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diaphragm injury

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https://www.readbyqxmd.com/read/28087340/electrophysiological-alterations-in-diaphragm-muscle-caused-by-abdominal-ischemia-reperfusion
#1
Seckin Tuncer, Nizamettin Dalkilic, Ilksen Burat
Ischemia-reperfusion injury is the major complication of abdominal aortic surgery, and it mainly affects the lower extremities and remote organs. In the present study, the electrophysiological alterations in diaphragm that underlie the post-operative respiratory dysfunction were investigated. Wistar Albino rats were randomly divided into two groups: SHAM (only laparotomy was performed) and IR (abdominal aorta was clamped for 30min and reperfused for 2h). Following the operational period diaphragm muscles were isolated and electrophysiological experiments were carried out in-vitro...
January 10, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28066670/image-guided-thoracoscopic-surgery-with-dye-localization-in-a-hybrid-operating-room
#2
Shun-Mao Yang, Wei-Chun Ko, Mong-Wei Lin, Hsao-Hsun Hsu, Chih-Yang Chan, I-Hui Wu, Yeun-Chung Chang, Jin-Shing Chen
BACKGROUND: The rate of detection of small pulmonary nodules (SPNs) has increased. Thoracoscopic resection following image-guided localization had been a reliable alternative in their treatment. We present our experience with image-guided dye localization using robotic C-arm computed tomography (CT) followed by immediate video-assisted thoracoscopic surgery (VATS) for SPNs in a hybrid operating room (OR). METHODS: From July 2015 to July 2016, 25 consecutive patients with SPNs smaller than 2 cm underwent robotic C-arm CT-guided blue dye tattooing followed by immediate VATS in a hybrid OR...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28035466/a-rare-postoperative-complication-of-anterior-lower-thoracic-instrumentation-diaphragmatic-laceration-with-hemothorax
#3
Yat Wa Wong, Jason Pui Yin Cheung, Keith Dip Kei Luk, Kenneth Man Chee Cheung
PURPOSE: To highlight the importance of preventing visceral injury due to prominent anterior implants at the spinal column. METHODS: A 52-year-old man with cord compression was treated with a T9/10 discectomy and instrumented fusion via a right thoracotomy and trans-pleural approach. Postoperatively, he had improved lower limb numbness. However, after a bout of coughing, there was sudden increase in chest drain output, hemodynamic instability and massive fluid collection in the right chest cavity...
December 29, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28013057/neural-control-of-ventilation-prevents-both-over-distension-and-de-recruitment-of-experimentally-injured-lungs
#4
Lukas Brander, Onnen Moerer, Göran Hedenstierna, Jennifer Beck, Jukka Takala, Arthur S Slutsky, Christer Sinderby
BACKGROUND: Endogenous pulmonary reflexes may protect the lungs during mechanical ventilation. We aimed to assess integration of continuous neurally adjusted ventilatory assist (cNAVA), delivering assist in proportion to diaphragm's electrical activity during inspiration and expiration, and Hering-Breuer inflation and deflation reflexes on lung recruitment, distension, and aeration before and after acute lung injury (ALI). METHODS: In 7 anesthetised rabbits with bilateral pneumothoraces, we identified adequate cNAVA level (cNAVAAL) at the plateau in peak ventilator pressure during titration procedures before (healthy lungs with endotracheal tube, [HLETT]) and after ALI (endotracheal tube [ALIETT] and during non-invasive ventilation [ALINIV])...
December 21, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28012765/impotence-following-radical-prostatectomy-insight-into-etiology-and-prevention
#5
Patrick C Walsh, Pieter J Donker
This study was undertaken to identify the cause of impotence in men undergoing radical prostatectomy, with the hope that this information may provide insight into the possible prevention of this complication. The autonomic innervation of the corpora cavernosa in the male fetus and newborn was traced to determine the topographical relationship between the pelvic nerve plexus, and the prostate, urethra and urogenital diaphragm. We have demonstrated that the branches of the pelvic plexus that innervate the corpora cavernosa are situated between the rectum and urethra, and penetrate the urogenital diaphragm near or in the muscular wall of the urethra...
