, following an increase or decrease in PEEP.

  4. Resistor array performance errors associated with extended targets

    Science.gov (United States)

    Sisko, R. Bryan; Marlow, Steven A.; Huber, August J.; Thompson, Rhoe A.

    2006-05-01

    In recent hardware-in-the-loop tests conducted in a cryogenic chamber, a dual band sensor observed radiometric anomalies for extended targets. In order to understand the radiometric errors associated with the infrared projection arrays, systematic measurements were performed at both cryogenic and ambient temperatures. Air Force Research Laboratory (AFRL) engineers have previously investigated an artifact observed in these arrays called "busbar robbing," but these observations were of square blocks of emitters and did not characterize radiometric accuracy of extended targets in a dynamic engagement scenario. It was discovered that when numerous emitters in a contiguous pattern are turned on, rather than scattered over the array, the "busbar robbing" effect causes the actual emitter outputs to be different from what you measure if you drive them to the same level with fewer pixels. When the emitters that are driven have some "aspect ratio" or elongated shape, then the effect is dependent on how this pattern is aligned with the emitter axes. The results of these experiments address the radiometric error that can be expected from the resistor array projectors for end game scenarios when a target becomes extended at both ambient and cryogenic temperatures.

  5. Development of Low-Noise High Value Chromium Silicide Resistors for Cryogenic Detector Applications

    Science.gov (United States)

    Jhabvala, Murzy; Babu, Sachi; Monroy, Carlos; Darren, C.; Krebs, Carolyn A. (Technical Monitor)

    2001-01-01

    Extremely high sensitivity detectors, such as silicon bolometers are required in many NASA missions for detection of photons from the x-ray to the far infrared regions. Typically, these detectors are cooled to well below the liquid helium (LHe) temperature (4.2 K) to achieve the maximum detection performance. As photoconductors, they are generally operated with a load resistor and a pre-set bias voltage, which is then coupled to the input gate of a source-follower Field Effect Transistor (FET) circuit. It is imperative that the detector system signal to noise performance be limited by the noise of the detector and not by the noise of the external components. The load resistor value is selected to optimize the detector performance. These two criteria tend to be contradictory in that these detectors require load resistors in the hundreds of megaohms, which leads to a higher Johnson noise. Additionally, the physical size of the resistor must be small for device integration as required by such missions as the NASA High Resolution Airborne Wide-Band Camera (HAWC) instrument and the Submillimeter High Angular Resolution Camera (SHARC) for the Caltech Submillimeter Observatory (CSO). We have designed, fabricated and characterized thin film resistors using a CrSi/TiW/Al metal system on optical quality quartz substrates. The resistor values range from 100 megaohms to over 650 megaohms and are Johnson noise limited at LHe temperatures. The resistor film is sputtered with a sheet resistance ranging from 300 ohms to 1600 ohms and the processing sequence developed for these devices allows for chemically fine tuning the sheet resistance in-situ. The wafer fabrication process was of sufficiently high yield (>80%) providing clusters of good resistors for integrated multiple detector channels, a very important feature in the assembly of these two instruments.

  6. Special features of large-size resistors for high-voltage pulsed installations

    Science.gov (United States)

    Minakova, N. N.; Ushakov, V. Ya.

    2017-12-01

    Many structural materials in pulsed power engineering operate under extreme conditions. For example, in high-voltage electrophysical installations among which there are multistage high-voltage pulse generators (HVPG), rigid requirements are imposed on characteristics of solid-state resistors that are more promising in comparison with widely used liquid resistors. Materials of such resistors shall be able to withstand strong electric fields, operate at elevated temperatures, in transformer oil, etc. Effective charge of high-voltage capacitors distributed over the HVPG steps (levels) requires uniform voltage distribution along the steps of the installation that can be obtained using large-size resistors. For such applications, polymer composite materials are considered rather promising. They can work in transformer oil and have small mass in comparison with bulky resistors on inorganic basis. This allows technical solutions already developed and implemented in HVPG with liquid resistors to be employed. This paper is devoted to the solution of some tasks related to the application of filled polymers in high-voltage engineering.

  7. Abdominal wall reconstruction for large incisional hernia restores expiratory lung function

    DEFF Research Database (Denmark)

    Jensen, Kristian K; Backer, Vibeke; Jorgensen, Lars N

    2017-01-01

    (horizontal fascial defect width >10 cm) were compared with 18 patients with an intact abdominal wall who underwent colorectal resection. Patients were examined pre- and 1-year postoperatively. Examined measures included forced vital capacity, forced expiratory volume in first second, peak expiratory flow......-up, the abdominal wall reconstruction group showed significant improvement in percent predicted peak expiratory flow and maximal expiratory mouth pressure, whereas all other measurements of lung function remained unchanged. Respiratory quality of life did not change significantly. Patients who underwent abdominal...... wall reconstruction showed a significantly greater improvement of percent predicted peak expiratory flow compared with patients undergoing colorectal resection. CONCLUSION: Abdominal wall reconstruction for large incisional hernia improved long-term expiratory lung function. Respiratory quality of life...

  8. Control of abdominal and expiratory intercostal muscle activity during vomiting - Role of ventral respiratory group expiratory neurons

    Science.gov (United States)

    Miller, Alan D.; Tan, L. K.; Suzuki, Ichiro

    1987-01-01

    The role of ventral respiratory group (VRG) expiratory (E) neurons in the control of abdominal and internal intercostal muscle activity during vomiting was investigated in cats. Two series of experiments were performed: in one, the activity of VRG E neurons was recorded during fictive vomiting in cats that were decerebrated, paralyzed, and artificially ventilated; in the second, the abdominal muscle activity during vomiting was compared before and after sectioning the axons of descending VRG E neurons in decerebrate spontaneously breathing cats. The results show that about two-thirds of VRG E neurons that project at least as far caudally as the lower thoracic cord contribute to internal intercostal muscle activity during vomiting. The remaining VRG E neurons contribute to abdominal muscle activation. As shown by severing the axons of the VRG E neurons, other, as yet unidenified, inputs (either descending from the brain stem or arising from spinal reflexes) can also produce abdominal muscle activation.

  9. Expiratory and expiratory plus inspiratory muscle training improves respiratory muscle strength in subjects with COPD: systematic review.

    Science.gov (United States)

    Neves, Leonardo F; Reis, Manoela H; Plentz, Rodrigo D M; Matte, Darlan L; Coronel, Christian C; Sbruzzi, Graciele

    2014-09-01

    Inspiratory muscle training (IMT) produces beneficial effects in COPD subjects, but the effects of expiratory muscle training (EMT) and EMT plus IMT in ventilatory training are still unclear. The aim of this study was to systematically review the effects of EMT and EMT plus IMT compared to control groups of COPD subjects. This study is a systematic review and meta-analysis. The search strategy included MEDLINE, Embase, LILACS, PEDro, and Cochrane CENTRAL and also manual search of references in published studies on the subject. Randomized trials comparing EMT and EMT plus IMT versus control groups of subjects with COPD were included. The outcomes analyzed were respiratory muscle strength and functional capacity. Two reviewers independently extracted the data. The search retrieved 609 articles. Five studies were included. We observed that EMT provided higher gain in maximum expiratory pressure (P(E(max)) 21.49 cm H2O, 95% CI 13.39-29.59) and maximum inspiratory pressure (P(I(max)) 7.68 cm H2O, 95% CI 0.90-14.45) compared to control groups. There was no significant difference in the 6-min walk test distance (29.01 m, 95% CI -39.62 to 97.65) and dyspnea (0.15, 95% CI -0.77 to 1.08). In relation to EMT plus IMT, we observed that P(E(max)) (31.98 cm H2O, 95% CI 26.93-37.03) and P(I(max)) (27.98 cm H2O, 95% CI 20.10-35.85) presented higher values compared to control groups. EMT and EMT plus IMT improve respiratory muscle strength and can be used as part of the treatment during pulmonary rehabilitation of subjects with severe to very severe COPD. Copyright © 2014 by Daedalus Enterprises.

  10. Implementation of variable segments to model the arterial system using electromechanical analogy

    Science.gov (United States)

    Borik, Stefan; Cap, Ivo; Babusiak, Branko; Capova, Klara

    2017-05-01

    The article deals with the design of an electrical model of variable segments of a non-symmetrical tree of small arteries This model can be used to simulate the blood pressure and flow. Peripheral arterial resistance changes are modelled by an exponentially dependent resistor. By modulating the capacitor value, we can model the arterial wall properties which depend on the arterial pressure. Simulations are performed in which vasoconstriction and vasodilation were modelled by varying the transmural pressure. As a result, we can observe the changes in the blood pressure for each arterial generation.

  11. Effects of high voltage pulse trimming on structural properties of thick-film resistors

    Directory of Open Access Journals (Sweden)

    Stanimirović Zdravko

    2017-01-01

    Full Text Available Nowadays, compact and reliable electronic devices including up-to-date ceramic micro-electro-mechanical systems require thick-film resistors with significantly reduced dimensions and stable and precise resistance values. For that reason, instead of standard laser trimming method, high voltage pulse trimming of thick-film resistors is being introduced. This method allows controlled and reliable resistance adjustment regardless of resistor position or dimensions and without the presence of cuts. However, it causes irreversible structural changes in the pseudorandom network formed during sintering causing the changes in conducting mechanisms. In this paper results of the experimental investigation of high voltage pulse trimming of thick-film resistors are presented. Obtained results are analyzed and correlations between resistance and low-frequency noise changes and changes in conducting mechanisms in resistors due to high voltage pulse trimming are observed. Sources of measured fluctuations are identified and it is shown that this type of trimming is a valid alternative trimming method to the dominant laser trimming. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III44003 and III45007

  12. Architecture design of resistor/FET-logic demultiplexer for hybrid CMOS/nanodevice circuit interconnect.

    Science.gov (United States)

    Li, Shu; Zhang, Tong

    2008-05-07

    Hybrid nanoelectronics consisting of nanodevice crossbars on top of CMOS backplane circuits is emerging as one viable option to sustain Moore's law after the CMOS scaling limit is reached. One main design challenge in such hybrid nanoelectronics is the interface between the highly dense nanowires in nanodevice crossbars and relatively coarse microwires in the CMOS domain. Such an interface can be realized through a logic circuit called a demultiplexer (demux). In this context, all the prior work on demux design uses a single type of device, such as resistor, diode or field effect transistor (FET), to realize the demultiplexing function. However, different types of devices have their own advantages and disadvantages in terms of functionality, manufacturability, speed and power consumption. This makes none of them provide a satisfactory solution. To tackle this challenge, this work proposes to combine resistor with FET to implement the demux, leading to the hybrid resistor/FET-logic demux. Such hybrid demux architecture can make these two types of devices complement each other well to improve the overall demux design effectiveness. Furthermore, due to the inevitable fabrication process variations at the nanoscale, the effects of resistor conductance and FET threshold voltage variability are analyzed and evaluated based on computer simulations. The simulation results provide the requirement on the fabrication process to ensure a high demux reliability, and promise the hybrid resistor/FET-logic demux an improved addressability and process variance tolerance.

  13. Respiratory and hemodynamic effects of diminished expiratory flow during artificial ventilation

    NARCIS (Netherlands)

    W. van Rooyen (Willem)

    1986-01-01

    textabstractThe supposition, that a diminished expiratory flow (DEF) during artificial ventilation will improve blood-gas exchange. especially in obstructive pulmonary disease and that DEF improves blood-gas exchange better than a comparable positive end-expiratory pressure (PEEP. producing the same

  14. Effects of positive end-expiratory pressure titration on gas exchange, respiratory mechanics and hemodynamics in anesthetized horses.

    Science.gov (United States)

    Ambrósio, Aline M; Ida, Keila K; Souto, Maria Tmr; Oshiro, Alexandre H; Fantoni, Denise T

    2013-11-01

    To assess if positive end-expiratory pressure (PEEP) titration improves gas exchange and respiratory mechanics, without hemodynamic impairment in horses during anesthesia. Prospective, randomized study. Thirteen isoflurane-anesthetized healthy horses. After 60 minutes of anesthesia with spontaneous breathing, mechanical ventilation was initiated with an inspiratory-expiratory ratio of 1:2, PEEP of 5 cmH2O, tidal volume of 10-20 mL kg(-1) and respiratory rate adjusted to maintain normocapnia. Constant PEEP of 5 cmH2O was continued (control group; n = 6) or titrated (PEEP group; n = 7) by increasing and decreasing PEEP from 5 to 20 cmH2O at 15-minute intervals. The horses were instrumented with an arterial catheter to measure blood pressure and allow collection of blood for pH and blood gas analysis and a Swan-Ganz catheter for measurement of cardiac output (CO) using thermodilution. Cardiopulmonary assessment was recorded before PEEP titration and after 15 minutes at each PEEP value. In the PEEP group, static compliance (range) (Cst 278-463 mL cmH2O(-1)) was significantly higher and the shunt fraction (Q·s/Q·t 7-20%) and the alveolar-arterial oxygen difference [P(A-a)O2 95-325 mmHg] were significantly lower than in the control group [Cst of 246-290 mL cmH2O(-1), Q·s/Q·t of 16-19%, P(A-a)O2 of 253-310 mmHg; p respiratory mechanics impairment during inhalation anesthesia can be treated using PEEP titration from 5 to 20 cmH2O, without clinically important hemodynamic effects in healthy horses. © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  15. Study of steatites for using as a high density resistor nucleus; Estudo de esteatito para utilizacao como nucleo de resistor de alta densidade

    Energy Technology Data Exchange (ETDEWEB)

    Salas, Humberto Terrazas; Costa, Antonio Carlos Lopes da; Barbosa, Joao Batista Santos; Silva, Luiz Carlos da; Rocha, Francisco de Assis [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN), Belo Horizonte, MG (Brazil)]. E-mail: salasht@cdtn.br

    2005-07-01

    In nuclear facilities where high density power resistors are applied in fuel irradiation circuits in the PWR reactor type, the probability of accident is high, therefore, it is necessary to experimentally test the nuclear facility safety project. In order to reach this goal, it is necessary to use an electric isolated material capable of withstanding high temperatures without melting or becoming deteriorated. That is where the lytologic type, classified as steatite or soapstone, must be used. The present work characterizes the steatite samples, suggesting the lytologic type to be used as the high density power resistors nucleus. Samples were selected from a steatite' processing industry located in the district of Cachoeira do Campo in Minas Gerais State. These lytologic types were sawed, evaluated macroscopically, subjected to specific preparation methods for chemical analysis and X rays diffraction, exposed to high temperatures, as well as petrographic studies and microanalyses. Samples marked by lower concentration levels of carbonates. (author)

  16. Expiratory and Inspiratory Cries Detection Using Different Signals' Decomposition Techniques.

    Science.gov (United States)

    Abou-Abbas, Lina; Tadj, Chakib; Gargour, Christian; Montazeri, Leila

    2017-03-01

    This paper addresses the problem of automatic cry signal segmentation for the purposes of infant cry analysis. The main goal is to automatically detect expiratory and inspiratory phases from recorded cry signals. The approach used in this paper is made up of three stages: signal decomposition, features extraction, and classification. In the first stage, short-time Fourier transform, empirical mode decomposition (EMD), and wavelet packet transform have been considered. In the second stage, various set of features have been extracted, and in the third stage, two supervised learning methods, Gaussian mixture models and hidden Markov models, with four and five states, have been discussed as well. The main goal of this work is to investigate the EMD performance and to compare it with the other standard decomposition techniques. A combination of two and three intrinsic mode functions (IMFs) that resulted from EMD has been used to represent cry signal. The performance of nine different segmentation systems has been evaluated. The experiments for each system have been repeated several times with different training and testing datasets, randomly chosen using a 10-fold cross-validation procedure. The lowest global classification error rates of around 8.9% and 11.06% have been achieved using a Gaussian mixture models classifier and a hidden Markov models classifier, respectively. Among all IMF combinations, the winner combination is IMF3+IMF4+IMF5. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Effect of Annealing Process on the Properties of Ni(55%)Cr(40%)Si(5%) Thin-Film Resistors.

    Science.gov (United States)

    Cheng, Huan-Yi; Chen, Ying-Chung; Li, Pei-Jou; Yang, Cheng-Fu; Huang, Hong-Hsin

    2015-10-02

    Resistors in integrated circuits (ICs) are implemented using diffused methods fabricated in the base and emitter regions of bipolar transistor or in source/drain regions of CMOS. Deposition of thin films on the wafer surface is another choice to fabricate the thin-film resistors in ICs' applications. In this study, Ni(55%)Cr(40%)Si(5%) (abbreviated as NiCrSi) in wt % was used as the target and the sputtering method was used to deposit the thin-film resistors on Al2O3 substrates. NiCrSi thin-film resistors with different thicknesses of 30.8 nm~334.7 nm were obtained by controlling deposition time. After deposition, the thin-film resistors were annealed at 400 °C under different durations in N₂ atmosphere using the rapid thermal annealing (RTA) process. The sheet resistance of NiCrSi thin-film resistors was measured using the four-point-probe method from 25 °C to 125 °C, then the temperature coefficient of resistance could be obtained. We aim to show that resistivity of NiCrSi thin-film resistors decreased with increasing deposition time (thickness) and the annealing process had apparent effect on the sheet resistance and temperature coefficient of resistance. We also aim to show that the annealed NiCrSi thin-film resistors had a low temperature coefficient of resistance (TCR) between 0 ppm/°C and +50 ppm/°C.

  18. Expiratory Muscle Strength Training Evaluated With Simultaneous High Resolution Manometry and Electromyography

    Science.gov (United States)

    Hutcheson, Katherine A.; Hammer, Michael J.; Rosen, Sarah P.; Jones, Corinne A.; McCulloch, Timothy M.

    2017-01-01

    Objective To examine feasibility of a simultaneous high-resolution pharyngeal manometry (HRM) and electromyography (EMG) experimental paradigm to detect swallowing-related patterns of palatal, laryngeal, and pharyngeal muscle activity during expiratory training. Study Design Technical report. Methods Simultaneous HRM, surface submental, and intramuscular EMG were acquired in two healthy participants during five tasks: 10-cc water swallow, maximum expiratory pressure (MEP) testing, and expiratory muscle strength training (EMST) at three pressure levels (sham, 50%, and 75% MEP). Results Experimental conditions were feasible. Velopharyngeal closing pressure, palate EMG activity, and pharyngeal EMG activity increased as expiratory load increased. In contrast, thyroarytenoid EMG activity was low during the expiratory task, consistent with glottic opening during exhalation. Submental EMG patterns were more variable during expiratory tasks. Intraluminal air pressures recorded with HRM were correlated with measured expiratory pressures and target valve-opening pressures of the EMST device. Conclusion Results suggest that a simultaneous HRM/EMG/EMST paradigm may be used to detect previously unquantified swallowing-related muscle activity during EMST, particularly in the palate and pharynx. Our approach and initial findings will be helpful to guide future hypothesis-driven studies and may enable investigators to evaluate other muscle groups active during these tasks. Defining mechanisms of action is a critical next step toward refining therapeutic algorithms using EMST and other targeted treatments for populations with dysphagia and airway disorders. PMID:28083946

  19. Expiratory muscle strength training evaluated with simultaneous high-resolution manometry and electromyography.

    Science.gov (United States)

    Hutcheson, Katherine A; Hammer, Michael J; Rosen, Sarah P; Jones, Corinne A; McCulloch, Timothy M

    2017-04-01

    To examine feasibility of a simultaneous high-resolution pharyngeal manometry (HRM) and electromyography (EMG) experimental paradigm to detect swallowing-related patterns of palatal, laryngeal, and pharyngeal muscle activity during expiratory training. Technical report. Simultaneous HRM, surface submental, and intramuscular EMG were acquired in two healthy participants during five tasks: 10-cc water swallow, maximum expiratory pressure (MEP) testing, and expiratory muscle strength training (EMST) at three pressure levels (sham, 50%, and 75% MEP). Experimental conditions were feasible. Velopharyngeal closing pressure, palate EMG activity, and pharyngeal EMG activity increased as expiratory load increased. In contrast, thyroarytenoid EMG activity was low during the expiratory task, consistent with glottic opening during exhalation. Submental EMG patterns were more variable during expiratory tasks. Intraluminal air pressures recorded with HRM were correlated with measured expiratory pressures and target valve-opening pressures of the EMST device. Results suggest that a simultaneous HRM/EMG/EMST paradigm may be used to detect previously unquantified swallowing-related muscle activity during EMST, particularly in the palate and pharynx. Our approach and initial findings will be helpful to guide future hypothesis-driven studies and may enable investigators to evaluate other muscle groups active during these tasks. Defining mechanisms of action is a critical next step toward refining therapeutic algorithms using EMST and other targeted treatments for populations with dysphagia and airway disorders. 4. Laryngoscope, 127:797-804, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  20. Manual compression of the abdomen to assess expiratory flow limitation during mechanical ventilation.

    Science.gov (United States)

    Lemyze, Malcolm; Favory, Raphael; Alves, Isabelle; Perez, Thierry; Mathieu, Daniel

    2012-02-01

    The aim of this study was to evaluate the manual compression of the abdomen (MCA) during expiration as a simple bedside method to detect expiratory flow limitation (EFL) during daily clinical practice of mechanical ventilation (MV). We studied 44 semirecumbent intubated and sedated critically ill patients. Flow-volume loops obtained during MCA were superimposed upon the preceding breaths and recorded with the ventilator. Expiratory flow limitation was expressed as percentage of expiratory tidal volume without any increase in flow during MCA (MCA [%V(T)]). In the first 13 patients, MCA was validated by comparison with the negative expiratory pressure (NEP) technique. Esophageal pressure changes during MCA and intrinsic positive end-expiratory pressure were also recorded in all the patients. Manual compression of the abdomen and NEP agreed in all cases in detecting EFL with a bias of -0.16%. Percentage of expiratory tidal volume without any increase in flow during MCA is highly correlated with percentage of expiratory tidal volume without any increase in flow during NEP (n = 13, P respiratory disease. Manual compression of the abdomen provides a simple, rapid, and safe bedside reliable maneuver to detect and quantify EFL during mechanical ventilation. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Proposal Intensity Adequacy of Expiratory Effort and Heart Rate Behavior During the Valsalva Maneuver in Preadolescents

    Directory of Open Access Journals (Sweden)

    Mario Augusto Paschoal

    2014-08-01

    Full Text Available Background: When performing the Valsalva maneuver (VM, adults and preadolescents produce the same expiratory resistance values. Objective: To analyze heart rate (HR in preadolescents performing VM, and propose a new method for selecting expiratory resistance. Method: The maximal expiratory pressure (MEP was measured in 45 sedentary children aged 9-12 years who subsequently performed VM for 20 s using an expiratory pressure of 60%, 70%, or 80% of MEP. HR was measured before, during, and after VM. These procedures were repeated 30 days later, and the data collected in the sessions (E1, E2 were analyzed and compared in periods before, during (0-10 and 10-20 s, and after VM using nonparametric tests. Results: All 45 participants adequately performed VM in E1 and E2 at 60% of MEP. However, only 38 (84.4% and 25 (55.5% of the participants performed the maneuver at 70% and 80% of MEP, respectively. The HR delta measured during 0-10 s and 10-20 s significantly increased as the expiratory effort increased, indicating an effective cardiac autonomic response during VM. However, our findings suggest the VM should not be performed at these intensities. Conclusion: HR increased with all effort intensities tested during VM. However, 60% of MEP was the only level of expiratory resistance that all participants could use to perform VM. Therefore, 60% of MEP may be the optimal expiratory resistance that should be used in clinical practice.

  2. Hand-Drawn Resistors and a Simple Tester Using a Light-Emitting Diode

    Science.gov (United States)

    Kamata, Masahiro; Abe, Mayumi

    2012-01-01

    A thick line drawn on a sheet of paper with a 6B pencil is electrically conductive and its resistance can be roughly estimated using a simple tester made of a light-emitting diode (LED) and a lithium coin-type cell. Using this hand-drawn resistor and the LED tester, we developed teaching materials that help students to understand how electrical…

  3. A neutral grounding metallic resistor failure in a 35 kV network

    Directory of Open Access Journals (Sweden)

    Simić Ninoslav

    2011-01-01

    Full Text Available This paper presents the results of observations and measurements of the impedance of the metal resistor for grounding neutral of the 35 kV network, before and after damaging event. The proposed measures are to be taken in order to eliminate a failure in this particular case, as well as the prevention of similar events.

  4. Theoretical analysis of highly linear tunable filters using Switched-Resistor techniques

    NARCIS (Netherlands)

    Jiraseree-amornkun, Amorn; Jiraseree-Amornkun, A.; Worapishet, Apisak; Klumperink, Eric A.M.; Nauta, Bram; Surakampontorn, Wanlop

    2008-01-01

    Abstract—In this paper, an in-depth analysis of switched-resistor (S-R) techniques for implementing low-voltage low-distortion tunable active-RC filters is presented. The S-R techniques make use of switch(es) with duty-cycle-controlled clock(s) to achieve tunability of the effective resistance and,

  5. Hot-electron effect in PdAu thin-film resistors with attached cooling fins

    NARCIS (Netherlands)

    Pleikies, J.; Usenko, O.; Stolz, R.; Fritzsch, L.; Frossati, G.; Flokstra, Jakob

    2009-01-01

    The sensitivity of superconducting electronics operated in the sub-Kelvin temperature range is usually limited by the hot-electron effect. Here, an increased thermal resistance due to a weakened electron–phonon coupling leads to a higher temperature of the electrons in the thin-film shunt resistors

  6. A study of cross-bridge kelvin resistor structures for reliable measurement of low contact resistances

    NARCIS (Netherlands)

    Stavitski, N.; Klootwijk, J.H.; van Zeijl, H.W.; Kovalgin, Alexeij Y.; Wolters, Robertus A.M.

    2008-01-01

    The parasitic factors that strongly influence the measurement accuracy of Cross-Bridge Kelvin Resistor (CBKR) structures for low specific contact resistances (�?c) have been extensively discussed during last few decades and the minimum of the �?c value, which could be accurately extracted, was

  7. Implications of expiratory muscle strength training for rehabilitation of the elderly: Tutorial.

    Science.gov (United States)

    Kim, Jaeock; Sapienza, Christine M

    2005-01-01

    With age, physical functions decline, which influences respiratory performance. One of the physical changes associated with aging is sarcopenia, a reduction in muscle strength and power. Sarcopenia has been extensively studied in the elderly with regard to limb function but less with regard to respiratory function. Elderly individuals experience reduced muscle mass and strength in respiratory musculature, which may hinder the ability to generate adequate expiratory driving force for both ventilatory and nonventilatory activities. Increasing expiratory muscle strength may enhance an elderly individual's ability to generate and maintain the expiratory driving force critical to cough, speak, and swallow. Previous studies demonstrate that expiratory muscle strength training (EMST) improves ventilatory and nonventilatory functions. This paper discusses the potential impact that EMST can have on the rehabilitation of respiratory muscle decline, particularly in the elderly. This tutorial reviews an EMST paradigm, its physiological underpinnings, and its potential outcomes.

  8. The effects of antioxidant vitamin supplementation on expiratory flow rates at rest and during exercise.

    Science.gov (United States)

    Chenoweth, Leonie M; Smith, Joshua R; Ferguson, Christine S; Downey, Amy E; Harms, Craig A

    2015-10-01

    Previous studies suggest that pulmonary function is associated with fruit and vegetable consumption and plasma concentrations of antioxidant vitamins. Also, expiratory flow limitation (EFL) has been reported to limit ventilation during exercise in healthy individuals. We hypothesized antioxidant vitamin supplementation (AVS) would increase resting expiratory flow rates in healthy subjects and reduce EFL during exercise. Ten healthy, nonsmoking subjects (5 M/5 W), consuming flow rates (FEF25-75, FEF50) by ~9%. Following AVS, %EFL was significantly reduced by ~15% at minute 15, 20, and end-exercise with no change (p > 0.05) in end-expiratory lung volumes. Breathing frequency and ratings of perceived exertion and dyspnea were also lower (p 0.05) were evident at rest or during exercise with PLA. These results suggest that AVS can increase TAS, improve resting expiratory flow rates and reduce EFL during exercise in healthy subjects who are not meeting fruit and vegetable recommendations.

  9. Physiological and morphological determinants of maximal expiratory flow in chronic obstructive lung disease

    NARCIS (Netherlands)

    H.A.W.M. Tiddens (Harm); J.M. Bogaard (Jan); J.C. de Jongste (Johan); W.C.J. Hop (Wim); H.O. Coxson (Harvey); P.D. Pare

    1996-01-01

    textabstractMaximal expiratory flow in chronic obstructive pulmonary disease (COPD) could be reduced by three different mechanisms; loss of lung elastic recoil, decreased airway conductance upstream of flow-limiting segments; and increased collapsibility of airways. We

  10. Effect of Supplementing Oxygen with Positive end Expiratory Pressure During Elective Caesarean Section under Spinal Anaesthesia on Foetus

    Science.gov (United States)

    Prabhu, Ramesh; Jayaraj; Shenoy, U Kailasanath

    2010-01-01

    Background: It is known fact that pre-oxygenation with positive end-expiratory pressure (PEEP) improves the Partial pressure of oxygen (PO 2). In this regard not many studies have been done in pregnant women to know its effect on foetus. In this randomised double blind controlled study, we analysed effect of pre-oxygenation with PEEP during caesarean section on foetal umbilical venous PO 2. Patients & Methods: 40 term pregnant women, ASA I or II, undergoing elective Caesarean section under spinal anaes-thesia were randomly divided into PEEP and Non-PEEP groups of 20 each. PEEP group received oxygen flow of 6 L/minute with PEEP of 5 cmH 2O using a modified Mapleson A circuit with fixed unidirectional PEEP valve at the expiratory port during pre-oxygenation and Non PEEP group received same fresh gas flow of oxygen using same breathing circuit without PEEP. Maternal arterial blood samples were collected before applying PEEP and at the end of 5 minutes of facemask application for oxygen analysis. Immediately after baby was delivered umbilical venous samples were taken for blood gas analysis. Results: Both groups were comparable in terms of maternal baseline oxygen saturation (Spo 2) and base line Po 2. After 5 minutes PO 2was higher in PEEP Group than non PEEP group (491.65 + 49.96 vs. 452.08 + 77.61). Umbilical venous Po 2in PEEP group was higher than non PEEP group (34.22 + 6.50 vs. 28.29 + 6.10 mm of Hg). Conclusion: Application of PEEP during pre-oxygenation for spinal anaesthesia can increase foetal umbilical venous PO2. PMID:21547172

  11. Decreased peak expiratory flow in pediatric passive smokers

    Directory of Open Access Journals (Sweden)

    Fitri Yanti

    2011-08-01

    Full Text Available Background Indonesia ranks fifth among countries with the highest aggregate levels of tobacco consumption in the world. Infants and children exposed to environmental tobacco smoke have increased rates of asthma, respiratory and ear infections, as well as reduced lung function. The effects of tobacco smoke exposure on lung function in children have been reported to be dependent on the source of smoke and the length and dose of exposure. Lung function may also be affected by a child’s gender and asthma status. Objective To compare peak expiratory flow (PEF in pediatric passive smokers to that of children not exposed to second hand smoke, and to define factors that may affect PEF in passive smokers. Methods In August 2009 we conducted a cross-sectional study at an elementary school in the Langkat district. Subjects were aged 6 to 12 years, and divided into two groups: passive smokers and those not exposed to secondhand smoke. Subjects’ PEFs were measured with a Mini-Wright peak flow meter. Measurements were performed in triplicate with the highest value recorded as the PEF. Demographic data including age, sex, weight, height, family income, parental education levels and occupations were obtained through questionnaires. Results Of the 170 participants, 100 were passive smokers and 70 were not exposed to secondhand smoke. Age distribution, weight and height were similar in both groups. We observed a significant difference in PEFs between the group of passive smokers and the group not exposed to secondhand smoke, 211.3 L/minute (SD 61.08 and 242.7 L/minute (SD 77.09, respectively (P < 0.005. The number of years of exposure to smoke (P = 0.079 and the number of cigarettes smoked daily in the household (P = 0.098 did not significantly influence PEF. Conclusion The PEF in pediatric passive smokers was significantly lower than that of children not exposed to secondhand smoke. PEF in passive smokers was not influenced by the number of years of smoke

  12. Expiratory muscle strength training improves swallowing and respiratory outcomes in people with dysphagia: a systematic review.

    Science.gov (United States)

    Brooks, Marinda; McLaughlin, Emma; Shields, Nora

    2017-11-01

    To investigate the effects of expiratory muscle strength training on communication and swallowing outcomes in adults with acquired motor based communication and/or swallowing difficulties of any aetiology. A systematic review was conducted. Six databases (CINAHL, MEDLINE, EMBASE, SPEECHBYTE, AMED and PUBMED) were searched from inception until end of May 2016. Randomised and non-randomised controlled studies and pre-test/post-test studies published in English that investigated the effects of expiratory muscle strength training were included. Study quality was assessed using the PEDro scale. Data were analysed descriptively and effect sizes and associated 95% confidence intervals were calculated. Seven articles reporting data from five studies were included. Preliminary data suggests expiratory muscle strength training improved airway safety during swallowing in people with dysphagia and increased the strength of the expiratory muscles in all patient groups. There was little evidence to suggest changes in communication outcomes after expiratory muscle strength training. Speech-language pathologists might consider using expiratory muscle strength training to improve airway safety in adults with swallowing disorders.

  13. 1/f Electrical Noise in Planar Resistors: The Joint Effect of a Backgating Noise and an Instrumental Disturbance

    OpenAIRE

    Izpura Torres, José Ignacio

    2008-01-01

    Any planar resistor (channel) close to a conducting layer left floating (gate) forms a capacitor C whose thermal voltage noise (kT/C noise) has a backgating effect on the sheet resistance of the channel that is a powerful source of 1/f resistance noise in planar resistors and, hence, in planar devices. This 1/f spectrum is created by the bias voltage V DS applied to the resistor, which is a disturbance that takes it out of thermal equilibrium and changes the resistance noise that existed in t...

  14. Nanoporous carbon tunable resistor/transistor and methods of production thereof

    Science.gov (United States)

    Biener, Juergen; Baumann, Theodore F; Dasgupta, Subho; Hahn, Horst

    2014-04-22

    In one embodiment, a tunable resistor/transistor includes a porous material that is electrically coupled between a source electrode and a drain electrode, wherein the porous material acts as an active channel, an electrolyte solution saturating the active channel, the electrolyte solution being adapted for altering an electrical resistance of the active channel based on an applied electrochemical potential, wherein the active channel comprises nanoporous carbon arranged in a three-dimensional structure. In another embodiment, a method for forming the tunable resistor/transistor includes forming a source electrode, forming a drain electrode, and forming a monolithic nanoporous carbon material that acts as an active channel and selectively couples the source electrode to the drain electrode electrically. In any embodiment, the electrolyte solution saturating the nanoporous carbon active channel is adapted for altering an electrical resistance of the nanoporous carbon active channel based on an applied electrochemical potential.

  15. SQUID-based current sensing noise thermometry for quantum resistors at dilution refrigerator temperatures

    Science.gov (United States)

    Kleinbaum, Ethan; Shingla, Vidhi; Csáthy, G. A.

    2017-03-01

    We present a dc Superconducting QUantum Interference Device (SQUID)-based current amplifier with an estimated input referred noise of only 2.3 fA/√{Hz}. Because of such a low amplifier noise, the circuit is useful for Johnson noise thermometry of quantum resistors in the kΩ range down to mK temperatures. In particular, we demonstrate that our circuit does not contribute appreciable noise to the Johnson noise of a 3.25 kΩ resistor down to 16 mK. Our circuit is a useful alternative to the commonly used High Electron Mobility Transistor-based amplifiers, but in contrast to the latter, it offers a much reduced 1/f noise. In comparison to SQUIDs interfaced with cryogenic current comparators, our circuit has similar low noise levels, but it is easier to build and to shield from magnetic pickup.

  16. 4-bit digital to analog converter using R-2R ladder and binary weighted resistors

    Science.gov (United States)

    Diosanto, J.; Batac, M. L.; Pereda, K. J.; Caldo, R.

    2017-06-01

    The use of a 4-bit digital-to-analog converter using two methods; Binary Weighted Resistors and R-2R Ladder is designed and presented in this paper. The main components that were used in constructing both circuits were different resistor values, operational amplifier (LM741) and single pole double throw switches. Both circuits were designed using MULTISIM software to be able to test the circuit for its ideal application and FRITZING software for the layout designing and fabrication to the printed circuit board. The implementation of both systems in an actual circuit benefits in determining and comparing the advantages and disadvantages of each. It was realized that the binary weighted circuit is more efficient DAC, having lower percentage error of 0.267% compared to R-2R ladder circuit which has a minimum of percentage error of 4.16%.

  17. Resonant mode behavior of lumped-resistor-loaded electric-inductive-capacitive resonator and its absorber application

    Directory of Open Access Journals (Sweden)

    Hong-Min Lee

    2013-05-01

    Full Text Available This paper presents investigations into the resonant mode behavior of a lumped-resistor-loaded electric-inductive-capacitive (ELC resonator, which is illuminated with a parallel polarization external electromagnetic wave. An ELC resonator exhibits a negative effective permittivity for both parallel and perpendicular polarizations. In contrast to a common ELC resonator, the lumped-resistor-loaded ELC resonator exhibits a switchable resonant mode behavior, thereby revealing a negative effective permeability. In addition, this resonator exhibits a low quality factor owing to the loaded lumped resistors. A metamaterial absorber, which consists of a lumped-resistor-loaded ELC resonator and a cut-wire strip, is designed to confirm the effectiveness of the resonator.

  18. Refinements in practical accuracy factors for resistor-array IR scene projectors

    Science.gov (United States)

    Pritchard, Alan P.; Venables, Mark A.; Lake, Stephen P.; Gough, David W.

    1998-07-01

    We describe incremental improvements in measurement, understanding and control of sensor-perceived scene accuracy factors for BAe resistor-array IR scene projector devices by means of system and device design, analysis and measurement methodology. Progress has been made in the areas of fill- factor measurement, aliasing effects, dead pixel statistics, image spreading, the design of non-uniformity correction (NUC) systems, busbar robbing, heatsink effects and noise sources.

  19. Zero-point term and quantum effects in the Johnson noise of resistors: a critical appraisal

    Science.gov (United States)

    Kish, Laszlo B.; Niklasson, Gunnar A.; Granqvist, Claes G.

    2016-05-01

    There is a longstanding debate about the zero-point term in the Johnson noise voltage of a resistor. This term originates from a quantum-theoretical treatment of the fluctuation-dissipation theorem (FDT). Is the zero-point term really there, or is it only an experimental artifact, due to the uncertainty principle, for phase-sensitive amplifiers? Could it be removed by renormalization of theories? We discuss some historical measurement schemes that do not lead to the effect predicted by the FDT, and we analyse new features that emerge when the consequences of the zero-point term are measured via the mean energy and force in a capacitor shunting the resistor. If these measurements verify the existence of a zero-point term in the noise, then two types of perpetual motion machines can be constructed. Further investigation with the same approach shows that, in the quantum limit, the Johnson-Nyquist formula is also invalid under general conditions even though it is valid for a resistor-antenna system. Therefore we conclude that in a satisfactory quantum theory of the Johnson noise, the FDT must, as a minimum, include also the measurement system used to evaluate the observed quantities. Issues concerning the zero-point term may also have implications for phenomena in advanced nanotechnology.

  20. Maximum Bandwidth Enhancement of Current Mirror using Series-Resistor and Dynamic Body Bias Technique

    Directory of Open Access Journals (Sweden)

    V. Niranjan

    2014-09-01

    Full Text Available This paper introduces a new approach for enhancing the bandwidth of a low voltage CMOS current mirror. The proposed approach is based on utilizing body effect in a MOS transistor by connecting its gate and bulk terminals together for signal input. This results in boosting the effective transconductance of MOS transistor along with reduction of the threshold voltage. The proposed approach does not affect the DC gain of the current mirror. We demonstrate that the proposed approach features compatibility with widely used series-resistor technique for enhancing the current mirror bandwidth and both techniques have been employed simultaneously for maximum bandwidth enhancement. An important consequence of using both techniques simultaneously is the reduction of the series-resistor value for achieving the same bandwidth. This reduction in value is very attractive because a smaller resistor results in smaller chip area and less noise. PSpice simulation results using 180 nm CMOS technology from TSMC are included to prove the unique results. The proposed current mirror operates at 1Volt consuming only 102 µW and maximum bandwidth extension ratio of 1.85 has been obtained using the proposed approach. Simulation results are in good agreement with analytical predictions.

  1. Vanadium sesquioxide (V2O3)-based semiconducting temperature sensitive resistors for uncooled microbolometers

    Science.gov (United States)

    Abdel-Rahman, Mohamed; Alduraibi, Mohammad; Zia, Muhammad Fakhar; Bahidra, Esme; Alasaad, Amr

    2017-05-01

    This paper reports on a semiconducting resistor material based on vanadium sesquioxide (V2O3) with electrical resistivity and temperature coefficient of resistance (TCR) appropriate for microbolometer applications. In this work, V2O3-based semiconducting resistor material was synthesized and electrically characterized. The developed material was prepared by annealing, in O2 and N2 atmospheres, a cascaded multilayer structure composed of V2O3 (10 nm) and V (5 nm) room temperature sputter coated thin films. The developed 55 nm thin film microbolometer resistor material possessed high temperature sensitivity from 20∘C to 45∘C with a TCR of -3.68%/∘C and room temperature resistivity of 0.57 Ω ṡcm for O2 annealed samples and a TCR of -3.72%/∘C and room temperature resistivity of 0.72 Ω ṡcm for N2 annealed samples. The surface morphologies of the synthesized thin films were studied using atomic force microscopy showing no significant post-growth annealing effect on the smoothness of the samples surfaces.

  2. Equivalence of effective medium and random resistor network models for disorder-induced unsaturating linear magnetoresistance

    Science.gov (United States)

    Ramakrishnan, Navneeth; Lai, Ying Tong; Lara, Silvia; Parish, Meera M.; Adam, Shaffique

    2017-12-01

    A linear unsaturating magnetoresistance at high perpendicular magnetic fields, together with a quadratic positive magnetoresistance at low fields, has been seen in many different experimental materials, ranging from silver chalcogenides and thin films of InSb to topological materials like graphene and Dirac semimetals. In the literature, two very different theoretical approaches have been used to explain this classical magnetoresistance as a consequence of sample disorder. The phenomenological random resistor network model constructs a grid of four terminal resistors, each with a varying random resistance. The effective medium theory model imagines a smoothly varying disorder potential that causes a continuous variation of the local conductivity. Here, we demonstrate numerically that both models belong to the same universality class and that a restricted class of the random resistor network is actually equivalent to the effective medium theory. Both models are also in good agreement with experiments on a diverse range of materials. Moreover, we show that in both cases, a single parameter, i.e., the ratio of the fluctuations in the carrier density to the average carrier density, completely determines the magnetoresistance profile.

  3. Electrohydrodynamic printing of organic polymeric resistors on flat and uneven surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Maktabi, Sepehr; Chiarot, Paul R., E-mail: pchiarot@binghamton.edu [Department of Mechanical Engineering, State University of New York at Binghamton, Binghamton, New York 13902 (United States)

    2016-08-28

    In materials printing applications, the ability to generate fine droplets is critical for achieving high-resolution features. Other desirable characteristics are high print speeds, large stand-off distances, and minimal instrumentation requirements. In this work, a tunable electrohydrodynamic (EHD) printing technique capable of generating micron-sized droplets is reported. This method was used to print organic resistors on flat and uneven substrates. These ubiquitous electronic components were built using the commercial polymer-based conductive ink poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) (PEDOT:PSS), which has been widely used in the manufacturing of organic electronic devices. Resistors with widths from 50 to 500 μm and resistances from 1 to 70 Ω/μm were created. An array of emission modes for EHD printing was identified. Among these, the most promising is the microdripping mode, where droplets 10 times smaller than the nozzle's inner diameter were created at frequencies in excess of 5 kHz. It was found that the ink flow rate, applied voltage, and stand-off distance all significantly influence the droplet generation frequency. In particular, the experimental results reveal that the frequency increases nonlinearly with the applied voltage. The non-Newtonian shear thinning behavior of PEDOT:PSS strongly influenced the droplet frequency. Finally, the topology of a 3-dimensional target substrate had a significant effect on the structure and function of a printed resistor.

  4. Effect of Annealing Process on the Properties of Ni(55%Cr(40%Si(5% Thin-Film Resistors

    Directory of Open Access Journals (Sweden)

    Huan-Yi Cheng

    2015-10-01

    Full Text Available Resistors in integrated circuits (ICs are implemented using diffused methods fabricated in the base and emitter regions of bipolar transistor or in source/drain regions of CMOS. Deposition of thin films on the wafer surface is another choice to fabricate the thin-film resistors in ICs’ applications. In this study, Ni(55%Cr(40%Si(5% (abbreviated as NiCrSi in wt % was used as the target and the sputtering method was used to deposit the thin-film resistors on Al2O3 substrates. NiCrSi thin-film resistors with different thicknesses of 30.8 nm~334.7 nm were obtained by controlling deposition time. After deposition, the thin-film resistors were annealed at 400 °C under different durations in N2 atmosphere using the rapid thermal annealing (RTA process. The sheet resistance of NiCrSi thin-film resistors was measured using the four-point-probe method from 25 °C to 125 °C, then the temperature coefficient of resistance could be obtained. We aim to show that resistivity of NiCrSi thin-film resistors decreased with increasing deposition time (thickness and the annealing process had apparent effect on the sheet resistance and temperature coefficient of resistance. We also aim to show that the annealed NiCrSi thin-film resistors had a low temperature coefficient of resistance (TCR between 0 ppm/°C and +50 ppm/°C.

  5. Patterns of expiratory and inspiratory activation for thoracic motoneurones in the anaesthetized and the decerebrate rat.

    Science.gov (United States)

    de Almeida, Anoushka T R; Al-Izki, Sarah; Denton, Manuel Enríquez; Kirkwood, Peter A

    2010-08-01

    The nervous control of expiratory muscles is less well understood than that of the inspiratory muscles, particularly in the rat. The patterns of respiratory discharges in adult rats were therefore investigated for the muscles of the caudal intercostal spaces, with hypercapnia and under either anaesthesia or decerebration. With neuromuscular blockade and artificial ventilation, efferent discharges were present for both inspiration and expiration in both external and internal intercostal nerves. This was also the case for proximal internal intercostal nerve branches that innervate only internal intercostal and subcostalis muscles. If active, this region of muscle in other species is always expiratory. Here, inspiratory bursts were almost always present. The expiratory activity appeared only gradually and intermittently, when the anaesthesia was allowed to lighten or as the pre-decerebration anaesthesia wore off. The intermittent appearance is interpreted as the coupling of a slow medullary expiratory oscillator with a faster inspiratory one. The patterns of nerve discharges, in particular the inspiratory or biphasic activation of the internal and subcostalis layers, were confirmed by observations of equivalent patterns of EMG discharges in spontaneously breathing preparations, using denervation procedures to identify which muscles generated the signals. Some motor units were recruited in both inspiratory and expiratory bursts. These patterns of activity have not previously been described and have implications both for the functional role of multiple respiratory oscillators in the adult and for the mechanical actions of the muscles of the caudal intercostal spaces, including subcostalis, which is a partly bisegmental muscle.

  6. Logic Gates Made of N-Channel JFETs and Epitaxial Resistors

    Science.gov (United States)

    Krasowski, Michael J.

    2008-01-01

    Prototype logic gates made of n-channel junction field-effect transistors (JFETs) and epitaxial resistors have been demonstrated, with a view toward eventual implementation of digital logic devices and systems in silicon carbide (SiC) integrated circuits (ICs). This development is intended to exploit the inherent ability of SiC electronic devices to function at temperatures from 300 to somewhat above 500 C and withstand large doses of ionizing radiation. SiC-based digital logic devices and systems could enable operation of sensors and robots in nuclear reactors, in jet engines, near hydrothermal vents, and in other environments that are so hot or radioactive as to cause conventional silicon electronic devices to fail. At present, current needs for digital processing at high temperatures exceed SiC integrated circuit production capabilities, which do not allow for highly integrated circuits. Only single to small number component production of depletion mode n-channel JFETs and epitaxial resistors on a single substrate is possible. As a consequence, the fine matching of components is impossible, resulting in rather large direct-current parameter distributions within a group of transistors typically spanning multiples of 5 to 10. Add to this the lack of p-channel devices to complement the n-channel FETs, the lack of precise dropping diodes, and the lack of enhancement mode devices at these elevated temperatures and the use of conventional direct coupled and buffered direct coupled logic gate design techniques is impossible. The presented logic gate design is tolerant of device parameter distributions and is not hampered by the lack of complementary devices or dropping diodes. In addition to n-channel JFETs, these gates include level-shifting and load resistors (see figure). Instead of relying on precise matching of parameters among individual JFETS, these designs rely on choosing the values of these resistors and of supply potentials so as to make the circuits perform

  7. Setting individualized positive end-expiratory pressure level with a positive end-expiratory pressure decrement trial after a recruitment maneuver improves oxygenation and lung mechanics during one-lung ventilation.

    Science.gov (United States)

    Ferrando, Carlos; Mugarra, Ana; Gutierrez, Andrea; Carbonell, Jose Antonio; García, Marisa; Soro, Marina; Tusman, Gerardo; Belda, Francisco Javier

    2014-03-01

    We investigated whether individualized positive end-expiratory pressure (PEEP) improves oxygenation, ventilation, and lung mechanics during one-lung ventilation compared with standardized PEEP. Thirty patients undergoing thoracic surgery were randomly allocated to the study or control group. Both groups received an alveolar recruitment maneuver at the beginning and end of one-lung ventilation. After the alveolar recruitment maneuver, the control group had their lungs ventilated with a 5 cm·H2O PEEP, while the study group had their lungs ventilated with an individualized PEEP level determined by a PEEP decrement trial. Arterial blood samples, lung mechanics, and volumetric capnography were recorded at multiple timepoints throughout the procedure. The individualized PEEP values in study group were higher than the standardized PEEP values (10 ± 2 vs 5 cm·H2O; P ventilation was switched to one-lung ventilation and increased after the alveolar recruitment maneuver. During one-lung ventilation, oxygenation was maintained in the study group but decreased in the control group. After one-lung ventilation, arterial oxygenation was significantly higher in the study group (306 vs 231 mm·Hg, P = 0.007). Static compliance decreased in both groups when bilateral-lung ventilation was switched to one-lung ventilation. Static compliance increased significantly only in the study group (P ventilation, the improvements in oxygenation and lung mechanics after an alveolar recruitment maneuver were better preserved by ventilation by using individualized PEEP with a PEEP decrement trial than with a standardized 5 cm·H2O of PEEP.

  8. High Positive End-Expiratory Pressure Is Associated with Improved Survival in Obese Patients with Acute Respiratory Distress Syndrome.

    Science.gov (United States)

    Bime, Christian; Fiero, Mallorie; Lu, Zhenqiang; Oren, Eyal; Berry, Cristine E; Parthasarathy, Sairam; Garcia, Joe G N

    2017-02-01

    In acute respiratory distress syndrome, minimizing lung injury from repeated collapse and reopening of alveoli by applying a high positive end-expiratory pressure improves oxygenation without influencing mortality. Obesity causes alveolar atelectasis, thus suggesting that a higher positive end-expiratory pressure might be more protective among the obese. We hypothesized that the effect of applying a high positive end-expiratory pressure on mortality from acute respiratory distress syndrome would differ by obesity status. This was a retrospective analysis of 505 patients from the Assessment of Low tidal Volume and elevated End-expiratory volume to Obviate Lung Injury Trial, a multicenter randomized trial that compared a higher vs a lower positive end-expiratory pressure ventilatory strategy in acute respiratory distress syndrome. We examined the relationship between positive end-expiratory pressure strategy and 60-day mortality stratified by obesity status. Among obese patients with acute respiratory distress syndrome, those assigned to a high positive end-expiratory pressure strategy experienced lower mortality compared with those assigned to a low strategy (18% vs 32%; P = .04). Among the nonobese, those assigned to high positive end-expiratory pressure strategy experienced similar mortality with those assigned to low strategy (34% vs 23%; P = .13). Multivariate analysis demonstrated an interaction between obesity status and the effect of positive end-expiratory pressure strategy on mortality (P pressure was associated with improved survival among the subgroup of patients with acute respiratory distress syndrome who are obese. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Upper airway collapsibility evaluated by a negative expiratory pressure test in severe obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Salvatore Romano

    2011-01-01

    Full Text Available OBJECTIVES: To investigate the usefulness of measuring upper airway collapsibility with a negative expiratory pressure application as a screening test for severe obstructive sleep apnea (OSA. INTRODUCTION: OSA is a risk factor for cardiovascular disease, and it may have serious consequences. Its recognition may have important implications during the perioperative period. Increased upper airway collapsibility is one of the main determinants of OSA, and its evaluation could be useful for identifying this condition. METHODS: Severe OSA and normal subjects (24 in each group were matched by body mass index and referred to our sleep laboratory. The subjects were enrolled in an overnight sleep study, and a diurnal negative expiratory pressure test was performed. Flow drop (DV and expiratory volume were measured in the first 0.2 s (V02 of the negative expiratory pressure test. RESULTS: DV (% and V02 (% values were statistically different between normal and OSA subjects. OSA patients showed a greater decrease in flow than normal subjects. In addition, severely OSA patients exhaled during the first 0.2 s of the negative expiratory pressure application was an average of only 11.2% of the inspired volume compared to 34.2% for the normal subjects. Analysis of the receiver operating characteristics showed that V02 (% and DV (% could accurately identify severe OSA in subjects with sensitivities of 95.8% and 91.7%, respectively, and specificities of 95.8% and 91.7%, respectively. CONCLUSIONS: V02 (% and DV (% are highly accurate parameters for detecting severe OSA. The pharyngeal collapsibility measurement, which uses negative expiratory pressure during wakefulness, is predictive of collapsibility during sleep.

  10. Impacts of Modelling Simplifications on Predicted Dispersion of Human Expiratory Droplets

    DEFF Research Database (Denmark)

    Liu, Li; Nielsen, Peter Vilhelm; Xu, Chunwen

    2016-01-01

    Person-to-person transmission of droplets and droplet nuclei during expiratory activities constitutes a prerequisite for airborne and droplet-borne infections. This study focuses on the impact of modelling simplifications on one manikin’s exposure to the other’s expiratory droplets via breathing....... The exhalation airflows are compared and validated by measurement results of human subjects. The flow field between two manikins are found significantly influenced by their exhalation airflows. Mono-dispersed droplets with an initial diameter of 10 μm are released from one breathe of a manikin. All droplets...... different from a detailed shape of human body and mouth....

  11. Peak expiratory flow rates produced with the Laerdal and Mapleson-C bagging circuits.

    Science.gov (United States)

    Jones, A; Hutchinson, R; Lin, E; Oh, T

    1992-01-01

    This study compared the peak expiratory flow rates (PEFR) at different inspiratory pause pressures (IPP) produced by the Mapleson-C circuit and the Laerdal self-inflating resuscitator. The difference in PEFR produced by the two circuits was significantly different at the lowest and the highest IPP studied (I3 and 38cm H20). The greatest differences in the mean expiratory flow rates produced was, however, only 0.07 litre sec(-7). The authors suggest that the choice of bagging circuit should depend on the experience and familiarity of the therapist with the circuit. Copyright © 1992 Australian Physiotherapy Association. Published by . All rights reserved.

  12. Effectiveness of end-expiratory lung volume measurements during the lung recruitment maneuver for patients with atelectasis.

    Science.gov (United States)

    Nakahashi, Susumu; Gando, Satoshi; Ishikawa, Takehiko; Wada, Takeshi; Yanagida, Yuichiro; Kubota, Nobuhiko; Uegaki, Shinji; Hayakawa, Mineji; Sawamura, Atsushi

    2013-08-01

    The aim of this study was to determine whether the relative change in the end-expiratory lung volume (EELV) obtained by the recruitment maneuver (RM) can serve as an indicator of the change in the P/F ratio. The effects of the intermittent stepwise increases in the RM (peak inspiratory pressure, 45, 50, and 55 cm H2O) were compared in 21 patients with atelectasis under mechanical ventilation. The EELV, the ratio of arterial oxygen concentration to the fraction of inspired oxygen P/F ratio, and relative change rate (Δ) in these parameters were evaluated after each RM. A greater improvement in the EELV (1157 ± 344 mL vs 1469 ± 396 mL) and P/F ratio (250 ± 99 vs 320 ± 92) was observed after the RM. The ΔEELV was correlated with the ΔP/F ratio (ρ = 0.73, P < .01) and was identified as an accurate predictor of the improvement of the ΔP/F ratio by the receiver operating characteristic curve (the area under the curve, 0.93; P < .01). These results suggest that the ΔEELV obtained by intermittent stepwise RM can serve as an indicator of the change in the P/F ratio. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Positive end-expiratory pressure and renal function influence B-type natriuretic peptide in patients with severe sepsis and septic shock.

    Science.gov (United States)

    Issa, Victor Sarli; Taniguchi, Leandro Utino; Park, Marcelo; Cruz, Luiz Monteiro; Bocchi, Edimar Alcides; Velasco, Irineu Tadeu; Soriano, Francisco

    2008-08-01

    Myocardial dysfunction is a complication associated with a poor prognosis in septic patients. A biomarker of cardiac function providing prognostic information is of paramount interest. We sought to determine the value of B-type natriuretic peptide in patients with severe sepsis/septic shock. We performed a prospective study in patients with severe sepsis/septic shock in a medical intensive care unit. B-type natriuretic peptide level was determined within 24 hours after the diagnosis of severe sepsis/septic shock. We also analyzed mortality, and presence of association between B-type natriuretic peptide and clinical, hemodynamic and respiratory variables. 23 (9 women; 14 men) patients with ages ranging from 20-79 (mean 51.3+/-18.6) years old and APACHE score of 22.6+/-11.8 were included; 15 (65.2%) patients received pulmonary artery catheters, and 20 (87%) were mechanically ventilated. Multivariate analysis disclosed inverse association between B-type natriuretic peptide values with positive end-expiratory pressure values, and direct association with creatinine (beta 0.548 and 0.377, p 0.02 and 0.002, respectively), but not with mortality, clinical and hemodynamic parameters. This is the first report on an inverse association between positive end-expiratory pressure and BNP levels in patients with severe sepsis and septic shock. BNP and creatinine levels should be taken into consideration when analyzing B-type natriuretic peptide levels in this setting.

  14. Evaluation of Peak Expiratory Flow rates (PEFR) of Workers in a ...

    African Journals Online (AJOL)

    Method: In this descriptive cross-sectional study, 105 workers of a cement company who presented for the annual fitness to work exercise were sampled and had their peak expiratory flow rates measured using a spirometer. Data were also collected using structured interviewer-administered questionnaires and a walk ...

  15. THE EFFECT OF SUBMAXIMAL INHALATION ON MEASURES DERIVED FROM FORCED EXPIRATORY SPIROMETRY

    Science.gov (United States)

    THE EFFECT OF SUBMAXIMAL INHALATION ON MEASURES DERIVED FROM FORCED EXPIRATORY SPIROMETRY. William F. McDonnell Human Studies Division, NHEERL, U.S. Environmental Protection Agency, RTP, NC 27711. Short-term exposure to ozone results in a neurally-mediated decrease in the ab...

  16. Peak Expiratory Flow as a Surrogate for Health Related Quality of ...

    African Journals Online (AJOL)

    Background: Health Related Quality of Life (HRQL) measures can capture the non-respiratory effects of Chronic Obstructive Pulmonary Disease (COPD). However the relationship with Peak Expiratory Flow (PEF) is not well understood. Aim: To determine the relationship of PEF and quality of life measurements in patients ...

  17. Changes in peak expiratory flow indices as a proxy for changes in bronchial hyperresponsiveness

    NARCIS (Netherlands)

    Douma, WR; Kerstjens, HAM; Roos, CM; Koeter, GH; Postma, DS

    Guidelines for asthma management advocate home peak expiratory flow (PEF) monitoring. It is commonly stated that PEF variability is a good prosy of branchial hyperresponsiveness (BHR), a hallmark of asthma, However, this has hardly been tested longitudinally, as required to monitor asthma, This

  18. INFLUENCE OF TREATMENT ON PEAK EXPIRATORY FLOW ACID ITS RELATION TO AIRWAY HYPERRESPONSIVENESS AND SYMPTOMS

    NARCIS (Netherlands)

    KERSTJENS, HAM; BRAND, PLP; DEJONG, PM; KOETER, GH; POSTMA, DS; QUANJER, PH; SLUITER, HJ; POUW, EM; SCHOONBROOD, DFME; ROOS, CM; JANSEN, HM; DEGOOYER, A; VANDERMARK, TW; STERK, PJ; WEVER, AMJ; DIJKMAN, JH; DEKHUIJZEN, PNR; FOLGERING, HTM; VANHERWAARDEN, CLA; OVERBEEK, SE; BOGAARD, JM; HILVERING, C; GANS, SJ; MENGELERS, HJJ; VANDERBRUGGENBOGAARTS, BAHA; KREUKNIET, J; VANESSENZANDVLIET, EEM; KERREBIJN, KF; DUIVERMAN, EJ; KOUWENBERG, JM; PRINSEN, JE; WAALKENS, HJ; GERRITSEN, J; KNOL, K; DEMONCHY, JGR; DEKKER, FW; KAPTEIN, AA; MERKUS, PJFM; POCOCK, SJ; HUGHES, MD; BLEECKER, ER; MEYERS, DA

    1994-01-01

    Background - Despite effective treatments, the morbidity and mortality of obstructive airways disease (asthma and COPD) remains high. Home monitoring of peak expiratory dow (PEF) is increasingly being advocated as an aid to better management of obstructive airways disease. The few available studies

  19. Seasonal variations in house dust mite influence the circadian peak expiratory flow amplitude

    NARCIS (Netherlands)

    Postma, DS; vanderHeide, S; deReus, DM; Koeter, GH; vanAalderen, WMC; Meijer, G.

