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Zhang Y, Wang D, Gong H, Tang H, Dong G, Wang B, Xia H. A biomechanical study of a polymer material bundled rib fracture fixator. Technol Health Care 2024:THC240928. [PMID: 39093098 DOI: 10.3233/thc-240928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
BACKGROUND Rib fractures are one of the most common blunt injuries, accounting for approximately 10% of all trauma patients and 60% of thoracic injuries. Multiple rib fractures, especially flail chest, can cause local chest wall softening due to the loss of rib support, leading to paradoxical breathing, severe pain, and a high likelihood of accompanying lung contusions. OBJECTIVE This study investigates the mechanical properties of a new polymer material rib internal fixator to provide theoretical data for its clinical use. METHODS We conducted in vitro mechanical tests on 20 fresh caudal fin sheep ribs, using different fracture models across four randomly assigned groups (five ribs per group). The fixators were assessed using non-destructive three-point bending, torsion, and unilateral compression tests, with results averaged. Additionally, finite element analysis compared stress and strain in the polymer fixators and titanium alloy rib plates during bending and torsion tests. RESULTS In vitro tests showed that the polymer fixators handled loads effectively up to a maximum without increase beyond a certain displacement. Bending and torsion tests via finite element analysis showed the polymer material sustained lower maximum equivalent stresses (84.455 MPa and 14.426 MPa) compared to titanium alloy plates (219.88 MPa and 46.47 MPa). CONCLUSION The polymer rib fixator demonstrated sufficient strength for rib fracture fixation and was superior in stress management compared to titanium alloy plates in both bending and torsion tests, supporting its potential clinical application.
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Affiliation(s)
- Yongmin Zhang
- Department of Cardiothoracic Surgery, Tianjin Hospital Affiliated to Tianjin University, Tianjin, China
- Department of Cardiothoracic Surgery, Tianjin Hospital Affiliated to Tianjin University, Tianjin, China
| | - Dongbin Wang
- Department of Cardiothoracic Surgery, Tianjin Hospital Affiliated to Tianjin University, Tianjin, China
- Department of Cardiothoracic Surgery, Tianjin Hospital Affiliated to Tianjin University, Tianjin, China
| | - Hao Gong
- Department of Cardiothoracic Surgery, Tianjin Hospital Affiliated to Tianjin University, Tianjin, China
| | - Haosen Tang
- Graduate School, Tianjin Medical University, Tianjin, China
| | - Guangqi Dong
- Graduate School, Tianjin Medical University, Tianjin, China
| | - Bin Wang
- School of Materials, Tianjin University, Tianjin, China
| | - Honggang Xia
- Department of Cardiothoracic Surgery, Tianjin Hospital Affiliated to Tianjin University, Tianjin, China
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Zheng Y, Chen Y, Li Y, Zheng S, Yang S. Diaphragm dysfunction is found in patients with chronic painful temporomandibular disorder: A case-control study. Heliyon 2024; 10:e32872. [PMID: 39022095 PMCID: PMC11253231 DOI: 10.1016/j.heliyon.2024.e32872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 07/20/2024] Open
Abstract
Aim To determine whether patients with chronic painful temporomandibular disorder (TMD) had abnormal diaphragm function compared to healthy controls and to explore the correlation between diaphragm contractility, psychological status, and pain characteristics. Methods A single-blinded, case-control study was conducted involving 23 chronic painful TMD patients and 22 healthy volunteers. The examination and diagnosis were performed according to the Diagnostic Criteria for Temporomandibular Disorders, and questionnaires were used to evaluate pain, depression, anxiety, and physical symptoms status. B-mode ultrasound was used to measure diaphragm thickness and contractility. The sonographer responsible for measuring the diaphragm was blinded to group membership. Results 1. Depression, anxiety, and physical symptoms scores were significantly higher in the patients than in the controls (p < 0.05). 2. The Interference Score of pain was significantly correlated with depression and physical symptoms (p < 0.01). 3. Bilateral diaphragm contractility was significantly smaller in the patients than in the controls (right: P = 0.003; left: P = 0.001). 3. There was no correlation between diaphragm contractility on the left and right sides in the patients (r = -0.112, P = 0.611), while there was a positive correlation in the control group (r = 0.638, P = 0.001). 4. No correlation was found between the degree of diaphragm contractility, psychological status, and pain scores. Conclusions 1. Patients with chronic painful TMD have worse psychological status, including depression, anxiety, and physical symptoms. 2. Patients with chronic painful TMD have a smaller degree of bilateral diaphragm contractility and more significant left-right incongruity, which indicated that diaphragm dysfunction may be correlated with chronic painful temporomandibular disorder.
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Affiliation(s)
- Yaqing Zheng
- Department of Stomatology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, 363000, China
- Department of Stomatology, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen, 361015, China
| | - Yonghui Chen
- Department of Stomatology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, 363000, China
| | - Yifeng Li
- Department of Stomatology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, 363000, China
| | - Sijing Zheng
- Department of Stomatology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, 363000, China
| | - Shuping Yang
- Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, 363000, China
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Kawamura K, Sasaki K, Sasaki SI, Tomita K. Axonal projection of the medullary expiratory neurons in the feline thoracic spinal cord. Respir Physiol Neurobiol 2024; 322:104218. [PMID: 38237882 DOI: 10.1016/j.resp.2024.104218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 01/26/2024]
Abstract
Expiratory neurons in the caudal ventral respiratory group extend descending axons to the lumbar and sacral spinal cord, and they possess axon collaterals, the distribution of which has been well-documented. Likewise, these expiratory neurons extend axons to the thoracic spinal cord and innervate thoracic expiratory motoneurons. These axons also give rise to collaterals, and their distribution may influence the strength of synaptic connectivity between the axons and the thoracic expiratory motoneurons. We investigated the distribution of axon collaterals in the thoracic spinal cord using a microstimulation technique. This study was performed on cats; one cat was used to make an anatomical atlas and six were used in the experiment. Extracellular spikes of expiratory neurons were recorded in artificially ventilated cats. The thoracic spinal gray matter was microstimulated from dorsal to ventral sites at 100-μm intervals using a glass-insulated tungsten microelectrode with a current of 150-250 μA. The stimulation tracks were made at 1 mm intervals along the spinal cord in segments Th9 to Th13, and the effective stimulating sites of antidromic activation in axon collaterals were systematically mapped. The effective stimulating sites in the contralateral thoracic spinal cord with expiratory neurons in the caudal ventral respiratory group (cVRG) occupied 14.4% of the total length of the thoracic spinal cord examined. The mean percentage of effective stimulating tracks per unit was 18.6 ± 4.4%. The distribution of axon collaterals of expiratory neurons in the feline thoracic spinal cord indeed resembled that reported in the upper lumbar spinal cord. We propose that a single medullary expiratory neuron exerts excitatory effects across multiple segments of the thoracic spinal cord via its collaterals.
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Affiliation(s)
- Kenta Kawamura
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-machi, Inashiki-gun, Ibaraki 300-0394, Japan.
| | - Kazumasa Sasaki
- Department of Anatomy, Toho University, 5-21-16 Ohmorinishi, Ohta-ku, Tokyo 143-8540, Japan
| | - Sei-Ichi Sasaki
- Toyo Public Health College, 6-21-7 Honmachi, Shibuya-ku, Tokyo 151-0071, Japan
| | - Kazuhide Tomita
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-machi, Inashiki-gun, Ibaraki 300-0394, Japan
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Liebsch C, Spering C, Wilke HJ. [Biomechanics of thoracic wall instability]. UNFALLCHIRURGIE (HEIDELBERG, GERMANY) 2024; 127:180-187. [PMID: 37964040 DOI: 10.1007/s00113-023-01389-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 11/16/2023]
Abstract
Traumatic injuries of the thorax can entail thoracic wall instability (flail chest), which can affect both the shape of the thorax and the mechanics of respiration; however, so far little is known about the biomechanics of the unstable thoracic wall and the optimal surgical fixation. This review article summarizes the current state of research regarding experimental models and previous findings. The thoracic wall is primarily burdened by complex muscle and compression forces during respiration and the mechanical coupling to spinal movement. Previous experimental models focused on the burden caused by respiration, but are mostly not validated, barely established, and severely limited with respect to the simulation of physiologically occurring forces. Nevertheless, previous results suggested that osteosynthesis of an unstable thoracic wall is essential from a biomechanical point of view to restore the native respiratory mechanics, thoracic shape and spinal stability. Moreover, in vitro studies also showed better stabilizing properties of plate osteosynthesis compared to intramedullary splints, wires or screws. The optimum number and selection of ribs to be fixated for the different types of thoracic wall instability is still unknown from a biomechanical perspective. Future biomechanical investigations should simulate respiratory and spinal movement by means of validated models.
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Affiliation(s)
- Christian Liebsch
- Institut für Unfallchirurgische Forschung und Biomechanik, Zentrum für Traumaforschung Ulm, Universitätsklinikum Ulm, Helmholtzstr. 14, 89081, Ulm, Deutschland.
| | - Christopher Spering
- Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Hans-Joachim Wilke
- Institut für Unfallchirurgische Forschung und Biomechanik, Zentrum für Traumaforschung Ulm, Universitätsklinikum Ulm, Helmholtzstr. 14, 89081, Ulm, Deutschland
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Tagliabue G, Ji M, Zuege DJ, Easton PA. Divergent expiratory braking activity of costal and crural diaphragm. Respir Physiol Neurobiol 2024; 321:104205. [PMID: 38135107 DOI: 10.1016/j.resp.2023.104205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/27/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND There is increasing clinical interest in understanding the contribution of the diaphragm in early expiration, especially during mechanical ventilation. However, current experimental evidence is limited, so essential activity of the diaphragm during expiration and diaphragm segmental differences in expiratory activity, are unknown. OBJECTIVES To determine if: 1) the diaphragm is normally active into expiration during spontaneous breathing and hypercapnic ventilation, 2) expiratory diaphragmatic activity is distributed equally among the segments of the diaphragm, costal and crural. METHODS In 30 spontaneously breathing male and female canines, awake without confounding anesthetic, we measured directly both inspiratory and expiratory electrical activity (EMG), and corresponding mechanical shortening, of costal and crural diaphragm, during room air and hypercapnia. RESULTS During eupnea, costal and crural diaphragm are active into expiration, showing significant and distinct expiratory activity, with crural expiratory activity greater than costal, for both magnitude and duration. This diaphragm segmental difference diverged further during progressive hypercapnic ventilation: crural expiratory activity progressively increased, while costal expiratory activity disappeared. CONCLUSION The diaphragm is not passive during expiration. During spontaneous breathing, expiratory activity -"braking"- of the diaphragm is expressed routinely, but is not equally distributed. Crural muscle "braking" is greater than costal muscle in magnitude and duration. With increasing ventilation during hypercapnia, expiratory activity -"braking"- diverges notably. Crural expiratory activity greatly increases, while costal expiratory "braking" decreases in magnitude and duration, and disappears. Thus, diaphragm expiratory "braking" action represents an inherent, physiological function of the diaphragm, distinct for each segment, expressing differing neural activation.
