Science.gov

Sample records for airway microvascular leakage

  1. Effect of subchronic in vivo exposure to nitrogen dioxide on lung tissue inflammation, airway microvascular leakage, and in vitro bronchial muscle responsiveness in rats.

    PubMed Central

    Chitano, P; Rado, V; Di Stefano, A; Papi, A; Boniotti, A; Zancuoghi, G; Boschetto, P; Romano, M; Salmona, M; Ciaccia, A; Fabbri, L M; Mapp, C E

    1996-01-01

    OBJECTIVES: In a previous study on bronchoalveolar lavage fluid from rats exposed in vivo for seven days to 10 ppm nitrogen dioxide (NO2), it has been shown that there is an influx of macrophages into the airways. The present study investigated the effect of seven day exposure to 10 ppm NO2, on: (a) lung tissue inflammation and morphology; (b) airway microvascular leakage; (c) in vitro contractile response of main bronchi. METHODS: Lung tissue was studied by light microscopy, after fixing the lungs by inflation with 4% formalin at a pressure of 20 cm H2O. Microvascular leakage was measured by extravasation of Evans blue dye in the larynx, trachea, main bronchi, and intrapulmonary airways. Smooth muscle responsiveness was evaluated by concentration-responses curves to acetylcholine (10(-9)-10(-3) M), serotonin (10(-9)-10(-4) M), and voltage-response curves (12-28 V) to electrical field stimulation. RESULTS: Histology showed an increased total inflammation at the level of respiratory bronchioles and alveoli. No influx of inflammatory cells was found in the main bronchi. A loss of cilia in the epithelium of small airways and ectasia of alveolar capillaries was also found. By contrast, no alterations to microvascular permeability or modification of bronchial smooth muscle responsiveness was found. CONCLUSIONS: Subchronic exposure to 10 ppm NO2 causes airway inflammation and structural damage, but does not cause any persistent alteration to microvascular permeability or bronchial smooth muscle responsiveness in rats. Images Figure 1 PMID:8758032

  2. Acute Alcohol Intoxication-Induced Microvascular Leakage

    PubMed Central

    Doggett, Travis M.; Breslin, Jerome W.

    2014-01-01

    Background Alcohol intoxication can increase inflammation and worsen injury, yet the mechanisms involved are not clear. We investigated whether acute alcohol intoxication elevates microvascular permeability, and investigated potential signaling mechanisms in endothelial cells that may be involved. Methods Conscious rats received a 2.5 g/kg alcohol bolus via gastric catheters to produce acute intoxication. Microvascular leakage of intravenously administered FITC-albumin from the mesenteric microcirculation was assessed by intravital microscopy. Endothelial-specific mechanisms were studied using cultured endothelial cell monolayers. Transendothelial electrical resistance (TER) served as an index of barrier function, before and after treatment with alcohol or its metabolite acetaldehyde. Pharmacologic agents were used to test the roles of alcohol metabolism, oxidative stress, p38 mitogen-activated protein (MAP) kinase, myosin light chain kinase (MLCK), rho kinase (ROCK), and exchange protein activated by cAMP (Epac). VE-cadherin localization was investigated to assess junctional integrity. Rac1 and RhoA activation were assessed by ELISA assays. Results Alcohol significantly increased FITC-albumin extravasation from the mesenteric microcirculation. Alcohol also significantly decreased TER and disrupted VE-cadherin organization at junctions. Acetaldehyde significantly decreased TER, but inhibition of ADH or application of a superoxide dismutase mimetic failed to prevent alcohol-induced decreases in TER. Inhibition of p38 MAP kinase, but not MLCK or ROCK, significantly attenuated the alcohol-induced barrier dysfunction. Alcohol rapidly decreased GTP-bound Rac1 but not RhoA during the drop in TER. Activation of Epac increased TER, but did not prevent alcohol from decreasing TER. However, activation of Epac after initiation of alcohol-induced barrier dysfunction quickly resolved TER to baseline levels. Conclusions Our results suggest that alcohol intoxication increases

  3. Albumin microvascular leakage in brains with diabetes mellitus.

    PubMed

    Fujihara, Ryuji; Chiba, Yoichi; Nakagawa, Toshitaka; Nishi, Nozomu; Murakami, Ryuta; Matsumoto, Koichi; Kawauchi, Machi; Yamamoto, Tetsuji; Ueno, Masaki

    2016-09-01

    Their aim was to examine whether microvascular leakage of endogenous albumin, a representative marker for blood-brain barrier (BBB) damage, was induced in the periventricular area of diabetic db/db mice because periventricular white matter hyperintensity formation in magnetic resonance images was accelerating in elderly patients with diabetes mellitus. Using light and electron microscopes, and semi-quantitative analysis techniques, immunoreactivity of endogenous albumin, indicating vascular permeability, was examined in the periventricular area and spinal cord of db/db mice and db/+m control mice. Greater immunoreactivity of albumin was observed in the vessel wall of the periventricular area of db/db mice than in controls. Additionally, weak immunoreactivity was observed in the spinal cord of both db/db mice and controls. The number of gold particles, indicating immunoreactivity of albumin, in the perivascular area of db/db mice was significantly higher than that of control mice, but there was no significant difference in the number of particles in the spinal cord between db/db mice and controls. These findings suggest that albumin microvascular leakage, or BBB breakdown, is induced in the periventricular area of diabetic mice. Microsc. Res. Tech. 79:833-837, 2016. © 2016 Wiley Periodicals, Inc. PMID:27333535

  4. Microvascular leakage of plasma proteins after PUVA and UVA

    SciTech Connect

    Staberg, B.; Worm, A.M.; Rossing, N.; Brodthagen, H.

    1982-04-01

    The transcapillary escape rate of albumin (TERalb), is a parameter of the leakage of macromolecules from the total microvasculature. In patients with psoriasis short-term PUVA treatment induces an increase in TERalb. In this study TERalb was measured in 3 groups of normal humans treated with PUVA, UVA and 8-methoxypsoralen. Treatment with PUVA and UVA caused a statistically significant increase in TERalb, whereas treatment with 8-methoxypsoralen did not induce any measurable changes. It is concluded that the UVA irradiation causes the abnormal leakage of macromolecules, whereas psoralen is not the responsible component. Furthermore the phenomenon can be elicited in normals and is not based on a preexisting psoriasis.

  5. Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever.

    PubMed

    Bethell, D B; Gamble, J; Pham, P L; Nguyen, M D; Tran, T H; Ha, T H; Tran, T N; Dong, T H; Gartside, I B; White, N J; Day, N P

    2001-01-15

    Dengue shock syndrome (DSS) is a potentially lethal complication of dengue virus infection associated with hypotension and leakage of plasma water into the extravascular space. To determine whether the underlying pathophysiology of DSS is distinct from that in milder forms of the disease, we assessed microvascular permeability, by use of strain gauge plethysmography, in Vietnamese children with DSS (n=19), or dengue hemorrhagic fever (DHF) without shock (n=16), and in healthy control children (n=15). At admission and after fluid resuscitation, the mean coefficient of microvascular permeability (K(f)) for the patients with dengue was approximately 50% higher than that for the control patients (P=.02). There was no significant difference in K(f) between the 2 groups of patients with dengue; this suggests the same underlying pathophysiology. We hypothesize that in patients with DSS, the fluctuations in K(f) are larger than those in patients with DHF, which leads to short-lived peaks of markedly increased microvascular permeability and consequent hemodynamic shock.

  6. Endotoxin, interleukin-1, and tumor necrosis factor cause neutrophil-dependent microvascular leakage in postcapillary venules.

    PubMed Central

    Yi, E. S.; Ulich, T. R.

    1992-01-01

    Acute inflammation is characterized mainly by the egress of neutrophils from postcapillary venules and by increased vascular permeability leading to the formation of edema. The microvascular site of increased vascular permeability in local acute inflammatory lesions was investigated after the injection of endotoxin (LPS), interleukin-1 (IL-1), and tumor necrosis factor (TNF) into the dermis overlying the cremasteric and rectus abdominis muscles of rats. LPS caused leakage of colloidal carbon peaking at 3 to 4 hours at the level of the postcapillary venules and capillary leak was variably observed at later time points. IL-1 and TNF also caused postcapillary venular leakage. IL-1 was as potent as LPS and more so than TNF. The microvascular leak caused by LPS, IL-1, and TNF was accompanied by the tissue accumulation of neutrophils, and was neutrophil-dependent because LPS, IL-1, and TNF did not cause vascular labelling in neutropenic rats. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 PMID:1546745

  7. Microvascular destruction identifies murine allografts that cannot be rescued from airway fibrosis

    PubMed Central

    Babu, Ashok N.; Murakawa, Tomohiro; Thurman, Joshua M.; Miller, Edmund J.; Henson, Peter M.; Zamora, Martin R.; Voelkel, Norbert F.; Nicolls, Mark R.

    2007-01-01

    Small airway fibrosis (bronchiolitis obliterans syndrome) is the primary obstacle to long-term survival following lung transplantation. Here, we show the importance of functional microvasculature in the prevention of epithelial loss and fibrosis due to rejection and for the first time, relate allograft microvascular injury and loss of tissue perfusion to immunotherapy-resistant rejection. To explore the role of alloimmune rejection and airway ischemia in the development of fibroproliferation, we used a murine orthotopic tracheal transplant model. We determined that transplants were reperfused by connection of recipient vessels to donor vessels at the surgical anastomosis site. Microcirculation through the newly formed vascular anastomoses appeared partially dependent on VEGFR2 and CXCR2 pathways. In the absence of immunosuppression, the microvasculature in rejecting allografts exhibited vascular complement deposition, diminished endothelial CD31 expression, and absent perfusion prior to the onset of fibroproliferation. Rejecting grafts with extensive endothelial cell injury were refractory to immunotherapy. After early microvascular loss, neovascularization was eventually observed in the membranous trachea, indicating a reestablishment of graft perfusion in established fibrosis. One implication of this study is that bronchial artery revascularization at the time of lung transplantation may decrease the risk of subsequent airway fibrosis. PMID:18060031

  8. Nedocromil sodium in obstructive airways disease: effect on symptoms and plasma protein leakage in sputum.

    PubMed

    Schoonbrood, D F; Out, T A; Hart, A A; Habets, F J; Roos, C M; Jansen, H M

    1997-07-01

    In patients with asthma or chronic obstructive pulmonary disease, there is chronic airway inflammation with increased leakage of plasma proteins into the airway lumen, which can be reduced by inhaled glucocorticosteroids. Nedocromil sodium is an anti-inflammatory drug, and we questioned whether it also affects the leakage of plasma proteins. In a double-blind placebo-controlled study we investigated the effect of 12 weeks of treatment with nedocromil on forced expiratory volume in one second (FEV1), provocative concentration of histamine causing a 20% fall in FEV1 (PC20), peak flow, symptom scores, and plasma protein leakage in sputum, in 31 patients with obstructive airways disease and sputum production (mean (range) FEV1 61% of predicted (42-87%); geometric mean (range) PC20 0.39 (0.04-2.9) mg x mL(-1)). As a measure for plasma protein leakage we calculated the relative coefficients of excretion (RCE) of proteins from serum to the soluble phase of sputum. There was a small increase in morning and evening peak flow (p<0.05) and a decrease in night-time bronchodilator use (p<0.02) in favour of nedocromil. The RCE of alpha2-macroglobulin to albumin significantly decreased after treatment with nedocromil (p=0.03). The results show limited clinical efficacy of nedocromil in our study group. They further suggest that the anti-inflammatory properties of nedocromil extend to inhibition of plasma protein leakage into the airways.

  9. Differential effects of topically applied formalin and aromatic compounds on neurogenic-mediated microvascular leakage in rat skin.

    PubMed

    Futamura, Masaki; Goto, Shiho; Kimura, Ryoko; Kimoto, Izumi; Miyake, Mio; Ito, Komei; Sakamoto, Tatsuo

    2009-01-01

    Various volatile organic compounds (VOCs) act as a causative agent of skin inflammation. We investigated the effect of topical application of several VOCs and formalin on microvascular leakage in rat skin. We tested capsaicin, which is a reagent that specifically causes the skin response via endogenously released tachykinins. Evans blue dye extravasation served as an index of the increase in skin vascular permeability. After shaving the abdomen, we applied formalin, m-xylene, toluene, styrene, benzene, ethylbenzene, acetone, diethyl ether, hexane, heptane, cyclohexane and capsaicin to the skin. At 40min after application, skin samples were collected. Among all of the VOCs tested, all of the aromatic compounds significantly produced skin microvascular leakage that was similar to formalin and capsaicin. We also investigated the skin responses seen after the intravenous administration of CP-99,994 (1.5 or 5mg/kg), which is a tachykinin NK1 receptor antagonist, ketotifen (1 or 3mg/kg), which is a histamine H1 receptor antagonist that stabilizes the mast cells, and the topical application of capsazepine (22.5 or 50mM), which is the transient receptor potential vanilloid 1 (TRPV1) antagonist. The response induced by formalin and capsaicin was completely inhibited by CP-99,994. On the other hand, the antagonist partially reduced the response induced by m-xylene, toluene and styrene by 39%, 50% and 46%, respectively. Capsazepine and ketotifen did not alter the response induced by formalin or any of the aromatic compounds. Like capsaicin, formalin and the aromatic compounds at least partially caused skin microvascular leakage, which was due to tachykinin NK1 receptor activation related to the release of tachykinins from the sensory nerve endings. However, it is unlikely that mast cells and TRPV1 play an important role in the skin response.

  10. Role of EP2 and EP4 receptors in airway microvascular leak induced by prostaglandin E2

    PubMed Central

    Jones, Victoria C; Birrell, Mark A; Maher, Sarah A; Griffiths, Mark; Grace, Megan; O'Donnell, Valerie B; Clark, Stephen R

    2016-01-01

    Background and Purpose Airway microvascular leak (MVL) involves the extravasation of proteins from post‐capillary venules into surrounding tissue. MVL is a cardinal sign of inflammation and an important feature of airway inflammatory diseases such as asthma. PGE2, a product of COX‐mediated metabolism of arachidonic acid, binds to four receptors, termed EP1–4. PGE2 has a wide variety of effects within the airway, including modulation of inflammation, sensory nerve activation and airway tone. However, the effect of PGE2 on airway MVL and the receptor/s that mediate this have not been described. Experimental Approach Evans Blue dye was used as a marker of airway MVL, and selective EP receptor agonists and antagonists were used alongside EP receptor‐deficient mice to define the receptor subtype involved. Key Results PGE2 induced significant airway MVL in mice and guinea pigs. A significant reduction in PGE2‐induced MVL was demonstrated in Ptger2 −/− and Ptger4 −/− mice and in wild‐type mice pretreated simultaneously with EP2 (PF‐04418948) and EP4 (ER‐819762) receptor antagonists. In a model of allergic asthma, an increase in airway levels of PGE2 was associated with a rise in MVL; this change was absent in Ptger2 −/− and Ptger4 −/− mice. Conclusions and Implications PGE2 is a key mediator produced by the lung and has widespread effects according to the EP receptor activated. Airway MVL represents a response to injury and under ‘disease’ conditions is a prominent feature of airway inflammation. The data presented highlight a key role for EP2 and EP4 receptors in MVL induced by PGE2. PMID:26639895

  11. Reversibility and reproducibility of histamine induced plasma leakage in nasal airways.

    PubMed Central

    Svensson, C; Baumgarten, C R; Pipkorn, U; Alkner, U; Persson, C G

    1989-01-01

    Plasma exudation is one cardinal factor in airways defence and inflammation. In inflammatory airway diseases such as rhinitis and asthma, however, plasma leakage may also have a pathogenetic role. Experimental data from animals indicate that highly sensitive, active, and reversible processes regulate the vascular and mucosal permeability to macromolecules. With the use of a nasal lavage model for the recovery of liquids on the mucosal surface the effect of histamine on the macromolecular permeability of the airway endothelial-epithelial barriers was studied in normal subjects. The concentrations of albumin, kinins, and N-alpha-beta-tosyl-L-arginine-methyl esterase (TAME) in nasal lavage fluid were measured and nasal symptoms assessed by a scoring technique. The reproducibility of three repeated challenges with 30 minute intervals on the same day was studied in 12 subjects and compared with the same procedure (three challenges) on a different day. Sneezing decreased significantly (p less than 0.05) after the first histamine challenge but was maintained thereafter. Otherwise, the mean values for symptoms and for markers of vascular leakage were very similar both for the three challenges in the same session and for the two challenge sessions on a different day. Sneezing, blockage, and secretions were associated with increased concentrations of TAME esterase (maximum 9000 cpm/ml), kinins (1.4 ng/ml), and albumin (0.3 g/l) in lavage fluid. Both the symptoms and the measures of plasma exudation were reversible and reproducible in the three repeat histamine challenges and at two challenge sessions on different days. These findings support the view that non-injurious, active processes regulate the inflammatory flow of macromolecules across airways endothelial-epithelial barriers. The present experimental approach would be suitable for studies of the modulatory effects of inflammatory stimulus induced plasma leakage and symptoms in human airways. PMID:2648641

  12. Interplay between parasite cysteine proteases and the host kinin system modulates microvascular leakage and macrophage infection by promastigotes of the Leishmania donovani complex.

    PubMed

    Svensjö, Erik; Batista, Paulo R; Brodskyn, Claudia I; Silva, Robson; Lima, Ana Paula C A; Schmitz, Verônica; Saraiva, Elvira; Pesquero, João B; Mori, Marcelo A S; Müller-Esterl, Werner; Scharfstein, Julio

    2006-01-01

    Kinins, the vasoactive peptides proteolytically liberated from kininogens, were recently recognized as signals alerting the innate immune system. Here we demonstrate that Leishmania donovani and Leishmania chagasi, two etiological agents of visceral leishmaniasis (VL), activate the kinin system. Intravital microscopy in the hamster cheek pouch showed that topically applied promastigotes induced macromolecular leakage (FITC-dextran) through postcapillary venules. Peaking at 15 min, the parasite-induced leakage was drastically enhanced by captopril (Cap), an inhibitor of angiotensin-converting enzyme (ACE), a kinin-degrading metallopeptidase. The enhanced microvascular responses were cancelled by HOE-140, an antagonist of the B2 bradykinin receptor (B2R), or by pre-treatment of promastigotes with the irreversible cysteine proteinase inhibitor N-methylpiperazine-urea-Phe-homoPhe-vinylsulfone-benzene (N-Pip-hF-VSPh). In agreement with the above-mentioned data, the promastigotes vigorously induced edema in the paw of Cap-treated J129 mice, but not Cap-B2R-/- mice. Analysis of parasite-induced breakdown of high molecular weight kininogens (HK), combined with active site-affinity-labeling with biotin-N-Pip-hF-VSPh, identified 35-40 kDa proteins as kinin-releasing cysteine peptidases. We then checked if macrophage infectivity was influenced by interplay between these kinin-releasing parasite proteases, kininogens, and kinin-degrading peptidases (i.e. ACE). Our studies revealed that full-fledged B2R engagement resulted in vigorous increase of L. chagasi uptake by resident macrophages. Evidence that inflammatory macrophages treated with HOE-140 became highly susceptible to amastigote outgrowth, assessed 72 h after initial macrophage interaction, further suggests that the kinin/B2R activation pathway may critically modulate inflammation and innate immunity in visceral leishmaniasis. PMID:16203170

  13. Small airway epithelial cells exposure to printer-emitted engineered nanoparticles induces cellular effects on human microvascular endothelial cells in an alveolar-capillary co-culture model.

    PubMed

    Sisler, Jennifer D; Pirela, Sandra V; Friend, Sherri; Farcas, Mariana; Schwegler-Berry, Diane; Shvedova, Anna; Castranova, Vincent; Demokritou, Philip; Qian, Yong

    2015-01-01

    The printer is one of the most common office equipment. Recently, it was reported that toner formulations for printing equipment constitute nano-enabled products (NEPs) and contain engineered nanomaterials (ENMs) that become airborne during printing. To date, insufficient research has been performed to understand the potential toxicological properties of printer-emitted particles (PEPs) with several studies using bulk toner particles as test particles. These studies demonstrated the ability of toner particles to cause chronic inflammation and fibrosis in animal models. However, the toxicological implications of inhalation exposures to ENMs emitted from laser printing equipment remain largely unknown. The present study investigates the toxicological effects of PEPs using an in vitro alveolar-capillary co-culture model with Human Small Airway Epithelial Cells (SAEC) and Human Microvascular Endothelial Cells (HMVEC). Our data demonstrate that direct exposure of SAEC to low concentrations of PEPs (0.5 and 1.0 µg/mL) caused morphological changes of actin remodeling and gap formations within the endothelial monolayer. Furthermore, increased production of reactive oxygen species (ROS) and angiogenesis were observed in the HMVEC. Analysis of cytokine and chemokine levels demonstrates that interleukin (IL)-6 and MCP-1 may play a major role in the cellular communication observed between SAEC and HMVEC and the resultant responses in HMVEC. These data indicate that PEPs at low, non-cytotoxic exposure levels are bioactive and affect cellular responses in an alveolar-capillary co-culture model, which raises concerns for potential adverse health effects.

  14. Endothelial gaps and adherent leukocytes in allergen-induced early- and late-phase plasma leakage in rat airways.

    PubMed

    Baluk, P; Bolton, P; Hirata, A; Thurston, G; McDonald, D M

    1998-06-01

    Exposure of sensitized individuals to antigen can induce allergic responses in the respiratory tract, manifested by early and late phases of vasodilatation, plasma leakage, leukocyte influx, and bronchoconstriction. Similar responses can occur in the skin, eye, and gastrointestinal tract. The early-phase response involves mast cell mediators and the late-phase response is leukocyte dependent, but the mechanism of leakage is not understood. We sought to identify the leaky blood vessels, to determine whether these vessels contained endothelial gaps, and to analyze the relationship of the gaps to adherent leukocytes, using biotinylated lectins or silver nitrate to stain the cells in situ and Monastral blue as a tracer to quantify plasma leakage. Most of the leakage occurred in postcapillary venules (< 40-microns diameter), whereas most of the leukocyte migration (predominantly neutrophils) occurred in collecting venules. Capillaries and arterioles did not leak. Endothelial gaps were found in the leaky venules, both by silver nitrate staining and by scanning electron microscopy, and 94% of the gaps were distinct from sites of leukocyte adhesion or migration. We conclude that endothelial gaps contribute to both early and late phases of plasma leakage induced by antigen, but most leakage occurs upstream to sites of leukocyte adhesion. PMID:9626051

  15. Microvascular rarefaction

    PubMed Central

    2010-01-01

    The goals of this presentation are twofold: (1) to briefly sketch the field of vascular rarefaction as a key component of various fibrotic diseases and (2) to illustrate it with four vignettes depicting diverse mechanisms of microvascular rarefaction. Specifically, I shall describe migratory and angiogenic incompetence of endothelial cells under conditions of reduced bioavailability of nitric oxide, role of endothelial-to-mesenchymal cell and mesenchymal stem cell-to-endothelial reprogramming, and potential role of antiangiogenic peptides in the development of graft vascular disease as exemplified by chronic allograft nephropathy PMID:20592859

  16. Hemorheology and Microvascular Disorders

    PubMed Central

    Cho, Daniel J

    2011-01-01

    The present review presents basic concepts of blood rheology related to vascular diseases. Blood flow in large arteries is dominated by inertial forces exhibited at high flow velocities, while viscous forces (i.e., blood rheology) play an almost negligible role. When high flow velocity is compromised by sudden deceleration as at a bifurcation, endothelial cell dysfunction can occur along the outer wall of the bifurcation, initiating inflammatory gene expression and, through mechanotransduction, the cascade of events associated with atherosclerosis. In sharp contrast, the flow of blood in microvessels is dominated by viscous shear forces since the inertial forces are negligible due to low flow velocities. Shear stress is a critical parameter in microvascular flow, and a force-balance approach is proposed for determining microvascular shear stress, accounting for the low Reynolds numbers and the dominance of viscous forces over inertial forces. Accordingly, when the attractive forces between erythrocytes (represented by the yield stress of blood) are greater than the shear force produced by microvascular flow, tissue perfusion itself cannot be sustained, leading to capillary loss. The yield stress parameter is presented as a diagnostic candidate for future clinical research, specifically, as a fluid dynamic biomarker for microvascular disorders. The relation between the yield stress and diastolic blood viscosity (DBV) is described using the Casson model for viscosity, from which one may be able determine thresholds of DBV where the risk of microvascular disorders is high. PMID:21779279

  17. What Causes Coronary Microvascular Disease?

    MedlinePlus

    ... Living With Clinical Trials Links Related Topics Angina Atherosclerosis Coronary Heart Disease Coronary Heart Disease Risk Factors ... Microvascular Disease? The same risk factors that cause atherosclerosis may cause coronary microvascular disease. Atherosclerosis is a ...

  18. Microvascular invasion in hepatocellular carcinoma

    PubMed Central

    Ünal, Emre; İdilman, İlkay Sedakat; Akata, Deniz; Özmen, Mustafa Nasuh; Karçaaltıncaba, Muşturay

    2016-01-01

    Microvascular invasion is a crucial histopathologic prognostic factor for hepatocellular carcinoma. We reviewed the literature and aimed to draw attention to clinicopathologic and imaging findings that may predict the presence of microvascular invasion in hepatocellular carcinoma. Imaging findings suggesting microvascular invasion are disruption of capsule, irregular tumor margin, peritumoral enhancement, multifocal tumor, increased tumor size, and increased glucose metabolism on positron emission tomography-computed tomography. In the presence of typical findings, microvascular invasion may be predicted. PMID:26782155

  19. Reversibility of retinal microvascular changes in severe falciparum malaria.

    PubMed

    Maude, Richard J; Kingston, Hugh W F; Joshi, Sonia; Mohanty, Sanjib; Mishra, Saroj K; White, Nicholas J; Dondorp, Arjen M

    2014-09-01

    Malarial retinopathy allows detailed study of central nervous system vascular pathology in living patients with severe malaria. An adult with cerebral malaria is described who had prominent retinal whitening with corresponding retinal microvascular obstruction, vessel dilatation, increased vascular tortuosity, and blood retinal barrier leakage with decreased visual acuity, all of which resolved on recovery. Additional study of these features and their potential role in elucidating the pathogenesis of cerebral malaria is warranted.

  20. Extravascular fibrin, plasminogen activator, plasminogen activator inhibitors, and airway hyperresponsiveness

    PubMed Central

    Wagers, Scott S.; Norton, Ryan J.; Rinaldi, Lisa M.; Bates, Jason H.T.; Sobel, Burton E.; Irvin, Charles G.

    2004-01-01

    Mechanisms underlying airway hyperresponsiveness are not yet fully elucidated. One of the manifestations of airway inflammation is leakage of diverse plasma proteins into the airway lumen. They include fibrinogen and thrombin. Thrombin cleaves fibrinogen to form fibrin, a major component of thrombi. Fibrin inactivates surfactant. Surfactant on the airway surface maintains airway patency by lowering surface tension. In this study, immunohistochemically detected fibrin was seen along the luminal surface of distal airways in a patient who died of status asthmaticus and in mice with induced allergic airway inflammation. In addition, we observed altered airway fibrinolytic system protein balance consistent with promotion of fibrin deposition in mice with allergic airway inflammation. The airways of mice were exposed to aerosolized fibrinogen, thrombin, or to fibrinogen followed by thrombin. Only fibrinogen followed by thrombin resulted in airway hyperresponsiveness compared with controls. An aerosolized fibrinolytic agent, tissue-type plasminogen activator, significantly diminished airway hyperresponsiveness in mice with allergic airway inflammation. These results are consistent with the hypothesis that leakage of fibrinogen and thrombin and their accumulation on the airway surface can contribute to the pathogenesis of airway hyperresponsiveness. PMID:15232617

  1. Improving stopping construction to minimize leakage

    PubMed Central

    Grau, Roy H.; Mazzella, Andrew L.; Martikainen, Anu L.

    2015-01-01

    The proper sealing of stoppings is an important step in reducing leakage from the intake to the return airways. Leakage and the subsequent loss of ventilation resulting from improperly sealed stoppings can lead to unhealthy and unsafe working conditions. The research presented in this paper investigates the total leakage of a stopping, including air leakage through the stopping, at the stopping perimeter, and through the coalbed. The study also examines sealing considerations for stoppings that are constructed under roof control screen, the effects that wooden wedges had on inhibiting efficient application of polyurethane foam sealant, and airflow leakage through the surrounding coal. The work involved building a stopping in a dead end room of the NIOSH Safety Research Coal Mine and then pressurising the room using compressed air. Stopping leakage was evaluated by measuring air pressure loss in the enclosed room due to the air leakage. Part of the research utilises a diluted soap solution that was applied to the stopping and the surrounding coal to detect air leakage signified by bubble formations. The results show that stopping leakage can be minimised with proper sealing PMID:26379366

  2. Surgical Airway

    PubMed Central

    Patel, Sapna A; Meyer, Tanya K

    2014-01-01

    Close to 3% of all intubation attempts are considered difficult airways, for which a plan for a surgical airway should be considered. Our article provides an overview of the different types of surgical airways. This article provides a comprehensive review of the main types of surgical airways, relevant anatomy, necessary equipment, indications and contraindications, preparation and positioning, technique, complications, and tips for management. It is important to remember that the placement of a surgical airway is a lifesaving procedure and should be considered in any setting when one “cannot intubate, cannot ventilate”. PMID:24741501

  3. Long noncoding RNA-MEG3 is involved in diabetes mellitus-related microvascular dysfunction.

    PubMed

    Qiu, Gui-Zhen; Tian, Wei; Fu, Hai-Tao; Li, Chao-Peng; Liu, Ban

    2016-02-26

    Microvascular dysfunction is an important characteristic of diabetic retinopathy. Long non-coding RNAs (lncRNAs) play important roles in diverse biological processes. In this study, we investigated the role of lncRNA-MEG3 in diabetes-related microvascular dysfunction. We show that MEG3 expression level is significantly down-regulated in the retinas of STZ-induced diabetic mice, and endothelial cells upon high glucose and oxidative stress. MEG3 knockdown aggravates retinal vessel dysfunction in vivo, as shown by serious capillary degeneration, and increased microvascular leakage and inflammation. MEG3 knockdown also regulates retinal endothelial cell proliferation, migration, and tube formation in vitro. The role of MEG3 in endothelial cell function is mainly mediated by the activation of PI3k/Akt signaling. MEG3 up-regulation may serve as a therapeutic strategy for treating diabetes-related microvascular complications. PMID:26845358

  4. Microvascular decompression for intractable singultus.

    PubMed

    Saito, Atsushi; Hatayama, Toru; Kon, Hiroyuki; Nakamura, Taigen; Sasaki, Tatsuya

    2016-10-01

    Intractable singultus due to cerebrovascular disease is very rare. We report a case of intractable singultus that improved after microvascular decompression and present a literature review. The patient was a 58-year-old man with a 30-year history of persistent singultus. Its frequency and duration gradually increased and it was resistant to multiple medical treatments. Microvascular decompression to relieve pressure on the anterolateral surface of the lower medulla oblongata from the vertebral artery resulted in the resolution of singultus. Patients with intractable idiopathic singultus who fail to respond to medical therapy need to be considered for the evaluation of cerebrovascular diseases and microvascular decompression. PMID:27335312

  5. Analyzing Leakage Through Cracks

    NASA Technical Reports Server (NTRS)

    Romine, William D.

    1993-01-01

    Two related computer programs written for use in analyzing leakage through cracks. Leakage flow laminar or turbulent. One program used to determine dimensions of crack under given flow conditions and given measured rate of leakage. Other used to determine rate of leakage of gas through crack of given dimensions under given flow conditions. Programs, written in BASIC language, accelerate and facilitate iterative calculations and parametric analyses. Solve equations of Fanno flow. Enables rapid solution of leakage problem.