    1996-01-01

    The aim of the study was to investigate whether seasonal differences in house dust mite (HDM) allergen exposure influence the circadian peak expiratory flow (PEF) amplitude in asthmatic children. Asthmatic children (n = 25) with a solitary allergy to HDM were studied in spring and in autumn. All

  20. Pharmacologic Interventions to Improve Splanchnic Oxygenation During Ventilation with Positive End-Expiratory Pressure

    NARCIS (Netherlands)

    Fournell, A.; Scheeren, T. W. L.; Picker, O.; Schwarte, L. A.; Wolf, M; Bucher, HU; Rudin, M; VanHuffel, S; Wolf, U; Bruley, DF; Harrison, DK

    2012-01-01

    Mechanical ventilation with positive end-expiratory pressure (PEEP) is an indispensable tool in the management of respiratory failure to preserve or improve lung function and systemic oxygenation. However, PEEP per se may also, as has been shown in experimental animals, impair regional

  1. EFFECTS OF POSITIVE EXPIRATORY PRESSURE BREATHING DURING EXERCISE IN PATIENTS WITH COPD

    NARCIS (Netherlands)

    VANDERSCHANS, GP; DEJONG, W; DEVRIES, G; KAAN, WA; POSTMA, DS; KOETER, GH; VANDERMARK, TW

    The effect of breathing with a positive expiratory pressure of 5 cm H2O was investigated in eight patients with COPD (mean [SD] FEV(1) = 54 [13] percent predicted). Specific work of breathing (Wsp) and myoelectrical activity of the following respiratory muscles were measured at rest: scalene muscle,

  2. EFFECT OF POSITIVE EXPIRATORY PRESSURE BREATHING IN PATIENTS WITH CYSTIC-FIBROSIS

    NARCIS (Netherlands)

    VANDERSCHANS, CP; VANDERMARK, TW; DEVRIES, G; PIERS, DA; BEEKHUIS, H; DANKERTROELSE, JE; POSTMA, DS; KOETER, GH

    The effect of positive expiratory pressure breathing, alone and in combination with coughing, was investigated in eight patients with cystic fibrosis. Functional residual capacity and total lung capacity was measured with a body plethysmograph before, during, and immediately after breathing with

  3. Changes in forced expiratory volume in 1 second over time in COPD

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Edwards, Lisa D; Scanlon, Paul D

    2011-01-01

    A key feature of chronic obstructive pulmonary disease (COPD) is an accelerated rate of decline in forced expiratory volume in 1 second (FEV(1)), but data on the variability and determinants of this change in patients who have established disease are scarce....

  4. Expiratory computed tomographic techniques: a cause of a poor rate of change in lung volume.

    Science.gov (United States)

    Morikawa, Keiko; Okada, Fumito; Mori, Hiromu

    2015-01-01

    Ninety-nine patients (29 males and 70 females; mean age, 57.1 years; range, 22-81 years) were included in this study to evaluate the factors affecting smaller lung volume changes in expiratory high-resolution computed tomography performed to depict air trapping. All patients underwent inspiratory and expiratory chest thin-section CT examinations and pulmonary function tests. Air trapping on CT images was graded subjectively. All variables (age, sex, diagnosis, pulmonary function index, and air trapping score) were compared with the degree of change in lung volume between the inspiratory and expiratory CT examinations. The variables affecting a lower degree of volume change were vital capacity, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0), and the FEV1.0/FVC ratio. Bronchiolitis obliterans was the dominant diagnosis in patients with insufficient degrees of breath holding and in patients with negative air trapping scores despite an abnormal air trapping index. An insufficient degree of lung changes between inspiration and expiration on CT examinations represented bronchiolitis obliterans, which resulted in low FEV1.0 and FEV1.0/FVC values. Changes in the time gap from the announcement of exhalation and breath holding to the start of scanning most effectively indicated air trapping in patients with bronchiolar disorders.

  5. Exogenous stimuli and circadian peak expiratory flow variation in allergic asthmatic children

    NARCIS (Netherlands)

    Postma, DS; VanderHeide, S; DeReus, DM; Koeter, GH; VanAalderen, WMC; Meijer, G.

    The influence of exogenous factors in the home on the circadian variation of airway obstruction has not been fully assessed in children with asthma. The aim of the present study was to investigate the contribution of exogenous stimuli to the degree of peak expiratory flow (PEF) variability during 24

  6. Quality estimation of thick-film resistor terminations based on electrical parameters extraction

    Science.gov (United States)

    Kiełbasiński, Konrad; Jakubowska, Małgorzata; Kalenik, Jerzy; Młożniak, Anna

    2008-01-01

    The RoHS and WEEE regulation forced the large investigations for environmental friendly materials in electronic. The Lead and cadmium which was the significant component of resistors and conductors used in thick-film technology have to be replaced. Quick and precise measurement techniques need to be elaborated to maintain consumer's demand. Usually the test samples with the conductive and resistive layers were used for electrical parameters measurements. The layer thickness measurements and mean value of resistance allowed calculating the sheet resistance. Such a method of measurement have very serious disadvantage. The calculated mean value can be significantly affected by resistors terminations, especially if silver conductor is used, which is known as an easily migrating material. The solution was known and involved preparing and printing samples with the reference terminations. Silver platinum and silver palladium conductors are less susceptible to migration, therefore they were used in previous investigations. The reference terminations improves the precision of calculating sheet resistance, however they enlarges the number of measurements and its influence could still be significant. The authors proposed completely new method of sheet resistance calculation. Such a calculated value called True Sheet Resistance do not depend on the phenomena taking place at the termination, The second evaluated value called Offset indicates the influence of the terminations on measured resistance, and also termination quality. Its value is correlated with the diffusion rate at the interface between conductive film and resistive film at the termination. The usability of this method was proven by performing multiple firing test. One kind of resistive layer was printed on different kinds of conductive layers. The samples were fired sequently and measured. Then the old method of resistor properties evaluation was compared to the new one.

  7. Random-Resistor-Random-Temperature Kirchhoff-Law-Johnson-Noise (RRRT-KLJN Key Exchange

    Directory of Open Access Journals (Sweden)

    Kish Laszlo B.

    2016-03-01

    Full Text Available We introduce two new Kirchhoff-law-Johnson-noise (KLJN secure key distribution schemes which are generalizations of the original KLJN scheme. The first of these, the Random-Resistor (RR- KLJN scheme, uses random resistors with values chosen from a quasi-continuum set. It is well-known since the creation of the KLJN concept that such a system could work in cryptography, because Alice and Bob can calculate the unknown resistance value from measurements, but the RR-KLJN system has not been addressed in prior publications since it was considered impractical. The reason for discussing it now is the second scheme, the Random Resistor Random Temperature (RRRT- KLJN key exchange, inspired by a recent paper of Vadai, Mingesz and Gingl, wherein security was shown to be maintained at non-zero power flow. In the RRRT-KLJN secure key exchange scheme, both the resistances and their temperatures are continuum random variables. We prove that the security of the RRRT-KLJN scheme can prevail at a non-zero power flow, and thus the physical law guaranteeing security is not the Second Law of Thermodynamics but the Fluctuation-Dissipation Theorem. Alice and Bob know their own resistances and temperatures and can calculate the resistance and temperature values at the other end of the communication channel from measured voltage, current and power-flow data in the wire. However, Eve cannot determine these values because, for her, there are four unknown quantities while she can set up only three equations. The RRRT-KLJN scheme has several advantages and makes all former attacks on the KLJN scheme invalid or incomplete.

  8. Effects of different PEEP levels on respiratory mechanics and oxygenation after coronary artery bypass grafting.

    Science.gov (United States)

    Borges, Daniel Lago; Nina, Vinícius José da Silva; Costa, Marina de Albuquerque Gonçalves; Baldez, Thiago Eduardo Pereira; Santos, Natália Pereira dos; Lima, Ilka Mendes; Figuerêdo, Eduardo Durans; Lula, Josimary Lima da Silva

    2013-01-01

    To compare the effects of different levels of positive end-expiratory pressure on respiratory mechanics and oxygenation indexes in the immediate postoperative period of coronary artery bypass grafting. Randomized clinical trial in which 136 patients underwent coronary artery bypass grafting between January 2011 and March 2012 were divided into three groups and admitted to mechanical ventilation with different positive end-expiratory pressure levels: Group A, 5 cmH2O (n=44), Group B, 8 cmH2O (n=47) and Group C, 10 cmH2O (n=45). Data about respiratory mechanics were obtained from mechanical ventilator monitor and oxygenation indexes from arterial blood gas samples, collected twenty minutes after intensive care unit admission. Patients with chronic obstructive pulmonary disease and patients submitted to off-pump, emergency or combined operations were not included. For statistical analysis, we used Kruskal-Wallis, G and Chi-square tests, considering results significant when Pventilated with positive end-expiratory pressure of 10 cmH2O (Group C) had best compliance (P=0.04) and airway resistance values, this, however, without statistical significance. They also had best oxygenation indexes, with statistical difference in all analyzed variables, and lower frequency of hypoxemia (P=0.03). Higher levels of positive end-expiratory pressure in immediate postoperative period of coronary artery bypass grafting improved pulmonary compliance values and increased oxygenation indexes, resulting in lower frequency of hypoxemia.

  9. Effects of duty cycle and positive end-expiratory pressure on mucus clearance during mechanical ventilation*.

    Science.gov (United States)

    Li Bassi, Gianluigi; Saucedo, Lina; Marti, Joan-Daniel; Rigol, Montserrat; Esperatti, Mariano; Luque, Nestor; Ferrer, Miquel; Gabarrus, Albert; Fernandez, Laia; Kolobow, Theodor; Torres, Antoni

    2012-03-01

    During mechanical ventilation, air flows may play a role in mucus transport via two-phase gas liquid flow. The aim of this study was to evaluate effects of duty cycles and positive end-expiratory pressure on mucus clearance in pigs using mechanical ventilation, and to assess their safety. Prospective randomized animal study. Animal research facility, University of Barcelona, Spain. Eight healthy pigs. Pigs were intubated and on volume-control mechanical ventilation for up to 84 hrs. After 4, 24, 48, and 72 hrs of mechanical ventilation, six levels of duty cycle (0.26, 0.33, 0.41, 0.50, 0.60, and 0.75) with no associated positive end-expiratory pressure or 5 cm H2O of positive end-expiratory pressure were randomly applied. Surgical bed was oriented 30 degrees in the reverse Trendelenburg position, as in the semirecumbent position. Inspiratory and expiratory flows and hemodynamics were measured after each 30-min ventilation period. Mucus movement was assessed through fluoroscopy tracking of radio-opaque markers. Mucus velocity was described by a positive vector (toward the glottis) or negative vector (toward the lungs). No effect of positive end-expiratory pressure was found; however, as duty cycle was increasingly prolonged, a trend toward reduced velocity of mucus moving toward the lungs and increased outward mucus velocity was found (p = .064). Two clusters of mucus velocities were identified as duty cycle was prolonged beyond 0.41. Thus, duty cycle >0.41 increased mean expiratory-inspiratory flow bias from -4.1 ± 4.6 to 7.9 ± 5.9 L/min (p < .0001) and promoted outward mucus velocity from -0.22 ± 1.71 mm/min (range, -5.78 to 2.42) to 0.53 ± 1.06 mm/min (-1.91 to 3.88; p = .0048). Duty cycle of 0.75 resulted in intrinsic positive end-expiratory pressure (2.1 ± 1.1 cm H2O [p < .0001] vs. duty cycle 0.26-0.5), with no hemodynamic compromise. In the semirecumbent position, mucus clearance is improved with prolongation of the duty cycle. However, in clinical

  10. Comparison of the effectiveness of manual and ventilator hyperinflation at different levels of positive end-expiratory pressure in artificially ventilated and intubated intensive care patients.

    Science.gov (United States)

    Savian, Camila; Paratz, Jennifer; Davies, Andrew

    2006-01-01

    Manual hyperinflation (MHI) and ventilator hyperinflation (VHI) are two methods of recruitment maneuvers used in ventilated patients to improve lung compliance and secretion mobilization. The use of VHI may minimize the adverse effects of disconnection from the ventilator, but it is uncertain whether high levels of positive end-expiratory pressure (PEEP) would decrease the peak expiratory flow rate (PEFR) and consequently affect secretion clearance. The aim of this study was to compare the effectiveness of MHI and VHI in terms of clearing pulmonary secretions (sputum wet weight and PEFR), improving static respiratory system compliance and oxygenation (arterial oxygen tension/fraction of inspired oxygen), and altering mean arterial pressure, heart rate, and carbon dioxide output at different levels of PEEP. This was a randomized crossover study involving 14 general intensive care patients who were intubated and mechanically ventilated. Sputum production was similar in both techniques and levels of PEEP. There were no differences in improvement in oxygenation and static respiratory system compliance between MHI and VHI. However, VHI increased Cst significantly at 30 minutes posttreatment (P = .012), and a significant difference was observed between levels 5 and 7.5 cmH(2)O (P = .02) of PEEP for MHI. MHI generated higher PEFR than VHI (P technique; however, VCO(2) was significantly different for techniques (P = .045) and over time (P = .05). The VHI technique seems to promote greater improvements in respiratory mechanics with less metabolic disturbance compared with MHI. Other variables such as sputum production, hemodynamics, and oxygenation were affected similarly by both techniques.

  11. Experimental Modeling of Monolithic Resistors for Silicon ICS with a Robust Optimizer-Driving Scheme

    Directory of Open Access Journals (Sweden)

    Philippe Leduc

    2002-06-01

    Full Text Available Today, an exhaustive library of models describing the electrical behavior of integrated passive components in the radio-frequency range is essential for the simulation and optimization of complex circuits. In this work, a preliminary study has been done on Tantalum Nitride (TaN resistors integrated on silicon, and this leads to a single p-type lumped-element circuit. An efficient extraction technique will be presented to provide a computer-driven optimizer with relevant initial model parameter values (the "guess-timate". The results show the unicity in most cases of the lumped element determination, which leads to a precise simulation of self-resonant frequencies.

  12. Resistor array infrared projector nonuniformity correction: search for performance improvement IV

    Science.gov (United States)

    Swierkowski, Leszek; Joyce, Robert A.; Williams, Owen M.

    2009-05-01

    We assess the issues that need to be addressed to ensure that a resistor array infrared projector is capable of validly simulating the real world. These include control of the additional sources of blurring and aliasing arising from the presence of the projector and its associated scene generation system, nonuniformity correction, busbar robbing, spurious back reflections and narcissus. In particular, we reconfirm that a 2 × 2 projector/unit-under-test pixel mapping ratio offers a good compromise for controlling the additional blurring and aliasing, and furthermore, we demonstrate achievement of projector nonuniformity noise equivalent temperature differences (NETDs) in the 20 mK range.

  13. Resistor array infrared projector nonuniformity correction: search for performance improvement II

    Science.gov (United States)

    Świerkowski, Leszek; Joyce, Robert A.; Williams, Owen M.

    2007-04-01

    Research leading towards the continued improvement in resistor array infrared projector nonuniformity correction (NUC) is reported, particularly at low drive levels relevant to thermal imager and FLIR test and evaluation applications. Moire fringes have been successfully compensated, as has the checkerboard effect seen in earlier flood NUC measurements. With these improvements, the residual nonuniformity associated with the random spatial noise has been reduced successfully to the 0.1-0.2% rms level, equivalent to 20-60 mK noise equivalent temperature differences. The random noise is accompanied, however, by a low spatial frequency fixed pattern, currently unexplained but possibly attributable to busbar robbing in the electronic backplane.

  14. Design and fabrication progress in BAe's high-complexity resistor-array IR scene projector devices

    Science.gov (United States)

    Pritchard, Alan P.; Balmond, Mark D.; Lake, Stephen P.; Gough, David W.; Venables, Mark A.; Sturland, Ian M.; Hebbron, Michael C.; Brimecombe, Lucy A.

    1998-07-01

    Developments are described in the design and manufacture of full 512 X 512 infra-red scene projector (IRSP) systems, as well as in a high complexity demonstrator program to realize 1024 X 1024 complexity. Design aspects include choice of drive circuit, the suspended resistor pixel design factors, the choice of busbar configurations, and the optimization of emissivity coatings. Design of the peripheral drive systems for the 512 system is outlined, and progress on manufacture reported. Development plans for the provision of suitable high complexity computer scene generation is outlined.

  15. Current redistribution in resistor networks: Fat-tail statistics in regular and small-world networks

    Science.gov (United States)

    Lehmann, Jörg; Bernasconi, Jakob

    2017-03-01

    The redistribution of electrical currents in resistor networks after single-bond failures is analyzed in terms of current-redistribution factors that are shown to depend only on the topology of the network and on the values of the bond resistances. We investigate the properties of these current-redistribution factors for regular network topologies (e.g., d -dimensional hypercubic lattices) as well as for small-world networks. In particular, we find that the statistics of the current redistribution factors exhibits a fat-tail behavior, which reflects the long-range nature of the current redistribution as determined by Kirchhoff's circuit laws.

  16. Diffraction phase microscopy imaging and multi-physics modeling of the nanoscale thermal expansion of a suspended resistor.

    Science.gov (United States)

    Wang, Xiaozhen; Lu, Tianjian; Yu, Xin; Jin, Jian-Ming; Goddard, Lynford L

    2017-07-04

    We studied the nanoscale thermal expansion of a suspended resistor both theoretically and experimentally and obtained consistent results. In the theoretical analysis, we used a three-dimensional coupled electrical-thermal-mechanical simulation and obtained the temperature and displacement field of the suspended resistor under a direct current (DC) input voltage. In the experiment, we recorded a sequence of images of the axial thermal expansion of the central bridge region of the suspended resistor at a rate of 1.8 frames/s by using epi-illumination diffraction phase microscopy (epi-DPM). This method accurately measured nanometer level relative height changes of the resistor in a temporally and spatially resolved manner. Upon application of a 2 V step in voltage, the resistor exhibited a steady-state increase in resistance of 1.14 Ω and in relative height of 3.5 nm, which agreed reasonably well with the predicted values of 1.08 Ω and 4.4 nm, respectively.

  17. Effects of positive end-expiratory pressure titration and recruitment maneuver on lung inflammation and hyperinflation in experimental acid aspiration-induced lung injury.

    Science.gov (United States)

    Ambrosio, Aline M; Luo, Rubin; Fantoni, Denise T; Gutierres, Claudia; Lu, Qin; Gu, Wen-Jie; Otsuki, Denise A; Malbouisson, Luiz M S; Auler, Jose O C; Rouby, Jean-Jacques

    2012-12-01

    In acute lung injury positive end-expiratory pressure (PEEP) and recruitment maneuver are proposed to optimize arterial oxygenation. The aim of the study was to evaluate the impact of such a strategy on lung histological inflammation and hyperinflation in pigs with acid aspiration-induced lung injury. Forty-seven pigs were randomly allocated in seven groups: (1) controls spontaneously breathing; (2) without lung injury, PEEP 5 cm H2O; (3) without lung injury, PEEP titration; (4) without lung injury, PEEP titration + recruitment maneuver; (5) with lung injury, PEEP 5 cm H2O; (6) with lung injury, PEEP titration; and (7) with lung injury, PEEP titration + recruitment maneuver. Acute lung injury was induced by intratracheal instillation of hydrochloric acid. PEEP titration was performed by incremental and decremental PEEP from 5 to 20 cm H2O for optimizing arterial oxygenation. Three recruitment maneuvers (pressure of 40 cm H2O maintained for 20 s) were applied to the assigned groups at each PEEP level. Proportion of lung inflammation, hemorrhage, edema, and alveolar wall disruption were recorded on each histological field. Mean alveolar area was measured in the aerated lung regions. Acid aspiration increased mean alveolar area and produced alveolar wall disruption, lung edema, alveolar hemorrhage, and lung inflammation. PEEP titration significantly improved arterial oxygenation but simultaneously increased lung inflammation in juxta-diaphragmatic lung regions. Recruitment maneuver during PEEP titration did not induce additional increase in lung inflammation and alveolar hyperinflation. In a porcine model of acid aspiration-induced lung injury, PEEP titration aimed at optimizing arterial oxygenation, substantially increased lung inflammation. Recruitment maneuvers further improved arterial oxygenation without additional effects on inflammation and hyperinflation.

  18. Accurate SPICE Modeling of Poly-silicon Resistor in 40nm CMOS Technology Process for Analog Circuit Simulation

    Directory of Open Access Journals (Sweden)

    Sun Lijie

    2015-01-01

    Full Text Available In this paper, the SPICE model of poly resistor is accurately developed based on silicon data. To describe the non-linear R-V trend, the new correlation in temperature and voltage is found in non-silicide poly-silicon resistor. A scalable model is developed on the temperature-dependent characteristics (TDC and the temperature-dependent voltage characteristics (TDVC from the R-V data. Besides, the parasitic capacitance between poly and substrate are extracted from real silicon structure in replacing conventional simulation data. The capacitance data are tested through using on-wafer charge-induced-injection error-free charge-based capacitance measurement (CIEF-CBCM technique which is driven by non-overlapping clock generation circuit. All modeling test structures are designed and fabricated through using 40nm CMOS technology process. The new SPICE model of poly-silicon resistor is more accurate to silicon for analog circuit simulation.

  19. Thermal analysis and temperature characteristics of a braking resistor for high-speed trains for changes in the braking current

    Science.gov (United States)

    Lee, Dae-Dong; Kang, Hyun-Il; Shim, Jae-Myung

    2015-09-01

    Electric brake systems are used in high-speed trains to brake trains by converting the kinetic energy of a railway vehicle to electric energy. The electric brake system consists of a regenerative braking system and a dynamic braking system. When the electric energy generated during the dynamic braking process is changed to heat through the braking resistor, the braking resistor can overheat; thus, failures can occur to the motor block. In this paper, a braking resistor for a high-speed train was used to perform thermal analyses and tests, and the results were analyzed. The analyzed data were used to estimate the dependence of the brake currents and the temperature rises on speed changes up to 300 km/h, at which a test could not be performed.

  20. Comprehensive behavioral model of dual-gate high voltage JFET and pinch resistor

    Science.gov (United States)

    Banáš, Stanislav; Paňko, Václav; Dobeš, Josef; Hanyš, Petr; Divín, Jan

    2016-09-01

    Many analog technologies operate in large voltage range and therefore include at least one or more high voltage devices built from low doped layers. Such devices exhibit effects not covered by standard compact models, namely pinching (depletion) effects, in high voltage FETs often called quasisaturation. For example, the conventional compact JFET model is insufficient and oversimplified. Its scalability is controlled by the area factor, which only multiplies currents and capacitances but does not take into account existing 3-D effects. Also the optional second independent gate is missing. Therefore, the customized four terminal (4T) model written in Verilog-A (FitzPatrick and Miller, 2007; Sagdeo, 2007) was developed. It converges very well, its simulation speed is comparable with conventional compact models, and contains all required phenomena, including parasitic effects as, for example, impact ionization. This model has universal usage for many types of devices in various high voltage technologies such as stand-alone voltage dependent resistor, pinch resistor, drift area of power FET, part of special high side or start-up devices, and dual-gate JFET.

  1. [Clinical research of using optimal compliance to determine positive end-expiratory pressure].

    Science.gov (United States)

    Xu, Lei; Feng, Quan-sheng; Lian, Fu; Shao, Xin-hua; Li, Zhi-bo; Wang, Zhi-yong; Li, Jun

    2012-07-01

    To observe the availability and security of optimal compliance strategy to titrate the optimal positive end-expiratory pressure (PEEP), compared with quasi-static pressure-volume curve (P-V curve) traced by low-flow method. Fourteen patients received mechanical ventilation with acute respiratory distress syndrome (ARDS) admitted in intensive care unit (ICU) of Tianjin Third Central Hospital from November 2009 to December 2010 were divided into two groups(n = 7). The quasi-static P-V curve method and the optimal compliance titration were used to set the optimal PEEP respectively, repeated 3 times in a row. The optimal PEEP and the consistency of repeated experiments were compared between groups. The hemodynamic parameters, oxygenation index (OI), lung compliance (C), cytokines and pulmonary surfactant-associated protein D (SP-D) concentration in plasma before and 2, 4, and 6 hours after the experiment were observed in each group. (1) There were no significant differences in gender, age and severity of disease between two groups. (2)The optimal PEEP [cm H(2)O, 1 cm H(2)O=0.098 kPa] had no significant difference between quasi-static P-V curve method group and the optimal compliance titration group (11.53 ± 2.07 vs. 10.57 ± 0.87, P>0.05). The consistency of repeated experiments in quasi-static P-V curve method group was poor, the slope of the quasi-static P-V curve in repeated experiments showed downward tendency. The optimal PEEP was increasing in each measure. There was significant difference between the first and the third time (10.00 ± 1.58 vs. 12.80 ± 1.92, P titration method had good reproducibility as the optimal PEEP without significant difference in each measure. (3) After the quasi-static P-V curve traced, the heart rate (HR, bpm), temperature (centigrade), interleukin-6 (IL-6, ng/L), tumor necrosis factor-α (TNF-α, ng/L), SP-D (μg/L) showed a gradually increasing tendency, the mean artery pressure (MAP, mm Hg, 1 mm Hg = 0.133 kPa), continuous cardiac

  2. Effects of manual rib cage compressions on expiratory flow and mucus clearance during mechanical ventilation.

    Science.gov (United States)

    Martí, Joan Daniel; Li Bassi, Gianluigi; Rigol, Montserrat; Saucedo, Lina; Ranzani, Otavio Tavares; Esperatti, Mariano; Luque, Nestor; Ferrer, Miquel; Vilaro, Jordi; Kolobow, Theodor; Torres, Antoni

    2013-03-01

    We investigated the effects of two different types of manual rib cage compression on expiratory flow and mucus clearance during prolonged mechanical ventilation in pigs. Prospective randomized animal study. Animal research facility, University of Barcelona, Spain. Nine healthy pigs. Pigs were tracheally intubated, sedated, paralyzed, and mechanically ventilated. The animals were prone on a surgical bed in the anti-Trendelenburg position. The experiments were carried out at approximately 60 and 80 hrs from the beginning of mechanical ventilation. Two types of manual rib cage compressions were tested: Hard and brief rib cage compressions synchronized with early expiratory phase (hard manual rib cage compression) and soft and gradual rib cage compressions applied during the late expiratory phase (soft manual rib cage compression). The interventions were randomly applied for 15min with a 15-min interval between treatments. Respiratory flow and mucus movement were assessed during the interventions. Respiratory mechanics and hemodynamics were assessed prior to and after the interventions. Peak expiratory flow increased to 60.1±7.1L/min in comparison to 51.2±4.6L/min without treatment (p < 0.0015) and 48.7±4.3L/min with soft manual rib cage compression (p = 0.0002). Similarly, mean expiratory flow increased to 28.4±5.2L/min during hard manual rib cage compression vs. 15.9±2.2 and 16.6±2.8L/min without treatment and soft manual rib cage compression, respectively (p = 0.0006). During hard manual rib cage compression, mucus moved toward the glottis (1.01 ± 2.37mm/min); conversely, mucus moved toward the lungs during no treatment and soft manual rib cage compression, -0.28 ± 0.61 and -0.15±0.95mm/min, respectively (p = 0.0283). Soft manual rib cage compression slightly worsened static lung elastance and cardiac output (p = 0.0391). Hard manual rib cage compression improved mucus clearance in animals positioned in the anti-Trendelenburg position. The technique

  3. Interaction between intra-abdominal pressure and positive-end expiratory pressure

    Directory of Open Access Journals (Sweden)

    Jamili Anbar Torquato

    2009-02-01

    Full Text Available OBJECTIVE: The aim of this study was to quantify the interaction between increased intra-abdominal pressure and Positive-End Expiratory Pressure. METHODS: In 30 mechanically ventilated ICU patients with a fixed tidal volume, respiratory system plateau and abdominal pressure were measured at a Positive-End Expiratory Pressure level of zero and 10 cm H2O. The measurements were repeated after placing a 5 kg weight on the patients' belly. RESULTS: After the addition of 5 kg to the patients' belly at zero Positive-End Expiratory Pressure, both intra-abdominal pressure (p<0.001 and plateau pressures (p=0.005 increased significantly. Increasing the Positive-End Expiratory Pressure levels from zero to 10 cm H2O without weight on the belly did not result in any increase in intra-abdominal pressure (p=0.165. However, plateau pressures increased significantly (p< 0.001. Increasing Positive-End Expiratory Pressure from zero to 10 cm H2O and adding 5 kg to the belly increased intra-abdominal pressure from 8.7 to 16.8 (p<0.001 and plateau pressure from 18.26 to 27.2 (p<0.001. Maintaining Positive-End Expiratory Pressure at 10 cm H2O and placing 5 kg on the belly increased intra-abdominal pressure from 12.3 +/- 1.7 to 16.8 +/- 1.7 (p<0.001 but did not increase plateau pressure (26.6+/-1.2 to 27.2 +/-1.1 -p=0.83. CONCLUSIONS: The addition of a 5kg weight onto the abdomen significantly increased both IAP and the airway plateau pressure, confirming that intra-abdominal hypertension elevates the plateau pressure. However, plateau pressure alone cannot be considered a good indicator for the detection of elevated intra-abdominal pressure in patients under mechanical ventilation using PEEP. In these patients, the intra-abdominal pressure must also be measured.

  4. Is peak expiratory flow rate a predictor of complications in diabetes? The Wisconsin Epidemiologic Study of Diabetic Retinopathy.

    Science.gov (United States)

    Klein, B E; Moss, S E; Klein, R; Cruickshanks, K J

    2001-01-01

    The Objective of this study was to determine whether peak expiratory flow rate is a predictor of complications of diabetes. Peak expiratory flow rate was measured at the 10-year follow-up (third examination) of a cohort of persons with younger-onset diabetes. The relationships of progression of diabetic retinopathy by two steps, progression to proliferative retinopathy and of incidences of macular edema, sore or ulcers on feet or ankles, lower extremity amputation, proteinuria, and cardiovascular disease 4 years after this examination with respect to peak expiratory flow rate were evaluated. Study procedures including measurements of blood pressure, height and weight, grading of fundus photographs, peak expiratory flow rate, urinalysis, and medical history were performed according to standard protocols. Peak expiratory flow rate was not associated in univariate analyses with progression of retinopathy, incidences of proliferative retinopathy, macular edema or lower extremity amputation, sores or ulcers on feet or ankles, gross proteinuria, or self-reported cardiovascular disease. However, when using multivariable models to include the effects of other risk factors, peak expiratory flow rate was significantly associated with the combined incidences of sores or ulcers on feet and ankles, or lower extremity amputations (OR=0.61, 95% CI 0.42-0.88). These data suggest that peak expiratory flow rate is a predictor of subsequent complications in the lower extremities in those with long duration of younger-onset diabetes. Evaluating this association in an incipient cohort would illuminate whether the relationship we found is likely to be causal.

  5. Impacts of Modelling Simplifications on Predicted Dispersion of Human Expiratory Droplets

    DEFF Research Database (Denmark)

    Liu, Li; Nielsen, Peter Vilhelm; Xu, Chunwen

    2016-01-01

    simplifying the room air condition into isothermal condition, or neglecting the body plume of the manikin. It will also change the microenvironment completely by simplifying the shape of human grid in to a robot shape. The trajectories of both the exhalation airflows and droplet nuclei are significantly......Person-to-person transmission of droplets and droplet nuclei during expiratory activities constitutes a prerequisite for airborne and droplet-borne infections. This study focuses on the impact of modelling simplifications on one manikin’s exposure to the other’s expiratory droplets via breathing....... The exhalation airflows are compared and validated by measurement results of human subjects. The flow field between two manikins are found significantly influenced by their exhalation airflows. Mono-dispersed droplets with an initial diameter of 10 μm are released from one breathe of a manikin. All droplets...

  6. Effects of chest wall compression on expiratory flow rates in patients with chronic obstructive pulmonary disease

    OpenAIRE

    Masafumi Nozoe; Kyoshi Mase; Tomoyuki Ogino; Shigefumi Murakami; Sachie Takashima; Kazuhisa Domen

    2016-01-01

    Background: Manual chest wall compression (CWC) during expiration is a technique for removing airway secretions in patients with respiratory disorders. However, there have been no reports about the physiological effects of CWC in patients with chronic obstructive pulmonary disease (COPD). Objective: To compare the effects of CWC on expiratory flow rates in patients with COPD and asymptomatic controls. Method: Fourteen subjects were recruited from among patients with COPD who were receivi...

  7. Forced expiratory manoeuvres in children: do they meet ATS and ERS criteria for spirometry?

    Science.gov (United States)

    Arets, H G; Brackel, H J; van der Ent, C K

    2001-10-01

    The aim of this study was to evaluate the applicability of American Thoracic Society and European Respiratory Society criteria for spirometry in children. Maximal expiratory flow/volume (MEFV) measurements from 446 school-age children, experienced in performing MEFV manoeuvres, were studied and acceptability (start-of-test (backward extrapolated volume as a percentage of forced vital capacity (FVC) ([Vbc%FVC) or as an absolute value (Vbe), end-of-test (forced expiratory time (FET)) and reproducibility criteria (absolute and percentage difference between best and second-best FVC and forced expiratory volume in one second (FEV1) (deltaFVC, deltaFVC %, deltaFEV1 and deltaFEV1 %)) were applied to these manoeuvres. The Vbe%FVC criterion was met by 91.5%, the Vbe <0.15 L criterion by 94.8% and the Vbe <0.10 L by 60.1% of children. Vbe <0.15 L appeared to be a more useful parameter than Vbe%FVC. The FET criterion was met by only 15.3% of children. deltaFVC <0.2 L and deltaFEV1 <0.2 L were met by 97.1% and 98.4%, and deltaFVC <0.1 L and deltaFEV1 <0.1 L by 79.8% and 84.3% of the children, respectively. These criteria appeared to be less useful compared to percentage criteria (deltaFVC % and deltaFEV1 %). Even experienced children did not meet all international criteria for spirometry. However, most of their MEFV curves are useful for interpretation. Based on the performance of these children, a re-evaluation of criteria for maximal expiratory flow/volume measurements in children is proposed.

  8. Comparison of intermittent positive pressure breathing and temporary positive expiratory pressure in patients with severe chronic obstructive pulmonary disease.

    Science.gov (United States)

    Nicolini, Antonello; Mollar, Elena; Grecchi, Bruna; Landucci, Norma

    2014-01-01

    Results supporting the use and the effectiveness of positive expiratory, pressure devices in chronic obstructive pulmonary disease (COPD) patients are still controversial, We have tested the hypothesis that adding TPEP or IPPB to standard pharmacological therapy may provide additional clinical benefit over, pharmacological therapy only in patients with severe COPD. Fourty-five patients were randomized in three groups: a group was treated; with IPPB,a group was treated with TPEP and a group with pharmacological; therapy alone (control group). Primary outcome measures included the measurement of scale or, questionnaire concerning dyspnea (MRC scale),dyspnea,cough, and, sputum (BCSS) and quality of life (COPD assessment test) (CAT). Secondary, outcome measures were respiratory function testing,arterial blood gas,analysis,and hematological examinations. Both patients in the IPPB group and in the TPEP group showed a significant, improvement in two of three tests (MRC,CAT) compared to the control, group.However,in the group comparison analysis for, the same variables between IPPB group and TPEP group we observed a, significant improvement in the IPPB group (P≤.05 for MRC and P≤.01 for, CAT). The difference of action of the two techniques are evident in the results of, pulmonary function testing: IPPB increases FVC, FEV1, and MIP; this reflects, its capacity to increase lung volume. Also TPEP increases FVC and FEV1 (less, than IPPB), but increases MEP, while decreasing total lung capacity and, residual volume. The two techniques (IPPB and TPEP) improves significantly dyspnea; quality of; life tools and lung function in patients with severe COPD. IPPB demonstrated a greater effectiveness to improve dyspnea and quality of life tools (MRC, CAT) than TPEP. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  9. Experimental Study of Dispersion and Deposition of Expiratory Aerosols in Aircraft Cabins and Impact on Infectious Disease Transmission

    DEFF Research Database (Denmark)

    To, G.N.S.; Wan, M.P.; Chao, C.Y.H.

    2009-01-01

    The dispersion and deposition characteristics of polydispersed expiratory aerosols were investigated in an aircraft cabin mockup to study the transmission of infectious diseases. The airflow was characterized by particle image velocimetry (PIV) measurements. Aerosol dispersionwas measured...... heightened the exposure to passengers seated further away. 60-70% of expiratory aerosols in mass were deposited, with significant portions on surfaces close to the source, suggesting that disease transmission risk via indirect contact in addition to airborne risk is possible. The physical transport processes...... of expiratory aerosols could be used to shed insights on some epidemiological observations on in-flight transmission of certain infectious diseases....

  10. Predictive Regression Equations of Flowmetric and Spirometric Peak Expiratory Flow in Healthy Moroccan Children.

    Science.gov (United States)

    Bouti, Khalid; Benamor, Jouda; Bourkadi, Jamal Eddine

    2017-08-01

    Peak Expiratory Flow (PEF) has never been characterised among healthy Moroccan school children. To study the relationship between PEF and anthropometric parameters (sex, age, height and weight) in healthy Moroccan school children, to establish predictive equations of PEF; and to compare flowmetric and spirometric PEF with Forced Expiratory Volume in 1 second (FEV1). This cross-sectional study was conducted between April, 2016 and May, 2016. It involved 222 (122 boys and 100 girls) healthy school children living in Ksar el-Kebir, Morocco. We used mobile equipments for realisation of spirometry and peak expiratory flow measurements. SPSS (Version 22.0) was used to calculate Student's t-test, Pearson's correlation coefficient and linear regression. Significant linear correlation was seen between PEF, age and height in boys and girls. The equation for prediction of flowmetric PEF in boys was calculated as 'F-PEF = -187+ 24.4 Age + 1.61 Height' (p-valuePEF = -151 + 17Age + 1.59Height' (p-valuePEF in boys was calculated as 'S-PEF = -199+ 9.8Age + 2.67Height' (p-valuePEF = -181 + 8.5Age + 2.5Height' (p-valuePEF predictive equations in Moroccan children. Our results appeared to be reliable, as evident by the high correlation coefficient in this sample. PEF can be an alternative of FEV1 in centers without spirometry.

  11. Suppression of Adverse Effects of GIC Using Controlled Variable Grounding Resistor

    Science.gov (United States)

    Abuhussein, A.; Ali, M. H.

    2016-12-01

    Geomagnetically induced current (GIC) has a harmful impact on power systems, with a large footprint. Mitigation strategies for the GIC are required to protect the integrity of the power system. To date, the adverse effects of GIC are being mitigated by either operational procedures or grounding fixed capacitors (GFCs). The operational procedures are uncertain, reduce systems' reliability, and increase energy losses. On the other hand, GFCs, incur voltage spikes, increase the transformer cost substantially, and require protection circuitry. This study investigates new possible approaches to cope with GIC, by using a controlled variable grounding resistor (CVGR), without interfering with the system's normal operation. In addition, the new techniques help suppress unsymmetrical faults in the power network. The controllability of the grounding resistor is applied using three different techniques: (1) a Parallel switch that is controlled by PI regulated duty cycle, (2) a Parallel switch that is triggered by a preset values in a look-up-table (LUT), and (3) a Mechanical resistor varied by a Fuzzy logic controller (FLC). The experimental results were obtained and validated using the MATLAB/SIMULINK software. A hypothetical power system that consists of a generator, a 765kv, 500 km long transmission lines connecting between a step-up, Δ-Yn, transformer, and a step-down, Yn-Δ, transformer, is considered. The performance of the CVGR is compared with that of the GFC under the cases of GIC event and unsymmetrical faults. From the simulation results, the following points are concluded: The CVGR effectively suppresses the GIC flowing in the system. Consequently, it protects the transformers from saturation and the rest of the system from collapsing. The CVGR also reduces the voltage and power swings associated with unsymmetrical faults and blocks the zero sequence current flowing through the neutral of the transformer. The performance of the CVGR surpasses that of the GFC in

  12. Flexible and twistable non-volatile memory cell array with all-organic one diode-one resistor architecture.

    Science.gov (United States)

    Ji, Yongsung; Zeigler, David F; Lee, Dong Su; Choi, Hyejung; Jen, Alex K-Y; Ko, Heung Cho; Kim, Tae-Wook

    2013-01-01

    Flexible organic memory devices are one of the integral components for future flexible organic electronics. However, high-density all-organic memory cell arrays on malleable substrates without cross-talk have not been demonstrated because of difficulties in their fabrication and relatively poor performances to date. Here we demonstrate the first flexible all-organic 64-bit memory cell array possessing one diode-one resistor architectures. Our all-organic one diode-one resistor cell exhibits excellent rewritable switching characteristics, even during and after harsh physical stresses. The write-read-erase-read output sequence of the cells perfectly correspond to the external pulse signal regardless of substrate deformation. The one diode-one resistor cell array is clearly addressed at the specified cells and encoded letters based on the standard ASCII character code. Our study on integrated organic memory cell arrays suggests that the all-organic one diode-one resistor cell architecture is suitable for high-density flexible organic memory applications in the future.

  13. METHOD OF DETERMINING THE START TIME OF INDUCTION MOTORS IN THE CONTROL OF RESISTOR-THYRISTOR MODULES

    Directory of Open Access Journals (Sweden)

    V.I. Lobov

    2015-08-01

    Full Text Available Purpose. An electric general-purpose drive with asynchronous motor is proposed. For motor control in stator and rotor, circuits used resistors and thyristors. These elements included together in various ways. This allows to get a variety of power converter circuit with resistor-thyristor modules. Methodology. Taking into account the technical requirements for industrial machinery developed an analytical method for determining the run-up controlled induction motor. Formed starting modes by changing the value of the equivalent resistor-thyristor modules. Using logic synthesis and function of thyristors switching to determine the equivalent value of resistor-thyristor modules. Scientific novelty. It lies in the fact that the proposed method of calculation to determine the run-up in the limited amount of transient current and torque of the motor. The total moment of inertia and the static moment of the drive do not have a significant impact on the maximum value of the transient electromagnetic torque. Most of these options affect the transition process, the oscillation frequency of the electromagnetic torque and the motor speed. Practical value. The method used for calculating allows to select the simplest laws of launch control actuator and apply open-loop control system without increasing the cost of the power converter, so it is of practical importance.

  14. Technical-economic evaluation of the utilization of closing resistor in CEMIG extra-high voltage circuit breakers

    Energy Technology Data Exchange (ETDEWEB)

    Rocha, Angelica C.O.; Pinto, Roberto del Giudice R.; Teixeira, Jose Cleber; Fonseca, Rodrigo Assuncao; F. Junior, Sebastiao V. [Companhia Energetica de Minas Gerais (CEMIG), Belo Horizonte, MG (Brazil)

    1994-12-31

    This paper presents the technical and economic studies performed by CEMIG, Companhia Energetica de Minas Gerais, Brazil, concerning the use of closing resistor in its extra-high voltage (EHV) breakers. The analysis emphasizes the advantages which could be achieved with the elimination of the resistor as far as costs and reliability are concerned. This evaluation was motivated by two 500 kV breaker failures resulting from the breakdown of the closing resistor operation mechanism. These occurrences resulted in operative restriction for CEMIG EHV system. The analysis demanded a review of the capability criteria of silicon carbide (Si C) gap arresters, which are still greatly used in CEMIG EHV System, and of the procedures to be applied when carrying out the transient studies. The investigation resulted in the prompt removal of closing resistors from circuit breakers in CEMIG extra-high voltage system generating an economy of approximately U$ 840,00 and an improvement in safety and system reliability. (author) 13 refs., 4 figs., 1 tab.

  15. Cross-Bridge Kelvin resistor structures for reliable measurement of low contact resistances and contact interface characterization

    NARCIS (Netherlands)

    Stavitski, N.; Klootwijk, J.H.; van Zeijl, H.W.; Kovalgin, Alexeij Y.; Wolters, Robertus A.M.

    2009-01-01

    The parasitic factors that strongly influence the measurement accuracy of Cross-Bridge Kelvin Resistor (CBKR) structures for low specific contact resistances (�?�c) have been extensively discussed during last few decades and the minimum of the �?�c value, which could be accurately extracted, was

  16. Posterolateral surface electrical stimulation of abdominal expiratory muscles to enhance cough in spinal cord injury.

    Science.gov (United States)

    Butler, Jane E; Lim, Julianne; Gorman, Robert B; Boswell-Ruys, Claire; Saboisky, Julian P; Lee, Bonsan B; Gandevia, Simon C

    2011-02-01

    Spinal cord injury (SCI) patients have respiratory complications because of abdominal muscle weakness and paralysis, which impair the ability to cough. This study aims to enhance cough in high-level SCI subjects (n = 11, SCI at or above T6) using surface electrical stimulation of the abdominal muscles via 2 pairs of posterolaterally placed electrodes. From total lung capacity, subjects performed maximum expiratory pressure (MEP) efforts against a closed airway and voluntary cough efforts. Both efforts were performed with and without superimposed trains of electrical stimulation (50 Hz, 1 second) at a submaximal intensity set to evoke a gastric pressure (P(ga)) of 40 cm H(2)O at functional residual capacity. In the MEP effort, stimulation increased the maximal P(ga) (from 21.4 ± 7.0 to 59.0 ± 5.7 cm H(2)O) and esophageal pressure (P(es); 47.2 ± 11.7 to 65.6 ± 13.6 cm H(2)O). During the cough efforts, stimulation increased P(ga) (19.5 ± 6.0 to 57.9 ± 7.0 cm H(2)O) and P(es) (31.2 ± 8.7 to 56.6 ± 10.5 cm H(2)O). The increased expiratory pressures during cough efforts with stimulation increased peak expiratory flow (PEF, by 36% ± 5%), mean expiratory flow (by 80% ± 8%), and expired lung volume (by 41% ± 16%). In every subject, superimposed electrical stimulation improved peak expiratory flow during cough efforts (by 0.99 ± 0.12 L/s; range, 0.41-1.80 L/s). Wearing an abdominal binder did not improve stimulated cough flows or pressures. The increases in P(ga) and PEF with electrical stimulation using the novel posterolateral electrode placement are 2 to 3 times greater than improvements reported in other studies. This suggests that posterolateral electrical stimulation of abdominal muscles is a simple noninvasive way to enhance cough in individuals with SCI.

  17. The differential effects of inspiratory, expiratory, and combined resistive breathing on healthy lung

    Directory of Open Access Journals (Sweden)

    Loverdos K

    2016-07-01

    Full Text Available Konstantinos Loverdos,1 Dimitrios Toumpanakis,1 Eleni Litsiou,1 Vassiliki Karavana,1 Constantinos Glynos,1 Christina Magkou,2 Stamatios Theocharis,3 Theodoros Vassilakopoulos1 1Department of Critical Care, Pulmonary Unit and Marianthi Simou Applied Biomedical Research and Training Center, Evangelismos General Hospital, University of Athens Medical School, 2Department of Pathology, Evangelismos General Hospital, 31st Department of Pathology, University of Athens Medical School, Athens, Greece Abstract: Combined resistive breathing (CRB is the hallmark of obstructive airway disease pathophysiology. We have previously shown that severe inspiratory resistive breathing (IRB induces acute lung injury in healthy rats. The role of expiratory resistance is unknown. The possibility of a load-dependent type of resistive breathing-induced lung injury also remains elusive. Our aim was to investigate the differential effects of IRB, expiratory resistive breathing (ERB, and CRB on healthy rat lung and establish the lowest loads required to induce injury. Anesthetized tracheostomized rats breathed through a two-way valve. Varying resistances were connected to the inspiratory, expiratory, or both ports, so that the peak inspiratory pressure (IRB was 20%–40% or peak expiratory (ERB was 40%–70% of maximum. CRB was assessed in inspiratory/expiratory pressures of 30%/50%, 40%/50%, and 40%/60% of maximum. Quietly breathing animals served as controls. At 6 hours, respiratory system mechanics were measured, and bronchoalveolar lavage was performed for measurement of cell and protein concentration. Lung tissue interleukin-6 and interleukin-1β levels were estimated, and a lung injury histological score was determined. ERB produced significant, load-independent neutrophilia, without mechanical or permeability derangements. IRB 30% was the lowest inspiratory load that provoked lung injury. CRB increased tissue elasticity, bronchoalveolar lavage total cell, macrophage

  18. A Novel Read Scheme for Large Size One-Resistor Resistive Random Access Memory Array

    Science.gov (United States)

    Zackriya, Mohammed; Kittur, Harish M.; Chin, Albert

    2017-02-01

    The major issue of RRAM is the uneven sneak path that limits the array size. For the first time record large One-Resistor (1R) RRAM array of 128x128 is realized, and the array cells at the worst case still have good Low-/High-Resistive State (LRS/HRS) current difference of 378 nA/16 nA, even without using the selector device. This array has extremely low read current of 9.7 μA due to both low-current RRAM device and circuit interaction, where a novel and simple scheme of a reference point by half selected cell and a differential amplifier (DA) were implemented in the circuit design.

  19. Resistor-logic demultiplexers for nanoelectronics based on constant-weight codes.

    Science.gov (United States)

    Kuekes, Philip J; Robinett, Warren; Roth, Ron M; Seroussi, Gadiel; Snider, Gregory S; Stanley Williams, R

    2006-02-28

    The voltage margin of a resistor-logic demultiplexer can be improved significantly by basing its connection pattern on a constant-weight code. Each distinct code determines a unique demultiplexer, and therefore a large family of circuits is defined. We consider using these demultiplexers for building nanoscale crossbar memories, and determine the voltage margin of the memory system based on a particular code. We determine a purely code-theoretic criterion for selecting codes that will yield memories with large voltage margins, which is to minimize the ratio of the maximum to the minimum Hamming distance between distinct codewords. For the specific example of a 64 × 64 crossbar, we discuss what codes provide optimal performance for a memory.

  20. Use of a Pre-Insertion Resistor to Minimize Zero-Missing Phenomenon and Switching Overvoltages

    DEFF Research Database (Denmark)

    Bak, Claus Leth; da Silva, Filipe Miguel Faria; Gudmundsdottir, Unnur Stella

    2009-01-01

    With the increasing use of High-Voltage Cables, which have different electric characteristics from Overhead Lines, phenomenon like current zero-missing start to appear more often on the transmission systems. Methods to prevent zero-missing phenomenon are still being studied and compared to see...... which countermeasure works the best. Technically the best way to avoid zero-missing phenomenon produces very high switching overvoltages, making the operator to choose to either avoid the zero-missing phenomenon or to minimize the switching transients. This paper presents a method of determining...... an optimal value of the resistance of the pre-insertion resistor that results in minimizing both the zero-missing phenomenon and switching overvoltages simultaneously....

  1. Effects of a 1:1 inspiratory to expiratory ratio on respiratory mechanics and oxygenation during one-lung ventilation in the lateral decubitus position.

    Science.gov (United States)

    Kim, S H; Choi, Y S; Lee, J G; Park, I H; Oh, Y J

    2012-11-01

    Prolonged inspiratory to expiratory (I:E) ratio ventilation may have both positive and negative effects on respiratory mechanics and oxygenation during one-lung ventilation (OLV), but definitive information is currently lacking. We therefore compared the effects of volume-controlled ventilation with I:E ratios of 1:1 and 1:2 on respiratory mechanics and oxygenation during OLV. Fifty-six patients undergoing thoracoscopic lobectomy were randomly assigned volume-controlled ventilation with an I:E ratio of 1:1 (group 1:1, n=28) or 1:2 (group 1:2, n=28) during OLV. Arterial and central venous blood gas analyses and respiratory variables were recorded 15 minutes into two-lung ventilation, at 30 and 60 minutes during OLV, and 15 minutes after two-lung ventilation was re-initiated. Peak and plateau airway pressures in cmH2O [standard deviation] during OLV were significantly lower in group 1:1 than in group 1:2 (P ventilation with an I:E ratio of 1:1 reduced peak and plateau airway pressures improved dynamic compliance and efficiency of alveolar ventilation, but it did not improve arterial oxygenation in a substantial manner. Furthermore, the associated increase in mean airway pressure might have reduced cardiac output, resulting in a lower central venous oxygen saturation.

  2. The importance of the expiratory pause. Comparison of the Mapleson A, C and D breathing systems using a lung model.

    Science.gov (United States)

    Cook, L B

    1996-05-01

    A physical lung model simulating spontaneous respiration was used to investigate the influence of the respiratory pattern on the efficiency of the Mapleson A, C and D breathing systems. It is shown that the Mapleson A system is always the most efficient breathing system and that its performance is relatively independent of the respiratory pattern. When the expiratory pause is minimal, the Mapleson C system is almost as efficient as the Mapleson A, but becomes ever less efficient as the expiratory pause increases. The Mapleson D system is very inefficient when the expiratory pause is short. With a longer expiratory pause, this system's efficiency approaches that of the Mapleson A. The experimental results are compared with predictions generated by a mathematical model. There is good agreement between the two, validating the mathematics used.

  3. Coronary Artery Bypass Grafting

    Science.gov (United States)

    ... Health Topics / Coronary Artery Bypass Grafting Coronary Artery Bypass Grafting What Is Coronary artery bypass grafting (CABG) ... multiple coronary arteries during one surgery. Coronary Artery Bypass Grafting Figure A shows the location of the ...

  4. Coronary Arteries

    Science.gov (United States)

    ... animations for grades K-6. The Coronary Arteries Coronary Circulation The heart muscle, like every other organ or ... the heart by its own vascular system, called coronary circulation. The aorta (the main blood supplier to the ...

  5. Electrical properties of nano-resistors made from the Zr-doped HfO2 high-k dielectric film

    Science.gov (United States)

    Zhang, Shumao; Kuo, Yue

    2018-03-01

    Electrical properties of nano-sized resistors made from the breakdown of the metal-oxide-semiconductor capacitor composed of the amorphous high-k gate dielectric have been investigated under different stress voltages and temperatures. The effective resistance of nano-resistors in the device was estimated from the I–V curve in the high voltage range. It decreased with the increase of the number of resistors. The resistance showed complicated temperature dependence, i.e. it neither behaves like a conductor nor a semiconductor. In the low voltage operation range, the charge transfer was controlled by the Schottky barrier at the nano-resistor/Si interface. The barrier height decreased with the increase of stress voltage, which was probably caused by the change of the nano-resistor composition. Separately, it was observed that the barrier height was dependent on the temperature, which was probably due to the dynamic nano-resistor formation process and the inhomogeneous barrier height distribution. The unique electrical characteristics of this new type of nano-resistors are important for many electronic and optoelectronic applications.

  6. The effects of positive end-expiratory pressure on respiratory system mechanics and hemodynamics in postoperative cardiac surgery patients

    Directory of Open Access Journals (Sweden)

    J.O.C. Auler Jr.

    2000-01-01

    Full Text Available We prospectively evaluated the effects of positive end-expiratory pressure (PEEP on the respiratory mechanical properties and hemodynamics of 10 postoperative adult cardiac patients undergoing mechanical ventilation while still anesthetized and paralyzed. The respiratory mechanics was evaluated by the inflation inspiratory occlusion method and hemodynamics by conventional methods. Each patient was randomized to a different level of PEEP (5, 10 and 15 cmH2O, while zero end-expiratory pressure (ZEEP was established as control. PEEP of 15-min duration was applied at 20-min intervals. The frequency dependence of resistance and the viscoelastic properties and elastance of the respiratory system were evaluated together with hemodynamic and respiratory indexes. We observed a significant decrease in total airway resistance (13.12 ± 0.79 cmH2O l-1 s-1 at ZEEP, 11.94 ± 0.55 cmH2O l-1 s-1 (P<0.0197 at 5 cmH2O of PEEP, 11.42 ± 0.71 cmH2O l-1 s-1 (P<0.0255 at 10 cmH2O of PEEP, and 10.32 ± 0.57 cmH2O l-1 s-1 (P<0.0002 at 15 cmH2O of PEEP. The elastance (Ers; cmH2O/l was not significantly modified by PEEP from zero (23.49 ± 1.21 to 5 cmH2O (21.89 ± 0.70. However, a significant decrease (P<0.0003 at 10 cmH2O PEEP (18.86 ± 1.13, as well as (P<0.0001 at 15 cmH2O (18.41 ± 0.82 was observed after PEEP application. Volume dependence of viscoelastic properties showed a slight but not significant tendency to increase with PEEP. The significant decreases in cardiac index (l min-1 m-2 due to PEEP increments (3.90 ± 0.22 at ZEEP, 3.43 ± 0.17 (P<0.0260 at 5 cmH2O of PEEP, 3.31 ± 0.22 (P<0.0260 at 10 cmH2O of PEEP, and 3.10 ± 0.22 (P<0.0113 at 15 cmH2O of PEEP were compensated for by an increase in arterial oxygen content owing to shunt fraction reduction (% from 22.26 ± 2.28 at ZEEP to 11.66 ± 1.24 at PEEP of 15 cmH2O (P<0.0007. We conclude that increments in PEEP resulted in a reduction of both airway resistance and respiratory elastance. These results

  7. Effects of chest wall compression on expiratory flow rates in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Nozoe, Masafumi; Mase, Kyoshi; Ogino, Tomoyuki; Murakami, Shigefumi; Takashima, Sachie; Domen, Kazuhisa

    2016-03-15

    Manual chest wall compression (CWC) during expiration is a technique for removing airway secretions in patients with respiratory disorders. However, there have been no reports about the physiological effects of CWC in patients with chronic obstructive pulmonary disease (COPD). To compare the effects of CWC on expiratory flow rates in patients with COPD and asymptomatic controls. Fourteen subjects were recruited from among patients with COPD who were receiving pulmonary rehabilitation at the University Hospital (COPD group). Fourteen age-matched healthy subjects were also consecutively recruited from the local community (Healthy control group). Airflow and lung volume changes were measured continuously with the subjects lying in supine position during 1 minute of quiet breathing (QB) and during 1 minute of CWC by a physical therapist. During CWC, both the COPD group and the healthy control group showed significantly higher peak expiratory flow rates (PEFRs) than during QB (mean difference for COPD group 0.14 L/sec, 95% confidence interval (CI) 0.04 to 0.24, pCOPD group (-0.25 L/sec, 95% CI -0.43 to -0.07, pCOPD group (0.05 L/sec, 95% CI -0.01 to 0.12: -0.01 L/sec, 95% CI -0.11 to 0.08: 0.02 L/sec, 95% CI -0.05 to 0.90) with the application of CWC. The effects of chest wall compression on expiratory flow rates was different between COPD patients and asymptomatic controls.

  8. Prediction of forced expiratory volume in spirometric pulmonary function test using adaptive neuro fuzzy inference system.

    Science.gov (United States)

    Mythili, A; Sujatha, C M; Srinivasan, S; Ramakrishnan, S

    2012-01-01

    Spirometry is the most frequently performed clinical test to assess the dynamics of pulmonary function in human subjects. It measures airflow from fully inflated lungs through forced expiratory maneuver and generates large data set. However, these investigations often result in incomplete data sets due to the inability of the children and patients to perform this test. Hence, there is a requirement for prediction of significant parameters from the available incomplete data set. In this work, the results of model based prediction of two such significant parameters, Forced Expiratory Volume in one second (FEV1) and, Forced Expiratory Volume in six seconds (FEV6), are reported. The measured spirometric parameters are given as inputs to the Adaptive Neuro Fuzzy Inference System (ANFIS) which classifies data sets using fuzzy system based multilayer architecture. Triangular, Trapezoidal, Gaussian, Pi and Gbell membership functions are used to train and test the prediction process. The performance of the model is evaluated by computing their prediction error statistics of average value, standard deviation and root mean square. Results show that ANFIS model is capable of predicting FEV1 and FEV6 in both normal and abnormal subjects. Trapezoidal membership function predicted FEV1 with high precision and accuracy using a set of 21 rules. Similar prediction accuracy is observed in FEV6 using Gaussian membership function. Further, it is observed that prediction accuracy is found to be high for normal subjects with better correlation with measured values. It appears that this method is useful in enhancing diagnostic relevance of spirometric investigations in case of children and patients who are not able to perform the test as FEV1 and FEV6 are the useful indices to characterize pulmonary abnormalities.

  9. Peak expiratory flow rate in healthy children aged 6-17 years

    DEFF Research Database (Denmark)

    Høst, A; Høst, A H; Ibsen, T

    1994-01-01

    Peak expiratory flow rate (PEFR) was measured in a cross-sectional study in 861 healthy Danish schoolchildren aged 6-17 years using a Mini Wright peak flowmeter. We found a strong correlation between PEFR and height, age and sex. The results were comparable with those from previous studies using...... a Wright peak flowmeter. The equation for prediction of PEFR in boys was calculated as (3.8 x height) + (10.6 x age) - 313.2 (p age) - 143.9 (p

  10. Effects of chest wall compression on expiratory flow rates in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Masafumi Nozoe

    2016-01-01

    Full Text Available Background: Manual chest wall compression (CWC during expiration is a technique for removing airway secretions in patients with respiratory disorders. However, there have been no reports about the physiological effects of CWC in patients with chronic obstructive pulmonary disease (COPD. Objective: To compare the effects of CWC on expiratory flow rates in patients with COPD and asymptomatic controls. Method: Fourteen subjects were recruited from among patients with COPD who were receiving pulmonary rehabilitation at the University Hospital (COPD group. Fourteen age-matched healthy subjects were also consecutively recruited from the local community (Healthy control group. Airflow and lung volume changes were measured continuously with the subjects lying in supine position during 1 minute of quiet breathing (QB and during 1 minute of CWC by a physical therapist. Results: During CWC, both the COPD group and the healthy control group showed significantly higher peak expiratory flow rates (PEFRs than during QB (mean difference for COPD group 0.14 L/sec, 95% confidence interval (CI 0.04 to 0.24, p<0.01, mean difference for healthy control group 0.39 L/sec, 95% CI 0.25 to 0.57, p<0.01. In the between-group comparisons, PEFR was significantly higher in the healthy control group than in the COPD group (-0.25 L/sec, 95% CI -0.43 to -0.07, p<0.01. However, the expiratory flow rates at the lung volume at the PEFR during QB and at 50% and 25% of tidal volume during QB increased in the healthy control group (mean difference for healthy control group 0.31 L/sec, 95% CI 0.15 to 0.47, p<0.01: 0.31 L/sec, 95% CI 0.15 to 0.47, p<0.01: 0.27 L/sec, 95% CI 0.13 to 0.41, p<0.01, respectively but not in the COPD group (0.05 L/sec, 95% CI -0.01 to 0.12: -0.01 L/sec, 95% CI -0.11 to 0.08: 0.02 L/sec, 95% CI -0.05 to 0.90 with the application of CWC. Conclusion: The effects of chest wall compression on expiratory flow rates was different between COPD patients and

  11. Integral resistors and capacitors for mixed-signal packages using electroless plating and polymer-ceramic nanocomposites

    Science.gov (United States)

    Chahal, Premjeet

    In this work, new approaches to achieving integral resistors and capacitors on large area substrates at low temperatures in a high density wiring (HDW) environment using non-vacuum deposition techniques are introduced. This includes the use of polymer-ceramic nanocomposites for integral capacitors and electroless plating for integral resistors. From the literature review it is believed that resistors in the range of 5--50 ohm/square and capacitors in the range of 1--20 nF/cm2 can satisfy most of the mixed-signal application needs. The proposed materials can satisfy this need as demonstrated in this work. Several test vehicles were fabricated and measured to characterize the material properties, and demonstrate conventional and novel circuits for mixed-signal applications. To begin with, several polymer-ceramic combinations were analyzed under varying conditions to gain a fundamental understanding of the material system. Experimental advances have been made to achieve high dielectric constant values for both epoxy-ceramic and polyimide-ceramic systems. These material systems in general can satisfy specific capacitances in the range of 1--22 nF/cm2. These materials were found to be stable into the GHz range and have low loss-tangent. For electroless resistors, several plating baths were studied and a combination of Ni-P/Ni-W-P was found to produce the best results. Uniform plating was achieved through better nucleation of PdCl2 catalyst through the use of organosilane surface treatment. The Ni-P/Ni-W-P films produced sheet resistance in the range of 5--50 ohm/square and TCR below 50 ppm/°C. The material is stable into the GHz range. Upon optimizing the electrical properties and processing of capacitors and resistors, several test vehicles were fabricated to demonstrate some conventional and novel passive structures for RF and mixed-signal applications (e.g., filters, delay lines, etc.). Some of the structures were modeled using MDS and PSPICE and a good correlation

  12. Arterial stiffness

    Directory of Open Access Journals (Sweden)

    Ursula Quinn

    2012-09-01

    Full Text Available Measurements of biomechanical properties of arteries have become an important surrogate outcome used in epidemiological and interventional cardiovascular research. Structural and functional differences of vessels in the arterial tree result in a dampening of pulsatility and smoothing of blood flow as it progresses to capillary level. A loss of arterial elastic properties results a range of linked pathophysiological changes within the circulation including increased pulse pressure, left ventricular hypertrophy, subendocardial ischaemia, vessel endothelial dysfunction and cardiac fibrosis. With increased arterial stiffness, the microvasculature of brain and kidneys are exposed to wider pressure fluctuations and may lead to increased risk of stroke and renal failure. Stiffening of the aorta, as measured by the gold-standard technique of aortic Pulse Wave Velocity (aPWV, is independently associated with adverse cardiovascular outcomes across many different patient groups and in the general population. Therefore, use of aPWV has been proposed for early detection of vascular damage and individual cardiovascular risk evaluation and it seems certain that measurement of arterial stiffness will become increasingly important in future clinical care. In this review we will consider some of the pathophysiological processes that result from arterial stiffening, how it is measured and factors that may drive it as well as potential avenues for therapy. In the face of an ageing population where mortality from atheromatous cardiovascular disease is falling, pathology associated with arterial stiffening will assume ever greater importance. Therefore, understanding these concepts for all clinicians involved in care of patients with cardiovascular disease will become vital.