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Affiliation(s)
- Giovanni Tagliabue
- University of Calgary, Cumming School of Medicine, Department of Critical Care Medicine, Calgary, Alberta, Canada
| | - Michael Ji
- University of Calgary, Cumming School of Medicine, Department of Critical Care Medicine, Calgary, Alberta, Canada
| | - Danny J Zuege
- University of Calgary, Cumming School of Medicine, Department of Critical Care Medicine, Calgary, Alberta, Canada
| | - Paul A Easton
- University of Calgary, Cumming School of Medicine, Department of Critical Care Medicine, Calgary, Alberta, Canada.
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Liu X, Yang Y, Jia J. Respiratory muscle ultrasonography evaluation and its clinical application in stroke patients: A review. Front Neurosci 2023; 17:1132335. [PMID: 37090789 PMCID: PMC10115993 DOI: 10.3389/fnins.2023.1132335] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
Background Respiratory muscle ultrasound is a widely available, highly feasible technique that can be used to study the contribution of the individual respiratory muscles related to respiratory dysfunction. Stroke disrupts multiple functions, and the respiratory function is often significantly decreased in stroke patients. Method A search of the MEDLINE, Web of Science, and PubMed databases was conducted. We identified studies measuring respiratory muscles in healthy and patients by ultrasonography. Two reviewers independently extracted and documented data regarding to the criteria. Data were extracted including participant demographics, ultrasonography evaluation protocol, subject population, reference values, etc. Result A total of 1954 participants from 39 studies were included. Among them, there were 1,135 participants from 19 studies on diaphragm, 259 participants from 6 studies on extra-diaphragmatic inspiratory muscles, and 560 participants from 14 studies on abdominal expiratory muscles. The ultrasonic evaluation of diaphragm and abdominal expiratory muscle thickness had a relatively typically approach, while, extra-diaphragmatic inspiratory muscles were mainly used in ICU that lack of a consistent paradigm. Conclusion Diaphragm and expiratory muscle ultrasound has been widely used in the assessment of respiratory muscle function. On the contrary, there is not enough evidence to assess extra-diaphragmatic inspiratory muscles by ultrasound. In addition, the thickness of the diaphragm on the hemiplegic side was lower than that on the non-hemiplegic side in stroke patients. For internal oblique muscle (IO), rectus abdominis muscle (RA), transversus abdominis muscle (TrA), and external oblique muscle (EO), most studies showed that the thickness on the hemiplegic side was lower than that on the non-hemiplegic side.Clinical Trial Registration: The protocol of this review was registered in the PROSPERO database (CRD42022352901).
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Affiliation(s)
- Xiaoman Liu
- Department of Rehabilitation Medicine, The People’s Hospital of Suzhou New District, Suzhou, China
| | - Ying Yang
- Department of Rehabilitation Medicine, The People’s Hospital of Suzhou New District, Suzhou, China
| | - Jie Jia
- Department of Rehabilitation Medicine, Fudan University Huashan Hospital, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Fudan University Huashan Hospital, Shanghai, China
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Wang J, Hou X, Zhang X, Wang X, Qin W, Li Q, Ma F, Sun L. Comparison of pulmonary function during interscalene block vs. supraclavicular block: a single-center, double-blind, randomized trial. BMC Anesthesiol 2023; 23:12. [PMID: 36624368 PMCID: PMC9830806 DOI: 10.1186/s12871-022-01967-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023] Open
Abstract
BACKROUND The supraclavicular plexus block (SCB) and interscalene plexus block (ISB) have the potential to pulmonary function, the duration of the potential remains uncertain. So, we compared the effect of SCB and ISB on pulmonary function, especially the duration time. METHODS Ninety-six patients were finally allocated to group I and group S. The ISB and the SCB procedures were performed with ultrasound guidance before anesthesia induction. An investigator recorded the diaphragm mobility and respiratory function test indicators before the block (T0) and at 30 min (T30 min), 4 h (T4), 8 h (T8), and 12 h (T12) after the block. The diaphragmatic paralysis rate was calculated for above timepoint. The VAS, the recovery time for the sensory and motor block, and adverse reactions within 24 h of administering the block were also recorded. RESULTS The recovery times of diaphragm mobility in group I were longer than those in group S. Compared with group I, group S had a significantly lower diaphragmatic paralysis rate during eupnea breathing at T30 min and T8 after the block. Similarly, group S had a significantly lower diaphragmatic paralysis rate at deep breathing at T30 min, T8, and T12 after the block. The recovery times of FEV1 and FVC in group I were longer than those in group S. The other results were not statistically significant. CONCLUSIONS Ultrasound-guided ISB resulted in a longer periods with a suppressive effect on pulmonary function than SCB. TRIALS REGISTRATION 17/12/2019, ChiCTR1900028286.
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Affiliation(s)
- Jiajia Wang
- grid.410645.20000 0001 0455 0905Department of Anesthesiology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, Shandong China
| | - Xinwei Hou
- Department of Anesthesiology, Yingkou Central Hospital, Yingkou, Liaoning China
| | - Xiao Zhang
- grid.410645.20000 0001 0455 0905Department of Anesthesiology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, Shandong China
| | - Xueting Wang
- grid.410645.20000 0001 0455 0905Department of Anesthesiology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, Shandong China
| | - Weiwei Qin
- grid.410645.20000 0001 0455 0905Department of Anesthesiology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, Shandong China
| | - Qiujie Li
- grid.410645.20000 0001 0455 0905Department of Anesthesiology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, Shandong China
| | - Fuguo Ma
- grid.410645.20000 0001 0455 0905Department of Anesthesiology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, Shandong China
| | - Lixin Sun
- grid.410645.20000 0001 0455 0905Department of Anesthesiology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, Shandong China
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Zhao X, Guo S, Xiao S, Song Y. Thorax Dynamic Modeling and Biomechanical Analysis of Chest Breathing in Supine Lying Position. J Biomech Eng 2022; 144:101004. [PMID: 35420121 PMCID: PMC9125866 DOI: 10.1115/1.4054346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 04/06/2022] [Indexed: 11/08/2022]
Abstract
During respiration, the expansion and contraction of the chest and abdomen are coupled with each other, presenting a complex torso movement pattern. A finite element (FE) model of chest breathing based on the HUMOS2 human body model was developed. One-dimensional muscle units with active contraction functions were incorporated into the model based on Hill's active muscle model so as to generate muscle contraction forces that can change over time. The model was validated by comparing it to the surface displacement of the chest and abdomen during respiration. Then, the mechanism of the coupled motion of the chest and abdomen was analyzed. The analyses revealed that since the abdominal wall muscles are connected to the lower edge of the rib cage through tendons, the movement of the rib cage may cause the abdominal wall muscles to be stretched in both horizontal and vertical in a supine position. The anteroposterior and the right-left diameters of the chest will increase at inspiration, while the right-left diameter of the abdomen will decrease even though the anteroposterior diameter of the abdomen increases. The external intercostal muscles at different regions had different effects on the motion of the ribs during respiration. In particular, the external intercostal muscles at the lateral region had a larger effect on pump handle movement than bucket handle movement, and the external intercostal muscles at the dorsal region had a greater influence on bucket handle movement than pump handle movement.
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Affiliation(s)
- Xingli Zhao
- State Key Laboratory of Reliability and Intelligence of Electrical Equipment, Hebei University of Technology, 8, No. 1 Dingzigu Road, Hongqiao District, Tianjin 300131, China; Hebei Key Laboratory of Robot Sensing and Human-Robot Interaction, Hebei University of Technology, 8, No. 1 Dingzigu Road, Hongqiao District, Tianjin 300131, China; School of Mechanical Engineering, Hebei University of Technology, 8, No. 1 Dingzigu Road, Hongqiao District, Tianjin 300131, China
| | - Shijie Guo
- State Key Laboratory of Reliability and Intelligence of Electrical Equipment, Hebei University of Technology, 8, No. 1 Dingzigu Road, Hongqiao District, Tianjin 300131, China; Hebei Key Laboratory of Robot Sensing and Human-Robot Interaction, Hebei University of Technology, 8, No. 1 Dingzigu Road, Hongqiao District, Tianjin 300131, China; School of Mechanical Engineering, Hebei University of Technology, 8, No. 1 Dingzigu Road, Hongqiao District, Tianjin 300131, China
| | - Sen Xiao
- School of Mechanical Engineering, Hebei University of Technology, 8, No. 1 Dingzigu Road, Hongqiao District, Tianjin 300131, China
| | - Yao Song
- State Key Laboratory of Reliability and Intelligence of Electrical Equipment, Hebei University of Technology, 8, No. 1 Dingzigu Road, Hongqiao District, Tianjin 300131, China; Hebei Key Laboratory of Robot Sensing and Human-Robot Interaction, Hebei University of Technology, 8, No. 1 Dingzigu Road, Hongqiao District, Tianjin 300131, China
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Intercostal muscle oxygenation and expiratory loaded breathing at rest: Respiratory pattern effect. Respir Physiol Neurobiol 2022; 304:103925. [PMID: 35662640 DOI: 10.1016/j.resp.2022.103925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/24/2022] [Accepted: 05/29/2022] [Indexed: 11/21/2022]
Abstract
In patients with airway obstruction, an increase in breathing frequency at rest is commonly associated with a dynamic hyperinflation (DH). In such a situation, intercostal muscle oxygenation may be disturbed. This hypothesis was examined in a context of simulated airway obstruction in healthy subjects. After a control period of 5 min, twelve participants (20 ± 2 years) breathed at rest through a 20-cmH2O expiratory threshold load, either by increasing or reducing their respiratory rate (ETLF+ or ETLF). Tissue saturation index (TSI) and concentration changes in oxyhaemoglobin (oxy[Hb+Mb]) were measured as well as cardiorespiratory variables. Inspiratory capacity was decreased in ETLF+ (p < 0.001) and correlated with dyspnea. An increase in oxy[Hb+Mb] occurred in ETLF+ that was higher than in ETLF (p < 0.01). TSI was not different between conditions. In healthy subjects at rest, an increase in respiratory rate during a simulated obstruction with an expiratory threshold load resulted in paradoxical response with DH emergence while intercostal muscle oxygenation was preserved.
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Khurram OU, Gransee HM, Sieck GC, Mantilla CB. Automated evaluation of respiratory signals to provide insight into respiratory drive. Respir Physiol Neurobiol 2022; 300:103872. [PMID: 35218924 PMCID: PMC9157394 DOI: 10.1016/j.resp.2022.103872] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/09/2022] [Accepted: 02/17/2022] [Indexed: 01/17/2023]
Abstract
The diaphragm muscle (DIAm) is the primary inspiratory muscle in mammals and is highly active throughout life displaying rhythmic activity. The repetitive activation of the DIAm (and of other muscles driven by central pattern generator activity) presents an opportunity to analyze these physiological data on a per-event basis rather than pooled on a per-subject basis. The present study highlights the development and implementation of a graphical user interface-based algorithm using an analysis of critical points to detect the onsets and offsets of individual respiratory events across a range of motor behaviors, thus facilitating analyses of within-subject variability. The algorithm is designed to be robust regardless of the signal type (e.g., EMG or transdiaphragmatic pressure). Our findings suggest that this approach may be particularly beneficial in reducing animal numbers in certain types of studies, for assessments of perturbation studies where the effects are relatively small but potentially physiologically meaningful, and for analyses of respiratory variability.
