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physiology of pleura

Douglas L Miller
Diagnostic ultrasound can induce pulmonary capillary hemorrhage (PCH) in rats and other mammals. This phenomenon represents the only clearly demonstrated biological effect of (non-contrast enhanced) diagnostic ultrasound and thus presents a uniquely important safety issue. However, the physical mechanism responsible for PCH remains uncertain more than 25 y after its discovery. Experimental research has indicated that neither heating nor acoustic cavitation, the predominant mechanisms for bioeffects of ultrasound, is responsible for PCH...
September 17, 2016: Ultrasound in Medicine & Biology
Torry A Tucker, Ann Jeffers, Jake Boren, Brandon Quaid, Shuzi Owens, Kathleen B Koenig, Yoshikazu Tsukasaki, Galina Florova, Andrey A Komissarov, Mitsuo Ikebe, Steven Idell
BACKGROUND: Pleural infection affects about 65,000 patients annually in the US and UK. In this and other forms of pleural injury, mesothelial cells (PMCs) undergo a process called mesothelial (Meso) mesenchymal transition (MT), by which PMCs acquire a profibrogenic phenotype with increased expression of α-smooth muscle actin (α-SMA) and matrix proteins. MesoMT thereby contributes to pleural organization with fibrosis and lung restriction. Current murine empyema models are characterized by early mortality, limiting analysis of the pathogenesis of pleural organization and mechanisms that promote MesoMT after infection...
December 2016: Clinical and Translational Medicine
Apeksha Chaturvedi, Steven Lee, Nina Klionsky, Abhishek Chaturvedi
Evaluation for pneumothorax is an important indication for obtaining chest radiographs in patients who have had trauma, recent cardiothoracic surgery or are on ventilator support. By definition, a persistent pneumothorax constitutes ongoing bubbling of air from an in situ chest drain, 48 h after its insertion. Persistent pneumothorax remains a diagnostic dilemma and identification of potentially treatable aetiologies is important. These may be chest tube related (kinks or malposition), lung parenchymal disease, bronchopleural fistula, or rarely, oesophageal-pleural fistula...
June 2016: Insights Into Imaging
Micha Sam Brickman Raredon, Kevin A Rocco, Ciprian P Gheorghe, Amogh Sivarapatna, Mahboobe Ghaedi, Jenna L Balestrini, Thomas L Raredon, Elizabeth A Calle, Laura E Niklason
Decellularized organs are now established as promising scaffolds for whole-organ regeneration. For this work to reach therapeutic practice, techniques and apparatus are necessary for doing human-scale clinically applicable organ cultures. We have designed and constructed a bioreactor system capable of accommodating whole human or porcine lungs, and we describe in this study relevant technical details, means of assembly and operation, and validation. The reactor has an artificial diaphragm that mimics the conditions found in the chest cavity in vivo, driving hydraulically regulated negative pressure ventilation and custom-built pulsatile perfusion apparatus capable of driving pressure-regulated or volume-regulated vascular flow...
2016: BioResearch Open Access
Veronika Aleksandrovych, Jerzy A Walocha, Krzysztof Gil
Telocytes (TCs) are a newly discovered type of cell with numerous functions. They have been found in a large variety of organs: heart (endo-, myo-, epi- and pericardium, myocardial sleeves, heart valves); digestive tract and annex glands (oesophagus, stomach, duodenum, jejunum, liver, gallbladder, salivary gland, exocrine pancreas); respiratory system (trachea and lungs); urinary system (kidney, renal pelvis, ureters, bladder, urethra); female reproductive system (uterus, Fallopian tube, placenta, mammary gland); vasculature (blood vessels, thoracic duct); serous membranes (mesentery and pleura); and other organs (skeletal muscle, meninges and choroid plexus, neuromuscular spindles, fascia lata, skin, eye, prostate, bone marrow)...
June 2016: Journal of Cellular and Molecular Medicine
Matteo Pecchiari, Patrizia Sartori, Vincenzo Conte, Edgardo D'Angelo, Claudia Moscheni
To verify the hypothesis that by enmeshing lubricants, microvilli reduce the coefficient of kinetic friction (μ) of pleural mesothelium, μ was measured during reciprocating sliding of rabbit's visceral against parietal pleura before and after addition of hyaluronan, and related to the morphological features of the microvillar network. Because no relation was found between μ or μ changes after hyaluronan and microvillar characteristics, the latter are not determinants of the frictional forces which oppose sliding of normal mesothelial surfaces under physiological conditions, nor of the effects of hyaluronan...