  13. Effects of sitting position and applied positive end-expiratory pressure on respiratory mechanics of critically ill obese patients receiving mechanical ventilation*.

    Science.gov (United States)

    Lemyze, Malcolm; Mallat, Jihad; Duhamel, Alain; Pepy, Florent; Gasan, Gaëlle; Barrailler, Stéphanie; Vangrunderbeeck, Nicolas; Tronchon, Laurent; Thevenin, Didier

    2013-11-01

    To evaluate the extent to which sitting position and applied positive end-expiratory pressure improve respiratory mechanics of severely obese patients under mechanical ventilation. Prospective cohort study. A 15-bed ICU of a tertiary hospital. Fifteen consecutive critically ill patients with a body mass index (the weight in kilograms divided by the square of the height in meters) above 35 were compared to 15 controls with body mass index less than 30. Respiratory mechanics was first assessed in the supine position, at zero end-expiratory pressure, and then at positive end-expiratory pressure set at the level of auto-positive endexpiratory pressure. Second, all measures were repeated in the sitting position. Assessment of respiratory mechanics included plateau pressure, auto-positive end-expiratory pressure, and flow-limited volume during manual compression of the abdomen, expressed as percentage of tidal volume to evaluate expiratory flow limitation. In supine position at zero end-expiratory pressure, all critically ill obese patients demonstrated expiratory flow limitation (flow-limited volume, 59.4% [51.3-81.4%] vs 0% [0-0%] in controls; p mechanical ventilation, sitting position constantly and significantly relieved expiratory flow limitation and auto-positive end-expiratory pressure resulting in a dramatic drop in alveolar pressures. Combining sitting position and applied positive end-expiratory pressure provides the best strategy.

  14. Direct numerical simulation of expiratory crackles: Relationship between airway closure dynamics and acoustic fluctuations.

    Science.gov (United States)

    Ii, Satoshi; Wada, Shigeo

    2017-01-04

    This paper investigates the relationship between airway closure dynamics and acoustic fluctuations in expiratory crackles using direct numerical simulation. A unified mathematical model is proposed to deal with flow in an airway, elastic deformation of the airway wall, surface tension driven motion of the liquid film that lines the airway, and their acoustic fluctuations because of material compressibility. Airway closure is induced by increasing the surrounding pressure, then the source of the pressure fluctuations is measured over time. Our results show that the airway closure occurs suddenly because of a bridge formation of the liquid film, and high energy transfer occurs between the kinetic energy, the surface energy of the liquid interface, and the elastic energy of the airway wall, invoking a large acoustic fluctuation that causes the expiratory crackles. Nonlinear behavior is observed in terms of the airway wall stiffness; the dynamic motion of the airway closure becomes moderate and both the energy transfer and acoustic fluctuations are dramatically reduced with an increase in airway wall stiffness. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. A model of end-expiratory lung impedance dependency on total extracellular body water

    Science.gov (United States)

    Suchomel, J.; Sobota, V.

    2013-04-01

    Electrical impedance tomography (EIT) is an attractive method for clinical monitoring of patients during mechanical ventilation. This study evaluates lung impedance measurements using Dräger PulmoVista 500 EIT system on an animal model. Mechanically ventilated model was created. Vital signs were monitored as well as mechanical ventilation parameters. Extracellular fluid balance and blood volume were handled as follows: 30-40% of total blood volume were removed and returned back, 0.5 to 1 litre of Ringer's solution was injected afterwards. The quantity of injected fluids was recorded for each animal. During this process thoracic electrical impedance measurement was performed. Recorded data from PulmoVista 500 EIT system were analysed using the official Dräger EIT Data Analysis Tool. The dependency of end-expiratory lung impedance on the change of fluid balance was observed. The relation between end-expiratory (minimum impedance value) frames and changes of fluid balance is shown. Preliminary results strongly support the expectation that electrical impedance of thorax can be affected by total extracellular fluid change.

  16. Estimation of tracheal pressure and imposed expiratory work of breathing by the endotracheal tube, heat and moisture exchanger, and ventilator during mechanical ventilation.

    Science.gov (United States)

    Uchiyama, Akinori; Yoshida, Takeshi; Yamanaka, Hidenori; Fujino, Yuji

    2013-07-01

    The resistance of the endotracheal tube (ETT), the heat and moisture exchanger (HME), and the ventilator may affect the patient's respiratory status. Although previous studies examined the inspiratory work of breathing (WOB), investigation of WOB in the expiratory phase is rare. We estimated tracheal pressure at the tip of the ETT (Ptrach) and calculated expiratory WOB imposed by the ETT, the HME, and the expiratory valve. We examined imposed expiratory WOB in patients under a continuous mandatory ventilation (CMV) mode and during spontaneous breathing trials (SBTs). We hypothesized that imposed expiratory WOB would increase with heightened ventilatory demand. We measured airway pressure (Paw) and respiratory flow (V). We estimated Ptrach using the equation Ptrach = Paw - K1 × V(K2) - 2.70 × V(L/s)(1.42). K1 and K2 were determined by the inner diameter (ID) of the ETT. Imposed expiratory WOB was calculated from the area of Ptrach above PEEP versus lung volume. We examined imposed expiratory WOB and imposed expiratory resistance in relation to mean expiratory flow. We examined 28 patients under CMV mode, and 29 during SBT. During both CMV and SBT, as mean expiratory flow increased, imposed expiratory WOB increased. The regression curves between mean expiratory flow (x) (L/s) and imposed expiratory WOB (y) (J/L) were y = 1.35x(0.83) (R(2) = 0.79) for 7 mm ID ETT under CMV, y = 1.12x(0.82) (R(2) = 0.73) for 8 mm ID ETT under CMV, y = 1.07x(1.04) (R(2) = 0.85) for 7 mm ID ETT during SBT, and y = 0.84x(0.93) (R(2) = 0.75) for 8 mm ID ETT during SBT. Levels of imposed expiratory WOB were affected by ETT diameter and ventilator mode. The reason for increasing imposed expiratory WOB was an increase in expiratory resistance imposed by the ETT and HME. Under mechanical ventilation, imposed expiratory WOB should be considered in patients with higher minute ventilation.

  17. An experimental study on the impacts of inspiratory and expiratory muscles activities during mechanical ventilation in ARDS animal model

    Science.gov (United States)

    Zhang, Xianming; Du, Juan; Wu, Weiliang; Zhu, Yongcheng; Jiang, Ying; Chen, Rongchang

    2017-01-01

    In spite of intensive investigations, the role of spontaneous breathing (SB) activity in ARDS has not been well defined yet and little has been known about the different contribution of inspiratory or expiratory muscles activities during mechanical ventilation in patients with ARDS. In present study, oleic acid-induced beagle dogs’ ARDS models were employed and ventilated with the same level of mean airway pressure. Respiratory mechanics, lung volume, gas exchange and inflammatory cytokines were measured during mechanical ventilation, and lung injury was determined histologically. As a result, for the comparable ventilator setting, preserved inspiratory muscles activity groups resulted in higher end-expiratory lung volume (EELV) and oxygenation index. In addition, less lung damage scores and lower levels of system inflammatory cytokines were revealed after 8 h of ventilation. In comparison, preserved expiratory muscles activity groups resulted in lower EELV and oxygenation index. Moreover, higher lung injury scores and inflammatory cytokines levels were observed after 8 h of ventilation. Our findings suggest that the activity of inspiratory muscles has beneficial effects, whereas that of expiratory muscles exerts adverse effects during mechanical ventilation in ARDS animal model. Therefore, for mechanically ventilated patients with ARDS, the demands for deep sedation or paralysis might be replaced by the strategy of expiratory muscles paralysis through epidural anesthesia. PMID:28230150

  18. Noise Measurements Of Resistors With The Use Of Dual-Phase Virtual Lock-In Technique

    Directory of Open Access Journals (Sweden)

    Stadler Adam Witold

    2015-12-01

    Full Text Available Measurement of low-frequency noise properties of modern electronic components is a very demanding challenge due to the low magnitude of a noise signal and the limit of a dissipated power. In such a case, an ac technique with a lock-in amplifier or the use of a low-noise transformer as the first stage in the signal path are common approaches. A software dual-phase virtual lock-in (VLI technique has been developed and tested in low-frequency noise studies of electronic components. VLI means that phase-sensitive detection is processed by a software layer rather than by an expensive hardware lock-in amplifier. The VLI method has been tested in exploration of noise in polymer thick-film resistors. Analysis of the obtained noise spectra of voltage fluctuations confirmed that the 1/f noise caused by resistance fluctuations is the dominant one. The calculated value of the parameter describing the noise intensity of a resistive material, C = 1·10−21 m3, is consistent with that obtained with the use of a dc method. On the other hand, it has been observed that the spectra of (excitation independent resistance noise contain a 1/f component whose intensity depends on the excitation frequency. The phenomenon has been explained by means of noise suppression by impedances of the measurement circuit, giving an excellent agreement with the experimental data.

  19. Force Sensing Resistor and Evaluation of Technology for Wearable Body Pressure Sensing

    Directory of Open Access Journals (Sweden)

    Davide Giovanelli

    2016-01-01

    Full Text Available Wearable technologies are gaining momentum and widespread diffusion. Thanks to devices such as activity trackers, in form of bracelets, watches, or anklets, the end-users are becoming more and more aware of their daily activity routine, posture, and training and can modify their motor-behavior. Activity trackers are prevalently based on inertial sensors such as accelerometers and gyroscopes. Loads we bear with us and the interface pressure they put on our body also affect posture. A contact interface pressure sensing wearable would be beneficial to complement inertial activity trackers. What is precluding force sensing resistors (FSR to be the next best seller wearable? In this paper, we provide elements to answer this question. We build an FSR based on resistive material (Velostat and printed conductive ink electrodes on polyethylene terephthalate (PET substrate; we test its response to pressure in the range 0–2.7 kPa. We present a state-of-the-art review, filtered by the need to identify technologies adequate for wearables. We conclude that the repeatability is the major issue yet unsolved.

  20. Combined TiN- and TaN temperature compensated thin film resistors

    Energy Technology Data Exchange (ETDEWEB)

    Malmros, Anna, E-mail: anna.malmros@chalmers.se; Andersson, Kristoffer; Rorsman, Niklas

    2012-01-01

    The opposite signs of the temperature coefficient of resistance (TCR) of two thin film materials, titanium nitride (TiN) and tantalum nitride (TaN), were used to form temperature compensated thin film resistors (TFRs). The principle of designing temperature compensated TFRs by connecting TFRs of each compound in series or in parallel was demonstrated. TiN, TaN, and combined TiN and TaN TFRs for monolithic microwave integrated circuits (MMICs) were fabricated by reactive sputtering. DC characterization was performed over the temperature range of 30-200 Degree-Sign C. The TiN TFRs exhibited an increase in resistivity with temperature with TCRs of 540 and 750 ppm/ Degree-Sign C. The TaN TFR on the other hand exhibited a negative TCR of - 470 ppm/ Degree-Sign C. The shunted TFRs were fabricated by serial deposition of TiN and TaN to form a bilayer component. The TCRs of the series- and shunt configurations were experimentally reduced to - 60 and 100 ppm/ Degree-Sign C, respectively. The concept of temperature compensation was used to build a Wheatstone bridge with an application in on-chip temperature sensing.

  1. Characteristics research of pressure sensor based on nanopolysilicon thin films resistors

    Science.gov (United States)

    Zhao, Xiaofeng; Li, Dandan; Wen, Dianzhong

    2017-10-01

    To further improve the sensitivity temperature characteristics of pressure sensor, a kind of pressure sensor taking nanopolysilicon thin films as piezoresistors is proposed in this paper. On the basis of the microstructure analysis by X-ray diffraction (XRD) and scanning electron microscope (SEM) tests, the preparing process of nanopolysilicon thin films is optimized. The effects of film thickness and annealing temperature on the micro-structure of nanopolysilicon thin films were studied, respectively. In order to realize the measurement of external pressure, four nanopolysilicon thin films resistors were arranged at the edges of square silicon diaphragm connected to a Wheatstone bridge, and the chip of the sensor was designed and fabricated on a 〈100〉 orientation silicon wafer by microelectromechanical system (MEMS) technology. Experimental result shows that when I = 6.80 mA, the sensitivity of the sensor PS-1 is 0.308 mV/kPa, and the temperature coefficient of sensitivity (TCS) is about ‑1742 ppm/∘C in the range of ‑40-140∘C. It is possible to obviously improve the sensitivity temperature characteristics of pressure sensor by the proposed sensors.

  2. Nitrogen washout/washin, helium dilution and computed tomography in the assessment of end expiratory lung volume

    Science.gov (United States)

    Chiumello, Davide; Cressoni, Massimo; Chierichetti, Monica; Tallarini, Federica; Botticelli, Marco; Berto, Virna; Mietto, Cristina; Gattinoni, Luciano

    2008-01-01

    Introduction End expiratory lung volume (EELV) measurement in the clinical setting is routinely performed using the helium dilution technique. A ventilator that implements a simplified version of the nitrogen washout/washin technique is now available. We compared the EELV measured by spiral computed tomography (CT) taken as gold standard with the lung volume measured with the modified nitrogen washout/washin and with the helium dilution technique. Methods Patients admitted to the general intensive care unit of Ospedale Maggiore Policlinico Mangiagalli Regina Elena requiring ventilatory support and, for clinical reasons, thoracic CT scanning were enrolled in this study. We performed two EELV measurements with the modified nitrogen washout/washin technique (increasing and decreasing inspired oxygen fraction (FiO2) by 10%), one EELV measurement with the helium dilution technique and a CT scan. All measurements were taken at 5 cmH2O airway pressure. Each CT scan slice was manually delineated and gas volume was computed with custom-made software. Results Thirty patients were enrolled (age = 66 +/- 10 years, body mass index = 26 +/- 18 Kg/m2, male/female ratio = 21/9, partial arterial pressure of carbon dioxide (PaO2)/FiO2 = 190 +/- 71). The EELV measured with the modified nitrogen washout/washin technique showed a very good correlation (r2 = 0.89) with the data computed from the CT with a bias of 94 +/- 143 ml (15 +/- 18%, p = 0.001), within the limits of accuracy declared by the manufacturer (20%). The bias was shown to be highly reproducible, either decreasing or increasing the FiO2 being 117+/-170 and 70+/-160 ml (p = 0.27), respectively. The EELV measured with the helium dilution method showed a good correlation with the CT scan data (r2 = 0.91) with a negative bias of 136 +/- 133 ml, and appeared to be more correct at low lung volumes. Conclusions The EELV measurement with the helium dilution technique (at low volumes) and modified nitrogen washout/washin technique

  3. Optimal planning of series resistor to control time constant of test circuit for high-voltage AC circuit-breakers

    Directory of Open Access Journals (Sweden)

    Yoon-Ho Kim

    2016-01-01

    Full Text Available The equivalent test circuit that can deliver both short-circuit current and recovery voltage is used to verify the performance of high-voltage circuit breakers. Most of the parameters in this circuit can be obtained by using a simple calculation or a simulation program. The ratings of the circuit breaker include rated short-circuit breaking current, rated short-circuit making current, rated operating sequence of the circuit breaker and rated short-time current. Among these ratings, the short-circuit making capacity of the circuit breaker is expressed in peak value and not in RMS value similar to breaking capacity. A series resistor or super-excitation is used to control the peak value of the short-circuit current in the equivalent test circuit. When using a series resistor, a higher rating of circuit breakers leads to a higher thermal capacity, thereby requiring additional space. Therefore, an effective, optimal design of the series resistor is essential. This paper proposes a method for reducing thermal capacity and selecting the optimal resistance to limit the making current by controlling the DC time constant of the test circuit.

  4. TU-CD-BRA-11: Application of Bone Suppression Technique to Inspiratory/expiratory Chest Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, R; Sanada, S [Kanazawa University, Kanazawa, Ishikawa (Japan); Sakuta, K; Kawashima, H [Kanazawa University Hospital, Kanazawa, Ishikawa (Japan); Kishitani, Y [TOYO Corporation, Chuoh-ku, Tokyo (Japan)

    2015-06-15

    Purpose: The bone suppression technique based on advanced image processing can suppress the conspicuity of bones on chest radiographs, creating soft tissue images normally obtained by the dual-energy subtraction technique. This study was performed to investigate the usefulness of bone suppression technique in quantitative analysis of pulmonary function in inspiratory/expiratory chest radiography. Methods: Commercial bone suppression image processing software (ClearRead; Riverain Technologies) was applied to paired inspiratory/expiratory chest radiographs of 107 patients (normal, 33; abnormal, 74) to create corresponding bone suppression images. The abnormal subjects had been diagnosed with pulmonary diseases, such as pneumothorax, pneumonia, emphysema, asthma, and lung cancer. After recognition of the lung area, the vectors of respiratory displacement were measured in all local lung areas using a cross-correlation technique. The measured displacement in each area was visualized as displacement color maps. The distribution pattern of respiratory displacement was assessed by comparison with the findings of lung scintigraphy. Results: Respiratory displacement of pulmonary markings (soft tissues) was able to be quantified separately from the rib movements on bone suppression images. The resulting displacement map showed a left-right symmetric distribution increasing from the lung apex to the bottom region of the lung in many cases. However, patients with ventilatory impairments showed a nonuniform distribution caused by decreased displacement of pulmonary markings, which were confirmed to correspond to area with ventilatory impairments found on the lung scintigrams. Conclusion: The bone suppression technique was useful for quantitative analysis of respiratory displacement of pulmonary markings without any interruption of the rib shadows. Abnormal areas could be detected as decreased displacement of pulmonary markings. Inspiratory/expiratory chest radiography combined

  5. Effects of expiratory muscle activation via high-frequency spinal cord stimulation.

    Science.gov (United States)

    Kowalski, K E; Romaniuk, J R; Kowalski, T; DiMarco, A F

    2017-12-01

    In persons with spinal cord injury, lower thoracic low-frequency spinal cord stimulation (LF-SCS; 50 Hz, 15 mA) is a useful method to restore an effective cough. Unfortunately, the high-stimulus-amplitude requirements and potential activation of pain fibers significantly limit this application in persons with intact sensation. In this study, the mechanism of the expiratory muscle activation, via high-frequency SCS (HF-SCS; 500 Hz, 1 mA) was evaluated in dogs. In group 1, the effects of electrode placement on airway pressure generation (P) was evaluated. Maximal P occurred at the T9-T10 level with progressive decrements in P at more rostral and caudal levels for both LF-SCS and HF-SCS. In group 2, electromyographic (EMG) latencies of internal intercostal muscle (II) activation were evaluated before and after spinal root section and during direct motor root stimulation. Onset time of II EMG activity during HF-SCS was significantly longer (3.84 ± 1.16 ms) than obtained during direct motor root activation (1.61 ± 0.10 ms). In group 3, P and external oblique (EO) EMG activity, before and after sequential spinal section at the T11-T12 level, were evaluated. Bilateral dorsal column section significantly reduced EO EMG activity below the section and resulted in a substantial fall in P. Subsequent lateral funiculi section completely abolished those activities and resulted in further reductions in P. We conclude that 1) activation of the expiratory muscles via HF-SCS is dependent entirely on synaptic spinal cord pathways, and 2) HF-SCS at the T9 level produces a comparable level of muscle activation with that achieved with LF-SCS but with much lower stimulus amplitudes. NEW & NOTEWORTHY The findings in the present study suggest that lower thoracic high-frequency spinal cord stimulation with low stimulus currents results in sufficient activation of the expiratory muscles via spinal circuitry to produce large positive airway pressures sufficient to generate an

  6. Occlusive Peripheral Arterial Disease

    Science.gov (United States)

    ... but also to the worsening of the disease. Obstructive peripheral arterial disease most commonly develops in the arteries of the legs, including the two branches of the aorta (iliac arteries), main arteries of the thighs (femoral arteries), of ... arterial disease may also develop in the part ...

  7. Measurement of small ion beams by thermal ionisation mass spectrometry using new 10(13) Ohm resistors.

    Science.gov (United States)

    Koornneef, J M; Bouman, C; Schwieters, J B; Davies, G R

    2014-03-28

    We tested 5 newly manufactured - prototype - 10(13)Ohm resistors in the feedback loop of Faraday cup amplifiers to measure small ion beams by Thermal Ionisation Mass Spectrometry (TIMS). The high Ohmic resistors installed in the TRITON Plus at the VU University Amsterdam theoretically have 10 times lower noise levels relative to the default 10(11)Ohm resistors. To investigate the precision and accuracy of analyses using these new amplifiers we measured Sr and Nd isotopes of reference standards at a range of ion currents (3.2×10(-16) to 1×10(-12) A, corresponding to intensities of 32 μV to 100 mV on a default 10(11)Ohm amplifier) and on small amounts of material (100 and 10 pg). Internal precision and external reproducibility for Sr and Nd isotope ratios are both better when collected on 10(13) compared 10(12)Ohm resistors and to the default 10(11)Ohm resistors. At an (87)Sr ion current of 3×10(-14) A (3 mV on a 10(11)Ohm amplifier) the internal precision (2 SE) of (87)Sr/(86)Sr is 5 times better for 10(13)Ohm resistors compared to 10(11)Ohm resistors. The external reproducibility (2 SD) at this beam intensity is 9 times better. Multiple 100 and 10 pg Sr standards, ran to exhaustion, yielded low (87)Sr/(86)Sr compared to the long term average (e.g. 10 pg average=0.710083±164 (n=11) instead of 0.710244±12, n=73). The average off-set for 10 pg standards can be explained by a loading blank contribution of 1.3 pg. In contrast, Nd data on 100 pg and 10 pg samples are accurate suggesting that Nd loading blanks do not compromise the data. The external reproducibility of (143)Nd/(144)Nd on 100 pg samples is 125 ppm and 3.3‰ on 10 pg samples (2 RSD=relative standard deviation, n=10). Thus, variability in Nd and Sr isotope ratios in the 4th decimal place, e.g. (143)Nd/(144)Nd 0.5110-0.5119 or (87)Sr/(86)Sr 0.7100-0.7109, can be resolved in 10 to 100 pg samples provided that the procedural blanks and chemical separation are optimal. For measurements in the beam

  8. The respiratory drive to thoracic motoneurones in the cat and its relation to the connections from expiratory bulbospinal neurones

    DEFF Research Database (Denmark)

    Saywell, S A; Anissimova, N P; Ford, T W

    2007-01-01

    The descending control of respiratory-related motoneurones in the thoracic spinal cord remains the subject of some debate. In this study, direct connections from expiratory bulbospinal neurones to identified motoneurones were investigated using spike-triggered averaging and the strengths of conne......The descending control of respiratory-related motoneurones in the thoracic spinal cord remains the subject of some debate. In this study, direct connections from expiratory bulbospinal neurones to identified motoneurones were investigated using spike-triggered averaging and the strengths...

  9. Maximal Expiratory Flow at FRC (V′maxFRC): Methods of Selection and Differences in Reported Values

    OpenAIRE

    Koumbourlis, Anastassios C.; Chen, Xin C.; Rao, J. Sunil; Schluchter, Mark D; Easley, Kirk; Colin, Andrew A.; Hiatt, Peter; Kattan, Meyer; McCarthy, Kevin; Mellins, Robert B.; Peavy, Hannah; Platzker, Arnold C.G.; Steinbach, Suzanne; Ting, Andrew; Weisner, Michael D.

    2004-01-01

    We compared three methods of reporting maximal expiratory flow (V′maxFRC) measured in partial expiratory flow-volume curves (PEFVCs) at the point of functional residual capacity (FRC). PEFVCs were obtained with the rapid thoracoabdominal compression technique (RTC) on a total of 446 occasions in 281 HIV-negative, asymptomatic infants (4.8–28.1 months old). Three different expressions of V′maxFRC were recorded: 1) the highest measured flow (maxV′FRC), 2) the mean of the three highest flows (me...

  10. Variable positive end-expiratory pressure can maintain oxygenation in experimental acute respiratory distress syndrome induced by oleic acid in dogs

    Directory of Open Access Journals (Sweden)

    F.C. Lanza

    2009-08-01

    Full Text Available The use of positive end-expiratory pressure (PEEP or lung recruitment maneuvers (RM to improve oxygenation in acute respiratory distress syndrome (ARDS is used but it may reduce cardiac output (CO. Intermittent PEEP may avoid these complications. Our objective was to determine if variable PEEP compared with constant PEEP is capable of maintaining arterial oxygenation and minimizing hemodynamic alterations with or without RM. Eighteen dogs with ARDS induced by oleic acid were randomized into three equal groups: group 1, low variable PEEP; group 2, high variable PEEP, and group 3, RM + high variable PEEP. All groups were submitted to constant PEEP, followed by variable PEEP (PEEP was increased from 5 to 10 cmH2O in group 1, and from 5 to 18 cmH2O in the other two groups. PaO2 was higher in group 3 (356.2 ± 65.4 mmHg than in group 1 (92.7 ± 29.7 mmHg and group 2 (228.5 ± 72.4 mmHg, P 0.05. Variable PEEP is able to maintain PaO2 when performed in combination with RM in dogs with ARDS. After RM, CO was reduced and there was no relevant difference between the variable and constant PEEP periods.

  11. Inspiratory and expiratory elastance in a non-linear autoregressive model of pulmonary mechanics

    Directory of Open Access Journals (Sweden)

    Langdon Ruby

    2016-09-01

    Full Text Available For patients with acute respiratory distress syndrome (ARDS, the use of mathematical models to determine patient-specific ventilator settings can reduce ventilator induced lung injury and improve patient outcomes. A non-linear autoregressive model of pulmonary mechanics was used to identify inspiratory and expiratory pressure-dependent elastance (Ei and Ee as independent variables. The analysis was implemented on 19 data sets of recruitment manoeuvres (RMs that were performed on 10 mechanically ventilated patients. At pressures p = 15–20 cmH2O the agreement between Ei and Ee was low. However, Ei was a well-matched predictor of Ee for p = 25–40 cmH2O, with R2 ≥ 0.78, and there was no significant bias in the difference between Ei and Ee. Since many other models cannot uniquely identify Ei and Ee, the outcome may provide further insight into the characteristics of ARDS lungs in sedated patients.

  12. Individualized positive end-expiratory pressure application in patients with acute respiratory distress syndrome.

    Science.gov (United States)

    Pintado, M C; de Pablo, R

    2014-11-01

    Current treatment of acute respiratory distress syndrome is based on ventilatory support with a lung protective strategy, avoiding the development of iatrogenic injury, including ventilator-induced lung injury. One of the mechanisms underlying such injury is atelectrauma, and positive end-expiratory pressure (PEEP) is advocated in order to avoid it. The indicated PEEP level has not been defined, and in many cases is based on the patient oxygen requirements for maintaining adequate oxygenation. However, this strategy does not consider the mechanics of the respiratory system, which varies in each patient and depends on many factors-including particularly the duration of acute respiratory distress syndrome. A review is therefore made of the different methods for adjusting PEEP, focusing on the benefits of individualized application. Copyright © 2013 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  13. Effects of different PEEP levels on respiratory mechanics and oxygenation after coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Daniel Lago Borges

    2013-09-01

    Full Text Available OBJECTIVE: To compare the effects of different levels of positive end-expiratory pressure on respiratory mechanics and oxygenation indexes in the immediate postoperative period of coronary artery bypass grafting. METHODS: Randomized clinical trial in which 136 patients underwent coronary artery bypass grafting between January 2011 and March 2012 were divided into three groups and admitted to mechanical ventilation with different positive end-expiratory pressure levels: Group A, 5 cmH2O (n=44, Group B, 8 cmH2O (n=47 and Group C, 10 cmH2O (n=45. Data about respiratory mechanics were obtained from mechanical ventilator monitor and oxygenation indexes from arterial blood gas samples, collected twenty minutes after intensive care unit admission. Patients with chronic obstructive pulmonary disease and patients submitted to off-pump, emergency or combined operations were not included. For statistical analysis, we used Kruskal-Wallis, G and Chi-square tests, considering results significant when P<0.05. RESULTS: Groups were homogeneous in terms of demographic, clinical and surgical variables. Patients ventilated with positive end-expiratory pressure of 10 cmH2O (Group C had best compliance (P=0.04 and airway resistance values, this, however, without statistical significance. They also had best oxygenation indexes, with statistical difference in all analyzed variables, and lower frequency of hypoxemia (P=0.03. CONCLUSION: Higher levels of positive end-expiratory pressure in immediate postoperative period of coronary artery bypass grafting improved pulmonary compliance values and increased oxygenation indexes, resulting in lower frequency of hypoxemia.

  14. End expiratory oxygen concentrations to predict central venous oxygen saturation: an observational pilot study

    Directory of Open Access Journals (Sweden)

    Steuerwald Michael

    2006-09-01

    Full Text Available Abstract Background A non-invasive surrogate measurement for central venous oxygen saturation (ScVO2 would be useful in the ED for assessing therapeutic interventions in critically ill patients. We hypothesized that either linear or nonlinear mathematical manipulation of the partial pressure of oxygen in breath at end expiration (EtO2 would accurately predict ScVO2. Methods Prospective observational study of a convenience sample of hemodialysis patients age > 17 years with existing upper extremity central venous catheters were enrolled. Using a portable respiratory device, we collected both tidal breathing and end expiratory oxygen and carbon dioxide concentrations, volume and flow on each patient. Simultaneous ScVO2 measurements were obtained via blood samples collected from the hemodialysis catheter. Two models were used to predict ScVO2: 1 Best-fit multivariate linear regression equation incorporating all respiratory variables; 2 MathCAD to model the decay curve of EtO2 versus expiratory volume using the least squares method to estimate the pO2 that would occur at Results From 21 patients, the correlation between EtO2 and measured ScVO2 yielded R2 = 0.11. The best fit multivariate equation included EtCO2 and EtO2 and when solved for ScVO2, the equation yielded a mean absolute difference from the measured ScVO2 of 8 ± 6% (range -18 to +17%. The predicted ScVO2 value was within 10% of the actual value for 57% of the patients. Modeling of the EtO2 curve did not accurately predict ScVO2 at any lung volume. Conclusion We found no significant correlation between EtO2 and ScVO2. A linear equation incorporating EtCO2 and EtO2 had at best modest predictive accuracy for ScVO2.

  15. End expiratory oxygen concentrations to predict central venous oxygen saturation: an observational pilot study.

    Science.gov (United States)

    Jones, Alan E; Kuehne, Karl; Steuerwald, Michael; Kline, Jeffrey A

    2006-09-20

    A non-invasive surrogate measurement for central venous oxygen saturation (ScVO2) would be useful in the ED for assessing therapeutic interventions in critically ill patients. We hypothesized that either linear or nonlinear mathematical manipulation of the partial pressure of oxygen in breath at end expiration (EtO2) would accurately predict ScVO2. Prospective observational study of a convenience sample of hemodialysis patients age > 17 years with existing upper extremity central venous catheters were enrolled. Using a portable respiratory device, we collected both tidal breathing and end expiratory oxygen and carbon dioxide concentrations, volume and flow on each patient. Simultaneous ScVO2 measurements were obtained via blood samples collected from the hemodialysis catheter. Two models were used to predict ScVO2: 1) Best-fit multivariate linear regression equation incorporating all respiratory variables; 2) MathCAD to model the decay curve of EtO2 versus expiratory volume using the least squares method to estimate the pO2 that would occur at <20% of total lung capacity. From 21 patients, the correlation between EtO2 and measured ScVO2 yielded R2 = 0.11. The best fit multivariate equation included EtCO2 and EtO2 and when solved for ScVO2, the equation yielded a mean absolute difference from the measured ScVO2 of 8 +/- 6% (range -18 to +17%). The predicted ScVO2 value was within 10% of the actual value for 57% of the patients. Modeling of the EtO2 curve did not accurately predict ScVO2 at any lung volume. We found no significant correlation between EtO2 and ScVO2. A linear equation incorporating EtCO2 and EtO2 had at best modest predictive accuracy for ScVO2.

  16. Effects of positive end-expiratory pressure on the sigmoid equation in experimental acute lung injury.

    Science.gov (United States)

    Bayle, Frederique; Guerin, Claude; Viale, Jean-Paul; Richard, Jean-Christophe; Annat, Guy

    2004-11-01

    To describe inflation and deflation volume-pressure (V-P) curves of the respiratory system by the sigmoidal equation at different levels of positive end-expiratory pressure (PEEP) in acute lung injury. Experimental study. Physiological laboratory in a university setting. Six pigs of 25 kg each. Acute lung injury was induced by oleic acid. PEEP was applied from 0 to 15 cm H(2)O and from 15 to 0 cm H(2)O for 10 min in steps of 5 cmH(2)O. Inflation and deflation V-P curves were constructed from an automated super-syringe that delivers a constant flow of 7 l/min in both inspiratory and expiratory directions. V-P curves were obtained at each level of PEEP without disconnecting the animal from the ventilator. The experimental data were fitted to the sigmoid equation which provided the true inflection point (c), the point of maximal compliance increase (Pmci) reflecting opening/closure and the point of maximal compliance decrease (Pmcd) reflecting end of recruitment/onset of de-recruitment. The sigmoid equation provided an excellent fit. The values of the coefficients of determination were greater than 0.970 (median 0.996, IQR 0.994-0.997 for the 84 determinations). Negative values of Pmci in the deflation limb of the V-P curve were recorded in five pigs, suggesting closure below the volume range studied. Inflation and deflation V-P curves at different PEEPs can be fitted by the sigmoid equation. However, further work is needed to investigate the meaning of negative values for Pmci.

  17. Respiratory variation of the extrahepatic bile duct: evaluation with deep inspiratory and expiratory MRCP.

    Science.gov (United States)

    Ito, Katsuyoshi; Shimizu, Ayame; Tanabe, Masahiro; Matsunaga, Naofumi

    2012-05-01

    The purpose of the study was to evaluate the respiratory variation of the extrahepatic bile duct in morphology including shape, length and duct diameter on the breath-hold magnetic resonance cholangiopancreatography (MRCP) obtained during deep inspiration and deep expiration in patients with or without biliary diseases. This study included 102 patients with or without biliary diseases. Breath-hold MRCP was obtained twice during the end-inspiration and the end-expiration. MRCP images were evaluated for the length, maximal diameter and "bowing" of the extrahepatic bile duct. In the normal group, the mean maximal diameter of the extrahepatic bile duct was significantly larger on the end-inspiratory MRCP (8.0 ± 2.0 mm) than on the end-expiratory MRCP (7.3 ± 1.8 mm) (P<.0001), while it was not significantly different in the dilated group. In the normal group, 25 (39%) of 65 patients had an increase in the mean maximal diameter of more than 1 mm at the end-inspiration, whereas 4 (11%) of 37 patients in the dilated group had it. The bowing of the extrahepatic bile duct on the end-inspiratory MRCP was observed in 60 (92%) of 65 normal patients, while it was seen in 22 (60%) of 37 patients with biliary dilatation (P<.0001). Deep inspiratory and expiratory MRCP demonstrated the respiratory variations of the extrahepatic bile duct in the shape (bowing), length and maximal duct diameter in patients with nondilated bile ducts. Awareness of this normal phenomenon will be important for the correct interpretation of MRCP in patients with or without biliary diseases. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Associations between air pollution and peak expiratory flow among patients with persistent asthma.

    Science.gov (United States)

    Qian, Zhengmin; Lin, Hung-Mo; Chinchilli, Vernon M; Lehman, Erik B; Stewart, Walter F; Shah, Nirav; Duan, Yinkang; Craig, Timothy J; Wilson, William E; Liao, Duanping; Lazarus, Stephen C; Bascom, Rebecca

    2009-01-01

    Responses of patients with persistent asthma to ambient air pollution may be different from those of general populations. For example, asthma medications may modify the effects of ambient air pollutants on peak expiratory flow (PEF). Few studies examined the association between air pollution and PEF in patients with persistent asthma on well-defined medication regimens using asthma clinical trial data. Airway obstruction effects of ambient air pollutants, using 14,919 person-days of daily self-measured peak expiratory flow (PEF), were assessed from 154 patients with persistent asthma during the 16 wk of active treatment in the Salmeterol Off Corticosteroids Study trial. The three therapies were an inhaled corticosteroid, an inhaled long-acting beta-agonist, and placebo. The participants were nonsmokers aged 12 through 63 yr, recruited from 6 university-based ambulatory care centers from February 1997 to January 1999. Air pollution data were derived from the U.S. Environmental Protection Agency Aerometric Information Retrieval System. An increase of 10 ppb of ambient daily mean concentrations of NO2 was associated with a decrease in PEF of 1.53 L/min (95% confidence interval [CI] -2.93 to -0.14) in models adjusted for age, gender, race/ethnicity, asthma clinical center, season, week, daily average temperature, and daily average relative humidity. The strongest association between NO2 and PEF was observed among the patients treated with salmeterol. Negative associations were also found between PEF and SO2 and between PEF and PM(10), respectively. The results show that the two medication regimens protected against the effects of PM(10). However, salmeterol increased the sensitivity to NO2 and triamcinalone enhanced the sensitivity to SO2.

  19. The Kölliker-Fuse nucleus acts as a timekeeper for late-expiratory abdominal activity.

    Science.gov (United States)

    Jenkin, Sarah E M; Milsom, William K; Zoccal, Daniel B

    2017-04-21

    While the transition from the inspiratory to the post-inspiratory (post-I) phase is dependent on the pons, little attention has been paid to understanding the role of the pontine respiratory nuclei, specifically the Kölliker-Fuse nucleus (KF), in transitioning from post-I to the late expiratory (late-E) activity seen with elevated respiratory drive. To elucidate this, we used the in situ working heart-brainstem preparation of juvenile male Holtzman rats and recorded from the vagus (cVN), phrenic (PN) and abdominal nerves (AbN) during baseline conditions and during chemoreflex activation [with potassium cyanide (KCN; n=13) or hypercapnia (8% CO 2 ; n=10)] to recruit active expiration. Chemoreflex activation with KCN increased PN frequency and cVN post-I and AbN activities. The inhibition of KF with isoguvacine microinjections (10mM) attenuated the typical increase in PN frequency and cVN post-I activity, and amplified the AbN response. During hypercapnia, AbN late-E activity emerged in association with a significant reduction in expiratory time. KF inhibition during hypercapnia significantly decreased PN frequency and reduced the duration and amplitude of post-I cVN activity, while the onset of the AbN late-E bursts occurred significantly earlier. Our data reveal a negative relationship between KF-induced post-I and AbN late-E activities, suggesting that the KF coordinates the transition between post-I to late-E activity during conditions of elevated respiratory drive. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

  20. A thermally-invariant, additively manufactured, high-power graphene resistor for flexible electronics

    Science.gov (United States)

    Michel, Monica; Biswas, Chandan; Tiwary, Chandra S.; Saenz, Gustavo A.; Hossain, Ridwan F.; Ajayan, Pulickel; Kaul, Anupama B.

    2017-06-01

    Solution processed two-dimensional (2D) layered materials and their integration with additive manufacturing techniques, such as ink-jet printing, is a facile approach for incorporating these exotic materials into device platforms for flexible electronics. In this work, graphene ink formulations are successfully utilized toward the design and fabrication of high-power resistive structures that are printed on both rigid and flexible substrates and have the potential to deliver close to 10 W of power. A near-flat, negative temperature coefficient of resistivity (TCR) is measured with an activation energy E a ~ 2.4 meV for electron hopping, which is 100×  lower compared to E a values for high TCR materials. The TCR and E a values are amongst the lowest reported for 2D layered material systems. The thermal-invariance of resistivity for such high-power graphene printed resistors is attractive for applications, for example to provide a stable heating source for flexible electronics over extreme thermal environments. The transport characteristics of the ink-jet printed features is modeled as a composite structure in order to explain the thermal response which appears to be mediated via defects in the sonicated graphite, and correlates well to inferences made from Raman spectroscopy and transmission electron microscopy analysis conducted on the printed graphene structures. In order to fabricate such functional structures with ink-jet printing, the active nozzle number, printing passes, and annealing conditions are shown to play an important role to determine line resolution, and also dictate the morphological and electronic transport characteristics of the printed graphene features.

  1. Protein losing enteropathy secondary to a pulmonary artery stent

    Directory of Open Access Journals (Sweden)

    Narayanswami Sreeram

    2012-01-01

    Full Text Available A 2-year-old patient with hypoplastic left heart syndrome presented 6 months following Fontan completion with protein-losing enteropathy (PLE. He had undergone stent implantation in the left pulmonary artery after the Norwood procedure, followed by redilation of the stent prior to Fontan completion. Combined bronchoscopic and catheterization studies during spontaneous breathing confirmed left bronchial stenosis behind the stent, and diastolic systemic ventricular pressure during expiration of 25 mm Hg. We postulate that the stent acts as a valve, against which the patient generates high expiratory pressures, which are reflected in the ventricular diastolic pressure. This may be the cause of PLE.

  2. End-expiratory lung volume during mechanical ventilation: A comparison with reference values and the effect of positive end-expiratory pressure in intensive care unit patients with different lung conditions

    NARCIS (Netherlands)

    I.G. Bikker (Ido); J. van Bommel (Jasper); D. dos Reis Miranda; J. Bakker (Jan); D.A.M.P.J. Gommers (Diederik)

    2008-01-01

    textabstractIntroduction: Functional residual capacity (FRC) reference values are obtained from spontaneous breathing patients, and are measured in the sitting or standing position. During mechanical ventilation FRC is determined by the level of positive end-expiratory pressure (PEEP), and it is

  3. Positive end-expiratory pressure improves survival in a rodent model of cardiopulmonary resuscitation using high-dose epinephrine.

    LENUS (Irish Health Repository)

    McCaul, Conán

    2009-10-01

    Multiple interventions have been tested in models of cardiopulmonary resuscitation (CPR) to optimize drug use, chest compressions, and ventilation. None has studied the effects of positive end-expiratory pressure (PEEP) on outcome. We hypothesized that because PEEP can reverse pulmonary atelectasis, lower pulmonary vascular resistance, and potentially improve cardiac output, its use during CPR would increase survival.

  4. Submental sEMG and Hyoid Movement during Mendelsohn Maneuver, Effortful Swallow, and Expiratory Muscle Strength Training

    Science.gov (United States)

    Wheeler-Hegland, Karen M.; Rosenbek, John C.; Sapienza, Christine M.

    2008-01-01

    Purpose: This study investigated the concurrent biomechanical and electromyographic properties of 2 swallow-specific tasks (effortful swallow and Mendelsohn maneuver) and 1 swallow-nonspecific (expiratory muscle strength training [EMST]) swallow therapy task in order to examine the differential effects of each on hyoid motion and associated…

  5. Nebulized hypertonic saline via positive expiratory pressure versus via jet nebulizer in patients with severe cystic fibrosis.

    LENUS (Irish Health Repository)

    O'Connell, Oisin J

    2011-06-01

    Nebulized hypertonic saline is a highly effective therapy for patients with cystic fibrosis (CF), yet 10% of patients are intolerant of hypertonic saline administered via jet nebulizer. Positive expiratory pressure (PEP) nebulizers splint open the airways and offers a more controlled rate of nebulization.

  6. Improvement of lung mechanics by exogenous surfactant: effect of prior application of high positive end-expiratory pressure

    NARCIS (Netherlands)

    A. Hartog (Anneke); D.A.M.P.J. Gommers (Diederik); J.J. Haitsma (Jack); B.F. Lachmann (Burkhard)

    2000-01-01

    textabstractThe use of a ventilation strategy with high positive end-expiratory pressure (PEEP) that is intended to recruit collapsed alveoli and to prevent recurrent collapse can reduce alveolar protein influx in experimental acute lung injury (ALI). This could affect

  7. Positive end expiratory pressure titrated by transpulmonary pressure improved oxygenation and respiratory mechanics in acute respiratory distress syndrome patients with intra-abdominal hypertension.

    Science.gov (United States)

    Yang, Yi; Li, Yang; Liu, Song-Qiao; Liu, Ling; Huang, Ying-Zi; Guo, Feng-Mei; Qiu, Hai-Bo

    2013-01-01

    Intra-abdominal hypertension (IAH) is common in acute respiratory distress syndrome (ARDS) patients and when resulting in decrease of chest wall compliance will weaken the effect of positive end expiratory pressure (PEEP). We investigated the effect of PEEP titrated by transpulmonary pressure (Ptp) on oxygenation and respiratory mechanics in ARDS patients with IAH compared with PEEP titrated by ARDSnet protocol. ARDS patients admitted to the intensive care unit (ICU) of the Zhongda Hospital were enrolled. Patients were ventilated with volume control mode with tidal volume of 6 ml/kg under two different PEEP levels titrated by Ptp method and ARDSnet protocol. Respiratory mechanics, gas exchange and haemodynamics were measured after 30 minutes of ventilation in each round. IAH was defined as intra-abdominal pressure of 12 mmHg or more. Seven ARDS patients with IAH and 8 ARDS patients without IAH were enrolled. PEEP titrated by Ptp were significant higher than PEEP titrated by ARDSnet protocol in both ARDS patients with IAH ((17.3 ± 2.6) cmH2O vs. (6.3 ± 1.6) cmH2O and without IAH ((9.5 ± 2.1) cmH2O vs. (7.8 ± 1.9) cmH2O). Arterial pressure of O2/fraction of inspired oxygen (PaO2/FiO2) was much higher under PEEP titrated by Ptp when compared with PEEP titrated by ARDSnet protocol in ARDS patients with IAH ((27.2 ± 4.0) cmHg vs. (20.9 ± 5.0) cmHg. But no significant difference of PaO2/FiO2 between the two methods was found in ARDS patients without IAH. In ARDS patients with IAH, static compliance of lung and respiratory system were higher under PEEP titrated by Ptp than by ARDSnet protocol. In ARDS patients with IAH, central venous pressure (CVP) was higher during PEEP titrated by Ptp than by ARDSnet protocol. Positive end expiratory pressure titrated by transpulmonary pressure was higher than PEEP titrated by ARDSnet protocol and improved oxygenation and respiratory mechanics in ARDS patients with IAH.

  8. The adjustable systemic-pulmonary artery shunt provides precise control of flow in vivo.

    Science.gov (United States)

    Douglas, William I; Moore, Karabeth B; Resig, Phillip P; Mohiuddin, M Waqar

    2010-01-01

    The ratio of pulmonary:systemic blood flow (Qp:Qs) remains problematic after single ventricle reconstruction. The adjustable systemic-pulmonary artery shunt (AS) was created as a solution for this problem. Prototype ASs were created using a screw-plunger mechanism as a variable resistor. A stepper motor controls plunger displacement. Six adult dogs underwent placement of a 4-mm AS in the femoral position to test its ability to control flow. Shunts were placed as arteriovenous fistulae to simulate the continuous flow of systemic-pulmonary AS. The 3.5-mm control shunts (CS) were placed on the contralateral side. The stepper motor was rotated from fully open to 3.4 mm of plunger depression for six complete cycles. Flow in the fully open AS was 687.9 +/- 28.7 cc/min* vs. 578.7 +/- 26.8 cc/min in the CS (flow +/- standard error, *p < 0.005 vs. CS). Standard deviation of flow was similar between the AS and CS, implying hysteresis in resistor function did not contribute to flow variability. Peak torque requirement to turn the resistor was 2.4 mNm. The AS offers excellent control of flow in vivo. Control of Qp:Qs may lead to improved outcomes for single ventricle reconstructions.

  9. Higher BMI is associated with higher expiratory airflow normalised for lung volume (FEF25-75/FVC) in COPD.

    Science.gov (United States)

    Abston, Eric; Comellas, Alejandro; Reed, Robert Michael; Kim, Victor; Wise, Robert A; Brower, Roy; Fortis, Spyridon; Beichel, Reinhard; Bhatt, Surya; Zabner, Joseph; Newell, John; Hoffman, Eric A; Eberlein, Michael

    2017-01-01

    The obesity paradox in chronic obstructive pulmonary disease (COPD), whereby patients with higher body mass index (BMI) fare better, is poorly understood. Higher BMIs are associated with lower lung volumes and greater lung elastic recoil, a key determinant of expiratory airflow. The forced expiratory flow (25-75) (FEF25-75)/forced vital capacity (FVC) ratio reflects effort-independent expiratory airflow in the context of lung volume and could be modulated by BMI. We analysed data from the COPDGene study, an observational study of 10 192 subjects, with at least a 10 pack-year smoking history. Data were limited to subjects with BMI 20-40 kg/m(2) (n=9222). Subjects were stratified according to forced expiratory volume in 1 s (FEV1) (%predicted)-quintiles. In regression analyses and Cox proportional hazard models, we analysed the association between BMI, the FEF25-75/FVC ratio, the imaging phenotype, COPD exacerbations, hospitalisations and death. There was no correlation between BMI and FEV1(%predicted). However, a higher BMI is correlated with a higher FEF25-75/FVC ratio. In CT scans, a higher BMI was associated with less emphysema and less air trapping. In risk-adjusted models, the quintile with the highest FEF25-75/FVC ratio was associated with a 46% lower risk of COPD exacerbations (OR 0.54, pBMI was not independently associated with these outcomes. A higher BMI is associated with lower lung volumes and higher expiratory airflows when normalised for lung volume, as quantified by the FEF25-75/FVC ratio. A higher FEF25-75/FVC ratio is associated with a lower risk of COPD exacerbations and death and might quantify functional aspects of the paradoxical effect of higher BMIs on COPD.

  10. Dangerous Pressurization and Inappropriate Alarms during Water Occlusion of the Expiratory Circuit of Commonly Used Infant Ventilators.

    Directory of Open Access Journals (Sweden)

    Murray Hinder

    Full Text Available Non-invasive continuous positive airways pressure is commonly a primary respiratory therapy delivered via multi-purpose ventilators in premature newborns. Expiratory limb occlusion due to water accumulation or 'rainout' from gas humidification is a frequent issue. A case of expiratory limb occlusion due to rainout causing unexpected and excessive repetitive airway pressurisation in a Draeger VN500 prompted a systematic bench test examination of currently available ventilators.To assess neonatal ventilator response to partial or complete expiratory limb occlusion when set to non-invasive continuous positive airway pressure mode.Seven commercially available neonatal ventilators connected to a test lung using a standard infant humidifier circuit with partial and/or complete expiratory limb occlusion were examined in a bench test study. Each ventilator was set to deliver 6 cmH2O in non-invasive mode and respiratory mechanics data for 75%, 80% and 100% occlusion were collected.Several ventilators responded inappropriately with complete occlusion by cyclical pressurisation/depressurisation to peak pressures of between 19·4 and 64·6 cm H2O at rates varying between 2 to 77 inflations per minute. Tidal volumes varied between 10·1 and 24·3mL. Alarm responses varied from 'specific' (tube occluded to 'ambiguous' (Safety valve open. Carefusion Avea responded by continuing to provide the set distending pressure and displaying an appropriate alarm message. Draeger Babylog 8000 did not alarm with partial occlusions and incorrectly displayed airways pressure at 6·1cmH2O compared to the measured values of 13cmH2O.This study found a potential for significant adverse ventilator response due to complete or near complete expiratory limb occlusion in CPAP mode.

  11. Pressures and Oscillation Frequencies Generated by Bubble-Positive Expiratory Pressure Devices.

    Science.gov (United States)

    Santos, Mary D; Milross, Maree A; Eisenhuth, John P; Alison, Jennifer A

    2017-04-01

    Positive expiratory pressure (PEP) devices are used to assist with airway clearance. Little is known about the therapist-made or commercially available bubble-PEP devices. The aim of this study was to determine the end-expiratory pressures (cm H2O) and oscillation frequencies (Hz) generated when a range of flows were applied to the therapist-made bubble-PEP devices (Bubble-PEP-3cm and Bubble-PEP-0cm) and commercial bubble-PEP devices (AguaPEP, Hydrapep, and Therabubble). This was a bench-top experimental study using a compressed air source, flow rotameter (flows of 5, 10, 15, 20, and 25 L/min), and pressure transducer. Data were collected using a data acquisition device with PhysioDAQxs software and analyzed with Breathalyser software to determine the pressures and oscillation frequencies generated by 5 bubble-PEP devices. Each flow was constant for a 30-s measurement period, and measurements were repeated in triplicate. The 5 devices were: a therapist-made Bubble-PEP-3cm device (filled with 13 cm of water, tubing resting 3 cm from the base of the container); the therapist-made Bubble-PEP-0cm (filled with 10 cm of water, tubing resting at the base of the container); and the AguaPEP, Hydrapep, and Therabubble devices with water to the 10 cm mark on the containers. Flows of 5-25 L/min produced the following mean ± SD PEP and oscillation frequencies (Hz): the Bubble-PEP-3cm produced PEP of 10.4 ± 0.14 to 10.8 ± 0.24 cm H2O, oscillations between 13 and 17 Hz; the Bubble-PEP-0cm produced PEP of 10.9 ± 0.01 to 12.9 ± 0.08 cm H2O, oscillations between 12 and 14 Hz; the AguaPEP produced PEP from 9.7 ± 0.02 to 11.5 ± 0.02 cm H2O, oscillations between 11 and 17 Hz; the Hydrapep produced PEP of 9.6 ± 0.35 to 10.7 ± 0.39 cm H2O, oscillations between 14 and 17 Hz; and the Therabubble produced PEP from 8.6 ± 0.01 to 12.8 ± 0.03 cm H2O, oscillations between 14 and 17 Hz. Bubble-PEP-3cm maintained the most stable pressure throughout the range of flows tested. All

  12. End-Expiratory Lung Volume in Patients with Acute Respiratory Distress Syndrome: A Time Course Analysis.

    Science.gov (United States)

    Kalenka, Armin; Gruner, Felix; Weiß, Christel; Viergutz, Tim

    2016-08-01

    Lung injury can be caused by ventilation and non-physiological lung stress (transpulmonary pressure) and strain [inflated volume over functional residual capacity ratio (FRC)]. FRC is severely decreased in patients with acute respiratory distress syndrome (ARDS). End-expiratory lung volume (EELV) is FRC plus lung volume increased by the applied positive end-expiratory pressure (PEEP). Measurement using the modified nitrogen multiple breath washout technique may help titrating PEEP during ARDS and allow determining dynamic lung strain (tidal volume over EELV) in patients ventilated with PEEP. In this observational study, we measured EELV for up to seven consecutive days in patients with ARDS at different PEEP levels. Thirty sedated patients with ARDS (10 mild, 14 moderate, 6 severe) underwent decremental PEEP testing (20, 15, 10, 5 cm H2O) for up to 7 days after inclusion. At all PEEP levels examined, over a period of 7 days the measured absolute EELVs showed no significant change over time [PEEP 20 cm H2O 2464 ml at day 1 vs. 2144 ml at day 7 (p = 0.78), PEEP 15 cm H2O 2226 ml vs. 1990 ml (p = 0.36), PEEP 10 1835 ml vs. 1858 ml (p = 0.76) and PEEP 5 cm H2O 1487 ml vs. 1612 ml (p = 0.37)]. In relation to the predicted body weight (pbw), no significant change in EELV/kg pbw over time could be detected either at any PEEP level or over time [PEEP 20 36 ml/kg pbw at day 1 vs. 33 ml/kg pbw at day 7 (p = 0.66); PEEP 15 33 vs. 29 ml/kg pbw (p = 0.32); PEEP 10 27 vs. 27 ml/kg pbw (p = 0.70) and PEEP 5 22 vs. 24 ml/kg pbw (p = 0.70)]. Oxygenation significantly improved over time from PaO2/FiO2 of 169 mmHg at day 1 to 199 mmHg at day 7 (p lung-protective ventilation on the basis of calculation of dynamic strain as the ratio of VT to EELV.

  13. Controlled mechanical ventilation with constant positive end-expiratory pressure and alveolar recruitment manoeuvres during anaesthesia in laterally or dorsally recumbent horses.

    Science.gov (United States)

    Hopster, Klaus; Rohn, Karl; Ohnesorge, Bernhard; Kästner, Sabine B R

    2017-01-01

    To compare the effects of controlled mechanical ventilation (CMV) and constant positive end-expiratory pressure (PEEP) and interposed recruitment manoeuvres (RMs) with those of CMV without PEEP on gas exchange during general anaesthesia and the early recovery period. Prospective, randomized clinical trial. A total of 48 Warmblood horses undergoing elective surgery in lateral (Lat) (n = 24) or dorsal (Dors) (n = 24) recumbency. Premedication (romifidine), induction (diazepam and ketamine) and maintenance (isoflurane in oxygen) were identical in all horses. Groups Lat- CMV and Dors-CMV (each n = 12) were ventilated using CMV. Groups Lat-RM and Dors-RM (each n = 12) were ventilated using CMV with constant PEEP (10 cmH2O) and intermittent RMs (three consecutive breaths with peak inspiratory pressure of 60 cmH2O, 80 cmH2O and 60 cmH2O, respectively). RMs were applied as required to maintain PaO2 at > 400 mmHg (> 53.3 kPa). Dobutamine was given to maintain mean arterial blood pressure at > 60 mmHg. Physiological parameters were recorded every 10 minutes. Arterial blood gases were measured intra- and postoperatively. Statistical analyses were conducted using analyses of variance (anova),t tests and the Mann-Whitney U-test. Horses in Dors-RM had higher PaO2 values [478 ± 35 mmHg (63.7 ± 4.6 kPa)] than horses in Dors-CMV [324 ± 45 mmHg (43.2 ± 6 kPa)] during anaesthesia and the early recovery period. There were no differences between horses in groups Lat-CMV and Lat-RM. Other measured parameters did not differ between groups. Ventilation with CMV, constant PEEP and interposed RM provided improved arterial oxygenation in horses in dorsal recumbency that lasted into the early recovery period, but had no benefit in horses in lateral recumbency. This mode of ventilation may provide a clinically practicable method of improving oxygenation in anaesthetized horses, especially in dorsal recumbency. Copyright © 2016 Association of Veterinary Anaesthetists and American

  14. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... results of stenting versus endarterectomy for carotid-artery stenosis. N Engl J Med . 2016;374(11):1021- ...

  15. Carotid Artery Disease

    Science.gov (United States)

    ... head with blood. If you have carotid artery disease, the arteries become narrow or blocked, usually because ... other substances found in the blood. Carotid artery disease is serious because it can block the blood ...

  16. Coronary artery disease (image)

    Science.gov (United States)

    ... through these arteries is critical for the heart. Coronary artery disease usually results from the build-up of fatty material and plaque, a condition called atherosclerosis. As the coronary arteries narrow, the flow of blood to the ...

  17. Peripheral arterial line (image)

    Science.gov (United States)

    A peripheral arterial line is a small, short plastic catheter placed through the skin into an artery of the arm or leg. The purpose of a peripheral arterial line is to allow continuous monitoring of blood pressure ...

  18. Can Preoperative Peak Expiratory Flow Predict Postoperative Pulmonary Complications in Lung Cancer Patients Undergoing Lobectomy?

    Directory of Open Access Journals (Sweden)

    Kun ZHOU

    2017-09-01

    Full Text Available Background and objective Postoperative pulmonary complications (PPCs, especially postoperative pneumonia (POP, directly affect the rapid recovery of lung cancer patients after surgery. Peak expiratory flow (PEF can reflect airway patency and cough efficiency. Moreover, cough impairment may lead to accumulation of pulmonary secretions which can increase the risk of PPCs. The aim of this study is to investigate the effect of preoperative PEF on PPCs in patients with lung cancer. Methods Retrospective research was conducted on 433 lung cancer patients who underwent lobectomy at the West China Hospital of Sichuan University from January 2014 to December 2015. The associations between preoperative PEF and PPCs were analyzed based on patients’ basic characteristics and clinical data in hospital. Results Preoperative PEF value in PPCs group (280.93±88.99 L/min was significantly lower than that in non-PPCs group (358.38±93.69 L/min (P320 L/min group (9.4%(P<0.001. Conclusion Preoperative PEF and PPCs are correlated, and PEF may be used as a predictor of PPCs.

  19. [Can Preoperative Peak Expiratory Flow Predict Postoperative Pulmonary Complications in Lung Cancer Patients Undergoing Lobectomy?

    Science.gov (United States)

    Zhou, Kun; Wu, Yanming; Su, Jianhua; Lai, Yutian; Shen, Cheng; Li, Pengfei; Che, Guowei

    2017-09-20

    Postoperative pulmonary complications (PPCs), especially postoperative pneumonia (POP), directly affect the rapid recovery of lung cancer patients after surgery. Peak expiratory flow (PEF) can reflect airway patency and cough efficiency. Moreover, cough impairment may lead to accumulation of pulmonary secretions which can increase the risk of PPCs. The aim of this study is to investigate the effect of preoperative PEF on PPCs in patients with lung cancer. Retrospective research was conducted on 433 lung cancer patients who underwent lobectomy at the West China Hospital of Sichuan University from January 2014 to December 2015. The associations between preoperative PEF and PPCs were analyzed based on patients' basic characteristics and clinical data in hospital. Preoperative PEF value in PPCs group (280.93±88.99) L/min was significantly lower than that in non-PPCs group (358.38±93.69) L/min (PPEF and operative time were independent risk factors for PPCs. Further, ROC curve showed that PEF=320 L/min was the cut-off value for predicting the occurrence of PPCs (AUC=0.706, 95%CI: 0.661-0.749). The incidence of PPCs in PEF≤320 L/min group (26.6%) was significantly higher than that in PEF>320 L/min group (9.4%)(PPEF and PPCs are correlated, and PEF may be used as a predictor of PPCs.

  20. [Improvement in expiratory peak flow (PEF) of COPD patients due to "lung" sport for 12 months].