  6. Pathophysiological roles of microvascular alterations in pulmonary inflammatory diseases: possible implications of tumor necrosis factor-alpha and CXC chemokines

    PubMed Central

    Orihara, Kanami; Matsuda, Akio

    2008-01-01

    Chronic obstructive pulmonary disease (COPD) and bronchial asthma are common respiratory diseases that are caused by chronic inflammation of the airways. Although these diseases are mediated by substantially distinct immunological reactions, especially in mild cases, they both show increased numbers of neutrophils, increased production of tumor necrosis factor-alpha (TNF-α) and poor responses to corticosteroids, particularly in patients with severe diseases. These immunological alterations may contribute strongly to airway structural changes, commonly referred to as airway remodeling. Microvascular alterations, a component of airway remodeling and caused by chronic inflammation, are observed and appear to be clinically involved in both diseases. It has been well established that vascular endothelial growth factor (VEGF) plays important roles in the airway microvascular alterations in mild and moderate cases of both diseases, but any role that VEGF might play in severe cases of these diseases remains unclear. Here, we review recent research findings, including our own data, and discuss the possibility that TNF-α and its associated CXC chemokines play roles in microvascular alterations that are even more crucial than those of VEGF in patients with severe COPD or asthma. PMID:19281078

  7. Cardiopulmonary bypass increases pulmonary microvascular permeability through the Src kinase pathway: Involvement of caveolin-1 and vascular endothelial cadherin

    PubMed Central

    ZHANG, JUNWEN; JIANG, ZHAOLEI; BAO, CHUNRONG; MEI, JU; ZHU, JIAQUAN

    2016-01-01

    Changes in pulmonary microvascular permeability following cardiopulmonary bypass (CPB) and the underlying mechanisms have not yet been established. Therefore, the aim of the present study was to elucidate the alterations in pulmonary microvascular permeability following CPB and the underlying mechanism. The pulmonary microvascular permeability was measured using Evans Blue dye (EBD) exclusion, and the neutrophil infiltration and proinflammatory cytokine secretion was investigated. In addition, the activation of Src kinase and the phosphorylation of caveolin-1 and vascular endothelial cadherin (VE-cadherin) was examined. The results revealed that CPB increased pulmonary microvascular leakage, neutrophil count and proinflammatory cytokines in the bronchoalveolar lavage fluid, and activated Src kinase. The administration of PP2, an inhibitor of Src kinase, decreased the activation of Src kinase and attenuated the increase in pulmonary microvascular permeability observed following CPB. Two important proteins associated with vascular permeability, caveolin-1 and VE-cadherin, were significantly activated at 24 h in the lung tissues following CPB, which correlated with the alterations in pulmonary microvascular permeability and Src kinase. PP2 administration inhibited their activation, suggesting that they are downstream factors of Src kinase activation. The data indicated that the Src kinase pathway increased pulmonary microvascular permeability following CPB, and the activation of caveolin-1 and VE-cadherin may be involved. Inhibition of this pathway may provide a potential therapy for acute lung injury following cardiac surgery. PMID:26847917

  8. Land-use Leakage

    SciTech Connect

    Calvin, Katherine V.; Edmonds, James A.; Clarke, Leon E.; Bond-Lamberty, Benjamin; Kim, Son H.; Wise, Marshall A.; Thomson, Allison M.; Kyle, G. Page

    2009-12-01

    Leakage occurs whenever actions to mitigate greenhouse gas emissions in one part of the world unleash countervailing forces elsewhere in the world so that reductions in global emissions are less than emissions mitigation in the mitigating region. While many researchers have examined the concept of industrial leakage, land-use policies can also result in leakage. We show that land-use leakage is potentially as large as or larger than industrial leakage. We identify two potential land-use leakage drivers, land-use policies and bioenergy. We distinguish between these two pathways and run numerical experiments for each. We also show that the land-use policy environment exerts a powerful influence on leakage and that under some policy designs leakage can be negative. International “offsets” are a potential mechanism to communicate emissions mitigation beyond the borders of emissions mitigating regions, but in a stabilization regime designed to limit radiative forcing to 3.7 2/m2, this also implies greater emissions mitigation commitments on the part of mitigating regions.

  9. Shroud leakage flow discouragers

    DOEpatents

    Bailey, Jeremy Clyde; Bunker, Ronald Scott

    2002-01-01

    A turbine assembly includes a plurality of rotor blades comprising a root portion, an airfoil having a pressure sidewall and a suction sidewall, and a top portion having a cap. An outer shroud is concentrically disposed about said rotor blades, said shroud in combination with said tip portions defining a clearance gap. At least one circumferential shroud leakage discourager is disposed within the shroud. The leakage discourager(s) increase the flow resistance and thus reduce the flow of hot gas flow leakage for a given pressure differential across the clearance gap to improve overall turbine efficiency.

  10. A history of vascular and microvascular surgery.

    PubMed

    Rickard, Rory F; Hudson, Donald A

    2014-10-01

    The history of microvascular surgery is intimately linked to that of vascular surgery. Microvascular techniques, developed mainly in China, Japan, Australia, and the United States of America, built on the principles of vascular anastomosis established by pioneers in France, Germany, Italy, and the United States of America. We present a history of the technique here.

  11. Universal leakage elimination

    SciTech Connect

    Byrd, Mark S.; Lidar, Daniel A.; Wu, L.-A.; Zanardi, Paolo

    2005-05-15

    'Leakage' errors are particularly serious errors which couple states within a code subspace to states outside of that subspace, thus destroying the error protection benefit afforded by an encoded state. We generalize an earlier method for producing leakage elimination decoupling operations and examine the effects of the leakage eliminating operations on decoherence-free or noiseless subsystems which encode one logical, or protected qubit into three or four qubits. We find that by eliminating a large class of leakage errors, under some circumstances, we can create the conditions for a decoherence-free evolution. In other cases we identify a combined decoherence-free and quantum error correcting code which could eliminate errors in solid-state qubits with anisotropic exchange interaction Hamiltonians and enable universal quantum computing with only these interactions.

  12. Triggers of airway inflammation.

    PubMed

    Kerrebijn, K F

    1986-01-01

    Most asthmatics have hyperresponsive airways. This makes them more sensitive than non-asthmatics to bronchoconstricting environmental exposures which, in their turn, may enhance responsiveness. Airway inflammation is considered to be a key determinant of airway hyperresponsiveness: the fact that chronic airway inflammation in cystic fibrosis does not lead to airway hyperresponsiveness of any importance indicates, however, that the role of airway inflammation is complex and incompletely elucidated. The main inducers of airway inflammation are viral infections, antigens, occupational stimuli and pollutants. Although exercise, airway cooling and hyper- or hypotonic aerosols are potent stimuli of bronchoconstriction, it is questionable if airway inflammation is involved in their mode of action. Each of the above-mentioned stimuli is discussed, with emphasis laid on the relation of symptoms to mechanisms. PMID:3533597

  13. Emergency airway puncture

    MedlinePlus

    Emergency airway puncture is the placement of a hollow needle through the throat into the airway. It ... efforts to assist with breathing have failed. A hollow needle or tube can be inserted into the ...

  14. Myosin light chain kinase-dependent microvascular hyperpermeability in thermal injury.

    PubMed

    Huang, Qiaobing; Xu, Wenjuan; Ustinova, Elena; Wu, Mack; Childs, Ed; Hunter, Felicia; Yuan, Sarah

    2003-10-01

    Although the critical role of systemic inflammatory edema in the development of multiple organ failure in patients with massive burns has been fully recognized, the precise mechanisms responsible for the accumulation of blood fluid and proteins in tissues remote from the burn wound are poorly understood. The aim of this study was to test the hypothesis that circulating factors released during thermal injury cause microvascular leakage by triggering endothelial cell contraction and barrier dysfunction. A third-degree scald burn was induced in rats on the dorsal skin covering 25% total body surface area. The microcirculation and transvascular flux of albumin were observed in the rat mesentery using intravital fluorescence microscopy. The direct effect of circulating factors on microvascular barrier function was assessed by measuring the apparent permeability coefficient of albumin in isolated rat mesenteric venules during perfusion of plasma freshly withdrawn from burned rats. The in vivo study showed that the transvenular flux of albumin was significantly increased over a 6-h period with a maximal response seen at 3 h postburn. Importantly, perfusion of noninjured venules with burn plasma induced a time-dependent increase in albumin permeability. Pharmacological inhibition of protein kinase C, Src tyrosine kinases, or mast cell activation did not significantly affect the hyperpermeability response; however, blockage of myosin light chain phosphorylation with the myosin light chain kinase inhibitor ML-7 greatly attenuated the burn-induced increase in venular permeability in a dose-related pattern. The results support a role for endogenous circulating factors in microvascular leakage during burns. Myosin light chain phosphorylation-dependent endothelial contractile response may serve as an end-point effector leading to microvascular barrier dysfunction. PMID:14501951

  15. Careers in Airway Science.

    ERIC Educational Resources Information Center

    Federal Aviation Administration (DOT), Washington, DC.

    The Federal Aviation Administration (FAA) has initiated the Airway Science curriculum as a method of preparing the next generation of aviation technicians and managers. This document: (1) discusses the FAA's role in the Airway Science program; (2) describes some of the career fields that FAA offers to Airway Science graduates (air traffic control…

  16. The emergency airway.

    PubMed

    Goon, Serena S H; Stephens, Robert C M; Smith, Helen

    2009-12-01

    The 'can't intubate, can't ventilate' scenario is a nightmare for all clinicians who manage airways. Cricothyroidotomy is one of several emergency airway management techniques. Cricothyroidotomy is a short-term solution which provides oxygenation, not ventilation, and is not a definitive airway. Although there are tests which can help predict whether an intubation will be difficult, they are not always good predictors. As the can't intubate, can't ventilate scenario is rare, cricothyroidotomy is an unfamiliar procedure to many. In this situation, expert help must be called for early on. In the meantime, it is vital that all other simple airway manoeuvres have been attempted, such as good positioning of the patient with head tilt and chin lift, and use of airway adjuncts like the oral (Guedel) airway or nasopharyngeal airway, and the laryngeal mask airway. However, if attempts to secure the airway are unsuccessful, there may be no other option than to perform a cricothyroidotomy. It is a difficult decision to make, but with increasing hypoxia, it is essential that one oxygenates the patient. Cricothyroidotomy provides an opening in the pace between the anterior inferior border of the thyroid cartilage and the anterior superior border of the cricoid cartilage, allowing access to the airway below the glottis. The anatomical considerations are important when performing this procedure (Ellis, 2009), and there are other scenarios when it is used. It is not without consequence, as with any procedure.

  17. Coronary microvascular obstruction in acute myocardial infarction.

    PubMed

    Niccoli, Giampaolo; Scalone, Giancarla; Lerman, Amir; Crea, Filippo

    2016-04-01

    The success of a primary percutaneous intervention (PCI) in the setting of ST elevation myocardial infarction depends on the functional and structural integrity of coronary microcirculation. Coronary microvascular dysfunction and obstruction (CMVO) occurs in up to half of patients submitted to apparently successful primary PCI and is associated to a much worse outcome. The current review summarizes the complex mechanisms responsible for CMVO, including pre-existing coronary microvascular dysfunction, and highlights the current limitations in the assessment of microvascular function. More importantly, at the light of the substantial failure of trials hitherto published on the treatment of CMVO, this review proposes a novel integrated therapeutic approach, which should overcome the limitations of previous studies.

  18. Engineering Airway Epithelium

    PubMed Central

    Soleas, John P.; Paz, Ana; Marcus, Paula; McGuigan, Alison; Waddell, Thomas K.

    2012-01-01

    Airway epithelium is constantly presented with injurious signals, yet under healthy circumstances, the epithelium maintains its innate immune barrier and mucociliary elevator function. This suggests that airway epithelium has regenerative potential (I. R. Telford and C. F. Bridgman, 1990). In practice, however, airway regeneration is problematic because of slow turnover and dedifferentiation of epithelium thereby hindering regeneration and increasing time necessary for full maturation and function. Based on the anatomy and biology of the airway epithelium, a variety of tissue engineering tools available could be utilized to overcome the barriers currently seen in airway epithelial generation. This paper describes the structure, function, and repair mechanisms in native epithelium and highlights specific and manipulatable tissue engineering signals that could be of great use in the creation of artificial airway epithelium. PMID:22523471

  19. Effects of S-nitrosation on hemoglobin-induced microvascular damage.

    PubMed

    Burke, Tara K; Teng, Xinjun; Patel, Rakesh P; Baldwin, Ann L

    2006-01-01

    Blood substitutes, such as diaspirin cross-linked hemoglobin (Hb), cause microvascular leakiness to macromolecules. Because of the potentially stabilizing effects of nitric acid (NO) on endothelium, experiments were performed to determine whether S-nitrosohemoglobin (SNO-Hb), a potential NO-donor Hb-based blood substitute, would not cause microvascular damage. Release of NO, or its metabolites, from the SNO-Hb was facilitated by addition of glutathione, which aids in the decomposition of S-nitrosothiols. In anesthetized rats, the mesenteric microvasculature was perfused with SNO-Hb with glutathione (six rats), SNO-Hb alone (six rats), or saline (eight rats) for 10 min, followed by fluorescein isothiocyanate (FITC)-albumin for 1 min, and finally fixed for epifluorescence microscopic examination. When comparing the SNO-Hb group with saline, both the numbers and areas of leaks were significantly increased [0.019 +/- 0.003 (SEM) microm vs. 0.0030 +/- 0.0004 and 7.36 +/- 1.50 vs. 0.156 +/- 0.035 (p < 0.005)]. With the addition of glutathione, leakage was still high (0.005 +/- 0.00005 microm and 5.086 +/- 0.064 microm) but decreased compared with SNO-Hb alone (p < 0.005). In conclusion, NO, or a related vasodilator, when released from SNO-Hb, significantly reduces but does not eliminate microvascular damage. Further improvements may result by S-nitrosating a more stable form of modified hemoglobin. PMID:16910757

  20. Atrial natriuretic peptide increases microvascular blood flow and macromolecular escape during renin infusion in the hamster

    SciTech Connect

    Boric, M.P.; Albertini, R. )

    1990-02-01

    The effects of Atrial Natriuretic Peptide (ANP) on microvascular hemodynamics and macromolecular permselectivity were studied in the hamster cheek pouch under resting conditions and during intravenous renin infusion. Fluorescent intravital microscopy was used to observe arteriolar diameters and to detect escape of fluorescent dextran of 150 K-Daltons (FITC-Dx-150). Microvascular plasma flow was estimated by clearance of 51Cr-EDTA and net macromolecular transport by clearance of FITC-Dx-150. At rest, topical ANP (2-250 ng/ml) had no effect on arteriolar diameter, 51Cr-EDTA clearance, relative vascular conductance (RVC) or FITC-Dx-150 clearance. Infusion of renin (10 mU/Kg/Hr, iv) elevated systemic arterial pressure by 30% and reduced cheek pouch RVC by 26%. During renin infusion, topical ANP (50 ng/ml) produced transient arteriolar vasodilation, and increased 51Cr-EDTA clearance (+35%), RVC (+58%) and FITC-Dx-150 clearance (+54%), without affecting systemic pressure. ANP did not induce venular leakage sites under any condition, but changes in FITC-Dx-150 clearance were highly correlated with changes in 51Cr-EDTA clearance, suggesting that the larger macromolecular escape was due to increases in microvascular blood flow and capillary/post-capillary hydrostatic pressure.

  1. Vascular endothelial growth factor as a key inducer of angiogenesis in the asthmatic airways.

    PubMed

    Meyer, Norbert; Akdis, Cezmi A

    2013-02-01

    Asthma is a chronic inflammatory disease of the airways characterized by structural airway changes, which are known as airway remodeling, including smooth muscle hypertrophy, goblet cell hyperplasia, subepithelial fibrosis, and angiogenesis. Vascular remodeling in asthmatic lungs results from increased angiogenesis, which is mainly mediated by vascular endothelial growth factor (VEGF). VEGF is a key regulator of blood vessel growth in the airways of asthma patients by promoting proliferation and differentiation of endothelial cells and inducing vascular leakage and permeability. In addition, VEGF induces allergic inflammation, enhances allergic sensitization, and has a role in Th2 type inflammatory responses. Specific inhibitors of VEGF and blockers of its receptors might be useful to control chronic airway inflammation and vascular remodeling, and might be a new therapeutic approach for chronic inflammatory airway disease like asthma.

  2. Electrical leakage detection circuit

    DOEpatents

    Wild, Arthur

    2006-09-05

    A method is provided for detecting electrical leakage between a power supply and a frame of a vehicle or machine. The disclosed method includes coupling a first capacitor between a frame and a first terminal of a power supply for a predetermined period of time. The current flowing between the frame and the first capacitor is limited to a predetermined current limit. It is determined whether the voltage across the first capacitor exceeds a threshold voltage. A first output signal is provided when the voltage across the capacitor exceeds the threshold voltage.

  3. Association of Microvascular Function and Endothelial Biomarkers With Clinical Outcome in Dengue: An Observational Study

    PubMed Central

    Yacoub, Sophie; Lam, Phung Khanh; Vu, Le Hoang Mai; Le, Thi Lien; Ha, Ngo Thanh; Toan, Tran Thi; Van, Nguyen Thu; Quyen, Nguyen Than Ha; Le Duyen, Huynh Thi; Van Kinh, Nguyen; Fox, Annette; Mongkolspaya, Juthathip; Wolbers, Marcel; Simmons, Cameron Paul; Screaton, Gavin Robert; Wertheim, Heiman; Wills, Bridget

    2016-01-01

    Background. The hallmark of severe dengue is increased microvascular permeability, but alterations in the microcirculation and their evolution over the course of dengue are unknown. Methods. We conducted a prospective observational study to evaluate the sublingual microcirculation using side-stream dark-field imaging in patients presenting early (<72 hours after fever onset) and patients hospitalized with warning signs or severe dengue in Vietnam. Clinical findings, microvascular function, global hemodynamics assessed with echocardiography, and serological markers of endothelial activation were determined at 4 time points. Results. A total of 165 patients were enrolled. No difference was found between the microcirculatory parameters comparing dengue with other febrile illnesses. The proportion of perfused vessels (PPV) and the mean flow index (MFI) were lower in patients with dengue with plasma than those without leakage (PPV, 88.1% vs 90.6% [P = .01]; MFI, 2.1 vs 2.4 [P = .007]), most markedly during the critical phase. PPV and MFI were correlated with the endothelial activation markers vascular cell adhesion molecule 1 (P < .001 for both) and angiopoietin 2 (P < .001 for both), negatively correlated. Conclusions. Modest microcirculatory alterations occur in dengue, are associated with plasma leakage, and are correlate with molecules of endothelial activation, angiopoietin 2 and vascular cell adhesion molecule 1. PMID:27230099

  4. Dammarenediol-II Prevents VEGF-Mediated Microvascular Permeability in Diabetic Mice.

    PubMed

    Kim, Su-Hyeon; Jung, Se-Hui; Lee, Yeon-Ju; Han, Jung Yeon; Choi, Yong-Eui; Hong, Hae-Deun; Jeon, Hye-Yoon; Hwang, JongYun; Na, SungHun; Kim, Young-Myeong; Ha, Kwon-Soo

    2015-12-01

    Diabetic retinopathy is a major diabetic complication predominantly caused by vascular endothelial growth factor (VEGF)-induced vascular permeability in the retina; however, treatments targeting glycemic control have not been successful. Here, we investigated the protective effect of dammarenediol-II, a precursor of triterpenoid saponin biosynthesis, on VEGF-induced vascular leakage using human umbilical vein endothelial cells (HUVECs) and diabetic mice. We overproduced the compound in transgenic tobacco expressing Panax ginseng dammarenediol-II synthase gene and purified using column chromatography. Analysis of the purified compound using a gas chromatography-mass spectrometry system revealed identical retention time and fragmentation pattern to those of authentic standard dammarenediol-II. Dammarenediol-II inhibited VEGF-induced intracellular reactive oxygen species generation, but it had no effect on the levels of intracellular Ca(2+) in HUVECs. We also found that dammarenediol-II inhibited VEGF-induced stress fiber formation and vascular endothelial-cadherin disruption, both of which play critical roles in modulating endothelial permeability. Notably, microvascular leakage in the retina of diabetic mice was successfully inhibited by intravitreal dammarenediol-II injection. Our results suggest that the natural drug dammarenediol-II may have the ability to prevent diabetic microvascular complications, including diabetic retinopathy. PMID:26400610

  5. Pulmonary Microvascular Blood Flow in Mild Chronic Obstructive Pulmonary Disease and Emphysema. The MESA COPD Study

    PubMed Central

    Hueper, Katja; Vogel-Claussen, Jens; Parikh, Megha A.; Austin, John H. M.; Bluemke, David A.; Carr, James; Choi, Jiwoong; Goldstein, Thomas A.; Gomes, Antoinette S.; Hoffman, Eric A.; Kawut, Steven M.; Lima, Joao; Michos, Erin D.; Post, Wendy S.; Po, Ming Jack; Prince, Martin R.; Liu, Kiang; Rabinowitz, Dan; Skrok, Jan; Smith, Ben M.; Watson, Karol; Yin, Youbing; Zambeli-Ljepovic, Alan M.

    2015-01-01

    Rationale: Smoking-related microvascular loss causes end-organ damage in the kidneys, heart, and brain. Basic research suggests a similar process in the lungs, but no large studies have assessed pulmonary microvascular blood flow (PMBF) in early chronic lung disease. Objectives: To investigate whether PMBF is reduced in mild as well as more severe chronic obstructive pulmonary disease (COPD) and emphysema. Methods: PMBF was measured using gadolinium-enhanced magnetic resonance imaging (MRI) among smokers with COPD and control subjects age 50 to 79 years without clinical cardiovascular disease. COPD severity was defined by standard criteria. Emphysema on computed tomography (CT) was defined by the percentage of lung regions below −950 Hounsfield units (−950 HU) and by radiologists using a standard protocol. We adjusted for potential confounders, including smoking, oxygenation, and left ventricular cardiac output. Measurements and Main Results: Among 144 participants, PMBF was reduced by 30% in mild COPD, by 29% in moderate COPD, and by 52% in severe COPD (all P < 0.01 vs. control subjects). PMBF was reduced with greater percentage emphysema−950HU and radiologist-defined emphysema, particularly panlobular and centrilobular emphysema (all P ≤ 0.01). Registration of MRI and CT images revealed that PMBF was reduced in mild COPD in both nonemphysematous and emphysematous lung regions. Associations for PMBF were independent of measures of small airways disease on CT and gas trapping largely because emphysema and small airways disease occurred in different smokers. Conclusions: PMBF was reduced in mild COPD, including in regions of lung without frank emphysema, and may represent a distinct pathological process from small airways disease. PMBF may provide an imaging biomarker for therapeutic strategies targeting the pulmonary microvasculature. PMID:26067761

  6. Roles of LOX-1 in microvascular dysfunction.

    PubMed

    Lubrano, Valter; Balzan, Silvana

    2016-05-01

    Studies from human and animal models with metabolic disease and hypertension highlight atrophic remodeling, reduced lumen size and thinner vascular walls of microvessels with profound density reduction. This impaired vascular response limits the perfusion of peripheral tissues inducing organ damage. These conditions are strongly associated with oxidative stress and in particular with the up-regulation of lectin-like oxidized low density lipoprotein receptor-1 (LOX-1). Several factors such as cytokines, shear stress, and advanced glycation end-products, especially oxLDL, can up-regulate LOX-1. The activation of this receptor induces the production of adhesion molecules, cytokines and the release of reactive oxygen species via NADPH oxidase. LOX-1 is considered a potent mediator of endothelial dysfunction and it is significantly associated with reduced microvascular endothelium NO-dependent vasodilation in hypercholesterolemia and hypertension. Microvascular endothelial cells increased the expression of IL-6 in association with the increased concentration of LDL and its degree of oxidation. Moreover, increased IL-6 levels are associated with up-regulation of LOX-1 in a dose-dependent manner. Another consequence of microvascular inflammation is the generation of small amounts of ROS, similar to those induced by low concentration of oxLDL (<5 μg/mL) which induces capillary tube formation of endothelial cells, through LOX-1 up-regulation. In light of its central role, LOX-1 represents an attractive therapeutic target for the treatment of human atherosclerotic diseases and microvascular disorders. PMID:26907636

  7. Microvascular dysfunction in the context of diabetic neuropathy.

    PubMed

    Stirban, Alin

    2014-01-01

    Microvascular dysfunction in diabetes plays a crucial role in the development of diabetic complications. The skin, as one of the most accessible organs, serves as a model for the investigation of microvascular dysfunction. Several non-invasive, mostly laser-Doppler-based methods have been developed lately to assess microvascular function in the skin. Microvascular functional changes occur even in the prediabetic state and become more complex with overt diabetes, being exacerbated by the presence of peripheral and/or autonomic diabetic neuropathy. The present article aims at shedding light on the implication of endothelial and neurovascular dysfunction in microvascular changes in diabetes, highlighting the contribution of different forms of diabetic neuropathy.

  8. Controversies in Pediatric Perioperative Airways

    PubMed Central

    Klučka, Jozef; Štourač, Petr; Štoudek, Roman; Ťoukálková, Michaela; Harazim, Hana; Kosinová, Martina

    2015-01-01

    Pediatric airway management is a challenge in routine anesthesia practice. Any airway-related complication due to improper procedure can have catastrophic consequences in pediatric patients. The authors reviewed the current relevant literature using the following data bases: Google Scholar, PubMed, Medline (OVID SP), and Dynamed, and the following keywords: Airway/s, Children, Pediatric, Difficult Airways, and Controversies. From a summary of the data, we identified several controversies: difficult airway prediction, difficult airway management, cuffed versus uncuffed endotracheal tubes for securing pediatric airways, rapid sequence induction (RSI), laryngeal mask versus endotracheal tube, and extubation timing. The data show that pediatric anesthesia practice in perioperative airway management is currently lacking the strong evidence-based medicine (EBM) data that is available for adult subpopulations. A number of procedural steps in airway management are derived only from adult populations. However, the objective is the same irrespective of patient age: proper securing of the airway and oxygenation of the patient. PMID:26759809

  9. Leakage-resistant blood vessels in mice transgenically overexpressing angiopoietin-1.

    PubMed

    Thurston, G; Suri, C; Smith, K; McClain, J; Sato, T N; Yancopoulos, G D; McDonald, D M

    1999-12-24

    Angiopoietin-1 (Ang1) and vascular endothelial growth factor (VEGF) are endothelial cell-specific growth factors. Direct comparison of transgenic mice overexpressing these factors in the skin revealed that the VEGF-induced blood vessels were leaky, whereas those induced by Ang1 were nonleaky. Moreover, vessels in Ang1-overexpressing mice were resistant to leaks caused by inflammatory agents. Coexpression of Ang1 and VEGF had an additive effect on angiogenesis but resulted in leakage-resistant vessels typical of Ang1. Ang1 therefore may be useful for reducing microvascular leakage in diseases in which the leakage results from chronic inflammation or elevated VEGF and, in combination with VEGF, for promoting growth of nonleaky vessels.

  10. Management of the difficult airway.

    PubMed

    Strauss, Robert A; Noordhoek, Roseanna

    2010-03-01

    The oral and maxillofacial surgeon frequently encounters and manages difficult airways. Knowledge of and calm progression by practitioner and staff through different means to ventilate and manage a difficult airway are crucial. Practitioners should become comfortable with different types of alternative or rescue airways in order to intervene quickly in case of emergent or unanticipated airway compromise.

  11. Leakage Characteristics of Dual-Cannula Fenestrated Tracheostomy Tubes during Positive Pressure Ventilation: A Bench Study.

    PubMed

    Berlet, Thomas; Marchon, Mathias

    2016-01-01

    This study compared the leakage characteristics of different types of dual-cannula fenestrated tracheostomy tubes during positive pressure ventilation. Fenestrated Portex® Blue Line Ultra®, TRACOE® twist, or Rüsch® Traceofix® tracheostomy tubes equipped with nonfenestrated inner cannulas were tested in a tracheostomy-lung simulator. Transfenestration pressures and transfenestration leakage rates were measured during positive pressure ventilation. The impact of different ventilation modes, airway pressures, temperatures, and simulated static lung compliance settings on leakage characteristics was assessed. We observed substantial differences in transfenestration pressures and transfenestration leakage rates. The leakage rates of the best performing tubes were <3.5% of the delivered minute volume. At body temperature, the leakage rates of these tracheostomy tubes were <1%. The tracheal tube design was the main factor that determined the leakage characteristics. Careful tracheostomy tube selection permits the use of fenestrated tracheostomy tubes in patients receiving positive pressure ventilation immediately after stoma formation and minimises the risk of complications caused by transfenestration gas leakage, for example, subcutaneous emphysema. PMID:27073395

  12. Leakage Characteristics of Dual-Cannula Fenestrated Tracheostomy Tubes during Positive Pressure Ventilation: A Bench Study

    PubMed Central

    2016-01-01

    This study compared the leakage characteristics of different types of dual-cannula fenestrated tracheostomy tubes during positive pressure ventilation. Fenestrated Portex® Blue Line Ultra®, TRACOE® twist, or Rüsch® Traceofix® tracheostomy tubes equipped with nonfenestrated inner cannulas were tested in a tracheostomy-lung simulator. Transfenestration pressures and transfenestration leakage rates were measured during positive pressure ventilation. The impact of different ventilation modes, airway pressures, temperatures, and simulated static lung compliance settings on leakage characteristics was assessed. We observed substantial differences in transfenestration pressures and transfenestration leakage rates. The leakage rates of the best performing tubes were <3.5% of the delivered minute volume. At body temperature, the leakage rates of these tracheostomy tubes were <1%. The tracheal tube design was the main factor that determined the leakage characteristics. Careful tracheostomy tube selection permits the use of fenestrated tracheostomy tubes in patients receiving positive pressure ventilation immediately after stoma formation and minimises the risk of complications caused by transfenestration gas leakage, for example, subcutaneous emphysema. PMID:27073395

  13. Leakage Characteristics of Dual-Cannula Fenestrated Tracheostomy Tubes during Positive Pressure Ventilation: A Bench Study.

    PubMed

    Berlet, Thomas; Marchon, Mathias

    2016-01-01

    This study compared the leakage characteristics of different types of dual-cannula fenestrated tracheostomy tubes during positive pressure ventilation. Fenestrated Portex® Blue Line Ultra®, TRACOE® twist, or Rüsch® Traceofix® tracheostomy tubes equipped with nonfenestrated inner cannulas were tested in a tracheostomy-lung simulator. Transfenestration pressures and transfenestration leakage rates were measured during positive pressure ventilation. The impact of different ventilation modes, airway pressures, temperatures, and simulated static lung compliance settings on leakage characteristics was assessed. We observed substantial differences in transfenestration pressures and transfenestration leakage rates. The leakage rates of the best performing tubes were <3.5% of the delivered minute volume. At body temperature, the leakage rates of these tracheostomy tubes were <1%. The tracheal tube design was the main factor that determined the leakage characteristics. Careful tracheostomy tube selection permits the use of fenestrated tracheostomy tubes in patients receiving positive pressure ventilation immediately after stoma formation and minimises the risk of complications caused by transfenestration gas leakage, for example, subcutaneous emphysema.

  14. Treatment of hemimasticatory spasm with microvascular decompression.

    PubMed

    Wang, Yong-Nan; Dou, Ning-Ning; Zhou, Qiu-Meng; Jiao, Wei; Zhu, Jin; Zhong, Jun; Li, Shi-Ting

    2013-01-01

    Hemimasticatory spasm is a rare disorder characterized by paroxysmal involuntary contraction of the jaw-closing muscles. As the ideology and pathogenesis of the disease are still unclear, there has been no treatment that could give rise to a good outcome so far. Herein, we tried to use surgical management to cure the disease. Six patients with the disease were included in this study. These patients underwent microvascular decompression of the motor fibers of the trigeminal root. After the operation, all faces of the patients felt relaxed at varied degrees, except for 1 patient. Our study showed that microvascular decompression of the trigeminal nerve could lead to a better outcome. However, a control study with a large sample is needed before this technique is widely used.

  15. Duct Leakage Repeatability Testing

    SciTech Connect

    Walker, Iain; Sherman, Max

    2014-08-01

    The purpose of this report is to evaluate the repeatability of the three most significant measurement techniques for duct leakage using data from the literature and recently obtained field data. We will also briefly discuss the first two factors. The main question to be answered by this study is to determine if differences in the repeatability of these tests methods is sufficient to indicate that any of these methods is so poor that it should be excluded from consideration as an allowed procedure in codes and standards. The three duct leak measurement methods assessed in this report are the two duct pressurization methods that are commonly used by many practitioners and the DeltaQ technique. These are methods B, C and A, respectively of the ASTM E1554 standard. Although it would be useful to evaluate other duct leak test methods, this study focused on those test methods that are commonly used and are required in various test standards, such as BPI (2010), RESNET (2014), ASHRAE 62.2 (2013), California Title 24 (CEC 2012), DOE Weatherization and many other energy efficiency programs.

  16. Duct Leakage Repeatability Testing

    SciTech Connect

    Walker, Iain; Sherman, Max

    2014-01-01

    Duct leakage often needs to be measured to demonstrate compliance with requirements or to determine energy or Indoor Air Quality (IAQ) impacts. Testing is often done using standards such as ASTM E1554 (ASTM 2013) or California Title 24 (California Energy Commission 2013 & 2013b), but there are several choices of methods available within the accepted standards. Determining which method to use or not use requires an evaluation of those methods in the context of the particular needs. Three factors that are important considerations are the cost of the measurement, the accuracy of the measurement and the repeatability of the measurement. The purpose of this report is to evaluate the repeatability of the three most significant measurement techniques using data from the literature and recently obtained field data. We will also briefly discuss the first two factors. The main question to be answered by this study is to determine if differences in the repeatability of these tests methods is sufficient to indicate that any of these methods is so poor that it should be excluded from consideration as an allowed procedure in codes and standards.

  17. Multifamily Envelope Leakage Model

    SciTech Connect

    Faakye, Omari; Griffiths, Dianne

    2015-05-08

    “The cost for blower testing is high, because it is labor intensive, and it may disrupt occupants in multiple units. This high cost and disruption deter program participants, and dissuade them from pursuing energy improvements that would trigger air leakage testing, such as improvements to the building envelope.” This statement found in a 2012 report by Heschong Mahone Group for several California interests emphasizes the importance of reducing the cost and complexity of blower testing in multifamily buildings. Energy efficiency opportunities are being bypassed. The cost of single blower testing is on the order of $300. The cost for guarded blower door testing—the more appropriate test for assessing energy savings opportunities—could easily be six times that, and that’s only if you have the equipment and simultaneous access to multiple apartments. Thus, the proper test is simply not performed. This research seeks to provide an algorithm for predicting the guarded blower door test result based upon a single, total blower door test.