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Affiliation(s)
- Obaid U Khurram
- Department of Physiology, Northwestern University, Chicago, IL 60611, USA; Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL 60611, USA.
| | - Heather M Gransee
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Gary C Sieck
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN 55905, USA; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
| | - Carlos B Mantilla
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN 55905, USA; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
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Vergari C, Skalli W, Clavel L, Demuynck M, Valentin R, Sandoz B, Similowski T, Attali V. Functional analysis of the human rib cage over the vital capacity range in standing position using biplanar X-ray imaging. Comput Biol Med 2022; 144:105343. [DOI: 10.1016/j.compbiomed.2022.105343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 11/24/2022]
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Jia Y, Zhang Q. Research Progress on Diaphragm Ultrasound in Chronic Obstructive Pulmonary Disease: A Narrative Review. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:587-597. [PMID: 35065813 DOI: 10.1016/j.ultrasmedbio.2021.10.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 09/28/2021] [Accepted: 10/28/2021] [Indexed: 06/14/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a common disease of the respiratory system, and its prevalence and mortality remain high. COPD results in continuous impairment of lung function, which severely affects the patient's work and life. In severe cases, there will be acute respiratory failure, which endangers the lives of patients, and respiratory muscle dysfunction is one of the main reasons for this result. As the diaphragm is the most important inspiratory muscle, its dysfunction has a great impact on the deterioration of respiratory function in COPD patients. With the development of ultrasound, more and more studies have found that diaphragm ultrasound can play an important role in the diagnosis and treatment of COPD patients. The main purpose of this article is to review the research progress on diaphragm ultrasound in COPD and briefly introduce diaphragmatic ultrasound examination methods.
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Affiliation(s)
- Yuhao Jia
- Department of Ultrasound, Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Qunxia Zhang
- Department of Ultrasound, Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
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Kim SH, Shin HJ, Cho HY. Impact of Types of Breathing on Static Balance Ability in Healthy Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031205. [PMID: 35162227 PMCID: PMC8835336 DOI: 10.3390/ijerph19031205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 12/04/2022]
Abstract
Recent studies have suggested that breathing type may affect balance ability. However, most of these studies were conducted on the elderly and patients with musculoskeletal or neurological disorders. Therefore, the effect of voluntary breathing, such as thoracic and abdominal breathing, on the balance ability of people in various age groups is not clearly understood. The purpose of this study was to investigate the differences in balance ability according to the type of breathing in healthy young adults. This study included 78 healthy, young adults. All subjects were assessed for balance ability in neutral breathing, thoracic breathing, and abdominal breathing through a crossover design. Balance ability was assessed during static standing using a force plate. Participants were trained in voluntary breathing, evaluated using electromyography. During voluntary breathing, sway velocity, anterior-posterior difference, and anterior-posterior standard deviation increased while anterior-posterior sample entropy decreased compared to neutral breathing (p < 0.05). Compared with thoracic breathing, abdominal breathing increased sway velocity and variability, and reduced complexity (p < 0.05). These findings show that balance ability is affected by breathing, even in healthy young adults.
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Affiliation(s)
- Sung-Hyeon Kim
- Department of Health Science, Gachon University Graduate School, Incheon 21936, Korea; (S.-H.K.); (H.-J.S.)
| | - Ho-Jin Shin
- Department of Health Science, Gachon University Graduate School, Incheon 21936, Korea; (S.-H.K.); (H.-J.S.)
| | - Hwi-Young Cho
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon 21936, Korea
- Correspondence: ; Tel.: +82-32-820-4560; Fax: +82-32-820-4449
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14
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Effect of chest mobilization on intercostal muscle stiffness. Curr Res Physiol 2022; 5:429-435. [DOI: 10.1016/j.crphys.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 11/30/2022] Open
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Burgos J, Barrios C, Mariscal G, Lorente A, Lorente R. Non-uniform Segmental Range of Motion of the Thoracic Spine During Maximal Inspiration and Exhalation in Healthy Subjects. Front Med (Lausanne) 2021; 8:699357. [PMID: 34527680 PMCID: PMC8435595 DOI: 10.3389/fmed.2021.699357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background and Objective: To analyse the range of motion of the thoracic spine by radiographically measuring changes in the sagittal profile of different thoracic segments during maximal inspiration and exhalation. The starting hypothesis was that forced deep breathing requires an active, but non-uniform widening of the lordotic–kyphotic range of motion of the different thoracic segments. Methods: Cross-sectional study. Participants were 40 healthy volunteers aged 21–60. Conventional anteroposterior and functional sagittal chest radiographs were performed during maximal inspiration and exhalation. The range of motion of each spinal thoracic functional segment, global T1–T12 motion, and the sagittal displacement of the thoracic column during breathing were measured. Considering the different type of ribs and their attachment the spine and sternum, thoracic segments were grouped in T1–T7, T7–T10, and T10–T12. The displacement of the thoracic spine with respect to the sternum and manubrium was also recorded. Results: The mean difference from inspiration to exhalation in the T1–T12 physiologic kyphosis was 15.9° ± 4.6°, reflecting the flexibility of the thoracic spine during deep breathing (30.2%). The range of motion was wider in the caudal hemicurve than in the cranial hemicurve, indicating more flexibility of the caudal component of the thoracic kyphosis. A wide range of motion from inspiration to exhalation was found at T7–T10, responsible for 73% of T1–T12 sagittal movement. When the sample was stratified according to age ranges (20–30, 30–45, and 45–60 yr.), none of the measurements for inspiration or exhalation showed statistically significant differences. Only changes at this level showed a positive correlation with changes in the global thoracic kyphosis (r = 0.794, p <0.001). Conclusion: The range of motion of the thoracic spine plays a relevant role in respiration dynamics. Maximal inspiration appears to be highly dependent on the angular movements of the T7–T10 segment.
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Affiliation(s)
- Jesús Burgos
- Division of Pediatric Orthopedics, Hospital Ramon y Cajal, Madrid, Spain
| | - Carlos Barrios
- Institute for Research on Musculoskeletal Disorders, Valencia Catholic University, Valencia, Spain
| | - Gonzalo Mariscal
- Institute for Research on Musculoskeletal Disorders, Valencia Catholic University, Valencia, Spain
| | - Alejandro Lorente
- Orthopaedic Surgery Department, Hospital Ramon y Cajal, Madrid, Spain
| | - Rafael Lorente
- Spine Surgery Unit, Hospital Infanta Cristina, Badajoz, Spain
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16
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Luu BL, McDonald RJ, Bolsterlee B, Héroux ME, Butler JE, Hudson AL. Movement of the ribs in supine humans for small and large changes in lung volume. J Appl Physiol (1985) 2021; 131:174-183. [PMID: 34013751 DOI: 10.1152/japplphysiol.01046.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
An object-tracking algorithm was used on computed tomography (CT) images of the thorax from six healthy participants and nine participants with chronic obstructive pulmonary disease (COPD) to describe the movement of the ribs between the static lung volumes of functional residual capacity (FRC) and total lung capacity (TLC). The continuous motion of the ribs during tidal breathing was also described using four-dimensional CT datasets from seven participants with thoracic esophageal malignancies. Rib motion was defined relative to a local joint coordinate system where rotations about the axes that predominantly affected the anteroposterior and transverse diameters of the rib cage were referred to as pump-handle and bucket-handle movements, respectively. Between TLC and FRC, pump-handle movements were 1.8 times larger in healthy participants than in participants with COPD, in line with their 1.6 times larger inspiratory capacities. However, when rib motion was normalized to the change in lung volume, pump-handle movements were similar for healthy participants and participants with COPD. We found no differences in bucket-handle movements between participant groups before and after normalization. Pump-handle movement was the dominant rib motion between FRC and TLC, on average four times greater than bucket-handle movement in healthy participants. For expiratory tidal volume, pump-handle movements were 20% smaller than bucket-handle movements. When normalized to tidal volume and compared with inspiratory capacity, pump-handle movements were smaller and bucket-handle movements were larger during tidal breathing. The findings suggest that the pump-handle and bucket-handle components of rib motion vary for small and large changes in lung volume.NEW & NOTEWORTHY Rib movements over inspiratory capacity are comparable for healthy participants and participants with chronic obstructive pulmonary disease when normalized to the change in lung volume. The kinematics of the ribs during tidal breathing were described from four-dimensional computed tomography images. For large changes in lung volume with inspiratory capacity, pump-handle movements of the ribs are four times greater than bucket-handle movements, whereas at tidal volume, pump-handle movements are 20% smaller than bucket-handle movements.
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Affiliation(s)
- Billy L Luu
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Rhys J McDonald
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,University of New South Wales, Sydney, New South Wales, Australia
| | - Bart Bolsterlee
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,University of New South Wales, Sydney, New South Wales, Australia
| | - Martin E Héroux
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,University of New South Wales, Sydney, New South Wales, Australia
| | - Jane E Butler
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,University of New South Wales, Sydney, New South Wales, Australia
| | - Anna L Hudson
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,University of New South Wales, Sydney, New South Wales, Australia
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Ladjal H, Beuve M, Giraud P, Shariat B. Towards Non-Invasive Lung Tumor Tracking Based on Patient Specific Model of Respiratory System. IEEE Trans Biomed Eng 2021; 68:2730-2740. [PMID: 33476262 DOI: 10.1109/tbme.2021.3053321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The goal of this paper is to calculate a complex internal respiratory and tumoral movements by measuring respiratory air flows and thorax movements. In this context, we present a new lung tumor tracking approach based on a patient-specific biomechanical model of the respiratory system, which takes into account the physiology of respiratory motion to simulate the real non-reproducible motion. The behavior of the lungs, is directly driven by the simulated actions of the breathing muscles, i.e. the diaphragm and the intercostal muscles (the rib cage). In this paper, the lung model is monitored and controlled by a personalized lung pressure/volume relationship during a whole respiratory cycle. The lung pressure and rib kinematics are patient specific and obtained by surrogate measurement. The rib displacement corresponding to the transformation which was computed by finite helical axis method from the end of exhalation (EE) to the end of inhalation (EI). The lung pressure is calculated by an optimization framework based on inverse finite element analysis, by minimizing the lung volume errors, between the respiratory volume (respiratory airflow exchange) and the simulated volume (calculated by biomechanical simulation). We have evaluated the model accuracy on five public datasets. We have also evaluated the lung tumor motion identified in 4D CT scan images and compared it with the trajectory that was obtained by finite element simulation. The effects of rib kinematics on lung tumor trajectory were investigated. Over all phases of respiration, our developed model is able to predict the lung tumor motion with an average landmark error of [Formula: see text]. The results demonstrate the effectiveness of our physics-based model. We believe that this model can be potentially used in 4D dose computation, removal of breathing motion artifacts in positron emission tomography (PET) or gamma prompt image reconstruction.