    Science.gov (United States)

    Jungblut, S; Frickmann, H; Klingler, J; Müller, U; Bargon, J

    2007-02-01

    This prospective, randomised, controlled study deals with the question whether it is possible to induce an improvement of peak expiratory flow (PEF) in patients suffering from COPD by a structured "lung" sport programme over a longer period of time (12 months). Furthermore, a comparison with the spontaneous course of the disease was performed. A group of 7 COPD patients (1 man, 6 women, mean age 70 years, COPD grade II - III according to GOLD) who regularly took part in a structured lung sport programme was compared with a control group of 10 COPD patients (5 men, 5 women, mean age 67.5 years, COPD grade II - III according to GOLD) who denied doing sport. The PEF values of the patients were measured after 0 and 12 months during exacerbation-free intervals. The relative changes of PEF in percent after one year were statistically compared. There was an improvement of PEF of about + 10.4 % (standard deviation SD +/- 8.9 %) after 12 months of lung sport. The spontaneous course of the disease of the patients who denied doing sport led to a decrease of PEF of about - 8.8 % (standard deviation SD +/- 11.5 %). The difference in PEF changes with respect to "lung" sport and to the spontaneous course of COPD was highly significant (p PEF due to sport among COPD patients speaks in favour of a positive effect of "lung" sport.

  1. Effect of swimming on peak expiratory flow rate of atopic children.

    Science.gov (United States)

    Bemanian, Mohammad Hassan; Shirkhoda, Shima; Nakhjavani, Mina; Mozafari, Habibeh

    2009-06-01

    This study was conducted to evaluate the role of swimming on mechanic of lung in healthy individual and patients with asthma. A total 76 girls who took part in the course of regular swimming session three day per week for eight weeks enrolled in this study. All of them completed ISAAC written questionnaire and individual who was suspected of asthma or other atopic diseases was referred to allergist for more evaluation. Peak expiratory flow rate was recorded for participants at beginning, one hour after swimming and two months later. According to ISAAC questionnaire 35.4% had asthma or other atopic diseases. Increase in PEFR more than 20% of personal best was seen in 21.9% after one hour swimming and in 27.6% after two months. Increase in PEFR was significant in healthy individual and asthmatic patients and obese but was not significant in patients with allergic rhinitis or eczema. This study suggests swimming in indoor pool is useful for patients with asthma in spite of potential toxic role of chlorine in exacerbation of asthma symptoms and lung mechanics.

  2. Lung volume and expiratory flow rates from pre- to post-puberty.

    Science.gov (United States)

    Smith, Joshua R; Emerson, Sam R; Kurti, Stephanie P; Gandhi, Kirti; Harms, Craig A

    2015-08-01

    The purpose was to determine if the airways and lungs grow disproportionately from pre- to post-puberty in boys and girls. We hypothesized that the airways grow at a slower rate than lung volume (i.e. dysanapsis growth) during puberty and boys would exhibit more dysanaptic growth compared to girls. Twenty-one pre-pubescent children [11 boys (pre 10.1 ± 0.5 years, post 15.3 ± 0.5 years); 10 girls (pre 9.4 ± 1.0 years, post 14.1 ± 1.0 years)] performed pulmonary function tests (PFTs) ~5 years ago from an original cohort of 40 children. These 21 children performed PFTs, which included forced vital capacity (FVC) and forced expiratory flow at 50 % FVC (FEF50). Static pressure at 50 % of FVC [Pst(L)50 %] was estimated based on age. Dysanapsis ratio (DR) was calculated [FEF50 × FVC(-1) × Pst(L) 50 % (-1) ]. Maturation status was determined via Tanner stages. Stage of maturation was not different (p > 0.05) between boys and girls (4.2 ± 0.6 stage vs. 3.7 ± 0.7 stage, respectively). FVC and FEF50 increased (p 0.05) from pre- to post-puberty. FEF50 and FVC significantly increased and DR decreased (p 0.05) compared to girls. These data suggest that dysanaptic growth occurs during puberty and that it is not different between boys and girls.

  3. Brainstem and spinal projections of augmenting expiratory neurons in the rat.

    Science.gov (United States)

    Ezure, Kazuhisa; Tanaka, Ikuko; Saito, Yoshiaki

    2003-01-01

    There are two types of expiratory neurons with augmenting firing patterns (E-AUG neurons), those in the Bötzinger complex (BOT) and those in the caudal ventral respiratory group (cVRG). We studied their axonal projections morphologically using intracellular labeling of single E-AUG neurons with Neurobiotin, in anesthetized, paralyzed and artificially-ventilated rats. BOT E-AUG neurons (n = 11) had extensive axonal projections to the brainstem, but E-AUG neurons (n = 5) of the cVRG sent axons that descended the contralateral spinal cord without medullary collaterals. In addition to these somewhat expected characteristics, the present study revealed a number of new projection patterns of the BOT E-AUG neurons. First, as compared with the dense projections to the ipsilateral brainstem, those to the contralateral side were sparse. Second, several BOT E-AUG neurons sent long ascending collaterals to the pons, which included an axon that reached the ipsilateral parabrachial and Kölliker-Fuse nuclei and distributed boutons. Third, conspicuous projections from branches of these ascending collaterals to the area dorsolateral to the facial nucleus were found. Thus, the present study has shown an anatomical substrate for the extensive inhibitory projections of single BOT E-AUG neurons to the areas spanning the bilateral medulla and the pons. Copyright 2002 Elsevier Science Ireland Ltd and the Japan Neuroscience Society

  4. Can Peak Expiratory Flow Measurements Differentiate Chronic Obstructive Pulmonary Disease from Congestive Heart Failure?

    Directory of Open Access Journals (Sweden)

    John E. Gough

    2012-01-01

    Full Text Available Dyspneic patients are commonly encountered by Emergency Medical Service (EMS. Frequent causes include Chronic Obstructive Pulmonary Disease (COPD and Congestive Heart Failure (CHF. Measurement of peak expiratory flow rate (PEFR has been proposed to help differentiate COPD from CHF. This prospective, cohort, pilot study was conducted to determine if PEFR in patients with an exacerbation of COPD were significantly different than CHF. Included were patients presenting with dyspnea plus a history of COPD and/or CHF. A PEFR was measured, values were compared to predicted average, and a percentage was calculated. Twenty-one patients were enrolled. Six had a diagnosis of COPD, 12 CHF; 3 had other diagnoses. Mean percentage of predicted PEFR with COPD was 26.36%, CHF 48.9% (=0.04. Patients presenting with acute COPD had significantly lower percentage of predicted PEFR than those with CHF. These results suggest that PEFR may be useful in differentiating COPD from CHF. This study should be expanded to the prehospital setting with a larger number of subjects.

  5. PROGRESSIVE MUSCLE RELAXATION INCREASE PEAK EXPIRATORY FLOW RATE ON CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS

    Directory of Open Access Journals (Sweden)

    Tintin Sukartini

    2017-07-01

    Full Text Available Introduction: Limited progressive air flow in Chronic Obstructive Pulmonary Disease (COPD can caused by small airway disease (bronchiolitis obstructive and loss of elasticity of the lung (emphysema. Further it can be decreasing the quality of life in COPD patients because dyspnea and uncomfortable in activity. Progressive muscle relaxation (PMR is one of the relaxation technique that can repair pulmonary ventilation by decreasing chronic constriction of the respiratory muscles. The objective of this study was to analyze the effect of progressive muscle relaxation on raised peak expiratory flow rate (PEFR. Method: A pre-experimental one group pre-post test design was used in this study. Population was all of the COPD patients at Pulmonary Specialist Polyclinic Dr Mohamad Soewandhie Surabaya. There were 8 respondents taken by using purposive sampling. PEFR was counted by using peak flow meter every six day. Data were analyzed by using Paired t-Test with significance level  p≤0.05. Result: The result showed that PMR had significance level on increasing of PEFR (p=0.012. Discussion: It can be concluded that PMR has an effect on raise PEFR. Further studies are recommended to measure the effect of PMR on respiratory rate (RR, heart rate (HR subjective dyspnoe symptoms, forced expiration volume on the first minute (FEV1 and mid maximum flow rate (MMFR in COPD patients.

  6. Peak expiratory flow as a predictor for the effectiveness of sport for patients with COPD.

    Science.gov (United States)

    Jungblut, S; Frickmann, H; Klingler, J; Zimmermann, B; Bargon, Joachim

    2006-01-31

    This study intended to find simple parameters that were able to determine the increase in physical performance as a result of sport in a group of patients with COPD (lung sport). We regularly investigated pulse, oxygenation and peak expiratory flow in participants with COPD of a "lung sport group", who participated in a structured weekly training program under professional supervision. Ten volunteers (7 females, 3 males, median of age = 69) with COPD (grade II-III) took part in the study. - The relative changes after 3 and 6 months were compared with the values of the first month of exercise. Measurements were carried out before exercise, after stamina training and at the end of the program. - Pulse and oxygenation did not show any changes. However, there was a significant improvement of peak flow after 6 months. - These peak flow changes represent further evidence of positive effects of sport in COPD and provide a parameter which allows the patients themselves to measure and evaluate the success of their physical activity.

  7. Maximum expiratory flow-volume curves during short periods of microgravity

    Science.gov (United States)

    Guy, H. J. B.; Prisk, G. K.; Elliott, A. R.; West, J. B.

    1991-01-01

    Nine normal subjects were studied in a NASA microgravity research aircraft to elucidate the effect of normal gravitation on the shape of the maximum expiratory flow-volume (MEFV). They performed multiple MEFV maneuvers at 0, 1, and approximately 2 G. The MEFV curves for each subject were filtered, aligned at residual volume, and ensemble-averaged to produce an average MEFV curve for each state, allowing differences to be studied. Most subjects showed a decrease in the forced vital capacity at 0 G. The mean lung volume associated with a given flow was lower at 0 G over about the upper half of the vital capacity. There were consistent but highly individual changes in the position and magnitude of detailed features of the curve. This supports the concept that the location and motion of choke points that determine the detailed individual configuration of MEFG curves can be significantly influenced by gravitational forces, presumably via the effects of change in longitudinal tension on local airway pressure-diameter behavior and thus wave speed.

  8. A Comprehensive Breath Plume Model for Disease Transmission via Expiratory Aerosols

    Science.gov (United States)

    Halloran, S. K.; Wexler, A. S.; Ristenpart, W. D.

    2012-11-01

    The peak in influenza incidence during wintertime represents a longstanding unresolved scientific question. One hypothesis is that the efficacy of airborne transmission via aerosols is increased at low humidity and temperature, conditions that prevail in wintertime. Recent experiments with guinea pigs suggest that transmission is indeed maximized at low humidity and temperature, a finding which has been widely interpreted in terms of airborne influenza virus survivability. This interpretation, however, neglects the effect of the airflow on the transmission probability. Here we provide a comprehensive model for assessing the probability of disease transmission via expiratory aerosols between test animals in laboratory conditions. The spread of aerosols emitted from an infected animal is modeled using dispersion theory for a homogeneous turbulent airflow. The concentration and size distribution of the evaporating droplets in the resulting ``Gaussian breath plume'' are calculated as functions of downstream position. We demonstrate that the breath plume model is broadly consistent with the guinea pig experiments, without invoking airborne virus survivability. Moreover, the results highlight the need for careful characterization of the airflow in airborne transmission experiments.

  9. IDENTIFIKASI NILAI HAMBAT JENIS ARANG KAYU, ARANG KULIT MANGGA, DAN ARANG KULIT PISANG: BAHAN ALTERNATIF PENGGANTI RESISTOR FILM KARBON

    Directory of Open Access Journals (Sweden)

    Intan Kusumawati

    2014-05-01

    Full Text Available Penelitian ini bertujuan untuk mengetahui nilai hambat jenis pada arang kayu, arang kulit mangga, dan arang kulit pisang sebagai bahan alternatif pengganti resistor film karbon. Pada penelitian ini dilakukan penumbukkan arang kayu, arang kulit mangga, dan kulit pisang sehingga dihasilkan bubuk arang yang halus melalui proses penyaringan. Setelah itu dilakukan pemampatan arang kayu dalam pipet/sedotan plastik dengan luas permukaan (A = 4,08 x 10-4 cm. Kemudian hambatan diukur menggunakan multimeter dan dilakukan perhitungan hambat jenis arang tersebut. Hasil penelitian menunjukkan bahwa arang kayu (0,73 x 106 m memiliki nilai hambat yang tinggi sehingga hambat jenisnya juga lebih tinggi dibandingkan dengan arang kulit mangga (0,28 x 106  m dan arang kulit pisang (0,24 x 106 m. Hal ini dikarenakan terjadi proses karbonisasi sempurna dalam pembuatan arang kayu. Oleh karena nilai hambatan yang dapat terbaca pada multimeter hanya menggunakan batas skala yang besar (Mega Ohm, maka arang kulit kayu, arang kulit mangga, dan arang kulit pisang hanya dapat dijadikan sebagai bahan alternatif pengganti resistor film karbon dengan ukuran nilai hambatan besar.

  10. Versatile Tunable Current-Mode Universal Biquadratic Filter Using MO-DVCCs and MOSFET-Based Electronic Resistors

    Directory of Open Access Journals (Sweden)

    Hua-Pin Chen

    2014-01-01

    Full Text Available This paper presents a versatile tunable current-mode universal biquadratic filter with four-input and three-output employing only two multioutput differential voltage current conveyors (MO-DVCCs, two grounded capacitors, and a well-known method for replacement of three grounded resistors by MOSFET-based electronic resistors. The proposed configuration exhibits high-output impedance which is important for easy cascading in the current-mode operations. The proposed circuit can be used as either a two-input three-output circuit or a three-input single-output circuit. In the operation of two-input three-output circuit, the bandpass, highpass, and bandreject filtering responses can be realized simultaneously while the allpass filtering response can be easily obtained by connecting appropriated output current directly without using additional stages. In the operation of three-input single-output circuit, all five generic filtering functions can be easily realized by selecting different three-input current signals. The filter permits orthogonal controllability of the quality factor and resonance angular frequency, and no inverting-type input current signals are imposed. All the passive and active sensitivities are low. Postlayout simulations were carried out to verify the functionality of the design.

  11. Versatile tunable current-mode universal biquadratic filter using MO-DVCCs and MOSFET-based electronic resistors.

    Science.gov (United States)

    Chen, Hua-Pin

    2014-01-01

    This paper presents a versatile tunable current-mode universal biquadratic filter with four-input and three-output employing only two multioutput differential voltage current conveyors (MO-DVCCs), two grounded capacitors, and a well-known method for replacement of three grounded resistors by MOSFET-based electronic resistors. The proposed configuration exhibits high-output impedance which is important for easy cascading in the current-mode operations. The proposed circuit can be used as either a two-input three-output circuit or a three-input single-output circuit. In the operation of two-input three-output circuit, the bandpass, highpass, and bandreject filtering responses can be realized simultaneously while the allpass filtering response can be easily obtained by connecting appropriated output current directly without using additional stages. In the operation of three-input single-output circuit, all five generic filtering functions can be easily realized by selecting different three-input current signals. The filter permits orthogonal controllability of the quality factor and resonance angular frequency, and no inverting-type input current signals are imposed. All the passive and active sensitivities are low. Postlayout simulations were carried out to verify the functionality of the design.

  12. Relationship between pre-extubation positive endexpiratory pressure and oxygenation after coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Reijane Oliveira Lima

    2015-08-01

    Full Text Available Abstract Introduction After removal of endotracheal tube and artificial ventilation, ventilatory support should be continued, offering oxygen supply to ensure an arterial oxygen saturation close to physiological. Objective: The aim of this study was to investigate the effects of positive-end expiratory pressure before extubation on the oxygenation indices of patients undergoing coronary artery bypass grafting. Methods: A randomized clinical trial with seventy-eight patients undergoing coronary artery bypass grafting divided into three groups and ventilated with different positive-end expiratory pressure levels prior to extubation: Group A, 5 cmH2O (n=32; Group B, 8 cmH2O (n=26; and Group C, 10 cmH2O (n=20. Oxygenation index data were obtained from arterial blood gas samples collected at 1, 3, and 6 h after extubation. Patients with chronic pulmonary disease and those who underwent off-pump, emergency, or combined surgeries were excluded. For statistical analysis, we used Shapiro-Wilk, G, Kruskal-Wallis, and analysis of variance tests and set the level of significance at P<0.05. Results Groups were homogenous with regard to demographic, clinical, and surgical variables. There were no statistically significant differences between groups in the first 6 h after extubation with regard to oxygenation indices and oxygen therapy utilization. Conclusion: In this sample of patients undergoing coronary artery bypass grafting, the use of different positive-end expiratory pressure levels before extubation did not affect gas exchange or oxygen therapy utilization in the first 6 h after endotracheal tube removal.

  13. Volume-monitored chest CT: a simplified method for obtaining motion-free images near full inspiratory and end expiratory lung volumes

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Kathryn S. [The Ohio State University College of Medicine, Columbus, OH (United States); Long, Frederick R. [Nationwide Children' s Hospital, The Children' s Radiological Institute, Columbus, OH (United States); Flucke, Robert L. [Nationwide Children' s Hospital, Department of Pulmonary Medicine, Columbus, OH (United States); Castile, Robert G. [The Research Institute at Nationwide Children' s Hospital, Center for Perinatal Research, Columbus, OH (United States)

    2010-10-15

    Lung inflation and respiratory motion during chest CT affect diagnostic accuracy and reproducibility. To describe a simple volume-monitored (VM) method for performing reproducible, motion-free full inspiratory and end expiratory chest CT examinations in children. Fifty-two children with cystic fibrosis (mean age 8.8 {+-} 2.2 years) underwent pulmonary function tests and inspiratory and expiratory VM-CT scans (1.25-mm slices, 80-120 kVp, 16-40 mAs) according to an IRB-approved protocol. The VM-CT technique utilizes instruction from a respiratory therapist, a portable spirometer and real-time documentation of lung volume on a computer. CT image quality was evaluated for achievement of targeted lung-volume levels and for respiratory motion. Children achieved 95% of vital capacity during full inspiratory imaging. For end expiratory scans, 92% were at or below the child's end expiratory level. Two expiratory exams were judged to be at suboptimal volumes. Two inspiratory (4%) and three expiratory (6%) exams showed respiratory motion. Overall, 94% of scans were performed at optimal volumes without respiratory motion. The VM-CT technique is a simple, feasible method in children as young as 4 years to achieve reproducible high-quality full inspiratory and end expiratory lung CT images. (orig.)

  14. OSL and TL of Resistors of Mobile Phones for Retrospective Accident Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J. I.; Kim, J. L.; Pradhan, A. S.; Chang, I.; Kim, B. H. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2012-05-15

    work place and in the public rather than actual health hazard due to radiation exposure. Therefore, a quick demonstration of measurement of doses following the accident is needed to reassure those receiving insignificant or low level of exposures that they are quite safe and need no treatment. This confidence building also becomes an important aspect of dosimetry. As the ranges of doses which could be encountered in such situations may vary from the background level to significantly high doses depending on the type of accident / incident and the location of personnel, it becomes important that the techniques used in retrospective dosimetry should be very sensitive and should be able to measure doses in a wide range from background level to several Gy. More recently, with the increasing apprehensions of nuclear terrorism / dirty bomb, research and developments in retrospective dosimetry has gained a new momentum the world over. Among the TL and OSL sensitive materials, the extraction and the processing of the materials from bricks and roof tiles is a very time consuming process and gives indirect estimate of individual doses. On the other hand, TL and OSL properties of components of electronic devices mobile phones, i-pods, black-berries, mp3 players and USB sticks containing ceramics with luminescence properties (e.g resistors, capacitors, resonators, antenna switches, transistors etc.) and chip cards containing silica epoxy (e.g. credit cards, bank cards, social security card, telephone card, SIM cards, ID cards e.g) are being considered very attractive and being evaluated. In this study, the TL and OSL properties of the electronic components of mobile phones are investigated and dose recovery potential is evaluated with a presumption that a mobile phone has become a part of body belongings masses of almost ages

  15. Effects of positive expiratory pressure on chest wall volumes in subjects with stroke compared to healthy controls: a case-control study.

    Science.gov (United States)

    Cabral, Elis E A; Resqueti, Vanessa R; Lima, Illia N D F; Gualdi, Lucien P; Aliverti, Andrea; Fregonezi, Guilherme A F

    2017-07-08

    Alterations in respiratory system kinematics in stroke lead to restrictive pattern associated with decreased lung volumes. Chest physical therapy, such as positive expiratory pressure, may be useful in the treatment of these patients; however, the optimum intensity to promote volume and motion changes of the chest wall remains unclear. To assess the effect of different intensities of positive expiratory pressure on chest wall kinematics in subjects with stroke compared to healthy controls. 16 subjects with chronic stroke and 16 healthy controls matched for age, gender, and body mass index were recruited. Chest wall volumes were assessed using optoelectronic plethysmography during quiet breathing, 5 minutes, and recovery. Three different intensities of positive expiratory pressure (10, 15, and 20cmH2O) were administered in a random order with a 30 minutes rest interval between intensities. During positive expiratory pressure, tidal chest wall expansion increased in both groups compared to quiet breathing; however, this increase was not significant in the subjects with stroke (0.41 vs. 1.32L, 0.56 vs. 1.54L, 0.52 vs. 1.8L, at 10, 15, 20cmH2O positive expiratory pressure, for stroke and control groups; p<0.001). End-expiratory chest wall volume decreased in controls, mainly due to the abdomen, and increased in the stroke group, mainly due the pulmonary rib cage. Positive expiratory pressure administration facilitates acute lung expansion of the chest wall and its compartments in restricted subjects with stroke. Positive expiratory pressure intensities above 10cmH2O should be used with caution as the increase in end-expiratory volume led to hyperinflation in subjects with stroke. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  16. Cystic Fibrosis: Are Volumetric Ultra-Low-Dose Expiratory CT Scans Sufficient for Monitoring Related Lung Disease?

    DEFF Research Database (Denmark)

    Loeve, Martine; Lequin, Maarten H; Bruijne, Marleen de

    2009-01-01

    with CF aged 6–20 years (eight males, 12 females) underwent low-dose end-inspiratory CT and ultra-low-dose end-expiratory CT. Informed consent was obtained. Scans were randomized and scored by using the Brody-II CT scoring system to assess bronchiectasis, airway wall thickening, mucus plugging......-inspiratory and end-expiratory CT scores for Brody-II total score (ICC = 0.96), bronchiectasis (ICC = 0.98), airway wall thickening (ICC = 0.94), mucus plugging (ICC = 0.96), and opacities (ICC = 0.90). Intra- and interobserver agreement were good to very good (ICC range, 0.70–0.98). Bland-Altman plots showed...

  17. Pulmonary rehabilitation program including respiratory conditioning for chronic obstructive pulmonary disease (COPD): Improved hyperinflation and expiratory flow during tidal breathing.

    Science.gov (United States)

    Yoshimi, Kaku; Ueki, Jun; Seyama, Kuniaki; Takizawa, Makiko; Yamaguchi, Seiko; Kitahara, Eriko; Fukazawa, Shinji; Takahama, Yukiko; Ichikawa, Masako; Takahashi, Kazuhisa; Fukuchi, Yoshinosuke

    2012-06-01

    Pulmonary rehabilitation has generally relieved symptoms, strengthened exercise endurance and improved health-related quality of life (QOL) in patients with COPD, but recovery of pulmonary function remains questionable. This analysis of our innovative rehabilitation program is directed at documenting changes in patients' expiratory airflow limitation, pulmonary symptoms and QOL. This program is designed to provide "respiratory conditioning", a physical therapist-assisted intensive flexibility training that focuses on stretching and rib cage mobilization. Thirty-one patients with COPD who attended rehabilitation sessions at Juntendo University Hospital from 1999 to 2006 were analyzed. Pulmonary function, expiratory flow limitation during tidal breathing, six minute walk distance (6MWD), respiratory muscle strength, and St. George Respiratory Questionnaire (SGRQ) were measured before and after pulmonary rehabilitation. In participants ages 68±7 years, the FEV(1)% predicted was 39.3±15.7%. 6MWD, SGRQ and respiratory muscle strength were significantly improved after pulmonary rehabilitation. Although neither FEV(1)% predicted nor FEV(1)/FVC was affected to a significant extent, indicating little effect on airflow limitation, expiratory flow limitation in supine as well as seated during tidal breathing improved significantly. Moreover, rehabilitation significantly diminished TLC% predicted, FRC% predicted, RV% predicted and RV/TLC values, thus indicating a reduction of hyperinflation of the lungs at rest. The present results suggest that our rehabilitation program with respiratory conditioning significantly lowered the hyperinflation of lungs at rest as well as the expiratory flow limitation during tidal breathing. In patients with COPD, overall pulmonary function improved, exercise endurance increased and health-related QOL was enhanced.

  18. The Effects of Parental Smoking on Anthropometric Parameters, Peak Expiratory Flow Rate and Physical Condition in School Children

    OpenAIRE

    Pavić, Ivan; Čepin Bogović, Jasna; Krmek, Martina; Pavić, Pero; Anić Jurica, Sonja; Dodig, Slavica

    2014-01-01

    Passive smoking in children is a considerable health problem, mainly arising from parental smoking. The objectives of the present cross-sectional study were to assess the impact of passive smoking on 1) anthropometric parameters; 2) peak expiratory flow rate (PEFR); and 3) physical condition in school children. The target population included 177 children attending elementary school 5th to 8th grade. Study subjects were divided into two groups according to parental smoking habits. Body weight ...

  19. Comparison of different levels of positive expiratory pressure on chest wall volumes in healthy children and patients with fibrosis

    OpenAIRE

    Brilhante, Silvia Angélica; Florêncio, Rêcio Bento; Gualdi, Lucien Peroni; Resqueti,Vanessa Regiane; Aliverti,Andrea; Andrade, Armele de Fátima Dornelas de; Fregonezi, Guilherme Augusto de Freitas

    2017-01-01

    ABSTRACT Positive Expiratory Pressure (PEP) improves lung function, however, PEP-induced changes are not fully established. The aim of this study was to assess the acute effects of different PEP levels on chest wall volumes and the breathing pattern in children with Cystic Fibrosis (CF). Anthropometric data, lung function values, and respiratory muscle strength were collected. Chest wall volumes were assessed by Optoelectronic plethysmography at rest and during the use of different PEP levels...

  20. Peripheral chemoreceptors tune inspiratory drive via tonic expiratory neuron hubs in the medullary ventral respiratory column network

    OpenAIRE

    Segers, L. S.; Nuding, S. C.; Ott, M. M.; Dean, J. B.; Bolser, D C; O?Connor, R.; Morris, K. F.; Lindsey, B. G.

    2014-01-01

    Models of brain stem ventral respiratory column (VRC) circuits typically emphasize populations of neurons, each active during a particular phase of the respiratory cycle. We have proposed that “tonic” pericolumnar expiratory (t-E) neurons tune breathing during baroreceptor-evoked reductions and central chemoreceptor-evoked enhancements of inspiratory (I) drive. The aims of this study were to further characterize the coordinated activity of t-E neurons and test the hypothesis that peripheral c...

  1. Functional electrical stimulation to the abdominal wall muscles synchronized with the expiratory flow does not induce muscle fatigue.

    Science.gov (United States)

    Okuno, Yukako; Takahashi, Ryoichi; Sewa, Yoko; Ohse, Hirotaka; Imura, Shigeyuki; Tomita, Kazuhide

    2017-03-01

    [Purpose] Continuous electrical stimulation of abdominal wall muscles is known to induce mild muscle fatigue. However, it is not clear whether this is also true for functional electrical stimulation delivered only during the expiratory phase of breathing. This study aimed to examine whether or not intermittent electrical stimulation delivered to abdominal wall muscles induces muscle fatigue. [Subjects and Methods] The subjects were nine healthy adults. Abdominal electrical stimulation was applied for 1.5 seconds from the start of expiration and then turned off during inspiration. The electrodes were attached to both sides of the abdomen at the lower margin of the 12th rib. Abdominal electrical stimulation was delivered for 15 minutes with the subject in a seated position. Expiratory flow was measured during stimulus. Trunk flexor torque and electromyography activity were measured to evaluate abdominal muscle fatigue. [Results] The mean stimulation on/off ratio was 1:2.3. The declining rate of abdominal muscle torque was 61.1 ± 19.1% before stimulus and 56.5 ± 20.9% after stimulus, not significantly different. The declining rate of mean power frequency was 47.8 ± 11.7% before stimulus and 47.9 ± 10.2% after stimulus, not significantly different. [Conclusion] It was found that intermittent electrical stimulation to abdominal muscles synchronized with the expiratory would not induce muscle fatigue.

  2. How does positive end-expiratory pressure reduce intrapulmonary shunt in canine pulmonary edema?

    Science.gov (United States)

    Malo, J; Ali, J; Wood, L D

    1984-10-01

    We ventilated separately the right and left lungs of seven dogs having thoracotomies and catheters in both lower lobe veins. Two hours after right atrial injection of oleic acid, shunt (Qs/QT) in each lower lobe increased from 0.10 to 0.47. Ten minutes after positive end-expiratory pressure (PEEP) was increased from 3 to 13 cmH2O in one lung, mean lobar Qs/QT decreased to 0.06 with no change in its fraction of pulmonary blood flow measured by microsphere techniques. At the same time mean Qs/QT in the other lower lobe was 0.48. At end expiration each lower lobe hilum was then clamped, and the excised lobe was quickly frozen over liquid N2. There was no difference in the extravascular lung liquid per gram blood-free dry lobe between the lower lobes (7.5 +/- 2.6 ml/g), but perivascular cuff liquid was greater in the lower lobe with PEEP (3.8 +/- 2.8 ml/g) than in the lower lobes without PEEP (2.4 +/- 1.7 ml/g). Light microscopy revealed that 77.8 +/- 9.0% of the alveoli were flooded in the lobe without PEEP, but only 22.2 +/- 11.8% were flooded in the lobe with PEEP. The mean linear intercepts of the flooded alveoli were not different between lower lobes, and both were reduced to about 50% of the size of adjacent unflooded units in the same lobe. Alveolar septum thickness was greater without PEEP. We conclude that PEEP reduces Qs/QT by inflating previously flooded and collapsed air spaces and by redistributing the excess alveolar water into the compliant perivascular space, thus eliminating the obstacle to pulmonary O2 transfer.

  3. Peak expiratory flow at increased barometric pressure: comparison of peak flow meters and volumetric spirometer.

    Science.gov (United States)

    Thomas, P S; Ng, C; Bennett, M

    2000-01-01

    Increasing numbers of patients are receiving hyperbaric oxygen therapy as an intensive care treatment, some of whom have pre-existing airway obstruction. Spirometers are the ideal instruments for measuring airway obstruction, but peak flow meters are useful and versatile devices. The behaviour of both types of device was therefore studied in a hyperbaric unit under conditions of increased pressure. It is important to have a non-electrical indicator of airway obstruction, to minimize the fire risk in the hyperoxic environment. The hypothesis was tested that, assuming that dynamic resistance is unchanged, both the Wright's standard and mini-peak flow meters would over-read peak expiratory flow (PEF) under increased pressure when compared with a volumetric spirometer, as the latter is unaffected by air density. It was postulated that a correction factor could be derived so that PEF meters could be used in this setting. Seven normal subjects performed volume-dependent spirometry to derive PEF, and manoeuvres using both standard and mini PEF meters at sea level, under hyperbaric conditions at 303, 253 and 152 kPa (3, 2.5 and 1.5 atmospheres respectively; 1 atmosphere absolute=101.08 kPa), and again at sea level. There was a progressive and significant decline in PEF with increasing pressure as measured by the spirometer (69.46+/-0.8% baseline at 303 kPa compared with 101 kPa), while the PEF meters showed a progressive increase in their readings (an increase of 7.86+/-1.69% at 303 kPa with the mini PEF meter). Using these data points, a correction factor was derived which allows appropriate values to be calculated from the Wright's meter readings under these conditions.

  4. Influence Of Number Of Pregnancies In Peak Expiratory Flow And Body Composition Of Pregnant Women

    Directory of Open Access Journals (Sweden)

    Andrea Carla Brandao da Costa Santos

    2017-06-01

    Full Text Available Objectives: to describe and compare the mean values of the body composition and the peak expiratory flow (PEF in primigravidae and multigravidae and, to determine its correlation with obstetric, anthropometric and body composition variables. Method: it was performed a cross-sectional study of 120 healthy pregnant women at low risk, including 77 primigravidae and 43 multigravidae. The PEF was measured by spirometry and the body composition by multisegmental electrical impedance. The unpaired t test was used to compare the groups and the Pearson correlation test was used to determine the association between PEF and independent variables. A multiple linear regression was used to estimate the relationship between the dependent variable, the PEF and the independent variables. Results: the body composition variables in multigravidae women showed higher values compared to the primigravidae, being statistically significant, except for fat mass. In primigravidae, the PEF was correlated significantly with maternal age and height. In multigravidae, the PEF was correlated with maternal age, height, pre-pregnancy and current weight, total body water, extracellular water, fat mass, lean mass and fat-free mass. A Multiple linear regression analysis showed that, in primigravidae, height and maternal age were associated with PEF, being responsible for explaining 14.5% of its variability. The current weight and the maternal age explained 42.3% of peak flow variability in multigravidae. Conclusion: The PEF seemed to be influenced by the number of pregnancies. Changes were observed in relation to the body composition, as it was evidenced in correlation with the PEF in multigravidae women. Keywords: Pregnancy. Spirometry. Weight gain.

  5. Daily changes of peak expiratory flow and respiratory symptom occurrence around a soy processing factory.

    Science.gov (United States)

    Heederik, Dick; Doekes, Gert; van Strien, Rob; Brunekreef, Bert

    2014-01-01

    To evaluate sensitization and acute respiratory health effects in inhabitants living in the vicinity of a factory producing soy oil. Two panels of potential responders were created on the basis of a response to a short screening questionnaire sent to random samples of 1,000 exposed and 1,000 non-exposed individuals living around the factory and a control area. Individuals responding to the questionnaire were invited for a medical evaluation, including a respiratory symptom questionnaire and skin prick testing, for a panel of common allergens and a soy allergen extract. This resulted in 53 atopic and/or asthmatic inhabitants from the area surrounding the factory and 30 comparable control subjects. In these subjects, morning and evening Peak Expiratory Flow (PEF), respiratory symptoms and medication use were recorded daily during a 10-week period in the autumn. At the same time, soy allergen and endotoxin concentrations were determined in airborne dust in the exposed and the control area. The wind direction relative to the location of a subjects' house and the factory was used to determine whether an individual was exposed on a particular day. Only few of the atopic subjects were sensitized to soy. PEF showed a decrease, respiratory symptoms and bronchodilator use, an increase among soy sensitized subjects after having been downwind from the factory. Airborne soy allergen was found more frequently in the area surrounding the factory and levels were higher than in the control area. Highest levels were found on the factory premises. Only a weak association was found with wind direction. Airborne endotoxin concentrations did not show a consistent pattern with distance, but levels were clearly higher on the factory premises. Sensitization to soy allergen was not increased among the population sample living in the vicinity of the factory. Soy sensitized individuals living in the surroundings of the factory reported more respiratory symptoms, used bronchodilators more

  6. A comprehensive breath plume model for disease transmission via expiratory aerosols.

    Directory of Open Access Journals (Sweden)

    Siobhan K Halloran

    Full Text Available The peak in influenza incidence during wintertime in temperate regions represents a longstanding, unresolved scientific question. One hypothesis is that the efficacy of airborne transmission via aerosols is increased at lower humidities and temperatures, conditions that prevail in wintertime. Recent work with a guinea pig model by Lowen et al. indicated that humidity and temperature do modulate airborne influenza virus transmission, and several investigators have interpreted the observed humidity dependence in terms of airborne virus survivability. This interpretation, however, neglects two key observations: the effect of ambient temperature on the viral growth kinetics within the animals, and the strong influence of the background airflow on transmission. Here we provide a comprehensive theoretical framework for assessing the probability of disease transmission via expiratory aerosols between test animals in laboratory conditions. The spread of aerosols emitted from an infected animal is modeled using dispersion theory for a homogeneous turbulent airflow. The concentration and size distribution of the evaporating droplets in the resulting "Gaussian breath plume" are calculated as functions of position, humidity, and temperature. The overall transmission probability is modeled with a combination of the time-dependent viral concentration in the infected animal and the probability of droplet inhalation by the exposed animal downstream. We demonstrate that the breath plume model is broadly consistent with the results of Lowen et al., without invoking airborne virus survivability. The results also suggest that, at least for guinea pigs, variation in viral kinetics within the infected animals is the dominant factor explaining the increased transmission probability observed at lower temperatures.

  7. Nasal Expiratory Positive Airway Pressure Devices (Provent for OSA: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Muhammad Riaz

    2015-01-01

    Full Text Available Objective. To quantify the effectiveness of nasal expiratory positive airway pressure (nasal EPAP devices or Provent as treatment for obstructive sleep apnea (OSA. Methods. PubMed and six other databases were searched through November 15, 2015, without language limitations. Results. Eighteen studies (920 patients were included. Pre- and post-nasal EPAP means ± standard deviations (M ± SD for apnea-hypopnea index (AHI in 345 patients decreased from 27.32±22.24 to 12.78±16.89 events/hr (relative reduction = 53.2%. Random effects modeling mean difference (MD was −14.78 events/hr [95% CI −19.12, −10.45], p value < 0.00001. Oxygen desaturation index (ODI in 247 patients decreased from 21.2±19.3 to 12.4±14.1 events/hr (relative reduction = 41.5%, p value < 0.00001. Lowest oxygen saturation (LSAT M ± SD improved in 146 patients from 83.2±6.8% to 86.2±11.1%, MD 3 oxygen saturation points [95% CI 0.57, 5.63]. Epworth Sleepiness Scale (ESS M ± SD improved (359 patients from 9.9±5.3 to 7.4±5.0, MD −2.5 [95% CI −3.2, −1.8], p value < 0.0001. Conclusion. Nasal EPAP (Provent reduced AHI by 53.2%, ODI by 41.5% and improved LSAT by 3 oxygen saturation points. Generally, there were no clear characteristics (demographic factors, medical history, and/or physical exam finding that predicted favorable response to these devices. However, limited evidence suggests that high nasal resistance could be associated with treatment failure. Additional studies are needed to identify demographic and polysomnographic characteristics that would predict therapeutic success with nasal EPAP (Provent.

  8. Radial Artery Aneurysm

    Directory of Open Access Journals (Sweden)

    Ali Fedakar

    2011-04-01

    Full Text Available Upper limb aneurysms are less frequently seen than the other aneurysm. Radial arterial aneurysm is usually associated with the trauma. Interventional procedures can cause pseudoaneurysm at the radial artery puncture sites. Radial artery aneurysm may cause the thromboembolic events at the fingers and the hand. We present a case of isolated radial arterial aneurysm with idiopathic origin.

  9. Single umbilical artery

    Directory of Open Access Journals (Sweden)

    Shanthi Ramesh

    2015-01-01

    Full Text Available The umbilical cord usually contains two arteries and one vein. The vein carries the oxygenated blood from the placenta to the fetus. The arteries carry the deoxygenated blood and the waste products from the fetus to the placenta. Occasionally, primary agenesis or secondary atrophy of one of the arteries occurs resulting in single umbilical artery.

  10. Single umbilical artery

    OpenAIRE

    Shanthi Ramesh; Sangeetha Hariprasath; Gunasekaran Anandan; P John Solomon; Vijayakumar, V.

    2015-01-01

    The umbilical cord usually contains two arteries and one vein. The vein carries the oxygenated blood from the placenta to the fetus. The arteries carry the deoxygenated blood and the waste products from the fetus to the placenta. Occasionally, primary agenesis or secondary atrophy of one of the arteries occurs resulting in single umbilical artery.

  11. Single umbilical artery.

    Science.gov (United States)

    Ramesh, Shanthi; Hariprasath, Sangeetha; Anandan, Gunasekaran; Solomon, P John; Vijayakumar, V

    2015-04-01

    The umbilical cord usually contains two arteries and one vein. The vein carries the oxygenated blood from the placenta to the fetus. The arteries carry the deoxygenated blood and the waste products from the fetus to the placenta. Occasionally, primary agenesis or secondary atrophy of one of the arteries occurs resulting in single umbilical artery.

  12. Effects of a 1:1 inspiratory to expiratory ratio on respiratory mechanics and oxygenation during one-lung ventilation in patients with low diffusion capacity of lung for carbon monoxide: a crossover study.

    Science.gov (United States)

    Lee, Kyuho; Oh, Young Jun; Choi, Yong Seon; Kim, Shin Hyung

    2015-09-01

    To investigate the effects of a 1:1 inspiratory-to-expiratory (I:E) ventilation ratio on oxygenation and respiratory mechanics during one-lung ventilation (OLV) in patients with low diffusion capacity of lung for carbon monoxide (DLCO). Prospective, randomized, crossover study. Operating room, university hospital. Twenty-six patients with a preoperative DLCO less than 80% who were scheduled for lung lobectomy requiring OLV under general anesthesia. In the first group (n = 13), OLV was begun with a 1:1 I:E ratio, which was switched to a 1:2 I:E ratio after 30 minutes. In the second group (n = 13), the modes of ventilation were performed in the opposite order. Pressure-controlled ventilation with 5 cm H2O of positive end-expiratory pressure and a tidal volume of 5 to 8 mL/kg was applied during OLV. Arterial and central venous blood gas analyses were recorded and used to calculate intrapulmonary shunt fraction and physiologic dead space. These measurements were taken at 4 time points: 10 minutes after two-lung ventilation in the lateral decubitus position, 30 minutes after initiation of OLV, 30 minutes after switching the I:E ratio, and 10 minutes after two-lung ventilation was resumed. There was no difference in arterial oxygen tension during OLV between the 2 groups (P = .429). Arterial carbon dioxide tension and peak airway pressure were lower in the 1:1 group than in the 1:2 group (P = .003; P = .008). Physiologic dead space was also decreased in the 1:1 I:E ratio group (P = .003). Mean airway pressure and dynamic compliance were higher in the 1:1 group (P = .003; P = .007). Pressure-controlled ventilation with a 1:1 I:E ventilation ratio did not improve oxygenation in patients with low DLCO during OLV compared with a 1:2 I:E ventilation ratio. However, it did provide benefits in terms of respiratory mechanics and increased the efficiency of alveolar ventilation during OLV. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Actividades de experimentación con materiales de bajo coste para la enseñanza de física: resistores y capacitores de grafito

    Directory of Open Access Journals (Sweden)

    Marcos Alfredo Salami

    2007-04-01

    Full Text Available This work presents an investigation carried out at the Pontifical Catholic University of Rio Grande do Sul from April 2002 to December 2003, involving the feasibility of using resistors and capacitors made of graphite laid upon paper, cardboard and plastic, in order to help the learning of electricity through experimentation. Its specific focus was the contents on resistibility, calculation of equivalent resistance of serial and parallel associations of resistors and capacitors, dependence of capacitance to the area, to the distance between the boards and the shape of the boards. The low cost technique resulting from this development allows students to playfully manipulate variables involved in the definition of electric resistance and capacitance, besides making it possible for them to crate and modify freely the associations of resistors andcapacitors, by just using a multimeter with a capacimeter function, paper and a 6B type pencil. It also has a great potential to stimulate the comprehension and learning process of such contents once it is pleasant, simple and low costly. It also promotes the engagement and free participation of all students. Graphite has already been used in the production of resistors to measure individual resistance and associations as described in the article by (Rocha Filho et al., 2004, and also in the production of capacitors to measure the capacitances in the activities mentioned in the master’s dissertation of (Salami, 2004.

  14. Second Sound Measurement using SMD resistors to simulate Quench locations on the 704 MHZ Single-Cell Cavity at CERN

    CERN Document Server

    Liao, K; Ciapala, E; Junginger, T; Weingarten, W

    2012-01-01

    Oscillating Superleak Transducers (OSTs) containing flexible porous membranes are widely used to detect the so-called second sound temperature wave when a quench event occurs in a superconducting RF cavity. In principle, from the measured speed of this wave and the travel time between the quench event and several OSTs, the location of the quench sites can be derived by triangulation. Second sound behaviour has been simulated through different surface mount (SMD) resistors setups on a Superconducting Proton Linac (SPL) test cavity, to help understanding the underlying physics and improve quench localisation. Experiments are described that have been conducted to search for explanation of heat transfer during cavity quench that causes contradictory triangulation results.

  15. Characterization of the first prototypes of Silicon Photomultipliers with bulk-integrated quench resistor fabricated at MPI semiconductor laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Jendrysik, Christian, E-mail: jendrysik@hll.mpg.de [Max-Planck-Institut Halbleiterlabor, Otto-Hahn-Ring 6, D-81739 Munich (Germany); Max-Planck-Institut für Physik, Föhringer Ring 6, D-80805 Munich (Germany); Andriček, Ladislav; Liemann, Gerhard; Moser, Hans-Günther; Ninković, Jelena; Richter, Rainer [Max-Planck-Institut Halbleiterlabor, Otto-Hahn-Ring 6, D-81739 Munich (Germany); Max-Planck-Institut für Physik, Föhringer Ring 6, D-80805 Munich (Germany); Schopper, Florian [Max-Planck-Institut Halbleiterlabor, Otto-Hahn-Ring 6, D-81739 Munich (Germany); Max-Planck-Institut für extraterrestrische Physik, Giessenbachstraße, D-85748 Garching (Germany)

    2013-08-01

    In this paper new results of the characterization of Silicon Photomultipliers (SiPMs) with bulk-integrated quench resistor will be presented. The novel detector concept was developed at the Max-Planck-Institute (MPI) semiconductor laboratory and allows a metal and polysilicon free entrance window which offers an improvement in photon detection efficiency (PDE). For electrical separation and suppression of optical cross talk (OCT) an insensitive area (gap) between neighboring cells is required. Based on simulations the first prototypes with devices of different combinations of cell size and gap were fabricated, providing the opportunity to study the influence of these parameters on the detector performance. First PDE measurements of the new detector are presented together with results of the influence of geometrical variations. Also an outlook on possible future developments of the concept with single cell read-out is given.

  16. The Effect of Salt Space on Clinical Findings and Peak Expiratory Flow in Children with Mild to Moderate Asthma: A Randomized Crossover Trial

    National Research Council Canada - National Science Library

    Saeideh Mazloomzadeh; Niousha Bakhshi; Akefeh Ahmadiafshar; Mehdi Gholami

    2017-01-01

    ...‚ thus exploring other therapeutic plans could be desirable. The aim of this study was to investigate the effect of salt space on clinical findings and peak expiratory flow rate among children with asthma...

  17. Directly writing resistor, inductor and capacitor to composite functional circuits: a super-simple way for alternative electronics.

    Science.gov (United States)

    Gao, Yunxia; Li, Haiyan; Liu, Jing

    2013-01-01

    The current strategies for making electronic devices are generally time, water, material and energy consuming. Here, the direct writing of composite functional circuits through comprehensive use of GaIn10-based liquid metal inks and matching material is proposed and investigated, which is a rather easy going and cost effective electronics fabrication way compared with the conventional approaches. Owing to its excellent adhesion and electrical properties, the liquid metal ink was demonstrated as a generalist in directly making various basic electronic components such as planar resistor, inductor and capacitor or their combination and thus composing circuits with expected electrical functions. For a precise control of the geometric sizes of the writing, a mask with a designed pattern was employed and demonstrated. Mechanisms for justifying the chemical components of the inks and the magnitudes of the target electronic elements so as to compose various practical circuits were disclosed. Fundamental tests on the electrical components including capacitor and inductor directly written on paper with working time up to 48 h and elevated temperature demonstrated their good stability and potential widespread adaptability especially when used in some high frequency circuits. As the first proof-of-concept experiment, a typical functional oscillating circuit including an integrated chip of 74HC04 with a supply voltage of 5 V, a capacitor of 10 nF and two resistors of 5 kΩ and 1 kΩ respectively was directly composed on paper through integrating specific electrical elements together, which presented an oscillation frequency of 8.8 kHz. The present method significantly extends the roles of the metal ink in recent works serving as only a single electrical conductor or interconnecting wires. It opens the way for directly writing out complex functional circuits or devices on different substrates. Such circuit composition strategy has generalized purpose and can be extended to more

  18. Directly Writing Resistor, Inductor and Capacitor to Composite Functional Circuits: A Super-Simple Way for Alternative Electronics

    Science.gov (United States)

    Gao, Yunxia; Li, Haiyan; Liu, Jing

    2013-01-01

    Background The current strategies for making electronic devices are generally time, water, material and energy consuming. Here, the direct writing of composite functional circuits through comprehensive use of GaIn10-based liquid metal inks and matching material is proposed and investigated, which is a rather easy going and cost effective electronics fabrication way compared with the conventional approaches. Methods Owing to its excellent adhesion and electrical properties, the liquid metal ink was demonstrated as a generalist in directly making various basic electronic components such as planar resistor, inductor and capacitor or their combination and thus composing circuits with expected electrical functions. For a precise control of the geometric sizes of the writing, a mask with a designed pattern was employed and demonstrated. Mechanisms for justifying the chemical components of the inks and the magnitudes of the target electronic elements so as to compose various practical circuits were disclosed. Results Fundamental tests on the electrical components including capacitor and inductor directly written on paper with working time up to 48 h and elevated temperature demonstrated their good stability and potential widespread adaptability especially when used in some high frequency circuits. As the first proof-of-concept experiment, a typical functional oscillating circuit including an integrated chip of 74HC04 with a supply voltage of 5 V, a capacitor of 10 nF and two resistors of 5 kΩ and 1 kΩ respectively was directly composed on paper through integrating specific electrical elements together, which presented an oscillation frequency of 8.8 kHz. Conclusions The present method significantly extends the roles of the metal ink in recent works serving as only a single electrical conductor or interconnecting wires. It opens the way for directly writing out complex functional circuits or devices on different substrates. Such circuit composition strategy has

  19. Effects of environmental tobacco smoke on peak expiratory flow rates on healthy school children

    Directory of Open Access Journals (Sweden)

    Vujnović-Živković Zorica

    2016-01-01

    Full Text Available Introduction: Tobacco smoke is one of the most important environmental pollutants (ETS. Passive exposure to tobacco smoke is involuntary and it presents a health risk for children. Objective: To establish if there are differences in Peak Expiratory Flow Rates (PEF values of healthy school children who live in households with and without tobacco smoke. Methods: PEF measurements were taken for 830 school children, from elementary schools in Nis and Laplje Selo. Measurements were obtained with new peak flow meters Vitalograf-normal range (EN 13826, 3 to 5 times. The highest values were taken for analysis. P < 0.05 was considered significant. Results: We considered PEF values for 830 healthy school children, 599 (72.17% from households with tobacco smoke (ETS, and 231 (27.83% without ETS. Exposure to parenteral smoking was associated with reduced PEF rates: 312.01 L/min (95% CI=301.38-322.65 L/min, for boys and 284.64 L/min (95% CI=275.73-293.55 L/min, for girls. PEF rates for children from households without ETS are 313.79 L/min (95% CI=295.63-331.93 L/min for boys, and 302.0 L/min (95% CI=287.02- 316.98 L/min for girls. PEF rates were significantly lower for girls from households with ETS (p<0.05. Boys, with and without ETS, had no statistically significant differences between their height, weight and age, so their PEF rates could be compared by their absolute values. For girls, this was not the case, and after age, height and weight adjustments their PEF rates showed no statistical significance (p= 0,346. Conclusions: Parental and household smoking were associated with decreased lung function in school age children. Although it's possible to reduce exposure to tobacco smoke in public places, it's important to inform parents about long-term impact of tobacco smoke on the health of their children.

  20. Impact of the prolonged slow expiratory maneuver on respiratory mechanics in wheezing infants *

    Science.gov (United States)

    Lanza, Fernanda de Cordoba; Wandalsen, Gustavo Falbo; da Cruz, Carolina Lopes; Solé, Dirceu

    2013-01-01

    OBJECTIVE: To evaluate changes in respiratory mechanics and tidal volume (VT) in wheezing infants in spontaneous ventilation after performing the technique known as the prolonged, slow expiratory (PSE) maneuver. METHODS: We included infants with a history of recurrent wheezing and who had had no exacerbations in the previous 15 days. For the assessment of the pulmonary function, the infants were sedated and placed in the supine position, and a face mask was used and connected to a pneumotachograph. The variables of tidal breathing (VT and RR) as well as those of respiratory mechanics-respiratory system compliance (Crs), respiratory system resistance (Rrs), and the respiratory system time constant (prs)-were measured before and after three consecutive PSE maneuvers. RESULTS: We evaluated 18 infants. The mean age was 32 ± 11 weeks. After PSE, there was a significant increase in VT (79.3 ± 15.6 mL vs. 85.7 ± 17.2 mL; p = 0.009) and a significant decrease in RR (40.6 ± 6.9 breaths/min vs. 38.8 ± 0,9 breaths/min; p = 0.042). However, no significant differences were found in the variables of respiratory mechanics (Crs: 11.0 ± 3.1 mL/cmH2O vs. 11.3 ± 2.7 mL/cmH2O; Rrs: 29.9 ± 6.2 cmH2O • mL−1 • s−1 vs. 30.8 ± 7.1 cmH2O • mL−1 • s−1; and prs: 0.32 ± 0.11 s vs. 0.34 ±0.12 s; p > 0.05 for all). CONCLUSIONS: This respiratory therapy technique is able to induce significant changes in VT and RR in infants with recurrent wheezing, even in the absence of exacerbations. The fact that the variables related to respiratory mechanics remained unchanged indicates that the technique is safe to apply in this group of patients. Studies involving symptomatic infants are needed in order to quantify the functional effects of the technique. PMID:23503488

  1. Impact of the prolonged slow expiratory maneuver on respiratory mechanics in wheezing infants.

    Science.gov (United States)

    Lanza, Fernanda de Cordoba; Wandalsen, Gustavo Falbo; Cruz, Carolina Lopes da; Solé, Dirceu

    2013-01-01

    To evaluate changes in respiratory mechanics and tidal volume (V T) in wheezing infants in spontaneous ventilation after performing the technique known as the prolonged, slow expiratory (PSE) maneuver. We included infants with a history of recurrent wheezing and who had had no exacerbations in the previous 15 days. For the assessment of the pulmonary function, the infants were sedated and placed in the supine position, and a face mask was used and connected to a pneumotachograph. The variables of tidal breathing (V T and RR) as well as those of respiratory mechanics-respiratory system compliance (Crs), respiratory system resistance (Rrs), and the respiratory system time constant (prs)-were measured before and after three consecutive PSE maneuvers. We evaluated 18 infants. The mean age was 32 ± 11 weeks. After PSE, there was a significant increase in V T (79.3 ± 15.6 mL vs. 85.7 ± 17.2 mL; p = 0.009) and a significant decrease in RR (40.6 ± 6.9 breaths/min vs. 38.8 ± 0,9 breaths/min; p = 0.042). However, no significant differences were found in the variables of respiratory mechanics (Crs: 11.0 ± 3.1 mL/cmH2O vs. 11.3 ± 2.7 mL/cmH2O; Rrs: 29.9 ± 6.2 cmH2O • mL-1 • s-1 vs. 30.8 ± 7.1 cmH2O • mL-1 • s-1; and prs: 0.32 ± 0.11 s vs. 0.34 ±0.12 s; p > 0.05 for all). This respiratory therapy technique is able to induce significant changes in V T and RR in infants with recurrent wheezing, even in the absence of exacerbations. The fact that the variables related to respiratory mechanics remained unchanged indicates that the technique is safe to apply in this group of patients. Studies involving symptomatic infants are needed in order to quantify the functional effects of the technique.

  2. Zero expiratory pressure and low oxygen concentration promote heterogeneity of regional ventilation and lung densities.

    Science.gov (United States)

    Borges, J B; Porra, L; Pellegrini, M; Tannoia, A; Derosa, S; Larsson, A; Bayat, S; Perchiazzi, G; Hedenstierna, G

    2016-08-01

    It is not well known what is the main mechanism causing lung heterogeneity in healthy lungs under mechanical ventilation. We aimed to investigate the mechanisms causing heterogeneity of regional ventilation and parenchymal densities in healthy lungs under anesthesia and mechanical ventilation. In a small animal model, synchrotron imaging was used to measure lung aeration and regional-specific ventilation (sV̇). Heterogeneity of ventilation was calculated as the coefficient of variation in sV̇ (CVsV̇ ). The coefficient of variation in lung densities (CVD ) was calculated for all lung tissue, and within hyperinflated, normally and poorly aerated areas. Three conditions were studied: zero end-expiratory pressure (ZEEP) and FI O2 0.21; ZEEP and FI O2 1.0; PEEP 12 cmH2 O and FI O2 1.0 (Open Lung-PEEP = OLP). The mean tissue density at OLP was lower than ZEEP-1.0 and ZEEP-0.21. There were larger subregions with low sV̇ and poor aeration at ZEEP-0.21 than at OLP: 12.9 ± 9.0 vs. 0.6 ± 0.4% in the non-dependent level, and 17.5 ± 8.2 vs. 0.4 ± 0.1% in the dependent one (P = 0.041). The CVsV̇ of the total imaged lung at PEEP 12 cmH2 O was significantly lower than on ZEEP, regardless of FI O2 , indicating more heterogeneity of ventilation during ZEEP (0.23 ± 0.03 vs. 0.54 ± 0.37, P = 0.049). CVD changed over the different mechanical ventilation settings (P = 0.011); predominantly, CVD increased during ZEEP. The spatial distribution of the CVD calculated for the poorly aerated density category changed with the mechanical ventilation settings, increasing in the dependent level during ZEEP. ZEEP together with low FI O2 promoted heterogeneity of ventilation and lung tissue densities, fostering a greater amount of airway closure and ventilation inhomogeneities in poorly aerated regions. © 2016 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

  3. Daily changes of peak expiratory flow and respiratory symptom occurrence around a soy processing factory

    Directory of Open Access Journals (Sweden)

    Dick Heederik

    2014-03-01

    Full Text Available Objectives. To evaluate sensitization and acute respiratory health effects in inhabitants living in the vicinity of a factory producing soy oil. Methods. Two panels of potential responders were created on the basis of a response to a short screening questionnaire sent to random samples of 1,000 exposed and 1,000 non-exposed individuals living around the factory and a control area. Individuals responding to the questionnaire were invited for a medical evaluation, including a respiratory symptom questionnaire and skin prick testing, for a panel of common allergens and a soy allergen extract. This resulted in 53 atopic and/or asthmatic inhabitants from the area surrounding the factory and 30 comparable control subjects. In these subjects, morning and evening Peak Expiratory Flow (PEF, respiratory symptoms and medication use were recorded daily during a 10-week period in the autumn. At the same time, soy allergen and endotoxin concentrations were determined in airborne dust in the exposed and the control area. The wind direction relative to the location of a subjects’ house and the factory was used to determine whether an individual was exposed on a particular day. Results. Only few of the atopic subjects were sensitized to soy. PEF showed a decrease, respiratory symptoms and bronchodilator use, an increase among soy sensitized subjects after having been downwind from the factory. Airborne soy allergen was found more frequently in the area surrounding the factory and levels were higher than in the control area. Highest levels were found on the factory premises. Only a weak association was found with wind direction. Airborne endotoxin concentrations did not show a consistent pattern with distance, but levels were clearly higher on the factory premises. Conclusion. Sensitization to soy allergen was not increased among the population sample living in the vicinity of the factory. Soy sensitized individuals living in the surroundings of the factory

  4. Daily changes of peak expiratory flow and respiratory symptom occurrence around a soy processing factory

    Directory of Open Access Journals (Sweden)

    Dick Heederik

    2014-04-01

    Full Text Available Objectives. To evaluate sensitization and acute respiratory health effects in inhabitants living in the vicinity of a factory producing soy oil. Methods. Two panels of potential responders were created on the basis of a response to a short screening questionnaire sent to random samples of 1,000 exposed and 1,000 non-exposed individuals living around the factory and a control area. Individuals responding to the questionnaire were invited for a medical evaluation, including a respiratory symptom questionnaire and skin prick testing, for a panel of common allergens and a soy allergen extract. This resulted in 53 atopic and/or asthmatic inhabitants from the area surrounding the factory and 30 comparable control subjects. In these subjects, morning and evening Peak Expiratory Flow (PEF, respiratory symptoms and medication use were recorded daily during a 10-week period in the autumn. At the same time, soy allergen and endotoxin concentrations were determined in airborne dust in the exposed and the control area. The wind direction relative to the location of a subjects’ house and the factory was used to determine whether an individual was exposed on a particular day. Results. Only few of the atopic subjects were sensitized to soy. PEF showed a decrease, respiratory symptoms and bronchodilator use, an increase among soy sensitized subjects after having been downwind from the factory. Airborne soy allergen was found more frequently in the area surrounding the factory and levels were higher than in the control area. Highest levels were found on the factory premises. Only a weak association was found with wind direction. Airborne endotoxin concentrations did not show a consistent pattern with distance, but levels were clearly higher on the factory premises. Conclusion. Sensitization to soy allergen was not increased among the population sample living in the vicinity of the factory. Soy sensitized individuals living in the surroundings of the factory

  5. Anomalous left coronary artery from the pulmonary artery

    Science.gov (United States)

    ... of the left coronary artery arising from the pulmonary artery; ALCAPA; ALCAPA syndrome; Bland-White-Garland syndrome; ... children with ALCAPA, the LCA originates from the pulmonary artery. The pulmonary artery is the major blood ...

  6. Paired inspiratory/expiratory spiral CT and continuous respiration cine CT in the diagnosis of tracheal instability

    Energy Technology Data Exchange (ETDEWEB)

    Heussel, C.P.; Schreiber, W.; Thelen, M.; Kauczor, H.U. [Dept. of Radiology, Johannes Gutenberg Univ., Mainz (Germany); Hafner, B. [Dept. of Ear-Nose-Throat Surgery, Johannes Gutenberg Univ., Mainz (Germany); Lill, J. [Dept. of Pneumology, Johannes Gutenberg Univ., Mainz (Germany)

    2001-06-01

    In tracheo- and bronchomalacia, localisation and determination of collapse is necessary for planning of surgical procedure. We compared inspiratory and expiratory spiral CT, cine CT, bronchoscopy, exemplary cine MR, and evaluated the clinical relevance. Twenty-nine patients (2 follow-ups; mean age 61 years, age range 27-85 years) with suspected or verified tracheal stenosis or collapse (post-tracheotomy: n=17; neoplasm: n=5; other: n=7) underwent paired breath-hold inspiratory and expiratory spiral CT. Forty-five additional cine CT were performed at 1-4 levels (mean 1.5) during continuous respiration (increment 100 ms) to clarify respiratory collapse. The tracheal cross-sectional diameters of both techniques were calculated. Comparison with bronchoscopy, follow-up, and influence upon therapy were evaluated retrospectively. Exemplary comparison with cine MR (8 frames/s) was done in 3 cases. In addition to bronchoscopy, further information concerning localisation, extent, collapse, stability of the tracheal wall, distal portions of the stenosis and extraluminal compressions were obtained. A significantly higher degree and more pathological collapses (>50%) were seen using cine CT (38%) compared with paired spiral CT (13%; degree: p<0.0001; number: p<0.001). The findings changed the further therapeutic procedure in 16 of 29 patients. Further stenoses were excluded and bronchoscopy was verified in another 13 of 29. Temporal resolution of cine CT and cine MR is sufficient; however, spatial resolution of cine MR is inferior. Paired inspiratory and expiratory spiral CT localises tracheal stenoses and demonstrates relevant extraluminal compression. Significantly improved evaluation of respiratory collapse and further information of localised tracheal instability is obtained by cine CT. Cine MR promises more functional information especially due to free choice of imaging plane. (orig.)