  18. Predictors of Microvascular Invasion in Hepatocellular Carcinoma.

    PubMed

    Yamashita, Yo-Ichi; Shirabe, Ken; Aishima, Shinichi; Maehara, Yoshihiko

    2015-09-01

    This chapter covers a range of important topics in the evaluation of the microvascular invasion (MVI) in hepatocellular carcinoma (HCC) before treatment. The malignant potential of HCC is reflected by the types of MVI such as portal venous (vp), hepatic vein (vv) or bile duct (b) infiltration. The identification of the type of MVI in HCC has a key role in decisions regarding the effective treatment of HCC. Here, we describe the possible and important predictors of MVI in HCC. PMID:26398341

  19. Fabrication of 3-dimensional multicellular microvascular structures

    PubMed Central

    Barreto-Ortiz, Sebastian F.; Fradkin, Jamie; Eoh, Joon; Trivero, Jacqueline; Davenport, Matthew; Ginn, Brian; Mao, Hai-Quan; Gerecht, Sharon

    2015-01-01

    Despite current advances in engineering blood vessels over 1 mm in diameter and the existing wealth of knowledge regarding capillary bed formation, studies for the development of microvasculature, the connecting bridge between them, have been extremely limited so far. Here, we evaluate the use of 3-dimensional (3D) microfibers fabricated by hydrogel electrospinning as templates for microvascular structure formation. We hypothesize that 3D microfibers improve extracellular matrix (ECM) deposition from vascular cells, enabling the formation of freestanding luminal multicellular microvasculature. Compared to 2-dimensional cultures, we demonstrate with confocal microscopy and RT-PCR that fibrin microfibers induce an increased ECM protein deposition by vascular cells, specifically endothelial colony-forming cells, pericytes, and vascular smooth muscle cells. These ECM proteins comprise different layers of the vascular wall including collagen types I, III, and IV, as well as elastin, fibronectin, and laminin. We further demonstrate the achievement of multicellular microvascular structures with an organized endothelium and a robust multicellular perivascular tunica media. This, along with the increased ECM deposition, allowed for the creation of self-supporting multilayered microvasculature with a distinct circular lumen following fibrin microfiber core removal. This approach presents an advancement toward the development of human microvasculature for basic and translational studies.—Barreto-Ortiz, S. F., Fradkin, J., Eoh, J., Trivero, J., Davenport, M., Ginn, B., Mao, H.-Q., Gerecht, S. Fabrication of 3-dimensional multicellular microvascular structures. PMID:25900808

  20. Hypertension Management and Microvascular Insulin Resistance in Diabetes

    PubMed Central

    Ko, Seung-Hyun; Cao, Wenhong; Liu, Zhenqi

    2011-01-01

    Type 2 diabetes is in essence a vascular disease and is frequently associated with hypertension, macrovascular events, and microvascular complications. Microvascular dysfunction, including impaired recruitment and capillary rarefaction, has been implicated in the pathogenesis of diabetic complications. Microvascular insulin resistance and renin-angiotensin system upregulation are present in diabetes, and each contributes to the development of hypertension and microvascular dysfunction. In the insulin-sensitive state, insulin increases microvascular perfusion by increasing endothelial nitric oxide production, but this effect is abolished by insulin resistance. Angiotensin II, acting via the type 1 receptors, induces inflammation and oxidative stress, leading to impaired insulin signaling, reduced nitric oxide availability, and vasoconstriction. Conversely, it acts on the type 2 receptors to cause vasodilatation. Because substrate and hormonal exchanges occur in the microvasculature, antihypertensive agents targeted to improve microvascular insulin sensitivity and function may have beneficial effects beyond their capacity to lower blood pressure in patients with diabetes. PMID:20582734

  1. Airway management in trauma.

    PubMed

    Langeron, O; Birenbaum, A; Amour, J

    2009-05-01

    Maintenance of a patent and prevention of aspiration are essential for the management of the trauma patient, that requires experienced physicians in airway control techniques. Difficulties of the airway control in the trauma setting are increased by the vital failures, the risk of aspiration, the potential cervical spine injury, the combative patient, and the obvious risk of difficult tracheal intubation related to specific injury related to the trauma. Endotracheal intubation remains the gold standard in trauma patient airway management and should be performed via the oral route with a rapid sequence induction and a manual in-line stabilization maneuver, to decrease the risks previously mentioned. Different techniques to control the airway in trauma patients are presented: improvement of the laryngoscopic vision, lighted stylet tracheal intubation, retrograde technique for orotracheal intubation, the laryngeal mask and the intubating laryngeal mask airways, the combitube and cricothyroidotomy. Management of the airway in trauma patients requires regular training in these techniques and the knowledge of complementary techniques allowing tracheal intubation or oxygenation to overcome difficult intubation and to prevent major complications as hypoxemia and aspiration. PMID:19412149

  2. Skin microvascular endothelial function as a biomarker in cardiovascular diseases?

    PubMed

    Hellmann, Marcin; Roustit, Matthieu; Cracowski, Jean-Luc

    2015-08-01

    Skin microvascular endothelial function is impaired in many cardiovascular diseases, and could be therefore considered as a representative vascular bed. However, today, available evidence allows considering skin microvascular endothelial function neither as a diagnostic biomarker nor as a prognostic biomarker in cardiovascular diseases. Large follow-up studies using standardized methods should now be conducted to assess the potential predictive value of skin microvascular function in cardiovascular diseases.

  3. Role of upper airway ultrasound in airway management.

    PubMed

    Osman, Adi; Sum, Kok Meng

    2016-01-01

    Upper airway ultrasound is a valuable, non-invasive, simple, and portable point of care ultrasound (POCUS) for evaluation of airway management even in anatomy distorted by pathology or trauma. Ultrasound enables us to identify important sonoanatomy of the upper airway such as thyroid cartilage, epiglottis, cricoid cartilage, cricothyroid membrane, tracheal cartilages, and esophagus. Understanding this applied sonoanatomy facilitates clinician to use ultrasound in assessment of airway anatomy for difficult intubation, ETT and LMA placement and depth, assessment of airway size, ultrasound-guided invasive procedures such as percutaneous needle cricothyroidotomy and tracheostomy, prediction of postextubation stridor and left double-lumen bronchial tube size, and detecting upper airway pathologies. Widespread POCUS awareness, better technological advancements, portability, and availability of ultrasound in most critical areas facilitate upper airway ultrasound to become the potential first-line non-invasive airway assessment tool in the future. PMID:27529028

  4. Role of upper airway ultrasound in airway management.

    PubMed

    Osman, Adi; Sum, Kok Meng

    2016-01-01

    Upper airway ultrasound is a valuable, non-invasive, simple, and portable point of care ultrasound (POCUS) for evaluation of airway management even in anatomy distorted by pathology or trauma. Ultrasound enables us to identify important sonoanatomy of the upper airway such as thyroid cartilage, epiglottis, cricoid cartilage, cricothyroid membrane, tracheal cartilages, and esophagus. Understanding this applied sonoanatomy facilitates clinician to use ultrasound in assessment of airway anatomy for difficult intubation, ETT and LMA placement and depth, assessment of airway size, ultrasound-guided invasive procedures such as percutaneous needle cricothyroidotomy and tracheostomy, prediction of postextubation stridor and left double-lumen bronchial tube size, and detecting upper airway pathologies. Widespread POCUS awareness, better technological advancements, portability, and availability of ultrasound in most critical areas facilitate upper airway ultrasound to become the potential first-line non-invasive airway assessment tool in the future.

  5. Direct ink writing of microvascular networks

    NASA Astrophysics Data System (ADS)

    Wu, Willie

    Nature is replete with examples of embedded microvascular systems that enable efficient fluid flow and distribution for autonomic healing, cooling, and energy harvesting. The ability to incorporate microvascular networks in functional materials systems is therefore both scientifically and technologically important. In this PhD thesis, the direct-write assembly of planar and 3D biomimetic microvascular networks within polymer and hydrogel matrices is demonstrated. In addition, the influence of network design of fluid transport efficiency is characterized. Planar microvascular networks composed of periodic lattices of uniformal microchannels and hierarchical, branching architectures are constructed by direct-write assembly of a fugitive organic ink. Several advancements are required to facilitate their patterning, including pressure valving, dual ink printing, and dynamic pressure variation to allow tunable control of ink deposition. The hydraulic conductance is measured using a high pressure flow meter as a function of network design. For a constant vascular volume and areal coverage, 2- and 4-generation branched architectures that obey Murray's Law exhibited the highest hydraulic conductivity. These experimental observations are in good agreement with predictions made by analytic models. 3D microvascular networks are fabricated by omnidirectional printing a fugitive organic ink into a photopolymerizable hydrogel matrix that is capped with fluid filler of nearly identical composition. Using this approach, 3D networks of arbitrary design can be patterned. After ink deposition is complete, the matrix and fluid filler are chemically cross-linked via UV irradiation, and the ink is removed by liquefication. Aqueous solutions composed of a triblock copolymer of polyethylene oxide (PEO)-polypropylene oxide (PPO)-PEO constitute the materials system of choice due to their thermal- and concentration-dependent phase behavior. Specifically, the fugitive ink consists of a 23 w

  6. Indirect airway challenges.

    PubMed

    Joos, G F; O'Connor, B; Anderson, S D; Chung, F; Cockcroft, D W; Dahlén, B; DiMaria, G; Foresi, A; Hargreave, F E; Holgate, S T; Inman, M; Lötvall, J; Magnussen, H; Polosa, R; Postma, D S; Riedler, J

    2003-06-01

    Indirect challenges act by causing the release of endogenous mediators that cause the airway smooth muscle to contract. This is in contrast to the direct challenges where agonists such as methacholine or histamine cause airflow limitation predominantly via a direct effect on airway smooth muscle. Direct airway challenges have been used widely and are well standardised. They are highly sensitive, but not specific to asthma and can be used to exclude current asthma in a clinic population. Indirect bronchial stimuli, in particular exercise, hyperventilation, hypertonic aerosols, as well as adenosine, may reflect more directly the ongoing airway inflammation and are therefore more specific to identify active asthma. They are increasingly used to evaluate the prevalence of bronchial hyperresponsiveness and to assess specific problems in patients with known asthma, e.g. exercise-induced bronchoconstriction, evaluation before scuba diving. Direct bronchial responsiveness is only slowly and to a modest extent, influenced by repeated administration of inhaled steroids. Indirect challenges may reflect more closely acute changes in airway inflammation and a change in responsiveness to an indirect stimulus may be a clinically relevant marker to assess the clinical course of asthma. Moreover, some of the indirect challenges, e.g. hypertonic saline and mannitol, can be combined with the assessment of inflammatory cells by induction of sputum.

  7. Cathepsin S Cleavage of Protease-Activated Receptor-2 on Endothelial Cells Promotes Microvascular Diabetes Complications.

    PubMed

    Kumar Vr, Santhosh; Darisipudi, Murthy N; Steiger, Stefanie; Devarapu, Satish Kumar; Tato, Maia; Kukarni, Onkar P; Mulay, Shrikant R; Thomasova, Dana; Popper, Bastian; Demleitner, Jana; Zuchtriegel, Gabriele; Reichel, Christoph; Cohen, Clemens D; Lindenmeyer, Maja T; Liapis, Helen; Moll, Solange; Reid, Emma; Stitt, Alan W; Schott, Brigitte; Gruner, Sabine; Haap, Wolfgang; Ebeling, Martin; Hartmann, Guido; Anders, Hans-Joachim

    2016-06-01

    Endothelial dysfunction is a central pathomechanism in diabetes-associated complications. We hypothesized a pathogenic role in this dysfunction of cathepsin S (Cat-S), a cysteine protease that degrades elastic fibers and activates the protease-activated receptor-2 (PAR2) on endothelial cells. We found that injection of mice with recombinant Cat-S induced albuminuria and glomerular endothelial cell injury in a PAR2-dependent manner. In vivo microscopy confirmed a role for intrinsic Cat-S/PAR2 in ischemia-induced microvascular permeability. In vitro transcriptome analysis and experiments using siRNA or specific Cat-S and PAR2 antagonists revealed that Cat-S specifically impaired the integrity and barrier function of glomerular endothelial cells selectively through PAR2. In human and mouse type 2 diabetic nephropathy, only CD68(+) intrarenal monocytes expressed Cat-S mRNA, whereas Cat-S protein was present along endothelial cells and inside proximal tubular epithelial cells also. In contrast, the cysteine protease inhibitor cystatin C was expressed only in tubules. Delayed treatment of type 2 diabetic db/db mice with Cat-S or PAR2 inhibitors attenuated albuminuria and glomerulosclerosis (indicators of diabetic nephropathy) and attenuated albumin leakage into the retina and other structural markers of diabetic retinopathy. These data identify Cat-S as a monocyte/macrophage-derived circulating PAR2 agonist and mediator of endothelial dysfunction-related microvascular diabetes complications. Thus, Cat-S or PAR2 inhibition might be a novel strategy to prevent microvascular disease in diabetes and other diseases.

  8. 49 CFR 230.78 - Leakage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Leakage. 230.78 Section 230.78 Transportation... Signal Equipment § 230.78 Leakage. (a) Main reservoirs and related piping. Leakage from main reservoir... to 60 percent of the maximum operating pressure. (b) Brake cylinders. Leakage from brake...

  9. 49 CFR 230.78 - Leakage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Leakage. 230.78 Section 230.78 Transportation... Signal Equipment § 230.78 Leakage. (a) Main reservoirs and related piping. Leakage from main reservoir... to 60 percent of the maximum operating pressure. (b) Brake cylinders. Leakage from brake...

  10. 49 CFR 230.78 - Leakage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Leakage. 230.78 Section 230.78 Transportation... Signal Equipment § 230.78 Leakage. (a) Main reservoirs and related piping. Leakage from main reservoir... to 60 percent of the maximum operating pressure. (b) Brake cylinders. Leakage from brake...

  11. 49 CFR 230.78 - Leakage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Leakage. 230.78 Section 230.78 Transportation... Signal Equipment § 230.78 Leakage. (a) Main reservoirs and related piping. Leakage from main reservoir... to 60 percent of the maximum operating pressure. (b) Brake cylinders. Leakage from brake...

  12. 49 CFR 230.78 - Leakage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Leakage. 230.78 Section 230.78 Transportation... Signal Equipment § 230.78 Leakage. (a) Main reservoirs and related piping. Leakage from main reservoir... to 60 percent of the maximum operating pressure. (b) Brake cylinders. Leakage from brake...

  13. Rapid clearance of xanthines from airway and pulmonary tissues

    SciTech Connect

    Kroell, F.K.; Karlsson, J.A.; Nilsson, E.; Ryrfeldt, A.; Persson, C.G. )

    1990-05-01

    The airway and pulmonary fate of two antiasthma xanthines was examined in a guinea pig perfused lung preparation where the airway mechanics and airway microvascular perfusion are maintained at near normal values. 14C-theophylline or 14C-enprofylline was infused for 10, 30, and 300 s into the pulmonary artery of the guinea pig isolated lung. The radioactivity increased rapidly (within 10 s) in tracheobronchial as well as in lung tissue, confirming that the large airway microcirculation was well supplied also by the perfusion. The effluent concentrations of total 3H and 14C radioactivity at the onset, during, and after intrapulmonary infusion of 14C-labeled xanthines and 3H-sucrose were closely associated, suggesting that the xanthines, like sucrose, largely distributed in extracellular fluid and were not taken up by the tissues. No metabolites of enprofylline or theophylline could be detected in the lung tissue or lung effluent, suggesting that xanthines are not biotransformed by the guinea pig lung. After intratracheal instillation of 14C-theophylline, the peak radioactivity in the lung effluent appeared in the second 15-s fraction after instillation, and after 10 and 60 min, 68.1 +/- 4.7% and 86.9 +/- 8.4%, respectively, of the given dose had appeared in the lung effluent. The present data suggest a mainly extracellular distribution and a rapid clearance of xanthines from the lung and airway tissues. The rapid disappearance of topical theophylline may explain the lack of success of inhalation therapy with this drug.

  14. Mechanisms underlying the cerebral microvascular responses to angiotensin II-induced hypertension.

    PubMed

    Vital, Shantel A; Terao, Satoshi; Nagai, Mutsumi; Granger, D Neil

    2010-11-01

    Angiotensin II (AngII) and AngII type-1 receptors (AT1r) have been implicated in the pathogenesis of hypertension and ischemic stroke. The objectives of this study was to determine if/how chronic AngII administration affects blood-brain barrier (BBB) function and blood cell adhesion in the cerebral microvasculature. AngII-loaded osmotic pumps were implanted in wild type (WT) and mutant mice. Leukocyte and platelet adhesion were monitored in cerebral venules by intravital microscopy and BBB permeability detected by Evans blue leakage. AngII (two week) infusion increased blood pressure in WT mice. This was accompanied by an increased BBB permeability and a high density of adherent leukocytes and platelets. AT1r (on the vessel wall, but not on blood cells) was largely responsible for the microvascular responses to AngII. Immunodeficient (Rag-1(-/-) ) mice exhibited blunted blood cell recruitment responses without a change in BBB permeability. A similar protection pattern was noted in RANTES(-/-) and P-selectin(-/-) mice, with bone marrow chimeras (blood cell deficiency only) yielding responses comparable to the respective knockouts. These findings implicate AT1r in the microvascular dysfunction associated with AngII-induced hypertension and suggest that immune cells and blood cell-associated RANTES and P-selectin contribute to the blood cell recruitment, but not the BBB failure, elicited by AngII. PMID:21044218

  15. Lipopolysaccharide Induces Human Pulmonary Micro-Vascular Endothelial Apoptosis via the YAP Signaling Pathway

    PubMed Central

    Yi, Lei; Huang, Xiaoqin; Guo, Feng; Zhou, Zengding; Chang, Mengling; Tang, Jiajun; Huan, Jingning

    2016-01-01

    Gram-negative bacterial lipopolysaccharide (LPS) induces a pathologic increase in lung vascular leakage under septic conditions. LPS-induced human pulmonary micro-vascular endothelial cell (HPMEC) apoptosis launches and aggravates micro-vascular hyper-permeability and acute lung injury (ALI). Previous studies show that the activation of intrinsic apoptotic pathway is vital for LPS-induced EC apoptosis. Yes-associated protein (YAP) has been reported to positively regulate intrinsic apoptotic pathway in tumor cells apoptosis. However, the potential role of YAP protein in LPS-induced HPMEC apoptosis has not been determined. In this study, we found that LPS-induced activation and nuclear accumulation of YAP accelerated HPMECs apoptosis. LPS-induced YAP translocation from cytoplasm to nucleus by the increased phosphorylation on Y357 resulted in the interaction between YAP and transcription factor P73. Furthermore, inhibition of YAP by small interfering RNA (siRNA) not only suppressed the LPS-induced HPMEC apoptosis but also regulated P73-mediated up-regulation of BAX and down-regulation of BCL-2. Taken together, our results demonstrated that activation of the YAP/P73/(BAX and BCL-2)/caspase-3 signaling pathway played a critical role in LPS-induced HPMEC apoptosis. Inhibition of the YAP might be a potential therapeutic strategy for lung injury under sepsis. PMID:27807512

  16. Comparative Efficacy of the Air-Q Intubating Laryngeal Airway during General Anesthesia in Pediatric Patients: A Systematic Review and Meta-Analysis

    PubMed Central

    Ahn, Eun Jin; Choi, Geun Joo; Kang, Hyun; Baek, Chong Wha; Jung, Yong Hun; Woo, Young Cheol; Bang, Si Ra

    2016-01-01

    Air-Q® (air-Q) is a supraglottic airway device which can be used as a guidance of intubation in pediatric as well as in adult patients. We evaluated the efficacy and safety of air-Q compared to other airway devices during general anesthesia in pediatric patients by conducting a systematic review and meta-analysis. A total of 10 studies including 789 patients were included in the final analysis. Compared with other supraglottic airway devices, air-Q showed no evidence for a difference in leakage pressure and insertion time. The ease of insertion was significantly lower than other supraglottic airway devices. The success rate of intubation was significantly lower than other airway devices. However, fiberoptic view was better through the air-Q than other supraglottic airway devices. Therefore, air-Q could be a safe substitute for other airway devices and may provide better fiberoptic bronchoscopic view. PMID:27419134

  17. Listeriolysin O mediates cytotoxicity against human brain microvascular

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Penetration of the brain microvascular endothelial layer is one of the routes L. monocytogenes use to breach the blood-brain barrier. Because host factors in the blood severely limit direct invasion of human brain microvascular endothelial cells (HBMECs) by L. monocytogenes, alternative mechanisms m...

  18. Rapid homogeneous endothelialization of high aspect ratio microvascular networks.

    PubMed

    Naik, Nisarga; Hanjaya-Putra, Donny; Haller, Carolyn A; Allen, Mark G; Chaikof, Elliot L

    2015-08-01

    Microvascularization of an engineered tissue construct is necessary to ensure the nourishment and viability of the hosted cells. Microvascular constructs can be created by seeding the luminal surfaces of microfluidic channel arrays with endothelial cells. However, in a conventional flow-based system, the uniformity of endothelialization of such an engineered microvascular network is constrained by mass transfer of the cells through high length-to-diameter (L/D) aspect ratio microchannels. Moreover, given the inherent limitations of the initial seeding process to generate a uniform cell coating, the large surface-area-to-volume ratio of microfluidic systems demands long culture periods for the formation of confluent cellular microconduits. In this report, we describe the design of polydimethylsiloxane (PDMS) and poly(glycerol sebacate) (PGS) microvascular constructs with reentrant microchannels that facilitates rapid, spatially homogeneous endothelial cell seeding of a high L/D (2 cm/35 μm; > 550:1) aspect ratio microchannels. MEMS technology was employed for the fabrication of a monolithic, elastomeric, reentrant microvascular construct. Isotropic etching and PDMS micromolding yielded a near-cylindrical microvascular channel array. A 'stretch - seed - seal' operation was implemented for uniform incorporation of endothelial cells along the entire microvascular area of the construct yielding endothelialized microvascular networks in less than 24 h. The feasibility of this endothelialization strategy and the uniformity of cellularization were established using confocal microscope imaging. PMID:26227213

  19. Rapid homogeneous endothelialization of high aspect ratio microvascular networks.

    PubMed

    Naik, Nisarga; Hanjaya-Putra, Donny; Haller, Carolyn A; Allen, Mark G; Chaikof, Elliot L

    2015-08-01

    Microvascularization of an engineered tissue construct is necessary to ensure the nourishment and viability of the hosted cells. Microvascular constructs can be created by seeding the luminal surfaces of microfluidic channel arrays with endothelial cells. However, in a conventional flow-based system, the uniformity of endothelialization of such an engineered microvascular network is constrained by mass transfer of the cells through high length-to-diameter (L/D) aspect ratio microchannels. Moreover, given the inherent limitations of the initial seeding process to generate a uniform cell coating, the large surface-area-to-volume ratio of microfluidic systems demands long culture periods for the formation of confluent cellular microconduits. In this report, we describe the design of polydimethylsiloxane (PDMS) and poly(glycerol sebacate) (PGS) microvascular constructs with reentrant microchannels that facilitates rapid, spatially homogeneous endothelial cell seeding of a high L/D (2 cm/35 μm; > 550:1) aspect ratio microchannels. MEMS technology was employed for the fabrication of a monolithic, elastomeric, reentrant microvascular construct. Isotropic etching and PDMS micromolding yielded a near-cylindrical microvascular channel array. A 'stretch - seed - seal' operation was implemented for uniform incorporation of endothelial cells along the entire microvascular area of the construct yielding endothelialized microvascular networks in less than 24 h. The feasibility of this endothelialization strategy and the uniformity of cellularization were established using confocal microscope imaging.

  20. Airway statuses and nasopharyngeal airway use for airway obstruction in syndromic craniosynostosis.

    PubMed

    Kouga, Takeshi; Tanoue, Koji; Matsui, Kiyoshi

    2014-05-01

    Syndromic craniosynostosis is associated with a high rate of respiratory difficulty, due mainly to midfacial hypoplasia. Nasopharyngeal airway establishment has been reported as the first-line approach to airway obstruction and may obviate the need for a highly invasive tracheotomy. No previous studies have compared airway obstruction status in syndromic craniosynostosis between cases requiring and not requiring airway managements. We focus on nasopharyngeal airway use and airway status outcomes to assess respiratory difficulty in patients with syndromic craniosynostosis. A retrospective data analysis of 51 cases with syndromic craniosynostosis was carried out. We divided 30 of the 51 cases with lateral pharyngeal x-rays taken before operations affecting airway diameters into 2 groups, one with neither nasopharyngeal airway insertion nor tracheotomy and the other with one or both of these interventions, and the mean diameters for 8 indices related to the pharyngeal space were compared. Cases with respiratory difficulty due to nasopharyngeal stenosis and requiring airway managements comprised a significantly higher proportion of those with Pfeiffer syndrome than patients with Crouzon or Apert syndrome. Comparative examination of lateral x-ray cephalometry between cases with neither nasopharyngeal airway insertion nor tracheotomy and cases with one or both revealed oropharyngeal diameters tended to be smaller in those with interventions. Cases requiring nasopharyngeal airway insertion were able to continue nasopharyngeal airway use for more than 1 year and a considerable number avoided tracheotomy. It may be worth considering an oropharyngeal-bypass nasopharyngeal airway before performing a tracheotomy. PMID:24820706

  1. Malvidin’s Effects on Rat Pial Microvascular Permeability Changes Due to Hypoperfusion and Reperfusion Injury

    PubMed Central

    Lapi, Dominga; Chiurazzi, Martina; Di Maro, Martina; Mastantuono, Teresa; Battiloro, Laura; Sabatino, Lina; Ricci, Serena; Di Carlo, Angelina; Starita, Noemy; Guida, Bruna; Santillo, Mariarosaria; Colantuoni, Antonio

    2016-01-01

    The present study was aimed to evaluate the malvidin’s protective effects on damage induced by 30 min bilateral common carotid artery occlusion (BCCAO) and 60 min reperfusion (RE) in rat pial microcirculation. Rat pial microcirculation was observed using fluorescence microscopy through a closed cranial window. Western blotting analysis was performed to investigate the endothelial nitric oxide synthase (eNOS), phosphorylated eNOS (p-eNOS) and matrix metalloproteinase 9 (MMP-9) expression. Moreover, MMP-9 activity was evaluated by zymography. Finally, neuronal damage and radical oxygen species (ROS) formation were assessed. In all animals, pial arterioles were classified in five orders of branching according to Strahler’s method. In hypoperfused rats, 30 min BCCAO and 60 min RE caused a decrease in arteriolar diameter, an increase in microvascular leakage and leukocyte adhesion, accompanied by decreased capillary perfusion and red blood cell velocity (VRBC). Moreover, marked neuronal damage and evident ROS generation were detected. Conversely, malvidin administration induced arteriolar dilation in dose-related manner, reducing microvascular leakage as well as leukocyte adhesion. Capillary perfusion and VRBC were protected. Nitric oxide (NO) synthase inhibition significantly attenuated malvidin’s effects on arteriolar diameter. Western blotting analysis revealed an increase in eNOS and p-eNOS expression, while zymography indicated a decrease in MMP-9 activity after malvidin’s administration. Furthermore, malvidin was able to prevent neuronal damage and to decrease ROS generation. In conclusion, malvidin protects rat pial microcirculation against BCCAO/RE injury, preventing blood-brain impairment and neuronal loss. Malvidin’s effects appear to be mediated by eNOS activation and scavenger activity. PMID:27445688

  2. Current Diagnostic and Therapeutic Strategies in Microvascular Angina

    PubMed Central

    Mumma, Bryn; Flacke, Nathalie

    2014-01-01

    Microvascular angina is common among patients with signs and symptoms of acute coronary syndrome and is associated with an increased risk of cardiovascular and cerebrovascular events. Unfortunately, microvascular is often under-recognized in clinical settings. The diagnosis of microvascular angina relies on assessment of the functional status of the coronary microvasculature. Invasive strategies include acetylcholine provocation, intracoronary Doppler ultrasound, and intracoronary thermodilution; noninvasive strategies include cardiac positron emission tomography (PET), cardiac magnetic resonance, and Doppler echocardiography. Once the diagnosis of microvascular angina is established, treatment is focused on improving symptoms and reducing future risk of cardiovascular and cerebrovascular events. Pharmacologic options and lifestyle modifications for patients with microvascular angina are similar to those for patients with coronary artery disease. PMID:25685641

  3. Vascular Anomalies and Airway Concerns

    PubMed Central

    Clarke, Caroline; Lee, Edward I.; Edmonds, Joseph

    2014-01-01

    Vascular anomalies, both tumors and malformations, can occur anywhere in the body, including the airway, often without any external manifestations. However, vascular anomalies involving the airway deserve special consideration as proper recognition and management can be lifesaving. In this article, the authors discuss vascular anomalies as they pertains to the airway, focusing on proper diagnosis, diagnostic modalities, and therapeutic options. PMID:25045336

  4. Assessment of v-gel supraglottic airway device placement in cats performed by inexperienced veterinary students.

    PubMed

    Barletta, M; Kleine, S A; Quandt, J E

    2015-11-21

    Endotracheal intubation has been associated with several complications in cats. The v-gel supraglottic airway device (SGAD) has been developed to adapt to the unique oropharynx of the cat and to overcome these complications. Thirty-three cats were randomly assigned to receive an endotracheal tube (ETT group) or a v-gel SGAD (v-gel group) after induction of general anaesthesia. Third year veterinary students without previous clinical experience placed these devices under direct supervision of an anaesthesiologist. Amount of propofol, number of attempts, time required to secure the airway, leakage around the device, signs of upper airway discomfort and food consumption were compared between the two groups. The v-gel group required less propofol (P=0.03), less time (P<0.01) and fewer attempts (P<0.01) to secure the cats' airway. The incidence of leakage was lower for the v-gel group immediately after placement of the device (P<0.01) and 60 minutes after induction of general anaesthesia (P=0.04). Cats that received the v-gel SGAD presented a lower incidence of upper airway discomfort immediately after the device was removed (P=0.03) and recorded a higher food consumption score (P=0.03). The v-gel SGAD is a feasible way to secure the airway of healthy cats when performed by inexperienced personnel.

  5. Myocardial perfusion echocardiography and coronary microvascular dysfunction

    PubMed Central

    Barletta, Giuseppe; Del Bene, Maria Riccarda

    2015-01-01

    Our understanding of coronary syndromes has evolved in the last two decades out of the obstructive atherosclerosis of epicardial coronary arteries paradigm to include anatomo-functional abnormalities of coronary microcirculation. No current diagnostic technique allows direct visualization of coronary microcirculation, but functional assessments of this circulation are possible. This represents a challenge in cardiology. Myocardial contrast echocardiography (MCE) was a breakthrough in echocardiography several years ago that claimed the capability to detect myocardial perfusion abnormalities and quantify coronary blood flow. Research demonstrated that the integration of quantitative MCE and fractional flow reserve improved the definition of ischemic burden and the relative contribution of collaterals in non-critical coronary stenosis. MCE identified no-reflow and low-flow within and around myocardial infarction, respectively, and predicted the potential functional recovery of stunned myocardium using appropriate interventions. MCE exhibited diagnostic performances that were comparable to positron emission tomography in microvascular reserve and microvascular dysfunction in angina patients. Overall, MCE improved echocardiographic evaluations of ischemic heart disease in daily clinical practice, but the approval of regulatory authorities is lacking. PMID:26730291

  6. Microvascular Repair: Post-Angiogenesis Vascular Dynamics

    PubMed Central

    LeBlanc, Amanda J.; Krishnan, Laxminarayanan; Sullivan, Christopher J.; Williams, Stuart K.; Hoying, James B.

    2013-01-01

    Vascular compromise and the accompanying perfusion deficits cause or complicate a large array of disease conditions and treatment failures. This has prompted the exploration of therapeutic strategies to repair or regenerate vasculatures thereby establishing more competent microcirculatory beds. Growing evidence indicates that an increase in vessel numbers within a tissue does not necessarily promote an increase in tissue perfusion. Effective regeneration of a microcirculation entails the integration of new stable microvessel segments into the network via neovascularization. Beginning with angiogenesis, neovascularization entails an integrated series of vascular activities leading to the formation of a new mature microcirculation and includes vascular guidance and inosculation, vessel maturation, pruning, arterio-venous specification, network patterning, structural adaptation, intussusception, and microvascular stabilization. While the generation of new vessel segments is necessary to expand a network, without the concomitant neovessel remodeling and adaptation processes intrinsic to microvascular network formation, these additional vessel segments give rise to a dysfunctional microcirculation. While many of the mechanisms regulating angiogenesis have been detailed, a thorough understanding of the mechanisms driving post-angiogenesis activities specific to neovascularization has yet to be fully realized, but is necessary in order to develop effective therapeutic strategies for repairing compromised microcirculations as a means to treat disease. PMID:22734666

  7. Effects of radiation therapy in microvascular anastomoses

    SciTech Connect

    Fried, M.P.

    1985-07-01

    The otolaryngologist, as a head and neck surgeon, commonly cares for patients with upper aerodigestive tract malignancies. Therapy of these neoplasms often requires wide excision. One standard reconstructive procedure utilizes pedicled regional flaps, both dermal and myodermal which have some disadvantages. The shortcomings of these pedicled regional flaps have led to the use of the vascularized free flap in certain cases. The occasional case may lead to catastrophe if microanastomoses fail when combined with radiation. Notwithstanding, many surgical series have reported success when radiation has been given. The present investigation was undertaken to assess the effects of radiation therapy on microvascular anastomoses when radiation is administered pre- or postoperatively or when nonradiated tissue is transferred to an irradiated recipient site. These effects were observed serially in an experimental rat model using a tubed superficial epigastric flap that adequately reflected tissue viability and vascular patency. The histologic changes were then noted over a three month period after completion of both radiation and surgery. This study adds credence to the observation of the lack of deleterious effects of radiation on experimental microvascular anastomotic patency whether the radiation is given before or after surgery or if radiated tissue is approximated to nonradiated vessels.