January 2016: Respiratory Physiology & Neurobiology
Ricardo Horta, Tiago Henriques-Coelho, Joana Costa, José Estevão-Costa, Diana Monteiro, Mariana Dias, José Braga, Alvaro Silva, Inês Azevedo, José Manuel Amarante
Congenital diaphragmatic hernia is a severe developmental anomaly characterized by the malformation of the diaphragm. An innervated reversed latissimus dorsi flap reconstruction for recurrent congenital diaphragmatic hernia has been described as an alternative to prosthetic patch repair to achieve pleuroperitoneal separation. However, there is very little supporting scientific data; therefore, there is no real basic understanding of the condition of the phrenic nerve in the absence of diaphragmatic muscle or even the neurotization options for restoring neodiaphragmatic muscle motion...
August 2015: Annals of Plastic Surgery
Emma Altobelli, Daniela Marzioni, Amedeo Lattanzi, Paolo Matteo Angeletti
HtrA1 appears to be involved in several physiological processes as well as in the pathogenesis of conditions such as Alzheimer's disease and osteoarthritis. It has also been hypothesized to play a role as a tumor suppressor. This manuscript reviews the current cancer-related HtrA1 research from the methodological and clinical standpoints including studies regarding its potential role as a tumor marker and/or prognostic factor. PRISMA method was used for study selection. The articles thus collected were examined and selected by two independent reviewers; any disagreement was resolved by a methodologist...
August 2015: Oncology Reports
P J Timoney, C S Breathnach
Franciscus Cornelis Donders was educated at Duizel and Boxmeer before entering the Military Medical School and the medical faculty at Utrecht University in 1835. In 1840, he received his MD from Leiden and spent 2 years in practice at Vlissingen before returning to Utrecht, where he was appointed as an extraordinary professor to lecture on forensic medicine, anthropology, general biology and ophthalmology. Refraction by the eye is complex, since the ray of light passes through many changes of refractive index in its path, and Donders simplified the account of the process by establishing an equivalent refractive system: the reduced eye...
September 2015: Irish Journal of Medical Science
Dirk Adriaensen, Inge Brouns, Jean-Pierre Timmermans
Specific subpopulations of lung-related primary afferent neurons in dorsal root and vagal sensory ganglia have been reported to express P2X2 and P2X3 receptors both in the neuronal cell bodies and in their peripheral terminals. The afferent innervation of airways and lungs is organised as sensory receptor structures, of which at least seven types with a vagal origin and two with a spinal origin have been reported. In view of the recently suggested therapeutic promise of ATP antagonism - specifically at P2X3 receptor expressing nociceptive fibres - in respiratory disorders, the present work focusses on four distinct populations of pulmonary sensory receptors that have so far been reported to express P2X2/3 receptors...
September 2015: Autonomic Neuroscience: Basic & Clinical
F B de la Quintana Gordon, B Nacarino Alcorta
Lung ultrasound has become part of the diagnostic armamentarium in Resuscitation and Recovery Units with an enormous potential due to its many advantages: capacity to diagnose more precisely than conventional radiology, earlier diagnosis, convenience due to being able to performed at the bedside, possibility of being performed by one person, absence of ionising radiation, and, due to its dynamic character, is capable of transforming into physiological processes that were once static images. However, lung ultrasound also has its limitations and has a learning curve...
June 2015: Revista Española de Anestesiología y Reanimación
Deborah Assayag, Christopher J Ryerson
Connective tissue diseases (CTDs) can affect the lungs through diseases of the chest wall, pleura, vasculature, airways, and parenchyma. Interstitial lung disease (ILD) is a common complication of CTD associated with increased morbidity and mortality. This article describes the evaluation of respiratory impairment in patients with CTD and summarizes the evidence that guides diagnosis and management of CTD-ILD. Patients with CTD with suspected ILD should undergo clinical, physiologic, and radiologic studies to evaluate for the presence of ILD, and these results should be integrated in a multidisciplinary setting to guide diagnosis and management...
May 2015: Rheumatic Diseases Clinics of North America
Charalampos Charalampidis, Andrianna Youroukou, George Lazaridis, Sofia Baka, Ioannis Mpoukovinas, Vasilis Karavasilis, Ioannis Kioumis, Georgia Pitsiou, Antonis Papaiwannou, Anastasia Karavergou, Kosmas Tsakiridis, Nikolaos Katsikogiannis, Eirini Sarika, Konstantinos Kapanidis, Leonidas Sakkas, Ipokratis Korantzis, Sofia Lampaki, Konstantinos Zarogoulidis, Paul Zarogoulidis
The pleural cavity is created between the 4(th) and 7(th) week of embryologic development. These embryonic components of visceral and parietal pleurae develop different anatomic characteristics with regard to vascular, lymphatic, and nervous supply. There are two layers: a superficial mesothelial cell layer facing the pleural space and an underlying connective tissue layer. The pleura might present inflammatory response and maintenance of the pleural fluid is observed. The latter function is especially important in the mechanical coupling of the lung and chest wall...