  7. Effect of endurance training on expiratory flow limitation and dynamic hyperinflation in patients with stable chronic obstructive pulmonary disease.

    Science.gov (United States)

    Chen, R; Chen, R; Chen, X; Chen, L

    2014-08-01

    Expiratory flow limitation (EFL) is the primary pathophysiological hallmark of chronic obstructive pulmonary disease (COPD). However, the effect of lower-extremity endurance training alone on EFL in patients with COPD remains largely unknown. This study aims to determine the effects of endurance training on EFL and dynamic hyperinflation in patients with stable COPD. This was a prospective, single-blinded, non-randomised controlled 12-week study recruiting Chinese patients with stable COPD in an endurance training group (n = 15) or a control group (n = 13). Before and at the end of the study, we measured the EFL, pulmonary function, peak inspiratory flow (PIF) and maximum inspiratory pressure (MIP); moreover, the patients underwent a constant work rate exercise test in which Borg dyspnoea scale, tidal breathing flow volume curves and inspiratory capacity (IC) were determined every other minute. Exercise training significantly improved the exercise endurance time (7.00 ± 3.05 vs 18.13 ± 6.44 min, P training had decreased breathing frequency (26.26 ± 7.13 vs 23.15 ± 5.34 breaths/min, P = 0.002), minute ventilation (30.28 ± 7.52 vs 26.85 ± 4.17 L, P = 0.013), tidal peak expiratory flow (1.53 ± 0.22 vs 1.32 ± 0.20 L/s, P = 0.006), mean expiratory flow (0.87 ± 0.19 vs 0.68 ± 0.15 L/s, P = 0.011) and Borg dyspnoea score (7.20 ± 1.15 vs 3.93 ± 1.39, P Endurance training may benefit stable COPD patients in improving exercise endurance, inspiratory muscle strength, ventilatory requirements, exercise-induced hyperinflation and exertional dyspnoea. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

  8. Influence of changing the diameter of the bubble generator bottle and expiratory limb on bubble CPAP: an in vitro study.

    Science.gov (United States)

    Wu, Chun-Shan; Lee, Chuen-Ming; Yuh, Yeong-Seng; Hua, Yi-Ming

    2012-12-01

    The noisy component of bubble continuous positive airway pressure (CPAP) is thought to contribute to breathing efficiency and lung volume recruitment, mainly because of stochastic resonance. The magnitude and frequency of the superimposed noise are vital to this process. We wanted to evaluate the in vitro effect of changing various parameters of the bubble CPAP circuit regarding the magnitude and frequency of pressure oscillations transmitted to the lung model. In a bubble CPAP lung model, we immersed different sizes (3.0∼12.5 mm) of the expiratory limb of the CPAP circuit into different depths under water (2.0∼10.0 cm) and used various diameters (2.9∼9.0 cm) of bubble generator bottles. We also varied the compliance of the model lung. We measured the changes in mean, magnitude, and frequency of pressure oscillations transmitted to the lung model at three different flow rates (namely 4, 8, and 12L/minute). Increasing the size and submergence depth of the expiratory limb of a CPAP circuit and decreasing the diameter of the bubble generator bottle intensified the magnitude but diminished the frequency of noise transmitted to the lung model. Decreasing compliance of the lung model intensified both the magnitude and frequency content of pressure oscillations in the model lung. The size and submergence depth of an expiratory limb of a CPAP circuit, the diameter of the bubble generator bottle, and the compliance of the model lung all influence the magnitude and frequency of the transmitted pressure waveform. Therefore, these factors may affect lung volume recruitment and breathing efficiency in bubble CPAP. Copyright © 2012. Published by Elsevier B.V.

  9. A combined inspiratory and expiratory muscle training program improves respiratory muscle strength and fatigue in multiple sclerosis.

    Science.gov (United States)

    Ray, Andrew D; Udhoji, Supriya; Mashtare, Terry L; Fisher, Nadine M

    2013-10-01

    To determine the effects of a short-duration, combined (inspiratory and expiratory), progressive resistance respiratory muscle training (RMT) protocol on respiratory muscle strength, fatigue, health-related quality of life, and functional performance in individuals with mild-to-moderate multiple sclerosis (MS). Quasi-experimental before-after trial. University rehabilitation research laboratory. Volunteers with MS (N=21) were divided into 2 groups: RMT (n=11; 9 women, 2 men; mean age ± SD, 50.9 ± 5.7y, mean Expanded Disability Status Scale score ± SD, 3.2 ± 1.9) and a control group that did not train (n=10; 7 women, 3 men; mean age ± SD, 56.2 ± 8.8y, mean Expanded Disability Status Scale score ± SD, 4.4 ± 2.1). Expanded Disability Status Scale scores ranged from 1 to ≤6.5. No patients withdrew from the study. Training was a 5-week combined progressive resistance RMT program, 3d/wk, 30 minutes per session. The primary outcome measures were maximal inspiratory pressure and expiratory pressure and the Modified Fatigue Impact Scale. All subjects completed secondary measures of pulmonary function, the six-minute walk test, the timed stair climb, the Multiple Sclerosis Self-Efficacy Scale, the Medical Outcomes Study 36-Item Short-Form Health Survey, and the Physical Activity Disability Scale. Maximal inspiratory pressure and expiratory pressure (mean ± SD) increased 35% ± 22% (Pfatigue (Modified Fatigue Impact Scale, Pmuscle strength and reduced fatigue in patients with mild to moderate MS. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  10. Early warning and prevention of pneumonia in acute leukemia by patient education, spirometry, and positive expiratory pressure

    DEFF Research Database (Denmark)

    Møller, Tom; Moser, Claus; Adamsen, Lis

    2016-01-01

    fever, emphasizing the need to approach infection protection with complementary efforts. In a randomized controlled design, we examined the applicability of patient-performed daily spirometry [forced expiratory volume in one second (FEV1)] as an early warning tool and explored the effectiveness...... in their continuous daily measurement of FEV1 and use of PEP. Daily measures of FEV1 may be an important early warning tool for assessment of pulmonary deterioration during critical phases of neutropenia. We suggest that strategic patient education in the use of spirometry and PEP should be part of standard of care...

  11. Effects of recruitment maneuver and positive end-expiratory pressure on respiratory mechanics and transpulmonary pressure during laparoscopic surgery.

    Science.gov (United States)

    Cinnella, Gilda; Grasso, Salvatore; Spadaro, Savino; Rauseo, Michela; Mirabella, Lucia; Salatto, Potito; De Capraris, Antonella; Nappi, Luigi; Greco, Pantaleo; Dambrosio, Michele

    2013-01-01

    The authors tested the hypothesis that during laparoscopic surgery, Trendelenburg position and pneumoperitoneum may worsen chest wall elastance, concomitantly decreasing transpulmonary pressure, and that a protective ventilator strategy applied after pneumoperitoneum induction, by increasing transpulmonary pressure, would result in alveolar recruitment and improvement in respiratory mechanics and gas exchange. In 29 consecutive patients, a recruiting maneuver followed by positive end-expiratory pressure 5 cm H(2)O maintained until the end of surgery was applied after pneumoperitoneum induction. Respiratory mechanics, gas exchange, blood pressure, and cardiac index were measured before (T(BSL)) and after pneumoperitoneum with zero positive end-expiratory pressure (T(preOLS)), after recruitment with positive end-expiratory pressure (T(postOLS)), and after peritoneum desufflation with positive end-expiratory pressure (T(end)). Esophageal pressure was used for partitioning respiratory mechanics between lung and chest wall (data are mean ± SD): on T(preOLS), chest wall elastance (E(cw)) and elastance of the lung (E(L)) increased (8.2 ± 0.9 vs. 6.2 ± 1.2 cm H(2)O/L, respectively, on T(BSL); P = 0.00016; and 11.69 ± 1.68 vs. 9.61 ± 1.52 cm H(2)O/L on T(BSL); P = 0.0007). On T(postOLS), both chest wall elastance and E(L) decreased (5.2 ± 1.2 and 8.62 ± 1.03 cm H(2)O/L, respectively; P = 0.00015 vs. T(preOLS)), and Pao(2)/inspiratory oxygen fraction improved (491 ± 107 vs. 425 ± 97 on T(preOLS); P = 0.008) remaining stable thereafter. Recruited volume (the difference in lung volume for the same static airway pressure) was 194 ± 80 ml. Pplat(RS) remained stable while inspiratory transpulmonary pressure increased (11.65 + 1.37 cm H(2)O vs. 9.21 + 2.03 on T(preOLS); P = 0.007). All respiratory mechanics parameters remained stable after abdominal desufflation. Hemodynamic parameters remained stable throughout the study. In patients submitted to laparoscopic surgery in

  12. Positive end-expiratory pressure attenuates hemodynamic effects induced by an overload of inspiratory muscles in patients with COPD

    Directory of Open Access Journals (Sweden)

    Schaper-Magalhães F

    2017-10-01

    Full Text Available Flavia Schaper-Magalhães,1 José Felippe Pinho,1 Carolina Andrade Bragança Capuruço,2 Maria Glória Rodrigues-Machado1 1Medical Sciences Faculty of Minas Gerais, Post-Graduation Program in Health Sciences, Belo Horizonte, Brazil; 2Department of Cardiology, Clinics Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil Background: Inspiratory muscle training (IMT using a Threshold® device is commonly used to improve the strength and endurance of inspiratory muscles. However, the effect of IMT, alone or with positive end-expiratory pressure (PEEP, on hemodynamic parameters in patients with chronic obstructive pulmonary disease (COPD remains unknown.Objective: To assess the effects of an overload of inspiratory muscles using IMT fixed at 30% of the maximal inspiratory pressure (MIP, and IMT associated with 5 cmH2O of PEEP (IMT + PEEP, on the echocardiographic parameters in healthy subjects and patients with COPD.Methods: Twenty patients with COPD (forced expiratory volume in 1 second 53.19±24.71 pred% and 15 age-matched healthy volunteers were evaluated using spirometry, MIP, the COPD assessment test (CAT, and the modified Medical Research Council (mMRC dyspnea scale. The E- (fast-filling phase and A- (atrial contraction phase waves were evaluated at the tricuspid and mitral valves during inspiration and expiration in the following sequence: at basal conditions, using IMT, and using IMT + PEEP.Results: Patients with COPD had reduced MIPs versus the control group. Ten patients had CAT scores <10 and 12 patients had mMRC scores <2. E-wave values at the mitral valve were significantly decreased with IMT during the inspiratory phase in both groups. These effects were normalized with IMT + PEEP. During the expiratory phase, use of IMT + PEEP normalized the reduction in E-wave values in the COPD group. During inspiration at the tricuspid valve, reduction in E-wave values during IMT was normalized by IMT + PEEP in COPD group. During the

  13. Bilateral renal artery variation

    OpenAIRE

    Üçerler, Hülya; Üzüm, Yusuf; İkiz, Z. Aslı Aktan

    2015-01-01

    Each kidney is supplied by a single renal artery, although renal artery variations are common. Variations of the renal arteryhave become important with the increasing number of renal transplantations. Numerous studies describe variations in renalartery anatomy. Especially the left renal artery is among the most critical arterial variations, because it is the referred side forresecting the donor kidney. During routine dissection in a formalin fixed male cadaver, we have found a bilateral renal...

  14. Artery Bypass Grafting

    African Journals Online (AJOL)

    Unknown

    nary artery disease (CAD) was coronary artery bypass graft (CAB G) using a segment of saphenous vein interposed between the ascend- ing aorta and the coronary artery distal to the obstructing lesion. This was performed by David Sabiston of Duke University in 1962. With the use of the recently developed technique of ...

  15. Carotid artery surgery - slideshow

    Science.gov (United States)

    ... right- and left-internal carotid arteries, and the right- and left-external carotid arteries. The carotid arteries deliver oxygen-rich blood from the heart to both the head and brain. Review Date 6/1/2015 Updated by: Daniel ...

  16. TO FIND OUT THE EFFECT OF VARIOUS BODY POSITIONS ON PEAK EXPIRATORY FLOW RATE (PEFR IN COPD PATIENTS

    Directory of Open Access Journals (Sweden)

    Meghan Metha

    2016-06-01

    Full Text Available Background: COPD is the second most common lung disorder. Respiratory mechanics of COPD is altered. Lung volumes & biomechanical changes lead to weak & ineffective expiratory maneuvers. Methods: 40 COPD subjects above the age of 45years were selected through purposive sampling. The subjects were placed in seven different positions namely Standing, Chair sitting, Long sitting, Semi fowler’s position, Supine, Side lying, Head down. Following this the subject performed three tests of PEFR with intermittent rest period as preferred by the subject between each trial. Results: PEFR achieved by subjects with COPD were significantly affected by body position. Standing (161.82 led to results which were significantly higher than all other positions followed by chair sitting (150.079, long sitting (141.495,semi fowler’s position (136.746, supine lying (126.829, side lying (120.162 and head low position (107.829 led to results which were significantly lower than all other positions. Conclusion: More the upright position, higher the PEFR. PEFR is more in standing and Head down position has the lowest PEFR value. Increased lung volumes in standing position can be related to the increased thoracic cavity volume owing to the effect of gravity and the inspiratory muscles would be able to expand the unrestricted thorax in all directions in this position & expiratory muscles attain their optimal length during standing.

  17. Effects of respiratory exercises on the vital capacity and forced expiratory volume in children with cerebral palsy.

    Science.gov (United States)

    Rothman, J G

    1978-04-01

    The purpose of this study was to determine if breathing exercises can increase the vital capacity in children with cerebral palsy. Ten children with spastic cerebral palsy, five in the experimental group and five in the control group, were the subjects for the study. A spirometer was used to measure vital capacity and the forced expiratory volume before and after the children performed a breathing exercise program. The pretest values for all 10 youngsters indicated a vital capacity lower than the normal predicted values. The breathing exercises selected emphasized strengthening of the muscles of inspiration and the muscles of expiration. In the breathing exercise program, the physical therapists also attempted to follow the Bobath treatment approach by inhibiting the abnormal breathing patterns and by teaching the child proper ways of breathing control. The results seem to indicate that a breathing exercise program can increase the vital capacity in youngsters with cerebral palsy. The vital capacity of the experimental group was increased by 0.46 liters after exercising for five to seven minutes each day for a period of eight weeks. The mean increase of the vital capacity was 31 percent over the pretest values. The control group showed no change in vital capacity. The pretest and posttest forced expiratory volumes of both groups were within normal limits.

  18. Exercise challenge in patients with asthma whose peak expiratory flow values are controlled within the green zone

    Directory of Open Access Journals (Sweden)

    Hideko Kobayashi

    1999-01-01

    Full Text Available Recent guidelines for the management of asthma recommend that peak expiratory flow (PEF should be measured to monitor the level of airflow limitation and to maintain PEF values within the green zone (80–100% of the patient's highest PEF value. Because no studies have evaluated the efficacy of PEF zone management on the basis of patients' physical activity, we studied the appearance of exercise-induced asthma (EIA using treadmill exercise challenging in asthma patients whose PEF values had been maintained in the green zone for at least 3 months. Exercise-induced asthma was induced in nine of 44 (20.5% asthma patients. The acetylcholine concentration required to cause a 20% fall in forced expiratory volume in 1 s (log PC20 was significantly lower in patients with EIA (2.39±0.21 μg/mL compared with patients without EIA (3.22±0.12 μg/mL; P <0.03. These results suggest that PEF green zone management alone does not ensure the ability to perform vigorous physical activity, especially in patients whose airway reactivity remains enhanced. Therefore, airway reactivity should be considered for asthma management.

  19. Spontaneous renal artery dissection.

    Science.gov (United States)

    John, Santhosh G; Pillai, Unnikrishnan; Vaidyan, Philip B; Ishiyama, Takaaki

    2010-01-01

    Isolated spontaneous dissection of renal arteries or its branches are extremely rare. Most cases of renal artery dissection are associated with underlying pathology of the renal arteries. We report a case of spontaneous dissection of the left main renal artery and infarction of the left kidney with positive antiphospholipid antibody. Extensive work up of the patient including imaging studies confirmed the diagnosis of SRAD. Antiphospholipid antibodies may have a role in the pathogenesis of arterial dissection by causing endothelial dysfunction. This is a first literature report.

  20. Intrathoracic tracheal volume and collapsibility on inspiratory and end-expiratory ct scans correlations with lung volume and pulmonary function in 85 smokers.

    Science.gov (United States)

    Yamashiro, Tsuneo; San José Estépar, Raúl; Matsuoka, Shin; Bartholmai, Brian J; Ross, James C; Diaz, Alejandro; Murayama, Sadayuki; Silverman, Edwin K; Hatabu, Hiroto; Washko, George R

    2011-03-01

    To evaluate the correlations of tracheal volume and collapsibility on inspiratory and end-expiratory computed tomography (CT) with lung volume and with lung function in smokers. The institutional review board approved this study at each institution. 85 smokers (mean age 68, range 45-87 years; 40 females and 45 males) underwent pulmonary function tests and chest CT at full inspiration and end-expiration. On both scans, intrathoracic tracheal volume and lung volume were measured. Collapsibility of the trachea and the lung was expressed as expiratory/inspiratory (E/I) ratios of these volumes. Correlations of the tracheal measurements with the lung measurements and with lung function were evaluated by the linear regression analysis. Tracheal volume showed moderate or strong, positive correlations with lung volume on both inspiratory (r = 0.661, P volume showed a strong, positive correlation with the E/I ratio of lung volume (r = 0.711, P volume and the ratio of forced expiratory volume in the first second to forced vital capacity (r = -0.436, P volume and the ratio of residual volume to total lung capacity (r = 0.253, P = .02). Tracheal volume and collapsibility, measured by inspiratory and end-expiratory CT scans, is related to lung volume and collapsibility. The highly collapsed trachea on end-expiratory CT does not indicate more severe airflow limitation or air-trapping in smokers. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

  1. Compromised Cardiopulmonary Exercise Capacity in Patients Early After Endoscopic Atraumatic Coronary Artery Bypass Graft: Implications for Rehabilitation.

    Science.gov (United States)

    Hansen, Dominique; Roijakkers, Ruben; Jackmaert, Lore; Robic, Boris; Hendrikx, Marc; Yilmaz, Alaaddin; Frederix, Ines; Rosseel, Michael; Dendale, Paul

    2017-02-01

    The purpose of this work was to test the hypothesis that cardiopulmonary exercise tolerance is better preserved early after endoscopic atraumatic coronary artery bypass graft (endo-ACAB) surgery versus coronary artery bypass graft (CABG) surgery. Twenty endo-ACAB surgery patients, 20 CABG surgery patients, and 15 healthy subjects executed a maximal cardiopulmonary exercise test, with assessment and comparison of cycling power output, O2 uptake, CO2 output, respiratory gas exchange ratio, end-tidal O2 and CO2 pressures, equivalents for O2 uptake and CO2 output, heart rate, O2 pulse, expiratory volume, tidal volume, respiratory rate, at peak exercise and ventilatory threshold. In patients, forced expiratory volume and forced vital capacity were measured. Oxygen uptake, CO2 output, expiratory and tidal volume, equivalents for O2 uptake and CO2 output, end-tidal O2 and CO2 pressures at peak exercise (matched peak respiratory gas exchange ratio between patient groups), and ventilatory threshold were significantly worse in patients versus healthy controls (P power, >0.80). All these parameters, and lung function, were, however, comparable between CABG and endo-ACAB surgery patients (P > 0.10). Exercise tolerance and ventilatory function during exercise seems, in contrast to expectation, equally compromised early after endo-ACAB surgery as opposed to after CABG surgery. These data may signify the need for exercise-based rehabilitation intervention early after endo-ACAB surgery.

  2. Actividades de experimentación con materiales de bajo coste para la enseñanza de física: resistores y capacitores de grafito

    Directory of Open Access Journals (Sweden)

    Marcos Alfredo Salami

    2007-01-01

    Full Text Available Este trabajo presenta una investigación realizada en la Pontifícia Universidade Católica do Rio Grande do Sul, entre abril de 2002 y diciembre de 2003, abarcando la viabilidad de utilización de resistores y capacitores hechos de grafito, depositado sobre papel, sobre cartulina y plástico, para auxiliar el aprendizaje de electricidad, cálculo de resistencia equivalente a asociaciones en serie y en paralelo de resistores y capacitores, y dependencia de la capacitancia con el área, con la distancia entre las placas y con el formato de las placas. La técnica de bajo coste resultante de ese desarrollo permite al estudiante manipular lúdicamente variables abarcadas en la definición de resistencia y capacitancia eléctrica, además de permitirle crear y cambiar libremente asociaciones de resistores y capacitores, usando únicamente un multímetro con función para capacímetro, papel y lápiz tipo 6B. También tiene un gran potencial para estimular el proceso de comprensión y aprendizaje de esos contenidos por que es agradable, sencillo, de bajo coste y promueve el compromiso y la libre participación de todos los alumnos. El grafito ya fue utilizado en la producción de resistores para medición de resistencias individuales y asociaciones, como fue descrito en de Rocha Filho et al. (2004, y también en la producción de capacitores para medición de capacitancias en actividades mencionadas en la tesis de maestría de Salami (2004.

  3. Non-volatile gated variable resistor based on doped La2CuO4+δ and SrTiO3 heterostructures

    Science.gov (United States)

    Weber, Dieter; Poppe, Ulrich

    2012-03-01

    Gated variable resistors were manufactured by depositing epitaxial heterostructures of doped La2CuO4+δ and SrTiO3 layers. Their conductance change as function of write current I and write time t followed a simple empirical law of the form ΔG/G = CIAtB. This behavior is in agreement with ionic transport that accelerates exponentially with electrical field strength.

  4. Positive expiratory pressure therapy versus other airway clearance techniques for bronchiectasis.

    Science.gov (United States)

    Lee, Annemarie L; Burge, Angela T; Holland, Anne E

    2017-09-27

    People with bronchiectasis experience chronic cough and sputum production and require the prescription of airway clearance techniques (ACTs). A common type of ACT prescribed is positive expiratory pressure (PEP) therapy. A previous review has suggested that ACTs including PEP therapy are beneficial compared to no treatment in people with bronchiectasis. However, the efficacy of PEP therapy in a stable clinical state or during an acute exacerbation compared to other ACTs in bronchiectasis is unknown. The primary aim of this review was to determine the effects of PEP therapy compared with other ACTs on health-related quality of life (HRQOL), rate of acute exacerbations, and incidence of hospitalisation in individuals with stable or an acute exacerbation of bronchiectasis.Secondary aims included determining the effects of PEP therapy upon physiological outcomes and clinical signs and symptoms compared with other ACTs in individuals with stable or an acute exacerbation of bronchiectasis. We searched the Cochrane Airways Group Specialised Register of Trials, PEDro and clinical trials registries from inception to February 2017 and we handsearched relevant journals. Randomised controlled parallel and cross-over trials that compared PEP therapy versus other ACTs in participants with bronchiectasis. We used standard methodological procedures as outlined by Cochrane. Nine studies involving 213 participants met the inclusion criteria, of which seven were cross-over in design. All studies included adults with bronchiectasis, with eight including participants in a stable clinical state and one including participants experiencing an acute exacerbation. Eight studies used oscillatory PEP therapy, using either a Flutter or Acapella device and one study used Minimal PEP therapy. The comparison intervention differed between studies. The methodological quality of studies was poor, with cross-over studies including suboptimal or no washout period, and a lack of blinding of

  5. On the extraction of the external drain and source resistors and effective channel length in Si-MOSFET

    Science.gov (United States)

    Joodaki, M.

    2015-09-01

    This paper focuses on the extraction of drain/source resistance and effective channel length (Leff) of the silicon MOSFET in the linear drain current region. Leff is expressed as a function of drain/source resistance, drain current, threshold voltage, drain voltage, and body-effect coefficient. Using this definition, an additional component of drain/source resistance in the linear drain current region, inversion charge reduction resistance (RΔQ), is introduced which results from the influence of drain/source resistors, internal source/body voltage and drain voltage on the total inversion charge. Finally, a new method for extraction of the drain/source resistance is developed. In this method several parameters that have impact on device behavior are considered. The parameters include gate voltage dependency, short channel effects, and poly gate length dependency. The results presented here are not only very useful for accurate device modeling and characterization, but are also vital to better understanding of the device physics. Furthermore, they can describe shortcomings of the other methods which use devices of different gate lengths. The extracted linear model provides less than 1.07% and 3.3% average absolute error and maximum error, respectively, for all seven devices under test over the gate voltage range of 0.75-2 V.

  6. Electrical and Gas Sensing Properties of SnO2 Thick Film Resistors Prepared by Screen-printing Method

    Directory of Open Access Journals (Sweden)

    R. Y. BORSE

    2008-10-01

    Full Text Available Thick films of tin-oxide (SnO2 were deposited on alumina substrates employing screen-printing technique. The films were dried and fired at 680 0C for 30 minutes. The variation of D.C. resistance of thick films was measured in air as well as in H2S gas atmosphere as a function of temperature. The SnO2 films exhibit semiconducting behaviour. The SnO2 thick films studied were also showing decrease in resistance with increase of concentration of H2S gas. The film resistors showed the highest sensitivity to H2S gas at 350 0C. The XRD studies of the thick film indicate the presence of different phases of SnO2. The elemental analysis was confirmed by EDX spectra. The surface morphological study of the films was analyzed by SEM. The microstructure of the films was porous resulting from loosely interconnected small crystallites. The parameters such as grain size, activation energy, sensitivity and response time were described.

  7. LPG and NH3 Sensing Properties of SnO2 Thick Film Resistors Prepared by Screen Printing Technique

    Directory of Open Access Journals (Sweden)

    A. S. GARDE

    2010-11-01

    Full Text Available The gas sensing behavior of SnO2 thick film resistors deposited on alumina substrates has been investigated for LPG and NH3 gas. The standard screen printing technology was used to prepare the thick films. The films were fired at optimized temperature of 780 0C for 30 minutes. The material characterization was performed by XRD, SEM, FTIR, UV and EDAX for elemental analysis. IR spectroscopy analysis at 2949.26 cm-1 showed the peak assigned to the –Sn-H vibration due to the effect of hybridization i.e. sp3 and the sharp peak at 3734.31 cm-1 assigned to –Sn-OH stretching vibration due to hydrogen bonding. The variation of D.C electrical resistance of SnO2 film samples was measured in air as well as in LPG and NH3 gas atmosphere as a function of temperature. The SnO2 film samples show negative temperature coefficient of résistance. The SnO2 film samples showed the highest sensitivity to 600 ppm of LPG at 230 0C and NH3 at 370 0C. The effect of microstructure on sensitivity, response time and recovery time of the sensor in the presence of LPG and NH3 gases were studied and discussed.

  8. Underlying Physics of Conductive Polymer Composites and Force Sensing Resistors (FSRs). A Study on Creep Response and Dynamic Loading.

    Science.gov (United States)

    Paredes-Madrid, Leonel; Matute, Arnaldo; Bareño, Jorge O; Parra Vargas, Carlos A; Gutierrez Velásquez, Elkin I

    2017-11-21

    Force Sensing Resistors (FSRs) are manufactured by sandwiching a Conductive Polymer Composite (CPC) between metal electrodes. The piezoresistive property of FSRs has been exploited to perform stress and strain measurements, but the rheological property of polymers has undermined the repeatability of measurements causing creep in the electrical resistance of FSRs. With the aim of understanding the creep phenomenon, the drift response of thirty two specimens of FSRs was studied using a statistical approach. Similarly, a theoretical model for the creep response was developed by combining the Burger's rheological model with the equations for the quantum tunneling conduction through thin insulating films. The proposed model and the experimental observations showed that the sourcing voltage has a strong influence on the creep response; this observation-and the corresponding model-is an important contribution that has not been previously accounted. The phenomenon of sensitivity degradation was also studied. It was found that sensitivity degradation is a voltage-related phenomenon that can be avoided by choosing an appropriate sourcing voltage in the driving circuit. The models and experimental observations from this study are key aspects to enhance the repeatability of measurements and the accuracy of FSRs.

  9. Application of the recursion-transform method in calculating the resistance of an M×N cobweb resistor network with an arbitrary boundary

    Science.gov (United States)

    Ji, Yinghua; Hu, Juju

    2017-10-01

    Looking for a handy and exact calculation for the equivalent resistance of an M×N resistor network is important, but difficult. In this paper, we present a standard and convenient approach to calculate the equivalent resistance of an M×N cobweb resistor network by applying multiple external current sources based on the nodal analysis in circuit theory and the recursion-transform (R-T) method. The test current source acts on different nodes in radial direction to obtain an analytical expression for the equivalent resistance between nodes of an M×N cobweb resistor network in radial direction. In our scheme, recalculations are not required to obtain the equivalent resistance between different radial nodes. We also discuss the influence of polygon sides of cobweb network and the ratio between two unit resistances on the equivalent resistance. The results show that, when the number of similar polygons M is given, with the increasing of the polygon sides and the ratio between two unit resistance, the equivalent resistances between two arbitrary radial nodes tend to a constant.

  10. testicular artery arising from an aberrant right renal artery

    African Journals Online (AJOL)

    User

    2017-08-17

    Aug 17, 2017 ... Correspondence to Dr. Emmanuel Henry Suluba, Department of Anatomy, School of Medicine,. Muhimbili University of Health and ... vein, left colic artery and the descending colon. Both right and left testicular arteries as ... anatomy of the vessels such as testicular arteries, ovarian arteries, renal arteries and.

  11. Duplicated middle cerebral artery

    Science.gov (United States)

    Perez, Jesus; Machado, Calixto; Scherle, Claudio; Hierro, Daniel

    2009-01-01

    Duplicated middle cerebral artery (DMCA) is an anomalous vessel arising from the internal carotid artery. The incidence DMCA is relatively law, and an association between this anomaly and cerebral aneurysms has been documented. There is a controversy whether DMCA may have perforating arteries. This is an important fact to consider in aneurysm surgery. We report the case of a 34-year-old black woman who suffered a subarachnoid hemorrhage and the angiography a left DMCA, and an aneurysm in an inferior branch of the main MCA. The DMCA and the MCA had perforating arteries. The aneurysm was clipped without complications. The observation of perforating arteries in our patient confirms that the DMCA may have perforating arteries. This is very important to be considered in cerebral aneurysms surgery. Moreover, the DMCA may potentially serve as a collateral blood supply to the MCA territory in cases of MCA occlusion. PMID:22140405

  12. Multivessel coronary artery thrombosis.

    Science.gov (United States)

    Kanei, Yumiko; Janardhanan, Rajesh; Fox, John T; Gowda, Ramesh M

    2009-02-01

    Simultaneous thrombosis of multiple epicardial coronary arteries is an uncommon clinical finding in ST-segment elevation myocardial infarction (STEMI). We describe a 37-year-old male present with inferior wall STEMI who was found to have large thrombi in both the right coronary artery (RCA) and the left anterior descending artery (LAD). We reviewed 23 patients with multivessel thrombosis in acute myocardial infarction in the literature. The mean age of patients was 53 +/- 14 years (32-82 years); 74% were males, and most patients had multiple risk factors for coronary artery disease. The LAD (78%) and RCA (87%) were the arteries involved for most patients. Aspiration thrombectomy was used in 3 cases. Though it is rare, STEMI with multiple culprit arteries can occur, and it is crucial to recognize this condition to determine the proper treatment, since most of these patients are critically ill.

  13. Annual decline in forced expiratory volume is steeper in aluminum potroom workers than in workers without exposure to potroom fumes

    Science.gov (United States)

    Henneberger, Paul K.; Einvik, Gunnar; Virji, Mohammed Abbas; Bakke, Berit; Kongerud, Johny

    2016-01-01

    Background Aluminum potroom exposure is associated with increased mortality of COPD but the association between potroom exposure and annual decline in lung function is unknown. We have measured lung volumes annually using spirometry from 1986 to 1996. The objective was to compare annual decline in forced expiratory volume in 1 s (dFEV1) and forced vital capacity (dFVC). Methods The number of aluminum potroom workers was 4,546 (81% males) and the number of workers in the reference group was 651 (76% males). The number of spirometries in the index group and the references were 24,060 and 2,243, respectively. Results After adjustment for confounders, the difference in dFEV1 and dFVC between the index and reference groups were 13.5 (P Wiley Periodicals, Inc. PMID:26853811

  14. Differential Effects of Intraoperative Positive End-expiratory Pressure (PEEP) on Respiratory Outcome in Major Abdominal Surgery Versus Craniotomy

    DEFF Research Database (Denmark)

    de Jong, Myrthe A C; Ladha, Karim S; Melo, Marcos F Vidal

    2015-01-01

    OBJECTIVES: In this study, we examined whether (1) positive end-expiratory pressure (PEEP) has a protective effect on the risk of major postoperative respiratory complications in a cohort of patients undergoing major abdominal surgeries and craniotomies, and (2) the effect of PEEP is differed.......91 (0.84 - 0.98)], whereas PEEP >5 cmH2O was not significantly associated with reduced odds of respiratory complications or hospital length of stay in patients undergoing craniotomy. CONCLUSIONS: The protective effects of PEEP are procedure specific with meaningful effects observed in patients...... by surgery type. BACKGROUND: Protective mechanical ventilation with lower tidal volumes and PEEP reduces compounded postoperative complications after abdominal surgery. However, data regarding the use of intraoperative PEEP is conflicting. METHODS: In this observational study, we included 5915 major...

  15. Assessment of Impact of High Particulate Concentration on Peak Expiratory Flow Rate of Lungs of Sand Stone Quarry Workers

    Directory of Open Access Journals (Sweden)

    Gopal Purohit

    2006-12-01

    Full Text Available This study was designed to assess the impact of high particulate concentration on peak expiratory flow rate of lungs of sand stone quarry workers. The workers were engaged in different types of activities such as drilling, loading and dressing. These different working conditions had different concentrations of RSPM, leading to different exposure levels in workers. It was found that exposure duration and exposure concentrations were the main factors responsible for damage to the respiratory tracts of the workers. The particles were deposited at various areas of the respiratory system and reduced the peak flow rate. It was also revealed from the study that most of the workers suffered from silicosis if the exposure duration was more than 20 years.

  16. Popliteal artery entrapment syndrome.

    LENUS (Irish Health Repository)

    O'Leary, D P

    2010-01-01

    Popliteal artery entrapment syndrome is a rare abnormality of the anatomical relationship between the popliteal artery and adjacent muscles or fibrous bands in the popliteal fossa. The following is a case report of a 19 year old female, in whom popliteal artery entrapment syndrome was diagnosed, and successfully treated surgically. A review of literature is also presented and provides details on how PAES is classified, diagnosed both clinically and radiologically, and treated surgically.

  17. Celiac Artery Compression Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammed Muqeetadnan

    2013-01-01

    Full Text Available Celiac artery compression syndrome is a rare disorder characterized by episodic abdominal pain and weight loss. It is the result of external compression of celiac artery by the median arcuate ligament. We present a case of celiac artery compression syndrome in a 57-year-old male with severe postprandial abdominal pain and 30-pound weight loss. The patient eventually responded well to surgical division of the median arcuate ligament by laparoscopy.

  18. Diagnosis of bronchiectasis and airway wall thickening in children with cystic fibrosis. Objective airway-artery quantification

    Energy Technology Data Exchange (ETDEWEB)

    Kuo, Wieying; Tiddens, Harm A.W.M. [Erasmus MC - Sophia Children' s Hospital, Department of Pediatric Pulmonology and Allergology, Rotterdam (Netherlands); Erasmus MC, Department of Radiology, Rotterdam (Netherlands); Bruijne, Marleen de [Erasmus MC, Biomedical Imaging Group Rotterdam, Departments of Medical Informatics and Radiology, Rotterdam (Netherlands); University of Copenhagen, Department of Computer Science, Copenhagen (Denmark); Petersen, Jens [University of Copenhagen, Department of Computer Science, Copenhagen (Denmark); Nasserinejad, Kazem [Erasmus MC Cancer Institute, HOVON Data Center, Clinical Trial Center, Rotterdam (Netherlands); Erasmus MC, Department of Biostatistics, Rotterdam (Netherlands); Ozturk, Hadiye [Erasmus MC - Sophia Children' s Hospital, Department of Pediatric Pulmonology and Allergology, Rotterdam (Netherlands); Chen, Yong [General Hospital of Ningxia Medical University, Department of Radiology, Yinchuan (China); Perez-Rovira, Adria [Erasmus MC - Sophia Children' s Hospital, Department of Pediatric Pulmonology and Allergology, Rotterdam (Netherlands); Erasmus MC, Biomedical Imaging Group Rotterdam, Departments of Medical Informatics and Radiology, Rotterdam (Netherlands)

    2017-11-15

    To quantify airway and artery (AA)-dimensions in cystic fibrosis (CF) and control patients for objective CT diagnosis of bronchiectasis and airway wall thickness (AWT). Spirometer-guided inspiratory and expiratory CTs of 11 CF and 12 control patients were collected retrospectively. Airway pathways were annotated semi-automatically to reconstruct three-dimensional bronchial trees. All visible AA-pairs were measured perpendicular to the airway axis. Inner, outer and AWT (outer-inner) diameter were divided by the adjacent artery diameter to compute A{sub in}A-, A{sub out}A- and A{sub WT}A-ratios. AA-ratios were predicted using mixed-effects models including disease status, lung volume, gender, height and age as covariates. Demographics did not differ significantly between cohorts. Mean AA-pairs CF: 299 inspiratory; 82 expiratory. Controls: 131 inspiratory; 58 expiratory. All ratios were significantly larger in inspiratory compared to expiratory CTs for both groups (p<0.001). A{sub out}A- and A{sub WT}A-ratios were larger in CF than in controls, independent of lung volume (p<0.01). Difference of A{sub out}A- and A{sub WT}A-ratios between patients with CF and controls increased significantly for every following airway generation (p<0.001). Diagnosis of bronchiectasis is highly dependent on lung volume and more reliably diagnosed using outer airway diameter. Difference in bronchiectasis and AWT severity between the two cohorts increased with each airway generation. (orig.)

  19. Quantitative assessment of cross-sectional area of small pulmonary vessels in patients with COPD using inspiratory and expiratory MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Matsuura, Yukiko, E-mail: matsuyuki_future@yahoo.co.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Kawata, Naoko, E-mail: chumito_03@yahoo.co.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Yanagawa, Noriyuki, E-mail: yanagawa@ho.chiba-u.ac.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Sugiura, Toshihiko, E-mail: sugiura@js3.so-net.ne.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Sakurai, Yoriko, E-mail: yoliri@nifty.com [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Sato, Misuzu, E-mail: mis_misuzu@yahoo.co.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Iesato, Ken, E-mail: iesato_k@yahoo.co.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Terada, Jiro, E-mail: jirotera@chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Sakao, Seiichiro, E-mail: sakao@faculty.chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Tada, Yuji, E-mail: ytada@faculty.chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Tanabe, Nobuhiro, E-mail: ntanabe@faculty.chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Suzuki, Yoichi, E-mail: ysuzuki@faculty.chiba-u.jp [Department of public Health, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Tatsumi, Koichiro, E-mail: tatsumi@faculty.chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan)

    2013-10-01

    Objectives: Structural and functional changes in pulmonary vessels are prevalent at the initial stages of chronic obstructive pulmonary disease (COPD). These vascular alterations can be assessed using cross-sectional area (CSA) of small pulmonary vessels. However, neither in non-COPD smokers nor in COPD patients it has been defined whether the structural changes of pulmonary vessels detected by paired inspiratory and expiratory CT scans are associated with emphysematous changes. We quantified the CSA and low attenuation area (LAA) and evaluated the changes in these parameters in the inspiratory and expiratory phases. Materials and methods: Fifty consecutive non-COPD smokers and COPD patients were subjected to multi detector-row CT and the percentage of vessels with a CSA less than 5 mm{sup 2} as well as the percentage LAA for total lung area (%CSA < 5, %LAA, respectively) were calculated. Results: The %CSA < 5 correlated negatively with %LAA. The %CSA < 5 was lower in COPD patients with emphysema as compared with non-COPD smokers and COPD patients with or without mild emphysema. In addition, the %CSA < 5 was lower in the no/mild emphysema subgroup as compared with non-COPD smokers. The respiratory phase change of %CSA < 5 in COPD patients was greater than that in non-COPD smokers. Conclusion: The percentage of small pulmonary vessels decreased as emphysematous changes increase, and this decrease was observed even in patients with no/mild emphysema. Furthermore, respiratory phase changes in CSA were higher in COPD patients than in non-COPD smokers.

  20. Serial Peak Expiratory Flow Rates in Patients Undergoing Upper Abdominal Surgeries Under General Anaesthesia and Thoracic Epidural Analgesia.

    Science.gov (United States)

    Misquith, Julie C R; Rao, Rammoorthi; Ribeiro, Karl Sa

    2016-02-01

    Anaesthesia and upper abdominal surgeries alter lung compliance and functional residual capacity resulting from atelectasis. Upper abdominal surgeries also cause a decrease in peak expiratory flow rates, cough reflex due to pain limited inspiration. This study aimed to study the effect of thoracic epidural analgesia (TEA) on the peak expiratory flow rates in patients undergoing upper abdominal surgeries. A total of 44 patients posted for elective surgery were enrolled. Group 1 patients received GA + 0.125% bupivacaine infusion TEA and Group 2 received GA + Inj. Diclofenac sodium 50 mg slow i.v. TID for Postoperative analgesia. Haemodynamics, VAS pain score, PEFR measurements were done at 60 minutes, 24 hours, 48 hours and 4 days after surgery in both groups. ABG analysis was taken pre operatively and 24 hours after surgery. The SBP and DBP values obtained at 60 minutes (p<0.016) 24 and 48 hours (p<0.001) and day 4 (p<0.02) postoperative showed highly significant difference between the two groups which indicate better haemodynamic parameters in patients receiving epidural analgesia. Postoperatively the difference in PEFR values at 60 minutes, 24 hour, 48 hour and day 4 were very highly significant. (p<0.001). Group1 had a 10.739% deficit on day 4 from its pre operative baseline value while group 2 showed a 34.825 % deficit which was very highly significant (p<0.001). The difference in VAS scores recorded at 60 minutes, 24 hours, 48 hours and day 4 post op were very highly statistically significant (p < 0.001). The ABG taken at 24 hours shows statistically significant difference with patients in group 2 showing decreased values in pCO2 and pO2 reflecting poorer ventilation and oxygenation. Thoracic epidural analgesia provides superior analgesia, better cough reflex as seen by better PEFR values, were haemodynamically more stable and their ABG values were better than the NSAID group.

  1. Glycine is used as a transmitter by decrementing expiratory neurons of the ventrolateral medulla in the rat.

    Science.gov (United States)

    Ezure, Kazuhisa; Tanaka, Ikuko; Kondo, Masahiro

    2003-10-01

    The medullary respiratory network involves various types of respiratory neurons. The present study focused on possible inhibitory neurons called decrementing expiratory (E-DEC) neurons and aimed to determine whether their transmitter is glycine or GABA. In Nembutal-anesthetized, neuromuscularly blocked, and artificially ventilated rats we labeled E-DEC neurons with Neurobiotin and processed the tissues for detection of mRNA encoding either glycine transporter 2 (GLYT2) as a marker for glycinergic neurons or glutamic acid decarboxylase isoform 67 (GAD67) as a marker for GABAergic neurons, using in situ hybridization. Of 38 E-DEC neurons that were labeled, cranial motoneurons (n = 14), which were labeled as control, were negative for either GLYT2 mRNA (n = 10) or GAD67 mRNA (n = 4). The other E-DEC neurons (n = 24) were non-motoneurons. Sixteen of them were examined for GLYT2 mRNA, and the majority (11 of 16) was GLYT2 mRNA-positive. The remaining E-DEC neurons (n = 8) were examined for GAD67 mRNA, and all of them were GAD67 mRNA-negative. The GLYT2 mRNA-positive E-DEC neurons were located in the ventrolateral medulla spanning the Bötzinger complex (BOT), the rostral ventral respiratory group (VRG), and the caudal VRG. We conclude that not only E-DEC neurons of the BOT but also many E-DEC neurons of the VRG are inhibitory and use glycine as a transmitter. Although the present negative data cannot rule out completely the release of GABA or co-release of glycine and GABA from E-DEC neurons, several lines of evidence suggest that the glycinergic process is primarily responsible for the phasic inhibition of the respiratory network during the expiratory phase.

  2. Renal Branch Artery Stenosis

    DEFF Research Database (Denmark)

    Andersson, Zarah; Thisted, Ebbe; Andersen, Ulrik Bjørn

    2017-01-01

    Renovascular hypertension is a common cause of pediatric hypertension. In the fraction of cases that are unrelated to syndromes such as neurofibromatosis, patients with a solitary stenosis on a branch of the renal artery are common and can be diagnostically challenging. Imaging techniques...... that perform well in the diagnosis of main renal artery stenosis may fall short when it comes to branch artery stenosis. We report 2 cases that illustrate these difficulties and show that a branch artery stenosis may be overlooked even by the gold standard method, renal angiography....

  3. Atherosclerotic femoral artery aneurysms

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Schroeder, T V

    1996-01-01

    Based on a clinical suspicion of an increase in the proportion of deep femoral aneurysms, we reviewed the case records of patients who underwent reconstructive procedures for femoral aneurysms to investigate if this could be confirmed and explained by selection of patient or modality of diagnosis...... femoral artery and 3 the deep femoral artery. The proportion of deep femoral aneurysm was therefore 3/17 = 18%. Previous series report that aneurysms of the profunda femoris artery occurs in only 1% to 2.6% of all femoral artery aneurysms. No explanation was found for this significant increase (p

  4. Thermosetting polyimide resin matrix composites with interpenetrating polymer networks for precision foil resistor chips based on special mechanical performance requirements

    Energy Technology Data Exchange (ETDEWEB)

    Wang, X.Y., E-mail: wxy@tju.edu.cn [School of Electronic Information Engineering, Tianjin University, Tianjin 300072 (China); Ma, J.X.; Li, C.G. [School of Electronic Information Engineering, Tianjin University, Tianjin 300072 (China); Wang, H.X. [ZHENGHE electronics Co., Ltd, Jining 272023 (China)

    2014-04-01

    Highlights: • Macromolecular materials were chosen to modify thermosetting polyimide (TSPI). • The formation of IPN structure in TSPI composite polymers was discussed. • The special mechanical properties required were the main study object. • The desired candidate materials should have proper hardness and toughness. • The specific mechanical data are quantitatively determined by experiments. - Abstract: Based on interpenetrating networks (IPNs) different macromolecular materials such as epoxy, phenolic, and silicone resin were chosen to modify thermosetting polyimide (TSPI) resin to solve the lack of performance when used for protecting precision foil resistor chips. Copolymerization modification, controlled at curing stage, was used to prepare TSPI composites considering both performance and process requirements. The mechanical properties related to trimming process were mainly studied due to the special requirements of the regularity of scratch edges caused by a tungsten needle. The analysis on scratch edges reveals that the generation and propagation of microcracks caused by scratching together with crack closure effect may lead to regular scratch traces. Experiments show that the elongation at break of TSPI composites is the main reason that determines the special mechanical properties. The desired candidate materials should have proper hardness and toughness, and the specific mechanical data are that the mean elongation at break and tensile strength of polymer materials are in the range of 9.2–10.4% and 100–107 MPa, respectively. Possible reasons for the effect of the modifiers chosen on TSPI polymers, the reaction mechanisms on modified TSPI resin and the IPN structure in TSPI composite polymers were discussed based on IR and TG analysis.

  5. Influence of Changing the Diameter of the Bubble Generator Bottle and Expiratory Limb on Bubble CPAP: An in vitro Study

    Directory of Open Access Journals (Sweden)

    Chun-Shan Wu

    2012-12-01

    Conclusion: The size and submergence depth of an expiratory limb of a CPAP circuit, the diameter of the bubble generator bottle, and the compliance of the model lung all influence the magnitude and frequency of the transmitted pressure waveform. Therefore, these factors may affect lung volume recruitment and breathing efficiency in bubble CPAP.

  6. Distribution of peak expiratory flow variability by age, gender and smoking habits in a random population sample aged 20-70 yrs

    NARCIS (Netherlands)

    Boezen, H M; Schouten, J. P.; Postma, D S; Rijcken, B

    1994-01-01

    Peak expiratory flow (PEF) variability can be considered as an index of bronchial lability. Population studies on PEF variability are few. The purpose of the current paper is to describe the distribution of PEF variability in a random population sample of adults with a wide age range (20-70 yrs),

  7. High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial

    NARCIS (Netherlands)

    Hemmes, Sabrine N. T.; Gama de Abreu, Marcelo; Pelosi, Paolo; Schultz, Marcus J.; Severgnini, Paolo; Hollmann, Markus W.; Binnekade, Jan M.; Wrigge, Hermann; Canet, Jaume; Hiesmayr, Michael; Schmid, Werner; Jaber, Samir; Hedenstierna, Göran; Putensen, Christian; Sessler, Daniel I.; Lachmann, Burkhard; Kacmarek, Robert M.; Slutsky, Arthur S.; de Baerdemaeker, Luc; de Hert, Stefan; Heyse, Bjorn; van Limmen, Jurgen; Mulier, Jan-Paul; Velghe, David; Jamaer, Luc; Vandenbrande, Jeroen; Bugedo, Guillermo; Florez, Jorge; Goranović, Tatjana; Mazul-Sunko, Branka; Bluth, Thomas; Güldner, Andreas; Kiss, Thomas; Koch, Thea; Spieth, Peter Markus; Uhlig, Christopher; Yaqub, Jonathan; Bastin, Bea; Geib, Johann; Schaefer, Maximilian S.; Weiss, Martin; Treschan, Tanja A.; Reske, Andreas W.; Simon, Philipp; Brodhun, Alexander; Ferner, Marion; Hartmann, Eric; Laufenberg-Feldmann, Rita; Strys, Lydia; de Robertis, Edoardo; Perilli, Valter; Proietti, Rodolfo; Amantea, Bruno; Caroleo, Santo; Tropea, Francesco; Bacuzzi, Alessandro; Vanoni, Massimo; Cinnella, Gilda; Caggianelli, Girolamo; D'Antini, Davide; La Bella, Daniela; Mollica, Giuseppina; Cortegiani, Andrea; Giarratano, Antonino; Montalto, Francesca; Raineri, Santi Maurizio; Barberis, Bruno; Celentano, Cristian; Grio, Michele; Spagnolo, Luigi; Gratarola, Angelo; Molin, Alexandre; Pellerano, Giulia; Pezzato, Stefano; Rusca, Roberta; Della Rocca, Giorgio; Bos, Lieuwe D. J.; Brunelli, Andrea; Marti, Agnes; Cegarra, Virginia; Merten, Alfred; Moral, Ma Victoria; Parera, Ana; Unzueta, Ma Carmen; Sabaté, Sergi; Sierra, Pilar; Mayoral, Juan F.; Prieto, Mercè; Gil, Manuel Granell; Marín, Conrado Minguez; Mills, Gary H.; Bodger, Phoebe; Vidal Melo, Marcos F.; Sulemanji, Demet; Sprung, Juraj

    2014-01-01

    Background The role of positive end-expiratory pressure in mechanical ventilation during general anaesthesia for surgery remains uncertain. Levels of pressure higher than 0 cm H2O might protect against postoperative pulmonary complications but could also cause intraoperative circulatory depression

  8. Effects of Inhaled Fenoterol and Positive End-Expiratory Pressure on the Respiratory Mechanics of Patients with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Claude Guerin

    2005-01-01

    Full Text Available BACKGROUND: During acute ventilatory failure in patients with chronic obstructive pulmonary disease (COPD, applying external positive end-expiratory pressure (PEEPe will reopen small airways and, thus, may enhance peripheral deposition as well as the physiological effects of inhaled beta-2 agonists.

  9. Lung-protective ventilation in intensive care unit and operation room : Tidal volume size, level of positive end-expiratory pressure and driving pressure

    NARCIS (Netherlands)

    Serpa Neto, A.

    2017-01-01

    Several investigations have shown independent associations between three ventilator settings – tidal volume size, positive end–expiratory pressure (PEEP) and driving pressure – and outcomes in patients with the acute respiratory distress syndrome (ARDS). There is an increasing notion that similar

  10. Heritability of cilioretinal arteries

    DEFF Research Database (Denmark)

    Taarnhøj, Nina Charlotte; Munch, Inger C; Kyvik, Kirsten O

    2005-01-01

    of healthy monozygotic and dizygotic twins were examined using digital fundus photography and visual assessment of grayscale fundus photographs and color transparencies to detect the presence of cilioretinal arteries. RESULTS: Cilioretinal arteries were present in 45.1% of participants and 28.8% of eyes...

  11. Peripheral artery disease - legs

    Science.gov (United States)

    ... the legs, feet, and toes Painful, non-bleeding sores on the feet or toes (most often black) that are slow ... block small arteries Coronary artery disease Impotence Open sores ... (gangrene) The affected leg or foot may need to be amputated

  12. Carotid Artery Screening

    Science.gov (United States)

    ... that look for inherited genetic markers linked to disease, and imaging tests that produce pictures of the inside of the body. These ... a risk factor. Risk factors for carotid artery disease include: age high blood pressure diabetes tobacco smoking high cholesterol coronary artery disease (CAD) obesity ...

  13. Transient expiratory flow interruptions (TEFI increase expiratory flow in acute asthma exacerbation Incremento del flujo espiratorio luego de interrupciones transitorias en la exacerbación aguda de asma

    Directory of Open Access Journals (Sweden)

    Alejandra Fernández

    2009-10-01

    Full Text Available We have shown that expiratory flows increase when expirations are rapidly interrupted in stable asthmatic patients. We hypothesized that a similar increase could be obtained in patients with acute exacerbation of bronchial asthma treated in the Emergency Room. A total of 30 asthmatic patients were randomly allocated into two groups, the study and the control groups. Patients in the study group were connected to a device with an inspiratory line designed to administer pressurized aerosols. The expiratory line passed through a valve completely interrupting flow at 4 Hz, with an open/closed time ratio of 10/3. The control group patients were also connected to the device, but with the valve kept open. Mean expiratory flow at tidal volume (MEFTV was measured under basal conditions and at 4, 8 and 12 minutes after connecting the patients to the device. All patients received standard treatment throughout the procedure. At all time points MEFTV increased more in the study than in the control group (p Demostramos que el flujo espiratorio máximo, en pacientes asmáticos en estado estable, se incrementaba cuando se generaban rápidas y transitorias interrupciones del flujo. Formulamos la hipótesis de que un incremento similar podría ser observado en pacientes con exacerbación aguda de asma tratados en la sala de emergencias. Un total de 30 pacientes asmáticos fueron distribuidos al azar en dos grupos. Los pacientes del grupo en estudio fueron conectados a un aparato con una vía inspiratoria diseñada para la administración de aerosoles. La vía espiratoria pasaba por una válvula que interrumpía el flujo completamente a 4 hz, con una relación tiempo abierta/tiempo cerrada de 10/3. Los pacientes del grupo control también fueron conectados al aparato pero con la válvula siempre abierta. Se midió el flujo medio de la espiración a volumen circulante en condiciones basales y a los 4, 8 y 12 minutos después de conectado el paciente al equipo. Todos

  14. BILATERAL DUPLICATION OF RENAL ARTERIES

    OpenAIRE

    Prajkta A Thete; Mehera Bhoir; M.V.Ambiye

    2014-01-01

    Routine dissection of a male cadaver revealed the presence of bilateral double renal arteries. On the right side the accessory renal artery originated from the abdominal aorta just above the main renal artery. On the left side the accessory renal artery originated from the abdominal aorta about 1 cm above the main renal artery. Knowledge of the variations of renal vascular anatomy has importance in exploration and treatment of renal trauma, renal transplantation, renal artery embolization, su...

  15. Oleic acid vs saline solution lung lavage-induced acute lung injury: effects on lung morphology, pressure-volume relationships, and response to positive end-expiratory pressure.

    Science.gov (United States)

    Luecke, Thomas; Meinhardt, Juergen P; Herrmann, Peter; Weiss, Andreas; Quintel, Michael; Pelosi, Paolo

    2006-08-01

    To compare two lung injury models (oleic acid [OA] and saline solution washout [SW]) regarding lung morphology, regional inflation, and recruitment during static pressure-volume (PV) curves, and the effects of positive end-expiratory pressure (PEEP) below and above the lower inflection point (Pflex). Fourteen adult pigs underwent OA or SW lung injury. Lung volumes were measured using CT. PV curves were obtained with simultaneous CT scanning at lung apex and base. Fractional inflation and recruitment were compared to data on PEEP above and below Pflex. Severity of lung injury was comparable. At zero PEEP, SW showed an increased amount of edema and poorly aerated lung volume, recruitment during inspiration, and a better oxygenation response with PEEP. Whole-lung PV curves were similar in both models, reflecting changes in alveolar inflation or deflation. On the inspiratory PV limb, recruitment and inflation were on the same line, while there was a substantial difference between deflation and derecruitment on the expiratory limb. PEEP-induced recruitment at lung apex and base was at or above the derecruitment line on the expiratory limb and showed no relationship to the whole-lung expiratory PV curve. The following conclusions were made: (1) OA and SW models are comparable in mechanics but not in lung injury characteristics; (2) neither inspiratory nor expiratory whole-lung PV curves are useful to select PEEP in order to optimize recruitment; and (3) after recruitment, there is no difference in derecruitment between the models at high PEEP, while more collapse occurs at lower PEEP in the basal sections of SW lungs.

  16. Corrigendum to "High-ohmic resistors fabricated by PureB layer for silicon drift detectors applications" [Solid State Electron. 105 (2015) 6-11

    Science.gov (United States)

    Golshani, Negin; Derakhshandeh, Jaber; Beenakker, C. I. M.; Ishihara, R.

    2016-05-01

    In a journal publication ;High-ohmic resistors fabricated by PureB layer for silicon drift detectors applications; by Negin Golshani; Jaber Derakhshandeh; C.I.M. Beenakker; R. Ishihara; published in Solid State Electronics, vol. 105, pp. 6-11, in 2015, an error occurred in the references by omitting the paper published by N. Golshani, et al., in the Proceedings of European Solid-State Device Research Conference (ESSDERC) in 2013 [1]. We apologize for any inconvenience caused. We also apologize for not properly acknowledging the contributions of Drs. L.K. Nanver, V. Mohammadi, and S. Ramesh to the first part of this research.

  17. Non-volatile gated variable resistor based on doped La2CuO4+delta and SrTiO3 heterostructures

    OpenAIRE

    Weber, D.; Poppe, U.

    2012-01-01

    Gated variable resistors were manufactured by depositing epitaxial heterostructures of doped La2CuO4+delta and SrTiO3 layers. Their conductance change as function of write current I and write time t followed a simple empirical law of the form Delta G/G = CI(A)t(B). This behavior is in agreement with ionic transport that accelerates exponentially with electrical field strength. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.3691599

  18. Cost-effectiveness of the Aerobika* oscillating positive expiratory pressure device in the management of COPD exacerbations

    Directory of Open Access Journals (Sweden)

    Khoudigian-Sinani S

    2017-10-01

    Full Text Available Shoghag Khoudigian-Sinani,1,2 Stacey Kowal,3 Jason A Suggett,4 Dominic P Coppolo5 1Faculty of Health Sciences, Department of Health Research, Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; 2QuintilesIMS, Toronto, ON, Canada; 3QuintilesIMS, Seattle, WA, USA; 4Trudell Medical International, London, ON, Canada; 5Monaghan Medical Corporation, Syracuse, NY, USA Introduction: COPD places a huge clinical and economic burden on the US health care system, with acute exacerbations representing a key driver of direct medical costs. Current treatments, although effective in reducing symptoms and limiting exacerbations, do not adequately target the underlying disease processes that drive exacerbation development. The Aerobika* oscillating positive expiratory pressure (OPEP device has been shown in a real-world effectiveness study to lower the frequency of moderate-to-severe exacerbations during a 30-day post-exacerbation period. This study sought to determine the impact on exacerbations and costs and to determine the cost-effectiveness of the Aerobika* device. Methods: Data from published literature and national fee schedules were used to model the cost-effectiveness of the Aerobika* device in patients who had experienced an exacerbation in the previous month, or a post-exacerbation care population. Exacerbation trends and the impact of the Aerobika* device on reducing exacerbation frequency were modeled using a one-year Markov model with monthly cycles and three health states: (i no exacerbation, (ii exacerbation, and (iii death. Scenario analysis and one-way sensitivity analysis (OWSA were also performed. Results: When the effect of Aerobika* device was assumed to last 30 days, use of the device resulted in cost-savings ($553 per patient and improved outcomes (ie, six fewer exacerbations per 100 patients per year compared to no OPEP/positive expiratory pressure therapy. When the effect of the Aerobika* device was assumed to extend

  19. Paired maximum inspiratory and expiratory plain chest radiographs for assessment of airflow limitation in chronic obstructive pulmonary disease

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, Takashi, E-mail: tkino@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Kawayama, Tomotaka, E-mail: kawayama_tomotaka@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Imamura, Youhei, E-mail: mamura_youhei@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Sakazaki, Yuki, E-mail: sakazaki@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Hirai, Ryo, E-mail: hirai_ryou@kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Ishii, Hidenobu, E-mail: shii_hidenobu@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Suetomo, Masashi, E-mail: jin_t_f_c@yahoo.co.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Matsunaga, Kazuko, E-mail: kmatsunaga@kouhoukai.or.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Azuma, Koichi, E-mail: azuma@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Fujimoto, Kiminori, E-mail: kimichan@med.kurume-u.ac.jp [Department of Radiology, Kurume University School of Medicine, Kurume (Japan); Hoshino, Tomoaki, E-mail: hoshino@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan)

    2015-04-15

    Highlights: •It is often to use computed tomography (CT) scan for diagnosis of chronic obstructive pulmonary disease. •CT scan is more expensive and higher. •A plane chest radiography more simple and cheap. Moreover, it is useful as detection of pulmonary emphysema, but not airflow limitation. •Our study demonstrated that the maximum inspiratory and expiratory plane chest radiography technique could detect severe airflow limitations. •We believe that the technique is helpful to diagnose the patients with chronic obstructive pulmonary disease. -- Abstract: Background: The usefulness of paired maximum inspiratory and expiratory (I/E) plain chest radiography (pCR) for diagnosis of chronic obstructive pulmonary disease (COPD) is still unclear. Objectives: We examined whether measurement of the I/E ratio using paired I/E pCR could be used for detection of airflow limitation in patients with COPD. Methods: Eighty patients with COPD (GOLD stage I = 23, stage II = 32, stage III = 15, stage IV = 10) and 34 control subjects were enrolled. The I/E ratios of frontal and lateral lung areas, and lung distance between the apex and base on pCR views were analyzed quantitatively. Pulmonary function parameters were measured at the same time. Results: The I/E ratios for the frontal lung area (1.25 ± 0.01), the lateral lung area (1.29 ± 0.01), and the lung distance (1.18 ± 0.01) were significantly (p < 0.05) reduced in COPD patients compared with controls (1.31 ± 0.02 and 1.38 ± 0.02, and 1.22 ± 0.01, respectively). The I/E ratios in frontal and lateral areas, and lung distance were significantly (p < 0.05) reduced in severe (GOLD stage III) and very severe (GOLD stage IV) COPD as compared to control subjects, although the I/E ratios did not differ significantly between severe and very severe COPD. Moreover, the I/E ratios were significantly correlated with pulmonary function parameters. Conclusions: Measurement of I/E ratios on paired I/E pCR is simple and

  20. Dosimetric Analysis of Organs at Risk During Expiratory Gating in Stereotactic Body Radiation Therapy for Pancreatic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Taniguchi, Cullen M.; Murphy, James D.; Eclov, Neville; Atwood, Todd F.; Kielar, Kayla N.; Christman-Skieller, Claudia; Mok, Ed; Xing, Lei; Koong, Albert C. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Chang, Daniel T., E-mail: dtchang@stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States)

    2013-03-15

    Purpose: To determine how the respiratory phase impacts dose to normal organs during stereotactic body radiation therapy (SBRT) for pancreatic cancer. Methods and Materials: Eighteen consecutive patients with locally advanced, unresectable pancreatic adenocarcinoma treated with SBRT were included in this study. On the treatment planning 4-dimensional computed tomography (CT) scan, the planning target volume (PTV), defined as the gross tumor volume plus 3-mm margin, the duodenum, and the stomach were contoured on the end-expiration (CT{sub exp}) and end-inspiration (CT{sub insp}) phases for each patient. A separate treatment plan was constructed for both phases with the dose prescription of 33 Gy in 5 fractions with 95% coverage of the PTV by the 100% isodose line. The dose-volume histogram (DVH) endpoints, volume of duodenum that received 20 Gy (V{sub 20}), V{sub 25}, and V{sub 30} and maximum dose to 5 cc of contoured organ (D{sub 5cc}), D{sub 1cc}, and D{sub 0.1cc}, were evaluated. Results: Dosimetric parameters for the duodenum, including V{sub 25}, V{sub 30}, D{sub 1cc}, and D{sub 0.1cc} improved by planning on the CT{sub exp} compared to those on the CT{sub insp}. There was a statistically significant overlap of the PTV with the duodenum but not the stomach during the CT{sub insp} compared to the CT{sub exp} (0.38 ± 0.17 cc vs 0.01 ± 0.01 cc, P=.048). A larger expansion of the PTV, in accordance with a Danish phase 2 trial, showed even more overlapping volume of duodenum on the CT{sub insp} compared to that on the CT{sub exp} (5.5 ± 0.9 cc vs 3.0 ± 0.8 cc, P=.0003) but no statistical difference for any stomach dosimetric DVH parameter. Conclusions: Dose to the duodenum was higher when treating on the inspiratory than on the expiratory phase. These data suggest that expiratory gating may be preferable to inspiratory breath-hold and free breathing strategies for minimizing risk of toxicity.