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Bretonneau Q, Pichon A, de Bisschop C. Effect of expiratory loaded breathing during moderate exercise on intercostal muscle oxygenation. Multidiscip Respir Med 2020; 15:702. [PMID: 33154819 PMCID: PMC7610065 DOI: 10.4081/mrm.2020.702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/16/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In patients with obstructive lung disease, maintaining adequate ventilation during exercise may require greater contraction of the respiratory muscles, which may lead to a compression of muscle capillaries. Furthermore, dynamic hyperinflation (DH) is frequent during exercise in these patients, as it allows to reach higher expiratory flows and to satisfy respiratory demand. However, in such situation, intercostal muscles are likely to be stretched, which could affect the diameter of their capillaries. Thus, in a context of high level of expiratory resistance, intercostal muscle oxygenation may be disturbed during exercise, especially if DH occurs. METHODS Twelve participants (22±2 years) performed two sessions of moderate exercise (20 min) by breathing freely with and without a 20-cmH2O expiratory threshold load (ETL). Tissue saturation index (TSI) and concentration changes from rest (Δ) in oxygenated ([O2Hb]) and total haemoglobin ([tHb]) were measured in the seventh intercostal space using near-infrared spectroscopy. Respiratory, metabolic and cardiac variables were likewise recorded. RESULTS Throughout exercise, dyspnea was higher and TSI was lower in ETL condition than in control (p<0.01). After a few minutes of exercise, Δ [O2Hb] was also lower in ETL condition, as well as Δ [tHb], when inspiratory capacity started to be reduced (p<0.05). Changes in [O2Hb] and dyspnea were correlated with changes in expiratory flow rate (Vt/Te) (r = -0.66 and 0.66, respectively; p<0.05). CONCLUSION During exercise with ETL, impaired muscle oxygenation could be due to a limited increase in blood volume resulting from strong muscle contraction and/or occurrence of DH.
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Affiliation(s)
- Quentin Bretonneau
- Faculté des Sciences du Sport, Laboratoire ‘MOVE’ (EA 6314), Université de Poitiers, France
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19
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Fung PCW, Kong RKC. A Novel Apprehension of the Primary Lung Meridian, Sinew Channel, Divergent Channel, Luo-Connecting Channel Acting as a Single Unit System to Serve Respiration Function Based on Modern Neurophysiology and Kinesiology. Chin Med 2020. [DOI: 10.4236/cm.2020.112004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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20
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Liebsch C, Graf N, Wilke HJ. In vitro analysis of kinematics and elastostatics of the human rib cage during thoracic spinal movement for the validation of numerical models. J Biomech 2019; 94:147-157. [DOI: 10.1016/j.jbiomech.2019.07.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/25/2019] [Accepted: 07/27/2019] [Indexed: 11/26/2022]
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21
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Shi ZH, Jonkman A, de Vries H, Jansen D, Ottenheijm C, Girbes A, Spoelstra-de Man A, Zhou JX, Brochard L, Heunks L. Expiratory muscle dysfunction in critically ill patients: towards improved understanding. Intensive Care Med 2019; 45:1061-1071. [PMID: 31236639 PMCID: PMC6667683 DOI: 10.1007/s00134-019-05664-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 05/30/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION This narrative review summarizes current knowledge on the physiology and pathophysiology of expiratory muscle function in ICU patients, as shared by academic professionals from multidisciplinary, multinational backgrounds, who include clinicians, clinical physiologists and basic physiologists. RESULTS The expiratory muscles, which include the abdominal wall muscles and some of the rib cage muscles, are an important component of the respiratory muscle pump and are recruited in the presence of high respiratory load or low inspiratory muscle capacity. Recruitment of the expiratory muscles may have beneficial effects, including reduction in end-expiratory lung volume, reduction in transpulmonary pressure and increased inspiratory muscle capacity. However, severe weakness of the expiratory muscles may develop in ICU patients and is associated with worse outcomes, including difficult ventilator weaning and impaired airway clearance. Several techniques are available to assess expiratory muscle function in the critically ill patient, including gastric pressure and ultrasound. CONCLUSION The expiratory muscles are the "neglected component" of the respiratory muscle pump. Expiratory muscles are frequently recruited in critically ill ventilated patients, but a fundamental understanding of expiratory muscle function is still lacking in these patients.
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Affiliation(s)
- Zhong-Hua Shi
- Department of Intensive Care Medicine, Amsterdam UMC, Location VUmc, Postbox 7057, 1007 MB,, Amsterdam, The Netherlands
- Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
| | - Annemijn Jonkman
- Department of Intensive Care Medicine, Amsterdam UMC, Location VUmc, Postbox 7057, 1007 MB,, Amsterdam, The Netherlands
| | - Heder de Vries
- Department of Intensive Care Medicine, Amsterdam UMC, Location VUmc, Postbox 7057, 1007 MB,, Amsterdam, The Netherlands
| | - Diana Jansen
- Department of Anesthesiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Coen Ottenheijm
- Department of Physiology, Amsterdam UMC, Location VUmc, Postbox 7057, 1007 MB, Amsterdam, The Netherlands
| | - Armand Girbes
- Department of Intensive Care Medicine, Amsterdam UMC, Location VUmc, Postbox 7057, 1007 MB,, Amsterdam, The Netherlands
| | - Angelique Spoelstra-de Man
- Department of Intensive Care Medicine, Amsterdam UMC, Location VUmc, Postbox 7057, 1007 MB,, Amsterdam, The Netherlands
| | - Jian-Xin Zhou
- Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
| | - Laurent Brochard
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Leo Heunks
- Department of Intensive Care Medicine, Amsterdam UMC, Location VUmc, Postbox 7057, 1007 MB,, Amsterdam, The Netherlands.
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Shih KS, Truong TA, Hsu CC, Hou SM. Biomechanical investigation of different surgical strategies for the treatment of rib fractures using a three-dimensional human respiratory model. ACTA ACUST UNITED AC 2019; 64:93-102. [PMID: 29095691 DOI: 10.1515/bmt-2017-0072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 10/09/2017] [Indexed: 01/17/2023]
Abstract
Rib fracture is a common injury and can result in pain during respiration. Conservative treatment of rib fracture is applied via mechanical ventilation. However, ventilator-associated complications frequently occur. Surgical fixation is another approach to treat rib fractures. Unfortunately, this surgical treatment is still not completely defined. Past studies have evaluated the biomechanics of the rib cage during respiration using a finite element method, but only intact conditions were modelled. Thus, the purpose of this study was to develop a realistic numerical model of the human rib cage and to analyse the biomechanical performance of intact, injured and treated rib cages. Three-dimensional finite element models of the human rib cage were developed. Respiratory movement of the human rib cage was simulated to evaluate the strengths and limitations of different scenarios. The results show that a realistic human respiratory movement can be simulated and the predicted results were closely related to previous study (correlation coefficient>0.92). Fixation of two fractured ribs significantly decreased the fixation index (191%) compared to the injured model. This fixation may provide adequate fixation stability as well as reveal lower bone stress and implant stress compared with the fixation of three or more fractured ribs.
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Affiliation(s)
- Kao-Shang Shih
- Department of Orthopedic Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan, ROC.,College of Medicine, Fu Jen Catholic University, Taipei 242, Taiwan, ROC
| | - Thanh An Truong
- Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taipei 106, Taiwan, ROC
| | - Ching-Chi Hsu
- Graduate Institute of Applied Science and Technology, National Taiwan University of Science and Technology, No. 43, Sec. 4, Keelung Rd., Taipei 106, Taiwan, ROC
| | - Sheng-Mou Hou
- Department of Orthopedic Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan, ROC
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Fogarty MJ, Sieck GC. Evolution and Functional Differentiation of the Diaphragm Muscle of Mammals. Compr Physiol 2019; 9:715-766. [PMID: 30873594 PMCID: PMC7082849 DOI: 10.1002/cphy.c180012] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Symmorphosis is a concept of economy of biological design, whereby structural properties are matched to functional demands. According to symmorphosis, biological structures are never over designed to exceed functional demands. Based on this concept, the evolution of the diaphragm muscle (DIAm) in mammals is a tale of two structures, a membrane that separates and partitions the primitive coelomic cavity into separate abdominal and thoracic cavities and a muscle that serves as a pump to generate intra-abdominal (Pab ) and intrathoracic (Pth ) pressures. The DIAm partition evolved in reptiles from folds of the pleural and peritoneal membranes that was driven by the biological advantage of separating organs in the larger coelomic cavity into separate thoracic and abdominal cavities, especially with the evolution of aspiration breathing. The DIAm pump evolved from the advantage afforded by more effective generation of both a negative Pth for ventilation of the lungs and a positive Pab for venous return of blood to the heart and expulsive behaviors such as airway clearance, defecation, micturition, and child birth. © 2019 American Physiological Society. Compr Physiol 9:715-766, 2019.
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Affiliation(s)
- Matthew J Fogarty
- Mayo Clinic, Department of Physiology & Biomedical Engineering, Rochester, Minnesota, USA
| | - Gary C Sieck
- Mayo Clinic, Department of Physiology & Biomedical Engineering, Rochester, Minnesota, USA
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Differential Cortical Control of Chest Wall Muscles During Pressure- and Volume-Related Expiratory Tasks and the Effects of Acute Expiratory Threshold Loading. Motor Control 2019; 23:13-33. [PMID: 29902955 DOI: 10.1123/mc.2016-0055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 01/25/2018] [Accepted: 02/23/2018] [Indexed: 11/18/2022]
Abstract
We examined whether or not coherence between chest wall intercostal and oblique muscles changed as a function of lung volume excursion, alveolar pressure, and muscular demand. We also assessed the effects of acute expiratory threshold loading (ETL) on chest wall muscular control. A total of 15 healthy adults (7 males; average age = 28 years) completed maximum performance and ETL tasks. Chest wall surface electromyographic and kinematic recordings were made. Participants also performed a session of acute ETL. We showed that corticomuscular control of the chest wall varied as a function of lung volume excursion and muscular effort. Acute ETL had some effect on respiratory kinematics but not coherence.
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Souza Neto JRNDE, Branco É, Giese EG, Lima ARDE. Morphological Characterization of Diaphragm in Common Squirrel Monkey (Saimiri sciureus). AN ACAD BRAS CIENC 2018; 90:169-178. [PMID: 29466481 DOI: 10.1590/0001-3765201820170167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 09/11/2017] [Indexed: 11/21/2022] Open
Abstract
The wall of the diaphragm can be affected by congenital or acquired alterations which allow the passage of viscera between the abdominal and chest cavities, allowing the formation of a diaphragmatic hernia. We characterized morphology and performed biometrics of the diaphragm in the common squirrel monkey Saimiri sciureus. After fixation, muscle fragments were collected and processed for optical microscopy. In this species the diaphragm muscle is attached to the lung by phrenopericardial ligament. It is also connected to the liver via the coronary and falciform ligaments. The muscle is composed of three segments in total: 1) sternal; 2) costal, and 3) a segment consisting of right and left diaphragmatic pillars. The anatomical structures analyzed were similar to those reported for other mammals. Histological analysis revealed stable, organized muscle fibers with alternation of light and dark streaks, indicating transverse striation.