December 21, 2016: Journal of Urology
https://www.readbyqxmd.com/read/28004760/angiotensin-ii-increases-glomerular-permeability-by-%C3%AE-arrestin-mediated-nephrin-endocytosis
#6
Eva Königshausen, Ulf M Zierhut, Martin Ruetze, Sebastian A Potthoff, Johannes Stegbauer, Magdalena Woznowski, Ivo Quack, Lars C Rump, Lorenz Sellin
Glomerular permeability and subsequent albuminuria are early clinical markers for glomerular injury in hypertensive nephropathy. Albuminuria predicts mortality and cardiovascular morbidity. AT1 receptor blockers protect from albuminuria, cardiovascular morbidity and mortality. A blood pressure independent, molecular mechanism for angiotensin II (Ang II) dependent albuminuria has long been postulated. Albuminuria results from a defective glomerular filter. Nephrin is a major structural component of the glomerular slit diaphragm and its endocytosis is mediated by β-arrestin2...
December 22, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27965930/a-case-of-severe-thoracoabdominal-impalement-by-a-steel-bar
#7
Ki Tae Kim, Pil Won Seo
A 53-year-old man arrived at the trauma center with a steel bar penetrating from the epigastrium to the right scapula. He was hypotensive and hypoxic, and immediate resuscitation and basic evaluation were performed. An emergency operation was performed due to an unstable hemodynamic state. Multiple injuries were confirmed in the right lower lobe, posterior chest wall, diaphragm, and liver lateral segment. Right lower lobectomy and liver lateral sectionectomy were performed following removal of the bar. The patient recovered without additional hemorrhage after the surgery, and was transferred to a rehabilitation institution with periodic follow-up...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27934791/comparison-of-single-incision-and-multi-incision-diagnostic-laparoscopy-on-evaluation-of-diaphragmatic-status-after-left-thoracoabdominal-penetrating-stab-wounds
#8
Mehmet Ilhan, Ali Fuat Kaan Gök, Süleyman Bademler, Ömer Cenk Cücük, Yiğit Soytaş, Hakan Teoman Yanar
AIM: Single incision diagnostic laparoscopy (SIDL) may be an alternative procedure to multi-incision diagnostic laparoscopy (MDL) for penetrating thoracoabdominal stab wounds. The purpose of this study is sharing our experience and comparing two techniques for diaphragmatic status. MATERIALS AND METHODS: Medical records of 102 patients with left thoracoabdominal penetrating stab injuries who admitted to Istanbul School of Medicine, Trauma and Emergency Surgery Clinic between February 2012 and April 2016 were examined...
January 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27932705/possible-role-for-glomerular-derived-angiotensinogen-in-nephrotic-syndrome
#9
Mihoko Yamazaki, Yoshiyasu Fukusumi, Mutsumi Kayaba, Yukina Kitazawa, Sayuri Takamura, Ichiei Narita, Hiroshi Kawachi
BACKGROUND AND OBJECTIVE: Renin-angiotensin system (RAS) inhibitors reduce glomerular injury and proteinuria, indicating that angiotensin II (Ang II) is involved in glomerular diseases. Although the local RAS is reported to play an essential role in maintaining local tissue functions, the role of the local RAS in regulating glomerular function is not well evaluated. In this study, we analyzed the glomerular expression of RAS components in nephrotic models and the effect of Ang II receptor blockers (ARB) on the expression of angiotensinogen (AGT)...
October 2016: Journal of the Renin-angiotensin-aldosterone System: JRAAS
https://www.readbyqxmd.com/read/27932480/magi2-mutations-cause-congenital-nephrotic-syndrome
#10
Agnieszka Bierzynska, Katrina Soderquest, Philip Dean, Elizabeth Colby, Ruth Rollason, Caroline Jones, Carol D Inward, Hugh J McCarthy, Michael A Simpson, Graham M Lord, Maggie Williams, Gavin I Welsh, Ania B Koziell, Moin A Saleem
Steroid-resistant nephrotic syndrome (SRNS), a heterogeneous disorder of the renal glomerular filtration barrier, results in impairment of glomerular permselectivity. Inheritance of genetic SRNS may be autosomal dominant or recessive, with a subset of autosomal recessive SRNS presenting as congenital nephrotic syndrome (CNS). Mutations in 53 genes are associated with human SRNS, but these mutations explain ≤30% of patients with hereditary cases and only 20% of patients with sporadic cases. The proteins encoded by these genes are expressed in podocytes, and malfunction of these proteins leads to a universal end point of podocyte injury, glomerular filtration barrier disruption, and SRNS...