  1. Dynamic change in respiratory resistance during inspiratory and expiratory phases of tidal breathing in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Nagase T

    2012-04-01

    Full Text Available Yasuhiro Yamauchi1,2, Tadashi Kohyama2, Taisuke Jo2, Takahide Nagase21Division of Health Promotion Center, 2Department of Respiratory Medicine, University of Tokyo, Tokyo, JapanBackground and objective: Chronic obstructive pulmonary disease (COPD is characterized by persistent airflow limitation consisting of airway obstruction and parenchymal emphysema, with loss of elastic recoil. The forced oscillation technique can detect impairment of lung function by measuring lung impedance during normal tidal breathing. Respiratory resistance (Rrs in COPD has been well-studied, but the differences in Rrs in the inspiratory and expiratory phases between mild and moderate COPD remain poorly understood. Since airway obstruction in COPD is known to change dynamically during tidal breathing and might affect Rrs, the differences in Rrs during tidal breathing between mild and moderate COPD were evaluated.Methods: Mild (n = 13 and moderate (n = 13 COPD patients were recruited at Tokyo University Hospital (Tokyo, Japan. Rrs was measured using MostGraph-01 (Chest MI, Inc, Tokyo, Japan, which depicted Rrs in a frequency- and respiratory cycle-dependent manner in three-dimensional graphics. Rrs was evaluated at 4–35 Hz during tidal breathing.Results: Rrs changed dynamically during tidal breathing in COPD. The mean Rrs values were significantly greater in the moderate COPD group than in the mild group. The maximal and minimal Rrs values at higher frequencies in the respiratory cycle were significantly greater in moderate COPD. In inspiratory–expiratory breath analysis, the maximal and minimal Rrs values at 20 Hz and 35 Hz were significantly greater in the moderate group, whereas at 4 Hz they did not differ significantly between the groups.Conclusion: Rrs changed dynamically during tidal breathing in patients with COPD. The Rrs values at higher frequencies were greater in moderate COPD than in mild COPD. Rrs at higher frequencies might reflect the degree of airway

  2. Platonic Relationships among Resistors

    Science.gov (United States)

    Allen, Bradley; Liu, Tongtian

    2015-01-01

    Calculating the effective resistance of an electrical network is a common problem in introductory physics courses. Such calculations are typically restricted to two-dimensional networks, though even such networks can become increasingly complex, leading to several studies on their properties. Furthermore, several authors have used advanced…

  3. Coronary Artery Bypass

    Directory of Open Access Journals (Sweden)

    Kadri Ceberut

    2011-01-01

    Full Text Available Ancient schwannoma is a rare variant of neural tumors though rarely seen in the thorax. The combination with coronary artery diseases is also rare. Here we describe a 66 year-old male who had undergone one-stage combined surgery for thoracic ancient schwannomas removal and coronary artery disease. The masses were, respectively, 13 cm in the middle mediastinum and 5 cm in diameter originating from the intercostal nerve. The tumors were successfully removed using sternotomy, and then a coronary artery bypass grafting was performed. Here we discuss this rare tumor in relation to the relevant literature.

  4. Can a central blood volume deficit be detected by systolic pressure variation during spontaneous breathing?

    DEFF Research Database (Denmark)

    Dahl, Michael; Hayes, Chris; Steen Rasmussen, Bodil

    2016-01-01

    BACKGROUND: Whether during spontaneous breathing arterial pressure variations (APV) can detect a volume deficit is not established. We hypothesized that amplification of intra-thoracic pressure oscillations by breathing through resistors would enhance APV to allow identification of a reduced...... resistors. A brachial arterial catheter was used to measure blood pressure and thus systolic pressure variation (SPV), pulse pressure variation and stroke volume variation . Pulse contour analysis determined stroke volume (SV) and CO and we evaluated whether APV could detect a 10 % decrease in CO. RESULTS...... (from 21 (±15)% to 30 (±13)%). Yet during head-up tilt, a SPV ≥ 37 % predicted a decrease in CO ≥ 10 % with a sensitivity and specificity of 78 % and 100 %, respectively. CONCLUSION: In spontaneously breathing healthy volunteers combined inspiratory and expiratory resistors enhance SPV during head...

  5. Reducing the number of daily measurements results in poor estimation of diurnal variability of peak expiratory flow in healthy individuals.

    Directory of Open Access Journals (Sweden)

    Gupta D

    2000-10-01

    Full Text Available AIM: To determine the effect of reducing number of daily measurements on estimation of diurnal variability (DV of peak expiratory flow (PEF. SUBJECTS AND METHODS: PEF was recorded five times daily for three days in 152 healthy adults. Amplitude percent mean (A%M and standard deviation percent mean (SD%M were calculated on third day from five, four, three and two daily readings. Proportion of variability explained by partial schedules was calculated and limits of agreement derived to assess if these methods could be used interchangeably. RESULTS: Four, three and two measurements explained 90-95%, 70-82% and 55% DV respectively using A%M. All schedules of partial measurement using SD%M explained >90% DV. Limits of agreement for A%M and SD%M widened as number of measurements were reduced. CONCLUSIONS: DV obtained by fewer daily measurements agrees poorly with results obtained from five measurements. SD%M is a better alternative if DV is assessed from fewer readings.

  6. Acute effects of Asian dust events on respiratory symptoms and peak expiratory flow in children with mild asthma.

    Science.gov (United States)

    Yoo, Young; Choung, Ji Tae; Yu, Jinho; Kim, Do Kyun; Koh, Young Yull

    2008-02-01

    The aim of this study was to investigate the possible adverse effects of Asian dust events on respiratory health in asthmatic children. Fifty-two children with mild asthma were studied for eight consecutive weeks in the spring of 2004 (March 8 to May 2). During the study period, five Asian dust days were identified; we included a lag period of two days following each of the events. Subjects recorded their respiratory symptom diaries and peak expiratory flow (PEF) twice daily during the study period; and they underwent methacholine bronchial challenge tests. The subjects reported a significantly higher frequency of respiratory symptoms during the Asian dust days than during the control days. They showed significantly more reduced morning and evening PEF values, and more increased PEF variability (10.1%+/-3.5% vs. 5.5%+/-2.2%) during the Asian dust days than during the control days. Methacholine PC(20) was not significantly different between before and after the study period (geometric mean: 2.82 mg/mL vs. 3.16 mg/mL). These results suggest that the short-term Asian dust events might be associated with increased acute respiratory symptoms and changes in PEF outcomes. However, there might be little long-term influence on airway hyperresponsiveness in children with mild asthma.

  7. End-Expiratory Occlusion Test Predicts Fluid Responsiveness in Patients With Protective Ventilation in the Operating Room.

    Science.gov (United States)

    Biais, Matthieu; Larghi, Mathilde; Henriot, Jeremy; de Courson, Hugues; Sesay, Musa; Nouette-Gaulain, Karine

    2017-12-01

    End-expiratory occlusion test (EEOT) has been proposed to predict fluid responsiveness in mechanically ventilated intensive care unit patients. The utility of this test during low-tidal-volume ventilation remains uncertain. This study aimed to determine whether hemodynamic variations induced by EEOT could predict the effect of volume expansion in patients with protective ventilation in the operating room. Forty-one patients undergoing neurosurgery were included. Stroke volume and pulse pressure variations were continuously recorded using pulse contour analysis before and immediately after a 30-second EEOT and after volume expansion (250 mL saline 0.9% given over 10 minutes). Patients with an increase in stroke volume ≥ 10% after volume expansion were defined as responders. Twenty patients were responders to fluid administration. EEOT induced a significant increase in stroke volume, which was correlated with the stroke volume changes induced by volume expansion (r = 0.55, P variation threshold was 9%, with a sensitivity of 60% (95% CI, 36%-81%) and specificity of 86% (95% CI, 64%-97%). The area under the receiver operating characteristics curve generated for changes in stroke volume induced by EEOT (0.91, 95% CI, 0.81-1.00) was significantly higher than the one obtained for pulse pressure variations (0.75, 95% CI, 0.60-0.90); P ventilation in the operating room. This test may have potential applications.

  8. Response to inhaled corticosteroids on serum CD28, quality of life, and peak expiratory flow rate in bronchial asthma.

    Science.gov (United States)

    Gupta, Anubhuti; Gupta, Lalit K; Rehan, Harmeet S; Prakash, Anupam

    2017-03-01

    CD28 is a 44 kDa glycoprotein that is important in initiating T-cell responses and that results in increased T-cell proliferation and interleukin-2 production. This study estimated the serum CD28 levels in patients with asthma and evaluated the effect of inhaled corticosteroids (ICS) on the levels of CD28, the peak expiratory flow rate (PEFR), and quality of life (QOL). This prospective, open-label, observational study enrolled 40 adult patients with asthma of mild-to-moderate severity who were started on ICS and 40 healthy controls. Patients with bronchial asthma were evaluated for their serum CD28 level and QOL by using Mini Asthma Quality of Life Questionnaire scores, severity of symptoms, and PEFR at baseline and after 4 weeks. The mean (standard deviation [SD]) serum CD28 concentration in patients with asthma was 107 ± 4.98 ng/mL, which was significantly elevated (p Asthma Quality of Life Questionnaire scores significantly increased, from 36.90 ± 10.31 on day 0 to 70.63 ± 11.56 on day 28 after ICS therapy (p bronchial asthma and reduced by ICS therapy. ICS also improved QOL scores and objective clinical outcomes in patients with asthma.

  9. Expiratory CT in cigarette smokers: correlation between areas of decreased lung attenuation, pulmonary function tests and smoking history

    Energy Technology Data Exchange (ETDEWEB)

    Verschakelen, J.A.; Scheinbaum, K.; Bogaert, J.; Baert, A.L. [Department of Radiology, University Hospitals, Leuven (Belgium); Demedts, M.; Lacquet, L.L. [Department of Pneumology, University Hospitals, Leuven (Belgium)

    1998-10-01

    The aim of this study was to determine the correlation between cigarette-smoke-related bronchial disease and air trapping as assessed by expiratory high-resolution CT (HRCT) scans. Thirty healthy subjects (11 non-smokers, 7 ex-smokers for > 2 years, 12 current smokers; age range 35-55 years) with a smoking history between 0 and 28.5 pack-years underwent pulmonary function tests (PFT) and HRCT in inspiration and expiration in supine and prone position. The extent of air trapping was scored in ventral and dorsal aspects of the upper, middle and lower lung portions. In 24 subjects (7 non-smokers, 7 ex-smokers, 10 current smokers) areas of focal air trapping were found, and were present significantly more often in dependent lung portions (p < 0.05) compared with non-dependent portions. No significant differences were found between apical and basal lung zones. Scores of focal air trapping were not significantly different between smokers and ex-smokers, but were significantly lower (p < 0.05) in non-smokers and showed a significant (p < 0.0005) correlation with pack-years. The degree of air trapping was also associated with several lung function tests, especially RV, DLCO, FRC, FEV1 and FEV1/VC. Air trapping is seen in smokers with normal PFT and correlates with the severity of the smoking history, independently of current smoking status. (orig.) (orig.) With 4 figs., 4 tabs., 59 refs.

  10. Paired maximum inspiratory and expiratory plain chest radiographs for assessment of airflow limitation in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Kinoshita, Takashi; Kawayama, Tomotaka; Imamura, Youhei; Sakazaki, Yuki; Hirai, Ryo; Ishii, Hidenobu; Suetomo, Masashi; Matsunaga, Kazuko; Azuma, Koichi; Fujimoto, Kiminori; Hoshino, Tomoaki

    2015-04-01

    The usefulness of paired maximum inspiratory and expiratory (I/E) plain chest radiography (pCR) for diagnosis of chronic obstructive pulmonary disease (COPD) is still unclear. We examined whether measurement of the I/E ratio using paired I/E pCR could be used for detection of airflow limitation in patients with COPD. Eighty patients with COPD (GOLD stage I=23, stage II=32, stage III=15, stage IV=10) and 34 control subjects were enrolled. The I/E ratios of frontal and lateral lung areas, and lung distance between the apex and base on pCR views were analyzed quantitatively. Pulmonary function parameters were measured at the same time. The I/E ratios for the frontal lung area (1.25±0.01), the lateral lung area (1.29±0.01), and the lung distance (1.18±0.01) were significantly (plung distance were significantly (p<0.05) reduced in severe (GOLD stage III) and very severe (GOLD stage IV) COPD as compared to control subjects, although the I/E ratios did not differ significantly between severe and very severe COPD. Moreover, the I/E ratios were significantly correlated with pulmonary function parameters. Measurement of I/E ratios on paired I/E pCR is simple and reproducible, and can detect airflow limitation in patients with severe and very severe COPD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Influence of Positive End-Expiratory Pressure on Myocardial Strain Assessed by Speckle Tracking Echocardiography in Mechanically Ventilated Patients

    Directory of Open Access Journals (Sweden)

    Federico Franchi

    2013-01-01

    Full Text Available Purpose. The effects of mechanical ventilation (MV on speckle tracking echocardiography- (STE-derived variables are not elucidated. The aim of the study was to evaluate the effects of positive end-expiratory pressure (PEEP ventilation on 4-chamber longitudinal strain (LS analysis by STE. Methods. We studied 20 patients admitted to a mixed intensive care unit who required intubation for MV and PEEP titration due to hypoxia. STE was performed at three times: (T1 PEEP = 5 cmH2O; (T2 PEEP = 10 cmH2O; and (T3 PEEP = 15 cmH2O. STE analysis was performed offline using a dedicated software (XStrain MyLab 70 Xvision, Esaote. Results. Left peak atrial-longitudinal strain (LS was significantly reduced from T1 to T2 and from T2 to T3 (. Right peak atrial-LS and right ventricular-LS showed a significant reduction only at T3 (. Left ventricular-LS did not change significantly during titration of PEEP. Cardiac chambers’ volumes showed a significant reduction at higher levels of PEEP (. Conclusions. We demonstrated for the first time that incremental PEEP affects myocardial strain values obtained with STE in intubated critically ill patients. Whenever performing STE in mechanically ventilated patients, care must be taken when PEEP is higher than 10 cmH2O to avoid misinterpreting data and making erroneous decisions.

  12. Decreased Peak Expiratory Flow Associated with Muscle Fiber-Type Switching in Spinal and Bulbar Muscular Atrophy.

    Directory of Open Access Journals (Sweden)

    Shinichiro Yamada

    Full Text Available The aim of this study was to characterize the respiratory function profile of subjects with spinal and bulbar muscular atrophy (SBMA, and to explore the underlying pathological mechanism by comparing the clinical and biochemical indices of this disease with those of amyotrophic lateral sclerosis (ALS. We enrolled male subjects with SBMA (n = 40 and ALS (n = 25 along with 15 healthy control subjects, and assessed their respiratory function, motor function, and muscle strength. Predicted values of peak expiratory flow (%PEF and forced vital capacity were decreased in subjects with SBMA compared with controls. In SBMA, both values were strongly correlated with the trunk subscores of the motor function tests and showed deterioration relative to disease duration. Compared with activities of daily living (ADL-matched ALS subjects, %PEF, tongue pressure, and grip power were substantially decreased in subjects with SBMA. Both immunofluorescence and RT-PCR demonstrated a selective decrease in the expression levels of the genes encoding the myosin heavy chains specific to fast-twitch fibers in SBMA subjects. The mRNA levels of peroxisome proliferator-activated receptor gamma coactivator 1-alpha and peroxisome proliferator-activated receptor delta were up-regulated in SBMA compared with ALS and controls. In conclusion, %PEF is a disease-specific respiratory marker for the severity and progression of SBMA. Explosive muscle strength, including %PEF, was selectively affected in subjects with SBMA and was associated with activation of the mitochondrial biogenesis-related molecular pathway in skeletal muscles.

  13. Effects of ultrafine and fine particles in urban air on peak expiratory flow among children with asthmatic symptoms.

    Science.gov (United States)

    Pekkanen, J; Timonen, K L; Ruuskanen, J; Reponen, A; Mirme, A

    1997-01-01

    It has been suggested that ultrafine particles in urban air may cause the health effects associated with thoracic particles (PM10). We therefore compared the effects of daily variations in particles of different sizes on peak expiratory flow (PEF) during a 57-day follow-up of 39 asthmatic children aged 7-12 years. The main source of particulate air pollution in the area was traffic. In addition to the measurements of PM10 and black smoke (BS) concentrations, an electric aerosol spectrometer was used to measure particle number concentrations in six size classes ranging from 0.01 to 10.0 microns. Daily variations in BS and particle number concentrations in size ranges between 0.032 and 0.32 micron and between 1.0 and 10.0 microns were highly intercorrelated (correlation coefficients about 0.9). Correlations with PM10 were somewhat lower (below 0.7). All these pollutants tended also to be associated with declines in morning PEF. However, the only statistically significant associations were observed with PM10 and BS. Different time lags of PM10 were also most consistently associated with declines in PEF. Therefore, in the present study on asthmatic children, the concentration of ultrafine particles was no more strongly associated with variations in PEF than PM10 or BS, as has earlier been suggested.

  14. Anatomy of renal arterial supply.

    Science.gov (United States)

    Khamanarong, K; Prachaney, P; Utraravichien, A; Tong-Un, T; Sripaoraya, K

    2004-05-01

    A thorough knowledge of the variations of the renal artery has grown in importance with the increasing numbers of renal transplants, vascular reconstructions, and various surgical and radiologic techniques. The literature indicates that multiple renal arteries are found in 9- 76% of cadavers. The purpose of this study is to establish the incidence and characteristics of variations of renal arteries in Thais. A total of 267 Thai cadavers were dissected in the anatomy laboratory. The anatomical findings included: a single hilar artery in 82% of cases; double renal arteries in 17% of cases (one hilar artery with an upper polar artery occurred in 7%; two hilar arteries in 7%, and one hilar artery combined with one lower polar artery in 3%); and triple renal arteries occurred in 1% (two hilar arteries with one upper polar artery in 0.4% and two hilar arteries with one lower polar artery in 0.6%). In preparation for interventions, such as living renal donation, vascular reconstruction, renovascular hypertension, or radical nephrectomy, the results indicate that preoperative renal imaging is necessary and that operative techniques with attention to multiple renal arteries should be considered. Copyright 2004 Wiley-Liss, Inc.

  15. Coronary Artery Bypass Surgery

    Science.gov (United States)

    ... don't help, you may need coronary artery bypass surgery. The surgery creates a new path for ... narrowed area or blockage. This allows blood to bypass (get around) the blockage. Sometimes people need more ...

  16. Pulmonary Arterial Hypertension

    Science.gov (United States)

    Pulmonary Arterial Hypertension What Is Pulmonary Hypertension? To understand pulmonary hypertension (PH) it helps to understand how blood ows throughout your body. While the heart is one organ, it ...

  17. Coronary artery spasm

    Science.gov (United States)

    ... blocker or a long-acting nitrate long-term. Beta-blockers are another type of medicine that is used with other coronary artery problems. However, beta-blockers may make this problem worse. They should be ...

  18. Peripheral Arterial Disease

    Science.gov (United States)

    Peripheral arterial disease (PAD) happens when there is a narrowing of the blood vessels outside of your heart. The cause of ... smoking. Other risk factors include older age and diseases like diabetes, high blood cholesterol, high blood pressure, ...

  19. Arterial bypass leg - slideshow

    Science.gov (United States)

    ... presentations/100155.htm Arterial bypass leg - series—Normal anatomy To use the sharing features on this page, ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  20. Mesenteric artery ischemia

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001156.htm Mesenteric artery ischemia To use the sharing features on this page, ... be removed. Outlook (Prognosis) The outlook for chronic mesenteric ischemia is good after a successful surgery. However, it ...

  1. Carotid Artery Disease

    Science.gov (United States)

    ... heart. It also helps you lose weight, control diabetes and reduce stress. Limit alcohol. Control chronic conditions. Managing conditions such as diabetes and high blood pressure helps protect your arteries. ...

  2. High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial.

    Science.gov (United States)

    Hemmes, Sabrine N T; Gama de Abreu, Marcelo; Pelosi, Paolo; Schultz, Marcus J

    2014-08-09

    The role of positive end-expiratory pressure in mechanical ventilation during general anaesthesia for surgery remains uncertain. Levels of pressure higher than 0 cm H2O might protect against postoperative pulmonary complications but could also cause intraoperative circulatory depression and lung injury from overdistension. We tested the hypothesis that a high level of positive end-expiratory pressure with recruitment manoeuvres protects against postoperative pulmonary complications in patients at risk of complications who are receiving mechanical ventilation with low tidal volumes during general anaesthesia for open abdominal surgery. In this randomised controlled trial at 30 centres in Europe and North and South America, we recruited 900 patients at risk for postoperative pulmonary complications who were planned for open abdominal surgery under general anaesthesia and ventilation at tidal volumes of 8 mL/kg. We randomly allocated patients to either a high level of positive end-expiratory pressure (12 cm H2O) with recruitment manoeuvres (higher PEEP group) or a low level of pressure (≤2 cm H2O) without recruitment manoeuvres (lower PEEP group). We used a centralised computer-generated randomisation system. Patients and outcome assessors were masked to the intervention. Primary endpoint was a composite of postoperative pulmonary complications by postoperative day 5. Analysis was by intention-to-treat. The study is registered at Controlled-Trials.com, number ISRCTN70332574. From February, 2011, to January, 2013, 447 patients were randomly allocated to the higher PEEP group and 453 to the lower PEEP group. Six patients were excluded from the analysis, four because they withdrew consent and two for violation of inclusion criteria. Median levels of positive end-expiratory pressure were 12 cm H2O (IQR 12-12) in the higher PEEP group and 2 cm H2O (0-2) in the lower PEEP group. Postoperative pulmonary complications were reported in 174 (40%) of 445 patients in the higher

  3. A middle mesenteric artery

    OpenAIRE

    Milnerowicz, Stanislaw; Milnerowicz, Artur; Taboła, Renata

    2012-01-01

    In 114 cases of the transverse colon isolated from cadavers (50 male, 64 female), anatomical examinations of the arterial system of the colon were performed. Arteriograms were obtained after dissecting and contrasting the colonic vessels with Mixobar contrast. In one case, on arteriography of the colon with its mesentery isolated from a 55-year-old male cadaver, a rare anatomical variant was found. The third mesenteric artery originated directly from the aorta—halfway between the superior and...

  4. Coronary artery fistulas

    Directory of Open Access Journals (Sweden)

    V. M. Subbotin

    2015-01-01

    Full Text Available Coronary artery fistulas are classified as abnormalities of termination and referred to as major congenital anomalies. Most coronary artery fistulas are small, unaccompanied by clinical symptoms, and diagnosed by echocardiography or coronarography performed for an unrelated cause. Such fistulas usually do not cause any complications and can spontaneously resolve. However, larger fistulas are usually >3 tones the size of a normal caliber of a coronary artery and may give rise to clinical symptoms in these cases. The clinical symptoms of coronary artery fistulas may mimic those of various heart diseases depending on which chamber a fistula drains into. Most fistulas are congenital. Congenital coronary artery fistulas may occur as an isolated malformation or be concurrent with other cardiac anomalies, more frequently with critical pulmonary stenosis or atresia with an intact interventricular septum and pulmonary stenoses, Fallot's tetralogy, aortic coarctation, and left heart hypoplasia. When choosing a treatment modality, one should take into account the number of fistula communications, the feeding vessel, localization of drainage, degree of myocardial damage, and hemodynamic relevance of the shunt caused by the presence of a fistula. The goal of treatment is to obliterate a fistula by preserving normal coronary blood flow. The risk for persisting fistula should be balanced with the potential risk of complications related to a procedure of coronarography and fistula occlusion. Percutaneous transcatheter coil occlusion of coronary artery fistulas is the modality of choice in children with the suitable anatomy of fistula communications and without concomitant congenital heart diseases.

  5. Effects of Hemibridge with Ball and Balloon Exercise on Forced Expiratory Volume and Pain in Patients with Chronic Low Back Pain: An Experimental Study

    OpenAIRE

    Jorida Fernandes; Akshay Chougule

    2017-01-01

    Background and objectives: Suboptimal breathing patterns and impairments of posture and trunk stability are often associated with musculoskeletal complaints such as low back pain. Respiration is also affected by poor neuromuscular control of core muscles. Immediate effects of hemibridge with ball and balloon exercise has been studied on chronic pain in athlete population. Objective: To evaluate the effects of hemibridge with ball and balloon exercise on pain, forced expiratory volume and func...

  6. Comparative effects of helium-oxygen and external positive end-expiratory pressure on respiratory mechanics, gas exchange, and ventilation-perfusion relationships in mechanically ventilated patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Jolliet, Philippe; Watremez, Christine; Roeseler, Jean; Ngengiyumva, J C; de Kock, Marc; Clerbaux, Thierry; Tassaux, Didier; Reynaert, Marc; Detry, Bruno; Liistro, Giuseppe

    2003-09-01

    To compare the effects of He/O(2) and external PEEP (PEEPe) on intrinsic PEEP (PEEPi), respiratory mechanics, gas exchange, and ventilation/perfusion (V(A)/Q) in mechanically ventilated COPD patients. Prospective, interventional study in the intensive care unit of a university hospital. Ten intubated, sedated, paralyzed, mechanically ventilated COPD patients studied in the following conditions: (a) baseline settings made by clinician in charge, air/O(2), ZEEP; (b) He/O(2), ZEEP; (c) air/O(2), ZEEP; (d) air/O(2), PEEPe 80% of PEEPi. Measurements at each condition included V(A)/Q by the multiple inert gas elimination technique (MIGET). PEEPi and trapped gas volume were comparably reduced by He/O(2) (4.2+/-4 vs. 7.7+/-4 cmH(2)O and 98+/-82 vs. 217+/-124 ml, respectively) and PEEPe (4.4+/-1.3 vs. 7.8+/-3.6 cmH(2)O and 120+/-107 vs. 216+/-115 ml, respectively). He/O(2) reduced inspiratory and expiratory respiratory system resistance (15.5+/-4.4 vs. 20.7+/-6.9 and 19+/-9 vs. 28.8+/-15 cmH(2)O l(-1)s(-1), respectively) and plateau pressure (13+/-4 vs. 17+/-6 cmH(2)O). PEEPe increased airway pressures, including total PEEP, and elastance. PaO(2)/FIO(2) was slightly reduced by He/O(2) (225+/-83 vs. 245+/-82) without significant V(A)/Q change. He/O(2) and PEEPe comparably reduced PEEPi and trapped gas volume. However, He/O(2) decreased airway resistance and intrathoracic pressures, at a small cost in arterial oxygenation. He/O(2) could offer an attractive option in COPD patients with PEEPi/dynamic hyperinflation.

  7. Correlation between the findings of expiratory high resolution computed tomography, respiratory function tests and tracheal index in chronic obstructive pulmonary disease

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    Meral Uyar

    2012-03-01

    Full Text Available Objectives: In this study we aimed to investigate the relationship between expiratory HRCT findings, tracheal index (TI and pulmonary function tests in patients with chronic obstructive pulmonary disease (COPD.Materials and methods: Sixty patients diagnosed with COPD in our hospital, department of pulmonary medicine, and 65 subjects complaining of cough with normal pulmonary function tests as a control group were enrolled in the study. All subjects were evaluated with HRCT. HRCT and pulmonary function tests were performed in same day and FEV1, FVC, FEV1/FVC values were recorded. Pearson Chi-Square, Independent Samples T test, and Mann Whitney U test were used for statistical evaluation.Results: Subjects’ mean age was 55.44±10.22 years. Bronchiectasis, bronchial wall thickening, emphysema, centrilobular bronchiolar thickening and air trapping were significantly higher in COPD group than control group. In patient group, TI values were lower than control group (p < 0.001. Also there was moderate negative relationship between TI and age (p = 0.00, r = -0.48.Conclusions: Expiratory HRCT findings and TI values show various degrees of relationship with pulmonary function test results in patients with COPD. Despite normal pulmonary function tests, pathological changes can be detected in expiratory HRCT scans

  8. CORRELATION OF SEVERITY OF APNOEA HYPOPNOEA INDEX (AHI WITH FORCED EXPIRATORY VOLUME 1 (FEV1 IN OVERLAP SYNDROME

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    Meenakshi Narasimhan

    2017-08-01

    Full Text Available BACKGROUND Overlap syndrome was first described by David Flenley in 1980 refers to the coexistence of Chronic Obstructive Pulmonary Disease (COPD and Obstructive Sleep Apnoea (OSA. The global prevalence of Overlap syndrome is 11-14% and 7.5% in India Overlap patients are at higher risk of developing Nocturnal desaturations, hypertension, congestive heart failure, stroke etc. resulting in greater mortality and morbidity. There are very few studies in India correlating factors like poor lung function, body mass index, high ESS score, MMRC dyspnea grading in COPD patients with OSA .Hence, this study was undertaken to correlate the association and severity of OSA using AHI with Forced Expiratory Volume in 1 sec (FEV1, Body Mass Index (BMI, Modified Medical Research Council dyspnea grade (MRC and high Epworth Sleepiness Scale (ESS. MATERIALS AND METHODS A prospective observational study, done in 66 COPD patients in Department of Respiratory Medicine, CHRI, Chennai. The diagnosis of COPD was based upon GOLD guidelines 2016. The OSA was diagnosed based on the American Academy of Sleep Medicine guidelines (AASMA. All COPD patients were subjected to detailed clinical history, thorough physical examination, ENT examination to rule out Upper airway obstruction. All patients were asked to fill up the Epworth sleepiness questionnaire. BMI was recorded. Dyspnea grading was done using MMRC scale. Patient was also subjected to Spirometry and overnight Polysomnography, RESULTS In patients with overlap syndrome, no correlation of statistical significance between the AHI and FEV1. Though, the grade of AHI showed an increase as the FEV1 decreased. Significant positive correlation was observed between AHI and MMRC as well as AHI and ESS. CONCLUSION In COPD patients FEV1 did not correlate with AHI grade and hence lung function cannot be used as predictor of OSA in COPD. However, simple clinical parameters like ESS and MMRC which show a positive correlation with AHI

  9. Effect of hourly concentration of particulate matter on peak expiratory flow in hospitalized children: A panel study

    Science.gov (United States)

    2011-01-01

    Background Little information is available on the possible association between hourly short-term air pollution and peak expiratory flow (PEF) in asthmatic children. Methods PEF was measured twice daily, from October through December, 2000, in 17 children aged 8 to 15 years hospitalized with severe asthma. A total of 1198 PEF measurements were made at 7 a.m. and 1175 at 7 p.m. Measurements were conducted immediately prior to medication under the guidance of trained nurses. PEF changes were estimated in 10-μg/m3 increments of particulate matter with a 50% cut-off aerodynamic diameter of ≤2.5 μm (PM2.5), with adjustment for sex, age, height, and temperature. Lagged-hour exposures of up to 24 hours were examined. Results Increased 24-hour mean concentration of PM2.5 was associated with a decrease in both morning and evening PEF (-3.0 l/minute; 95%CI: -4.6, -1.4 and -4.4 l/minute; 95%CI: -7.1, -1.7, respectively). In addition, hourly concentrations of PM2.5 and PEF showed a significant association between some lags of PM2.5 and PEF. Effect size was almost -3 l/minute in both morning and evening PEF for an hourly PM2.5 concentration of 10 μg/m3 in several lags. Even after adjustment for other air pollutants, some of the significant associations with PEF remained. Conclusion Among hospitalized children with severe asthma, increased hourly concentration of PM2.5 was associated with a decrease in PEF. PMID:21392385

  10. Is there an optimal level of positive expiratory pressure (PEP) to improve walking tolerance in patients with severe COPD?

    Science.gov (United States)

    Russo, Davide; Simonelli, Carla; Paneroni, Mara; Saleri, Manuela; Piroddi, Ines Maria Grazia; Cardinale, Francesco; Vitacca, Michele; Nicolini, Antonello

    2016-07-01

    The application of positive expiratory pressure (PEP) devices during exercise had been proposed in order to counteract the pulmonary hyperinflation, reduce the dyspnea and thus increase the exercise tolerance in patients with severe chronic obstructive pulmonary disease (COPD). This randomized controlled crossover trial investigated the effect of two different levels of PEP (1 cmH2O and 10 cmH2O) on distance covered at 6minute walk test (6MWT) in patients with severe COPD. Secondary outcomes were the evaluation of PEP effects on physiological and pulmonary function variables. Seventy-two severe COPD patients, referred to our hospitals as in and out patients, were recruited. A basal 6MWT without devices was performed on the first day, and then repeated with PEP 1 cmH2O (PEP1) and 10 cmH2O (PEP10), with a randomized crossover design. Slow and forced spirometries, including the inspiratory capacity measure, were repeated before and after each 6MWT. 50 patients (average age 69,92 year, mean FEV1 41,42% of predicted) concluded the trial. The 6MWT improved significantly among both PEP levels and baseline (323,8 mt at baseline vs. 337,8 PEP1 and 341,8 PEP10; p<.002 and p<.018, respectively). The difference between PEP10 and PEP1 did not reach the significance. No improvements were found in pulmonary function, symptoms and physiological variables after the 6MWT. In patients with severe COPD, the application of 1 cmH2O of PEP seems to improve the exercise tolerance as 10 cmH2O, with similar dyspnea. Further studies should investigate the effects of low levels of PEP on aerobic training programs. Copyright © 2016 SEPAR. Published by Elsevier Espana. All rights reserved.

  11. Increasing positive end-expiratory pressure (re-)improves intraoperative respiratory mechanics and lung ventilation after prone positioning.

    Science.gov (United States)

    Spaeth, J; Daume, K; Goebel, U; Wirth, S; Schumann, S

    2016-06-01

    Turning a patient prone, changes the respiratory mechanics and potentially the level of positive end-expiratory pressure (PEEP) that is necessary to prevent alveolar collapse. In this prospective clinical study we examined the impact of PEEP on the intratidal respiratory mechanics and regional lung aeration in the prone position. We hypothesized that a higher PEEP is required to maintain compliance and regional ventilation in the prone position. After ethical approval, 45 patients with healthy lungs undergoing lumbar spine surgery were examined in the supine position at PEEP 6 cm H2O and in the prone position at PEEP (6, 9 and 12 cm H2O). Dynamic compliance (CRS) and intratidal compliance-volume curves were determined and regional ventilation was measured using electrical impedance tomography. The compliance-volume curves were classified to indicate intratidal derecruitment, overdistension, or neither. CRS did not differ between postures and PEEP levels (P>0.28). At a PEEP of 6 cm H2O a compliance-volume profile indicating neither derecruitment nor overdistension was observed in 38 supine, but only in 20 prone positioned patients (Pventilation significantly. Respiratory system mechanics change substantially between supine and prone posture, which is not demonstrated in routine measurements. The intratidal compliance analysis suggests that in most patients a PEEP above commonly used settings is necessary to avoid alveolar collapse in the prone position. DRKS 00005692. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Effects of positive expiratory pressure on pulmonary clearance of aerosolized technetium-99m-labeled diethylenetriaminepentaacetic acid in healthy individuals

    Directory of Open Access Journals (Sweden)

    Isabella Martins de Albuquerque

    Full Text Available ABSTRACT Objective: To evaluate the effects of positive expiratory pressure (PEP on pulmonary epithelial membrane permeability in healthy subjects. Methods: We evaluated a cohort of 30 healthy subjects (15 males and 15 females with a mean age of 28.3 ± 5.4 years, a mean FEV1/FVC ratio of 0.89 ± 0.14, and a mean FEV1 of 98.5 ± 13.1% of predicted. Subjects underwent technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA radioaerosol inhalation lung scintigraphy in two stages: during spontaneous breathing; and while breathing through a PEP mask at one of three PEP levels-10 cmH2O (n = 10, 15 cmH2O (n = 10, and 20 cmH2O (n = 10. The 99mTc-DTPA was nebulized for 3 min, and its clearance was recorded by scintigraphy over a 30-min period during spontaneous breathing and over a 30-min period during breathing through a PEP mask. Results: The pulmonary clearance of 99mTc-DTPA was significantly shorter when PEP was applied-at 10 cmH2O (p = 0.044, 15 cmH2O (p = 0.044, and 20 cmH2O (p = 0.004-in comparison with that observed during spontaneous breathing. Conclusions: Our findings indicate that PEP, at the levels tested, is able to induce an increase in pulmonary epithelial membrane permeability and lung volume in healthy subjects.

  13. Computer quantification of "angle of collapse" on maximum expiratory flow volume curve for diagnosing asthma-COPD overlap syndrome.

    Science.gov (United States)

    Wang, Wei; Xie, Mengshuang; Dou, Shuang; Cui, Liwei; Xiao, Wei

    2016-01-01

    In a previous study, we demonstrated that asthma patients with signs of emphysema on quantitative computed tomography (CT) fulfill the diagnosis of asthma-COPD overlap syndrome (ACOS). However, quantitative CT measurements of emphysema are not routinely available for patients with chronic airway disease, which limits their application. Spirometry was a widely used examination tool in clinical settings and shows emphysema as a sharp angle in the maximum expiratory flow volume (MEFV) curve, called the "angle of collapse (AC)". The aim of this study was to investigate the value of the AC in the diagnosis of emphysema and ACOS. This study included 716 participants: 151 asthma patients, 173 COPD patients, and 392 normal control subjects. All the participants underwent pulmonary function tests. COPD and asthma patients also underwent quantitative CT measurements of emphysema. The AC was measured using computer models based on Matlab software. The value of the AC in the diagnosis of emphysema and ACOS was evaluated using receiver-operating characteristic (ROC) curve analysis. The AC of COPD patients was significantly lower than that of asthma patients and control subjects. The AC was significantly negatively correlated with emphysema index (EI; r=-0.666, P<0.001), and patients with high EI had a lower AC than those with low EI. The ROC curve analysis showed that the AC had higher diagnostic efficiency for high EI (area under the curve =0.876) than did other spirometry parameters. In asthma patients, using the AC ≤137° as a surrogate criterion for the diagnosis of ACOS, the sensitivity and specificity were 62.5% and 89.1%, respectively. The AC on the MEFV curve quantified by computer models correlates with the extent of emphysema. The AC may become a surrogate marker for the diagnosis of emphysema and help to diagnose ACOS.

  14. The effects of parental smoking on anthropometric parameters, peak expiratory flow rate and physical condition in school children.

    Science.gov (United States)

    Pavić, Ivan; Jurica, Sonja Anić; Pavić, Pero; Bogović, Jasna Cepin; Krmek, Martina; Dodig, Slavica

    2014-03-01

    Passive smoking in children is a considerable health problem, mainly arising from parental smoking. The objectives of the present cross-sectional study were to assess the impact of passive smoking on 1) anthropometric parameters; 2) peak expiratory flow rate (PEFR); and 3) physical condition in school children. The target population included 177 children attending elementary school 5th to 8th grade. Study subjects were divided into two groups according to parental smoking habits. Body weight and height were determined using a digital weighing scale and digital stadiometer; PEFR was measured between 8 a.m. and 10 a.m. using a Peak Flow Meter; and physical condition was assessed by the 6-minute run test. Sixty-six percent of study children were exposed to passive smoking. The children of smoking parents had higher BMI [18.79 (17.50-21.13) kg/m2] than children of nonsmoking parents [17.90 (16.00-20.00) kg/m2; p = 0.036]. There was no statistically significant difference in body height and weight. The children of smoking parents had statistically lower values of PEFR [M(IQR) = 84 (78-88)%, M(IQR) = 94 (89-101)%, respectively; p children of nonsmoking parents [M(IQR) = 2(1-3), M(IQR) = 4(3-5); respectively; p children to passive smoking by their parents resulted in an increase of BMI, impairment of lung function, and impairment of physical condition, especially in children of both smoking parents.

  15. A fully automated approach for baby cry signal segmentation and boundary detection of expiratory and inspiratory episodes.

    Science.gov (United States)

    Abou-Abbas, Lina; Tadj, Chakib; Fersaie, Hesam Alaie

    2017-09-01

    The detection of cry sounds is generally an important pre-processing step for various applications involving cry analysis such as diagnostic systems, electronic monitoring systems, emotion detection, and robotics for baby caregivers. Given its complexity, an automatic cry segmentation system is a rather challenging topic. In this paper, a framework for automatic cry sound segmentation for application in a cry-based diagnostic system has been proposed. The contribution of various additional time- and frequency-domain features to increase the robustness of a Gaussian mixture model/hidden Markov model (GMM/HMM)-based cry segmentation system in noisy environments is studied. A fully automated segmentation algorithm to extract cry sound components, namely, audible expiration and inspiration, is introduced and is grounded on two approaches: statistical analysis based on GMMs or HMMs classifiers and a post-processing method based on intensity, zero crossing rate, and fundamental frequency feature extraction. The main focus of this paper is to extend the systems developed in previous works to include a post-processing stage with a set of corrective and enhancing tools to improve the classification performance. This full approach allows to precisely determine the start and end points of the expiratory and inspiratory components of a cry signal, EXP and INSV, respectively, in any given sound signal. Experimental results have indicated the effectiveness of the proposed solution. EXP and INSV detection rates of approximately 94.29% and 92.16%, respectively, were achieved by applying a tenfold cross-validation technique to avoid over-fitting.

  16. Effect of bedding control on amount of house dust mite allergens, asthma symptoms, and peak expiratory flow rate.

    Science.gov (United States)

    Lee, Inn-Sook

    2003-04-30

    This quasi-experimental study was designed to investigate the effect of bedding control on the amount of house dust mite (HDM) allergens, asthma symptoms, and peak expiratory flow rate (PEFR) in asthmatics sensitive to HDMs. The subjects in the study were drawn from patients receiving treatment at the allergy clinics of three university-affiliated hospitals in Seoul. Forty-two patients without prior practice of the bedding control used in this study were selected. They commonly showed bronchial asthma caused by HDMs, and exhibited strong positive points (more than 3 points) in skin prick test (D. farinae, D. pteronyssinus), and positive response in both fluoro-allergosorbent test (FAST), and PC20 methacholine test. Of the subjects, alternatively, 22 were assigned to the experimental group and 20 to control group. Bedding control consisted of the use of outer cotton covers, boiling them for 10 minutes fortnightly, and disinfecting bedding by sunlight fortnightly. The experimental group was under bedding control for 4 weeks. The data were collected from October 2000 to January 2001. The results were as follows: 1. After bedding control, the total amount of HDM allergens decreased significantly in the experimental group. However there was no significant difference in the decrease of the amount of HDM allergens between the two groups. 2. Of the asthma symptoms, there was significant difference only in the decrease of the frequency of dyspnea, and in the increase of sleeping disturbance between the two groups after bedding control. 3. After bedding control, PEFR increased in the experimental group whereas it decreased in the control group. However, neither change was significant. The above findings indicate that bedding control improved several asthma symptoms in asthmatics sensitive to HDMs. Accordingly, we suggest that bedding control is adopted as a useful nursing intervention in the field.

  17. Peripheral chemoreceptors tune inspiratory drive via tonic expiratory neuron hubs in the medullary ventral respiratory column network.

    Science.gov (United States)

    Segers, L S; Nuding, S C; Ott, M M; Dean, J B; Bolser, D C; O'Connor, R; Morris, K F; Lindsey, B G

    2015-01-01

    Models of brain stem ventral respiratory column (VRC) circuits typically emphasize populations of neurons, each active during a particular phase of the respiratory cycle. We have proposed that "tonic" pericolumnar expiratory (t-E) neurons tune breathing during baroreceptor-evoked reductions and central chemoreceptor-evoked enhancements of inspiratory (I) drive. The aims of this study were to further characterize the coordinated activity of t-E neurons and test the hypothesis that peripheral chemoreceptors also modulate drive via inhibition of t-E neurons and disinhibition of their inspiratory neuron targets. Spike trains of 828 VRC neurons were acquired by multielectrode arrays along with phrenic nerve signals from 22 decerebrate, vagotomized, neuromuscularly blocked, artificially ventilated adult cats. Forty-eight of 191 t-E neurons fired synchronously with another t-E neuron as indicated by cross-correlogram central peaks; 32 of the 39 synchronous pairs were elements of groups with mutual pairwise correlations. Gravitational clustering identified fluctuations in t-E neuron synchrony. A network model supported the prediction that inhibitory populations with spike synchrony reduce target neuron firing probabilities, resulting in offset or central correlogram troughs. In five animals, stimulation of carotid chemoreceptors evoked changes in the firing rates of 179 of 240 neurons. Thirty-two neuron pairs had correlogram troughs consistent with convergent and divergent t-E inhibition of I cells and disinhibitory enhancement of drive. Four of 10 t-E neurons that responded to sequential stimulation of peripheral and central chemoreceptors triggered 25 cross-correlograms with offset features. The results support the hypothesis that multiple afferent systems dynamically tune inspiratory drive in part via coordinated t-E neurons. Copyright © 2015 the American Physiological Society.

  18. Low Variability in Peak Expiratory Flow Predicts Successful Inhaled Corticosteroid Step-Down in Adults with Asthma.

    Science.gov (United States)

    Tsurikisawa, Naomi; Oshikata, Chiyako; Sato, Toshio; Kimura, Goro; Mizuki, Masami; Tsuburai, Takahiro; Shoji, Shunsuke; Saito, Hiroshi; Shimoda, Terufumi

    2017-12-06

    The prognosis for patients beyond 1 year after reduction of their inhaled corticosteroid (ICS) dose remains unknown. Predictive factors that can be evaluated before the initiation of asthma treatment or at ICS dose reduction are unknown. We prospectively studied 223 patients in 6 hospitals in the National Hospital Organization of Japan during the 36 months after 50% reduction of their daily ICS dose. All patients recorded their morning and evening peak expiratory flows (PEFs) in their diaries. Lung function, bronchial hyperresponsiveness, fractional nitric oxide levels, number of eosinophils in sputum, and serum IgE levels were measured in most patients. Serum levels of IL-10, IL-33, and thymic stromal lymphopoietin before ICS dose reduction were measured in all patients. During the 36-month study period, asthma control was retained in 127 (59.6%) of the 213 enrolled patients who underwent ICS dose reduction. Multivariate logistic regression analysis revealed that, at the initiation of dose reduction, the factors most predictive of maintenance of asthma control after ICS dose reduction were a low serum IL-33 level (P < .01), low PEF variability over 1 week (P = .014), childhood onset of asthma (at age <10 years) (P = .03), and high serum IL-10 level (P = .035). We demonstrated that low PEF variability over 1 week, high serum IL-10 level, and low serum IL-33 concentration were useful factors for predicting that an adult's asthma will remain in control for months to years after a 50% reduction in the daily ICS dose. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  19. Endovascular uterine artery interventions

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    Chandan J Das

    2017-01-01

    Full Text Available Percutaneous vascular embolization plays an important role in the management of various gynecologic and obstetric abnormalities. Transcatheter embolization is a minimally invasive alternative procedure to surgery with reduced morbidity and mortality, and preserves the patient's future fertility potential. The clinical indications for transcatheter embolization are much broader and include many benign gynecologic conditions, such as fibroid, adenomyosis, and arteriovenous malformations (AVMs, as well as intractable bleeding due to inoperable advanced-stage malignancies. The most well-known and well-studied indication is uterine fibroid embolization. Uterine artery embolization (UAE may be performed to prevent or treat bleeding associated with various obstetric conditions, including postpartum hemorrhage (PPH, placental implantation abnormality, and ectopic pregnancy. Embolization of the uterine artery or the internal iliac artery also may be performed to control pelvic bleeding due to coagulopathy or iatrogenic injury. This article discusses these gynecologic and obstetric indications for transcatheter embolization and reviews procedural techniques and outcomes.

  20. Endovascular uterine artery interventions

    Science.gov (United States)

    Das, Chandan J; Rathinam, Deepak; Manchanda, Smita; Srivastava, D N

    2017-01-01

    Percutaneous vascular embolization plays an important role in the management of various gynecologic and obstetric abnormalities. Transcatheter embolization is a minimally invasive alternative procedure to surgery with reduced morbidity and mortality, and preserves the patient's future fertility potential. The clinical indications for transcatheter embolization are much broader and include many benign gynecologic conditions, such as fibroid, adenomyosis, and arteriovenous malformations (AVMs), as well as intractable bleeding due to inoperable advanced-stage malignancies. The most well-known and well-studied indication is uterine fibroid embolization. Uterine artery embolization (UAE) may be performed to prevent or treat bleeding associated with various obstetric conditions, including postpartum hemorrhage (PPH), placental implantation abnormality, and ectopic pregnancy. Embolization of the uterine artery or the internal iliac artery also may be performed to control pelvic bleeding due to coagulopathy or iatrogenic injury. This article discusses these gynecologic and obstetric indications for transcatheter embolization and reviews procedural techniques and outcomes. PMID:29379246

  1. Ruptured jejunal artery aneurysm

    Science.gov (United States)

    Costa, Sílvia; Costa, Alexandre; Pereira, Tiago; Maciel, Jorge

    2013-01-01

    Visceral artery aneurysms (VAAs), unlike aortic aneurysms, are very rare, but are also a potentially lethal vascular disease. Jejunal artery aneurysms only account for less than 3% of VAAs, but have a 30% risk of rupture, with 20% death rate, presenting with only few and vague symptoms. We report the case of a 76-year-old man presenting at the emergency department (ED) with a crampy epigastric pain and vomiting. An ultrasound performed diagnosed free abdominal fluid and immediate CT scan diagnosed jejunal artery aneurysm spontaneously rupturing, followed by hypovolaemic shock. Emergent surgery was undertaken, and aneurysmectomy, followed by partial enterectomy with primary anastomosis were performed, because of segmentary jejunal ischaemia. The patient's recovery was unremarkable. High level of suspicion, rapid diagnosis capability and prompt surgical or endovascular intervention, as well as an effective teamwork in the ED are critical to avoid the devastating consequences of ruptured VAAs. PMID:23771962

  2. Peak expiratory flow, breath rate and blood pressure in adults with changes in particulate matter air pollution during the Beijing Olympics: a panel study.

    Science.gov (United States)

    Mu, Lina; Deng, Furong; Tian, Lili; Li, Yanli; Swanson, Mya; Ying, Jingjing; Browne, Richard W; Rittenhouse-Olson, Kate; Zhang, Junfeng Jim; Zhang, Zuo-Feng; Bonner, Matthew R

    2014-08-01

    This study aims to examine whether changes in short-term exposures to particulate matter are associated with changes in lung function, breath rate, and blood pressure among healthy adults and whether smoking status modifies the association. We took advantage of the artificially controlled changes in air pollution levels that occurred during the 2008 Olympic Games in Beijing, China and conducted a panel study of 201 Beijing residents. Data were collected before, during, and after the Olympics, respectively. Linear mixed-effect models and generalized estimating equation models were used to compare measurements of peak expiratory flow, breath rate and blood pressure across three time points. The mean values of peak expiratory flow were 346.0 L/min, 399.3 L/min, and 364.1L/min over the three study periods. Peak expiratory flow levels increased in 78% of the participants when comparing the during- with pre- Olympics time points, while peak expiratory flow levels decreased in 80% of participants for the post- and during-Olympic periods comparison. In subgroup analyses comparing the during-Olympic to pre-Olympic time points, we found a larger percentage change in peak expiratory flow (+17%) among female, younger and non-smoking participants than among male, elderly and smoking participants (+12%). The percentage of participants with a fast breath rate (>20/min) changed from 9.7% to 4.9% to 30.1% among females, and from 7.9% to 2.6% to 27.3% among males over the three time points. The changes in blood pressure over the three study periods were not very clear, although there is an increase in diastolic pressure and a decrease in pulse pressure among males during the games. The results suggest that exposure to different air pollution levels has significant effects on respiratory function. Smoking, age and gender appear to modify participants' biological response to changes in air quality. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Superficial Femoral Artery Intervention by Single Transpedal Arterial Access.

    Science.gov (United States)

    Amoroso, Nicholas S; Shah, Sooraj; Liou, Michael; Ratcliffe, Justin; Lala, Moinakhtar; Diwan, Ravi; Huang, Yili; Rosero, Hugo; Coppola, John; Bertrand, Olivier F; Kwan, Tak W

    2015-11-01

    Atherosclerotic disease of the superficial femoral artery (SFA) is frequently seen and can be treated with percutaneous interventions, traditionally via femoral artery access. There are limited reports of transpedal artery access for peripheral artery interventions, but none to date describing routine primary transpedal artery approach for SFA stenting. In this preliminary study, we report 4 patients who underwent successful endovascular SFA stenting using a single transpedal artery access via a new ultra-low profile 6 Fr sheath (Glidesheath Slender; Terumo Corporation). All patients underwent successful SFA stenting without complication. Procedure time varied from 51 to 72 minutes. The mean contrast amount used was 56 mL; mean fluoroscopy time was 21 minutes; mean radiation dose was 91 mGy. At 1-month follow-up, duplex ultrasonography showed that all pedal arteries had remained patent. Transpedal artery approach as a primary approach to SFA stenting appears feasible and safe. Comparative trials with standard percutaneous femoral approach are warranted.

  4. Isolated celiac artery dissection.

    Science.gov (United States)

    DiMusto, Paul D; Oberdoerster, Molly M; Criado, Enrique

    2015-04-01

    Spontaneous celiac artery dissection is rare, and its natural history is not well studied. The objective of this study was to review our experience with the evaluation and management of this condition. During the last 8 years, 19 patients (14 men, five women) presented with the diagnosis of spontaneous celiac artery dissection. Each patient's clinical course was retrospectively reviewed, and patients were contacted for assessment of current symptoms. All patients had computed tomography scans documenting a celiac artery dissection without concomitant aortic dissection. Ages ranged from 39 to 76 years. Seven patients presented with abdominal pain, and 12 were diagnosed incidentally. All patients were initially treated with observation because none had threatened end organs. Patients presenting with aspirin or clopidogrel therapy were continued on these medications, but no patients were prescribed any medications due to their dissection. Three patients continued to have abdominal pain and eventually underwent celiac artery stenting. Pain improved after the intervention in all three. One patient with aneurysmal degeneration of the celiac artery underwent surgical repair. No other patients required intervention. Eighteen patients had follow-up within a year of data collection in the clinic or over the phone. The average time from the initial diagnosis to follow-up for the entire cohort was 46 months. None had abdominal or back pain related to the celiac dissection, had lost weight, or had to change their eating habits. Celiac artery dissection can be safely managed initially with observation. If abdominal pain is persistent, endovascular stenting may stabilize or improve the pain, and surgical reconstruction can be done for aneurysmal degeneration or occlusion, both unusual events. Long-term anticoagulation does not appear necessary in these patients. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  5. Popliteal Artery Entrapment Syndrome

    DEFF Research Database (Denmark)

    Altintas, Ümit; Helgstrand, Ulf Johan Vilhelm; Hansen, Marc A

    2013-01-01

    The purpose of this study was to report our experience with popliteal artery entrapment syndrome (PAES) with special emphasis on the applicability of duplex ultrasound scanning (DUS) when diagnosing PAES. In addition to examining the correlation between DUS and intraoperative findings in symptoma......The purpose of this study was to report our experience with popliteal artery entrapment syndrome (PAES) with special emphasis on the applicability of duplex ultrasound scanning (DUS) when diagnosing PAES. In addition to examining the correlation between DUS and intraoperative findings...

  6. Carotid artery stenting; Karotisangioplastie

    Energy Technology Data Exchange (ETDEWEB)

    Fiehler, Jens [Universitaetsklinikum Eppendorf, Hamburg (Germany). Klinik und Poliklinik fuer Neuroradiologische Diagnostik und Intervention, Diagnostikzentrum

    2009-09-15

    An ipsilateral stenosis of the internal carotid artery is found in 10 - 15 % of all ischemic strokes and indicates an increased risk of a second stroke. Carotid artery stenting (CAS) is a therapy that is established for many years. CAS reveals complication rates and long-term efficacy comparable to carotid endarterectomy (TEA). Especially younger patients seem to benefit from CAS. Abilities and experiences of the therapist and the choice of the techniques used are critical for patient safety. The efficacy of CAS for treatment of asymptomatic carotid stenosis is probable but still unproven in prospective-randomized trial. (orig.)

  7. Location of the internal carotid artery and ophthalmic artery ...

    African Journals Online (AJOL)

    Yasin Hamarat

    2017-10-06

    Oct 6, 2017 ... There are some published results of OA anatomical studies [18,20-22]. .... right eye) and the depth of intracranial segment of ophthal- mic artery ... internal carotid artery and segments of ophthalmic artery in high tension glaucoma patients. No. of glaucoma patients. Eye. ICA edge, mm. IOA, mm. EOA, mm.

  8. Pulmonary arterial hypertension in children after neonatal arterial switch operation

    NARCIS (Netherlands)

    Zijlstra, Willemijn MH; Elmasry, Ola; Pepplinkhuizen, Shari; Ivy, D Dunbar; Bonnet, Damien; Lévy, Marilyne; Gavilan, Jose Luis; Torrent-Vernetta, Alba; Mendoza, Alberto; Del Cerro, Maria Jesus; Moledina, Shahin; Berger, Rolf M. F.

    OBJECTIVES: Paediatric pulmonary arterial hypertension (PAH) after neonatal arterial switch operation (ASO) for transposition of the great arteries (TGA) is a clinically recognised entity with an estimated incidence of 0.6%-1.0%. Nevertheless, a clinical characterisation is lacking. We present an

  9. A rare case of Cystic artery arising from Gastroduodenal artery ...

    African Journals Online (AJOL)

    An uncommon anatomical variation in the origin and course of cystic artery was found during human cadaveric dissection in our laboratory. A blood vessel was seen arising from the gastroduodenal artery about 1 cm distal to its origin from the common hepatic artery. The vessel when traced towards its termination was found ...

  10. Validation of brachial artery pressure reconstruction from finger arterial pressure

    NARCIS (Netherlands)

    Guelen, Ilja; Westerhof, Berend E.; van der Sar, Gertrude L.; van Montfrans, Gert A.; Kiemeneij, Ferdinand; Wesseling, Karel H.; Bos, Willem Jan W.

    2008-01-01

    Objective Measurement of finger artery pressure with Finapres offers noninvasive continuous blood pressure, which, however, differs from brachial artery pressure. Generalized waveform filtering and level correction may convert the finger artery pressure waveform to a brachial waveform. An upper-arm

  11. Screening for Carotid Artery Stenosis

    Science.gov (United States)

    Understanding Task Force Recommendations Screening for Carotid Artery Stenosis The U.S. Preventive Services Task Force (Task Force) ... final recommendation statement on Screening for Carotid Artery Stenosis. This final recommendation statement applies to adults who ...

  12. Pharmacological modulation of arterial stiffness.

    LENUS (Irish Health Repository)

    Boutouyrie, Pierre

    2011-09-10

    Arterial stiffness has emerged as an important marker of cardiovascular risk in various populations and reflects the cumulative effect of cardiovascular risk factors on large arteries, which in turn is modulated by genetic background. Arterial stiffness is determined by the composition of the arterial wall and the arrangement of these components, and can be studied in humans non-invasively. Age and distending pressure are two major factors influencing large artery stiffness. Change in arterial stiffness with drugs is an important endpoint in clinical trials, although evidence for arterial stiffness as a therapeutic target still needs to be confirmed. Drugs that independently affect arterial stiffness include antihypertensive drugs, mostly blockers of the renin-angiotensin-aldosterone system, hormone replacement therapy and some antidiabetic drugs such as glitazones. While the quest continues for \\'de-stiffening drugs\\

  13. Effect of charge quantity on conduction mechanism of high- and low-resistance states during forming process in a one-transistor-one-resistor resistance random access memory

    Science.gov (United States)

    Wu, Cheng-Hsien; Chang, Ting-Chang; Tsai, Tsung-Ming; Chang, Kuan-Chang; Chu, Tian-Jian; Pan, Chih-Hung; Su, Yu-Ting; Chen, Po-Hsun; Lin, Shih-Kai; Hu, Shih-Jie; Sze, Simon M.

    2017-05-01

    The forming process is a necessary and irreversible process to activate the resistance switching behavior in a resistance random access memory (RRAM) device. However, during the forming process, an overshoot current leads to device damage and causes inferior resistance switching characteristics; consequently, the process is considered to be a key factor in device degradation. In this paper, we find that a discontinuous conduction path can be formed by a pulse forming process such that the operation current can be reduced. We further investigate how the charge quantity during the forming process affects the carrier conduction mechanism of HRS, with all experiments and results demonstrated on one-transistor-one-resistor (1T1R) devices.