February 2015: Journal of Thoracic Disease
Francesca Bodega, Chiara Sironi, Cristina Porta, Luciano Zocchi, Emilio Agostoni
Volume and protein concentration of pleural liquid in anesthetized rabbits after 1 or 3h of mechanical ventilation, with alveolar pressure equal to atmospheric at end expiration, were compared to those occurring after spontaneous breathing. Moreover, coefficient of kinetic friction between samples of visceral and parietal pleura, obtained after spontaneous or mechanical ventilation, sliding in vitro at physiological velocity under physiological load, was determined. Volume of pleural liquid after mechanical ventilation was similar to that previously found during spontaneous ventilation...
January 15, 2015: Respiratory Physiology & Neurobiology
Sungsoo Lee, Hyeong Ryul Kim, Sukki Cho, Dong Myung Huh, Eung Bae Lee, Kyoung Min Ryu, Deug Gon Cho, Hyo Chae Paik, Dong Kwan Kim, Sung-Ho Lee, Jeong Su Cho, Jae Ik Lee, Ho Choi, Kwhanmien Kim, Sanghoon Jheon
BACKGROUND: Thoracoscopic wedge resection is generally accepted as a standard surgical procedure for primary spontaneous pneumothorax. Because of the relatively high recurrence rate after surgery, additional procedures such as mechanical pleurodesis or visceral pleural coverage are usually applied to minimize recurrence, although mechanical pleurodesis has some potential disadvantages. The aim of this study was to clarify whether an additional coverage procedure on the staple line after thoracoscopic bullectomy prevents postoperative recurrence compared with additional pleurodesis...
December 2014: Annals of Thoracic Surgery
Cyril Charron, Xavier Repessé, Laurent Bodson, Siu-Ming Au, Antoine Vieillard-Baron
Critical care ultrasonography (CCUS) has been defined as an ultrasound evaluation of the heart, abdomen, pleura and lungs at the bedside by the intensivist, 24/7. Within CCUS, critical care echocardiography (CCE) is used to assess cardiac function and more generally haemodynamics. Experts in haemodynamics have published a 'consensus of 16' regarding an update on haemodynamic monitoring. They reported the ten key properties of an 'ideal' haemodynamic monitoring system, which perfectly match the ten good reasons we describe here for performing CCE in critically ill patients...
November 2014: Anaesthesiology Intensive Therapy
Ann Jeffers, Shuzi Owens, Kathleen Koenig, Brandon Quaid, Usha R Pendurthi, Vijaya M Rao, Steven Idell, Torry A Tucker
Tissue factor pathway inhibitor (TFPI) is the primary inhibitor of the extrinsic coagulation cascade, and its expression is reported to be relatively stable. Various pathophysiologic agents have been shown to influence TFPI activity by regulating its expression or by modifying the protein. It is not clear how TFPI activity is regulated in normal physiology or in injury. Because thrombin and TFPI are locally elaborated in pleural injury, we sought to determine if thrombin could regulate TFPI in human pleural mesothelial cells (HPMCs)...
June 2015: American Journal of Respiratory Cell and Molecular Biology
Norbert Berend
The interstitial lung diseases pathologically involve the pulmonary interstitium but may also involve the airways, pleura and pulmonary circulation. They may be idiopathic, be part of other conditions, or be related to drug or environmental exposures. This review will focus on diagnostic and prognostic information provided by lung function tests in the idiopathic interstitial pneumonias, particularly idiopathic pulmonary fibrosis and non-specific interstitial pneumonia. These disorders are characterized by small stiff lungs with impaired gas exchange...
October 2014: Respirology: Official Journal of the Asian Pacific Society of Respirology
Alexander G Markov, Salah Amasheh
Pleura consists of visceral and parietal cell layers, producing a fluid, which is necessary for lubrication of the pleural space. Function of both mesothelial cell layers is necessary for the regulation of a constant pleural fluid volume and composition to facilitate lung movement during breathing. Recent studies have demonstrated that pleural mesothelial cells show a distinct expression pattern of tight junction proteins which are known to ubiquitously determine paracellular permeability. Most tight junction proteins provide a sealing function to epithelia, but some have been shown to have a paracellular channel function or ambiguous properties...
2014: Frontiers in Physiology
Rebecca Myatt
Pleural effusions occur when fluid accumulates between the visceral and parietal pleura in the chest cavity, preventing the lung from expanding fully during inspiration. The reduction in lung volume, depression of the diaphragm and reduced chest wall compliance cause dyspnoea, and occasionally pain or cough. Pleural effusion is a complex problem caused by a variety of conditions requiring different treatment depending on the underlying diagnosis. This article discusses the causes and treatment of pleural effusions, referencing guidelines produced by the British Thoracic Society...
June 17, 2014: Nursing Standard
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