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Affiliation(s)
- José Ricardo N DE Souza Neto
- Laboratório de Pesquisa Morfológica Animal/LaPMA, Faculdade de Medicina Veterinária, Universidade Federal Rural da Amazônia/UFRA, Avenida Presidente Tancredo Neves, 2501, Montese, 66077-530 Belém, PA, Brazil
| | - Érika Branco
- Laboratório de Pesquisa Morfológica Animal/LaPMA, Faculdade de Medicina Veterinária, Universidade Federal Rural da Amazônia/UFRA, Avenida Presidente Tancredo Neves, 2501, Montese, 66077-530 Belém, PA, Brazil
| | - Elane G Giese
- Laboratório de Histologia e Embriologia Animal/LHEA, Faculdade de Medicina Veterinária, Universidade Federal Rural da Amazônia/UFRA, Avenida Presidente Tancredo Neves, 2501, Montese, 66077-530 Belém, PA, Brazil
| | - Ana Rita DE Lima
- Laboratório de Histologia e Embriologia Animal/LHEA, Faculdade de Medicina Veterinária, Universidade Federal Rural da Amazônia/UFRA, Avenida Presidente Tancredo Neves, 2501, Montese, 66077-530 Belém, PA, Brazil
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Yawata A, Tsubaki A, Yawata H, Takai H, Matsumoto K, Takehara N, Kobayashi R. Voluntary cough intensity and its influencing factors differ by sex in community-dwelling adults. Ther Adv Respir Dis 2017; 11:427-433. [PMID: 29202684 PMCID: PMC5933582 DOI: 10.1177/1753465817741607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Cough peak flow (CPF) is widely used for measuring voluntary cough intensity.
However, the respective factors that affect CPF are not known. The aim of
this study was to determine the factors affecting CPF by sex in
community-dwelling adults. Method: We recruited participants using posters exhibited at a public gymnasium.
Participation was voluntary, and all participants provided informed consent.
Nonsmoking community residents (102 males, 49.6 ± 20.2 years of age; 101
females, 51.4 ± 18.4 years of age) participated in this study. The main
outcome measures were sex differences in CPF, respiratory function,
respiratory muscle strength, thorax extension, and grip strength. Factors
affecting CPF by sex were analyzed using multiple regression analysis. Results: All parameters were higher in men than in women. CPF was affected by thorax
expansion at the tenth rib, inspiratory muscle strength and forced
expiration in 1 s in men, and thorax expansion at the tenth rib, inspiratory
reserve volume, and expiratory muscle power in women. A weak negative
correlation was observed between CPF and age (p = −0.24,
p < 0.05) in women. Conclusions: The factors affecting CPF differed by sex in community-dwelling adults. Clinical Trial Number: UMIN000023912
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Affiliation(s)
- Akiko Yawata
- Field of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata, 950-3198, Japan
| | - Atsuhiro Tsubaki
- Field of Physical Therapy, Graduate School of Niigata University of Health and Welfare, Niigata, Japan Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | | | - Haruna Takai
- Department of Rehabilitation, Marukawa Hospital, Toyama, Japan
| | - Kayomi Matsumoto
- Field of Physical Therapy, Graduate School of Niigata University of Health and Welfare, Niigata, Japan Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Nana Takehara
- Field of Physical Therapy, Graduate School of Niigata University of Health and Welfare, Niigata, Japan Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Ryosaku Kobayashi
- Field of Physical Therapy, Graduate School of Niigata University of Health and Welfare, Niigata, Japan Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
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Beyer B, Feipel V, Sholukha V, Chèze L, Van Sint Jan S. In-vivo analysis of sternal angle, sternal and sternocostal kinematics in supine humans during breathing. J Biomech 2017; 64:32-40. [DOI: 10.1016/j.jbiomech.2017.08.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 11/28/2022]
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Hudson AL, Gandevia SC, Butler JE. Task-dependent output of human parasternal intercostal motor units across spinal levels. J Physiol 2017; 595:7081-7092. [PMID: 28929509 DOI: 10.1113/jp274866] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 09/04/2017] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS During breathing, there is differential activity in the human parasternal intercostal muscles and the activity is tightly coupled to the known mechanical advantages for inspiration of the same regions of muscles. It is not known whether differential activity is preserved for the non-respiratory task of ipsilateral trunk rotation. In the present study, we compared single motor units during resting breathing and axial rotation of the trunk during apnoea. We not only confirmed non-uniform recruitment of motor units across parasternal intercostal muscles in breathing, but also demonstrated that the same motor units show an altered pattern of recruitment in the non-respiratory task of trunk rotation. The output of parasternal intercostal motoneurones is modulated differently across spinal levels depending on the task and these results help us understand the mechanisms that may govern task-dependent differences in motoneurone output. ABSTRACT During inspiration, there is differential activity in the human parasternal intercostal muscles across interspaces. We investigated whether the earlier recruitment of motor units in the rostral interspaces compared to more caudal spaces during inspiration is preserved for the non-respiratory task of ipsilateral trunk rotation. Single motor unit activity (SMU) was recorded from the first, second and fourth parasternal interspaces on the right side in five participants in two tasks: resting breathing and 'isometric' axial rotation of the trunk during apnoea. Recruitment of the same SMUs was compared between tasks (n = 123). During resting breathing, differential activity was indicated by earlier recruitment of SMUs in the first and second interspaces compared to the fourth space in inspiration (P < 0.01). By contrast, during trunk rotation, the same motor units showed an altered pattern of recruitment because SMUs in the first interspace were recruited later and at a higher rotation torque than those in the second and fourth interspaces (P < 0.05). Tested for a subset of SMUs, the reliability of the breathing and rotation tasks, as well as the SMU recruitment measures, was good-excellent [intraclass correlation (2,1): 0.69-0.91]. Thus, the output of parasternal intercostal motoneurones is modulated differently across spinal levels depending on the task. Given that the differential inspiratory output of parasternal intercostal muscles is linked to their relative mechanical effectiveness for inspiration and also that this output is altered in trunk rotation, we speculate that a mechanism matching neural drive to muscle mechanics underlies the task-dependent differences in output of axial motoneurone pools.
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Affiliation(s)
- Anna L Hudson
- Neuroscience Research Australia, Randwick, NSW, Australia.,University of New South Wales, Sydney, NSW, Australia
| | - Simon C Gandevia
- Neuroscience Research Australia, Randwick, NSW, Australia.,University of New South Wales, Sydney, NSW, Australia
| | - Jane E Butler
- Neuroscience Research Australia, Randwick, NSW, Australia.,University of New South Wales, Sydney, NSW, Australia
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29
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Tanaka T, Basoudan N, Melo LT, Wickerson L, Brochard LJ, Goligher EC, Reid WD. Deoxygenation of inspiratory muscles during cycling, hyperpnoea and loaded breathing in health and disease: a systematic review. Clin Physiol Funct Imaging 2017; 38:554-565. [PMID: 28940670 DOI: 10.1111/cpf.12473] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/28/2017] [Indexed: 11/26/2022]
Abstract
Assessing inspiratory muscle deoxygenation and blood flow can provide insight into anaerobic stress, recruitment strategies and mechanisms of inspiratory muscle limitation. Therefore, this review aimed to synthesize measurements of inspiratory muscle oxyhaemoglobin (O2 Hb), deoxyhaemoglobin (HHb), blood volume and flow of the inspiratory muscles acquired via near-infrared spectroscopy (NIRS) during cycling, hyperpnoea and loaded breathing in healthy non-athletes, healthy athletes and patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF). Searches were performed on Medline and Medline in-process, EMBASE, Central, Sportdiscus, PubMed and Compendex. Reviewers independently abstracted articles and assessed their quality using the modified Downs and Black checklist. Of the 644 articles identified, 21 met the inclusion criteria. Studies evaluated non-athletes (n = 9), athletes (n = 5), COPD (n = 2) and CHF (n = 5). The sample was 90% male and 73% were non-athletes and athletes. Interventions included cycle ergometry, hyperpnoea, loaded breathing, elbow flexor loading and combined loaded breathing and ergometry. Athletes and patients with CHF or COPD demonstrated deoxygenation of inspiratory accessory muscles that was often an opposite or exaggerated pattern compared to non-athletes. O2 Hb decreased and HHb increased significantly in inspiratory muscles during cycle ergometry and loaded breathing with accentuated changes during combined ergometry and loaded breathing. During different regimens of hyperpnoea or loaded breathing, comparisons of inspiratory muscles demonstrated that the sternocleidomastoid deoxygenated more than the intercostals, parasternals or scalenes. Evaluating inspiratory muscle deoxygenation via NIRS can inform mechanisms of inspiratory muscle limitation in non-athletes, athletes and patients with CHF or COPD.
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Affiliation(s)
- Takako Tanaka
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Nada Basoudan
- College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Luana T Melo
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Lisa Wickerson
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Laurent J Brochard
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.,Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ewan C Goligher
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Division of Respirology, University Health Network and Mount Sinai Hospital, Toronto, ON, Canada
| | - W Darlene Reid
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute, University Hospital Network, Toronto, ON, Canada
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30
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Khurram OU, Sieck GC, Mantilla CB. Compensatory effects following unilateral diaphragm paralysis. Respir Physiol Neurobiol 2017; 246:39-46. [PMID: 28790008 DOI: 10.1016/j.resp.2017.07.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 07/11/2017] [Accepted: 07/11/2017] [Indexed: 11/18/2022]
Abstract
Injury to nerves innervating respiratory muscles such as the diaphragm muscle results in significant respiratory compromise. Electromyography (EMG) and transdiaphragmatic pressure (Pdi) measurements reflect diaphragm activation and force generation. Immediately after unilateral diaphragm denervation (DNV), ventilatory behaviors can be accomplished without impairment, but Pdi generated during higher force non-ventilatory behaviors is significantly decreased. We hypothesized that 1) the initial reduction in Pdi during higher force behaviors after DNV is ameliorated after 14 days, and 2) changes in Pdi over time after DNV are associated with concordant changes in contralateral diaphragm EMG activity and ventilatory parameters. In adult male rats, the reduced Pdi during occlusion (∼40% immediately after DNV) was ameliorated to ∼20% reduction after 14 days. Contralateral diaphragm EMG activity did not significantly change immediately or 14days after DNV compared to the pre-injury baseline for any motor behavior. Taken together, these results suggest that over time after DNV compensatory changes in inspiratory related muscle activation may partially restore the ability to generate Pdi during higher force behaviors.
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Affiliation(s)
- Obaid U Khurram
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, United States
| | - Gary C Sieck
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, United States; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Carlos B Mantilla
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, United States; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN 55905, United States.