  14. Self-compliance Pt/HfO2/Ti/Si one-diode-one-resistor resistive random access memory device and its low temperature characteristics

    Science.gov (United States)

    Lu, Chao; Yu, Jue; Chi, Xiao-Wei; Lin, Guang-Yang; Lan, Xiao-Ling; Huang, Wei; Wang, Jian-Yuan; Xu, Jian-Fang; Wang, Chen; Li, Cheng; Chen, Song-Yan; Liu, Chunli; Lai, Hong-Kai

    2016-04-01

    A bipolar one-diode-one-resistor (1D1R) device with a Pt/HfO2/Ti/n-Si(001) structure was demonstrated. The 1D1R resistive random access memory (RRAM) device consists of a Ti/n-Si(001) diode and a Pt/HfO2/Ti resistive switching cell. By using the Ti layer as the shared electrode for both the diode and the resistive switching cell, the 1D1R device exhibits the property of stable self-compliance and the characteristic of robust resistive switching with high uniformity. The high/low resistance ratio reaches 103. The electrical RESET/SET curve does not deteriorate after 68 loops. Low-temperature studies show that the 1D1R RRAM device has a critical working temperature of 250 K, and at temperatures below 250 K, the device fails to switch its resistances.

  15. New CMOS-based Resistor-less Current-mode First-order All-pass Flter Using Only Ten Transistors and One External Capacitor

    Directory of Open Access Journals (Sweden)

    A. Lahiri

    2011-09-01

    Full Text Available This paper proposes a new, compact CMOS realization of current-mode (CM first-order all-pass filter (APF using no external resistors. The circuit is created using only ten transistors and one external capacitor. The circuit uses lower number of transistors as compared to previously reported CM APFs using active building block (ABB based approach. A comparison with previously reported CM APFs in terms of number of transistors and current consumption has been provided. As a design example, a 512 kHz pole-frequency (at typical process and 27ºC CM APF is designed in 40nm CMOS technology and validated through SPICE simulations.

  16. Microstructure and temperature coefficient of resistance of thin cermet resistor films deposited from CrSi{sub 2}-Cr-SiC targets by S-gun magnetron

    Energy Technology Data Exchange (ETDEWEB)

    Felmetsger, Valery V. [Tegal Corporation, 51 Daggett Drive, San Jose, California 95134 (United States)

    2010-01-15

    Technological solutions for producing nanoscale cermet resistor films with sheet resistances above 1000 {Omega}/{open_square} and low temperature coefficients of resistance (TCR) have been investigated. 2-40 nm thick cermet films were sputter deposited from CrSi{sub 2}-Cr-SiC targets by a dual cathode dc S-gun magnetron. In addition to studying film resistance versus temperature, the nanofilm structural features and composition were analyzed using scanning electron microscopy, atomic force microscopy, high-resolution transmission electron microscopy, energy-dispersive x-ray spectroscopy, and electron energy loss spectroscopy. This study has revealed that all cermet resistor films deposited at ambient and elevated temperatures were amorphous. The atomic ratio of Si to Cr in these films was about 2 to 1. The film TCR displayed a significant increase when the deposited film thickness was reduced below 2.5 nm. An optimized sputter process consisting of wafer degassing, cermet film deposition at elevated temperature with rf substrate bias, and a double annealing in vacuum, consisting of in situ annealing following the film sputtering and an additional annealing following the exposure of the wafers to air, has been found to be very effective for the film thermal stabilization and for fine tuning the film TCR. Cermet films with thicknesses in the range of 2.5-4 nm deposited using this technique had sheet resistances ranging from 1800 to 1200 {Omega}/{open_square} and TCR values from -50 ppm/ deg. C to near zero, respectively. A possible mechanism responsible for the high efficiency of annealing the cermet films in vacuum (after preliminary exposure to air), resulting in resistance stabilization and TCR reduction, is also discussed.

  17. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...

  18. Pulmonary artery sling: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Gil Hyun; Lee, Sun Wha; Cha, Sung Ho [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    1993-09-15

    Aberrant left-sided pulmonary artery(pulmonary artery sling) is an uncommon anomaly,which may cause significant respiratory abnormality. We report a case of pulmonary artery sling which is combined with persistent left superior vena cava and dextrocardia. This case were identified by esophagogram and CT and confirmed by MRI and angiography. We consider that MRI is a valuable new method for the diagnosis of aberrant left-sided pulmonary artery.

  19. Comparative evaluation of ventilatory function through pre and postoperative peak expiratory flow in patients submitted to elective upper abdominal surgery.

    Science.gov (United States)

    Scheeren, Caio Fernando Cavanus; Gonçalves, José Júlio Saraiva

    2016-01-01

    to evaluate the ventilatory function by Peak Expiratory Flow (PEF) in the immediate pre and postoperative periods of patients undergoing elective surgical procedures in the upper abdomen. we conducted a prospective cohort study including 47 patients admitted to the Hospital Regional de Mato Grosso do Sul from July to December 2014, who underwent elective surgeries of the upper abdomen, and submiited to spirometric evaluation and measurement of PEF immediately before and after surgery. of the 47 patients, 22 (46.8%) were male and 25 (53.20%) female. The mean preoperative PEF was 412.1±91.7, and postoperative, 331.0±87.8, indicating significant differences between the two variables. Men had higher PEF values than women, both in the pre and postoperative periods. There was a reasonable inverse correlation between age and decreased PEF. Both situations showed statistical significance (psexo masculino, e 25 (53,20%) do sexo feminino. A média do PFE pré-operatório foi 412,1±91,7, e do pós-operatório de 331,0±87,8, indicando diferenças significantes entre as duas variáveis. O sexo masculino apresentou maiores valores de PFE do que o feminino, tanto no pré-cirúrgico quanto no pós-cirúrgico. Observou-se razoável correlação inversamente proporcional entre as variáveis idade e diminuição do PFE. Ambas as situações mostraram significância estatística (p<0,001). O grupo composto por fumantes apresentou menores valores de PFE tanto no pré como no pós-operatório. O grupo composto por portadores de co-morbidades (HAS e/ou DM) apresentou menores valores de PFE tanto no pré como no pós-operatório (p=0,005). Em ambos os grupos, o pós-operatório determinou uma diminuição significativa do PFE (p<0,001). O tipo de cirurgia realizada e o tipo de anestesia não mostraram diferenças significantes em relação ao PFE. as variáveis mais implicadas na diminuição da função ventilatória, avaliadas através da PFE, foram: idade avançada, tabagismo e

  20. Positive end expiratory pressure for preterm infants requiring conventional mechanical ventilation for respiratory distress syndrome or bronchopulmonary dysplasia.

    Science.gov (United States)

    Bamat, Nicolas; Millar, David; Suh, Sanghee; Kirpalani, Haresh

    2012-01-18

    Conventional mechanical ventilation (CMV) of neonates has been used as a treatment of respiratory failure for over 30 years. While CMV facilitates gas exchange, it may simultaneously damage the lung. Positive end expiratory pressure (PEEP) has received less attention than other ventilation parameters when considering this balance of benefit and possible harm. While an appropriate level of PEEP may exert substantial benefits in ventilation, both inappropriately low or high levels may lead to harm. An appropriate level of PEEP for neonates may also be best achieved by an individualized approach. 1. To compare the effects of different levels of PEEP in preterm newborn infants requiring CMV for respiratory distress syndrome (RDS).2. To compare the effects of different levels of PEEP in preterm infants requiring CMV for bronchopulmonary dysplasia (BPD).3. To compare the effects of different methods for individualizing PEEP to an optimal level in preterm newborn infants requiring CMV for RDS. The search was performed in accordance with the standard search strategy for the Cochrane Neonatal Review Group. The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), Ovid MEDLINE, EMBASE, study references and experts were utilized for study identification. All randomized and quasi-randomized controlled trials studying preterm infants (less than 37 weeks gestational age) requiring CMV with endotracheal intubation and undergoing randomization to either different PEEP levels (RDS or BPD) or two or more alternative methods for individualizing PEEP levels (RDS only) were included. Cross-over trials were included but we limited the findings to those in the first cross-over period. Data collection and analysis were performed in accordance with the recommendations of the Cochrane Neonatal Review Group. An initial evaluation identified 10 eligible articles. Ultimately, a single study met our inclusion criteria. The study addressed the effects of different

  1. Intracranial artery dissection

    NARCIS (Netherlands)

    Sikkema, T.; Uyttenboogaart, Maarten; Eshghi, O.; De Keyser, J.; Brouns, R.; van Dijk, J.M.C.; Luijckx, G. J.

    The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be

  2. Artery Bypass Grafting

    African Journals Online (AJOL)

    development of CABG without CPB as occurring in three stages. Figure 1: The early stage: Grafts were limited to ... This interest led to the development of techniques such as mini- mally invasive direct coronary artery surgery (MIDCAB), surgery ... Diazepam 0.1 rng/kg P0. Cyclimorph 0.lmg/kg IMI on call to theatre. Theatre ...

  3. Peripheral artery bypass - leg

    Science.gov (United States)

    ... 25638515 www.ncbi.nlm.nih.gov/pubmed/25638515 . White CJ. Endovascular treatment of peripheral artery disease. In: Creager MA, Beckman JA, Loscalzo J, eds. Vascular Medicine: A Companion to Braunwald's Heart Disease . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 20. Review Date 1/31/2017 ...

  4. Pulmonary artery aneurysm

    African Journals Online (AJOL)

    Enrique

    2). An echocardiogram confirmed pulmonary valvular stenosis with post-stenotic dilatation and pul- monary artery aneurysm formation. The pulmonary valve pressure gradi- ent was > 28 mmHg. The patient set- tled on low-dose diuretic therapy, and following cardiothoracic surgical con- sultation it was decided that no surgi-.

  5. Peripheral arterial disease: an underestimated aetiology of exercise intolerance in chronic obstructive pulmonary disease patients.

    Science.gov (United States)

    Castagna, Olivier; Boussuges, Alain; Nussbaum, Eric; Marqueste, Louis; Brisswalter, Jeanick

    2008-06-01

    To assess the prevalence of peripheral arterial disease and its implications for exercise limitation in chronic obstructive pulmonary disease (COPD) patients. One hundred and fifty-one moderate-to-severe COPD patients (forced expiratory volume in 1 s: 37+/-6 SD% predicted) and 73 healthy age-matched control individuals (divided into 31 smokers and 42 nonsmokers) participated in this study. All COPD patients were either exsmokers or current smokers and their tobacco-smoking history was similar to that of healthy smokers. To evaluate the existence of arterial disease, lower limb perfusion pressure impairment was assessed using the ankle brachial index, whereas arterial stiffness was assessed by the pulse wave velocity (PWV). The definition of peripheral arterial disease required an ankle brachial index value of 0.90 or less, whereas the PWV increment was considered to be a direct witness of arterial stiffness increase. A 6-min walk test was performed to assess physical exercise capacity. Prevalence of peripheral arterial disease was higher in COPD patients than in healthy participants (81+/-3 SD; 49+/-5 SD and 9+/-2 SD%, respectively, in COPD, healthy smokers and nonsmokers). PWV mean values were significantly higher in COPD patients compared with healthy smokers and nonsmokers (10.3+/-2.1 SD m/s; 9.2+/-1.3 SD m/s and 8.7+/-2.2 SD m/s, respectively). The distance covered during the 6-min-walk test was associated positively with the degree of peripheral arterial disease (r=0.78; P=0.05) and negatively with the PWV values (r=-0.74; P=0.05). Not only tobacco-smoking history but also COPD severity was shown to influence these associations. The effect of peripheral arterial disease on exercise intolerance in COPD seems to be considerable. Therefore, COPD patients participating in a pulmonary rehabilitation programme should profit from a systematic search for arterial disease. Arterial dysfunction has to be taken into account in the multidisciplinary treatment of these

  6. Correlation between spirometry values and pulmonary artery pressure in young healthy subjects.

    Science.gov (United States)

    Grossman, Alon; Benderly, Michal; Prokupetz, Alex; Gordon, Barak; Kalter-Leibovici, Ofra

    2014-03-01

    Pulmonary hypertension is frequently associated with parenchymal lung disease. We evaluated the association between spirometry values and pulmonary artery systolic pressure (PASP) in young subjects without lung disease : We studied applicants to the Israeli Air Force, who undergo routine evaluation that includes resting spirometry and echocardiography. Applicants with overt lung disease were excluded. All echocardiographic studies performed in the years 1994 through 2010 (n = 6,598) were screened, and files that included PASP and spirometry values were analyzed for the association between PASP and FVC, FEV1, FEV1/FVC, peak expiratory flow, and forced expiratory flow during the middle half of the FVC maneuver. Of the 647 air force applicants who underwent echocardiography in which PASP was measurable and had spirometry data, 607 (94%) were male, and their average age was 18.16 ± 0.73 years. Mean PASP was 26.4 ± 5.2 mm Hg (range 10-41 mm Hg). None of the spirometry values significantly correlated with PASP. PASP in young healthy subjects is not significantly associated with spirometry values. Lung mechanics probably do not contribute significantly to PASP in this population.

  7. Pediatric nonaortic arterial aneurysms.

    Science.gov (United States)

    Davis, Frank M; Eliason, Jonathan L; Ganesh, Santhi K; Blatt, Neal B; Stanley, James C; Coleman, Dawn M

    2016-02-01

    Pediatric arterial aneurysms are extremely uncommon. Indications for intervention remain poorly defined and treatments vary. The impetus for this study was to better define the contemporary surgical management of pediatric nonaortic arterial aneurysms. A retrospective analysis was conducted of 41 children with 61 aneurysms who underwent surgical treatment from 1983 to 2015 at the University of Michigan. Arteries affected included: renal (n = 26), femoral (n = 7), iliac (n = 7), superior mesenteric (n = 4), brachial (n = 3), carotid (n = 3), popliteal (n = 3), axillary (n = 2), celiac (n = 2), ulnar (n = 2), common hepatic (n = 1), and temporal (n = 1). Intracranial aneurysms and aortic aneurysms treated during the same time period were not included in this study. Primary outcomes analyzed were postoperative complications, mortality, and freedom from reintervention. The study included 27 boys and 14 girls, with a median age of 9.8 years (range, 2 months-18 years) and a weight of 31.0 kg (range, 3.8-71 kg). Multiple aneurysms existed in 14 children. Obvious factors that contributed to aneurysmal formation included: proximal juxta-aneurysmal stenoses (n = 14), trauma (n = 12), Kawasaki disease (n = 4), Ehlers-Danlos type IV syndrome (n = 1), and infection (n = 1). Preoperative diagnoses were established using arteriography (n = 23), magnetic resonance angiography (n = 6), computed tomographic arteriography (n = 5), or ultrasonography (n = 7), and confirmed during surgery. Indications for surgery included risk of expansion and rupture, potential thrombosis or embolization of aneurysmal thrombus, local soft tissue and nerve compression, and secondary hypertension in the case of renal artery aneurysms. Primary surgical techniques included: aneurysm resection with reanastomsis, reimplantation, or angioplastic closure (n = 16), interposition (n = 10) or bypass grafts (n = 2), ligation (n = 9), plication (n = 8), endovascular occlusion (n = 3), and nephrectomy (n = 4) in

  8. COMPARISON OF EFFECTIVENESS OF DIAPHRAGMATIC BREATHING AND PURSEDLIP EXPIRATION EXERCISES IN IMPROVING THE FORCED EXPIRATORY FLOW RATE AND CHEST EXPANSION IN PATIENTS WITH BRONCHIAL ASTHMA

    Directory of Open Access Journals (Sweden)

    G. Shine

    2016-04-01

    Full Text Available Background: Asthma is growing problem in India and throughout the world. Breathing exercises are commonly incorporated in overall pulmonary rehabilitation program of patients with bronchial asthma. However there is a lack of awareness regarding following a specific exercise prescription which is based on individual’s requirements. Physiotherapist can help in designing an exercise prescription specific to an individual possibly to achieve more control over bronchial asthma. Methods: Thirty patients both male and female aged between 20 and 40 years diagnosed with bronchial asthma by the physician were assigned in two groups. Group-1 patients were given diaphragmatic breathing exercises and group-2 patients were given pursed-lip expiration exercises. Both groups received selected intervention for 6 weeks, 5 days in a week, 2 times in a day, and 20 minutes per session. Pre and post-test measures of forced expiratory flow rate were taken by peak expiratory flow meter and chest expansion was measured by inch tape. Data were analysed using Statistical Package for Social Sciences (SPSS version 17.0 software. The analysis was performed by using students paired t-test. Results: The study shows statistically significant improvement in diaphragmatic breathing exercise group when compared to pursed-lip expiration exercise group. The value of chest expansion has shown 2.04 % improvement in group1 and 1.01 % in group 2 whereas peak expiratory flow rate (PEFR showed 16.9 % improvement in group 1 and 2.27 % in group 2. Conclusion: Diaphragmatic breathing exercises play a vital role in rehabilitation of asthmatic patients to gain functional improvement and independence.

  9. Effect of expiratory muscle strength training on swallowing-related muscle strength in community-dwelling elderly individuals: a randomized controlled trial.

    Science.gov (United States)

    Park, Ji-Su; Oh, Dong-Hwan; Chang, Moon-Young

    2017-03-01

    This study aimed to investigate the effect of expiratory muscle strength training (EMST) on swallowing-related muscle strength in community-dwelling elderly individuals. Expiratory muscle strength training is an intervention for patients with oropharyngeal dysphagia. This training is associated with respiration, coughing, speech and swallowing, and its effectiveness has been proven in previous studies. However, the effects of EMST on elderly individuals and evidence are still lacking. This study included 24 community-dwelling senior citizens aged ≥65 years (12 men and 12 women). The experimental group trained at the 70% threshold value of the maximum expiratory pressure using an EMST device 5 days per week for 4 weeks and comprised five sets of five breaths through the device for 25 breaths per day. The placebo group trained with a resistance-free sham device. Post-intervention, muscle strength of the bilateral buccinator and the orbicularis oris muscles (OOM) was measured using the Iowa Oral Performance Instrument. Surface electromyography was used to measure activation of the suprahyoid muscles (SM). After intervention, the strength of the buccinator and the OOM in the experimental group showed statistically significant improvement. There was also statistically significant activation of the SM. In the placebo group, the strength of the orbicularis oris muscle alone improved. No statistically significant differences between groups were found for the strength of the buccinator and the OOM and the activation of the SM. EMST had a positive effect on swallowing-related muscle strength in elderly participants. © 2016 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  10. Expiratory flow-volume loop profile and patient outcome in chronic obstructive pulmonary disease in acute respiratory failure: a prospective observational study in a single intensive care unit.

    Science.gov (United States)

    Porot, Véronique; Ernesto, Sylvie; Leray, Véronique; Delannoy, Bertrand; Bourdin, Gael; Bayle, Frédérique; Richard, Jean-Christophe; Guérin, Claude

    2012-01-01

    Expiratory flow-volume (EFV) loops are continuously displayed on the screen of intensive care unit (ICU) ventilators. It was the aim of this study to investigate the relationships of EFV to chronic obstructive pulmonary disease (COPD) patient outcome. This is a prospective study on COPD patients who received invasive mechanical ventilation for acute respiratory failure in the ICU. Within the 24-hour post-intubation period, the angle of the EFV slope during the last 50% of expiration was computed and patients were stratified into 4 quartiles. Resistance, compliance of the respiratory system and change in end-expiratory lung volume above relaxation volume were assessed. Patients were followed up to hospital discharge. The main outcome was hospital mortality. Secondary outcomes were ICU mortality, length of ICU stay, duration of invasive ventilation, number of intubations, oxygen and non-invasive ventilation. Thirty-eight patients were analysed. The first quartile comprised 9 patients (median angle 11°, interquartile range 8-12), the second 10 patients (median angle 26°, range 19-30), the third 10 patients (median angle 42°, range 39-46), and the fourth 9 patients (median angle 53°, range 49-64). Hospital and ICU mortality were not different between groups. Lengths of ICU and hospital stay and length of invasive ventilation were significantly different between groups, with the highest values observed in the first quartile. The rate of oxygen use and non-invasive ventilation in the ICU and at hospital discharge was significantly different between groups, with the highest rate observed in the first quartile. There was a significant negative correlation between angle and resistance, compliance of the respiratory system and change in end-expiratory lung volume above the relaxation volume. The slope of the angle during the last 50% of expired volume in the COPD patients was associated with worsened respiratory mechanics and higher morbidity. Copyright © 2011 S. Karger

  11. Safety and effectiveness of alveolar recruitment maneuvers and positive end-expiratory pressure during general anesthesia for cesarean section: a prospective, randomized trial.

    Science.gov (United States)

    Aretha, D; Fligou, F; Kiekkas, P; Messini, C; Panteli, E; Zintzaras, E; Karanikolas, M

    2017-05-01

    During cesarean section, the supine position reduces functional residual capacity and worsens lung compliance. We tested the hypothesis that alveolar recruitment maneuvers and positive end-expiratory pressure improve lung compliance in women undergoing general anesthesia for cesarean section. Ninety women undergoing cesarean section were randomly assigned to one of two groups in a prospective, double-blind trial. In the alveolar recruitment maneuver group, pressure-control ventilation was used and inspiratory time was increased to 50% after delivery; positive end-expiratory pressure was increased to 20cmH 2 O and peak airway inspiratory pressure gradually increased to 45-50cmH 2 O. Volume-control ventilation was then used with low tidal volumes (6mL/kg) and positive end-expiratory pressure was reduced stepwise to 8cmH 2 O. In the control group, alveolar recruitment maneuvers were not used. Data were collected before and 3, 10 and 20min after the alveolar recruitment maneuver, before extubation and postoperatively at 10 and 20min. Dynamic compliance, peak airway inspiratory pressure, PaO 2 and PaO 2 /FiO 2 were significantly different in the alveolar recruitment maneuver group compared to controls at all time points during surgery except at baseline. Oxygen saturation was significantly greater in the alveolar recruitment maneuver group at 10 and 20min and before extubation. Dynamic compliance was 29.7-42.5% higher and peak airway inspiratory pressure 3.6-10.2% lower in the alveolar recruitment maneuver group compared to controls. The PaO 2 , PaO 2 /FiO 2 and oxygen saturation were higher (9.4-12%, 10.3-11.9% and 0.4-1.3%, respectively) in the alveolar recruitment maneuver group. Postoperatively, PaO 2 and oxygen saturation were significantly higher in the alveolar recruitment maneuver group compared to controls (PaO 2 9.2% at 10min and 8.4% at 20min, oxygen saturation 0.8% at 10min and 1.1% at 20min). There were no significant differences in hemodynamic stability or

  12. A Hybrid Windkessel Model of Blood Flow in Arterial Tree Using Velocity Profile Method

    Science.gov (United States)

    Aboelkassem, Yasser; Virag, Zdravko

    2016-11-01

    For the study of pulsatile blood flow in the arterial system, we derived a coupled Windkessel-Womersley mathematical model. Initially, a 6-elements Windkessel model is proposed to describe the hemodynamics transport in terms of constant resistance, inductance and capacitance. This model can be seen as a two compartment model, in which the compartments are connected by a rigid pipe, modeled by one inductor and resistor. The first viscoelastic compartment models proximal part of the aorta, the second elastic compartment represents the rest of the arterial tree and aorta can be seen as the connection pipe. Although the proposed 6-elements lumped model was able to accurately reconstruct the aortic pressure, it can't be used to predict the axial velocity distribution in the aorta and the wall shear stress and consequently, proper time varying pressure drop. We then modified this lumped model by replacing the connection pipe circuit elements with a vessel having a radius R and a length L. The pulsatile flow motions in the vessel are resolved instantaneously along with the Windkessel like model enable not only accurate prediction of the aortic pressure but also wall shear stress and frictional pressure drop. The proposed hybrid model has been validated using several in-vivo aortic pressure and flow rate data acquired from different species such as, humans, dogs and pigs. The method accurately predicts the time variation of wall shear stress and frictional pressure drop. Institute for Computational Medicine, Dept. Biomedical Engineering.

  13. Caliber-Persistent Artery

    Directory of Open Access Journals (Sweden)

    Sabrina Araújo Pinho Costa

    2015-01-01

    Full Text Available Caliber-persistent artery (CPLA of the lip is a common vascular anomaly in which a main arterial branch extends to the surface of the mucous tissue with no reduction in its diameter. It usually manifests as pulsatile papule, is easily misdiagnosed, and is observed more frequently among older people, suggesting that its development may involve a degenerative process associated with aging; CPLA is also characterized by the loss of tone of the adjacent supporting connective tissue. Although the diagnosis is clinical, high-resolution Doppler ultrasound is a useful noninvasive tool for evaluating the lesion. This report describes the case of a 58-year-old male patient who complained of a lesion of the lower lip with bleeding and recurrent ulceration. The patient was successfully treated in our hospital after a diagnosis of CPLA and is currently undergoing a clinical outpatient follow-up with no complaints.

  14. Effects of positive expiratory pressure on pulmonary clearance of aerosolized technetium-99m-labeled diethylenetriaminepentaacetic acid in healthy individuals.

    Science.gov (United States)

    Albuquerque, Isabella Martins de; Cardoso, Dannuey Machado; Masiero, Paulo Ricardo; Paiva, Dulciane Nunes; Resqueti, Vanessa Regiane; Fregonezi, Guilherme Augusto de Freitas; Menna-Barreto, Sérgio Saldanha

    2016-01-01

    To evaluate the effects of positive expiratory pressure (PEP) on pulmonary epithelial membrane permeability in healthy subjects. We evaluated a cohort of 30 healthy subjects (15 males and 15 females) with a mean age of 28.3 ± 5.4 years, a mean FEV1/FVC ratio of 0.89 ± 0.14, and a mean FEV1 of 98.5 ± 13.1% of predicted. Subjects underwent technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA) radioaerosol inhalation lung scintigraphy in two stages: during spontaneous breathing; and while breathing through a PEP mask at one of three PEP levels-10 cmH2O (n = 10), 15 cmH2O (n = 10), and 20 cmH2O (n = 10). The 99mTc-DTPA was nebulized for 3 min, and its clearance was recorded by scintigraphy over a 30-min period during spontaneous breathing and over a 30-min period during breathing through a PEP mask. The pulmonary clearance of 99mTc-DTPA was significantly shorter when PEP was applied-at 10 cmH2O (p = 0.044), 15 cmH2O (p = 0.044), and 20 cmH2O (p = 0.004)-in comparison with that observed during spontaneous breathing. Our findings indicate that PEP, at the levels tested, is able to induce an increase in pulmonary epithelial membrane permeability and lung volume in healthy subjects. Avaliar os efeitos da pressão expiratória positiva (PEP) na permeabilidade da membrana epitelial pulmonar em indivíduos saudáveis. Foi avaliada uma coorte de 30 indivíduos saudáveis (15 homens e 15 mulheres), com média de idade de 28,3 ± 5,4 anos, média da relação VEF1/CVF de 0,89 ± 0,14 e média de VEF1 de 98,5 ± 13,1% do previsto. Os indivíduos foram submetidos a cintilografia pulmonar por inalação de radioaerossol de ácido dietilenotriaminopentacético marcado com tecnécio-99m (99mTc-DTPA em inglês) em dois estágios: durante respiração espontânea e durante respiração com uma máscara de PEP de 10 cmH2O (n = 10), 15 cmH2O (n = 10) ou 20 cmH2O (n = 10). O 99mTc-DTPA foi nebulizado por 3 min, e sua depuração foi registrada por cintilografia por um

  15. Coronary Artery Anomalies in Animals

    Directory of Open Access Journals (Sweden)

    Brian A. Scansen

    2017-04-01

    Full Text Available Coronary artery anomalies represent a disease spectrum from incidental to life-threatening. Anomalies of coronary artery origin and course are well-recognized in human medicine, but have received limited attention in veterinary medicine. Coronary artery anomalies are best described in the dog, hamster, and cow though reports also exist in the horse and pig. The most well-known anomaly in veterinary medicine is anomalous coronary artery origin with a prepulmonary course in dogs, which limits treatment of pulmonary valve stenosis. A categorization scheme for coronary artery anomalies in animals is suggested, dividing these anomalies into those of major or minor clinical significance. A review of coronary artery development, anatomy, and reported anomalies in domesticated species is provided and four novel canine examples of anomalous coronary artery origin are described: an English bulldog with single left coronary ostium and a retroaortic right coronary artery; an English bulldog with single right coronary ostium and transseptal left coronary artery; an English bulldog with single right coronary ostium and absent left coronary artery with a prepulmonary paraconal interventricular branch and an interarterial circumflex branch; and a mixed-breed dog with tetralogy of Fallot and anomalous origin of all coronary branches from the brachiocephalic trunk. Coronary arterial fistulae are also described including a coronary cameral fistula in a llama cria and an English bulldog with coronary artery aneurysm and anomalous shunting vessels from the right coronary artery to the pulmonary trunk. These examples are provided with the intent to raise awareness and improve understanding of such defects.

  16. Repeated exercise-induced arterial hypoxemia in a healthy untrained woman.

    Science.gov (United States)

    Dominelli, Paolo B; Foster, Glen E; Dominelli, Giulio S; Querido, Jordan S; Henderson, William R; Koehle, Michael S; Sheel, A William

    2012-09-30

    A healthy 36-year-old untrained (maximal oxygen consumption (V(O2max)): 39 mL/kg/min) woman completed multiple graded exercise tests on a treadmill. Temperature-corrected arterial blood samples were obtained in addition to esophageal pressure. Significant hypoxemia (-13 mm Hg arterial oxygen tension decrease) and arterial oxyhemoglobin desaturation (-6% decrease) was observed relative to rest and occurred during submaximal exercise and worsened at maximal intensities. Expiratory flow limitation (28-40% intersection of tidal volume) was present at near-maximal intensities. Relieving mechanical ventilatory constraints with a helium inspirate (79% He:21% O(2)) partially reversed the hypoxemia. Conversely, increasing chemical ventilatory stimuli, with hypercapnia (3.5% CO(2)), failed to increase ventilation. Maintaining oxyhemoglobin saturation, via a mildly hyperoxic (26% O(2)) inspirate, increased exercise duration (+45 s) and V(O2max) (+5 mL/kg/min). We attribute the hypoxemia to an excessive A-a(O2) resulting from ventilation-perfusion mismatch and secondarily to mechanical ventilatory constraints. We conclude that a healthy untrained woman can develop EIAH and this remains stable over a period of 6 months. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Prevalence of chronic obstructive pulmonary disease among patients with systemic arterial hypertension without respiratory symptoms.

    Science.gov (United States)

    Rabahi, Marcelo Fouad; Pereira, Sheila Alves; Silva Júnior, José Laerte Rodrigues; de Rezende, Aline Pacheco; Castro da Costa, Adeliane; de Sousa Corrêa, Krislainy; Conde, Marcus Barreto

    2015-01-01

    The diagnosis of chronic obstructive pulmonary disease (COPD) is often delayed until later stages of the disease. The purpose of the present study was to determine the prevalence of COPD among adults on treatment for systemic arterial hypertension independently of the presence of respiratory symptoms. This cross-sectional study included adults aged ≥40 years with tobacco/occupational exposure and systemic arterial hypertension diagnosed at three Primary Health Care facilities in Goiania, Brazil. Patients were evaluated using a standardized respiratory questionnaire and spirometry. COPD prevalence was measured considering the value of forced vital capacity and/or forced expiratory volume in 1 second COPD (P=0.24). The prevalence of COPD in people with no previous COPD diagnosis was greater among those with no respiratory symptoms (100%) than among those with respiratory symptoms (56.1%) (P=0.01). Our findings suggest that regardless of the presence of respiratory symptoms, individuals aged ≥40 years with tobacco/occupational exposure and arterial hypertension may benefit from spirometric evaluation.

  18. Management of iatrogenic pulmonary artery injury during pulmonary artery banding

    Directory of Open Access Journals (Sweden)

    Neeti Makhija

    2017-01-01

    Full Text Available Pulmonary Artery banding (PAB is limited to selected patients who cannot undergo primary repair due to complex anatomy, associated co-morbidities, as a part of staged univentricular palliation, and for preparing the left ventricle prior to an arterial switch operation. We report a catastrophic iatrogenic complication in which the pulmonary artery was injured during the PAB. We discuss its multi-pronged management.

  19. Management of Iatrogenic Pulmonary Artery Injury during Pulmonary Artery Banding

    Science.gov (United States)

    Makhija, Neeti; Aggarwal, Shivani; Talwar, Sachin; Ladha, Suruchi; Das, Deepanwita; Kiran, Usha

    2017-01-01

    Pulmonary Artery banding (PAB) is limited to selected patients who cannot undergo primary repair due to complex anatomy, associated co-morbidities, as a part of staged univentricular palliation, and for preparing the left ventricle prior to an arterial switch operation. We report a catastrophic iatrogenic complication in which the pulmonary artery was injured during the PAB. We discuss its multi-pronged management. PMID:28701613

  20. Peripheral arterial disease in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Pecci, R; De La Fuente Aguado, J; Sanjurjo Rivo, A B; Sanchez Conde, P; Corbacho Abelaira, M

    2012-10-01

    Cardiovascular disease (CV) is the second leading cause of morbidity and mortality in chronic obstructive pulmonary disease (COPD). Peripheral arterial disease (PAD) is associated with cardiovascular disease, and its risk factors are common to other atherosclerotic diseases. The objective is to determine the prevalence of PAD in a population of patients with COPD using the ankle / brachial index (ABI) and to investigate the relationship between PAD and lung disease severity. In a prospective cross-sectional study, 246 patients with COPD were recruited. Patients were enrolled consecutively according to their admission to Povisa hospital from September 1, 2008, until March 1, 2010, and were assessed by clinical history, spirometry and ABI. The COPD severity was graded by GOLD criteria in spirometry. Overall, 84 patients (36.8%) had abnormal ABI results and 59 (70.2%) were asymptomatic for PAD. COPD patients with PAD had a higher prevalence of moderate to severe COPD (61.9% vs. 41.7%, P=0.004), lower mean forced expiratory volume in 1 second (FEV1) values (46.7% ± 15 vs. 52.3±14%, P=0.001) and a higher prevalence of hypertension (69% vs. 54.3%, P=0.03) and previous cardiovascular disease (34.5% vs. 21.3%, P=0.03). There was a high prevalence of asymptomatic PAD in the COPD patients we examined. Abnormal ABI results were associated with a higher prevalence of cardiovascular risk factors and more severe lung disease. The diagnosis of peripheral arterial disease in COPD is important because this is an entity that limits the patient's physical activity and impairs their quality of life in addition to turn it into a high cardiovascular risk patient that requiring additional therapeutic measures.

  1. Endothelin receptor antagonist and airway dysfunction in pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    Borst Mathias M

    2009-12-01

    Full Text Available Abstract Background In idiopathic pulmonary arterial hypertension (IPAH, peripheral airway obstruction is frequent. This is partially attributed to the mediator dysbalance, particularly an excess of endothelin-1 (ET-1, to increased pulmonary vascular and airway tonus and to local inflammation. Bosentan (ET-1 receptor antagonist improves pulmonary hemodynamics, exercise limitation, and disease severity in IPAH. We hypothesized that bosentan might affect airway obstruction. Methods In 32 IPAH-patients (19 female, WHO functional class II (n = 10, III (n = 22; (data presented as mean ± standard deviation pulmonary vascular resistance (11 ± 5 Wood units, lung function, 6 minute walk test (6-MWT; 364 ± 363.7 (range 179.0-627.0 m, systolic pulmonary artery pressure, sPAP, 79 ± 19 mmHg, and NT-proBNP serum levels (1427 ± 2162.7 (range 59.3-10342.0 ng/L were measured at baseline, after 3 and 12 months of oral bosentan (125 mg twice per day. Results and Discussion At baseline, maximal expiratory flow at 50 and 25% vital capacity were reduced to 65 ± 25 and 45 ± 24% predicted. Total lung capacity was 95.6 ± 12.5% predicted and residual volume was 109 ± 21.4% predicted. During 3 and 12 months of treatment, 6-MWT increased by 32 ± 19 and 53 ± 69 m, respectively; p Conclusion This study gives first evidence in IPAH, that during long-term bosentan, improvement of hemodynamics, functional parameters or serum biomarker occur independently from persisting peripheral airway obstruction.

  2. An Aberrant Artery Arising From Common Hepatic Artery

    Directory of Open Access Journals (Sweden)

    Surekha D. Jadhav

    2015-01-01

    Full Text Available Common hepatic artery is the branch of celiac trunk which is chief artery of the foregut. Branches of celiac trunk supply the gastrointestinal tract and its associated glands which are derived from foregut. Anatomy and variations of hepatic arterial system have become increasingly important due to increasing number of laparoscopic procedures, oncologic surgical interventions, and organ transplant cases. This case report describes a rare anatomical variation of an aberrant artery arising from common hepatic artery before the origin of gastroduodenal artery and proper hepatic artery.The aberrant artery traversed inferiorly and behind the body of the pancreas which divided into a right and left branches. The right branch ran behind the neck of the pancreas and it ended after giving few branches to head and body of pancreas. However, the left branch gave off branches to the proximal part of the jejunum. The presence of a branch arising directly from the common hepatic artery supplying the pancreas and jejunum is uncommon. Knowledge of such a rare variation is important not only for surgeons but also interventional radiologists and those studying anatomy

  3. Changes in thickness of the transversus abdominis during the abdominal drawing-in manoeuvre and expiratory muscle training in elderly people.

    Science.gov (United States)

    Sugimoto, Takamune; Yokogawa, Masami; Miaki, Hiroichi; Madokoro, Sachiko; Nakagawa, Takao

    2018-01-01

    [Purpose] It has been reported that exercises focusing upon the transversus abdominis (TrA) ameliorate low back pain (LBP). We investigated whether expiratory muscle training (EMT) can promote activity of the TrA to the same degree as the abdominal drawing-in manoeuvre (ADIM) in elderly individuals. [Subjects and Methods] Twenty-one elderly subjects (9 males, 12 females; mean age, 84.9 ± 6.6 years) without LBP symptoms were included. Using ultrasound imaging we measured changes in thickness of the lateral abdominal muscles, TrA, internal oblique muscle (IO), and external oblique muscle (EO) during ADIM and EMT. The load in EMT was set to 15% of maximal expiratory pressure. [Results] TrA showed a significant increase in muscle thickness during ADIM and EMT compared with at rest. A significant increase in muscle thickness was noted for EMT in comparison with ADIM. No significant differences were found for IO and EO. [Conclusion] In elderly people, EMT may be an effective alternative to ADIM for promoting activity of the TrA and can be used as an exercise to maintain TrA function.

  4. Changes in thickness of the transversus abdominis during the abdominal drawing-in manoeuvre and expiratory muscle training in elderly people

    Science.gov (United States)

    Sugimoto, Takamune; Yokogawa, Masami; Miaki, Hiroichi; Madokoro, Sachiko; Nakagawa, Takao

    2018-01-01

    [Purpose] It has been reported that exercises focusing upon the transversus abdominis (TrA) ameliorate low back pain (LBP). We investigated whether expiratory muscle training (EMT) can promote activity of the TrA to the same degree as the abdominal drawing-in manoeuvre (ADIM) in elderly individuals. [Subjects and Methods] Twenty-one elderly subjects (9 males, 12 females; mean age, 84.9 ± 6.6 years) without LBP symptoms were included. Using ultrasound imaging we measured changes in thickness of the lateral abdominal muscles, TrA, internal oblique muscle (IO), and external oblique muscle (EO) during ADIM and EMT. The load in EMT was set to 15% of maximal expiratory pressure. [Results] TrA showed a significant increase in muscle thickness during ADIM and EMT compared with at rest. A significant increase in muscle thickness was noted for EMT in comparison with ADIM. No significant differences were found for IO and EO. [Conclusion] In elderly people, EMT may be an effective alternative to ADIM for promoting activity of the TrA and can be used as an exercise to maintain TrA function. PMID:29410580

  5. Gas exchange and lung mechanics in patients with acute respiratory distress syndrome: comparison of three different strategies of positive end expiratory pressure selection.

    Science.gov (United States)

    Valentini, Ricardo; Aquino-Esperanza, José; Bonelli, Ignacio; Maskin, Patricio; Setten, Mariano; Danze, Florencia; Attie, Shiry; Rodriguez, Pablo O

    2015-04-01

    The purpose of the study was to compare gas exchange and lung mechanics between different strategies to select positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS). In 20 consecutive ARDS patients, 3 PEEP selection strategies were evaluated. One strategy was based on oxygenation using the ARDS network PEEP/fraction of inspired oxygen (Fio2) table; and two were based on lung mechanics, either PEEP titrated to reach a plateau pressure of 28 to 30 cm H2O as in the ExPress trial or best respiratory compliance method during a derecruitment maneuver. Gas exchange, airway pressures, stress index (SI), and end-expiratory transpulmonary pressure (P(tpe)) and end-inspiratory transpulmonary pressure (P(tpi)) values were assessed. Data are expressed as median (interquartile range [IQR]). Lower total PEEP levels were observed with the use of the PEEP/Fio2 table (8.7 [6-10] cm H2O); intermediate PEEP levels, with the Best Compliance approach (13.0 [10.2-13.8] cm H2O); and higher PEEP levels, with the ExPress strategy (16.5 [15.0-18.5] cm H2O) (P respiratory compliance approach resulted in better oxygenation levels without risk of overdistension according to SI and P(tpi), achieving a mild risk of lung collapse according to P(tpe). Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Effects of Hemibridge with Ball and Balloon Exercise on Forced Expiratory Volume and Pain in Patients with Chronic Low Back Pain: An Experimental Study

    Directory of Open Access Journals (Sweden)

    Jorida Fernandes

    2017-08-01

    Full Text Available Background and objectives: Suboptimal breathing patterns and impairments of posture and trunk stability are often associated with musculoskeletal complaints such as low back pain. Respiration is also affected by poor neuromuscular control of core muscles. Immediate effects of hemibridge with ball and balloon exercise has been studied on chronic pain in athlete population. Objective: To evaluate the effects of hemibridge with ball and balloon exercise on pain, forced expiratory volume and functional abilities in patients with chronic low back pain using Visual Analogue Scale (VAS, Forced Expiratory Volume (FEV and Modified Oswestry Disability Questionnaire (MODQ. Methods: The present experimental study was conducted among 30 participants between the age of 21 to 55 years with chronic non-specific LBP. The participants were given a hemibridge with ball and balloon exercise. Pre-interventional and 3rd day Post-interventional outcome measurements were taken using VAS, FEV1 and FEV6 and MODQ. Results: The difference between pre-and post of VAS was statistically highly significant (p=0.0001. The p value of FEV6 and MODQ by paired t test was statistically significant with p value of 0.02 and 0.0007 respectively. Conclusion: The study concludes that there is an immediate effect of hemibridge with ball and balloon exercise on pain, FEV6 and functional ability in patients with chronic LBP.

  7. Normal Expiratory Flow Rate and Lung Volumes in Patients with Combined Emphysema and Interstitial Lung Disease: A Case Series and Literature Review

    Directory of Open Access Journals (Sweden)

    Karen L Heathcote

    2011-01-01

    Full Text Available Pulmonary function tests in patients with idiopathic pulmonary fibrosis characteristically show a restrictive pattern including small lung volumes and increased expiratory flow rates resulting from a reduction in pulmonary compliance due to diffuse fibrosis. Conversely, an obstructive pattern with hyperinflation results in emphysema by loss of elastic recoil, expiratory collapse of the peripheral airways and air trapping. When the diseases coexist, pulmonary volumes are compensated, and a smaller than expected reduction or even normal lung volumes can be found. The present report describes 10 patients with progressive breathlessness, three of whom experienced severe limitation in their quality of life. All patients showed lung interstitial involvement and emphysema on computed tomography scan of the chest. The 10 patients showed normal spirometry and lung volumes with severe compromise of gas exchange. Normal lung volumes do not exclude diagnosis of idiopathic pulmonary fibrosis in patients with concomitant emphysema. The relatively preserved lung volumes may underestimate the severity of idiopathic pulmonary fibrosis and attenuate its effects on lung function parameters.

  8. Experimental blunt chest trauma--cardiorespiratory effects of different mechanical ventilation strategies with high positive end-expiratory pressure: a randomized controlled study.

    Science.gov (United States)

    Schreiter, Dierk; Carvalho, Nadja C; Katscher, Sebastian; Mende, Ludger; Reske, Alexander P; Spieth, Peter M; Carvalho, Alysson R; Beda, Alessandro; Lachmann, Burkhard; Amato, Marcelo B P; Wrigge, Hermann; Reske, Andreas W

    2016-01-12

    Uncertainty persists regarding the optimal ventilatory strategy in trauma patients developing acute respiratory distress syndrome (ARDS). This work aims to assess the effects of two mechanical ventilation strategies with high positive end-expiratory pressure (PEEP) in experimental ARDS following blunt chest trauma. Twenty-six juvenile pigs were anesthetized, tracheotomized and mechanically ventilated. A contusion was applied to the right chest using a bolt-shot device. Ninety minutes after contusion, animals were randomized to two different ventilation modes, applied for 24 h: Twelve pigs received conventional pressure-controlled ventilation with moderately low tidal volumes (VT, 8 ml/kg) and empirically chosen high external PEEP (16 cmH2O) and are referred to as the HP-CMV-group. The other group (n = 14) underwent high-frequency inverse-ratio pressure-controlled ventilation (HFPPV) involving respiratory rate of 65 breaths · min(-1), inspiratory-to-expiratory-ratio 2:1, development of intrinsic PEEP and recruitment maneuvers, compatible with the rationale of the Open Lung Concept. Hemodynamics, gas exchange and respiratory mechanics were monitored during 24 h. Computed tomography and histology were analyzed in subgroups. Comparing changes which occurred from randomization (90 min after chest trauma) over the 24-h treatment period, groups differed statistically significantly (all P values for group effect ventilation improved respiratory function and fulfilled relevant ventilation endpoints for trauma patients, i.e. restoration of oxygenation and lung aeration while avoiding hypercapnia and respiratory acidosis.

  9. Arterial responses during migraine headache

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg; Nielsen, T H; Olesen, J

    1990-01-01

    The superficial temporal artery has been thought to be the main focus of pain during migraine attacks, but its diameter has never been measured directly. The use of a new, high-resolution ultrasound machine to measure arterial size in 25 migraine patients with unilateral head pain showed...... that the lumen was wider on the painful than on the non-painful side during a migraine attack. The diameters of both radial arteries and the temporal artery on the non-painful side were smaller during than between attacks. The generalised vasoconstriction was not shared by the temporal artery on the affected...... side, which suggests a local vasodilatory response. The findings suggest that cephalic arteries may play a role in migraine pathogenesis....

  10. Understanding Arteries | Coronary Artery Disease | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... Artery If plaque continues to build up, the space inside the artery narrows. The artery walls become ... Plaque forms within the artery walls, narrowing the space inside and sometimes blocking blood flow. This process ...

  11. Resistant spontaneous coronary artery spasm.

    Science.gov (United States)

    Keskin, Kudret; Şahin, Alparslan; Yıldız, Süleyman Sezai; Aksan, Gökhan

    2015-10-01

    Coronary artery spasm should always be suspected in patients who have myocardial infarction with normal coronary arteries. This case report presents a 33-year-old woman with anterior myocardial infarction, whose coronary angiograph revealed normal left anterior descending artery and new onset complete occlusion of the circumflex artery at the time of the procedure. Nitroglycerin up to 800 mcg was administered without success. In such resistant cases, when all efforts fail, including prompt recognition and application of vasodilator drugs, retracting the catheter and waiting may play a role.

  12. Multiple Giant Coronary Artery Aneurysms

    Science.gov (United States)

    Usuku, Hiroki; Kojima, Sunao; Kuyama, Naoto; Hanatani, Shinsuke; Araki, Satoshi; Tsujita, Kenichi; Tsunoda, Ryusuke; Fukui, Toshihiro; Hokimoto, Seiji

    2017-01-01

    A 74-year-old man was admitted to our hospital with chest pain and dyspnea associated with ST elevation in leads II, III and aVF. An echocardiogram showed an enlarged mass lesion measuring nearly 80 mm. Coronary angiography showed two giant coronary artery aneurysms (CAAs) in the right coronary artery (RCA). CAAs were also seen in the left main trunk and left anterior descending artery. Computed tomography showed the CAA in the RCA was ruptured into the right atrium. We therefore diagnosed this patient with multiple CAAs, myocardial infarction and coronary artery rupture. He underwent successful surgical excision and coronary bypass surgery. PMID:28768966

  13. Countercurrent aortography via radial artery

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Hyung Kuk; Lee, Young Chun; Lee, Seung Chul; Jeon, Seok Chol; Joo, Kyung Bin; Lee, Seung Ro; Kim, Soon Yong [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1987-06-15

    Countercurrent aortography via radial artery was performed for detection of aortic arch anomalies in 4 infants with congenital heart disease. Author's cases of aortic arch anomalies were 3 cases of PDA, 1 case of coarctation of aorta, and 1 case of occlusion of anastomosis site on subclavian artery B-T shunt. And aberrant origin of the right SCA, interrupted aortic arch, hypoplastic aorta, anomalous origin of the right pulmonary artery from the ascending aorta can be demonstrated by this method. Countercurrent aortography affords an safe and simple method for detection of aortic arch anomalies without retrograde arterial catheterization, especially in small infants or premature babies.

  14. [Single umbilical artery (SUA)].

    Science.gov (United States)

    Staribratova, D; Belovezhdov, V; Milchev, N; Batashki, I; Apiosjan, Zh

    2010-01-01

    Single umbilical artery (SUA) is the most common abnormality of the umbilical cord. It is associated with an increased incidence of atresia of hollow organs, renal abnormalities, limb reduction defects and spontaneous abortions. The aim of our study is to establish the association of SUA with types of malformations and the corresponding pathology of pregnancy and parturition. Although our investigation is in proof of the association of SUA with anomalies of GIT, CCS and CNS, most of our cases exhibit circulatory disturbances leading to pathology of pregnancy and delivery.

  15. Anomalous left the pulmonary dilemma coronary artery artery from a ...

    African Journals Online (AJOL)

    a continuous murmur associated with angina-like attacks in older patients. Autopsy on these patients reveals a grossly dilated left coronary artery with viable anastomoses between the two coro- nary arteries. Finalll' sudden death is reported in 30% of adults with this anomaly.4, ,10 Characteristically, autopsy shows a large.

  16. Arterial occlusion to treat basilar artery dissecting aneurysm

    NARCIS (Netherlands)

    Cui, Qing Ke; Liu, Wei Dong; Liu, Peng; Li, Xue Yuan; Zhang, Lian Qun; Ma, Long Jia; Ren, Yun Fei; Wu, Ya Ping; Wang, Zhi Gang

    2015-01-01

    Object: To explore the clinical feasibility of employing occlusion to treat basilar artery dissecting aneurysm. Methods: One patient, male and 46 years old, suffered transient numbness and weakness on the right limbs. Cerebral angiography indicated basilar artery dissecting aneurysm. The patient

  17. Anomalous left the pulmonary dilemma coronary artery artery from a ...

    African Journals Online (AJOL)

    ; 8: 787-80I. 6. Wilson CL, Dlabal PW, Holeyfield RW, Akins CW, Knauf DG. Anomalous origin of left coronary artery from pulmonary artery: case report and review of. lileralUre concerning teenagers and adults.J Thorac Cardicn'asc SlIrg 1977; ...

  18. Association between internal carotid artery dissection and arterial tortuosity

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Piga, Mario [Azienda Ospedaliero Universitaria (A.O.U.), Department of Radiology, Monserrato, Cagliari (Italy); Argiolas, Giovanni Maria; Siotto, Paolo [Azienda Ospedaliero Brotzu (A.O.B.), Department of Radiology, di Cagliari (Italy); Sumer, Suna; Wintermark, Max [Neuroradiology Division, Neuroradiology, UVA Department of Radiology, Charlottesville, VA (United States); Raz, Eytan [New York University School of Medicine, Department of Radiology, New York, NY (United States); Sapienza University of Rome, Department of Neurology and Psychiatry, Rome (Italy); Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria (A.O.U.), Department of Vascular Surgery, di Cagliari (Italy)

    2014-10-18

    Carotid artery dissection is an important cause of ischemic stroke in all age groups, particularly in young patients. The purpose of this work was to assess whether there is an association between the presence of an internal carotid artery dissection (ICAD) and the arterial tortuosity. This study considered 124 patients (72 males and 52 females; median age 57 years) with CT/MR diagnosis of ICAD of the internal carotid artery were considered in this multi-centric retrospective study. The arterial tortuosity was evaluated and, when present, was categorized as elongation, kinking, or coiling. For each patient, both the right and left sides were considered for a total number of 248 arteries in order to have the same number of cases and controls. Fisher's exact test was applied to test the association between elongation, kinking, coiling, dissection, and the side affected by CAD. Fisher's exact test showed a statistically significant association between the ICAD and kinking (p = 0.0089) and coiling (p = 0.0251) whereas no statistically significant difference was found with arterial vessel elongation (p = 0.444). ICAD was more often seen on the left side compared to the right (p = 0.0001). These results were confirmed using both carotid arteries of the same patient as dependent parameter with p = 0.0012, 0.0129, and 0.3323 for kinking, coiling, and elongation, respectively. The presence of kinking and coiling is associated with ICAD. (orig.)

  19. Resistive switching mechanism in the one diode-one resistor memory based on p+-Si/n-ZnO heterostructure revealed by in-situ TEM.

    Science.gov (United States)

    Zhang, Lei; Zhu, Liang; Li, Xiaomei; Xu, Zhi; Wang, Wenlong; Bai, Xuedong

    2017-03-21

    One diode-one resistor (1D1R) memory is an effective architecture to suppress the crosstalk interference, realizing the crossbar network integration of resistive random access memory (RRAM). Herein, we designed a p + -Si/n-ZnO heterostructure with 1D1R function. Compared with the conventional multilayer 1D1R devices, the structure and fabrication technique can be largely simplified. The real-time imaging of formation/rupture process of conductive filament (CF) process demonstrated the RS mechanism by in-situ transmission electron microscopy (TEM). Meanwhile, we observed that the formed CF is only confined to the outside of depletion region of Si/ZnO pn junction, and the formation of CF does not degrade the diode performance, which allows the coexistence of RS and rectifying behaviors, revealing the 1D1R switching model. Furthermore, it has been confirmed that the CF is consisting of the oxygen vacancy by in-situ TEM characterization.

  20. Bench and mathematical modeling of the effects of breathing a helium/oxygen mixture on expiratory time constants in the presence of heterogeneous airway obstructions.

    Science.gov (United States)

    Martin, Andrew R; Katz, Ira M; Terzibachi, Karine; Gouinaud, Laure; Caillibotte, Georges; Texereau, Joëlle

    2012-05-30

    Expiratory time constants are used to quantify emptying of the lung as a whole, and emptying of individual lung compartments. Breathing low-density helium/oxygen mixtures may modify regional time constants so as to redistribute ventilation, potentially reducing gas trapping and hyperinflation for patients with obstructive lung disease. In the present work, bench and mathematical models of the lung were used to study the influence of heterogeneous patterns of obstruction on compartmental and whole-lung time constants. A two-compartment mechanical test lung was used with the resistance in one compartment held constant, and a series of increasing resistances placed in the opposite compartment. Measurements were made over a range of lung compliances during ventilation with air or with a 78/22% mixture of helium/oxygen. The resistance imposed by the breathing circuit was assessed for both gases. Experimental results were compared with predictions of a mathematical model applied to the test lung and breathing circuit. In addition, compartmental and whole-lung time constants were compared with those reported by the ventilator. Time constants were greater for larger minute ventilation, and were reduced by substituting helium/oxygen in place of air. Notably, where time constants were long due to high lung compliance (i.e. low elasticity), helium/oxygen improved expiratory flow even for a low level of resistance representative of healthy, adult airways. In such circumstances, the resistance imposed by the external breathing circuit was significant. Mathematical predictions were in agreement with experimental results. Time constants reported by the ventilator were well-correlated with those determined for the whole-lung and for the low-resistance compartment, but poorly correlated with time constants determined for the high-resistance compartment. It was concluded that breathing a low-density gas mixture, such as helium/oxygen, can improve expiratory flow from an obstructed

  1. Carotid artery stenosis -- self-care

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000717.htm Carotid artery stenosis - self-care To use the sharing features on ... feel their pulse under your jawline. Carotid artery stenosis occurs when the carotid arteries become narrowed or ...

  2. Genetics Home Reference: pulmonary arterial hypertension

    Science.gov (United States)

    ... Home Health Conditions Pulmonary arterial hypertension Pulmonary arterial hypertension Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Pulmonary arterial hypertension is a progressive disorder characterized by abnormally high ...

  3. Capsaicin and arterial hypertensive crisis

    National Research Council Canada - National Science Library

    Patanè, Salvatore; Marte, Filippo; La Rosa, Felice Carmelo; La Rocca, Roberto

    2010-01-01

    ...] . A case has also been reported of an arterial hypertensive crisis in a patient with a large ingestion of peppers and chili peppers the day before [5] . We present a case of an arterial hypertensive crisis in a 19-year-old Italian man with an abundant ingestion of peppers and chili peppers the preceding day. On August 4, 2008, a 19-year-...

  4. Heart Attack Coronary Artery Disease

    Science.gov (United States)

    ... prevent or slow the progression of coronary artery disease. A heart-healthy diet, exercise, and other lifestyle choices are the basic steps to keeping your heart strong and healthy. Coronary artery disease begins when fatty deposits (plaques) containing cholesterol build ...

  5. Epigenetics and Peripheral Artery Disease.

    Science.gov (United States)

    Golledge, Jonathan; Biros, Erik; Bingley, John; Iyer, Vikram; Krishna, Smriti M

    2016-04-01

    The term epigenetics is usually used to describe inheritable changes in gene function which do not involve changes in the DNA sequence. These typically include non-coding RNAs, DNA methylation and histone modifications. Smoking and older age are recognised risk factors for peripheral artery diseases, such as occlusive lower limb artery disease and abdominal aortic aneurysm, and have been implicated in promoting epigenetic changes. This brief review describes studies that have associated epigenetic factors with peripheral artery diseases and investigations which have examined the effect of epigenetic modifications on the outcome of peripheral artery diseases in mouse models. Investigations have largely focused on microRNAs and have identified a number of circulating microRNAs associated with human peripheral artery diseases. Upregulating or antagonising a number of microRNAs has also been reported to limit aortic aneurysm development and hind limb ischemia in mouse models. The importance of DNA methylation and histone modifications in peripheral artery disease has been relatively little studied. Whether circulating microRNAs can be used to assist identification of patients with peripheral artery diseases and be modified in order to improve the outcome of peripheral artery disease will require further investigation.

  6. A randomized trial of noninvasive positive end expiratory pressure in patients with acquired immune deficiency syndrome and hypoxemic respiratory failure.

    Science.gov (United States)

    Anjos, Carlos Frederico Dantas; Schettino, Guilherme Paula Pinto; Park, Marcelo; Souza, Vladimir Silva; Scalabrini Neto, Augusto

    2012-02-01

    Acquired immunodeficiency syndrome (AIDS) is a pandemic disease commonly associated with respiratory infections, hypoxemia, and death. Noninvasive PEEP has been shown to improve hypoxemia. In this study, we evaluated the physiologic effects of different levels of noninvasive PEEP in hypoxemic AIDS patients. Thirty AIDS patients with acute hypoxemic respiratory failure received a randomized sequence of noninvasive PEEP (5, 10, or 15 cm H(2)O) for 20 min. PEEP was provided through a facial mask with pressure-support ventilation (PSV) of 5 cm H(2)O and an F(IO(2)) of 1. Patients were allowed to breathe spontaneously for a 20-min washout period in between each PEEP trial. Arterial blood gases and clinical variables were recorded after each PEEP treatment. The results indicate that oxygenation improves linearly with increasing levels of PEEP. However, oxygenation levels were similar regardless of the first PEEP level administered (5, 10, or 15 cm H(2)O), and only the subgroup that received an initial treatment of the lowest level of PEEP (ie, 5 cm H(2)O) showed further improvements in oxygenation when higher PEEP levels were subsequently applied. The P(aCO(2)) also increased in response to PEEP elevation, especially with the highest level of PEEP (ie, 15 cm H(2)O). PSV of 5 cm H(2)O use was associated with significant and consistent improvements in the subjective sensations of dyspnea and respiratory rate reported by patients treated with any level of PEEP (from 0 to 15 cm H(2)O). AIDS patients with hypoxemic respiratory failure improve oxygenation in response to a progressive sequential elevation of PEEP (up to 15 cm H(2)O). However, corresponding elevations in P(aCO(2)) limit the recommended level of PEEP to 10 cm H(2)O. At a level of 5 cm H(2)O, PSV promotes an improvement in the subjective sensation of dyspnea regardless of the PEEP level employed.

  7. Effects of different levels of end-expiratory pressure on hemodynamic, respiratory mechanics and systemic stress response during laparoscopic cholecystectomy.

    Science.gov (United States)

    Sen, Oznur; Erdogan Doventas, Yasemin

    General anesthesia causes reduction of functional residual capacity. And this decrease can lead to atelectasis and intrapulmonary shunting in the lung. In this study we want to evaluate the effects of 5 and 10cmH2O PEEP levels on gas exchange, hemodynamic, respiratory mechanics and systemic stress response in laparoscopic cholecystectomy. American Society of Anesthesiologist I-II physical status 43 patients scheduled for laparoscopic cholecystectomy were randomly selected to receive external PEEP of 5cmH2O (PEEP 5 group) or 10cmH2O PEEP (PEEP 10 group) during pneumoperitoneum. Basal hemodynamic parameters were recorded, and arterial blood gases (ABG) and blood sampling were done for cortisol, insulin and glucose level estimations to assess the systemic stress response before induction of anesthesia. Thirty minutes after the pneumoperitoneum, the respiratory and hemodynamic parameters were recorded again and ABG and sampling for cortisol, insulin, and glucose levels were repeated. Lastly hemodynamic parameters were recorded; ABG analysis and sampling for stress response levels were taken after 60minutes from extubation. There were no statistical differences between the two groups about hemodynamic and respiratory parameters except mean airway pressure (Pmean). Pmean, compliance and PaO2; pH values were higher in 'PEEP 10 group'. Also, PaCO2 values were lower in 'PEEP 10 group'. No differences were observed between insulin and lactic acid levels in the two groups. But postoperative cortisol level was significantly lower in 'PEEP 10 group'. Ventilation with 10cmH2O PEEP increases compliance and oxygenation, does not cause hemodynamic and respiratory complications and reduces the postoperative stress response. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  8. [Effects of different levels of end-expiratory pressure on hemodynamic, respiratory mechanics and systemic stress response during laparoscopic cholecystectomy].