  8. Robust characterization of leakage errors

    NASA Astrophysics Data System (ADS)

    Wallman, Joel J.; Barnhill, Marie; Emerson, Joseph

    2016-04-01

    Leakage errors arise when the quantum state leaks out of some subspace of interest, for example, the two-level subspace of a multi-level system defining a computational ‘qubit’, the logical code space of a quantum error-correcting code, or a decoherence-free subspace. Leakage errors pose a distinct challenge to quantum control relative to the more well-studied decoherence errors and can be a limiting factor to achieving fault-tolerant quantum computation. Here we present a scalable and robust randomized benchmarking protocol for quickly estimating the leakage rate due to an arbitrary Markovian noise process on a larger system. We illustrate the reliability of the protocol through numerical simulations.

  9. Total airway reconstruction.

    PubMed

    Connor, Matthew P; Barrera, Jose E; Eller, Robert; McCusker, Scott; O'Connor, Peter

    2013-02-01

    We present a case of obstructive sleep apnea (OSA) that required multilevel surgical correction of the airway and literature review and discuss the role supraglottic laryngeal collapse can have in OSA. A 34-year-old man presented to a tertiary otolaryngology clinic for treatment of OSA. He previously had nasal and palate surgeries and a Repose tongue suspension. His residual apnea hypopnea index (AHI) was 67. He had a dysphonia associated with a true vocal cord paralysis following resection of a benign neck mass in childhood. He also complained of inspiratory stridor with exercise and intolerance to continuous positive airway pressure. Physical examination revealed craniofacial hypoplasia, full base of tongue, and residual nasal airway obstruction. On laryngoscopy, the paretic aryepiglottic fold arytenoid complex prolapsed into the laryngeal inlet with each breath. This was more pronounced with greater respiratory effort. Surgical correction required a series of operations including awake tracheostomy, supraglottoplasty, midline glossectomy, genial tubercle advancement, maxillomandibular advancement, and reconstructive rhinoplasty. His final AHI was 1.9. Our patient's supraglottic laryngeal collapse constituted an area of obstruction not typically evaluated in OSA surgery. In conjunction with treating nasal, palatal, and hypopharyngeal subsites, our patient's supraglottoplasty represented a key component of his success. This case illustrates the need to evaluate the entire upper airway in a complicated case of OSA. PMID:22965285

  10. Methods of airway resistance assessment.

    PubMed

    Urbankowski, Tomasz; Przybyłowski, Tadeusz

    2016-01-01

    Airway resistance is the ratio of driving pressure to the rate of the airflow in the airways. The most frequent methods used to measure airway resistance are whole-body plethysmography, the interrupter technique and the forced oscillation technique. All these methods allow to measure resistance during respiration at the level close to tidal volume, they do not require forced breathing manoeuvres or deep breathing during measurement. The most popular method for measuring airway resistance is whole-body plethysmography. The results of plethysmography include among others the following parameters: airway resistance (Raw), airway conductance (Gaw), specific airway resistance (sRaw) and specific airway conductance (sGaw). The interrupter technique is based on the assumption that at the moment of airway occlusion, air pressure in the mouth is equal to the alveolar pressure . In the forced oscillation technique (FOT), airway resistance is calculated basing on the changes in pressure and flow caused by air vibration. The methods for measurement of airway resistance that are described in the present paper seem to be a useful alternative to the most common lung function test - spirometry. The target group in which these methods may be widely used are particularly the patients who are unable to perform spirometry.

  11. Air-leakage control manual

    SciTech Connect

    Maloney, J.

    1991-05-01

    This manual is for builders and designers who are interested in building energy-efficient homes. The purpose of the manual is to provide the ``how and why`` of controlling air leakage by means of a system called the ``Simple Caulk and Seal`` (SIMPLE{center_dot}CS) system. This manual provides an overview of the purpose and contents of the manual; It discusses the forces that affect air leakage in homes and the benefits of controlling air leakage. Also discussed are two earlier approaches for controlling air leakage and the problems with these approaches. It describes the SIMPLE-{center_dot}CS system. It outlines the standard components of the building envelope that require sealing and provides guidelines for sealing them. It outlines a step-by-step procedure for analyzing and planning the sealing effort. The procedure includes (1) identifying areas to be sealed, (2) determining the most effective and convenient stage of construction in which to do the sealing, and (3) designating the appropriate crew member or trade to be responsible for the sealing.

  12. Air-Leakage Control Manual.

    SciTech Connect

    Maloney, Jim; Washington State Energy Office; United States. Bonneville Power Administration.

    1991-05-01

    This manual is for builders and designers who are interested in building energy-efficient homes. The purpose of the manual is to provide the how and why'' of controlling air leakage by means of a system called the Simple Caulk and Seal'' (SIMPLE{center dot}CS) system. This manual provides an overview of the purpose and contents of the manual; It discusses the forces that affect air leakage in homes and the benefits of controlling air leakage. Also discussed are two earlier approaches for controlling air leakage and the problems with these approaches. It describes the SIMPLE-{center dot}CS system. It outlines the standard components of the building envelope that require sealing and provides guidelines for sealing them. It outlines a step-by-step procedure for analyzing and planning the sealing effort. The procedure includes (1) identifying areas to be sealed, (2) determining the most effective and convenient stage of construction in which to do the sealing, and (3) designating the appropriate crew member or trade to be responsible for the sealing.

  13. Differentiation state determines neural effects on microvascular endothelial cells

    SciTech Connect

    Muffley, Lara A.; Pan, Shin-Chen; Smith, Andria N.; Ga, Maricar; Hocking, Anne M.; Gibran, Nicole S.

    2012-10-01

    Growing evidence indicates that nerves and capillaries interact paracrinely in uninjured skin and cutaneous wounds. Although mature neurons are the predominant neural cell in the skin, neural progenitor cells have also been detected in uninjured adult skin. The aim of this study was to characterize differential paracrine effects of neural progenitor cells and mature sensory neurons on dermal microvascular endothelial cells. Our results suggest that neural progenitor cells and mature sensory neurons have unique secretory profiles and distinct effects on dermal microvascular endothelial cell proliferation, migration, and nitric oxide production. Neural progenitor cells and dorsal root ganglion neurons secrete different proteins related to angiogenesis. Specific to neural progenitor cells were dipeptidyl peptidase-4, IGFBP-2, pentraxin-3, serpin f1, TIMP-1, TIMP-4 and VEGF. In contrast, endostatin, FGF-1, MCP-1 and thrombospondin-2 were specific to dorsal root ganglion neurons. Microvascular endothelial cell proliferation was inhibited by dorsal root ganglion neurons but unaffected by neural progenitor cells. In contrast, microvascular endothelial cell migration in a scratch wound assay was inhibited by neural progenitor cells and unaffected by dorsal root ganglion neurons. In addition, nitric oxide production by microvascular endothelial cells was increased by dorsal root ganglion neurons but unaffected by neural progenitor cells. -- Highlights: Black-Right-Pointing-Pointer Dorsal root ganglion neurons, not neural progenitor cells, regulate microvascular endothelial cell proliferation. Black-Right-Pointing-Pointer Neural progenitor cells, not dorsal root ganglion neurons, regulate microvascular endothelial cell migration. Black-Right-Pointing-Pointer Neural progenitor cells and dorsal root ganglion neurons do not effect microvascular endothelial tube formation. Black-Right-Pointing-Pointer Dorsal root ganglion neurons, not neural progenitor cells, regulate

  14. Microvascularization on collared peccary placenta: a microvascular cast study [corrected] in late pregnancy.

    PubMed

    Santos, Tatiana Carlesso; Oliveira, Moacir Franco; Dantzer, Vibeke; Miglino, Maria Angélica

    2012-07-01

    The microvascularization of the collared peccary (Tayassu tajacu) placenta was studied by vascular casts and immunolocalization of α-smooth muscle actin and vimentin, to identify the three dimensional organization and vascular flow interrelation in the microvasculature between the maternal and fetal compartments of the placentae. The immunolocalization of vimentin in the vascular endothelium and in the smooth muscle cells of blood vessels showed indented capillaries along the uterine epithelium and the trophoblast at the sides of complementary maternal and fetal microfolds, or rugae. This confers the three-dimensional structure observed in vascular casts. On the maternal side, casts demonstrated uterine folds coated by with primary and secondary ridges, and by areolae dispersed between these ridges. The arteriole runs through the center/middle of ridges, branching at the top into a microvascular network wall in a basket-like fashion. At the base of these baskets venules were formed. On the fetal side, arterioles branched centrally in the fetal rugae into a capillary network in a bulbous form, complementary to the opposite maternal depressions forming the baskets. At the base of the bulbous protrusions, the fetal venules arise. The blood vessel orientation in the materno-fetal interface of the placentae of collared peccaries suggests a blood flow pattern of the type countercurrent to cross current. The same pattern has been reported in domestic swine demonstrating that, even after 38 million years, the Tayassuidae and Suidae families exhibit similar placental morphology, which is here characterized at the microvascular level.

  15. Self-healing materials with microvascular networks.

    PubMed

    Toohey, Kathleen S; Sottos, Nancy R; Lewis, Jennifer A; Moore, Jeffrey S; White, Scott R

    2007-08-01

    Self-healing polymers composed of microencapsulated healing agents exhibit remarkable mechanical performance and regenerative ability, but are limited to autonomic repair of a single damage event in a given location. Self-healing is triggered by crack-induced rupture of the embedded capsules; thus, once a localized region is depleted of healing agent, further repair is precluded. Re-mendable polymers can achieve multiple healing cycles, but require external intervention in the form of heat treatment and applied pressure. Here, we report a self-healing system capable of autonomously repairing repeated damage events. Our bio-inspired coating-substrate design delivers healing agent to cracks in a polymer coating via a three-dimensional microvascular network embedded in the substrate. Crack damage in the epoxy coating is healed repeatedly. This approach opens new avenues for continuous delivery of healing agents for self-repair as well as other active species for additional functionality.

  16. Phase transition of the microvascular network architecture in human pathologies.

    PubMed

    Bianciardi, Giorgio; Traversi, Claudio; Cattaneo, Ruggero; De Felice, Claudia; Monaco, Annalisa; Tosi, Gianmarco; Parrini, Stefano; Latini, Giuseppe

    2012-01-01

    We have investigated the microvascular pattern in acquired or genetic diseases in humans. The lower gingival and vestibular oral mucosa, as well as the optic nerve head, was chosen to characterize the vascular pattern complexity due to the simple accessibility and visibility Local fractal dimensions, fractal dimension of the minimum path and Lempel-Ziv complexity have been used as operational numerical tools to characterize the microvascular networks. In the normal healthy subjects microvascular networks show nonlinear values corresponding to the complexity of a diffusion limited aggregation (DLA) model, while in several acquired or genetic diseases they are approaching the ones of an invasion percolation model. PMID:23193796

  17. Vascular tracers alter hemodynamics and airway pressure in anesthetized sheep

    SciTech Connect

    Albertine, K.H.; Staub, N.C.

    1986-11-01

    The technique of vascular labeling was developed to mark sites of increased microvascular permeability. We used the vascular labeling technique in anesthetized sheep and found that hemodynamics and airway pressure were adversely affected by intraarterial infusions of two vascular tracers. Monastral blue (nine sheep) immediately caused systemic arterial hypotension, pulmonary arterial hypertension, and bronchoconstriction. All three physiological responses were partially blocked by a cyclooxygenase inhibitor (indomethacin) but not by an H1-antihistamine (chlorpheniramine). Colloidal gold (nine sheep) caused immediate, but less dramatic, pulmonary arterial hypertension which was not attenuated by the blocking agents. We conclude that these two vascular tracers caused detrimental physiological side effects in sheep at the usual doses used to label injured microvessels in other species.

  18. Therapeutic effect of apatinib-loaded nanoparticles on diabetes-induced retinal vascular leakage.

    PubMed

    Jeong, Ji Hoon; Nguyen, Hong Khanh; Lee, Jung Eun; Suh, Wonhee

    2016-01-01

    Apatinib, a novel and selective inhibitor of vascular endothelial growth factor (VEGF) receptor 2, has been demonstrated recently to exhibit anticancer efficacy by inhibiting the VEGF signaling pathway. Given the importance of VEGF in retinal vascular leakage, the present study was designed to investigate whether apatinib-loaded polymeric nanoparticles inhibit VEGF-mediated retinal vascular hyperpermeability and block diabetes-induced retinal vascular leakage. For the delivery of water-insoluble apatinib, the drug was encapsulated in nanoparticles composed of human serum albumin (HSA)-conjugated polyethylene glycol (PEG). In vitro paracellular permeability and transendothelial electric resistance assays showed that apatinib-loaded HSA-PEG (Apa-HSA-PEG) nanoparticles significantly inhibited VEGF-induced endothelial hyperpermeability in human retinal microvascular endothelial cells. In addition, they substantially reduced the VEGF-induced junctional loss and internalization of vascular endothelial-cadherin, a major component of endothelial junction complexes. In vivo intravitreal injection of Apa-HSA-PEG nanoparticles in mice blocked VEGF-induced retinal vascular leakage. These in vitro and in vivo data indicated that Apa-HSA-PEG nanoparticles efficiently blocked VEGF-induced breakdown of the blood-retinal barrier. In vivo experiments with streptozotocin-induced diabetic mice showed that an intravitreal injection of Apa-HSA-PEG nanoparticles substantially inhibited diabetes-induced retinal vascular leakage. These results demonstrated, for the first time, that apatinib-loaded nanoparticles may be a promising therapeutic agent for the prevention and treatment of diabetes-induced retinal vascular disorders. PMID:27462154

  19. Therapeutic effect of apatinib-loaded nanoparticles on diabetes-induced retinal vascular leakage

    PubMed Central

    Jeong, Ji Hoon; Nguyen, Hong Khanh; Lee, Jung Eun; Suh, Wonhee

    2016-01-01

    Apatinib, a novel and selective inhibitor of vascular endothelial growth factor (VEGF) receptor 2, has been demonstrated recently to exhibit anticancer efficacy by inhibiting the VEGF signaling pathway. Given the importance of VEGF in retinal vascular leakage, the present study was designed to investigate whether apatinib-loaded polymeric nanoparticles inhibit VEGF-mediated retinal vascular hyperpermeability and block diabetes-induced retinal vascular leakage. For the delivery of water-insoluble apatinib, the drug was encapsulated in nanoparticles composed of human serum albumin (HSA)-conjugated polyethylene glycol (PEG). In vitro paracellular permeability and transendothelial electric resistance assays showed that apatinib-loaded HSA-PEG (Apa-HSA-PEG) nanoparticles significantly inhibited VEGF-induced endothelial hyperpermeability in human retinal microvascular endothelial cells. In addition, they substantially reduced the VEGF-induced junctional loss and internalization of vascular endothelial-cadherin, a major component of endothelial junction complexes. In vivo intravitreal injection of Apa-HSA-PEG nanoparticles in mice blocked VEGF-induced retinal vascular leakage. These in vitro and in vivo data indicated that Apa-HSA-PEG nanoparticles efficiently blocked VEGF-induced breakdown of the blood–retinal barrier. In vivo experiments with streptozotocin-induced diabetic mice showed that an intravitreal injection of Apa-HSA-PEG nanoparticles substantially inhibited diabetes-induced retinal vascular leakage. These results demonstrated, for the first time, that apatinib-loaded nanoparticles may be a promising therapeutic agent for the prevention and treatment of diabetes-induced retinal vascular disorders. PMID:27462154

  20. Managing upper airway obstruction.

    PubMed

    Innes, M H

    A complete respiratory obstruction can lead to death in 3 minutes. The first and constant duty of the nurse aider is to check that the person is breathing by looking, listening and feeling. Partial obstruction is no less serious than complete obstruction. The nurse aider, in any situation, should assess the problem and attempt to overcome the airway obstruction using the measures described. PMID:1490067

  1. Airway gene therapy.

    PubMed

    Davies, Jane C; Alton, Eric W F W

    2005-01-01

    Given both the accessibility and the genetic basis of several pulmonary diseases, the lungs and airways initially seemed ideal candidates for gene therapy. Several routes of access are available, many of which have been refined and optimized for nongene drug delivery. Two respiratory diseases, cystic fibrosis (CF) and alpha1-antitrypsin (alpha1-AT) deficiency, are relatively common; the single gene responsible has been identified and current treatment strategies are not curative. This type of inherited disease was the obvious initial target for gene therapy, but it has become clear that nongenetic and acquired diseases, including cancer, may also be amenable to this approach. The majority of preclinical and clinical studies in the airway have involved viral vectors, although for diseases such as CF, likely to require repeated application, non-viral delivery systems have clear advantages. However, with both approaches a range of barriers to gene expression have been identified that are limiting success in the airway and alveolar region. This chapter reviews these issues, strategies aimed at overcoming them, and progress into clinical trials with non-viral vectors in a variety of pulmonary diseases.

  2. 16 CFR 1507.5 - Pyrotechnic leakage.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Pyrotechnic leakage. 1507.5 Section 1507.5... FIREWORKS DEVICES § 1507.5 Pyrotechnic leakage. The pyrotechnic chamber in fireworks devices shall be sealed in a manner that prevents leakage of the pyrotechnic composition during shipping, handling,...

  3. 49 CFR 229.59 - Leakage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Leakage. 229.59 Section 229.59 Transportation... TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Safety Requirements Brake System § 229.59 Leakage. (a) Leakage from the main air reservoir and related piping may not exceed an average of 3 pounds per...

  4. 16 CFR 1507.5 - Pyrotechnic leakage.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Pyrotechnic leakage. 1507.5 Section 1507.5... FIREWORKS DEVICES § 1507.5 Pyrotechnic leakage. The pyrotechnic chamber in fireworks devices shall be sealed in a manner that prevents leakage of the pyrotechnic composition during shipping, handling,...

  5. 16 CFR 1507.5 - Pyrotechnic leakage.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Pyrotechnic leakage. 1507.5 Section 1507.5... FIREWORKS DEVICES § 1507.5 Pyrotechnic leakage. The pyrotechnic chamber in fireworks devices shall be sealed in a manner that prevents leakage of the pyrotechnic composition during shipping, handling,...

  6. 49 CFR 229.59 - Leakage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Leakage. 229.59 Section 229.59 Transportation... TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Safety Requirements Brake System § 229.59 Leakage. (a) Leakage from the main air reservoir and related piping may not exceed an average of 3 pounds per...

  7. 49 CFR 229.59 - Leakage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Leakage. 229.59 Section 229.59 Transportation... TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Safety Requirements Brake System § 229.59 Leakage. (a) Leakage from the main air reservoir and related piping may not exceed an average of 3 pounds per...

  8. 49 CFR 229.59 - Leakage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Leakage. 229.59 Section 229.59 Transportation... TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Safety Requirements Brake System § 229.59 Leakage. (a) Leakage from the main air reservoir and related piping may not exceed an average of 3 pounds per...

  9. 49 CFR 229.59 - Leakage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Leakage. 229.59 Section 229.59 Transportation... TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Safety Requirements Brake System § 229.59 Leakage. (a) Leakage from the main air reservoir and related piping may not exceed an average of 3 pounds per...

  10. 16 CFR 1507.5 - Pyrotechnic leakage.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Pyrotechnic leakage. 1507.5 Section 1507.5... FIREWORKS DEVICES § 1507.5 Pyrotechnic leakage. The pyrotechnic chamber in fireworks devices shall be sealed in a manner that prevents leakage of the pyrotechnic composition during shipping, handling,...

  11. 16 CFR 1507.5 - Pyrotechnic leakage.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Pyrotechnic leakage. 1507.5 Section 1507.5... FIREWORKS DEVICES § 1507.5 Pyrotechnic leakage. The pyrotechnic chamber in fireworks devices shall be sealed in a manner that prevents leakage of the pyrotechnic composition during shipping, handling,...

  12. Microvascular temporalis fascia transfer for penile girth enhancement.

    PubMed

    Küçükçelebi, A; Ertaş, N M; Aydin, A; Eroğlu, A; Ozmen, E; Velidedeoğlu, H

    2001-07-01

    The authors report a 44-year-old man with inadequate penile girth that caused psychological problems. Using microvascular temporalis fascia transfer, they achieved satisfactory penile girth enhancement based on reliable vascularity in a single stage. PMID:11756810

  13. Protein osmotic pressure gradients and microvascular reflection coefficients.

    PubMed

    Drake, R E; Dhother, S; Teague, R A; Gabel, J C

    1997-08-01

    Microvascular membranes are heteroporous, so the mean osmotic reflection coefficient for a microvascular membrane (sigma d) is a function of the reflection coefficient for each pore. Investigators have derived equations for sigma d based on the assumption that the protein osmotic pressure gradient across the membrane (delta II) does not vary from pore to pore. However, for most microvascular membranes, delta II probably does vary from pore to pore. In this study, we derived a new equation for sigma d. According to our equation, pore-to-pore differences in delta II increase the effect of small pores and decrease the effect of large pores on the overall membrane osmotic reflection coefficient. Thus sigma d for a heteroporous membrane may be much higher than previously derived equations indicate. Furthermore, pore-to-pore delta II differences increase the effect of plasma protein osmotic pressure to oppose microvascular fluid filtration. PMID:9277520

  14. Causes of the difficult airway.

    PubMed

    Orfanos, John G; Quereshy, Faisal A

    2010-03-01

    Recognizing a potentially difficult airway is important in avoiding a life-threatening emergency. There are 2 separate scenarios for considering the difficult airway: difficult mask ventilation (DMV) and difficult tracheal intubation (DTI). DMV can be described as lacking the ability to maintain oxygen saturation or lacking the ability to reverse signs of inadequate ventilation with positive-pressure mask ventilation under general anesthesia. DTI remains constant among anesthesia-related patient injuries, and is the third most common respiratory-related episode leading to death and possible brain damage. It is important to preoperatively assess every patient by completing a full history and physical. A thorough history can provide clues in detecting a possible difficult airway. Airway impairment has been further subdivided into the anatomic regions that affect the airway, namely above the larynx, supraglottic, glottic, subglottic, and tracheobronchial. This article discusses the factors that can result in a difficult airway.

  15. "Geyser" leakage on fluorescein angiography.

    PubMed

    Levy, Jaime; Fagan, Xavier J; Lifshitz, Tova; Schneck, Marina

    2013-11-22

    An 82-year-old patient with diabetes was followed up due to moderate nonproliferative diabetic retinopathy with macular edema in the right eye. Visual acuity was 6/36. Focal macular laser was conducted (A). Three years later, the patient presented with blurry vision in the right eye. Visual acuity was 3/60. Vitreous hemorrhage was observed (B), and neovascularization of the disc was suspected (C). Fluorescein angiography (D, mid venous phase; E-F, recirculation phase) confirmed neovascularization of the disc and depicted a striking vertical leakage. Panretinal photocoagulation was started. Possible explanations for the "geyser" leakage may be either a partial posterior vitreous detachment allowing the fluorescein to track upwards but not elsewhere or a pocket of syneretic vitreous allowing the fluorescein passage in which to diffuse, much like the passage the blood would have taken.

  16. "Geyser" leakage on fluorescein angiography.

    PubMed

    Levy, Jaime; Fagan, Xavier J; Lifshitz, Tova; Schneck, Marina

    2013-01-01

    An 82-year-old patient with diabetes was followed up due to moderate nonproliferative diabetic retinopathy with macular edema in the right eye. Visual acuity was 6/36. Focal macular laser was conducted (A). Three years later, the patient presented with blurry vision in the right eye. Visual acuity was 3/60. Vitreous hemorrhage was observed (B), and neovascularization of the disc was suspected (C). Fluorescein angiography (D, mid venous phase; E-F, recirculation phase) confirmed neovascularization of the disc and depicted a striking vertical leakage. Panretinal photocoagulation was started. Possible explanations for the "geyser" leakage may be either a partial posterior vitreous detachment allowing the fluorescein to track upwards but not elsewhere or a pocket of syneretic vitreous allowing the fluorescein passage in which to diffuse, much like the passage the blood would have taken. PMID:24548789

  17. Heat exchanger leakage problem location

    NASA Astrophysics Data System (ADS)

    Hejčík, Jiří; Jícha, Miroslav

    2012-04-01

    Recent compact heat exchangers are very often assembled from numerous parts joined together to separate heat transfer fluids and to form the required heat exchanger arrangement. Therefore, the leak tightness is very important property of the compact heat exchangers. Although, the compact heat exchangers have been produced for many years, there are still technological problems associated with manufacturing of the ideal connection between the individual parts, mainly encountered with special purpose heat exchangers, e.g. gas turbine recuperators. This paper describes a procedure used to identify the leakage location inside the prime surface gas turbine recuperator. For this purpose, an analytical model of the leaky gas turbine recuperator was created to assess its performance. The results obtained are compared with the experimental data which were acquired during the recuperator thermal performance analysis. The differences between these two data sets are used to indicate possible leakage areas.

  18. Microvascular Plasticity: Angiogenesis in Health and Disease--Preface.

    PubMed

    Secomb, Timothy W; Pries, Axel R

    2016-02-01

    This Special Topic Issue is concerned with the mechanisms that determine the structure of microvascular networks. The vast number of vessels and the highly plastic character of the microcirculation give evidence that microvascular network structures emerge as a result of responses of individual vessels and cells to the local stimuli that they experience, through a combination of angiogenesis, remodeling and pruning. The articles in this issue of Microcirculation address a range of cellular and molecular mechanisms involved in these processes. PMID:26639099

  19. Microvascular complications and diabetic retinopathy: recent advances and future implications.

    PubMed

    Barot, Megha; Gokulgandhi, Mitan R; Patel, Sulabh; Mitra, Ashim K

    2013-03-01

    Retinal microvascular alterations have been observed during diabetic retinopathy (DR) due to the retinal susceptibility towards subtle pathological alterations. Therefore, retinal microvascular pathology is essential to understand the nature of retinal degenerations during DR. In this review, the role of retinal microvasculature complications during progression of DR, along with recent efforts to normalize such alterations for better therapeutic outcome, will be underlined. In addition, current therapeutics and future directions for advancement of standard treatment for DR patients will be discussed. PMID:23464520

  20. Scalp reconstruction by microvascular free tissue transfer

    SciTech Connect

    Furnas, H.; Lineaweaver, W.C.; Alpert, B.S. )

    1990-05-01

    We report on a series of patients with scalp defects who have been treated with a variety of free flaps, spanning the era of microvascular free tissue transfer from its incipient stages to the present. Between 1971 and 1987, 18 patients underwent scalp reconstruction with 21 free flaps: 11 latissimus dorsi, 3 scalp transfers between identical twins, 3 groin, one combined latissimus dorsi and serratus anterior, two serratus anterior, and one omentum. These flaps were used to cover scalp defects resulting from burns, trauma, radiation, and tumors in patients ranging from 7 to 79 years of age. Follow-up has ranged from 3 weeks to 7 years. All of our flaps survived and covered complex defects, many of which had failed more conservative attempts at cover. One patient received radiation therapy to his flap without unfavorable sequelae. This experience began with a pioneering omental flap and includes cutaneous and muscle flaps. The latissimus dorsi is our first choice for free flap reconstruction of extensive, complicated scalp wounds because of its large size, predictable blood supply, ease of harvesting, and provision of excellent vascularity to compromised beds.

  1. Influence of silicone sheets on microvascular anastomosis.

    PubMed

    Hoang Nguyen, The; Kloeppel, Marcus; Hoehnke, Christoph; Staudenmaier, Rainer

    2008-12-01

    The use of silicone products combined with free flap transfer is well established in reconstructive surgery. We determined the risk of thrombosis as a result of direct contact between the silicone sheet and the point of microanastomosis. We performed microvascular surgery in 24 female Chinchilla Bastard rabbits weighing 3500 to 4000 g using two groups: Group 1 (n = 12), microanastomosis directly in contact with silicone sheets; and Group 2 (n = 12), microanastomosis protected by a 2 x 3 x 1-cm muscle cuff before being placed in contact with the silicone. We assessed flow-through of the microanastomosis by selective microangiography and histology at 1 and 3 weeks. All microanastomoses in Group 1 were occluded by postoperative thromboses, whereas all microanastomoses in Group 2 had adequate flow-through. Histologic analysis revealed thromboses in Group 1 formed from collagenous bundles of fiber securely attached to the intraluminal wall of the vessel. Three weeks after the procedure, these thromboses were canalized by varying small vessels. In Group 2, a slight luminal stenosis with evidence of infiltration of inflammatory cells at the microanastomosis line was observed histologically in all cases. Prefabricated flaps using silicone sheets and muscular cuffs placed around the anastomoses appear to reduce the risk of thrombosis and enhance neovascularization. PMID:18636304

  2. Calculating the GONG Leakage Matrix

    NASA Astrophysics Data System (ADS)

    Hill, F.; Howe, R.

    Since spherical harmonics do not form a complete orthonormal basis set over a portion of a sphere, helioseismic spectra computed for a specific target mode with degree ellt and azimuthal degree mt also contain modes with nearby ell'' and m''. These spatial leaks greatly increase the complexity of the observed spectrum, complicating the spectral fitting and degrading the resulting mode parameter estimates. This is particularly true where the target mode and the leaks have similar frequencies. Some strategies for fitting helioseismic spectra explicitly include the leakage matrix which estimates the relative strength of a mode (ell'' and m'') in the spectrum at (ellt,mt). Since the fitting methods assume that the matrix is correct and apply it as a constraint, an inaccurate matrix introduces systematic errors in the estimated mode parameters. It is thus important to have as accurate a matrix as possible. Here we report on the calculation of the leakage matrix for the GONG observations. The matrix elements are essentially the integrals (over the observed portion of the solar surface) of the crossproducts of the two spherical harmonics. However, several effects have been included to increase the accuracy of the matrix. These include the projection factor of the observable (velocity, intensity, modulation), the spatial apodization applied to the data, the finite rectangular pixel dimensions of the observations, and possible errors in the estimated image geometry. Other factors to be incorporated are the observed MTF, the merging of the GONG images, and the horizontal components of the oscillatory velocity field. We will compare the latest calculation with the observed spectrum and assess the relative importance of the input factors. We will also compare the leakage matrices for velocity and intensity to estimate their contribution to the large apparent differences in the helioseismic spectra obtained from these observables.

  3. Intermedin/adrenomedullin-2 is a hypoxia-induced endothelial peptide that stabilizes pulmonary microvascular permeability

    PubMed Central

    Aslam, Muhammad; Paddenberg, Renate; Quanz, Karin; Chang, Chia L.; Park, Jae-Il; Gries, Barbara; Rafiq, Amir; Faulhammer, Petra; Goldenberg, Anna; Papadakis, Tamara; Noll, Thomas; Hsu, Sheau Y. T.; Weissmann, Norbert; Kummer, Wolfgang

    2009-01-01

    Accumulating evidence suggests a pivotal role of the calcitonin receptor-like receptor (CRLR) signaling pathway in preventing damage of the lung by stabilizing pulmonary barrier function. Intermedin (IMD), also termed adrenomedullin-2, is the most recently identified peptide targeting this receptor. Here we investigated the effect of hypoxia on the expression of IMD in the murine lung and cultured murine pulmonary microvascular endothelial cells (PMEC) as well as the role of IMD in regulating vascular permeability. Monoclonal IMD antibodies were generated, and transcript levels were assayed by quantitative RT-PCR. The promoter region of IMD gene was analyzed, and the effect of hypoxia-inducible factor (HIF)-1α on IMD expression was investigated in HEK293T cells. Isolated murine lungs and a human lung microvascular endothelial cell monolayer model were used to study the effect of IMD on vascular permeability. IMD was identified as a pulmonary endothelial peptide by immunohistochemistry and RT-PCR. Hypoxia caused an upregulation of IMD mRNA in the murine lung and PMEC. As shown by these results, HIF-1α enhances IMD promoter activity. Our functional studies showed that IMD abolished the increase in pressure-induced endothelial permeability. Moreover, IMD decreased basal and thrombin-induced hyperpermeability of an endothelial cell monolayer in a receptor-dependent manner and activated PKA in these cells. In conclusion, IMD is a novel hypoxia-induced gene and a potential interventional agent for the improvement of endothelial barrier function in systemic inflammatory responses and hypoxia-induced vascular leakage. PMID:19684198

  4. Essential Role of Transglutaminase 2 in Vascular Endothelial Growth Factor-Induced Vascular Leakage in the Retina of Diabetic Mice.