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31
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Zhang HX, Du JM, Ding ZN, Zhu XY, Jiang L, Liu YJ. Hydrogen sulfide prevents diaphragm weakness in cecal ligation puncture-induced sepsis by preservation of mitochondrial function. Am J Transl Res 2017; 9:3270-3281. [PMID: 28804545 PMCID: PMC5553877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 06/17/2017] [Indexed: 06/07/2023]
Abstract
Mitochondrial dysfunction plays an important role in the pathogenesis of diaphragm weakness during sepsis. Recently, hydrogen sulfide (H2S), a gaseous transmitter endogenously generated by cystathionine-β-synthase (CBS), cystathionine-γ-lyase (CSE) and 3-mercaptopyruvate sulfurtransferase (3-MST), is found to improve mitochondrial function. The present study aimed to examine whether H2S synthases are expressed in the diaphragm, and investigated the effect of H2S donor in sepsis-induced diaphragm weakness and its relationship with mitochondrial function. Immunohistochemical staining of the rat diaphragm revealed that positive immunoreactivity for CBS, CSE as well as 3-MST was predominately localized to muscle cells. Using a cecal ligation and puncture (CLP)-induced sepsis model, it was found that CBS and CSE, but not 3-MST, was significantly down-regulated in the diaphragm at 24 h post-CLP compared with sham group. To determine the effect of H2S on sepsis-induced diaphragm weakness, H2S donor NaHS was intraperitoneally administered 30 min after CLP operation. NaHS at a dose of 50 μmol/kg significantly decreased the mortality in septic rats. CLP markedly reduced diaphragm-specific force generation (force/cross-sectional area and maximal titanic force), which was improved by NaHS treatment. In addition, CLP caused mitochondrial damage in the diaphragm tissues as evidenced by increased mitochondrial superoxide production, decreased mitochondrial membrane potential and ATP production, as well as mitochondrial ultrastructural abnormalities, which was also attenuated by NaHS treatment. These findings indicate that H2S donor may prevent sepsis-induced diaphragm weakness by preservation of mitochondrial function, suggesting that modulation of H2S levels may be considered as a potential therapeutic approach for diaphragm dysfunction during sepsis.
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Affiliation(s)
- Hai-Xia Zhang
- School of Kinesiology, The Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of SportShanghai 200438, China
- Department of Anesthesiology, Xinhua Hospital Chongming Branch, School of Medicine, Shanghai Jiaotong UniversityShanghai 202150, China
- Department of Anesthesiology, Surgical Intensive Care Unit, Xinhua Hospital, School of Medicine, Shanghai Jiaotong UniversityShanghai 200092, China
| | - Jun-Ming Du
- Department of Anesthesiology, Surgical Intensive Care Unit, Xinhua Hospital, School of Medicine, Shanghai Jiaotong UniversityShanghai 200092, China
| | - Zhong-Nuo Ding
- Department of Anesthesiology, Surgical Intensive Care Unit, Xinhua Hospital, School of Medicine, Shanghai Jiaotong UniversityShanghai 200092, China
| | - Xiao-Yan Zhu
- Department of Physiology, Second Military Medical UniversityShanghai 200433, China
| | - Lai Jiang
- Department of Anesthesiology, Surgical Intensive Care Unit, Xinhua Hospital, School of Medicine, Shanghai Jiaotong UniversityShanghai 200092, China
| | - Yu-Jian Liu
- School of Kinesiology, The Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of SportShanghai 200438, China
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Wang MM, Hao LY, Guo F, Zhong B, Zhong XM, Yuan J, Hao YF, Zhao S, Sun XF, Lei M, Jiao GY. Decreased intracellular [Ca 2+ ] coincides with reduced expression of Dhprα1s, RyR1, and diaphragmatic dysfunction in a rat model of sepsis. Muscle Nerve 2017; 56:1128-1136. [PMID: 28044347 DOI: 10.1002/mus.25554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2016] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Sepsis can cause decreased diaphragmatic contractility. Intracellular calcium as a second messenger is central to diaphragmatic contractility. However, changes in intracellular calcium concentration ([Ca2+ ]) and the distribution and co-localization of relevant calcium channels [dihydropyridine receptors, (DHPRα1s) and ryanodine receptors (RyR1)] remain unclear during sepsis. In this study we investigated the effect of changed intracellular [Ca2+ ] and expression and distribution of DHPRα1s and RyR1 on diaphragm function during sepsis. METHODS We measured diaphragm contractility and isolated diaphragm muscle cells in a rat model of sepsis. The distribution and co-localization of DHPRα1s and RyR1 were determined using immunohistochemistry and immunofluorescence, whereas intracellular [Ca2+ ] was measured by confocal microscopy and fluorescence spectrophotometry. RESULTS Septic rat diaphragm contractility, expression of DHPRα1s and RyR1, and intracellular [Ca2+ ] were significantly decreased in the rat sepsis model compared with controls. DISCUSSION Decreased intracellular [Ca2+ ] coincides with diaphragmatic contractility and decreased expression of DHPRα1s and RyR1 in sepsis. Muscle Nerve 56: 1128-1136, 2017.
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Affiliation(s)
- Meng-Meng Wang
- Department of Respiratory and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Postal Code 110004, People's Republic of China
| | - Li-Ying Hao
- Department of Pharmaceutical Toxicology, School of Pharmaceutical Sciences, China Medical University, Shenyang, People's Republic of China
| | - Feng Guo
- Department of Pharmaceutical Toxicology, School of Pharmaceutical Sciences, China Medical University, Shenyang, People's Republic of China
| | - Bin Zhong
- Department of Respiratory Medicine, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi Province, People's Republic of China
| | - Xiao-Mei Zhong
- Department of Respiratory and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Postal Code 110004, People's Republic of China
| | - Jing Yuan
- Department of Respiratory and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Postal Code 110004, People's Republic of China
| | - Yi-Fei Hao
- Department of Orthopedic Surgery, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Shuang Zhao
- Department of Respiratory and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Postal Code 110004, People's Republic of China
| | - Xue-Fei Sun
- Department of Pharmaceutical Toxicology, School of Pharmaceutical Sciences, China Medical University, Shenyang, People's Republic of China
| | - Ming Lei
- Department of Pharmaceutical Toxicology, School of Pharmaceutical Sciences, China Medical University, Shenyang, People's Republic of China
| | - Guang-Yu Jiao
- Department of Respiratory and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Postal Code 110004, People's Republic of China
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33
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Jiao G, Hao L, Wang M, Zhong B, Yu M, Zhao S, Wang P, Feng R, Tan S, Chen L. Upregulation of endoplasmic reticulum stress is associated with diaphragm contractile dysfunction in a rat model of sepsis. Mol Med Rep 2016; 15:366-374. [PMID: 27959404 DOI: 10.3892/mmr.2016.6014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 11/02/2016] [Indexed: 11/06/2022] Open
Abstract
Sepsis often causes diaphragm contractile dysfunction. Endoplasmic reticulum (ER) stress has been implicated in muscle contractile dysfunction. However, it remains unknown if ER stress occurs in the diaphragm during sepsis. In the present study, rats were divided into 4 groups and received placebo or one of three durations of endotoxin treatment (24, 48 h and 7 days). Isometric contractile force of the diaphragm was measured and lung wet-to-dry ratio (W/D) was calculated. Hematoxylin and eosin (H&E) staining of lung tissue was performed and electron microscopy assessed ER damage in the diaphragm during sepsis. The mRNA and protein expression of glucose‑regulated protein 78 kDa (GRP78), glucose-regulated protein 94 kDa (GRP94), C/EBP homologous protein (CHOP), endoplasmic reticulum protein 44 (ERP44), protein disulfide-isomerase like protein (ERP57) and protein disulfide isomerase family A member 4 (ERP72) in diaphragm muscles were measured using reverse transcription‑quantitative polymerase chain reaction and western blot analysis. The level of cleaved caspase-12 was analyzed by western blot analysis. The results demonstrated that sepsis increased lung W/D. H&E staining revealed that sepsis caused alveolar congestion, hemorrhage and rupture. Swollen and distended ER was observed using electron microscopy during sepsis and decreased diaphragm contractile function was also observed. The expression levels of ER stress markers (GRP78, GRP94, CHOP, ERP44, ERP57 and ERP72) and the level of cleaved caspase‑12 were significantly elevated in septic rats compared with control rats, particularly in the 48 h group. In conclusion, the present study indicated that weakened diaphragm contraction and damaged ER in septic rats was associated with increased expression of ER stress markers.
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Affiliation(s)
- Guangyu Jiao
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Liying Hao
- Department of Pharmaceutical Toxicology, School of Pharmaceutical Sciences, China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Mengmeng Wang
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Bin Zhong
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Miao Yu
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Shuang Zhao
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Pingping Wang
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Rui Feng
- Department of Pharmaceutical Toxicology, School of Pharmaceutical Sciences, China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Shutao Tan
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Liu Chen
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
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Ignasiak D, Ferguson SJ, Arjmand N. A rigid thorax assumption affects model loading predictions at the upper but not lower lumbar levels. J Biomech 2016; 49:3074-3078. [DOI: 10.1016/j.jbiomech.2016.07.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 07/03/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
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35
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McBain RA, Taylor JL, Gorman RB, Gandevia SC, Butler JE. Human intersegmental reflexes from intercostal afferents to scalene muscles. Exp Physiol 2016; 101:1301-1308. [PMID: 27460516 DOI: 10.1113/ep085907] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 07/25/2016] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? The aim was to determine whether specific reflex connections operate between intercostal afferents and the scalene muscles in humans, and whether these connections operate after a clinically complete cervical spinal cord injury. What is the main finding and its importance? This is the first description of a short-latency inhibitory reflex connection between intercostal afferents from intercostal spaces to the scalene muscles in able-bodied participants. We suggest that this reflex is mediated by large-diameter afferents. This intercostal-to-scalene inhibitory reflex is absent after cervical spinal cord injury and may provide a way to monitor the progress of the injury. Short-latency intersegmental reflexes have been described for various respiratory muscles in animals. In humans, however, only short-latency reflex responses to phrenic nerve stimulation have been described. Here, we examined the reflex connections between intercostal afferents and scalene muscles in humans. Surface EMG recordings were made from scalene muscles bilaterally, in seven able-bodied participants and seven participants with motor- and sensory-complete cervical spinal cord injury (median 32 years postinjury, range 5 months to 44 years). We recorded the reflex responses produced by stimulation of the eighth or tenth left intercostal nerve. A short-latency (∼38 ms) inhibitory reflex was evident in able-bodied participants, in ipsilateral and contralateral scalene muscles. This bilateral intersegmental inhibitory reflex occurred in 46% of recordings at low stimulus intensities (at three times motor threshold). It was more frequent (in 75-85% of recordings) at higher stimulus intensities (six and nine times motor threshold), but onset latency (38 ± 9 ms, mean ± SD) and the size of inhibition (23 ± 10%) did not change with stimulus intensity. The reflex was absent in all participants with spinal cord injury. As the intercostal-to-scalene reflex did not increase with larger stimulus intensities, it is likely to be mediated by large-diameter intercostal muscle afferents. This is the first demonstration of an intercostal-to-scalene reflex. As the reflex requires intact spinal connections, it may be a useful marker for recovery of thoracic or cervical spinal injury.