    Science.gov (United States)

    Sen, Oznur; Erdogan Doventas, Yasemin

    General anesthesia causes reduction of functional residual capacity. And this decrease can lead to atelectasis and intrapulmonary shunting in the lung. In this study we want to evaluate the effects of 5 and 10cmH2O PEEP levels on gas exchange, hemodynamic, respiratory mechanics and systemic stress response in laparoscopic cholecystectomy. American Society of Anesthesiologist I-II physical status 43 patients scheduled for laparoscopic cholecystectomy were randomly selected to receive external PEEP of 5cmH2O (PEEP 5 group) or 10cmH2O PEEP (PEEP 10 group) during pneumoperitoneum. Basal hemodynamic parameters were recorded, and arterial blood gases (ABG) and blood sampling were done for cortisol, insulin and glucose level estimations to assess the systemic stress response before induction of anesthesia. Thirty minutes after the pneumoperitoneum, the respiratory and hemodynamic parameters were recorded again and ABG and sampling for cortisol, insulin, and glucose levels were repeated. Lastly hemodynamic parameters were recorded; ABG analysis and sampling for stress response levels were taken after 60minutes from extubation. There were no statistical differences between the two groups about hemodynamic and respiratory parameters except mean airway pressure (Pmean). Pmean, compliance and PaO2; pH values were higher in 'PEEP 10 group'. Also, PaCO2 values were lower in 'PEEP 10 group'. No differences were observed between insulin and lactic acid levels in the two groups. But postoperative cortisol level was significantly lower in 'PEEP 10 group'. Ventilation with 10cmH2O PEEP increases compliance and oxygenation, does not cause hemodynamic and respiratory complications and reduces the postoperative stress response. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  9. Arterial stiffness and cognitive impairment.

    Science.gov (United States)

    Li, Xiaoxuan; Lyu, Peiyuan; Ren, Yanyan; An, Jin; Dong, Yanhong

    2017-09-15

    Arterial stiffness is one of the earliest indicators of changes in vascular wall structure and function and may be assessed using various indicators, such as pulse-wave velocity (PWV), the cardio-ankle vascular index (CAVI), the ankle-brachial index (ABI), pulse pressure (PP), the augmentation index (AI), flow-mediated dilation (FMD), carotid intima media thickness (IMT) and arterial stiffness index-β. Arterial stiffness is generally considered an independent predictor of cardiovascular and cerebrovascular diseases. To date, a significant number of studies have focused on the relationship between arterial stiffness and cognitive impairment. To investigate the relationships between specific arterial stiffness parameters and cognitive impairment, elucidate the pathophysiological mechanisms underlying the relationship between arterial stiffness and cognitive impairment and determine how to interfere with arterial stiffness to prevent cognitive impairment, we searched PUBMED for studies regarding the relationship between arterial stiffness and cognitive impairment that were published from 2000 to 2017. We used the following key words in our search: "arterial stiffness and cognitive impairment" and "arterial stiffness and cognitive impairment mechanism". Studies involving human subjects older than 30years were included in the review, while irrelevant studies (i.e., studies involving subjects with comorbid kidney disease, diabetes and cardiac disease) were excluded from the review. We determined that arterial stiffness severity was positively correlated with cognitive impairment. Of the markers used to assess arterial stiffness, a higher PWV, CAVI, AI, IMT and index-β and a lower ABI and FMD were related to cognitive impairment. However, the relationship between PP and cognitive impairment remained controversial. The potential mechanisms linking arterial stiffness and cognitive impairment may be associated with arterial pulsatility, as greater arterial pulsatility

  10. Patent arterial duct

    Directory of Open Access Journals (Sweden)

    Martin Robin P

    2009-07-01

    Full Text Available Abstract Patent arterial duct (PAD is a congenital heart abnormality defined as persistent patency in term infants older than three months. Isolated PAD is found in around 1 in 2000 full term infants. A higher prevalence is found in preterm infants, especially those with low birth weight. The female to male ratio is 2:1. Most patients are asymptomatic when the duct is small. With a moderate-to-large duct, a characteristic continuous heart murmur (loudest in the left upper chest or infraclavicular area is typical. The precordium may be hyperactive and peripheral pulses are bounding with a wide pulse pressure. Tachycardia, exertional dyspnoea, laboured breathing, fatigue or poor growth are common. Large shunts may lead to failure to thrive, recurrent infection of the upper respiratory tract and congestive heart failure. In the majority of cases of PAD there is no identifiable cause. Persistence of the duct is associated with chromosomal aberrations, asphyxia at birth, birth at high altitude and congenital rubella. Occasional cases are associated with specific genetic defects (trisomy 21 and 18, and the Rubinstein-Taybi and CHARGE syndromes. Familial occurrence of PAD is uncommon and the usual mechanism of inheritance is considered to be polygenic with a recurrence risk of 3%. Rare families with isolated PAD have been described in which the mode of inheritance appears to be dominant or recessive. Familial incidence of PAD has also been linked to Char syndrome, familial thoracic aortic aneurysm/dissection associated with patent arterial duct, and familial patent arterial duct and bicuspid aortic valve associated with hand abnormalities. Diagnosis is based on clinical examination and confirmed with transthoracic echocardiography. Assessment of ductal blood flow can be made using colour flow mapping and pulsed wave Doppler. Antenatal diagnosis is not possible, as PAD is a normal structure during antenatal life. Conditions with signs and symptoms of

  11. Paired inspiratory/expiratory volumetric CT and deformable image registration for quantitative and qualitative evaluation of airflow limitation in smokers with or without copd.

    Science.gov (United States)

    Nishio, Mizuho; Matsumoto, Sumiaki; Tsubakimoto, Maho; Nishii, Tatsuya; Koyama, Hisanobu; Ohno, Yoshiharu; Sugimura, Kazuro

    2015-03-01

    To evaluate paired inspiratory/expiratory computed tomography (CT; iCT/eCT) and deformable image registration for quantitative and qualitative assessment of airflow limitation in smokers. Paired iCT/eCT images acquired from 35 smokers (30 men and 5 women) were coregistered and subtraction images (air trapping CT images [aCT]) generated. To evaluate emphysema quantitatively, the percentage of low-attenuation volume (LAV%) on iCT was calculated at -950 HU, as were mean and kurtosis on aCT for quantitative assessment of air trapping. Parametric response maps of emphysema (PRMe) and of functional small airways disease (PRMs) were also obtained. For qualitative evaluation of emphysema, low-attenuation areas on iCT were scored by consensus of two radiologists using Goddard classification. To assess air trapping qualitatively, the degree of air trapping on aCT was scored. For each quantitative and qualitative index, the Spearman rank correlation coefficient for forced expiratory flow in 1 second was calculated, and differences in correlation coefficients were statistically tested. The correlation coefficients for the indices were as follows: mean on aCT, 0.800; kurtosis on aCT, -0.726; LAV%, -0.472; PRMe, -0.570; PRMs, -0.565; addition of PRMe and PRMs, -0.653; emphysema score, -0.502; air trapping score, -0.793. The indices showing significant differences were as follows: mean on aCT and addition of PRMe and PRMs (P = 1.43 × 10(-8)); air trapping score and emphysema score (P = .0169). Air trapping images yielded more accurate quantitative and qualitative evaluation of airflow limitation than did LAV%, PRMe, PRMs, and Goddard classification. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  12. Accuracy and precision of end-expiratory lung-volume measurements by automated nitrogen washout/washin technique in patients with acute respiratory distress syndrome.

    Science.gov (United States)

    Dellamonica, Jean; Lerolle, Nicolas; Sargentini, Cyril; Beduneau, Gaetan; Di Marco, Fabiano; Mercat, Alain; Richard, Jean-Christophe M; Diehl, Jean-Luc; Mancebo, Jordi; Rouby, Jean-Jacques; Lu, Qin; Bernardin, Gilles; Brochard, Laurent

    2011-01-01

    End-expiratory lung volume (EELV) is decreased in acute respiratory distress syndrome (ARDS), and bedside EELV measurement may help to set positive end-expiratory pressure (PEEP). Nitrogen washout/washin for EELV measurement is available at the bedside, but assessments of accuracy and precision in real-life conditions are scant. Our purpose was to (a) assess EELV measurement precision in ARDS patients at two PEEP levels (three pairs of measurements), and (b) compare the changes (Δ) induced by PEEP for total EELV with the PEEP-induced changes in lung volume above functional residual capacity measured with passive spirometry (ΔPEEP-volume). The minimal predicted increase in lung volume was calculated from compliance at low PEEP and ΔPEEP to ensure the validity of lung-volume changes. Thirty-four patients with ARDS were prospectively included in five university-hospital intensive care units. ΔEELV and ΔPEEP volumes were compared between 6 and 15 cm H2O of PEEP. After exclusion of three patients, variability of the nitrogen technique was less than 4%, and the largest difference between measurements was 81 ± 64 ml. ΔEELV and ΔPEEP-volume were only weakly correlated (r2 = 0.47); 95% confidence interval limits, -414 to 608 ml). In four patients with the highest PEEP (≥ 16 cm H2O), ΔEELV was lower than the minimal predicted increase in lung volume, suggesting flawed measurements, possibly due to leaks. Excluding those from the analysis markedly strengthened the correlation between ΔEELV and ΔPEEP volume (r2 = 0.80). In most patients, the EELV technique has good reproducibility and accuracy, even at high PEEP. At high pressures, its accuracy may be limited in case of leaks. The minimal predicted increase in lung volume may help to check for accuracy.

  13. Effects of increased positive end-expiratory pressure on intracranial pressure in acute respiratory distress syndrome: a protocol of a prospective physiological study.

    Science.gov (United States)

    Chen, Han; Xu, Ming; Yang, Yan-Lin; Chen, Kai; Xu, Jing-Qing; Zhang, Ying-Rui; Yu, Rong-Guo; Zhou, Jian-Xin

    2016-11-15

    There are concerns that the use of positive end-expiratory pressure (PEEP) in patients with brain injury may potentially elevate intracranial pressure (ICP). However, the transmission of PEEP into the thoracic cavity depends on the properties of the lungs and the chest wall. When chest wall elastance is high, PEEP can significantly increase pleural pressure. In the present study, we investigate the different effects of PEEP on the pleural pressure and ICP in different respiratory mechanics. This study is a prospective, single-centre, physiological study in patients with severe brain injury. Patients with acute respiratory distress syndrome with ventricular drainage will be enrolled. An oesophageal balloon catheter will be inserted to measure oesophageal pressure. Patients will be sedated and paralysed; airway pressure and oesophageal pressure will be measured during end-inspiratory occlusion and end-expiratory occlusion. Elastance of the chest wall, the lungs and the respiratory system will be calculated at PEEP levels of 5, 10 and 15 cm H2O. We will classify each patient based on the maximal ΔICP/ΔPEEP being above or below the median for the study population. 2 groups will thus be compared. The study protocol and consent forms were approved by the Institutional Review Board of Fujian Provincial Hospital. Study findings will be disseminated through peer-reviewed publications and conference presentations. NCT02670733; pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Patient-controlled positive end-expiratory pressure with neuromuscular disease: effect on speech in patients with tracheostomy and mechanical ventilation support.

    Science.gov (United States)

    Garguilo, Marine; Leroux, Karl; Lejaille, Michèle; Pascal, Sophie; Orlikowski, David; Lofaso, Frédéric; Prigent, Hélène

    2013-05-01

    Communication is a major issue for patients with tracheostomy who are supported by mechanical ventilation. The use of positive end-expiratory pressure (PEEP) may restore speech during expiration; however, the optimal PEEP level for speech may vary individually. We aimed to improve speech quality with an individually adjusted PEEP level delivered under the patient's control to ensure optimal respiratory comfort. Optimal PEEP level (PEEPeff), defined as the PEEP level that allows complete expiration through the upper airways, was determined for 12 patients with neuromuscular disease who are supported by mechanical ventilation. Speech and respiratory parameters were studied without PEEP, with PEEPeff, and for an intermediate PEEP level. Flow and airway pressure were measured. Microphone speech recordings were subjected to both quantitative and qualitative assessments of speech, including an intelligibility score, a perceptual score, and an evaluation of prosody determined by two speech therapists blinded to PEEP condition. Text reading time, phonation flow, use of the respiratory cycle for phonation, and speech comfort significantly improved with increasing PEEP, whereas qualitative parameters remained unchanged. This resulted mostly from the increase of the expiratory volume through the upper airways available for speech for all patients combined, with a rise in respiratory rate for nine patients. Respiratory comfort remained stable despite high levels of PEEPeff (median, 10.0 cm H2O; interquartile range, 9.5-12.0 cm H₂O). Patient-controlled PEEP allowed for the use of high levels of PEEP with good respiratory tolerance and significant improvement in speech (enabling phonation during the entire respiratory cycle in most patients). The device studied could be implemented in home ventilators to improve speech and, therefore, autonomy of patients with tracheostomy. ClinicalTrials.gov; No.: NCT01479959; URL: clinicaltrials.gov.

  15. Coronary Artery Disease

    DEFF Research Database (Denmark)

    Christiansen, Morten Krogh

    2017-01-01

    A family history of coronary artery disease (CAD) is an important risk factor for adverse coronary events, in particular if the disease has an early onset. The risk of CAD is influenced by genetic and environmental factors with a greater genetic contribution earlier in life. Through recent years......), and to characterize and quantify subclinical atherosclerosis in their relatives. Furthermore, the aim was to explore the impact of common genetic risk variants on the age of onset, familial clustering and disease severity. In study I, 143 patients with early- onset CAD were recruited from the Western Denmark Heart...... burden compared with late-onset CAD patients and healthy controls; however, the burden did not associate with familial clustering of CAD. Additionally, familial clustering seemed to be stronger associated with CAD disease severity than the polygenetic burden. Our findings emphasize the hereditary...

  16. Effect of azithromycin in combination with simvastatin in the treatment of chronic obstructive pulmonary disease complicated by pulmonary arterial hypertension.

    Science.gov (United States)

    Wang, Peidong; Yang, Jie; Yang, Yanwei; Ding, Zhixin

    2017-01-01

    To evaluate the effect of azithromycin in combination with simvastatin in the treatment of chronic obstructive pulmonary disease (COPD) complicated by pulmonary arterial hypertension. Eighty-six patients who developed COPD and pulmonary arterial hypertension and received treatment from August 2013 to October 2014 were selected and randomly divided into an observation group and a control group using random number table, 43 in each group. Patients in the control group were orally administrated 20 mg of simvastatin, once a day. Patients in the observation group took 0.25g of azithromycin enteric-coated tablets, once a day, besides simvastatin. The treatment course of both groups was six months. Blood gas analysis indexes, forced expiratory volume in first second (FEV 1 ), six minutes walking distance, dyspnea grade and blood lipid parameter were recorded and compared between the two groups. Arterial partial pressure of oxygen (PaO 2 ) and arterial partial pressure of carbon dioxide (PaCO 2 ) of the observation group were (68.13±3.03) mmHg and (45.08±2.27) mmHg after treatment, respectively. In the control group, the values were (60.01±4.72) mmHg and (38.93±1.61) mmHg, respectively. The improvement amplitude of the observation group was superior to that of the control group ( P peripheral systolic blood pressure (PSBP) and peripheral diastolic blood pressure (PDBP) of patients in the observation group were both lower than those of the control group, and the difference had statistical significance ( P arterial hypertension as it can significantly relieve ventilation disturbance, improve lung function, and decrease pulmonary arterial pressure. Hence it is worth clinical promotion.

  17. Habitual exercise and arterial aging.

    Science.gov (United States)

    Seals, Douglas R; Desouza, Christopher A; Donato, Anthony J; Tanaka, Hirofumi

    2008-10-01

    Aging affects the function and structure of arteries and increases the risk of cardiovascular diseases (CVD). In healthy sedentary adults, aging is associated with increased stiffness (reduced compliance) of large elastic arteries; impaired vascular endothelial function, including reductions in endothelium-dependent dilation (EDD), release of tissue-type plasminogen activator (fibrinolytic capacity) and endothelial progenitor cell number and function; increased intima-media wall thickness (IMT); and peripheral vasoconstriction (decreased basal leg blood flow). Habitual physical activity/increased aerobic exercise capacity is associated with reduced risk of CVD. Compared with their sedentary peers, adults who regularly perform aerobic exercise demonstrate smaller or no age-associated increases in large elastic artery stiffness, reductions in vascular endothelial function, and increases in femoral artery IMT. A short-term, moderate-intensity aerobic exercise intervention (brisk daily walking for 12 wk) improves carotid artery compliance and can restore vascular endothelial function in previously sedentary middle-aged and older adults. Reduced oxidative stress may be an important mechanism contributing to these effects. Habitual resistance exercise increases (high-intensity) or does not affect (moderate-intensity) large elastic artery stiffness, and prevents/restores the age-associated reduction in basal leg blood flow independent of changes in leg fat-free mass. Habitual exercise favorably modulates several expressions of arterial aging, thus preserving vascular function and possibly reducing the risk of CVD.

  18. Endoscopic Radial Artery Harvest for Coronary Artery Bypass Surgery

    Directory of Open Access Journals (Sweden)

    Kuan-Ming Chiu

    2006-01-01

    Conclusion: Endoscopic harvest of the radial artery is technically demanding, but excellent results can be achieved. The endoscopic approach can provide suitable conduits in a less invasive way than the open harvest technique.

  19. Local intra-arterial fibrinolysis without arterial occlusion?

    Energy Technology Data Exchange (ETDEWEB)

    Schumacher, M.; Yin, L.; Klisch, J. [Section Neuroradiology, Univ. Hospital, Freiburg (Germany); Hetzel, A. [Dept. of Neurology, Univ. Hospital, Freiburg (Germany)

    1999-07-01

    Local intra-arterial fibrinolysis (LIF) is the best choice at present for treatment of acute vessel occlusion in the vertebrobasilar teritory and also, in selected cases, in the carotid territory. In almost all cases angiography demonstrates the site of occlusion exactly and gives information about collateral circulation. Contrary to this common approach, we report five patients with severe acute thromboembolic stroke in whom angiography revealed no occlusion of relevant arteries or their main branches. Under the hypothesis of persisting occlusion of perforating arteries to the brain stem we performed LIF in patients with a clinical basilar artery syndrome. Outcome in all but one of them was good following LIF. The clinical details are described and possible reasons discussed. (orig.)

  20. Peripheral arterial stenosis and coronary artery disease coincidence

    Directory of Open Access Journals (Sweden)

    Reza Ghasemi

    2014-12-01

    Full Text Available Atherosclerosis is a chronic slow-developing condition affecting medium-size and large blood vessels. It is the principal underlying pathology of coronary heart disease and stroke. In some countries, coronary artery disease (CAD is the cause of nearly half (48% of the deaths and, loss of productivity life. Peripheral arterial disease (PAD is defined as atherosclerosis in peripheral arteries instead of coronary arteries. CAD and PAD have same risk factors and underlying pathophysiological processes. Therefore, patient with CAD should be considered for PAD. Ankle brachial index (ABI, duplex sonography, and some other non-invasive techniques are recommended for PAD diagnosis in patients with the history of CAD. Pharmacotherapy, endovascular interventions, and surgical management could be chosen according to the patient’s situation. Cardiologists and general practitioners should consider PAD in a patient with CAD or DM as a strong correlated disease.      

  1. Embolisation of the splenic artery

    Energy Technology Data Exchange (ETDEWEB)

    Essler, G.; Duex, A.

    1982-09-01

    In bleeding of oesophageal varices with resistance to common treatment embolisation of the splenic artery causes depression of the portal hypertension by forty per cent. Thrombosis of the splenic or portal vein as in splenectomies are not to be expected. The splenic vein remains open for later spleno-renal anastomosis. By occlusion of the splenic artery we were successful in stopping oesophageal bleeding. In a patient with dominant hypersplenism in portal hypertension the severity of the syndrome decreased after embolisation of the splenic artery. Thrombocytes, leukocytes and gammaglobulin increased.

  2. Cerebellar arteries originating from the internal carotid artery: angiographic evaluation and embryologic explanations

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Young; Han, Moon Hee; Yu, In Gyu; Chang, Ki Hyun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Eui Jong [Kyunghee Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Dae Ho [Soonchunhyang Univ. College of Medicine, Asan(Korea, Republic of)

    1997-06-01

    To find and describe the cerebellar arteries arising from the internal carotid artery, explain them embryologically, and evaluate their clinical implication. To determine the point in the internal carotid artery from which the cereballar artery arose anomalously, consecutive angiographic studies performed in the last three years were reviewed. The distribution of such anomalous cerebellar arteries, the point in the internal carotid artery from which the anomalous vessels originated, and associated findings were analyzed. Five anomalous origins of cerebellar arteries arising arising directly from the internal carotid artery were found in five patients. Three anterior inferior cerebellar arteries (AICA) and one common trunk of an AICA and a posterior inferior cerebellar artery (PICA) were found to originate from the internal carotid artery at a point close to the origin of the primitive trigeminal artery. A PICA arose from an artery presenting a course similar to the proatlantal intersegmental artery. Intracranial aneurysms in two patients, Moyamoya disease in one, and facial arteriovenous malformation in one. In our series, AICAs supplied from the arteries considered to be persistent trigeminal artery variants were the most common type. A correlation between type of anomalous cerebellar artery and type of carotid-vertebrobasilar anastomosis may exist. Cerebellar arteries originating anomalously from the internal carotid artery seem to occur as a result of the persistence of carotid-vertebrobasilar anastomoses associated with incomplete fusion of the longitudinal neural arteries. An understanding of these anomalous cerebellar arteries may help prevent accidents during therapeutic embolization and surgical treatment, as well as misinterpretation.

  3. Access to the ophthalmic artery by retrograde approach through the posterior communicating artery for intra-arterial chemotherapy of retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Pham, Chi-Tuan; Blanc, Raphael; Pistocchi, Silvia; Bartolini, Bruno; Piotin, Michel [Fondation Rothschild Hospital, Department of Interventional Neuroradiology, Paris (France); Lumbroso-Le Rouic, Livia [Institut Curie, Department of Ocular Oncology, Paris (France)

    2012-08-15

    Intra-arterial infusion of chemotherapy into the ophthalmic artery for treatment of retinoblastoma has been realized after catheterization of the internal carotid and temporary balloon occlusion beyond the orifice of the ophthalmic artery, or more recently after superselective canulation of the ophthalmic artery by a microcatheter. The superselective catheterization of the ophthalmic artery could be cumbersome because of the implantation of the ostium on the carotid siphon or because of the tortuosity of the carotid siphon. We report our experience of using a retrograde approach through the posterior communicating artery that allows a more direct angle of access to the origin of the ophthalmic artery. (orig.)

  4. Straight artery sign in extracranial carotid artery dissection.

    Science.gov (United States)

    Suwanwela, Nijasri C; Phanthumchinda, Kammant; Suwanwela, Nitaya

    2003-06-01

    Magnetic resonance imaging (MRI) has become generally accepted as a non-invasive method to provide the definitive diagnosis of cervicocerebral vessel dissection. The finding of an intramural hematoma on axial MR images is the characteristic sign of the disease. However, there has been no previous report of the characteristic magnetic resonance angiographic (MRA) findings. The authors retrospectively reviewed MRI and MRA findings of patients with spontaneous extracranial carotid dissection. The most striking finding on MRA was the straightness of the affected artery when compared to the non-affected side of the same patient. For quantitative measurement, "Carotid Straightness Index (CSI)" was developed to measure the straightness of the arteries and compared the indices of both extracranial internal carotid arteries in the same patient. The patients' age range was from 21-55 years (mean 38 years). There were 6 males and 3 females. All patients had the classical "Straight artery sign" on the MRA. The carotid straightness index was significantly higher in the affected artery when compared to the normal side of the same patient. The straight artery sign and the carotid straightness index can be very useful for early detection of the extracranial carotid dissection. It can be found in early stage disease or in less severe forms of carotid dissection where significant narrowing is not demonstrated.

  5. Can peak expiratory flow measurements reliably identify the presence of airway obstruction and bronchodilator response as assessed by FEV1 in primary care patients presenting with a persistent cough?

    NARCIS (Netherlands)

    Thiadens, HA; De Bock, GH; Dekker, FW; De Waal, MWM; Springer, MP; Postma, DS

    1999-01-01

    Background-In general practice airway obstruction and the bronchodilator response are usually assessed using peak expiratory flow (PEF) measurements. A study was carried out in patients presenting with persistent cough to investigate to what extent PEF measurements are reliable when compared with

  6. Giant coronary artery aneurysm after Takeuchi repair for anomalous left coronary artery from the pulmonary artery.

    Science.gov (United States)

    Dunlay, Shannon M; Bonnichsen, Crystal R; Dearani, Joseph A; Warnes, Carole A

    2014-01-01

    A 33-year-old woman with an anomalous left coronary artery arising from the pulmonary artery who had undergone Takeuchi repair at age 7 years presented for evaluation. The Takeuchi procedure creates an aortopulmonary window and an intrapulmonary tunnel that baffles the left coronary artery to the aorta. A mediastinal mass was identified as a giant aneurysm of the left coronary artery resulting in compression of the pulmonary artery and left upper pulmonary vein. The patient underwent open repair with patch closure at the aortic entrance of the left coronary Takeuchi repair and resection and evacuation of the aneurysm. A saphenous vein graft to the left anterior descending artery was performed. Postoperative echocardiography demonstrated normal left ventricular function. This is the first reported case of giant aneurysm formation after Takeuchi repair. The reported complications have included the development of pulmonary artery stenosis at the intrapulmonary baffle, baffle leak, decreased left ventricular function, and mitral regurgitation. In conclusion, late complications of the Takeuchi procedure are common, underscoring the importance of lifelong follow-up at a center with experience in treating coronary anomalies. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Coronary artery problems late after arterial switch operation for transposition of the great arteries.

    Science.gov (United States)

    Tsuda, Takeshi; Bhat, Abdul M; Robinson, Bradley W; Baffa, Jeanne M; Radtke, Wolfgang

    2015-01-01

    The incidence of late coronary artery abnormalities after arterial switch operation (ASO) for d-loop transposition of the great arteries may be underestimated. We retrospectively reviewed coronary artery morphology in 40 of 97 patients who survived the first year after ASO. Seven asymptomatic patients developed significant late coronary artery abnormalities. One patient died suddenly at home with severe left coronary artery (LCA) ostial stenosis at age 3.8 years. The second patient collapsed during exercise at age 9.6 years due to ventricular fibrillation and severe LCA ostial stenosis despite prior negative exercise stress test (EST) and myocardial perfusion imaging (MPI). The third patient was found to have moderate ostial stenosis of the LCA with negative EST and MPI. The fourth patient with exercise-induced ST-T depression and myocardial perfusion defect was shown to have complete LCA occlusion with collateral vessel formation. Three other patients had complete proximal obliteration of either of the coronary arteries with collateral supply. An additional 4 asymptomatic patients had trivial-mild narrowing of the LCA on routine selective coronary angiogram. Incidence of late coronary stenosis or occlusion was not infrequent after ASO (11.3%) and presented usually without preceding symptoms and often after negative non-invasive screening. We advocate routine coronary imaging in all patients after ASO before they participate in competitive sports.

  8. Therapeutic arterial embolisation in children

    Energy Technology Data Exchange (ETDEWEB)

    Legge, D.

    1984-05-01

    Arterial embolisation was performed in five paediatric patients. Indications were hypersplenism in two, gastrointestinal bleeding in two and treatment of an aneurysmal bone cyst in one. Embolisation provided definitive treatment in each case with no complications.

  9. Coronary artery anatomy and variants.

    Science.gov (United States)

    Malagò, Roberto; Pezzato, Andrea; Barbiani, Camilla; Alfonsi, Ugolino; Nicolì, Lisa; Caliari, Giuliana; Pozzi Mucelli, Roberto

    2011-12-01

    Variants and congenital anomalies of the coronary arteries are usually asymptomatic, but may present with severe chest pain or cardiac arrest. The introduction of multidetector CT coronary angiography (MDCT-CA) allows the detection of significant coronary artery stenosis. Improved performance with isotropic spatial resolution and higher temporal resolution provides a valid alternative to conventional coronary angiography (CCA) in many patients. MDCT-CA is now considered the ideal tool for three-dimensional visualization of the complex and tortuous anatomy of the coronary arteries. With multiplanar and volume-rendered reconstructions, MDCT-CA may even outperform CCA in determining the relative position of vessels, thus providing a better view of the coronary vascular anatomy. The purpose of this review is to describe the normal anatomy of the coronary arteries and their main variants based on MDCT-CA with appropriate reconstructions.

  10. Coronary artery anatomy and variants

    Energy Technology Data Exchange (ETDEWEB)

    Malago, Roberto; Pezzato, Andrea; Barbiani, Camilla; Alfonsi, Ugolino; Nicoli, Lisa; Caliari, Giuliana; Pozzi Mucelli, Roberto [Policlinico G.B. Rossi, University of Verona, Department of Radiology, Verona (Italy)

    2011-12-15

    Variants and congenital anomalies of the coronary arteries are usually asymptomatic, but may present with severe chest pain or cardiac arrest. The introduction of multidetector CT coronary angiography (MDCT-CA) allows the detection of significant coronary artery stenosis. Improved performance with isotropic spatial resolution and higher temporal resolution provides a valid alternative to conventional coronary angiography (CCA) in many patients. MDCT-CA is now considered the ideal tool for three-dimensional visualization of the complex and tortuous anatomy of the coronary arteries. With multiplanar and volume-rendered reconstructions, MDCT-CA may even outperform CCA in determining the relative position of vessels, thus providing a better view of the coronary vascular anatomy. The purpose of this review is to describe the normal anatomy of the coronary arteries and their main variants based on MDCT-CA with appropriate reconstructions. (orig.)

  11. Living with Carotid Artery Disease

    Science.gov (United States)

    ... arteries and highlights them on x-ray pictures. Magnetic Resonance Angiography Magnetic resonance angiography (MRA) uses a large magnet and ... symptoms start (do not drive yourself to the hospital). For more detailed information about the warning signs ...

  12. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system, sympathetic nervous system, release of...

  13. Coronary artery balloon angioplasty - slideshow

    Science.gov (United States)

    ... and the right heart; the left coronary artery supplies the left heart. Review Date 6/6/2016 Updated by: Deepak Sudheendra, MD, RPVI, Assistant Professor of Interventional Radiology & Surgery at the University of Pennsylvania Perelman School ...

  14. Peripheral Artery Disease and Diabetes

    Science.gov (United States)

    ... Venous Thromboembolism Aortic Aneurysm More Peripheral Artery Disease & Diabetes Updated:Jan 26,2016 People with diabetes are ... life. This content was last reviewed January 2016. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

  15. Idiopathic arterial calcification in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Maya [Department of Paediatric Radiology, Red Cross Children' s Hospital, Cape Town (South Africa); Red Cross Children' s Hospital, School of Child and Adolescent Health, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town (South Africa); Andronikou, Savvas; Solomon, Rustum; Sinclair, Paul; McCulloch, Mignon [Department of Paediatric Radiology, Red Cross Children' s Hospital, Cape Town (South Africa)

    2004-08-01

    Idiopathic arterial calcification in infancy is usually fatal with death in early life and diagnosis at post mortem. This report describes a unique, late presentation with hypertension and cardiac failure in a child aged 33 months, found to have widespread arterial calcification at radiological imaging. The calcium-phosphate axis was normal and there was no other demonstrable cause for calcification. Additionally, the histological features of arterial calcification at renal biopsy paralleled the findings in infants with this disorder. The late presentation in this case is unusual and has not been previously reported. Ultrasound and CT are sensitive for calcification, and the disease should be suspected in children presenting with cardiac or respiratory manifestations and features of arterial calcification, where no metabolic cause is established. (orig.)

  16. Flow measurements in the major visceral arteries

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, J.; Gerhardt, P.; Terwey, B.; Krastel, A.

    1982-02-01

    Arterial flow was measured by the spill-over technique in 202 coeliac arteries and 158 superior mesenteric arteries during the course of visceral angiography in 250 patients. In the coeliac artery a mean value of 15.8 +- 4.3 ml/sec was obtained, flow in the super mesenteric artery was significantly less at 12.1 +- 3.4 ml/sec. The wide variation from 4 to 26 ml/sec in the coeliac artery was remarkable, as well as flows from six to 20 ml/sec in the superior mesenteric artery.

  17. Aberrant ovarian artery arising from the common Iliac artery: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won Kyung [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Yang, Seung Boo; Lee, Jae Myeong [Dept. of Radiology, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi (Korea, Republic of); Goo, Dong Erk; Kim, Yong Jae; Chang, Yun Woo [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    2013-01-15

    A 46-year-old Vietnamese woman received embolization therapy in order to control postpartum hemorrhage. Angiography revealed an aberrant ovarian artery arising from the right common iliac artery. Superselective catheterization and subsequent embolization of the aberrant ovarian artery and bilateral uterine arteries were performed. Precise knowledge of the anatomic variations of the ovarian artery is important for successful embolization.

  18. Arterial compression during overhead throwing: a risk for arterial injury?

    Science.gov (United States)

    Stapleton, Claire H; Elias, Jade; Green, Danny J; Cable, N Tim; George, Keith P

    2010-08-01

    Case studies reporting aneurysm formation in the axillary artery have been described in overhead throwing athletes, possibly due to repetitive arterial compression by the humeral head that has been transiently observed during sonographic diagnostic arm manoeuvres. Whether compression negatively alters arterial health has not been investigated and was the focus of this study. The throwing arm of elite overhead athletes was screened for inducible axillary artery compression. Compressors (COMP, n = 11, mean age: 20 (SD: 2) year, 7 male, 4 female) were age and sex matched with noncompressing (NONCOMP) athlete controls. Four indices of arterial health (flow mediated dilation [FMD], conduit artery vasodilatory capacity [CADC], glyceryl-trinitrate [GTN]-induced vasodilation and intima-media thickness [IMT]) were assessed with high-resolution ultrasound at the brachial and the axillary, artery. No significant between-group differences were observed at the brachial, or axillary, artery for FMD (brachial: COMP: mean (SD) 6.2 (3.1)%, NONCOMP: 6.1 (3.5)%, p = 0.967, axillary: COMP: 8.0 (5.5)%, NONCOMP: 9.0 (3.6)%, p = 0.602), CADC (brachial: COMP: 10.4 (3.4)%, NONCOMP: 10.4 (5.4)%, p = 0.999, axillary: COMP: 9.6 (4.2)%, NONCOMP: 8.5 (3.2)%, p = 0.492), GTN-induced vasodilation (brachial: COMP: 17.9 (5.1)%, NONCOMP:14.1 (7.2)%, p = 0.173, axillary: COMP: 9.5 (4.3)%, NONCOMP: 7.7 (3.1)%, p = 0.302) or IMT (brachial: p = 0.084, axillary: p = 0.581). These results suggest that transient arterial compression, observed during diagnostic arm manoeuvres in overhead throwing athletes, is not associated with abnormal indices of artery function or structure and that other mechanisms must be responsible for the published cases of aneurysm formation in elite athletes performing overhead throwing actions. Copyright 2010 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  19. Habitual exercise and arterial aging

    OpenAIRE

    Seals, Douglas R.; DeSouza, Christopher A.; Donato, Anthony J.; Tanaka, Hirofumi

    2008-01-01

    Aging affects the function and structure of arteries and increases the risk of cardiovascular diseases (CVD). In healthy sedentary adults, aging is associated with increased stiffness (reduced compliance) of large elastic arteries; impaired vascular endothelial function, including reductions in endothelium-dependent dilation (EDD), release of tissue-type plasminogen activator (fibrinolytic capacity) and endothelial progenitor cell number and function; increased intima-media wall thickness (IM...

  20. Arterial function of carotid and brachial arteries in postmenopausal vegetarians

    Directory of Open Access Journals (Sweden)

    Su T

    2011-08-01

    Full Text Available Ta-Chen Su1, Pao-Ling Torng2, Jiann-Shing Jeng3, Ming-Fong Chen1, Chiau-Suong Liau1,41Division of Cardiology, Department of Internal Medicine, 2Department of Obstetrics and Gynecology, 3Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, 4Cardiovascular Center, Taipei Buddist Tzu-Chi Hospital, Hsin-Dian, Taipei, TaiwanBackground: Vegetarianism is associated with a lower risk of cardiovascular disease. However, studies of arterial function in vegetarians are limited.Methods: This study investigated arterial function in vegetarianism by comparing 49 healthy postmenopausal vegetarians with 41 age-matched omnivores. The arterial function of the common carotid artery was assessed by carotid duplex, while the pulse dynamics method was used to measure brachial artery distensibility (BAD, compliance (BAC, and resistance (BAR. Fasting blood levels of glucose, lipids, lipoprotein (a, high-sensitivity C-reactive protein, homocysteine, and vitamin B12 were also measured.Results: Vegetarians had significantly lower serum cholesterol, high-density and low-density lipoprotein, and glucose compared with omnivores. They also had lower vitamin B12 but higher homocysteine levels. Serum levels of lipoprotein (a and high-sensitivity C-reactive protein were no different between the two groups. There were no significant differences in carotid beta stiffness index, BAC, and BAD between the two groups even after adjustment for associated covariates. However, BAR was significantly lower in vegetarians than in omnivores. Multiple linear regression analysis revealed that age and pulse pressure were two important determinants of carotid beta stiffness index and BAD. Vegetarianism is not associated with better arterial elasticity.Conclusion: Apparently healthy postmenopausal vegetarians are not significantly better in terms of carotid beta stiffness index, BAC, and BAD, but have significantly decreased BAR than

  1. Is asymptomatic peripheral arterial disease associated with walking endurance in patients with COPD?

    Science.gov (United States)

    Sun, Kuo-Shao; Lin, Ming-Shian; Chen, Yi-Jen; Chen, Yih-Yuan; Chen, Solomon Chih-Cheng; Chen, Wei

    2015-01-01

    Symptomatic peripheral arterial disease (PAD) is associated with impaired walking endurance in patients with chronic obstructive pulmonary disease (COPD). However, it is unknown whether asymptomatic PAD is associated with impaired walking endurance in patients with COPD. This prospective cross-sectional study enrolled 200 COPD patients (mean age: 70.9 years) who volunteered to perform ankle-brachial index (ABI) and 6-minute walk test (6MWT) consecutively. Demographic data, lung function, dyspnea scales, and cardiovascular risk factors were recorded. The ABI was used to detect PAD (ABI <0.90). All patients were free of PAD symptoms at enrollment. Of the 200 COPD patients, 17 (8.5%) were diagnosed with asymptomatic PAD. The COPD patients without asymptomatic PAD did not walk significantly further on the 6MWT than the COPD patients with asymptomatic PAD (439±86 m vs 408±74 m, P=0.159). The strongest correlation with the distance walked on the 6MWT was Medical Research Council dyspnea scale (r (2)=-0.667, P<0.001), followed by oxygen-cost diagram (r (2)=0.582, P<0.001) and forced expiratory volume in 1 second (r (2)=0.532, P<0.001). In multivariate linear regression analysis, only age, forced expiratory volume in 1 second, and baseline pulse oximetry were independently correlated with the distance covered on the 6MWT (P<0.05). However, body mass index, baseline heart rate, and ABI were not correlated with the distance covered on the 6MWT. Asymptomatic PAD is not associated with walking endurance in patients with COPD. Therefore, it is important to detect and treat asymptomatic PAD early so that COPD patients do not progress to become exercise intolerant. Limited by the small sample size and predominantly male (99%) population in the study, further large-scale prospective studies are needed to verify the results.

  2. Pulmonary emphysema quantitation with Computed Tomography. Comparison between the visual score with high resolution CT, expiratory density mask with spiral CT and lung function studies; Valutazione quantitativa dell`enfisema polmonare mediante Tomografia Computerizzata. Confronto tra il punteggio visivo con alta risoluzione nell`inspirazione, maschera della densita` automatica con Tomografia Computerizzata spirale nell`espirazione ed esami funzionali respiratori

    Energy Technology Data Exchange (ETDEWEB)

    Zompatori, Maurizio; Battaglia, Milva; Rimondi, Maria Rita; Vivacqua, Donatella; Biscarini, Manuela [Policlinico S. Orsola-Malpighi, Bologna (Italy). Radiologia padiglione Pneumonefro; Fasano, Luca; Pacilli, Angela Maria Grazia; Guerrieri, Aldo; Fabbri, Mario [Policlinico S. Orsola-Malpighi, Bologna (Italy). Istituto di Fisiopatologia Respiratoria; Cavina, Mauro [Policlinico S. Orsola-Malpighi, Bologna (Italy). TSRM. Servizio di Tomografia Computerizzata

    1997-04-01

    CT is the most accurate method to detect pulmonary emphysema in vivo. They compared prospectively two different methods for emphysema quantitation in 5 normal volunteers and 20 consecutive patients with chronic obstructive pulmonary disease (COPD). All subjects were submitted to function tests and HRCT; three scans were acquired at preselected levels during inspiration. The type and extent of pulmonary emphysema were defined by two independent observers under blind conditions. Disagreements were subsequently settled by consent. All subjects were also examined with expiratory spiral CT using a density mask program, at two different cut-off levels (-850,-900 HU). Visual score and expiratory spiral density mask values (-850 HU) were significantly correlated (r = 0.86), but the visual extent of emphysema was always higher than shown by expiratory spiral CT. The emphysema extent assessed with both CT methods correlated with the function result of expiratory airflow obstruction and gas diffusion impairment (visual score versus forced expiratory volume in one second: r = -0.81, versus single breath carbon monoxide diffusion: r = -0.78. Spiral expiratory density mask -850 HU versus forced expiratory volume in one second: r = -0.85 versus single breath carbon monoxide diffusion: r = -0.77). When -900 HU was used as the cut-off value for the expiratory density mask, the correlation with single breath carbon monoxide diffusion worsened (r = -0.56). Visual score and expiratory density mask -850 HU gave similar results and permitted COPD patients to be clearly distinguished from normal controls (p < 0.01). They believe the true residual volume should lie somewhere in between the CT value and the function results with the helium dilution technique and conclude that the extent of pulmonary emphysema can be confidently assessed with CT methods. Finally, the simple visual score may be as reliable as such highly sophisticated new methods as the spiral expiratory density mask

  3. Intra-arterial thrombolysis of digital artery occlusions in a patient with polycythemia vera.

    Science.gov (United States)

    Jud, Philipp; Hafner, Franz; Gary, Thomas; Ghanim, Leyla; Lipp, Rainer; Brodmann, Marianne

    2017-01-01

    There are limited therapeutic options for the resolution of digital artery occlusions. Intra-arterial thrombolysis with anticoagulative and thrombolytic drugs successfully restored the blood flow in the affected digital arteries.

  4. Signs and Symptoms of Artery Disease | Coronary Artery Disease | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Coronary Artery Disease Signs and Symptoms of Artery Disease Past Issues / ... narrows or blocks these arteries—a condition called coronary artery disease (CAD) or coronary heart disease (CHD) occurs. A ...

  5. SU-E-T-258: Development of a New Patient Set-Up Monitoring System Using Force Sensing Resistor (FSR) Sensor for the Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Cho, M; Kim, T; Kang, S; Kim, D; Kim, K; Shin, D; Suh, T [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    Purpose: The purpose of this work is to develop a new patient set-up monitoring system using force sensing resistor (FSR) sensors that can confirm pressure of contact surface and evaluate its feasibility. Methods: In this study, we focused on develop the patient set-up monitoring system to compensate for the limitation of existing optical based monitoring system, so the developed system can inform motion in the radiation therapy. The set-up monitoring system was designed consisting of sensor units (FSR sensor), signal conditioning devices (USB cable/interface electronics), a control PC, and a developed analysis software. The sensor unit was made by attaching FSR sensor and dispersing pressure sponge to prevent error which is caused by concentrating specific point. Measured signal from the FSR sensor was sampled to arduino mega 2560 microcontroller, transferred to control PC by using serial communication. The measured data went through normalization process. The normalized data was displayed through the developed graphic user interface (GUI) software. The software was designed to display a single sensor unit intensity (maximum 16 sensors) and display 2D pressure distribution (using 16 sensors) according to the purpose. Results: Changes of pressure value according to motion was confirmed by the developed set-up monitoring system. Very small movement such as little physical change in appearance can be confirmed using a single unit and using 2D pressure distribution. Also, the set-up monitoring system can observe in real time. Conclusion: In this study, we developed the new set-up monitoring system using FSR sensor. Especially, we expect that the new set-up monitoring system is suitable for motion monitoring of blind area that is hard to confirm existing optical system and compensate existing optical based monitoring system. As a further study, an integrated system will be constructed through correlation of existing optical monitoring system. This work was supported by

  6. Non ohmic resistors on water

    OpenAIRE

    Borges, José Flávio Marcelino; UEPG - Paraná; Gabriel, Melina Corrêa; Gabriel; Prestes, Raphael Euclides

    2008-01-01

    In the Physics Laboratory to physicists and engineer students, the concepts studied in theory are experimentally realized as concepts about electric resistance, resistivity and ohmicity. A very simple and efficient way to observe ohmic behavior of resistances was found out by Physics and Engineering students of Universidade Estadual de Ponta Grossa. In this experiment, plastic and discardable tubes of commercial photographic films were filled up with water and water solut...

  7. A case report: accessory right renal artery

    Directory of Open Access Journals (Sweden)

    Patasi B

    2009-10-01

    Full Text Available Anatomical variations in the origin of the arteries in the abdominal area are very common. The arteries that show frequent variations include the celiac trunk, renal and gonadal arteries. During a routine dissection of a male cadaver, one main and one inferior accessory renal artery were found in the abdominal region. We discovered that the inferior accessory renal artery that originated from the right anterolateral aspect of abdominal aorta was running into the lower pole of the right kidney. The origin of the main right renal artery and the inferior accessory right renal artery were 19.8 mm and 53 mm below the superior mesenteric artery, respectively. The inferior accessory right renal artery ran directly into the inferior pole of the right kidney, in the area where the accessory right renal vein was leaving the right kidney. These anatomical variations and anomalies are important to know before any therapeutic or diagnostic procedures are performed in the abdominal area.

  8. Endarterectomized superficial femoral artery as an arterial patch.

    Science.gov (United States)

    Rollins, D L; Towne, J B; Bernhard, V M; Baum, P L

    1985-03-01

    Eighty-six patients underwent 90 profundaplasties for lower extremity ischemia using endarterectomized superficial femoral artery (ESFA) or vein as an arterial patch. Standard length profundaplasty was performed in 60 limbs and extended profundaplasty in 28. Seventy-two were performed for limb salvage and 18 for severe claudication. Fifty-four limbs underwent inflow reconstruction and profundaplasty, while 36 others had profundaplasty alone. Three-year cumulative patency rates were employed to compare the type of autogenous patch material to the profundaplasty length, operative indications, and procedures. In all groups, ESFA performed as well as vein. Endarterectomized superficial femoral artery patch angioplasty provides comparable long-term results to vein patch in patients undergoing profundaplasty, and demonstrates its durability as a vascular patch in situations where autogenous tissue is required or preferred while preserving the saphenous vein for later use.

  9. The impact of two different inspiratory to expiratory ratios (1:1 and 1:2) on respiratory mechanics and oxygenation during volume-controlled ventilation in robot-assisted laparoscopic radical prostatectomy: a randomized controlled trial.

    Science.gov (United States)

    Kim, Min-Soo; Kim, Na Young; Lee, Ki-Young; Choi, Young Deuk; Hong, Jung Hwa; Bai, Sun-Joon

    2015-09-01

    Volume-controlled ventilation with a prolonged inspiratory to expiratory ratio (I:E ratio) has been used to optimize gas exchange and respiratory mechanics in various surgical settings. We hypothesized that, when compared with an I:E ratio of 1:2, a prolonged I:E ratio of 1:1 would improve respiratory mechanics without reducing cardiac output (CO) during pneumoperitoneum and steep Trendelenburg positioning, both of which can impair respiratory function in robot-assisted laparoscopic radical prostatectomy. Furthermore, we evaluated its effect on oxygenation during robot-assisted laparoscopic radical prostatectomy. Eighty patients undergoing robot-assisted laparoscopic radical prostatectomy were randomly allocated to receive an I:E ratio of either 1:1 (group 1:1) or 1:2 (group 1:2). The primary endpoint, peak airway pressure (Ppeak), as well as hemodynamic data, including cardiac output (CO) and arterial oxygen tension (PaO2), were compared between groups at four time points: ten minutes after anesthesia induction (T1), 30 and 60 min after pneumoperitoneum with steep Trendelenburg positioning (T2 and T3), and ten minutes after supine positioning (T4). Overall comparisons were made between groups using linear mixed model analysis with post hoc testing of individual time points adjusted using a Bonferroni correction. Linear mixed model analysis showed a significant overall difference in Ppeak between the two groups (P < 0.001). Post hoc analysis showed a significantly lower mean (SD) Ppeak in group 1:1 than in group 1:2 at T2 [28.4 (4.0) cm H2O vs 32.8 (5.2) cm H2O, respectively; mean difference, 4.3 cm H2O; 95% confidence interval (CI), 2.3 to 6.4; P < 0.001] and T3 [27.8 (3.9) cm H2O vs 32.6 (5.0) cm H2O, respectively; mean difference, 4.7 cm H2O; 95% CI, 2.7 to 6.7; P < 0.001]. The CO assessed over these time points was comparable in both groups (P = 0.784). In addition, there were no significant differences in PaO2 between the two groups (P = 0

  10. Limited Lung Function: Impact of Reduced Peak Expiratory Flow on Health Status, Health-Care Utilization, and Expected Survival in Older Adults

    Science.gov (United States)

    Roberts, Melissa H.; Mapel, Douglas W.

    2012-01-01

    The authors examined whether peak expiratory flow (PEF) is a valid measure of health status in older adults. Survey and test data from the 2006 and 2008 cycles of the Health and Retirement Study, a longitudinal study of US adults over age 50 years (with biennial surveys initiated in 1992), were used to develop predicted PEF regression models and to examine relations between low PEF values and other clinical factors. Low PEF (PEF, on par with those for conditions known to be associated with poor health (cancer, heart disease, and stroke). In a multivariate regression model for difficulty with mobility, PEF remained an independent factor (odds ratio (OR) = 1.69, 95% confidence interval (CI): 1.53, 1.86). Persons with low PEF in 2006 were more likely to be hospitalized (OR = 1.26, 95% CI: 1.10, 1.43) within the subsequent 2 years and to estimate their chances of surviving for 10 or more years at less than 50% (OR = 1.69, 95% CI: 1.24, 2.30). PEF is a valid measure of health status in older persons, and low PEF is an independent predictor of hospitalization and poor subjective mortality assessment. PMID:22759722

  11. Accuracy of maximal expiratory flow-volume curve curvilinearity and fractional exhaled nitric oxide for detection of children with atopic asthma.

    Science.gov (United States)

    Park, Sang Hoo; Im, Min Ji; Eom, Sang-Yong; Hahn, Youn-Soo

    2017-09-01

    Airway pathology in children with atopic asthma can be reflected by the concave shape of the maximal expiratory flow-volume (MEFV) curve and high fractional exhaled nitric oxide (FeNO) values. We evaluated the capacity of the curvilinearity of the MEFV curve, FeNO, and their combination to distinguish subjects with atopic asthma from healthy individuals. FeNO and angle β, which characterizes the general configuration of the MEFV curve, were determined in 119 steroid-naïve individuals with atopic asthma aged 8 to 16 years, and in 92 age-matched healthy controls. Receiver operating characteristic (ROC) curve analyses were performed to determine the cutoff points of FeNO and angle β that provided the best combination of sensitivity and specificity for asthma detection. Asthmatic patients had a significantly smaller angle β and higher FeNO compared with healthy controls (both, Pcurve for the combination of angle β and FeNO improved to 0.91 (95% confidence interval [CI], 0.87-0.95) from 0.80 (95% CI, 0.75-0.86; Pcurve and FeNO is a useful tool to differentiate between children with and without atopic asthma.

  12. Changes in Positive End-Expiratory Pressure Alter the Distribution of Ventilation within the Lung Immediately after Birth in Newborn Rabbits

    Science.gov (United States)

    Kitchen, Marcus J.; Siew, Melissa L.; Wallace, Megan J.; Fouras, Andreas; Lewis, Robert A.; Yagi, Naoto; Uesugi, Kentaro; te Pas, Arjan B.; Hooper, Stuart B.

    2014-01-01

    Current recommendations suggest the use of positive end-expiratory pressures (PEEP) to assist very preterm infants to develop a functional residual capacity (FRC) and establish gas exchange at birth. However, maintaining a consistent PEEP is difficult and so the lungs are exposed to changing distending pressures after birth, which can affect respiratory function. Our aim was to determine how changing PEEP levels alters the distribution of ventilation within the lung. Preterm rabbit pups (28 days gestation) were delivered and mechanically ventilated with one of three strategies, whereby PEEP was changed in sequence; 0-5-10-5-0 cmH2O, 5-10-0-5-0 cmH2O or 10-5-0-10-0 cmH2O. Phase contrast X-ray imaging was used to analyse the distribution of ventilation in the upper left (UL), upper right (UR), lower left (LL) and lower right (LR) quadrants of the lung. Initiating ventilation with 10PEEP resulted in a uniform increase in FRC throughout the lung whereas initiating ventilation with 5PEEP or 0PEEP preferentially aerated the UR than both lower quadrants (pventilation at 10PEEP, the distribution of air at end-inflation was uniform across all quadrants and remained so regardless of the PEEP level. Uniform distribution of ventilation can be achieved by initiating ventilation with a high PEEP. After the lungs have aerated, small and stepped reductions in PEEP result in more uniform changes in ventilation. PMID:24690890

  13. The acute effects of a single session of expiratory muscle strength training on blood pressure, heart rate, and oxygen saturation in healthy adults

    Directory of Open Access Journals (Sweden)

    Helena eLaciuga

    2012-03-01

    Full Text Available Expiratory Muscle Strength Training (EMST is a rehabilitative program that has been tested for outcomes related to respiratory muscle strength, cough, swallow and voice function in healthy young adult, elderly individuals, and in patients with progressive neurodegenerative disease. Because EMST has been used in patient care, the associated cardiovascular responses during EMST are of importance. This study investigated the changes in systolic blood pressure (SBP, diastolic blood pressure (DBP, heart rate (HR, and oxygen saturation (SpO2 during one session of EMST in healthy, young adults as a preliminary study of device safety. Thirty-one participants completed a single session of 25 trials with the EMST device. Valsalva maneuvers were performed at the beginning and at the end of the EMST trials for task comparison. The SBP, DBP, HR, and SpO2 were recorded at the baseline prior to the EMST task and Valsalva, after 12 trials using the EMST device, and after five minutes of rest following the EMST session. A mixed linear model tested for changes across the six time points. The results indicated no significant change of SBP, DBP, HR, or SpO2 during or following the EMST trials or after performing the Valsalva maneuver. The results suggest that EMST does not elicit significant fluctuations of BP, HR, and SpO2 in healthy young adults even when considering the effects of covariates on the outcomes measures.

  14. Vascular Aging and Arterial Stiffness

    Directory of Open Access Journals (Sweden)

    Luana de Rezende Mikael

    Full Text Available Abstract Cardiovascular diseases (CVD account annually for almost one third of all deaths worldwide. Among the CVD, systemic arterial hypertension (SAH is related to more than half of those outcomes. Type 2 diabetes mellitus is an independent risk factor for SAH because it causes functional and structural damage to the arterial wall, leading to stiffness. Several studies have related oxidative stress, production of free radicals, and neuroendocrine and genetic changes to the physiopathogenesis of vascular aging. Indirect ways to analyze that aging process have been widely studied, pulse wave velocity (PWV being considered gold standard to assess arterial stiffness, because there is large epidemiological evidence of its predictive value for cardiovascular events, and it requires little technical knowledge to be performed. A pulse wave is generated during each cardiac contraction and travels along the arterial bed until finding peripheral resistance or any bifurcation point, determining the appearance of a reflected wave. In young individuals, arteries tend to be more elastic, therefore, the reflected wave occurs later in the cardiac cycle, reaching the heart during diastole. In older individuals, however, the reflected wave occurs earlier, reaching the heart during systole. Because PWV is an important biomarker of vascular damage, highly valuable in determining the patient’s global cardiovascular risk, we chose to review the articles on vascular aging in the context of cardiovascular risk factors and the tools available to the early identification of that damage.

  15. Celiac artery thrombosis and superior mesenteric artery stenosis

    Directory of Open Access Journals (Sweden)

    Mohit Sharma

    2016-01-01

    Full Text Available Acute thrombosis of the celiac artery trunk or elsewhere in mesenteric blood supply is a rare cause of acute abdominal pain. Celiac artery thrombosis carries high mortality and morbidity rates if the diagnosis and treatment are delayed. It is frequently associated with other cardiovascular events. The most common etiology is atherosclerosis. The main goal of the treatment is to revascularize and start the diminished or stopped mesenteric blood flow and to avoid end-organ ischemia. Thrombolysis with urokinase followed by anticoagulation with heparin in an emergency situation can save the life of the patient before surgical intervention.

  16. Bilateral variations of renal and testicular arteries

    Directory of Open Access Journals (Sweden)

    Gurses IA

    2009-05-01

    Full Text Available The variations of the arteries that develop from the mesonephric arteries – including renal, gonadal and suprarenal arteries – are common. Understanding the anatomy of the vascular variations of this region is essential for the clinicians to perform procedures such as renal transplantation, interventional radiologic procedures and renal vascular operations more safely and efficiently. In order to facilitate the clinical approaches, we present a male cadaver with bilateral double renal arteries accompanied with doubled right testicular arteries and a left testicular artery of high origin, and we discuss the surgical, radiologic and possible embryologic aspects.

  17. Influência da técnica de pressão expiratória positiva oscilante utilizando pressões expiratórias pré-determinadas na viscosidade e na transportabilidade do escarro em pacientes com bronquiectasia Influence that oscillating positive expiratory pressure using predetermined expiratory pressures has on the viscosity and transportability of sputum in patients with bronchiectasis

    Directory of Open Access Journals (Sweden)

    Ercy Mara Cipulo Ramos

    2009-12-01

    Full Text Available OBJETIVO: Verificar a efetividade da técnica de pressão expiratória positiva oscilante (PEPO utilizando pressões expiratórias pré-determinadas sobre a viscosidade e a transportabilidade do escarro em pacientes com bronquiectasia. MÉTODOS: Foram incluídos no estudo 15 pacientes estáveis com bronquiectasia (7 homens; média de idade = 53 ± 16 anos, submetidos a duas intervenções PEPO consecutivas, com 24 h de intervalo entre si, utilizando pressões expiratórias de 15 cmH2O (P15 e 25 cmH2O (P25. O protocolo consistiu de tosse voluntária; nova expectoração voluntária após 20 min, denominado tempo zero (T0; repouso de 10 min; e utilização da técnica em duas séries de 10 min (S1 e S2 de PEPO em P15 e P25, com intervalo de 10 min entre si. A viscosidade e transportabilidade do escarro foram avaliadas pela viscosimetria, velocidade relativa de transporte no palato de rã, deslocamento em máquina simuladora de tosse e ângulo de adesão. As amostras de escarro foram coletadas em T0, após S1 e após S2. Testes estatísticos específicos foram aplicados de acordo com a distribuição dos dados. RESULTADOS: Houve diminuição significante da viscosidade do escarro após S1 em P15 e após S2 em P25. Não houve diferenças significantes entre todas as amostras para a transportabilidade. CONCLUSÕES: Houve diminuição da viscosidade do escarro quando a PEPO foi realizada em P15 e P25, o que sugere que não seja necessário gerar alta pressão expiratória para obter o resultado desejado.OBJECTIVE: To determine the effectiveness of oscillating positive expiratory pressure (OPEP using predetermined expiratory pressures on the viscosity and transportability of sputum in patients with bronchiectasis. METHODS: The study involved 15 stable patients with bronchiectasis (7 males; mean age = 53 ± 16 years, submitted to two consecutive OPEP interventions, with a 24-h interval between the two, using positive expiratory pressures set at 15 cmH2O

  18. TRANSPOSISI ARTERI BESAR PADA DEWASA

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    Deni Arisanti

    2011-09-01

    Full Text Available AbstrakSeorang laki-laki umur 50 tahun dirawat di Emergensi Penyakit Dalam RSUP Dr. M. Djamil Padang dengan keluhan utama sesak nafas meningkat sejak 1 hari yang lalu. Sesak nafas semakin meningkat jika beraktifitas, dan berkurang jika istirahat dengan posisi bantal yang ditinggikan. Jika sesak nafas sering diikuti dengan bibir dan kuku yang membiru. Pasien sudah dikenal menderita penyakit jantung bawaan, awalnya lahir dengan kulit kebiruan dan mudah tersedak jika menyusu. Dari pemeriksaan fisik didapatkan: Clubbing finger, sianosis, peningkatan Vena Jugolaris, kardiomegali, dan pitting oedema. Dari laboratorium didapatkan: Hemoglobin: 17,1 gr/dl, Hematokrit : 62%, Ureum : 39 mg/dl, Kreatinin : 2,0 mg/dl, TKK :31, Echo Cardiography: Transposisi Arteri Besar, Large Ventrikel Septal Devect, trikuspit regurgitasi dengan hipertensi pulmonal dan moderat Mitral Regurgitasi. Pasien di diagnosa dengan Congestive Heart Failure Functional Class IV LVH- RVH, irama RBBB karena transposisi Arteri Besar dengan Ventrikel Septal Defek.Kata kunci: Transposisi Arteri Besar, Kelainan Jantung Bawaan.AbstractHas been treated a 50 years old man was hospitallized in Internal emengency Department of Dr. M. Djamil Hospital Padang with cief complaints of shortness of breath influenced activity, frequent night waking due to shortness of breath, and an elevated bed with a pillow. On physical examination found: clubbing, cyanosis, increased Jugolaris veins, cardiomegaly, and pitting edema. From the laboratium: Hemoglobin: 17,1 gr/dl, Hematokrit : 62%, Ureum : 39 mg/dl, Kreatinin : 2,0 mg/dl, TKK :31, Echo Cardiography shows: Transposition of the Great Arteries, Large Ventricle Septal Defect, Tricuspid Regurgitation with pulmonary hypertension, and moderate Mitral Regurgitation. Patients with definitife diagnosis: Congestive Heart Failure Functional Class IV LVH- RVH, RBBB rhythm Cause By Transposition of the Great Arteries with a Ventrikel Septal Defec.Key word

  19. Revascularisation of atherosclerotic mesenteric arteries

    DEFF Research Database (Denmark)

    Christensen, Max Greve; Lorentzen, Jørgen Ewald; Schroeder, T V

    1994-01-01

    : Department of Vascular Surgery, University Hospital Rigshospitalet, Copenhagen, Denmark. MATERIALS: 54 women and 36 men, aged 56 (median; range: 34-78 years) underwent 109 consecutive mesenteric reconstructions. The indication in 90 primary procedures was acute mesenteric ischaemia of non-embolic origin...... in 25 patients, chronic ischaemia in 53 and prophylactic reconstruction in connection with aortic surgery in 12 patients. The superior mesenteric artery (SMA) was revascularised in 87 patients and the coeliac axis or common hepatic artery in six. Thus, only three patients had both territories...

  20. Intimal injury from arterial clamps.

    Science.gov (United States)

    Slayback, J B; Bowen, W W; Hinshaw, D B

    1976-08-01

    Preliminary experimental data have been presented indicating that intimal injury of some degree is a virtually constant finding at the site of application of any arterial occluding clamp. These injuries vary from intimal distortion to complete fracture into the media of the vessel. The degree of injury appears directly proportional to the amount of pressure exerted through a given clamp. Atherosclerotic arteries are particularly subject to severe degrees of intimal injury. Preliminary observations suggest that heparin is not helpful in preventing platelet aggregation and initial thrombus formation at intimal injury sites. The problem of anticoagulation at such injury sites is being studied further.