    PubMed

    Lee, Yeon-Ju; Jung, Se-Hui; Kim, Su-Hyeon; Kim, Min-Soo; Lee, Sungeun; Hwang, JongYun; Kim, Soo-Youl; Kim, Young-Myeong; Ha, Kwon-Soo

    2016-08-01

    Diabetic retinopathy is predominantly caused by vascular endothelial growth factor (VEGF)-induced vascular leakage; however, the underlying mechanism is unclear. Here we designed an in vivo transglutaminase (TGase) activity assay in mouse retina and demonstrated that hyperglycemia induced vascular leakage by activating TGase2 in diabetic retina. VEGF elevated TGase2 activity through sequential elevation of intracellular Ca(2+) and reactive oxygen species (ROS) concentrations in endothelial cells. The TGase inhibitors cystamine and monodansylcadaverin or TGase2 small interfering RNA (siRNA) prevented VEGF-induced stress fiber formation and vascular endothelial (VE)-cadherin disruption, which play a critical role in modulating endothelial permeability. Intravitreal injection of two TGase inhibitors or TGase2 siRNA successfully inhibited hyperglycemia-induced TGase activation and microvascular leakage in the retinas of diabetic mice. C-peptide or ROS scavengers also inhibited TGase activation in diabetic mouse retinas. The role of TGase2 in VEGF-induced vascular leakage was further supported using diabetic TGase2(-/-) mice. Thus, our findings suggest that ROS-mediated activation of TGase2 plays a key role in VEGF-induced vascular leakage by stimulating stress fiber formation and VE-cadherin disruption. PMID:27207524

  5. Global airway disease beyond allergy.

    PubMed

    Hellings, Peter W; Prokopakis, Emmanuel P

    2010-03-01

    Besides the anatomic continuity of the upper and lower airways, inflammation in one part of the airway influences the homeostasis of the other. The mechanisms underlying this interaction have been studied primarily in allergic disease, showing systemic immune activation, induction of inflammation at a distance, and a negative impact of nasal inflammation on bronchial homeostasis. In addition to allergy, other inflammatory conditions of the upper airways are associated with lower airway disease. Rhinosinusitis is frequently associated with asthma and chronic obstructive pulmonary disease. The impairment of purification, humidification, and warming up of the inspired air by the nose in rhinosinusitis may be responsible in part for bronchial pathology. The resolution of sinonasal inflammation via medical and/or surgical treatment is responsible for the beneficial effect of the treatment on bronchial disease. This article provides a comprehensive overview of the current knowledge of upper and lower airway communication beyond allergic disease.

  6. The mechanics of airway closure.

    PubMed

    Heil, Matthias; Hazel, Andrew L; Smith, Jaclyn A

    2008-11-30

    We describe how surface-tension-driven instabilities of the lung's liquid lining may lead to pulmonary airway closure via the formation of liquid bridges that occlude the airway lumen. Using simple theoretical models, we demonstrate that this process may occur via a purely fluid-mechanical "film collapse" or through a coupled, fluid-elastic "compliant collapse" mechanism. Both mechanisms can lead to airway closure in times comparable with the breathing cycle, suggesting that surface tension is the primary mechanical effect responsible for the closure observed in peripheral regions of the human lungs. We conclude by discussing the influence of additional effects not included in the simple models, such as gravity, the presence of pulmonary surfactant, respiratory flow and wall motion, the airways' geometry, and the mechanical structure of the airway walls. PMID:18595784

  7. Operative endoscopy of the airway

    PubMed Central

    Walters, Dustin M.

    2016-01-01

    Airway endoscopy has long been an important and useful tool in the management of thoracic diseases. As thoracic specialists have gained experience with both flexible and rigid bronchoscopic techniques, the technology has continued to evolve so that bronchoscopy is currently the foundation for diagnosis and treatment of many thoracic ailments. Airway endoscopy plays a significant role in the biopsy of tumors within the airways, mediastinum, and lung parenchyma. Endoscopic methods have been developed to treat benign and malignant airway stenoses and tracheomalacia. And more recently, techniques have been conceived to treat end-stage emphysema and prolonged air leaks in select patients. This review describes the abundant uses of airway endoscopy, as well as technical considerations and limitations of the current technologies. PMID:26981263

  8. Systemic Microvascular Dysfunction and Inflammation after Pulmonary Particulate Matter Exposure

    PubMed Central

    Nurkiewicz, Timothy R.; Porter, Dale W.; Barger, Mark; Millecchia, Lyndell; Rao, K. Murali K.; Marvar, Paul J.; Hubbs, Ann F.; Castranova, Vincent; Boegehold, Matthew A.

    2006-01-01

    The epidemiologic association between pulmonary exposure to ambient particulate matter (PM) and cardiovascular dysfunction is well known, but the systemic mechanisms that drive this effect remain unclear. We have previously shown that acute pulmonary exposure to PM impairs or abolishes endothelium-dependent arteriolar dilation in the rat spinotrapezius muscle. The purpose of this study was to further characterize the effect of pulmonary PM exposure on systemic microvascular function and to identify local inflammatory events that may contribute to these effects. Rats were intratracheally instilled with residual oil fly ash (ROFA) or titanium dioxide at 0.1 or 0.25 mg/rat 24 hr before measurement of pulmonary and systemic microvascular responses. In vivo microscopy of the spinotrapezius muscle was used to study systemic arteriolar responses to intraluminal infusion of the Ca2+ ionophore A23187 or iontophoretic abluminal application of the adrenergic agonist phenylephrine (PHE). Leukocyte rolling and adhesion were quantified in venules paired with the studied arterioles. Histologic techniques were used to assess pulmonary inflammation, characterize the adherence of leukocytes to systemic venules, verify the presence of myeloperoxidase (MPO) in the systemic microvascular wall, and quantify systemic microvascular oxidative stress. In the lungs of rats exposed to ROFA or TiO2, changes in some bronchoalveolar lavage markers of inflammation were noted, but an indication of cellular damage was not found. In rats exposed to 0.1 mg ROFA, focal alveolitis was evident, particularly at sites of particle deposition. Exposure to either ROFA or TiO2 caused a dose-dependent impairment of endothelium-dependent arteriolar dilation. However, exposure to these particles did not affect microvascular constriction in response to PHE. ROFA and TiO2 exposure significantly increased leukocyte rolling and adhesion in paired venules, and these cells were positively identified as

  9. Systemic microvascular dysfunction and inflammation after pulmonary particulate matter exposure.

    PubMed

    Nurkiewicz, Timothy R; Porter, Dale W; Barger, Mark; Millecchia, Lyndell; Rao, K Murali K; Marvar, Paul J; Hubbs, Ann F; Castranova, Vincent; Boegehold, Matthew A

    2006-03-01

    The epidemiologic association between pulmonary exposure to ambient particulate matter (PM) and cardiovascular dysfunction is well known, but the systemic mechanisms that drive this effect remain unclear. We have previously shown that acute pulmonary exposure to PM impairs or abolishes endothelium-dependent arteriolar dilation in the rat spinotrapezius muscle. The purpose of this study was to further characterize the effect of pulmonary PM exposure on systemic microvascular function and to identify local inflammatory events that may contribute to these effects. Rats were intratracheally instilled with residual oil fly ash (ROFA) or titanium dioxide at 0.1 or 0.25 mg/rat 24 hr before measurement of pulmonary and systemic microvascular responses. In vivo microscopy of the spinotrapezius muscle was used to study systemic arteriolar responses to intraluminal infusion of the Ca2+ ionophore A23187 or iontophoretic abluminal application of the adrenergic agonist phenylephrine (PHE). Leukocyte rolling and adhesion were quantified in venules paired with the studied arterioles. Histologic techniques were used to assess pulmonary inflammation, characterize the adherence of leukocytes to systemic venules, verify the presence of myeloperoxidase (MPO) in the systemic microvascular wall, and quantify systemic microvascular oxidative stress. In the lungs of rats exposed to ROFA or TiO2, changes in some bronchoalveolar lavage markers of inflammation were noted, but an indication of cellular damage was not found. In rats exposed to 0.1 mg ROFA, focal alveolitis was evident, particularly at sites of particle deposition. Exposure to either ROFA or TiO2 caused a dose-dependent impairment of endothelium-dependent arteriolar dilation. However, exposure to these particles did not affect microvascular constriction in response to PHE. ROFA and TiO2 exposure significantly increased leukocyte rolling and adhesion in paired venules, and these cells were positively identified as

  10. Computational design of microvascular biomimetic materials

    NASA Astrophysics Data System (ADS)

    Aragon, Alejandro Marcos

    Biomimetic microvascular materials are increasingly considered for a variety of autonomic healing, cooling and sensing applications. The microvascular material of interest in this work consists of a network of hollow microchannels, with diameters as small as 10 mum, embedded in a polymeric matrix. Recent advances in the manufacturing of this new class of materials have allowed for the creation of very complex 2D and 3D structures. The computational design of such network structures, which is the focus of this work, involves a set of particular challenges, including a large number of design variables (e.g., topology of the network, number of diameters to consider and their sizes) that define the network, and a large number of multidisciplinary objective functions and constraints that drive the optimization process. The computational design tool to be developed must be capable of capturing the trade-off between the different objective and constraint functions, as, for example, networks designed for flow efficiency are likely to have a topology that is very different from those designed for structural integrity or thermal control. In this work, we propose to design these materials using Genetic Algorithms (GAs), the most common methodology within a broader category of Evolutionary Algorithms (EAs). GAs can be combined with a Pareto-selection mechanism to create Multi-Objective Genetic Algorithms (MOGAs), which enable the optimization of an arbitrary number of objective functions. As a result, a Pareto-optimal front is obtained, where all candidates are optimal solutions to the optimization problem. Adding a procedure to deal with constraints results in a powerful tool for multi-objective constrained optimization. The method allows the use of discrete variable problems and it does not require any a priori knowledge of the optimal solution. Furthermore, GAs search the entire decision space so the optimal solutions found are likely to be global. The

  11. Bariatric surgery and microvascular complications of type 2 diabetes mellitus.

    PubMed

    Jackson, Sabrina; le Roux, Carel W; Docherty, Neil G

    2014-11-01

    Metabolic dysregulation is the defining characteristic of type 2 diabetes mellitus (T2DM) and can give rise to microvascular complications, specifically retinopathy, nephropathy and neuropathy. Pharmacological targeting of risk factors for microvascular complications can yield therapeutic gains, particularly in relation to retinopathy and nephropathy. Bariatric surgery is superior to intensified pharmacotherapy in relation to glycaemic control and can remediate dyslipidaemia and hypertension. Consequently, evidence of the effect of bariatric surgery on microvascular complications is now emerging in the literature. Examination of the recent published evidence base (covering the period 2011-2014) on the effects of bariatric surgery on microvascular complications reveals further evidence supportive of the efficacy of bariatric surgery in preventing the incidence and progression of albuminuria and arresting renal functional decline. Data on retinopathy are more ambivalent potentially representing the potential in some cases for a degree of surgery associated reactive hypoglycaemia to detract from the benefits of amelioration of hyperglycaemia. A significant gap in the literature remains in relation to the effects of surgery on diabetic neuropathy. Overall, there is a pressing need for prospective randomised controlled trials examining long-term microvascular outcomes following bariatric surgery in patients with T2DM.

  12. Brain microvascular function during cardiopulmonary bypass

    SciTech Connect

    Sorensen, H.R.; Husum, B.; Waaben, J.; Andersen, K.; Andersen, L.I.; Gefke, K.; Kaarsen, A.L.; Gjedde, A.

    1987-11-01

    Emboli in the brain microvasculature may inhibit brain activity during cardiopulmonary bypass. Such hypothetical blockade, if confirmed, may be responsible for the reduction of cerebral metabolic rate for glucose observed in animals subjected to cardiopulmonary bypass. In previous studies of cerebral blood flow during bypass, brain microcirculation was not evaluated. In the present study in animals (pigs), reduction of the number of perfused capillaries was estimated by measurements of the capillary diffusion capacity for hydrophilic tracers of low permeability. Capillary diffusion capacity, cerebral blood flow, and cerebral metabolic rate for glucose were measured simultaneously by the integral method, different tracers being used with different circulation times. In eight animals subjected to normothermic cardiopulmonary bypass, and seven subjected to hypothermic bypass, cerebral blood flow, cerebral metabolic rate for glucose, and capillary diffusion capacity decreased significantly: cerebral blood flow from 63 to 43 ml/100 gm/min in normothermia and to 34 ml/100 gm/min in hypothermia and cerebral metabolic rate for glucose from 43.0 to 23.0 mumol/100 gm/min in normothermia and to 14.1 mumol/100 gm/min in hypothermia. The capillary diffusion capacity declined markedly from 0.15 to 0.03 ml/100 gm/min in normothermia but only to 0.08 ml/100 gm/min in hypothermia. We conclude that the decrease of cerebral metabolic rate for glucose during normothermic cardiopulmonary bypass is caused by interruption of blood flow through a part of the capillary bed, possibly by microemboli, and that cerebral blood flow is an inadequate indicator of capillary blood flow. Further studies must clarify why normal microvascular function appears to be preserved during hypothermic cardiopulmonary bypass.

  13. Hypercholesterolemia and microvascular dysfunction: interventional strategies.

    PubMed

    Stapleton, Phoebe A; Goodwill, Adam G; James, Milinda E; Brock, Robert W; Frisbee, Jefferson C

    2010-01-01

    Hypercholesterolemia is defined as excessively high plasma cholesterol levels, and is a strong risk factor for many negative cardiovascular events. Total cholesterol levels above 200 mg/dl have repeatedly been correlated as an independent risk factor for development of peripheral vascular (PVD) and coronary artery disease (CAD), and considerable attention has been directed toward evaluating mechanisms by which hypercholesterolemia may impact vascular outcomes; these include both results of direct cholesterol lowering therapies and alternative interventions for improving vascular function. With specific relevance to the microcirculation, it has been clearly demonstrated that evolution of hypercholesterolemia is associated with endothelial cell dysfunction, a near-complete abrogation in vascular nitric oxide bioavailability, elevated oxidant stress, and the creation of a strongly pro-inflammatory condition; symptoms which can culminate in profound impairments/alterations to vascular reactivity. Effective interventional treatments can be challenging as certain genetic risk factors simply cannot be ignored. However, some hypercholesterolemia treatment options that have become widely used, including pharmaceutical therapies which can decrease circulating cholesterol by preventing either its formation in the liver or its absorption in the intestine, also have pleiotropic effects with can directly improve peripheral vascular outcomes. While physical activity is known to decrease PVD/CAD risk factors, including obesity, psychological stress, impaired glycemic control, and hypertension, this will also increase circulating levels of high density lipoprotein and improving both cardiac and vascular function. This review will provide an overview of the mechanistic consequences of the predominant pharmaceutical interventions and chronic exercise to treat hypercholesterolemia through their impacts on chronic sub-acute inflammation, oxidative stress, and microvascular structure

  14. Leakage-current properties of encapsulants

    NASA Technical Reports Server (NTRS)

    Wen, L. C.

    1986-01-01

    A theoretical modeling of leakage current in ethylene vinyl acetate (EVA) and polyvinyl butyral (PVB) modules is being developed and is described. The modeling effort derives mathematical relationships for the bulk and surface conductivites of EVA and PVB, the surface conductivities of glass and polymeric films, and the EVA and PVB pottants, all as functions of environmental parameters. Results from the modeling indicate that for glass/EVA, the glass surface controls the interfacial conductivity, although EVA bulk conductivity controls total leakage current. For PVB/glass, the interface conductivity controls leakage currents for relative humidity (RH) less than 40 to 50%, but PVB bulk conductivity controls leakage current above 50% RH.

  15. TLR4 signalling in pulmonary stromal cells is critical for inflammation and immunity in the airways.

    PubMed

    Perros, Frederic; Lambrecht, Bart N; Hammad, Hamida

    2011-01-01

    Inflammation of the airways, which is often associated with life-threatening infection by Gram-negative bacteria or presence of endotoxin in the bioaerosol, is still a major cause of severe airway diseases. Moreover, inhaled endotoxin may play an important role in the development and progression of airway inflammation in asthma. Pathologic changes induced by endotoxin inhalation include bronchospasm, airflow obstruction, recruitment of inflammatory cells, injury of the alveolar epithelium, and disruption of pulmonary capillary integrity leading to protein rich fluid leak in the alveolar space. Mammalian Toll-like receptors (TLRs) are important signalling receptors in innate host defense. Among these receptors, TLR4 plays a critical role in the response to endotoxin. Lungs are a complex compartmentalized organ with separate barriers, namely the alveolar-capillary barrier, the microvascular endothelium, and the alveolar epithelium. An emerging theme in the field of lung immunology is that structural cells (SCs) of the airways such as epithelial cells (ECs), endothelial cells, fibroblasts and other stromal cells produce activating cytokines that determine the quantity and quality of the lung immune response. This review focuses on the role of TLR4 in the innate and adaptive immune functions of the pulmonary SCs. PMID:21943186

  16. TLR4 signalling in pulmonary stromal cells is critical for inflammation and immunity in the airways

    PubMed Central

    2011-01-01

    Inflammation of the airways, which is often associated with life-threatening infection by Gram-negative bacteria or presence of endotoxin in the bioaerosol, is still a major cause of severe airway diseases. Moreover, inhaled endotoxin may play an important role in the development and progression of airway inflammation in asthma. Pathologic changes induced by endotoxin inhalation include bronchospasm, airflow obstruction, recruitment of inflammatory cells, injury of the alveolar epithelium, and disruption of pulmonary capillary integrity leading to protein rich fluid leak in the alveolar space. Mammalian Toll-like receptors (TLRs) are important signalling receptors in innate host defense. Among these receptors, TLR4 plays a critical role in the response to endotoxin. Lungs are a complex compartmentalized organ with separate barriers, namely the alveolar-capillary barrier, the microvascular endothelium, and the alveolar epithelium. An emerging theme in the field of lung immunology is that structural cells (SCs) of the airways such as epithelial cells (ECs), endothelial cells, fibroblasts and other stromal cells produce activating cytokines that determine the quantity and quality of the lung immune response. This review focuses on the role of TLR4 in the innate and adaptive immune functions of the pulmonary SCs. PMID:21943186

  17. Free and microvascular bone grafting in the irradiated dog mandible

    SciTech Connect

    Altobelli, D.E.; Lorente, C.A.; Handren, J.H. Jr.; Young, J.; Donoff, R.B.; May, J.W. Jr.

    1987-01-01

    Microvascular and free rib grafts were placed in 4.5 cm defects in an edentate mandibular body defect 18 to 28 days after completion of 50 Gy of irradiation from a /sup 60/Co source. The animals were sacrificed from two to forty weeks postoperatively and evaluated clinically, radiographically, and histologically. There was a marked difference in the alveolar mucosal viability with the two grafts. Mucosal dehiscence was not observed over any of the microvascular grafts, but was present in seven-eighths of the free grafts. Union of the microvascular bone graft to the host bone occurred within six weeks. In contrast, after six weeks the free graft was sequestered in all the animals. An unexpected finding with both types of graft was the marked subperiosteal bone formation. This bone appeared to be derived from the host bed, stabilizing and bridging the defects bilaterally. The results suggest that radiated periosteum may play an important role in osteogenesis.

  18. Regional cutaneous microvascular flow responses during gravitational and LBNP stresses

    NASA Technical Reports Server (NTRS)

    Breit, Gregory A.; Watenpaugh, Donald E.; Ballard, Richard E.; Murthy, Gita; Hargens, Alan R.

    1993-01-01

    Due to the regional variability of local hydrostatic pressures, microvascular flow responses to gravitational stress probably vary along the length of the body. Although these differences in local autoregulation have been observed previously during whole-body tilting, they have not been investigated during application of artificial gravitational stresses, such as lower body negative pressure or high gravity centrifugation. Although these stresses can create equivalent G-levels at the feet, they result in distinct distributions of vascular transmural pressure along the length of the body, and should consequently elicit different magnitudes and distributions of microvascular response. In the present study, the effects of whole-body tilting and lower body negative pressure on the level and distribution of microvascular flows within skin along the length of the body were compared.

  19. Vascular grafts in microvascular surgery. An experimental study

    SciTech Connect

    Marrangoni, A.G.; Marcelli, G.; Culig, M.; Simone, S.T.

    1988-02-01

    The patency of microvascular grafts depends on the luminal diameter, which is determined by the amount of fibrin and platelets deposited on the intraluminal surface and the anastomotic site, and the extent of pseudointimal formation. An experimental microvascular model in rats has been developed in our laboratory using Indium-111-labeled platelets to measure the amount of deposition on grafts inserted into the infrarenal aorta. This study was designed to assess the patency rates in these grafts and the pathologic maturation as determined by light and electron microscopy. Our study suggests that substantial patency rates can be achieved in aspirin-treated rats, although there was little influence on the pathologic maturation. Indium-111 oxine-labeled platelets can be used to document platelet aggregation, and the technique can be a valuable adjunct in the study of microvascular grafts.

  20. Increased airway glucose increases airway bacterial load in hyperglycaemia.

    PubMed

    Gill, Simren K; Hui, Kailyn; Farne, Hugo; Garnett, James P; Baines, Deborah L; Moore, Luke S P; Holmes, Alison H; Filloux, Alain; Tregoning, John S

    2016-01-01

    Diabetes is associated with increased frequency of hospitalization due to bacterial lung infection. We hypothesize that increased airway glucose caused by hyperglycaemia leads to increased bacterial loads. In critical care patients, we observed that respiratory tract bacterial colonisation is significantly more likely when blood glucose is high. We engineered mutants in genes affecting glucose uptake and metabolism (oprB, gltK, gtrS and glk) in Pseudomonas aeruginosa, strain PAO1. These mutants displayed attenuated growth in minimal medium supplemented with glucose as the sole carbon source. The effect of glucose on growth in vivo was tested using streptozocin-induced, hyperglycaemic mice, which have significantly greater airway glucose. Bacterial burden in hyperglycaemic animals was greater than control animals when infected with wild type but not mutant PAO1. Metformin pre-treatment of hyperglycaemic animals reduced both airway glucose and bacterial load. These data support airway glucose as a critical determinant of increased bacterial load during diabetes. PMID:27273266

  1. Increased airway glucose increases airway bacterial load in hyperglycaemia

    PubMed Central

    Gill, Simren K.; Hui, Kailyn; Farne, Hugo; Garnett, James P.; Baines, Deborah L.; Moore, Luke S.P.; Holmes, Alison H.; Filloux, Alain; Tregoning, John S.

    2016-01-01

    Diabetes is associated with increased frequency of hospitalization due to bacterial lung infection. We hypothesize that increased airway glucose caused by hyperglycaemia leads to increased bacterial loads. In critical care patients, we observed that respiratory tract bacterial colonisation is significantly more likely when blood glucose is high. We engineered mutants in genes affecting glucose uptake and metabolism (oprB, gltK, gtrS and glk) in Pseudomonas aeruginosa, strain PAO1. These mutants displayed attenuated growth in minimal medium supplemented with glucose as the sole carbon source. The effect of glucose on growth in vivo was tested using streptozocin-induced, hyperglycaemic mice, which have significantly greater airway glucose. Bacterial burden in hyperglycaemic animals was greater than control animals when infected with wild type but not mutant PAO1. Metformin pre-treatment of hyperglycaemic animals reduced both airway glucose and bacterial load. These data support airway glucose as a critical determinant of increased bacterial load during diabetes. PMID:27273266

  2. Rat Pial Microvascular Responses to Transient Bilateral Common Carotid Artery Occlusion and Reperfusion: Quercetin's Mechanism of Action.

    PubMed

    Lapi, D; Vagnani, S; Pignataro, G; Esposito, E; Paterni, M; Colantuoni, A

    2012-01-01

    The aim of the present study was to assess quercetin's mechanism of action in rat pial microvessels during transient bilateral common carotid artery occlusion (BCCAO) and reperfusion. Rat pial microcirculation was visualized using fluorescence microscopy through a closed cranial window. Pial arterioles were classified in five orders of branchings. In ischemic rats, 30 min BCCAO and 60 min reperfusion caused arteriolar diameter decrease, microvascular leakage, leukocyte adhesion in venules, and reduction of capillary perfusion. Quercetin highest dose determined dilation in all arteriolar orders, by 40 ± 4% of baseline in order 2 vessels, and prevented microvascular permeability [0.15 ± 0.02 normalized gray levels (NGL)], leukocyte adhesion, and capillary failure. Protein kinase C (PKC) inhibition exerted by chelerythrine prior to quercetin attenuated quercetin-induced effects: order 2 arterioles dilated by 19.0 ± 2.4% baseline, while there was an increase in permeability (0.40 ± 0.05 NGL) and leukocyte adhesion with a marked decrease in capillary perfusion. Tyrosine kinase (TK) inhibition by tyrphostin 47 prior to quercetin lessened smaller pial arterioles responses, dilating by 20.7 ± 2.5% of baseline, while leakage increased (0.39 ± 0.04 NGL) sustained by slight leukocyte adhesion and ameliorated capillary perfusion. Inhibition of endothelium nitric oxide synthase (eNOS) by N(G)-nitro-L-arginine-methyl ester (L-NAME) prior to PKC or TK reduced the quercetin's effects on pial arteriolar diameter and leakage. eNOS inhibition by L-NAME reduced quercetin effects on pial arteriolar diameter and leakage. Finally, combined inhibition of PKC and TK prior to quercetin abolished quercetin-induced effects, decreasing eNOS expression, while blocking ATP-sensitive potassium (K(ATP)) channels by glibenclamide suppressed arteriolar dilation. In conclusion, the protective effects of quercetin could be due to different mechanisms resulting in NO

  3. Histamine-induced airway mucosal exudation of bulk plasma and plasma-derived mediators is not inhibited by intravenous bronchodilators.

    PubMed

    Svensson, C; Alkner, U; Pipkorn, U; Persson, C G

    1994-01-01

    Experimental data suggest the possibility that common bronchodilators, such as the xanthines and beta 2-adrenoceptor agonists, may produce microvascular anti-permeability effects in the subepithelial microcirculation of the airways. In this study, we have examined the effect of bronchodilators given intravenously on exudation of different-sized plasma proteins (albumin and fibrinogen) and the generation of plasma-derived peptides (bradykinins) in human nasal airways challenged with histamine. In a double-blind, crossover, placebo-controlled and randomised trial, 12 normal volunteers were given i.v.infusions of terbutaline sulphate, theophylline and enprofylline to produce therapeutic drug levels. The effect of topical nasal provocation with histamine was closely followed by frequently nasal lavage with saline. The lavage fluid levels of albumin, fibrinogen and bradykinins increased significantly after each histamine provocation. The ratio of albumin-to-fibrinogen in plasma and the lavage fluid was 24 and 56, respectively, indicating that topical histamine provocation induced a largely non-sieved flux of macromolecules across the endothelial-epithelial barriers. The systemically administered drugs did not affect the nasal symptoms (sneezing, secretion and blockage), nor did they significantly reduce the levels of plasma proteins and plasma-derived mediators in the nasal lavage fluids. The present data suggest that systemic xanthines and beta 2-adrenoceptor agonists, at clinically employed plasma levels, may not affect the microvascular (and epithelial) exudative permeability and the bradykinin forming capacity of human airways. PMID:8005188

  4. Apoptosis and the Airway Epithelium

    PubMed Central

    White, Steven R.

    2011-01-01

    The airway epithelium functions as a barrier and front line of host defense in the lung. Apoptosis or programmed cell death can be elicited in the epithelium as a response to viral infection, exposure to allergen or to environmental toxins, or to drugs. While apoptosis can be induced via activation of death receptors on the cell surface or by disruption of mitochondrial polarity, epithelial cells compared to inflammatory cells are more resistant to apoptotic stimuli. This paper focuses on the response of airway epithelium to apoptosis in the normal state, apoptosis as a potential regulator of the number and types of epithelial cells in the airway, and the contribution of epithelial cell apoptosis in important airways diseases. PMID:22203854

  5. Extraglottic airway devices: A review

    PubMed Central

    Ramaiah, Ramesh; Das, Debasmita; Bhananker, Sanjay M; Joffe, Aaron M

    2014-01-01

    Extraglottic airway devices (EAD) have become an integral part of anesthetic care since their introduction into clinical practice 25 years ago and have been used safely hundreds of millions of times, worldwide. They are an important first option for difficult ventilation during both in-hospital and out-of-hospital difficult airway management and can be utilized as a conduit for tracheal intubation either blindly or assisted by another technology (fiberoptic endoscopy, lightwand). Thus, the EAD may be the most versatile single airway technique in the airway management toolbox. However, despite their utility, knowledge regarding specific devices and the supporting data for their use is of paramount importance to patient's safety. In this review, number of commercially available EADs are discussed and the reported benefits and potential pitfalls are highlighted. PMID:24741502

  6. United airway disease: current perspectives

    PubMed Central

    Giavina-Bianchi, Pedro; Aun, Marcelo Vivolo; Takejima, Priscila; Kalil, Jorge; Agondi, Rosana Câmara

    2016-01-01

    Upper and lower airways are considered a unified morphological and functional unit, and the connection existing between them has been observed for many years, both in health and in disease. There is strong epidemiologic, pathophysiologic, and clinical evidence supporting an integrated view of rhinitis and asthma: united airway disease in the present review. The term “united airway disease” is opportune, because rhinitis and asthma are chronic inflammatory diseases of the upper and lower airways, which can be induced by allergic or nonallergic reproducible mechanisms, and present several phenotypes. Management of rhinitis and asthma must be jointly carried out, leading to better control of both diseases, and the lessons of the Allergic Rhinitis and Its Impact on Asthma initiative cannot be forgotten. PMID:27257389

  7. Radiofrequency radiation leakage from microwave ovens.

    PubMed

    Lahham, Adnan; Sharabati, Afifeh

    2013-12-01

    This work presents data on the amount of radiation leakage from 117 microwave ovens in domestic and restaurant use in the West Bank, Palestine. The study of leakage is based on the measurements of radiation emissions from the oven in real-life conditions by using a frequency selective field strength measuring system. The power density from individual ovens was measured at a distance of 1 m and at the height of centre of door screen. The tested ovens were of different types, models with operating powers between 1000 and 1600 W and ages ranging from 1 month to >20 y, including 16 ovens with unknown ages. The amount of radiation leakage at a distance of 1 m was found to vary from 0.43 to 16.4 μW cm(-2) with an average value equalling 3.64 μW cm(-2). Leakages from all tested microwave ovens except for seven ovens (∼6 % of the total) were below 10 μW cm(-2). The highest radiation leakage from any tested oven was ∼16.4 μW cm(-2), and found in two cases only. In no case did the leakage exceed the limit of 1 mW cm(-2) recommended by the ICNIRP for 2.45-GHz radiofrequency. This study confirms a linear correlation between the amount of leakage and both oven age and operating power, with a stronger dependence of leakage on age.

  8. 49 CFR 236.735 - Current, leakage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Current, leakage. A stray electric current of relatively small value which flows through or across the... 49 Transportation 4 2010-10-01 2010-10-01 false Current, leakage. 236.735 Section 236.735 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD...

  9. 49 CFR 236.735 - Current, leakage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Current, leakage. A stray electric current of relatively small value which flows through or across the... 49 Transportation 4 2012-10-01 2012-10-01 false Current, leakage. 236.735 Section 236.735 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD...

  10. 49 CFR 236.735 - Current, leakage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Current, leakage. A stray electric current of relatively small value which flows through or across the... 49 Transportation 4 2011-10-01 2011-10-01 false Current, leakage. 236.735 Section 236.735 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD...

  11. 49 CFR 236.735 - Current, leakage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Current, leakage. A stray electric current of relatively small value which flows through or across the... 49 Transportation 4 2014-10-01 2014-10-01 false Current, leakage. 236.735 Section 236.735 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD...

  12. 49 CFR 236.735 - Current, leakage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Current, leakage. A stray electric current of relatively small value which flows through or across the... 49 Transportation 4 2013-10-01 2013-10-01 false Current, leakage. 236.735 Section 236.735 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD...

  13. Predicting Envelope Leakage in Attached Dwellings

    SciTech Connect

    Faakye, O.; Arena, L.; Griffiths, D.

    2013-07-01

    The most common method for measuring air leakage is to use a single blower door to pressurize and/or depressurize the test unit. In detached housing, the test unit is the entire home and the single blower door measures air leakage to the outside. In attached housing, this 'single unit', 'total', or 'solo' test method measures both the air leakage between adjacent units through common surfaces as well air leakage to the outside. Measuring and minimizing this total leakage is recommended to avoid indoor air quality issues between units, reduce energy losses to the outside, reduce pressure differentials between units, and control stack effect. However, two significant limitations of the total leakage measurement in attached housing are: for retrofit work, if total leakage is assumed to be all to the outside, the energy benefits of air sealing can be significantly over predicted; for new construction, the total leakage values may result in failing to meet an energy-based house tightness program criterion. The scope of this research is to investigate an approach for developing a viable simplified algorithm that can be used by contractors to assess energy efficiency program qualification and/or compliance based upon solo test results.

  14. Analysis of Leakage Flows in Turbomachinery

    NASA Technical Reports Server (NTRS)

    Sindir, M. M.

    1986-01-01

    Navier-Stokes calculations predict leakage flow in high-pressure fuel pump. Accurate calculation of internal turbomachinery flow dynamics helps spot possible failure modes and establishes coupling between cyclic loading and structural dynamics. Approach also useful in analyzing two-and quasi-three-dimensional leakage flows in other turbomachinery components.

  15. Bag Test Measures Leakage From Insulated Pipe

    NASA Technical Reports Server (NTRS)

    Schock, Kent D.; Easter, Barry P.

    1994-01-01

    Test quantifies leakage of gas from pipe even though pipe covered with insulation. Involves use of helium analyzer to measure concentration of helium in impermeable bag around pipe. Test administered after standard soap-solution bubble test indicates presence and general class of leakage.

  16. Calculating Leakage Around Turbopump Inducer Shrouds

    NASA Technical Reports Server (NTRS)

    Meng, Sen Yih; Sindir, Munir M.