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Affiliation(s)
- Rachel A McBain
- Neuroscience Research Australia, Randwick, Sydney, NSW 2031, Australia.,University of New South Wales, Sydney, NSW 2052, Australia
| | - Janet L Taylor
- Neuroscience Research Australia, Randwick, Sydney, NSW 2031, Australia.,University of New South Wales, Sydney, NSW 2052, Australia
| | - Robert B Gorman
- Neuroscience Research Australia, Randwick, Sydney, NSW 2031, Australia
| | - Simon C Gandevia
- Neuroscience Research Australia, Randwick, Sydney, NSW 2031, Australia.,University of New South Wales, Sydney, NSW 2052, Australia
| | - Jane E Butler
- Neuroscience Research Australia, Randwick, Sydney, NSW 2031, Australia. .,University of New South Wales, Sydney, NSW 2052, Australia.
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36
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Beyer B, Van Sint Jan S, Chèze L, Sholukha V, Feipel V. Relationship between costovertebral joint kinematics and lung volume in supine humans. Respir Physiol Neurobiol 2016; 232:57-65. [PMID: 27421681 DOI: 10.1016/j.resp.2016.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 11/24/2022]
Abstract
This study investigates the relationship between the motion of the first ten costovertebral joints (CVJ) and lung volume over the inspiratory capacity (IC) using detailed kinematic analysis in a sample of 12 asymptomatic subjects. Retrospective codified spiral-CT data obtained at total lung capacity (TLC), middle of inspiratory capacity (MIC) and at functional residual capacity (FRC) were analysed. CVJ 3D kinematics were processed using previously-published methods. We tested the influence of the side, CVJ level and lung volume on CVJ kinematics. In addition, the correlations between anthropologic/pulmonary variables and CVJ kinematics were analysed. No linear correlation was found between lung volumes and CVJ kinematics. Major findings concerning 3D kinematics can be summarized as follows: 1) Ranges-of-motion decrease gradually with increasing CVJ level; 2) rib displacements are significantly reduced at lung volumes above the MIC and do not differ between CVJ levels; 3) the axes of rotation of the ribs are similarly oriented for all CVJ levels.
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Affiliation(s)
- Benoît Beyer
- Laboratory of Anatomy, Biomechanics and Organogenesis (L.A.B.O), Université Libre de Bruxelles, Brussels, Belgium; Laboratory of Functional Anatomy, Université Libre de Bruxelles, Brussels, Belgium; Univ Lyon, Université Claude Bernard Lyon 1, Ifsttar, UMR_T9406, LBMC, F69622 Lyon, France.
| | - Serge Van Sint Jan
- Laboratory of Anatomy, Biomechanics and Organogenesis (L.A.B.O), Université Libre de Bruxelles, Brussels, Belgium
| | - Laurence Chèze
- Univ Lyon, Université Claude Bernard Lyon 1, Ifsttar, UMR_T9406, LBMC, F69622 Lyon, France
| | - Victor Sholukha
- Laboratory of Anatomy, Biomechanics and Organogenesis (L.A.B.O), Université Libre de Bruxelles, Brussels, Belgium; Department of Applied Mathematics, Peter the Great St. Petersburg Polytechnic University (SPbPU), Russia
| | - Véronique Feipel
- Laboratory of Functional Anatomy, Université Libre de Bruxelles, Brussels, Belgium
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Jiao GY, Hao LY, Chen L, Gao CE, Feng R, Hu HY, Tan ST, Wang MM, Zhong B, Wang PP. High levels of positive end-expiratory pressure preserve diaphragmatic contractility during acute respiratory distress syndrome in rats. Exp Physiol 2016; 100:967-76. [PMID: 26053378 DOI: 10.1113/ep085083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 06/02/2015] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Higher levels of positive end-expiratory pressure (PEEP) have recently been used in patients with acute respiratory distress syndrome (ARDS). In normal physiological conditions, the ability of the diaphragm to generate pressure is reduced when the lung volume is elevated beyond its functional residual capacity. It is unknown whether higher levels of PEEP will have a negative impact on diaphragmatic contraction in the presence of the pathophysiology of ARDS. What is the main finding and its importance? Mechanical ventilation with higher levels of PEEP reduced lung injury, improved diaphragmatic contractility and increased the expression of both dihydropyridine receptor and ryanodine receptor in the diaphragms of rats with ARDS. Higher levels of positive end-expiratory pressure (PEEP) have recently been used in patients with acute respiratory distress syndrome (ARDS). In normal physiological conditions, the ability of the diaphragm to generate pressure is reduced when the lung volume is elevated beyond its functional residual capacity. Thus, it is critical to understand whether higher levels of PEEP will have a negative impact on diaphragmatic contraction in the presence of the pathophysiology of ARDS. This study was designed to determine whether higher levels of PEEP reduce diaphragmatic contractility in a rat model of ARDS generated using i.p. lipopolysaccharide. Forty rats were randomly assigned to the following five groups: a control group with no special treatment; an ARDS group with no mechanical ventilation; and three ARDS groups with mechanical ventilation with PEEP at 0, 5 or 10 cmH2 O, respectively. We found that mechanical ventilation with PEEP reduced lung injury, improved diaphragmatic contractility and increased the expression of both dihydropyridine receptor and ryanodine receptor in the diaphragms of rats with ARDS. These changes were most significant at a PEEP of 10 cmH2 O among all applied levels of PEEP. In conclusion, using a rat ARDS model, this study confirmed that diaphragmatic contractility was preserved by mechanical ventilation with high levels of PEEP.
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Affiliation(s)
- Guang-Yu Jiao
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Li-Ying Hao
- Department of Pharmaceutical Toxicology, School of Pharmaceutical Sciences, China Medical University, Shenyang, People's Republic of China
| | - Lie Chen
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Chun-E Gao
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Rui Feng
- Department of Pharmaceutical Toxicology, School of Pharmaceutical Sciences, China Medical University, Shenyang, People's Republic of China
| | - Hui-Yuan Hu
- Department of Pharmaceutical Toxicology, School of Pharmaceutical Sciences, China Medical University, Shenyang, People's Republic of China
| | - Shu-Tao Tan
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Meng-Meng Wang
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Bin Zhong
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Ping-Ping Wang
- Respiratory Department and Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
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38
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Zhang G, Chen X, Ohgi J, Miura T, Nakamoto A, Matsumura C, Sugiura S, Hisada T. Biomechanical simulation of thorax deformation using finite element approach. Biomed Eng Online 2016; 15:18. [PMID: 26852020 PMCID: PMC4744443 DOI: 10.1186/s12938-016-0132-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 01/26/2016] [Indexed: 01/16/2023] Open
Abstract
Background The biomechanical simulation of the human respiratory system is expected to be a useful tool for the diagnosis and treatment of respiratory diseases. Because the deformation of the thorax significantly influences airflow in the lungs, we focused on simulating the thorax deformation by introducing contraction of the intercostal muscles and diaphragm, which are the main muscles responsible for the thorax deformation during breathing. Methods We constructed a finite element model of the thorax, including the rib cage, intercostal muscles, and diaphragm. To reproduce the muscle contractions, we introduced the Hill-type transversely isotropic hyperelastic continuum skeletal muscle model, which allows the intercostal muscles and diaphragm to contract along the direction of the fibres with clinically measurable muscle activation and active force–length relationship. The anatomical fibre orientations of the intercostal muscles and diaphragm were introduced. Results Thorax deformation consists of movements of the ribs and diaphragm. By activating muscles, we were able to reproduce the pump-handle and bucket-handle motions for the ribs and the clinically observed motion for the diaphragm. In order to confirm the effectiveness of this approach, we simulated the thorax deformation during normal quiet breathing and compared the results with four-dimensional computed tomography (4D-CT) images for verification. Conclusions Thorax deformation can be simulated by modelling the respiratory muscles according to continuum mechanics and by introducing muscle contractions. The reproduction of representative motions of the ribs and diaphragm and the comparison of the thorax deformations during normal quiet breathing with 4D-CT images demonstrated the effectiveness of the proposed approach. This work may provide a platform for establishing a computational mechanics model of the human respiratory system.
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Affiliation(s)
- Guangzhi Zhang
- Department of Biomedical Engineering, Yamaguchi University, Ube, 755-8611, Japan.
| | - Xian Chen
- Department of Biomedical Engineering, Yamaguchi University, Ube, 755-8611, Japan.
| | - Junji Ohgi
- Department of Biomedical Engineering, Yamaguchi University, Ube, 755-8611, Japan.
| | - Toshiro Miura
- Tokuyama Central Hospital, Japan Community Healthcare Organization, Shunan, 745-8522, Japan.
| | - Akira Nakamoto
- Tokuyama Central Hospital, Japan Community Healthcare Organization, Shunan, 745-8522, Japan.
| | - Chikanori Matsumura
- Tokuyama Central Hospital, Japan Community Healthcare Organization, Shunan, 745-8522, Japan.
| | - Seiryo Sugiura
- The Department of Human and Engineered Environmental Studies, The University of Tokyo, Kashiwa, 277-0871, Japan.
| | - Toshiaki Hisada
- The Department of Human and Engineered Environmental Studies, The University of Tokyo, Kashiwa, 277-0871, Japan.
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Development and validation of real-time simulation of X-ray imaging with respiratory motion. Comput Med Imaging Graph 2015; 49:1-15. [PMID: 26773644 DOI: 10.1016/j.compmedimag.2015.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 07/29/2015] [Accepted: 12/07/2015] [Indexed: 11/23/2022]
Abstract
We present a framework that combines evolutionary optimisation, soft tissue modelling and ray tracing on GPU to simultaneously compute the respiratory motion and X-ray imaging in real-time. Our aim is to provide validated building blocks with high fidelity to closely match both the human physiology and the physics of X-rays. A CPU-based set of algorithms is presented to model organ behaviours during respiration. Soft tissue deformation is computed with an extension of the Chain Mail method. Rigid elements move according to kinematic laws. A GPU-based surface rendering method is proposed to compute the X-ray image using the Beer-Lambert law. It is provided as an open-source library. A quantitative validation study is provided to objectively assess the accuracy of both components: (i) the respiration against anatomical data, and (ii) the X-ray against the Beer-Lambert law and the results of Monte Carlo simulations. Our implementation can be used in various applications, such as interactive medical virtual environment to train percutaneous transhepatic cholangiography in interventional radiology, 2D/3D registration, computation of digitally reconstructed radiograph, simulation of 4D sinograms to test tomography reconstruction tools.