December 8, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27913649/identification-and-function-of-fibrocytes-in-skeletal-muscle-injury-repair-and-muscular-dystrophy
#11
Xingyu Wang, Wanming Zhao, Richard M Ransohoff, Lan Zhou
We identified and characterized the function of CD45(+)/collagen I(+) fibrocytes in acutely injured skeletal muscle of wild-type (WT) and Ccr2(-/-) mice, and in quadriceps and diaphragm muscles of mdx(5cv) mice, a mouse model for Duchenne muscular dystrophy. Fibrocytes were not detected in peripheral blood of WT mice after acute muscle injury or mdx(5cv) mice. Fibrocytes were detected in acutely injured muscles and in mdx(5cv) quadriceps and diaphragm muscles. These cells expressed F4/80 and CCR2, and they were mostly Ly6C(lo) They expressed a low level of collagens but a high level of profibrotic growth factors as compared with i...
December 15, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/27891095/differential-rna-expression-profile-of-skeletal-muscle-induced-by-experimental-autoimmune-myasthenia-gravis-in-rats
#12
Henry J Kaminski, Keiichi Himuro, Jumana Alshaikh, Bendi Gong, Georgiana Cheng, Linda L Kusner
The differential susceptibility of skeletal muscle by myasthenia gravis (MG) is not well understood. We utilized RNA expression profiling of extraocular muscle (EOM), diaphragm (DIA), and extensor digitorum (EDL) of rats with experimental autoimmune MG (EAMG) to evaluate the hypothesis that muscles respond differentially to injury produced by EAMG. EAMG was induced in female Lewis rats by immunization with acetylcholine receptor purified from the electric organ of the Torpedo. Six weeks later after rats had developed weakness and serum antibodies directed against the AChR, animals underwent euthanasia and RNA profiling performed on DIA, EDL, and EOM...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27888814/diaphragmatic-dysfunction-after-thoracic-operations
#13
Henning Gaissert, Susan R Wilcox
The perioperative management of diaphragmatic weakness and phrenic nerve dysfunction is complex, due to varied etiologies and clinical presentations. The factors leading to diaphragmatic weakness may culminate after the operation with transient or persistent respiratory failure. This review discusses diaphragmatic disorders and postoperative respiratory failure caused by unilateral or bilateral diaphragmatic impairment. The origins of neuromuscular weakness involving the diaphragm are diverse, and often lie within the domains of different medical specialties, with only a portion of the condition related to surgical intervention...
December 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27881723/intraspinal-microstimulation-and-diaphragm-activation-following-cervical-spinal-cord-injury
#14
Lynne M Mercier, Elisa J Gonzalez-Rothi, Kristi A Streeter, Savannah S Posgai, Alexander S Poirier, David D Fuller, Paul J Reier, David M Baekey
Intraspinal microstimulation (ISMS), using implanted electrodes, can evoke locomotor movements after spinal cord injury (SCI), but has not been explored in the context of respiratory motor output. An advantage over epidural and direct muscle stimulation is the potential of ISMS to selectively stimulate components of the spinal respiratory network. The present study tested the hypothesis that medullary respiratory activity could be used to trigger mid-cervical ISMS and diaphragm motor unit activation in rats with cervical SCI...
November 23, 2016: Journal of Neurophysiology
https://www.readbyqxmd.com/read/27879614/getting-a-better-look-outcomes-of-laparoscopic-versus-transdiaphragmatic-pericardial-window-for-penetrating-thoracoabdominal-trauma-at-a-level-i-trauma-center
#15
Jamie E Anderson, Edgardo S Salcedo, Kacie M Rounds, Joseph M Galante
BACKGROUND: In penetrating thoracoabdominal trauma, it is necessary to evaluate both the pericardial fluid and the diaphragm directly. Transdiaphragmatic pericardial windows (TDWs) provide direct access to the pericardium and diaphragm but expose the patient to the risks of laparotomy. We hypothesize that transabdominal laparoscopic pericardial windows (LPWs) are a safe and effective alternative to TDWs in stable patients. METHODS: This is a retrospective observational study of stable patients with thoracoabdominal penetrating trauma at a level I trauma center between January 2007 and June 2015, comparing outcomes after TDW versus LPW...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27878130/an-unusual-case-of-transorificial-abdomino-thoracic-impalement-injury-in-a-child
#16
Hemanshi Shah, Charu Tiwari, Shalika Jayaswal, Keshav Murthy
Impalement injuries are rare in the paediatric age group. Still rarer are injuries which traverse multiple body cavities. Such injuries require multispecialty management at a tertiary care centre. We describe a case of an accidental impalement injury in a 12-year-old boy after a fall from height. The rod was seen passing through the right lung in the paracardiac region, piercing the diaphragm and segment IV of the liver and then coursing anterior to the inferior vena cava in the midline. It was seen passing through the small bowel at multiple places and then coursing behind the bladder, entering the rectum and anal canal...