    1987-01-01

    New mathematical model for leakage flow around shrouded turbopump inducers yields more realistic analyses from which designers determine best geometry for leakage-flow-reinjection ports. Also, designers use calculated velocity profile at inducer leading edge to determine blade-angle distribution of inducer leading edge.

  17. Airway Surface Mycosis in Chronic Th2-Associated Airway Disease

    PubMed Central

    Porter, Paul; Lim, Dae Jun; Maskatia, Zahida Khan; Mak, Garbo; Tsai, Chu-Lin; Citardi, Martin J; Fakhri, Samer; Shaw, Joanne L.; Fothergil, Annette; Kheradmand, Farrah; Corry, David B; Luong, Amber

    2014-01-01

    Background Environmental fungi have been linked to T helper type 2 (Th2) cell-related airway inflammation and the Th2-associated chronic airway diseases asthma, chronic rhinosinusitis with nasal polyps (CRSwNP) and allergic fungal rhinosinusitis (AFRS), but whether these organisms participate directly or indirectly in disease pathology remains unknown. Objective To determine the frequency of fungus isolation and fungus-specific immunity in Th2-associated and non-associated airway disease patients. Methods Sinus lavage fluid and blood were collected from sinus surgery patients (n=118) including CRS patients with and without nasal polyps and AFRS and non-CRS/non-asthmatic control patients. Asthma status was deteremined from medical history. Sinus lavage fluids were cultured and directly examined for evidence of viable fungi. Peripheral blood mononuclear cells were restimulated with fungal antigens in an enzyme linked immunocell spot (ELISpot) assay to determine total memory fungus-specific IL-4-secreting cells. These data were compared to fungus-specific IgE levels measured from plasma by ELISA. Results Filamentous fungi were significantly more commonly cultured from Th2-associated airway disease subjects (asthma, CRSwNP, or AFRS: n=68) compared to non-Th2-associated control patients (n=31); 74% vs 16% respectively, p<0.001. Both fungus-specific IL-4 ELISpot (n=48) and specific IgE (n=70) data correlated with Th2-associated diseases (sensitivity 73% and specificity 100% vs. 50% and 77%, respectively). Conclusions The frequent isolation of fungi growing directly within the airways accompanied by specific immunity to these organisms only in patients with Th2-associated chronic airway diseases suggests that fungi participate directly in the pathogenesis of these conditions. Efforts to eradicate airway fungi from the airways should be considered in selected patients. Clinical Implications Airway fungi may contribute to the expression of sinusitis with nasal polyps and

  18. Microvascular effects of copper deficiency in rats

    SciTech Connect

    Schuschke, D.A.; Saari, J.T.; Ackermann, D.M.; Miller, F.N. )

    1989-02-15

    We have studied the microcirculatory responses in copper deficient rats using the rat cremaster muscle preparation. Male Sprague-Dawley rats were fed either a copper supplemented diet (CuS, 5 ppm) or a copper deficient diet (CuD, O ppm) for five weeks prior to experimentation. The rats (240-300g) were anesthetized with pentobarbital and the cremaster (with intact nerve and blood supply) were spread in a tissue bath filled with krebs solution. In vivo television microscopy was used to observe the microcirculation. Fluorescein isothiocyanate tagged to bovine serum albumin (FITC-BSA) was injected i.a. 30 min prior to the start of experimentation. In the CuS animals photoactivation of the intravascular FITC-BSA caused significant platelet aggregation and reduction in red blood cell column diameter (RBCCD) by 30 min and stasis of flow by 60 min. In CuD animals there was no reduction in RBCCD and only minor platelet aggregation after 60 min of photoactivation. Topical administration of compound 48/80 (1.0 and 10.0 {mu}g/ml) induced a significantly greater macromolecular leakage (increased interstitial fluorescence of FITC-BSA) in the CuD animals than in the control, CuS animals. These results suggest that copper deficiency results in marked alterations of the regulatory mechanisms governing thrombosis and inflammation.

  19. Airway obstruction with cricoid pressure.

    PubMed

    Hartsilver, E L; Vanner, R G

    2000-03-01

    Cricoid pressure may cause airway obstruction. We investigated whether this is related to the force applied and to the technique of application. We recorded expired tidal volumes and inflation pressures during ventilation via a face-mask and oral airway in 52 female patients who were anaesthetised and about to undergo elective surgery. An inspired tidal volume of 900 ml was delivered using a ventilator. Ventilation was assessed under five different conditions: no cricoid pressure, backwards cricoid pressure applied with a force of 30 N, cricoid pressure applied in an upward and backward direction with a force of 30 N, backwards cricoid pressure with a force of 44 N and through a tracheal tube. An expired tidal volume of < 200 ml was taken to indicate airway obstruction. Airway obstruction did not occur without cricoid pressure, but did occur in one patient (2%) with cricoid pressure at 30 N, in 29 patients (56%) with 30 N applied in an upward and backward direction and in 18 (35%) patients with cricoid pressure at 44 N. Cricoid pressure applied with a force of 44 N can cause airway obstruction but if cricoid pressure is applied with a force of 30 N, airway obstruction occurs less frequently (p = 0.0001) unless the force is applied in an upward and backward direction.

  20. A new removable airway stent

    PubMed Central

    Amundsen, Tore; Sørhaug, Sveinung; Leira, Håkon Olav; Tyvold, Stig Sverre; Langø, Thomas; Hammer, Tommy; Manstad-Hulaas, Frode; Mattsson, Erney

    2016-01-01

    Background Malignant airway obstruction is a feared complication and will most probably occur more frequently in the future because of increasing cancer incidence and increased life expectancy in cancer patients. Minimal invasive treatment using airway stents represents a meaningful and life-saving palliation. We present a new removable airway stent for improved individualised treatment. Methods To our knowledge, the new airway stent is the world's first knitted and uncovered self-expanding metal stent, which can unravel and be completely removed. In an in vivo model using two anaesthetised and spontaneously breathing pigs, we deployed and subsequently removed the stents by unravelling the device. The procedures were executed by flexible bronchoscopy in an acute and a chronic setting – a ‘proof-of-principle’ study. Results The new stent was easily and accurately deployed in the central airways, and it remained fixed in its original position. It was easy to unravel and completely remove from the airways without clinically significant complications. During the presence of the stent in the chronic study, granulation tissue was induced. This tissue disappeared spontaneously with the removal. Conclusions The new removable stent functioned according to its purpose and unravelled easily, and it was completely removed without significant technical or medical complications. Induced granulation tissue disappeared spontaneously. Further studies on animals and humans are needed to define its optimal indications and future use. PMID:27608269

  1. Airway obstruction with cricoid pressure.

    PubMed

    Hartsilver, E L; Vanner, R G

    2000-03-01

    Cricoid pressure may cause airway obstruction. We investigated whether this is related to the force applied and to the technique of application. We recorded expired tidal volumes and inflation pressures during ventilation via a face-mask and oral airway in 52 female patients who were anaesthetised and about to undergo elective surgery. An inspired tidal volume of 900 ml was delivered using a ventilator. Ventilation was assessed under five different conditions: no cricoid pressure, backwards cricoid pressure applied with a force of 30 N, cricoid pressure applied in an upward and backward direction with a force of 30 N, backwards cricoid pressure with a force of 44 N and through a tracheal tube. An expired tidal volume of < 200 ml was taken to indicate airway obstruction. Airway obstruction did not occur without cricoid pressure, but did occur in one patient (2%) with cricoid pressure at 30 N, in 29 patients (56%) with 30 N applied in an upward and backward direction and in 18 (35%) patients with cricoid pressure at 44 N. Cricoid pressure applied with a force of 44 N can cause airway obstruction but if cricoid pressure is applied with a force of 30 N, airway obstruction occurs less frequently (p = 0.0001) unless the force is applied in an upward and backward direction. PMID:10671836

  2. Thermal provocation to evaluate microvascular reactivity in human skin

    PubMed Central

    2010-01-01

    With increased interest in predictive medicine, development of a relatively noninvasive technique that can improve prediction of major clinical outcomes has gained considerable attention. Current tests that are the target of critical evaluation, such as flow-mediated vasodilation of the brachial artery and pulse-wave velocity, are specific to the larger conduit vessels. However, evidence is mounting that functional changes in the microcirculation may be an early sign of globalized microvascular dysfunction. Thus development of a test of microvascular reactivity that could be used to evaluate cardiovascular risk or response to treatment is an exciting area of innovation. This mini-review is focused on tests of microvascular reactivity to thermal stimuli in the cutaneous circulation. The skin may prove to be an ideal site for evaluation of microvascular dysfunction due to its ease of access and growing evidence that changes in skin vascular reactivity may precede overt clinical signs of disease. Evaluation of the skin blood flow response to locally applied heat has already demonstrated prognostic utility, and the response to local cooling holds promise in patients in whom cutaneous disorders are present. Whether either of these tests can be used to predict cardiovascular morbidity or mortality in a clinical setting requires further evaluation. PMID:20507974

  3. Xenobiotic Particle Exposure and Microvascular Endpoints: A Call to Arms

    PubMed Central

    Stapleton, Phoebe A.; Minarchick, Valerie C.; McCawley, Michael; Knuckles, Travis L.; Nurkiewicz, Timothy R.

    2011-01-01

    Xenobiotic particles can be considered in two genres: air pollution particulate matter and engineered nanoparticles. Particle exposures can occur in the greater environment, the workplace, and our homes. The majority of research in this field has, justifiably, focused on pulmonary reactions and outcomes. More recent investigations indicate that cardiovascular effects are capable of correlating with established mortality and morbidity epidemiological data following particle exposures. While the preliminary and general cardiovascular toxicology has been defined, the mechanisms behind these effects, specifically within the microcirculation, are largely unexplored. Therefore, the purpose of this review is several fold: first, a historical background on toxicological aspects of particle research is presented. Second, essential definitions, terminology, and techniques that may be unfamiliar to the microvascular scientist will be discussed. Third, the most current concepts and hypotheses driving cardiovascular research in this field will be reviewed. Lastly, potential future directions for the microvascular scientist will be suggested. Collectively speaking, microvascular research in the particle exposure field represents far more than a “niche”. The immediate demand for basic, translational, and clinical studies is high and diverse. Microvascular scientists at all career stages are strongly encouraged to expand their research interests to include investigations associated with particle exposures. PMID:21951337

  4. Targeting brain microvascular endothelial cells: a therapeutic approach to neuroprotection against stroke

    PubMed Central

    Yu, Qi-jin; Tao, Hong; Wang, Xin; Li, Ming-chang

    2015-01-01

    Brain microvascular endothelial cells form the interface between nervous tissue and circulating blood, and regulate central nervous system homeostasis. Brain microvascular endothelial cells differ from peripheral endothelial cells with regards expression of specific ion transporters and receptors, and contain fewer fenestrations and pinocytotic vesicles. Brain microvascular endothelial cells also synthesize several factors that influence blood vessel function. This review describes the morphological characteristics and functions of brain microvascular endothelial cells, and summarizes current knowledge regarding changes in brain microvascular endothelial cells during stroke progression and therapies. Future studies should focus on identifying mechanisms underlying such changes and developing possible neuroprotective therapeutic interventions. PMID:26807131

  5. Human airway ciliary dynamics

    PubMed Central

    Thompson, Kristin; Knowles, Michael R.; Davis, C. William

    2013-01-01

    Airway cilia depend on precise changes in shape to transport the mucus gel overlying mucosal surfaces. The ciliary motion can be recorded in several planes using video microscopy. However, cilia are densely packed, and automated computerized systems are not available to convert these ciliary shape changes into forms that are useful for testing theoretical models of ciliary function. We developed a system for converting planar ciliary motions recorded by video microscopy into an empirical quantitative model, which is easy to use in validating mathematical models, or in examining ciliary function, e.g., in primary ciliary dyskinesia (PCD). The system we developed allows the manipulation of a model cilium superimposed over a video of beating cilia. Data were analyzed to determine shear angles and velocity vectors of points along the cilium. Extracted waveforms were used to construct a composite waveform, which could be used as a standard. Variability was measured as the mean difference in position of points on individual waveforms and the standard. The shapes analyzed were the end-recovery, end-effective, and fastest moving effective and recovery with mean (± SE) differences of 0.31(0.04), 0.25(0.06), 0.50(0.12), 0.50(0.10), μm, respectively. In contrast, the same measures for three different PCD waveforms had values far outside this range. PMID:23144323

  6. Airway Hydration and COPD

    PubMed Central

    Ghosh, Arunava; Boucher, R.C.; Tarran, Robert

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is one of the prevalent causes of worldwide mortality and encompasses two major clinical phenotypes, i.e., chronic bronchitis (CB) and emphysema. The most common cause of COPD is chronic tobacco inhalation. Research focused on the chronic bronchitic phenotype of COPD has identified several pathological processes that drive disease initiation and progression. For example, the lung’s mucociliary clearance (MCC) system performs the critical task of clearing inhaled pathogens and toxic materials from the lung. MCC efficiency is dependent on: (i) the ability of apical plasma membrane ion channels such as the cystic fibrosis transmembrane conductance regulator (CFTR) and the epithelial Na+ channel (ENaC) to maintain airway hydration; (ii) ciliary beating; and, (iii) appropriate rates of mucin secretion. Each of these components is impaired in CB and likely contributes to the mucus stasis/accumulation seen in CB patients. This review highlights the cellular components responsible for maintaining MCC and how this process is disrupted following tobacco exposure and with CB. We shall also discuss existing therapeutic strategies for the treatment of chronic bronchitis and how components of the MCC can be used as biomarkers for the evaluation of tobacco or tobacco-like-product exposure. PMID:26068443

  7. A Novel Microvascular Flow Technique: Initial Results in Thyroids.

    PubMed

    Machado, Priscilla; Segal, Sharon; Lyshchik, Andrej; Forsberg, Flemming

    2016-03-01

    To evaluate the flow imaging capabilities of a new prototype ultrasound (US) image processing technique (superb micro-vascular imaging [SMI]; Toshiba Medical Systems, Tokyo, Japan) for depiction of microvascular flow in normal thyroid tissue and thyroid nodules compared with standard color and power Doppler US imaging.Ten healthy volunteers and 22 patients, with a total of 25 thyroid nodules, scheduled for US-guided fine needle aspiration were enrolled in this prospective study. Subjects underwent US examination consisting of grayscale, color and power Doppler imaging (CDI and PDI) followed by color and monochrome SMI and pulsed Doppler. SMI is a novel, microvascular flow imaging mode implemented on the Aplio 500 US system (Toshiba). SMI uses advanced clutter suppression to extract flow signals from large to small vessels and depicts this information at high frame rates as a color overlay image or as a monochrome map of flow. Two radiologists independently scored still images and digital clips for overall flow detection, vessel branching details and noise on a visual-analog scale of 1 (worst) to 10 (best).For the volunteers SMI visualized microvasculature with significantly lower velocity than CDI and PDI (P < 0.012). In all thyroid nodules, SMI demonstrated microvascular flow with significantly higher image scores and provided better depiction of the vessel branching details compared with CDI and PDI (P < 0.0001). Clutter noise was significantly higher in monochrome SMI mode than in the other modes, including color SMI (P < 0.001).The novel SMI mode consistently improved the depiction of thyroid microvascular flow compared with standard CDI and PDI.

  8. A Novel Microvascular Flow Technique: Initial Results in Thyroids.

    PubMed

    Machado, Priscilla; Segal, Sharon; Lyshchik, Andrej; Forsberg, Flemming

    2016-03-01

    To evaluate the flow imaging capabilities of a new prototype ultrasound (US) image processing technique (superb micro-vascular imaging [SMI]; Toshiba Medical Systems, Tokyo, Japan) for depiction of microvascular flow in normal thyroid tissue and thyroid nodules compared with standard color and power Doppler US imaging.Ten healthy volunteers and 22 patients, with a total of 25 thyroid nodules, scheduled for US-guided fine needle aspiration were enrolled in this prospective study. Subjects underwent US examination consisting of grayscale, color and power Doppler imaging (CDI and PDI) followed by color and monochrome SMI and pulsed Doppler. SMI is a novel, microvascular flow imaging mode implemented on the Aplio 500 US system (Toshiba). SMI uses advanced clutter suppression to extract flow signals from large to small vessels and depicts this information at high frame rates as a color overlay image or as a monochrome map of flow. Two radiologists independently scored still images and digital clips for overall flow detection, vessel branching details and noise on a visual-analog scale of 1 (worst) to 10 (best).For the volunteers SMI visualized microvasculature with significantly lower velocity than CDI and PDI (P < 0.012). In all thyroid nodules, SMI demonstrated microvascular flow with significantly higher image scores and provided better depiction of the vessel branching details compared with CDI and PDI (P < 0.0001). Clutter noise was significantly higher in monochrome SMI mode than in the other modes, including color SMI (P < 0.001).The novel SMI mode consistently improved the depiction of thyroid microvascular flow compared with standard CDI and PDI. PMID:25900162

  9. Efficacy of Surgical Airway Plasty for Benign Airway Stenosis

    PubMed Central

    Takahama, Makoto; Nakajima, Ryu; Kimura, Michitaka; Inoue, Hidetoshi; Yamamoto, Ryoji

    2015-01-01

    Background: Long-term patency is required during treatment for benign airway stenosis. This study investigated the effectiveness of surgical airway plasty for benign airway stenosis. Methods: Clinical courses of 20 patients, who were treated with surgical plasty for their benign airway stenosis, were retrospectively investigated. Results: Causes of stenosis were tracheobronchial tuberculosis in 12 patients, post-intubation stenosis in five patients, malacia in two patients, and others in one patient. 28 interventional pulmonology procedures and 20 surgical plasty were performed. Five patients with post-intubation stenosis and four patients with tuberculous stenosis were treated with tracheoplasty. Eight patients with tuberculous stenosis were treated with bronchoplasty, and two patients with malacia were treated with stabilization of the membranous portion. Anastomotic stenosis was observed in four patients, and one to four additional treatments were required. Performance status, Hugh–Jones classification, and ventilatory functions were improved after surgical plasty. Outcomes were fair in patients with tuberculous stenosis and malacia. However, efficacy of surgical plasty for post-intubation stenosis was not observed. Conclusion: Surgical airway plasty may be an acceptable treatment for tuberculous stenosis. Patients with malacia recover well after surgical plasty. There may be untreated patients with malacia who have the potential to benefit from surgical plasty. PMID:26567879

  10. Air leakage of newly instaled residential windows

    SciTech Connect

    Weidt, J.; Weidt, J.

    1980-06-01

    The air-leakage characteristics of five major window designs were measured in a field survey conducted in Twin Cities, Minnesota. A total of 192 windows (16 manufacturers) were tested at 58 sites representing a cross-section of single-family homes, townhouses, low- and high-rise apartments, and condominiums. Air-leakage measurements of the installed windows were compared with the current standard used by industry and government of 0.50 ft/sup 3//min/linear ft of crack. Other parameters studied were: effect of sash and frame material, effect of leakage between window frame and wall, differences among the product lines of a single manufacturer and between manufacturers, effect of installation practices, effect of cold weather on performance, change in performance over time for older windows, and performance of fixed glazing. Based on industry and government standards, 40% of all windows tested showed air-leakage characteristics higher than the 0.50 cfm/lfc standard, and 60% exceeded manufacturers' specifications for performance which in some cases were lower than the general industry standard. Analysis of the impact of various parameters on air-leakage performance showed that the operational design of the window was the most critical determinant although the ranking changes if performance is expressed in cfm/unit area or cfm/opening area. Air leakage was measured using a portable pressurization chamber. Smoke pencils, thermographic techniques and extensive photographic documentation provided additional data as to the location and cause of air leakage problems.

  11. Accurate airway segmentation based on intensity structure analysis and graph-cut

    NASA Astrophysics Data System (ADS)

    Meng, Qier; Kitsaka, Takayuki; Nimura, Yukitaka; Oda, Masahiro; Mori, Kensaku

    2016-03-01

    This paper presents a novel airway segmentation method based on intensity structure analysis and graph-cut. Airway segmentation is an important step in analyzing chest CT volumes for computerized lung cancer detection, emphysema diagnosis, asthma diagnosis, and pre- and intra-operative bronchoscope navigation. However, obtaining a complete 3-D airway tree structure from a CT volume is quite challenging. Several researchers have proposed automated algorithms basically based on region growing and machine learning techniques. However these methods failed to detect the peripheral bronchi branches. They caused a large amount of leakage. This paper presents a novel approach that permits more accurate extraction of complex bronchial airway region. Our method are composed of three steps. First, the Hessian analysis is utilized for enhancing the line-like structure in CT volumes, then a multiscale cavity-enhancement filter is employed to detect the cavity-like structure from the previous enhanced result. In the second step, we utilize the support vector machine (SVM) to construct a classifier for removing the FP regions generated. Finally, the graph-cut algorithm is utilized to connect all of the candidate voxels to form an integrated airway tree. We applied this method to sixteen cases of 3D chest CT volumes. The results showed that the branch detection rate of this method can reach about 77.7% without leaking into the lung parenchyma areas.

  12. Coronary Microvascular Dysfunction and Microvascular Angina: A Systematic Review of Therapies

    PubMed Central

    Marinescu, Mark A; Löffler, Adrián I.; Ouellette, Michelle; Smith, Lavone; Kramer, Christopher M.; Bourque, Jamieson

    2015-01-01

    Angina without coronary artery disease (CAD) has substantial morbidity and is present in 10–30% of patients undergoing angiography. Coronary microvascular dysfunction (CMD) is present in 50–65% of these patients. The optimal treatment of this cohort is undefined. We performed a systematic review to evaluate treatment strategies for objectively defined CMD in the absence of CAD. We included studies assessing therapy in human subjects with angina and coronary flow reserve (CFR) or myocardial perfusion reserve (MPR) <2.5 by positron emission tomography (PET), cardiac magnetic resonance imaging (CMR), dilution methods, or intracoronary Doppler in the absence of coronary artery stenosis ≥50% or structural heart disease. Only 8 articles met strict inclusion criteria. The articles were heterogeneous, using different treatments, end-points, and definitions of CMD. Small sample sizes severely limit the power of these studies, with an average of 11 patients per analysis. Studies evaluating, sildenafil, quinapril, estrogen, and transcutaneous electrical nerve stimulation (TENS) application demonstrated benefits in their respective endpoints. No benefit was found with L-arginine, doxazosin, pravastatin, and diltiazem. Our systematic review highlights that there is little data to support therapies for CMD. We assess the data meeting rigorous inclusion criteria and review the related but excluded literature. We additionally describe the next steps needed to address this research gap, including a standardized definition of CMD, routine assessment of CMD in studies of chest pain without obstructive CAD, and specific therapy assessment in the population with confirmed CMD. PMID:25677893

  13. Allergen-induced airway responses.

    PubMed

    Gauvreau, Gail M; El-Gammal, Amani I; O'Byrne, Paul M

    2015-09-01

    Environmental allergens are an important cause of asthma and can contribute to loss of asthma control and exacerbations. Allergen inhalation challenge has been a useful clinical model to examine the mechanisms of allergen-induced airway responses and inflammation. Allergen bronchoconstrictor responses are the early response, which reaches a maximum within 30 min and resolves by 1-3 h, and late responses, when bronchoconstriction recurs after 3-4 h and reaches a maximum over 6-12 h. Late responses are followed by an increase in airway hyperresponsiveness. These responses occur when IgE on mast cells is cross-linked by an allergen, causing degranulation and the release of histamine, neutral proteases and chemotactic factors, and the production of newly formed mediators, such as cysteinyl leukotrienes and prostaglandin D2. Allergen-induced airway inflammation consists of an increase in airway eosinophils, basophils and, less consistently, neutrophils. These responses are mediated by the trafficking and activation of myeloid dendritic cells into the airways, probably as a result of the release of epithelial cell-derived thymic stromal lymphopoietin, and the release of pro-inflammatory cytokines from type 2 helper T-cells. Allergen inhalation challenge has also been a widely used model to study potential new therapies for asthma and has an excellent negative predictive value for this purpose. PMID:26206871

  14. The Airway Microbiome at Birth

    PubMed Central

    Lal, Charitharth Vivek; Travers, Colm; Aghai, Zubair H.; Eipers, Peter; Jilling, Tamas; Halloran, Brian; Carlo, Waldemar A.; Keeley, Jordan; Rezonzew, Gabriel; Kumar, Ranjit; Morrow, Casey; Bhandari, Vineet; Ambalavanan, Namasivayam

    2016-01-01

    Alterations of pulmonary microbiome have been recognized in multiple respiratory disorders. It is critically important to ascertain if an airway microbiome exists at birth and if so, whether it is associated with subsequent lung disease. We found an established diverse and similar airway microbiome at birth in both preterm and term infants, which was more diverse and different from that of older preterm infants with established chronic lung disease (bronchopulmonary dysplasia). Consistent temporal dysbiotic changes in the airway microbiome were seen from birth to the development of bronchopulmonary dysplasia in extremely preterm infants. Genus Lactobacillus was decreased at birth in infants with chorioamnionitis and in preterm infants who subsequently went on to develop lung disease. Our results, taken together with previous literature indicating a placental and amniotic fluid microbiome, suggest fetal acquisition of an airway microbiome. We speculate that the early airway microbiome may prime the developing pulmonary immune system, and dysbiosis in its development may set the stage for subsequent lung disease. PMID:27488092

  15. Composite seal reduces alkaline battery leakage

    NASA Technical Reports Server (NTRS)

    Clatterbuck, C. H.; Plitt, K. F.

    1965-01-01

    Composite seal consisting of rubber or plastic washers and a metal washer reduces alkaline battery leakage. Adhesive is applied to each washer interface, and the washers are held together mechanically.

  16. Temperature effects on soybean imbibition and leakage.

    PubMed

    Leopold, A C

    1980-06-01

    As a part of an analysis of the nature of chilling injury to seeds, measurements were made of the initial linear rates of water entry into and solute leakage out of cotyledons of soybean at various temperatures. Arrhenius plots were approximately linear for water entry into both living and dead cotyledons, with the slope (and activation energy) for entry into living cells being insignificantly higher than for dead cells, suggesting little effect of membrane barriers on water entry. The plots for solute leakage showed 10-fold lower leakage rates from living than from dead tissues; a reversal of slope in the Arrhenius plot at temperatures below 15 C reflected increasing leakage rates, interpreted as a quantitative disruption of membrane reorganization at the temperatures associated with chilling injury.

  17. Apparatus for detecting leakage of liquid sodium

    DOEpatents

    Himeno, Yoshiaki

    1978-01-01

    An apparatus for detecting the leakage of liquid sodium includes a cable-like sensor adapted to be secured to a wall of piping or other equipment having sodium on the opposite side of the wall, and the sensor includes a core wire electrically connected to the wall through a leak current detector and a power source. An accidental leakage of the liquid sodium causes the corrosion of a metallic layer and an insulative layer of the sensor by products resulted from a reaction of sodium with water or oxygen in the atmospheric air so as to decrease the resistance between the core wire and the wall. Thus, the leakage is detected as an increase in the leaking electrical current. The apparatus is especially adapted for use in detecting the leakage of liquid sodium from sodium-conveying pipes or equipment in a fast breeder reactor.

  18. Regional cutaneous microvascular flow responses during gravitational and LBNP stresses.

    PubMed

    Breit, G A; Watenpaugh, D E; Ballard, R E; Murthy, G; Hargens, A R

    1993-01-01

    The most significant cardiovascular event during the transition to microgravity is the redistribution of vascular transmural pressures that results from the loss of hydrostatic gradients along the length of the body. The well-documented effects of this redistribution include facial venous engorgement, headache, and a significant decrease in leg volume. These effects predominantly represent bulk fluid volume shifts, especially in the venous macro- and microcirculation, where volume is a direct function of pressure, related by the mechanical compliance of the vascular compartment. When considering the effect of gravitational pressure alterations on microcirculatory blood flow and volume, however, this direct monotonic relationship no longer applies. Regional microvascular perfusion is largely a function of local arteriolar tone, which is subject to a variety of central and local controls. Lower body venous pooling during application of footward gravitational stress unloads arterial and cardiopulmonary baroreceptors, increasing sympathetic arteriolar tone to elicit vasoconstriction and a general decrease in microvascular perfusion. The same stimulus also triggers an increase in the levels of circulating vasoactive hormones, such as norepinephrine and angiotensin II, further augmenting arteriolar tone. Vasomotor tone is also mediated by local mechanisms such as myogenic autoregulation and veno-arteriolar reflexes, which enhance microvascular tone in response to elevated local arteriolar and venular pressure, respectively. Due to the regional variability of local hydrostatic pressures, microvascular flow responses to gravitational stress probably vary along the length of the body. Although these differences in local autoregulation have been observed previously during whole-body tilting, they have not been investigated during application of artificial gravitational stresses, such as lower body negative pressure (LBNP) or +Gz centrifugation. Although these stresses can

  19. Initial DAB Argon Storage Dewar Leakage

    SciTech Connect

    Dixon, K.; /Fermilab

    1990-05-30

    Any detectable leakage emanating from the argon storage dewar is undesirable; not only from a safety standpoint (eg, cryogenic burns, asphyxiation, etc.), but also small amounts of air back diffusing through leaks can render the argon unsuitable for the future physics experiments to take place within the cryostats. Whereas leakage through some of the control and manually operated valves on the dewar does not necessarily infroduce any of the above hazards directly, it could be high enough to be an economical, and perhaps an operational nuisance. Contained in the following is a compilation of the final leakage rates associated with the dewar during the period of January through May of 1990 and the raw data from which they were derived from. Also contained is a calculation of the total maximum allowable leakage rate int%ut of the dewar. The general strategy employed while leak checking the dewar was to eliminate all leaks found which could be relatively easily stopped and to reduce the more difficult ones to an acceptable level. Leakage past the seats/plugs of control and main relief valves in addition to leakage past the ball seals in the diverter valve fell into the latter category. Helium mass spectrometer leak detector (HMSLD), rate of rise (ROR) method, and throughput calculations based on effective pumping speeds were the means used to determine leakage rates. Usually the HMSLD method was used to detect the numerous smaller leaks (1 OE-S to 1 OE-1 0 std eels) which were eventually stopped by thread tightening, gasket replacement. redesign, etc. The ROR method helped measure the leakage past valve plugs and establish outgassing rates for volumes deemed as being tight; ie, no detectable leakage using the HMSLD. The throughput calculation was used only to determine the relatively large leak past the plug/seat of the vaporizer valve. A sample calculation of each leakage rate determining method is attached to this note. All leakage rates are given for helium gas at

  20. [Bile leakage in laparoscopic cholecystectomy. Authors' experience].

    PubMed

    Sperlongano, P; Pisaniello, D; Corsale, I; Cozza, G

    1999-01-01

    The Authors report their experience of two patients with bile leakage following videocholecystectomy (VLC) among a series of 163 cases. Reviewing the Literature, they analyze possible causes and mechanisms of bile spillage occurring after VCL. They also suggest some guidelines for a safe VLC, stressing the importance of the routinary placement of the sub-hepatic drainage to remove 48 hours to early detect possible bile leakages after surgery.

  1. Gate leakage mechanisms in strained Si devices

    NASA Astrophysics Data System (ADS)

    Yan, L.; Olsen, S. H.; Kanoun, M.; Agaiby, R.; O'Neill, A. G.

    2006-11-01

    This work investigates gate leakage mechanisms in advanced strained Si /SiGe metal-oxide-semiconductor field-effect transistor (MOSFET) devices. The impact of virtual substrate Ge content, epitaxial material quality, epitaxial layer structure, and device processing on gate oxide leakage characteristics are analyzed in detail. In state of the art MOSFETs, gate oxides are only a few nanometers thick. In order to minimize power consumption, leakage currents through the gate must be controlled. However, modifications to the energy band structure, Ge diffusion due to high temperature processing, and Si /SiGe material quality may all affect gate oxide leakage in strained Si devices. We show that at high oxide electric fields where gate leakage is dominated by Fowler-Nordheim tunneling, tensile strained Si MOSFETs exhibit lower leakage levels compared with bulk Si devices. This is a direct result of strain-induced splitting of the conduction band states. However, for device operating regimes at lower oxide electric fields Poole-Frenkel emissions contribute to strained Si gate leakage and increase with increasing virtual substrate Ge content. The emissions are shown to predominantly originate from surface roughness generating bulk oxide traps, opposed to Ge diffusion, and can be improved by introducing a high temperature anneal. Gate oxide interface trap density exhibits a dissimilar behavior and is highly sensitive to Ge atoms at the oxidizing surface, degrading with increasing thermal budget. Consequently advanced strained Si /SiGe devices are inadvertently subject to a potential tradeoff between power consumption (gate leakage current) and device reliability (gate oxide interface quality).

  2. Measuring Heat-Exchanger Water Leakage

    NASA Technical Reports Server (NTRS)

    Zampiceni, J.

    1986-01-01

    Water leakage in heat exchanger measured directly with help of electroytic hygrometer. In new technique, flow of nitrogen gas set up in one loop of heat exchanger. Other loop filled with water under pressure. Water concentration produced by leakage of water into nitrogen flow measured by hygrometer. New measurement method determines water concentrations up to 2,000 parts per million with accuracy of +/- 5 percent.

  3. Technology evaluation for space station atmospheric leakage

    SciTech Connect

    Lemon, D.K.; Friesel, M.A.; Griffin, J.W.; Skorpik, J.R.; Shepard, C.L.; Antoniak, Z.I.; Kurtz, R.J.