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de Bisschop C, Montaudon M, Glénet S, Guénard H. Feasibility of intercostal blood flow measurement by echo-Doppler technique in healthy subjects. Clin Physiol Funct Imaging 2015; 37:282-287. [DOI: 10.1111/cpf.12298] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/03/2015] [Indexed: 11/26/2022]
Affiliation(s)
| | - Michel Montaudon
- Unité d'imagerie thoracique et cardiovasculaire (Pr Laurent); Hôpital du Haut-Lévêque; CHU de Bordeaux; France
| | - Stéphane Glénet
- Laboratoire de physiologie; Université de Bordeaux; Bordeaux Cedex France
| | - Hervé Guénard
- Laboratoire de physiologie; Université de Bordeaux; Bordeaux Cedex France
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Bruno AG, Bouxsein ML, Anderson DE. Development and Validation of a Musculoskeletal Model of the Fully Articulated Thoracolumbar Spine and Rib Cage. J Biomech Eng 2015; 137:081003. [PMID: 25901907 DOI: 10.1115/1.4030408] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Indexed: 11/08/2022]
Abstract
We developed and validated a fully articulated model of the thoracolumbar spine in opensim that includes the individual vertebrae, ribs, and sternum. To ensure trunk muscles in the model accurately represent muscles in vivo, we used a novel approach to adjust muscle cross-sectional area (CSA) and position using computed tomography (CT) scans of the trunk sampled from a community-based cohort. Model predictions of vertebral compressive loading and trunk muscle tension were highly correlated to previous in vivo measures of intradiscal pressure (IDP), vertebral loading from telemeterized implants and trunk muscle myoelectric activity recorded by electromyography (EMG).
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Beyer B, Sholukha V, Dugailly PM, Rooze M, Moiseev F, Feipel V, Van Sint Jan S. In vivo thorax 3D modelling from costovertebral joint complex kinematics. Clin Biomech (Bristol, Avon) 2014; 29:434-8. [PMID: 24529962 DOI: 10.1016/j.clinbiomech.2014.01.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 01/21/2014] [Accepted: 01/21/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND The costovertebral joint complex is mechanically involved in both respiratory function and thoracic spine stability. The thorax has been studied for a long time to understand its involvement in the physiological mechanism leading to specific gas exchange. Few studies have focused on costovertebral joint complex kinematics, and most of them focused on experimental in vitro analysis related to loading tests or global thorax and/or lung volume change analysis. There is however a clinical need for new methods allowing to process in vivo clinical data. This paper presents results from in vivo analysis of the costovertebral joint complex kinematics from clinically-available retrospective data. METHODS In this study, in vivo spiral computed tomography imaging data were obtained from 8 asymptomatic subjects at three different lung volumes (from total lung capacity to functional residual capacity) calibrated using a classical spirometer. Fusion methods including 3D modelling and kinematic analysis were used to provide 3D costovertebral joint complex visualization for the true ribs (i.e., first seven pairs of ribs). FINDINGS The 3D models of the first seven pairs of costovertebral joint complexes were obtained. A continuous kinematics simulation was interpolated from the three discrete computerized tomography positions. Helical axis representation was also achieved. INTERPRETATION Preliminary results show that the method leads to meaningful and relevant results for clinical and pedagogical applications. Research in progress compares data from a sample of healthy volunteers with data collected from patients with cystic fibrosis to obtain new insights about the costovertebral joint complex range of motion and helical axis assessment in different pathological conditions.
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Affiliation(s)
- Benoît Beyer
- Laboratory of Anatomy, Biomechanics and Organogenesis, Université Libre de Bruxelles, Bruxelles, Belgium.
| | - Victor Sholukha
- Laboratory of Anatomy, Biomechanics and Organogenesis, Université Libre de Bruxelles, Bruxelles, Belgium; Department of Applied Mathematics, State Polytechnical University (SPbSPU), Saint Petersburg, Russia
| | - Pierre Michel Dugailly
- Laboratory of Functional Anatomy, Université Libre de Bruxelles, Bruxelles, Belgium; Laboratory of Manual Therapy, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Marcel Rooze
- Laboratory of Anatomy, Biomechanics and Organogenesis, Université Libre de Bruxelles, Bruxelles, Belgium; Laboratory of Functional Anatomy, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Fedor Moiseev
- Laboratory of Anatomy, Biomechanics and Organogenesis, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Véronique Feipel
- Laboratory of Functional Anatomy, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Serge Van Sint Jan
- Laboratory of Anatomy, Biomechanics and Organogenesis, Université Libre de Bruxelles, Bruxelles, Belgium
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Butler JE, Hudson AL, Gandevia SC. The Neural Control of Human Inspiratory Muscles. PROGRESS IN BRAIN RESEARCH 2014; 209:295-308. [DOI: 10.1016/b978-0-444-63274-6.00015-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Terson de Paleville DGL, McKay WB, Folz RJ, Ovechkin AV. Respiratory motor control disrupted by spinal cord injury: mechanisms, evaluation, and restoration. Transl Stroke Res 2013; 2:463-73. [PMID: 22408690 DOI: 10.1007/s12975-011-0114-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Pulmonary complications associated with persistent respiratory muscle weakness, paralysis, and spasticity are among the most important problems faced by patients with spinal cord injury when lack of muscle strength and disorganization of reciprocal respiratory muscle control lead to breathing insufficiency. This review describes the mechanisms of the respiratory motor control and its change in individuals with spinal cord injury, methods by which respiratory function is measured, and rehabilitative treatment used to restore respiratory function in those who have experienced such injury.
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Affiliation(s)
- Daniela G L Terson de Paleville
- Exercise Physiology, University of Louisville, Louisville, KY, USA. Physiology and Biophysics, University of Louisville, Louisville, KY, USA
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Jiao GY, Hao LY, Gao CE, Chen L, Sun XF, Yang HL, Li Y, Dai YN. Reduced DHPRα1S and RyR1 expression levels are associated with diaphragm contractile dysfunction during sepsis. Muscle Nerve 2013; 48:745-51. [PMID: 23943510 DOI: 10.1002/mus.23805] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2013] [Indexed: 02/06/2023]
Affiliation(s)
- Guang-Yu Jiao
- Respiratory Department and Intensive Care Unit; Shengjing Hospital of China Medical University; Shenyang Postal Code 110004 People's Republic of China
| | - Li-Ying Hao
- Department of Pharmaceutical Toxicology; School of Pharmaceutical Sciences; China Medical University; Shenyang People's Republic of China
| | - Chun-E Gao
- Respiratory Department and Intensive Care Unit; Shengjing Hospital of China Medical University; Shenyang Postal Code 110004 People's Republic of China
| | - Lie Chen
- Respiratory Department and Intensive Care Unit; Shengjing Hospital of China Medical University; Shenyang Postal Code 110004 People's Republic of China
| | - Xue-Fei Sun
- Department of Pharmaceutical Toxicology; School of Pharmaceutical Sciences; China Medical University; Shenyang People's Republic of China
| | - Hua-Li Yang
- Respiratory Department and Intensive Care Unit; Shengjing Hospital of China Medical University; Shenyang Postal Code 110004 People's Republic of China
| | - Ying Li
- Respiratory Department and Intensive Care Unit; Shengjing Hospital of China Medical University; Shenyang Postal Code 110004 People's Republic of China
| | - Yi-Ning Dai
- Respiratory Department and Intensive Care Unit; Shengjing Hospital of China Medical University; Shenyang Postal Code 110004 People's Republic of China
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Interventional radiology virtual simulator for liver biopsy. Int J Comput Assist Radiol Surg 2013; 9:255-67. [PMID: 23881251 DOI: 10.1007/s11548-013-0929-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 07/05/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Training in Interventional Radiology currently uses the apprenticeship model, where clinical and technical skills of invasive procedures are learnt during practice in patients. This apprenticeship training method is increasingly limited by regulatory restrictions on working hours, concerns over patient risk through trainees' inexperience and the variable exposure to case mix and emergencies during training. To address this, we have developed a computer-based simulation of visceral needle puncture procedures. METHODS A real-time framework has been built that includes: segmentation, physically based modelling, haptics rendering, pseudo-ultrasound generation and the concept of a physical mannequin. It is the result of a close collaboration between different universities, involving computer scientists, clinicians, clinical engineers and occupational psychologists. RESULTS The technical implementation of the framework is a robust and real-time simulation environment combining a physical platform and an immersive computerized virtual environment. The face, content and construct validation have been previously assessed, showing the reliability and effectiveness of this framework, as well as its potential for teaching visceral needle puncture. CONCLUSION A simulator for ultrasound-guided liver biopsy has been developed. It includes functionalities and metrics extracted from cognitive task analysis. This framework can be useful during training, particularly given the known difficulties in gaining significant practice of core skills in patients.
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Reilly CC, Jolley CJ, Ward K, MacBean V, Moxham J, Rafferty GF. Neural respiratory drive measured during inspiratory threshold loading and acute hypercapnia in healthy individuals. Exp Physiol 2013; 98:1190-8. [PMID: 23504646 DOI: 10.1113/expphysiol.2012.071415] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Understanding the effects of respiratory load on neural respiratory drive and respiratory pattern are key to understanding the regulation of load compensation in respiratory disease. The aim of the study was to examine and compare the recruitment pattern of the diaphragm and parasternal intercostal muscles when the respiratory system was loaded using two methods. Twelve subjects performed incremental inspiratory threshold loading up to 50% of their maximal inspiratory pressure, and 10 subjects underwent incremental, steady-state hypercapnia to a maximal inspired CO2 of 5%. The diaphragmatic electromyogram (EMGdi) was measured using a multipair oesophageal catheter, and the parasternal intercostal muscle EMG (sEMGpara) was recorded from bipolar surface electrodes positioned in the second intercostal space. The EMGdi and sEMGpara were analysed over the last minute of each increment of both protocols, normalized using the peak EMG recorded during maximal respiratory manoeuvres and expressed as EMG%max. The EMGdi%max and sEMGpara%max increased in parallel during the two loading methods, although EMGdi%max was consistently greater than sEMGpara%max in both conditions, inspiratory threshold loading [bias (SD) 9 (3)%, 95% limits of agreement 4-15%] and hypercapnia [bias (SD) 6 (3)%, 95% limits of agreement -0.05 to 12%]. Inspiratory threshold loading resulted in more pronounced increases in mean (SD) EMGdi%max [10 (7)-45 (28)%] and sEMGpara%max [5.3 (3.1)-40 (28)%] from baseline compared with EMGdi%max [7 (4)-21 (8)%] and sEMGpara%max [4.7 (2.3)-10 (4)%] during hypercapnia, despite comparable levels of ventilation. These data support the use of sEMGpara%max, as a non-invasive alternative to EMGdi%max recorded with an invasive oesophageal electrode catheter, for the quantification of neural respiratory drive. This technique should make evaluation of respiratory muscle function easier to undertake and therefore more readily acceptable in patients with respiratory disease, in whom transduction of neural respiratory drive to pressure generation can be compromised.
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Affiliation(s)
- Charles C Reilly
- Department of Asthma, Allergy and Respiratory Science, King's College London School of Medicine, London, UK.
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Do segmental reflexes play a role in the distribution of external intercostal EMG activity in the rabbit? Respir Physiol Neurobiol 2012; 183:1-9. [DOI: 10.1016/j.resp.2012.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 04/20/2012] [Accepted: 05/06/2012] [Indexed: 11/22/2022]
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Hudson AL, Gandevia SC, Butler JE. Control of human inspiratory motoneurones during voluntary and involuntary contractions. Respir Physiol Neurobiol 2011; 179:23-33. [DOI: 10.1016/j.resp.2011.06.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 06/14/2011] [Accepted: 06/14/2011] [Indexed: 11/17/2022]
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