October 2016: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/27867441/the-role-of-computed-tomography-in-the-diagnostics-of-diaphragmatic-injury-after-blunt-thoraco-abdominal-trauma
#17
Agata Gmachowska, Ryszard Pacho, Agnieszka Anysz-Grodzicka, Leopold Bakoń, Maria Gorycka, Wawrzyniec Jakuczun, Waldemar Patkowski
BACKGROUND: Diaphragmatic injuries occur in 0.8-8% of patients with blunt trauma. The clinical diagnosis of diaphragmatic rupture is difficult and may be overshadowed by associated injuries. Diaphragmatic rupture does not resolve spontaneously and may cause life-threatening complications. The aim of this study was to present radiological findings in patients with diaphragmatic injury. MATERIAL/METHODS: The analysis of computed tomography examinations performed between 2007 and 2012 revealed 200 patients after blunt thoraco-abdominal trauma...
2016: Polish Journal of Radiology
https://www.readbyqxmd.com/read/27832610/diaphragm-electromyographic-activity-following-unilateral-mid-cervical-contusion-injury-in-rats
#18
Sabhya Rana, Gary C Sieck, Carlos B Mantilla
Contusion type injuries to the spinal cord are characterized by tissue loss and disruption of spinal pathways. Mid-cervical spinal cord injuries impair the function of respiratory muscles and may contribute to significant respiratory complications. This study systematically assessed the impact of a 100-kDy unilateral C4 contusion injury on diaphragm muscle activity across a range of motor behaviors in rats. Chronic diaphragm EMG was recorded prior to injury, and at 1 and 7 days post injury. Histological analyses assessed the extent of perineuronal net formation, white matter sparing and phrenic motoneuron loss...
November 9, 2016: Journal of Neurophysiology
https://www.readbyqxmd.com/read/27832605/bdnf-effects-on-functional-recovery-across-motor-behaviors-after-cervical-spinal-cord-injury
#19
Vivian Hernandez-Torres, Heather M Gransee, Carlos B Mantilla, Yao Wang, Wen-Zhi Zhan, Gary C Sieck
Unilateral C2 cervical spinal cord hemisection (SH) disrupts descending excitatory drive to phrenic motor neurons, thereby paralyzing the ipsilateral diaphragm muscle (DIAm) during ventilatory behaviors. Recovery of rhythmic DIAm activity ipsilateral to injury occurs over time, consistent with neuroplasticity and strengthening of spared synaptic inputs to phrenic motor neurons. Localized intrathecal delivery of brain-derived neurotrophic factor (BDNF) to phrenic motor neurons after SH enhances recovery of eupneic DIAm activity...
November 9, 2016: Journal of Neurophysiology
https://www.readbyqxmd.com/read/27786562/spontaneous-breathing-during-mechanical-ventilation-risks-mechanisms-management
#20
Takeshi Yoshida, Yuji Fujino, Marcelo B P Amato, Brian P Kavanagh
Spontaneous respiratory effort during mechanical ventilation has long been recognized to improve oxygenation (1, 2) and because oxygenation is a key management target, such effort may seem beneficial. Also, disuse and loss of peripheral muscle and diaphragm function is increasingly recognized (3), and thus spontaneous breathing may confer additional advantage. Of course, all patients will need to transition to spontaneous effort if they are to become independent of the ventilator. Finally, epidemiologic data suggest that the use of partial (vs...
October 27, 2016: American Journal of Respiratory and Critical Care Medicine
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