    1990-02-01

    A concern in operation of a space station is leakage of atmosphere through seal points and through the walls as a result of damage from particle (space debris and micrometeoroid) impacts. This report describes a concept for a monitoring system to detect atmosphere leakage and locate the leak point. The concept is based on analysis and testing of two basic methods selected from an initial technology survey of potential approaches. 18 refs., 58 figs., 5 tabs.

  4. Postnatal Exposure History and Airways

    PubMed Central

    Murphy, Shannon R.; Schelegle, Edward S.; Edwards, Patricia C.; Miller, Lisa A.; Hyde, Dallas M.

    2012-01-01

    Postnatally, the lung continues to grow and differentiate while interacting with the environment. Exposure to ozone (O3) and allergens during postnatal lung development alters structural elements of conducting airways, including innervation and neurokinin abundance. These changes have been linked with development of asthma in a rhesus monkey model. We hypothesized that O3 exposure resets the ability of the airways to respond to oxidant stress and that this is mediated by changes in the neurokinin-1 receptor (NK-1R). Infant rhesus monkeys received episodic exposure to O3 biweekly with or without house dust mite antigen (HDMA) from 6 to 12 months of age. Age-matched monkeys were exposed to filtered air (FA). Microdissected airway explants from midlevel airways (intrapulmonary generations 5–8) for four to six animals in each of four groups (FA, O3, HDMA, and HDMA+O3) were tested for NK-1R gene responses to acute oxidant stress using exposure to hydrogen peroxide (1.2 mM), a lipid ozonide (10 μM), or sham treatment for 4 hours in vitro. Airway responses were measured using real-time quantitative RT-PCR of NK-1R and IL-8 gene expression. Basal NK-1R gene expression levels were not different between the exposure groups. Treatment with ozonide or hydrogen peroxide did not change NK-1R gene expression in animals exposed to FA, HDMA, or HDMA+O3. However, treatment in vitro with lipid ozonide significantly increased NK-1R gene expression in explants from O3–exposed animals. We conclude that a history of prior O3 exposure resets the steady state of the airways to increase the NK-1R response to subsequent acute oxidant stresses. PMID:22962062

  5. Leakage Suppression in the Toric Code

    NASA Astrophysics Data System (ADS)

    Suchara, Martin; Cross, Andrew; Gambetta, Jay

    2015-03-01

    Quantum codes excel at correcting local noise but fail to correct leakage faults that excite qubits to states outside the computational space. Aliferis and Terhal have shown that an accuracy threshold exists for leakage faults using gadgets called leakage reduction units (LRUs). However, these gadgets reduce the threshold and increase experimental complexity, and the costs have not been thoroughly understood. We explore a variety of techniques for leakage resilience in topological codes. Our contributions are threefold. First, we develop a leakage model that differs in critical details from earlier models. Second, we use Monte-Carlo simulations to survey several syndrome extraction circuits. Third, given the capability to perform 3-outcome measurements, we present a dramatically improved syndrome processing algorithm. Our simulations show that simple circuits with one extra CNOT per qubit reduce the accuracy threshold by less than a factor of 4 when leakage and depolarizing noise rates are comparable. This becomes a factor of 2 when the decoder uses 3-outcome measurements. Finally, when the physical error rate is less than 2 ×10-4 , placing LRUs after every gate may achieve the lowest logical error rate. We expect that the ideas may generalize to other topological codes.

  6. EFFECTS OF LEAKAGE NEUTRAL PARTICLES ON SHOCKS

    SciTech Connect

    Ohira, Yutaka

    2012-10-20

    In this paper, we investigate effects of neutral particles on shocks propagating into the partially ionized medium. We find that for 120 km s{sup -1} < u {sub sh} < 3000 km s{sup -1} (u {sub sh} is the shock velocity), about 10% of upstream neutral particles leak into the upstream region from the downstream region. Moreover, we investigate how the leakage neutral particles affect the upstream structure of the shock and particle accelerations. Using four-fluid approximations (upstream ions, upstream neutral particles, leakage neutral particles, and pickup ions), we provide analytical solutions of the precursor structure due to leakage neutral particles. It is shown that the upstream flow is decelerated in the precursor region and the shock compression ratio becomes smaller than without leakage neutral particles, but the total compression ratio does not change. Even if leakage of neutral particles is small (a few percent of total upstream particles), this smaller compression ratio of the shock can explain steep gamma-ray spectra from young supernova remnants. Furthermore, leakage neutral particles could amplify the magnetic field and heat the upstream region.

  7. Key Molecular Mechanisms of Chaiqinchengqi Decoction in Alleviating the Pulmonary Albumin Leakage Caused by Endotoxemia in Severe Acute Pancreatitis Rats

    PubMed Central

    Wu, Wei; Luo, Ruijie; Lin, Ziqi; Xia, Qing

    2016-01-01

    To reveal the key molecular mechanisms of Chaiqinchengqi decoction (CQCQD) in alleviating the pulmonary albumin leakage caused by endotoxemia in severe acute pancreatitis (SAP) rats. Rats models of SAP endotoxemia-induced acute lung injury were established, the studies in vivo provided the important evidences that the therapy of CQCQD significantly ameliorated the increases in plasma levels of lipopolysaccharide (LPS), sCd14, and Lbp, the elevation of serum amylase level, the enhancements of systemic and pulmonary albumin leakage, and the depravation of airways indicators, thus improving respiratory dysfunction and also pancreatic and pulmonary histopathological changes. According to the analyses of rats pulmonary tissue microarray and protein-protein interaction network, c-Fos, c-Src, and p85α were predicted as the target proteins for CQCQD in alleviating pulmonary albumin leakage. To confirm these predictions, human umbilical vein endothelial cells were employed in in vitro studies, which provide the evidences that (1) LPS-induced paracellular leakage and proinflammatory cytokines release were suppressed by pretreatment with inhibitors of c-Src (PP1) or PI3K (LY294002) or by transfection with siRNAs of c-Fos; (2) fortunately, CQCQD imitated the actions of these selective inhibitions agents to inhibit LPS-induced high expressions of p-Src, p-p85α, and c-Fos, therefore attenuating paracellular leakage and proinflammatory cytokines release. PMID:27413385

  8. Key Molecular Mechanisms of Chaiqinchengqi Decoction in Alleviating the Pulmonary Albumin Leakage Caused by Endotoxemia in Severe Acute Pancreatitis Rats.

    PubMed

    Wu, Wei; Luo, Ruijie; Lin, Ziqi; Xia, Qing; Xue, Ping

    2016-01-01

    To reveal the key molecular mechanisms of Chaiqinchengqi decoction (CQCQD) in alleviating the pulmonary albumin leakage caused by endotoxemia in severe acute pancreatitis (SAP) rats. Rats models of SAP endotoxemia-induced acute lung injury were established, the studies in vivo provided the important evidences that the therapy of CQCQD significantly ameliorated the increases in plasma levels of lipopolysaccharide (LPS), sCd14, and Lbp, the elevation of serum amylase level, the enhancements of systemic and pulmonary albumin leakage, and the depravation of airways indicators, thus improving respiratory dysfunction and also pancreatic and pulmonary histopathological changes. According to the analyses of rats pulmonary tissue microarray and protein-protein interaction network, c-Fos, c-Src, and p85α were predicted as the target proteins for CQCQD in alleviating pulmonary albumin leakage. To confirm these predictions, human umbilical vein endothelial cells were employed in in vitro studies, which provide the evidences that (1) LPS-induced paracellular leakage and proinflammatory cytokines release were suppressed by pretreatment with inhibitors of c-Src (PP1) or PI3K (LY294002) or by transfection with siRNAs of c-Fos; (2) fortunately, CQCQD imitated the actions of these selective inhibitions agents to inhibit LPS-induced high expressions of p-Src, p-p85α, and c-Fos, therefore attenuating paracellular leakage and proinflammatory cytokines release. PMID:27413385

  9. Airway Assessment for Office Sedation/Anesthesia.

    PubMed

    Rosenberg, Morton B; Phero, James C

    2015-01-01

    Whenever a patient is about to receive sedation or general anesthesia, no matter what the technique, the preoperative assessment of the airway is one of the most important steps in ensuring patient safety and positive outcomes. This article, Part III in the series on airway management, is directed at the ambulatory office practice and focuses on predicting the success of advanced airway rescue techniques.

  10. Photoacoustic microscopy of microvascular responses to cortical electrical stimulation

    NASA Astrophysics Data System (ADS)

    Tsytsarev, Vassiliy; Hu, Song; Yao, Junjie; Maslov, Konstantin; Barbour, Dennis L.; Wang, Lihong V.

    2011-07-01

    Advances in the functional imaging of cortical hemodynamics have greatly facilitated the understanding of neurovascular coupling. In this study, label-free optical-resolution photoacoustic microscopy (OR-PAM) was used to monitor microvascular responses to direct electrical stimulations of the mouse somatosensory cortex through a cranial opening. The responses appeared in two forms: vasoconstriction and vasodilatation. The transition between these two forms of response was observed in single vessels by varying the stimulation intensity. Marked correlation was found between the current-dependent responses of two daughter vessels bifurcating from the same parent vessel. Statistical analysis of twenty-seven vessels from three different animals further characterized the spatial-temporal features and the current dependence of the microvascular response. Our results demonstrate that OR-PAM is a valuable tool to study neurovascular coupling at the microscopic level.

  11. Multiple equilibrium states for blood flow in microvascular networks

    NASA Astrophysics Data System (ADS)

    Pollock-Muskin, Halley; Diehl, Cecilia; Mohamed, Nora; Karst, Nathan; Geddes, John; Storey, Brian

    2015-11-01

    When blood flows through a vessel bifurcation at the microvascular scale, the hematocrits in the downstream daughter vessels are generally not equal. This phenomenon, known as plasma skimming, can cause heterogeneity in the distribution of red blood cells inside a vessel network. Using established models for plasma skimming, we investigate the equilibrium states in a microvascular network with simple topologies. We find that even simple networks can have multiple equilibrium states for the flow rates and distributions of red blood cells inside the network for fixed inlet conditions. In a ladder network, we find that for certain inlet conditions the network can have 2N observable equilibrium states where N is the number of rungs in the ladder. For ladders with even just a few rungs, the complex equilibrium curves make it seemingly impossible to set the internal state of the network by controlling the inlet flows. Microfluidic experiments are being used to confirm the model predictions.

  12. Treatment of Angina Pectoris Associated with Coronary Microvascular Dysfunction.

    PubMed

    Ong, Peter; Athanasiadis, Anastasios; Sechtem, Udo

    2016-08-01

    Treatment of angina pectoris associated with coronary microvascular dysfunction is challenging as the underlying mechanisms are often diverse and overlapping. Patients with type 1 coronary microvascular dysfunction (i.e. absence of epicardial coronary artery disease and myocardial disease) should receive strict control of their cardiovascular risk factors and thus receive statins and ACE-inhibitors in most cases. Antianginal medication consists of ß-blockers and/or calcium channel blockers. Second line drugs are ranolazine and nicorandil with limited evidence. Despite individually titrated combinations of these drugs up to 30 % of patients have refractory angina. Rho-kinase inhibitors and endothelin-receptor antagonists represent potential drugs that may prove useful in these patients in the future.

  13. Impact of simulated microgravity on microvascular endothelial cell apoptosis.

    PubMed

    Kang, Chun-Yan; Zou, Lin; Yuan, Ming; Wang, Yang; Li, Tian-Zhi; Zhang, Ye; Wang, Jun-Feng; Li, Yan; Deng, Xiao-Wei; Liu, Chang-Ting

    2011-09-01

    Cardiovascular deconditioning is known to occur in astronauts exposed to microgravity. Endothelial dysfunction at microcirculatory sites might contribute to cardiovascular deconditioning induced by weightlessness. Recent studies have reported changes in the morphology and gene expression of endothelial cells exposed to conditions of simulated microgravity. The present study was aimed at examining the effects of microgravity on the apoptosis of microvascular endothelial cells and the mechanism underlying these effects. We simulated a microgravity environment and found that microgravity induced microvascular endothelial cell apoptosis and that this effect was correlated with the downregulation of the PI3K/Akt pathway, increased expression of NF-κB, and depolymerization of F-actin. These findings may provide important insights into the origin of the adverse physiological changes occurring due to exposure to microgravity conditions. PMID:21287193

  14. Impact of simulated microgravity on microvascular endothelial cell apoptosis.

    PubMed

    Kang, Chun-Yan; Zou, Lin; Yuan, Ming; Wang, Yang; Li, Tian-Zhi; Zhang, Ye; Wang, Jun-Feng; Li, Yan; Deng, Xiao-Wei; Liu, Chang-Ting

    2011-09-01

    Cardiovascular deconditioning is known to occur in astronauts exposed to microgravity. Endothelial dysfunction at microcirculatory sites might contribute to cardiovascular deconditioning induced by weightlessness. Recent studies have reported changes in the morphology and gene expression of endothelial cells exposed to conditions of simulated microgravity. The present study was aimed at examining the effects of microgravity on the apoptosis of microvascular endothelial cells and the mechanism underlying these effects. We simulated a microgravity environment and found that microgravity induced microvascular endothelial cell apoptosis and that this effect was correlated with the downregulation of the PI3K/Akt pathway, increased expression of NF-κB, and depolymerization of F-actin. These findings may provide important insights into the origin of the adverse physiological changes occurring due to exposure to microgravity conditions.

  15. Microvascular endothelium and pericytes: high yield, low passage cultures.

    PubMed

    Carson, M P; Haudenschild, C C

    1986-06-01

    Cultured microvascular endothelial cells (MEC) have become a valuable model for studies of microvascular physiology and pathology. Most current techniques involve manual removal of undesirable cell types or cloning, require one to several months, and yield high population doubling level cultures derived from a relatively small sample of the original population. We have devised a technique to more rapidly produce larger numbers of MEC. This method provided primary cultures consisting predominantly of MEC within 1 wk. The technique involves selective aspiration of gray matter from the bovine cerebral cortex followed by homogenization, sieving, enzymatic dissociation, and then dense plating (10(4) to 10(5) vessel fragments/cm2) onto gelatin- or fibronectin-coated plastic. Typical yields were 0.1 to 0.5 X 10(6) fragments/g of aspirated gray matter. The optimal culture medium for these cells was 15% equine plasma derived serum, 20% conditioned medium, 2% retinal extract, 60% fresh medium, and 500 micrograms/ml heparin. Cells attached within 24 h, well-spread colonies were present within 1 to 2 d, and cultures approached confluence within 2 to 3 d. Alkaline phosphatase staining confirmed the microvascular origin of the material plated. Morphology, Factor VIII-related antigen staining and 1,1'-dioctacecyl-3,3,3'3,-tetramethyl-indocarbocyanine perchlorate acetylated low density lipoprotein uptake suggested that MEC predominated. Cultures could be passaged and additionally purified by sequential exposure to pancreatin and trypsin-EDTA. Pancreatin selectively removed MEC colonies leaving a relatively homogeneous pericyte population. The relative ease with which such cultures can be produced should facilitate the in vitro study of brain microvascular function and may also provide insights useful for growing MEC from other vascular beds.

  16. Preventing microvascular complications in type 1 diabetes mellitus.

    PubMed

    Viswanathan, Vijay

    2015-04-01

    Patients with complications of diabetes such as retinopathy, nephropathy, and cardiovascular complications have increased hospital stay with greater economic burden. Prevention of complications should be started before the onset of type 1 diabetes mellitus (T1DM) by working on risk factors and thereafter by intervention upon confirmatory diagnosis which can prevent further damage to β-cells. The actual risk of getting microvascular complications like microalbuminuria and retinopathy progression starts at glycated hemoglobin (HbA1c) level of 7%. As per the American Diabetes Association, a new pediatric glycemic control target of HbA1c <7.5% across all ages replaces previous guidelines that had called for different targets by age. Evidence shows that prevalence of microvascular complications is greater in patients with age >20 years as compared to patients <10 years of age. Screening of these complications should be done regularly, and appropriate preventive strategies should be followed. Angiotensin converting enzyme inhibitors and angiotensin II receptor blocker reduce progression from microalbuminuria to macroalbuminuria and increase the regression rate to normoalbuminuria. Diabetic microvascular complications can be controlled with tight glycemic therapy, dyslipidemia management and blood pressure control along with renal function monitoring, lifestyle changes, including smoking cessation and low-protein diet. An integrated and personalized care would reduce the risk of development of microvascular complications in T1DM patients. The child with diabetes who receives limited care is more likely to develop long-term complications at an earlier age. Screening for subclinical complications and early interventions with intensive therapy is the need of the hour.

  17. Hemimasticatory spasm treated with microvascular decompression of the trigeminal nerve.

    PubMed

    Chon, Kyu-Hyon; Lee, Jong-Myong; Koh, Eun-Jeong; Choi, Ha-Young

    2012-09-01

    Hemimasticatory spasm is a very rare disorder of the trigeminal nerve characterized by paroxysmal involuntary contraction of the jaw-closing muscles. The mechanisms leading to hemimasticatory spasm are still unclear. Recently, injection of botulinum toxin has become the treatment of choice due to its excellent results. We report a case of a successful treatment of hemimasticatory spasm via microvascular decompression of the motor branch of the trigeminal nerve.

  18. Patterns and Variations in Microvascular Decompression for Trigeminal Neuralgia

    PubMed Central

    TODA, Hiroki; GOTO, Masanori; IWASAKI, Koichi

    2015-01-01

    Microvascular decompression (MVD) is a highly effective surgical treatment for trigeminal neuralgia (TN). Although there is little prospective clinical evidence, accumulated observational studies have demonstrated the benefits of MVD for refractory TN. In the current surgical practice of MVD for TN, there have been recognized patterns and variations in surgical anatomy and various decompression techniques. Here we provide a stepwise description of surgical procedures and relevant anatomical characteristics, as well as procedural options. PMID:25925756

  19. Endothelial glycocalyx dysfunction in disease: albuminuria and increased microvascular permeability.

    PubMed

    Salmon, Andrew H J; Satchell, Simon C

    2012-03-01

    Appreciation of the glomerular microcirculation as a specialized microcirculatory bed, rather than as an entirely separate entity, affords important insights into both glomerular and systemic microvascular pathophysiology. In this review we compare regulation of permeability in systemic and glomerular microcirculations, focusing particularly on the role of the endothelial glycocalyx, and consider the implications for disease processes. The luminal surface of vascular endothelium throughout the body is covered with endothelial glycocalyx, comprising surface-anchored proteoglycans, supplemented with adsorbed soluble proteoglycans, glycosaminoglycans and plasma constituents. In both continuous and fenestrated microvessels, this endothelial glycocalyx provides resistance to the transcapillary escape of water and macromolecules, acting as an integral component of the multilayered barrier provided by the walls of these microvessels (ie acting in concert with clefts or fenestrae across endothelial cell layers, basement membranes and pericytes). Dysfunction of any of these capillary wall components, including the endothelial glycocalyx, can disrupt normal microvascular permeability. Because of its ubiquitous nature, damage to the endothelial glycocalyx alters the permeability of multiple capillary beds: in the glomerulus this is clinically apparent as albuminuria. Generalized damage to the endothelial glycocalyx can therefore manifest as both albuminuria and increased systemic microvascular permeability. This triad of altered endothelial glycocalyx, albuminuria and increased systemic microvascular permeability occurs in a number of important diseases, such as diabetes, with accumulating evidence for a similar phenomenon in ischaemia-reperfusion injury and infectious disease. The detection of albuminuria therefore has implications for the function of the microcirculation as a whole. The importance of the endothelial glycocalyx for other aspects of vascular function

  20. Evaluation of intraoperative anticoagulants in microvascular free-flap surgery.

    PubMed Central

    Pugh, C. M.; Dennis, R. H.; Massac, E. A.

    1996-01-01

    This retrospective study evaluated anticoagulants used during surgery to determine efficacy and associated complications. The patient population was comprised of 15 patients who underwent microvascular free-flap surgery for wound coverage of the lower one third of the leg. Results indicated that the use of heparin in conjunction with other anticoagulants was associated with the development of more hematomas compared with the use of aspirin and dextran, both separately and together. PMID:8918071

  1. [Airway equipment and its maintenance for a non difficult adult airway management (endotracheal intubation and its alternative: face mask, laryngeal mask airway, laryngeal tube)].

    PubMed

    Francon, D; Estèbe, J P; Ecoffey, C

    2003-08-01

    The airway equipment for a non difficult adult airway management are described: endotracheal tubes with a specific discussion on how to inflate the balloon, laryngoscopes and blades, stylets and intubation guides, oral airways, face masks, laryngeal mask airways and laryngeal tubes. Cleaning and disinfections with the maintenance are also discussed for each type of airway management.

  2. Microvascular Transport and Tumor Cell Adhesion in the Microcirculation

    PubMed Central

    Fu, Bingmei M.; Liu, Yang

    2016-01-01

    One critical step in tumor metastasis is tumor cell adhesion to the endothelium forming the microvessel wall. Understanding this step may lead to new therapeutic concepts for tumor metastasis. Vascular endothelium forming the microvessel wall and the glycocalyx layer at its surface are the principal barriers to, and regulators of the material exchange between circulating blood and body tissues. The cleft between adjacent ECs (interendothelial cleft) is the principal pathway for water and solutes transport through the microvessel wall in health. It is also suggested to be the pathway for high molecular weight plasma proteins, leukocytes and tumor cells across microvessel walls in disease. Thus the first part of the review introduced the mathematical models for water and solutes transport through the interendothelial cleft. These models, combined with the experimental results from in vivo animal studies and electron microscopic observations, are used to evaluate the role of the endothelial surface glycocalyx, the junction strand geometry in the interendothelial cleft, and the surrounding extracellular matrix and tissue cells, as the determinants of microvascular transport. The second part of the review demonstrated how the microvascular permeability, hydrodynamic factors, microvascular geometry and cell adhesion molecules affect tumor cell adhesion in the microcirculation. PMID:22476895

  3. Obesity Related Coronary Microvascular Dysfunction: From Basic to Clinical Practice

    PubMed Central

    Selthofer-Relatić, K.; Bošnjak, I.; Kibel, A.

    2016-01-01

    Obesity related coronary microvascular disease is a medical entity which is not yet fully elucidated. The pathophysiological basis of coronary microcirculatory dysfunction consists of a heterogeneous group of disorders with individual morphologic/functional/clinical presentation and prognosis. Coronary microcirculatory changes include mechanisms connected with vascular dysfunction, as well as extravascular and vasostructural changes in responses to neural, mechanical, and metabolic factors. Cardiometabolic changes that include obesity, dyslipidemia, diabetes mellitus type II, and hypertension are associated with atherosclerosis of epicardial coronary arteries and/or microvascular coronary dysfunction, with incompletely understood underlying mechanisms. In obesity, microvascular disease is mediated via adipokines/cytokines causing chronic, subclinical inflammation with (a) reduced NO-mediated dilatation, (b) changed endothelial- and smooth muscle-dependent vasoregulating mechanisms, (c) altered vasomotor control with increased sympathetic activity, and (d) obesity related hypertension with cardiomyocytes hypertrophy and impaired cardiac vascular adaptation to metabolic needs. From a clinical point of view it can present itself in acute or chronic form with different prognosis, as a practice problem for real-life diagnosis and treatment. PMID:27092288

  4. Microvascular Abnormality in Schizophrenia as Shown by Retinal Imaging

    PubMed Central

    Meier, Madeline H.; Shalev, Idan; Moffitt, Terrie E.; Kapur, Shitij; Keefe, Richard S.E.; Wong, Tien; Belsky, Daniel W.; Harrington, HonaLee; Hogan, Sean; Houts, Renate; Caspi, Avshalom; Poulton, Richie

    2013-01-01

    Objective Retinal and cerebral microvessels are structurally and functionally homologous, but, unlike cerebral microvessels, retinal microvessels can be noninvasively measured in vivo via retinal imaging. Here we test the hypothesis that individuals with schizophrenia show microvascular abnormality and evaluate the utility of retinal imaging as a tool for future schizophrenia research. Methods Participants were members of the Dunedin Study, a population-representative cohort followed from birth with 95% retention. Study members underwent retinal imaging at age 38 years. We assessed retinal arteriolar and venular caliber for all members of the cohort, including individuals who developed schizophrenia. Results Study members who developed schizophrenia were distinguished by wider retinal venules, suggesting microvascular abnormality reflective of insufficient brain oxygen supply. Analyses that controlled for confounding health conditions suggested that wider retinal venules are not simply an artifact of co-occurring health problems in schizophrenia patients. Wider venules were also associated with a dimensional measure of adult psychosis symptoms and with psychosis symptoms reported in childhood. Conclusions Findings provide initial support for the hypothesis that individuals with schizophrenia show microvascular abnormality. Moreover, results suggest that the same vascular mechanisms underlie subthreshold symptoms and clinical disorder and that these associations may begin early in life. These findings highlight the promise of retinal imaging as a tool for understanding the pathogenesis of schizophrenia. PMID:24030514

  5. Evaluation of gravimetric techniques to estimate the microvascular filtration coefficient.

    PubMed

    Dongaonkar, R M; Laine, G A; Stewart, R H; Quick, C M

    2011-06-01

    Microvascular permeability to water is characterized by the microvascular filtration coefficient (K(f)). Conventional gravimetric techniques to estimate K(f) rely on data obtained from either transient or steady-state increases in organ weight in response to increases in microvascular pressure. Both techniques result in considerably different estimates and neither account for interstitial fluid storage and lymphatic return. We therefore developed a theoretical framework to evaluate K(f) estimation techniques by 1) comparing conventional techniques to a novel technique that includes effects of interstitial fluid storage and lymphatic return, 2) evaluating the ability of conventional techniques to reproduce K(f) from simulated gravimetric data generated by a realistic interstitial fluid balance model, 3) analyzing new data collected from rat intestine, and 4) analyzing previously reported data. These approaches revealed that the steady-state gravimetric technique yields estimates that are not directly related to K(f) and are in some cases directly proportional to interstitial compliance. However, the transient gravimetric technique yields accurate estimates in some organs, because the typical experimental duration minimizes the effects of interstitial fluid storage and lymphatic return. Furthermore, our analytical framework reveals that the supposed requirement of tying off all draining lymphatic vessels for the transient technique is unnecessary. Finally, our numerical simulations indicate that our comprehensive technique accurately reproduces the value of K(f) in all organs, is not confounded by interstitial storage and lymphatic return, and provides corroboration of the estimate from the transient technique.

  6. Delayed, bilateral, non-microvascular ear replantation after violent amputation.

    PubMed

    García-Murray, E; Adán-Rivas, O; Salcido-Calzadilla, H

    2009-06-01

    Amputation of any body part is undoubtedly a traumatic experience leaving a terrible deformity, especially when the part or parts involved are visible and constitute an essential component of someone's facial whole. Bilateral ear amputation and successful subsequent replantation has been reported historically, but not in the modern surgical literature. We report the case of a 27-year-old female who was abducted and suffered a bilateral ear amputation at the hands of one of her captors to speed delivery of ransom money; the severed parts were sent to the parents approximately 2 hours after the amputation had taken place, and the girl was released some 48 hours after the ears were delivered. Microvascular replantation was attempted immediately after admission to the hospital some 2 hours after her release, but failed, and so a non-microvascular replantation was performed and was successful, after approximately 54 hours of ischaemia time. We consider this the first report of a complete bilateral, delayed, non-microvascular, successful ear replantation in a human being in the modern literature. PMID:18083644

  7. Inflammatory pathways and microvascular responses in the lung.

    PubMed

    Kuebler, Wolfgang M

    2005-01-01

    Neutrophil granulocytes constitute an important host defense mechanism, but may at the same time damage functional tissue and propagate acute organ failure. This balance is particularly vulnerable in the lung which provides a large surface area for invading pathogens and microorganisms, and simultaneously harbors a large pool of physiologically marginated neutrophils within its microvascular bed. Pathophysiological stimuli further amplify this accumulation of blood cells and promote the emigration of neutrophils into the pulmonary interstitium and the airspaces by different mechanisms depending on the pathophysiological stimulus, its route of entry into or site of production in the lung, and the time course of its action. Importantly, the pulmonary microvascular endothelium plays a key role in regulating not only sequestration and emigration of neutrophils, but by initiating the inflammatory response to a variety of diverse stimuli many of which do not directly target the circulating neutrophil, but elicit microvascular reactions by primarily acting on the endothelium. This review highlights the inflammatory process in the pulmonary microvasculature with special emphasis on the role of the pulmonary endothelium.

  8. Microvascular architecture of the filiform papillae in primates and insectivores.

    PubMed

    Okada, S; Ohta, Y; Matsukawa, N; Sugioka, S

    1993-03-01

    The microvascular architecture of filiform papillae was investigated under a scanning electron microscope in man, Japanese monkeys, common squirrel monkeys, common marmosets, common tree shrews, large Japanese moles and dwarf shrews utilizing microvascular corrosion casts. Filiform papillae were circularly arranged in primates, and each of them was supplied by a hairpin capillary loop. These papillae sometimes were aggregated. The filiform papillae of Japanese monkeys exhibited markedly locational differences on the lingual dorsum and were supplied by circularly arranged capillary loops or by an intrapapillary capillary network. Small filiform papillae were located on an epithelial eminence in the lingual radix, each of them supplied by a low and simple hairpin capillary loop. The aggregated filiform papillae of common squirrel monkeys were less frequent without any locational differences. Low filiform papillae of common marmosets and tree shrews were simpler in form, being arranged in a circle and supplied by a simple hairpin capillary loop. The filiform papillae of insectivores were not arranged in a circle. The filiform papillae of dwarf shrews were supplied by an incomplete capillary ring without a loop. With respect to species differences, the circularly arranged capillary loops in man were most complicated and highly developed. Microvascular architecture of the filiform papillae of insectivores was much simpler, different from those observed in primates.

  9. Evaluation of gravimetric techniques to estimate the microvascular filtration coefficient.

    PubMed

    Dongaonkar, R M; Laine, G A; Stewart, R H; Quick, C M

    2011-06-01

    Microvascular permeability to water is characterized by the microvascular filtration coefficient (K(f)). Conventional gravimetric techniques to estimate K(f) rely on data obtained from either transient or steady-state increases in organ weight in response to increases in microvascular pressure. Both techniques result in considerably different estimates and neither account for interstitial fluid storage and lymphatic return. We therefore developed a theoretical framework to evaluate K(f) estimation techniques by 1) comparing conventional techniques to a novel technique that includes effects of interstitial fluid storage and lymphatic return, 2) evaluating the ability of conventional techniques to reproduce K(f) from simulated gravimetric data generated by a realistic interstitial fluid balance model, 3) analyzing new data collected from rat intestine, and 4) analyzing previously reported data. These approaches revealed that the steady-state gravimetric technique yields estimates that are not directly related to K(f) and are in some cases directly proportional to interstitial compliance. However, the transient gravimetric technique yields accurate estimates in some organs, because the typical experimental duration minimizes the effects of interstitial fluid storage and lymphatic return. Furthermore, our analytical framework reveals that the supposed requirement of tying off all draining lymphatic vessels for the transient technique is unnecessary. Finally, our numerical simulations indicate that our comprehensive technique accurately reproduces the value of K(f) in all organs, is not confounded by interstitial storage and lymphatic return, and provides corroboration of the estimate from the transient technique. PMID:21346245

  10. Microfabrication of cylindrical microfluidic channel networks for microvascular research.

    PubMed

    Huang, Zhouchun; Li, Xiang; Martins-Green, Manuela; Liu, Yuxin

    2012-10-01

    Current methods for formation of microvascular channel scaffolds are limited with non-circular channel cross-sections, complicated fabrication, and less flexibility in microchannel network design. To address current limitations in the creation of engineered microvascular channels with complex three-dimensional (3-D) geometries in the shape of microvessels, we have developed a reproducible, cost-effective, and flexible micromanufacturing process combined with photolithographic reflowable photoresist and soft lithography techniques to fabricate cylindrical microchannel and networks. A positive reflowable photoresist AZ P4620 was used to fabricate a master microchannel mold with semi-circular cross-sections. By the alignment and bonding of two polydimethylsiloxane (PDMS) microchannels replicated from the master mold together, a cylindrical microchannel or microchannel network was created. Further examination of the channel dimensions and surface profiles at different branching levels showed that the shape of the microfluidic channel was well approximated by a semi-circular surface, and a multi-level, multi-depth channel network was created. In addition, a computational fluidic dynamics (CFD) model was used to simulate shear flows and corresponding pressure distributions inside of the microchannel and channel network based on the dimensions of the fabricated channels. The fabricated multi-depth cylindrical microchannel network can provide platforms for the investigation of microvascular cells growing inside of cylindrical channels under shear flows and lumen pressures, and work as scaffolds for the investigation of morphogenesis and tubulogenesis. PMID:22729782

  11. Microfabrication of cylindrical microfluidic channel networks for microvascular research.

    PubMed

    Huang, Zhouchun; Li, Xiang; Martins-Green, Manuela; Liu, Yuxin

    2012-10-01

    Current methods for formation of microvascular channel scaffolds are limited with non-circular channel cross-sections, complicated fabrication, and less flexibility in microchannel network design. To address current limitations in the creation of engineered microvascular channels with complex three-dimensional (3-D) geometries in the shape of microvessels, we have developed a reproducible, cost-effective, and flexible micromanufacturing process combined with photolithographic reflowable photoresist and soft lithography techniques to fabricate cylindrical microchannel and networks. A positive reflowable photoresist AZ P4620 was used to fabricate a master microchannel mold with semi-circular cross-sections. By the alignment and bonding of two polydimethylsiloxane (PDMS) microchannels replicated from the master mold together, a cylindrical microchannel or microchannel network was created. Further examination of the channel dimensions and surface profiles at different branching levels showed that the shape of the microfluidic channel was well approximated by a semi-circular surface, and a multi-level, multi-depth channel network was created. In addition, a computational fluidic dynamics (CFD) model was used to simulate shear flows and corresponding pressure distributions inside of the microchannel and channel network based on the dimensions of the fabricated channels. The fabricated multi-depth cylindrical microchannel network can provide platforms for the investigation of microvascular cells growing inside of cylindrical channels under shear flows and lumen pressures, and work as scaffolds for the investigation of morphogenesis and tubulogenesis.

  12. 40 CFR 264.252 - Action leakage rate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Action leakage rate. 264.252 Section... Piles § 264.252 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for waste pile units subject to § 264.251(c) or (d). The action leakage rate is the maximum...

  13. 40 CFR 264.252 - Action leakage rate.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Action leakage rate. 264.252 Section... Piles § 264.252 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for waste pile units subject to § 264.251(c) or (d). The action leakage rate is the maximum...

  14. 49 CFR 192.706 - Transmission lines: Leakage surveys.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Transmission lines: Leakage surveys. 192.706... Transmission lines: Leakage surveys. Leakage surveys of a transmission line must be conducted at intervals not... transports gas in conformity with § 192.625 without an odor or odorant, leakage surveys using leak...

  15. 40 CFR 264.222 - Action leakage rate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Action leakage rate. 264.222 Section... Impoundments § 264.222 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for surface impoundment units subject to § 264.221 (c) or (d). The action leakage rate is the...

  16. 40 CFR 264.252 - Action leakage rate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Action leakage rate. 264.252 Section... Piles § 264.252 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for waste pile units subject to § 264.251(c) or (d). The action leakage rate is the maximum...

  17. 49 CFR 192.723 - Distribution systems: Leakage surveys.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Distribution systems: Leakage surveys. 192.723... Distribution systems: Leakage surveys. (a) Each operator of a distribution system shall conduct periodic leakage surveys in accordance with this section. (b) The type and scope of the leakage control...

  18. 40 CFR 264.252 - Action leakage rate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Action leakage rate. 264.252 Section... Piles § 264.252 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for waste pile units subject to § 264.251(c) or (d). The action leakage rate is the maximum...

  19. 40 CFR 264.222 - Action leakage rate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Action leakage rate. 264.222 Section... Impoundments § 264.222 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for surface impoundment units subject to § 264.221 (c) or (d). The action leakage rate is the...

  20. 49 CFR 192.723 - Distribution systems: Leakage surveys.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Distribution systems: Leakage surveys. 192.723... Distribution systems: Leakage surveys. (a) Each operator of a distribution system shall conduct periodic leakage surveys in accordance with this section. (b) The type and scope of the leakage control...

  1. 40 CFR 264.302 - Action leakage rate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Action leakage rate. 264.302 Section... § 264.302 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for landfill units subject to § 264.301(c) or (d). The action leakage rate is the maximum design flow rate...

  2. 40 CFR 264.252 - Action leakage rate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Action leakage rate. 264.252 Section... Piles § 264.252 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for waste pile units subject to § 264.251(c) or (d). The action leakage rate is the maximum...

  3. 49 CFR 192.723 - Distribution systems: Leakage surveys.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Distribution systems: Leakage surveys. 192.723... Distribution systems: Leakage surveys. (a) Each operator of a distribution system shall conduct periodic leakage surveys in accordance with this section. (b) The type and scope of the leakage control...

  4. 40 CFR 264.222 - Action leakage rate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Action leakage rate. 264.222 Section... Impoundments § 264.222 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for surface impoundment units subject to § 264.221 (c) or (d). The action leakage rate is the...

  5. 40 CFR 264.222 - Action leakage rate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Action leakage rate. 264.222 Section... Impoundments § 264.222 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for surface impoundment units subject to § 264.221 (c) or (d). The action leakage rate is the...

  6. 49 CFR 192.723 - Distribution systems: Leakage surveys.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Distribution systems: Leakage surveys. 192.723... Distribution systems: Leakage surveys. (a) Each operator of a distribution system shall conduct periodic leakage surveys in accordance with this section. (b) The type and scope of the leakage control...

  7. 49 CFR 192.706 - Transmission lines: Leakage surveys.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Transmission lines: Leakage surveys. 192.706... Transmission lines: Leakage surveys. Leakage surveys of a transmission line must be conducted at intervals not... transports gas in conformity with § 192.625 without an odor or odorant, leakage surveys using leak...

  8. 40 CFR 264.222 - Action leakage rate.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Action leakage rate. 264.222 Section... Impoundments § 264.222 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for surface impoundment units subject to § 264.221 (c) or (d). The action leakage rate is the...

  9. 49 CFR 192.706 - Transmission lines: Leakage surveys.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Transmission lines: Leakage surveys. 192.706... Transmission lines: Leakage surveys. Leakage surveys of a transmission line must be conducted at intervals not... transports gas in conformity with § 192.625 without an odor or odorant, leakage surveys using leak...

  10. 49 CFR 192.723 - Distribution systems: Leakage surveys.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Distribution systems: Leakage surveys. 192.723... Distribution systems: Leakage surveys. (a) Each operator of a distribution system shall conduct periodic leakage surveys in accordance with this section. (b) The type and scope of the leakage control...

  11. 40 CFR 264.302 - Action leakage rate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Action leakage rate. 264.302 Section... § 264.302 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for landfill units subject to § 264.301(c) or (d). The action leakage rate is the maximum design flow rate...

  12. 40 CFR 264.302 - Action leakage rate.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Action leakage rate. 264.302 Section... § 264.302 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for landfill units subject to § 264.301(c) or (d). The action leakage rate is the maximum design flow rate...

  13. 40 CFR 264.302 - Action leakage rate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Action leakage rate. 264.302 Section... § 264.302 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for landfill units subject to § 264.301(c) or (d). The action leakage rate is the maximum design flow rate...

  14. 40 CFR 264.302 - Action leakage rate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Action leakage rate. 264.302 Section... § 264.302 Action leakage rate. (a) The Regional Administrator shall approve an action leakage rate for landfill units subject to § 264.301(c) or (d). The action leakage rate is the maximum design flow rate...

  15. 21 CFR 870.2640 - Portable leakage current alarm.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Portable leakage current alarm. 870.2640 Section... leakage current alarm. (a) Identification. A portable leakage current alarm is a device used to measure the electrical leakage current between any two points of an electrical system and to sound an alarm...

  16. 49 CFR 192.706 - Transmission lines: Leakage surveys.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Transmission lines: Leakage surveys. 192.706... Transmission lines: Leakage surveys. Leakage surveys of a transmission line must be conducted at intervals not... transports gas in conformity with § 192.625 without an odor or odorant, leakage surveys using leak...

  17. Inflammatory bowel disease and airway diseases

    PubMed Central

    Vutcovici, Maria; Brassard, Paul; Bitton, Alain

    2016-01-01

    Airway diseases are the most commonly described lung manifestations of inflammatory bowel disease (IBD). However, the similarities in disease pathogenesis and the sharing of important environmental risk factors and genetic susceptibility suggest that there is a complex interplay between IBD and airway diseases. Recent evidence of IBD occurrence among patients with airway diseases and the higher than estimated prevalence of subclinical airway injuries among IBD patients support the hypothesis of a two-way association. Future research efforts should be directed toward further exploration of this association, as airway diseases are highly prevalent conditions with a substantial public health impact. PMID:27678355

  18. Inflammatory bowel disease and airway diseases

    PubMed Central

    Vutcovici, Maria; Brassard, Paul; Bitton, Alain

    2016-01-01

    Airway diseases are the most commonly described lung manifestations of inflammatory bowel disease (IBD). However, the similarities in disease pathogenesis and the sharing of important environmental risk factors and genetic susceptibility suggest that there is a complex interplay between IBD and airway diseases. Recent evidence of IBD occurrence among patients with airway diseases and the higher than estimated prevalence of subclinical airway injuries among IBD patients support the hypothesis of a two-way association. Future research efforts should be directed toward further exploration of this association, as airway diseases are highly prevalent conditions with a substantial public health impact.

  19. Lung function and airway diseases.

    PubMed

    Weiss, Scott T

    2010-01-01

    Two studies report genome-wide association studies for lung function, using cross-sectional spirometric measurements in healthy individuals. They identify six genetic loci newly associated to natural variation in lung function, which may have implications for the related airway diseases of asthma and chronic obstructive pulmonary disease. PMID:20037613

  20. A unique pulmonary microvascular endothelial cell niche revealed by Weibel-Palade bodies and Griffonia simplicifolia

    PubMed Central

    Stevens, Troy

    2014-01-01

    Abstract Pulmonary endothelium displays considerable heterogeneity along the vascular axis, from arteries to capillaries to veins. Griffonia simplicifolia is a lectin that recognizes pulmonary microvascular endothelium with preference over extra-alveolar endothelium in both arteries and veins, yet the precise vascular location where this phenotypic shift occurs is poorly resolved. We gelatin-filled the circulation and agarose-loaded the airways and then labeled the lung with Griffonia lectin to enable visualization of the endothelial transition zone. Endothelium in vessels with internal diameters less than 38 μm were uniformly Griffonia positive, whereas vessels with internal diameters greater than 60 μm were always Griffonia negative. Two populations of endothelium were identified in vessels ranging from 38 to 60 μm in diameter, including some that were positive and others that were negative for binding to G. simplicifolia. To better resolve this endothelial transition zone, we performed morphology studies to measure the distribution of Weibel-Palade bodies (WPbs), since WPbs are present in conduit vessel endothelium and absent in capillary endothelium. WPbs were found in endothelium with vascular dimensions as small as 18 μm in diameter but were not found in capillaries. Thus, we identify with precision that the endothelial phenotype transition from a cell that does not interact with Griffonia lectin to one that does occurs in blood vessels with internal diameters of approximately 38 μm, and we reveal an unappreciated vascular zone, between 18 and 38 μm in diameter, where endothelium both is Griffonia positive and possesses WPbs. PMID:25006426

  1. A unique pulmonary microvascular endothelial cell niche revealed by Weibel-Palade bodies and Griffonia simplicifolia.

    PubMed

    Wu, Songwei; Zhou, Chun; King, Judy A C; Stevens, Troy

    2014-03-01

    Pulmonary endothelium displays considerable heterogeneity along the vascular axis, from arteries to capillaries to veins. Griffonia simplicifolia is a lectin that recognizes pulmonary microvascular endothelium with preference over extra-alveolar endothelium in both arteries and veins, yet the precise vascular location where this phenotypic shift occurs is poorly resolved. We gelatin-filled the circulation and agarose-loaded the airways and then labeled the lung with Griffonia lectin to enable visualization of the endothelial transition zone. Endothelium in vessels with internal diameters less than 38 μm were uniformly Griffonia positive, whereas vessels with internal diameters greater than 60 μm were always Griffonia negative. Two populations of endothelium were identified in vessels ranging from 38 to 60 μm in diameter, including some that were positive and others that were negative for binding to G. simplicifolia. To better resolve this endothelial transition zone, we performed morphology studies to measure the distribution of Weibel-Palade bodies (WPbs), since WPbs are present in conduit vessel endothelium and absent in capillary endothelium. WPbs were found in endothelium with vascular dimensions as small as 18 μm in diameter but were not found in capillaries. Thus, we identify with precision that the endothelial phenotype transition from a cell that does not interact with Griffonia lectin to one that does occurs in blood vessels with internal diameters of approximately 38 μm, and we reveal an unappreciated vascular zone, between 18 and 38 μm in diameter, where endothelium both is Griffonia positive and possesses WPbs.

  2. Management of the difficult airway.

    PubMed

    Schwartz, D E; Wiener-Kronish, J P

    1991-09-01

    For clinicians involved in airway management, a plan of action for dealing with the difficult airway or a failed intubation should be developed well in advance of encountering a patient in whom intubation is not routine. When difficulty is anticipated, the equipment necessary for performing a difficult intubation should be immediately available. It also is prudent to have a surgeon skilled in performing a tracheotomy and a criothyroidotomy stand by. The intubation should be attempted in the awake state, preferably using the fiberoptic bronchoscope. The more challenging situation is when the difficult airway is confronted unexpectedly. After the first failed attempt at laryngoscopy, head position should be checked and the patient ventilated with oxygen by mask. A smaller styletted tube and possibly a different laryngoscope blade should be selected for a second attempt at intubation. The fiberoptic bronchoscope and other equipment for difficult intubation should be obtained. A second attempt should then be made. If this is unsuccessful, the patient should be reoxygenated, and assistance including a skilled anesthesiologist and surgeon should be summoned. On a third attempt, traction to the tongue can be applied by an assistant, a tube changer could be used to enter the larynx, or one of the other special techniques previously described can be used. If this third attempt fails, it may be helpful to have a physician more experienced in airway management attempt intubation after oxygen has been administered to the patient. If all attempts are unsuccessful, then invasive techniques to secure the airway will have to be performed. PMID:1934950

  3. [Supraglottic airways in infants and children].

    PubMed

    Goldmann, Kai

    2013-04-01

    The development of the LMA-Classic™ revolutionized anaesthesia practice as its wide-spread use led to the establishment of a unique form of airway management, the "supraglottic airway management", besides the existing classical airway management with the face mask or endotracheal tube. Today, 25 years later, along with the original prototype of supraglottic airways quite a few numbers of different devices exist that can be used to secure the airway "above the glottis". After initially primarily marketing adult sizes many suppliers offer paediatric sizes nowadays. However, the scientific evidence in terms of superiority or at a least equality to the original LMA-Classic( of any of these airway devices must be considered insufficient except for the LMA-ProSeal™. Consequently, the routine use of these devices outside controlled clinical studies must be considered questionable. The following article aims at providing a critical appraisal of currently available supraglottic airway devices for neonates and infants. PMID:23633256

  4. Laryngeal mask airway: uses in anesthesiology.

    PubMed

    Pinosky, M

    1996-06-01

    The laryngeal mask airway (LMA), developed in 1983, is a new device to assist in the management of the pediatric and adult airway. In 1991, the Food and Drug Administration gave its approval for use of the LMA in the United States. The LMA is reusable and appears to provide cost-effective airway management in numerous situations. The LMA is simple to use, atraumatic to insert, and helpful in overcoming an obstructed airway. Its role in management of the difficult airway and the traumatic airway is still evolving. This review will introduce the LMA to the nonanesthesiologist and review for the anesthesiologist the origins of the LMA, its physical structure, the technical aspects of insertion, problems with aspiration, its role in the difficult airway, and experience with the pediatric population.

  5. Sarcoidosis of the upper and lower airways.

    PubMed

    Morgenthau, Adam S; Teirstein, Alvin S

    2011-12-01

    Sarcoidosis is a systemic granulomatous disease of undetermined etiology characterized by a variable clinical presentation and disease course. Although clinical granulomatous inflammation may occur within any organ system, more than 90% of sarcoidosis patients have lung disease. Sarcoidosis is considered an interstitial lung disease that is frequently characterized by restrictive physiologic dysfunction on pulmonary function tests. However, sarcoidosis also involves the airways (large and small), causing obstructive airways disease. It is one of a few interstitial lung diseases that affects the entire length of the respiratory tract - from the nose to the terminal bronchioles - and causes a broad spectrum of airways dysfunction. This article examines airway dysfunction in sarcoidosis. The anatomical structure of the airways is the organizational framework for our discussion. We discuss sarcoidosis involving the nose, sinuses, nasal passages, larynx, trachea, bronchi and small airways. Common complications of airways disease, such as, atelectasis, fibrosis, bullous leions, bronchiectasis, cavitary lesions and mycetomas, are also reviewed. PMID:22082167

  6. Determination of leakage areas in nuclear piping

    SciTech Connect

    Keim, E.

    1997-04-01

    For the design and operation of nuclear power plants the Leak-Before-Break (LBB) behavior of a piping component has to be shown. This means that the length of a crack resulting in a leak is smaller than the critical crack length and that the leak is safely detectable by a suitable monitoring system. The LBB-concept of Siemens/KWU is based on computer codes for the evaluation of critical crack lengths, crack openings, leakage areas and leakage rates, developed by Siemens/KWU. In the experience with the leak rate program is described while this paper deals with the computation of crack openings and leakage areas of longitudinal and circumferential cracks by means of fracture mechanics. The leakage areas are determined by the integration of the crack openings along the crack front, considering plasticity and geometrical effects. They are evaluated with respect to minimum values for the design of leak detection systems, and maximum values for controlling jet and reaction forces. By means of fracture mechanics LBB for subcritical cracks has to be shown and the calculation of leakage areas is the basis for quantitatively determining the discharge rate of leaking subcritical through-wall cracks. The analytical approach and its validation will be presented for two examples of complex structures. The first one is a pipe branch containing a circumferential crack and the second one is a pipe bend with a longitudinal crack.

  7. Sustainable management of leakage from wastewater pipelines.

    PubMed

    DeSilva, D; Burn, S; Tjandraatmadja, G; Moglia, M; Davis, P; Wolf, L; Held, I; Vollertsen, J; Williams, W; Hafskjold, L

    2005-01-01

    Wastewater pipeline leakage is an emerging concern in Europe, especially with regards to the potential effect of leaking effluent on groundwater contamination and the effects infiltration has on the management of sewer reticulation systems. This paper describes efforts by Australia, in association with several European partners, towards the development of decision support tools to prioritize proactive rehabilitation of wastewater pipe networks to account for leakage. In the fundamental models for the decision support system, leakage is viewed as a function of pipeline system deterioration. The models rely on soil type identification across the service area to determine the aggressiveness of the pipe environment and for division of the area into zones based on pipe properties and operational conditions. By understanding the interaction between pipe materials, operating conditions, and the pipe environment in the mechanisms leading to pipe deterioration, the models allow the prediction of leakage rates in different zones across a network. The decision support system utilizes these models to predict the condition of pipes in individual zones, and to optimize the utilization of rehabilitation resources by targeting the areas with the highest leakage rates.

  8. Leakage Sign for Primary Intracerebral Hemorrhage

    PubMed Central

    Hirohata, Masaru; Nakamura, Yukihiko; Takeshige, Nobuyuki; Aoki, Takachika; Hattori, Gousuke; Sakata, Kiyohiko; Abe, Toshi; Uchiyama, Yuusuke; Sakamoto, Teruo; Morioka, Motohiro

    2016-01-01

    Background and Purpose— Recent studies of intracerebral hemorrhage treatments have highlighted the need to identify reliable predictors of hematoma expansion. Several studies have suggested that the spot sign on computed tomographic angiography (CTA) is a sensitive radiological predictor of hematoma expansion in the acute phase. However, the spot sign has low sensitivity for hematoma expansion. In this study, we evaluated the usefulness of a novel predictive method, called the leakage sign. Methods— We performed CTA for 80 consecutive patients presenting with spontaneous intracerebral hemorrhage. Two scans were completed: CTA phase and delayed phase (5 minutes after the CTA phase). By comparing the CTA phase images, we set a region of interest with a 10-mm diameter and calculated the Hounsfield units. We defined a positive leakage sign as a >10% increase in Hounsfield units in the region of interest. Additionally, hematoma expansion was determined on plain computed tomography at 24 hours in patients who did not undergo emergent surgery. Results— Positive spot signs and leakage signs were present in 18 (22%) patients and 35 (43%) patients, respectively. The leakage sign had higher sensitivity (93.3%) and specificity (88.9%) for hematoma expansion than the spot sign. The leakage sign, but not the spot sign, was significantly related with poor outcomes (severely disabled, vegetative state, and death) in all of the patients (P=0.03) and in patients with a hemorrhage in the putamen (P=0.0016). Conclusions— The results indicate that the leakage sign is a useful and sensitive method to predict hematoma expansion. PMID:26931155

  9. Inward leakage in tight-fitting PAPRs.

    PubMed

    Koh, Frank C; Johnson, Arthur T; Rehak, Timothy E

    2011-01-01

    A combination of local flow measurement techniques and fog flow visualization was used to determine the inward leakage for two tight-fitting powered air-purifying respirators (PAPRs), the 3M Breathe-Easy PAPR and the SE 400 breathing demand PAPR. The PAPRs were mounted on a breathing machine head form, and flows were measured from the blower and into the breathing machine. Both respirators leaked a little at the beginning of inhalation, probably through their exhalation valves. In both cases, the leakage was not enough for fog to appear at the mouth of the head form.

  10. Air heater leakage: worse than you think

    SciTech Connect

    Guffre, J.

    2006-04-15

    Every good engineer knows that you cannot control what you cannot measure. In the case of rotary regenerative air heaters, many plants fail to limit the negative impact of heater leakage because they use measurement procedures and/or devices that fail to take into account its indirect effects. For a 500 MW coal-fired plant the heat energy that air heaters capture and recycle amounts to about 60% of that existing in the boiler, equivalent to 1.5 Btu per hour. This article explains the importance of accurately measuring leakage levels and the need to use modern seals to make heaters air-tight. 4 figs.

  11. Inward Leakage in Tight-Fitting PAPRs

    PubMed Central

    Koh, Frank C.; Johnson, Arthur T.; Rehak, Timothy E.

    2011-01-01

    A combination of local flow measurement techniques and fog flow visualization was used to determine the inward leakage for two tight-fitting powered air-purifying respirators (PAPRs), the 3M Breathe-Easy PAPR and the SE 400 breathing demand PAPR. The PAPRs were mounted on a breathing machine head form, and flows were measured from the blower and into the breathing machine. Both respirators leaked a little at the beginning of inhalation, probably through their exhalation valves. In both cases, the leakage was not enough for fog to appear at the mouth of the head form. PMID:21647352

  12. Integrated care pathways for airway diseases (AIRWAYS-ICPs).

    PubMed

    Bousquet, J; Addis, A; Adcock, I; Agache, I; Agusti, A; Alonso, A; Annesi-Maesano, I; Anto, J M; Bachert, C; Baena-Cagnani, C E; Bai, C; Baigenzhin, A; Barbara, C; Barnes, P J; Bateman, E D; Beck, L; Bedbrook, A; Bel, E H; Benezet, O; Bennoor, K S; Benson, M; Bernabeu-Wittel, M; Bewick, M; Bindslev-Jensen, C; Blain, H; Blasi, F; Bonini, M; Bonini, S; Boulet, L P; Bourdin, A; Bourret, R; Bousquet, P J; Brightling, C E; Briggs, A; Brozek, J; Buhl, R; Bush, A; Caimmi, D; Calderon, M; Calverley, P; Camargos, P A; Camuzat, T; Canonica, G W; Carlsen, K H; Casale, T B; Cazzola, M; Cepeda Sarabia, A M; Cesario, A; Chen, Y Z; Chkhartishvili, E; Chavannes, N H; Chiron, R; Chuchalin, A; Chung, K F; Cox, L; Crooks, G; Crooks, M G; Cruz, A A; Custovic, A; Dahl, R; Dahlen, S E; De Blay, F; Dedeu, T; Deleanu, D; Demoly, P; Devillier, P; Didier, A; Dinh-Xuan, A T; Djukanovic, R; Dokic, D; Douagui, H; Dubakiene, R; Eglin, S; Elliot, F; Emuzyte, R; Fabbri, L; Fink Wagner, A; Fletcher, M; Fokkens, W J; Fonseca, J; Franco, A; Frith, P; Furber, A; Gaga, M; Garcés, J; Garcia-Aymerich, J; Gamkrelidze, A; Gonzales-Diaz, S; Gouzi, F; Guzmán, M A; Haahtela, T; Harrison, D; Hayot, M; Heaney, L G; Heinrich, J; Hellings, P W; Hooper, J; Humbert, M; Hyland, M; Iaccarino, G; Jakovenko, D; Jardim, J R; Jeandel, C; Jenkins, C; Johnston, S L; Jonquet, O; Joos, G; Jung, K S; Kalayci, O; Karunanithi, S; Keil, T; Khaltaev, N; Kolek, V; Kowalski, M L; Kull, I; Kuna, P; Kvedariene, V; Le, L T; Lodrup Carlsen, K C; Louis, R; MacNee, W; Mair, A; Majer, I; Manning, P; de Manuel Keenoy, E; Masjedi, M R; Melen, E; Melo-Gomes, E; Menzies-Gow, A; Mercier, G; Mercier, J; Michel, J P; Miculinic, N; Mihaltan, F; Milenkovic, B; Molimard, M; Momas, I; Montilla-Santana, A; Morais-Almeida, M; Morgan, M; N'Diaye, M; Nafti, S; Nekam, K; Neou, A; Nicod, L; O'Hehir, R; Ohta, K; Paggiaro, P; Palkonen, S; Palmer, S; Papadopoulos, N G; Papi, A; Passalacqua, G; Pavord, I; Pigearias, B; Plavec, D; Postma, D S; Price, D; Rabe, K F; Radier Pontal, F; Redon, J; Rennard, S; Roberts, J; Robine, J M; Roca, J; Roche, N; Rodenas, F; Roggeri, A; Rolland, C; Rosado-Pinto, J; Ryan, D; Samolinski, B; Sanchez-Borges, M; Schünemann, H J; Sheikh, A; Shields, M; Siafakas, N; Sibille, Y; Similowski, T; Small, I; Sola-Morales, O; Sooronbaev, T; Stelmach, R; Sterk, P J; Stiris, T; Sud, P; Tellier, V; To, T; Todo-Bom, A; Triggiani, M; Valenta, R; Valero, A L; Valiulis, A; Valovirta, E; Van Ganse, E; Vandenplas, O; Vasankari, T; Vestbo, J; Vezzani, G; Viegi, G; Visier, L; Vogelmeier, C; Vontetsianos, T; Wagstaff, R; Wahn, U; Wallaert, B; Whalley, B; Wickman, M; Williams, D M; Wilson, N; Yawn, B P; Yiallouros, P K; Yorgancioglu, A; Yusuf, O M; Zar, H J; Zhong, N; Zidarn, M; Zuberbier, T

    2014-08-01

    The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1) proposing a common framework of care pathways for chronic respiratory diseases, which will facilitate comparability and trans-national initiatives; 2) informing cost-effective policy development, strengthening in particular those on smoking and environmental exposure; 3) aiding risk stratification in chronic disease patients, using a common strategy; 4) having a significant impact on the health of citizens in the short term (reduction of morbidity, improvement of education in children and of work in adults) and in the long-term (healthy ageing); 5) proposing a common simulation tool to assist physicians; and 6) ultimately reducing the healthcare burden (emergency visits, avoidable hospitalisations, disability and costs) while improving quality of life. In the longer term, the incidence of disease may be reduced by innovative prevention strategies. AIRWAYSICPs was initiated by Area 5 of the Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing. All stakeholders are involved (health and social care, patients, and policy makers). PMID:24925919

  13. UPPER AIRWAY BLOCKS FOR AWAKE DIFFICULT AIRWAY MANAGEMENT.

    PubMed

    Pintaric, Tatjana Stopar

    2016-03-01

    Airway anesthesia is pivotal for successful awake intubation provided either topically or by blocks. Airway blocks are considered technically more difficult to perform and carry a higher risk of complications. However, in experienced hands, they can be useful as they provide excellent intubating conditions. For complete upper airway anesthesia, bilateral glossopharyngeal and superior laryngeal nerve blocks with translaryngeal injection are required. Superior laryngeal nerve block and translaryngeal injection can be performed easily, safely and with a high success rate in patients with normal anatomy. In those with difficult landmarks, ultrasound can be of assistance. For the superior laryngeal nerve block, other targets than the nerve itself must be established to make the technique consistently successful, easy to teach, learn and perform. The same applies to the translaryngeal injection, where the use of ultrasound is necessary for correct midline identification. Intraoral glossopharyngeal nerve block is also safe and easy to perform, but associated with long lasting discomfort. Bilateral extraoral peristyloid approach should be discouraged since inadvertent blocks of the closely adjacent vagus nerve cannot be prevented in this location. A safe and easy method of blocking the distal portions of the glossopharyngeal nerve for awake intubation is therefore required. PMID:27276778

  14. Integrated care pathways for airway diseases (AIRWAYS-ICPs).

    PubMed

    Bousquet, J; Addis, A; Adcock, I; Agache, I; Agusti, A; Alonso, A; Annesi-Maesano, I; Anto, J M; Bachert, C; Baena-Cagnani, C E; Bai, C; Baigenzhin, A; Barbara, C; Barnes, P J; Bateman, E D; Beck, L; Bedbrook, A; Bel, E H; Benezet, O; Bennoor, K S; Benson, M; Bernabeu-Wittel, M; Bewick, M; Bindslev-Jensen, C; Blain, H; Blasi, F; Bonini, M; Bonini, S; Boulet, L P; Bourdin, A; Bourret, R; Bousquet, P J; Brightling, C E; Briggs, A; Brozek, J; Buhl, R; Bush, A; Caimmi, D; Calderon, M; Calverley, P; Camargos, P A; Camuzat, T; Canonica, G W; Carlsen, K H; Casale, T B; Cazzola, M; Cepeda Sarabia, A M; Cesario, A; Chen, Y Z; Chkhartishvili, E; Chavannes, N H; Chiron, R; Chuchalin, A; Chung, K F; Cox, L; Crooks, G; Crooks, M G; Cruz, A A; Custovic, A; Dahl, R; Dahlen, S E; De Blay, F; Dedeu, T; Deleanu, D; Demoly, P; Devillier, P; Didier, A; Dinh-Xuan, A T; Djukanovic, R; Dokic, D; Douagui, H; Dubakiene, R; Eglin, S; Elliot, F; Emuzyte, R; Fabbri, L; Fink Wagner, A; Fletcher, M; Fokkens, W J; Fonseca, J; Franco, A; Frith, P; Furber, A; Gaga, M; Garcés, J; Garcia-Aymerich, J; Gamkrelidze, A; Gonzales-Diaz, S; Gouzi, F; Guzmán, M A; Haahtela, T; Harrison, D; Hayot, M; Heaney, L G; Heinrich, J; Hellings, P W; Hooper, J; Humbert, M; Hyland, M; Iaccarino, G; Jakovenko, D; Jardim, J R; Jeandel, C; Jenkins, C; Johnston, S L; Jonquet, O; Joos, G; Jung, K S; Kalayci, O; Karunanithi, S; Keil, T; Khaltaev, N; Kolek, V; Kowalski, M L; Kull, I; Kuna, P; Kvedariene, V; Le, L T; Lodrup Carlsen, K C; Louis, R; MacNee, W; Mair, A; Majer, I; Manning, P; de Manuel Keenoy, E; Masjedi, M R; Melen, E; Melo-Gomes, E; Menzies-Gow, A; Mercier, G; Mercier, J; Michel, J P; Miculinic, N; Mihaltan, F; Milenkovic, B; Molimard, M; Momas, I; Montilla-Santana, A; Morais-Almeida, M; Morgan, M; N'Diaye, M; Nafti, S; Nekam, K; Neou, A; Nicod, L; O'Hehir, R; Ohta, K; Paggiaro, P; Palkonen, S; Palmer, S; Papadopoulos, N G; Papi, A; Passalacqua, G; Pavord, I; Pigearias, B; Plavec, D; Postma, D S; Price, D; Rabe, K F; Radier Pontal, F; Redon, J; Rennard, S; Roberts, J; Robine, J M; Roca, J; Roche, N; Rodenas, F; Roggeri, A; Rolland, C; Rosado-Pinto, J; Ryan, D; Samolinski, B; Sanchez-Borges, M; Schünemann, H J; Sheikh, A; Shields, M; Siafakas, N; Sibille, Y; Similowski, T; Small, I; Sola-Morales, O; Sooronbaev, T; Stelmach, R; Sterk, P J; Stiris, T; Sud, P; Tellier, V; To, T; Todo-Bom, A; Triggiani, M; Valenta, R; Valero, A L; Valiulis, A; Valovirta, E; Van Ganse, E; Vandenplas, O; Vasankari, T; Vestbo, J; Vezzani, G; Viegi, G; Visier, L; Vogelmeier, C; Vontetsianos, T; Wagstaff, R; Wahn, U; Wallaert, B; Whalley, B; Wickman, M; Williams, D M; Wilson, N; Yawn, B P; Yiallouros, P K; Yorgancioglu, A; Yusuf, O M; Zar, H J; Zhong, N; Zidarn, M; Zuberbier, T

    2014-08-01

    The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1) proposing a common framework of care pathways for chronic respiratory diseases, which will facilitate comparability and trans-national initiatives; 2) informing cost-effective policy development, strengthening in particular those on smoking and environmental exposure; 3) aiding risk stratification in chronic disease patients, using a common strategy; 4) having a significant impact on the health of citizens in the short term (reduction of morbidity, improvement of education in children and of work in adults) and in the long-term (healthy ageing); 5) proposing a common simulation tool to assist physicians; and 6) ultimately reducing the healthcare burden (emergency visits, avoidable hospitalisations, disability and costs) while improving quality of life. In the longer term, the incidence of disease may be reduced by innovative prevention strategies. AIRWAYSICPs was initiated by Area 5 of the Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing. All stakeholders are involved (health and social care, patients, and policy makers).

  15. Effect of Qi-regulating,Phlegm-resolving,and Blood-promoting Prescription on Rat Coronary Microvascular Thrombosis and Coronary Microvascular Occlusion.

    PubMed

    2016-06-10

    Objective To explore the effect of qi-regulating,phlegm-resolving,and blood-promoting prescription on coronary microvascular thrombosis and coronary microvascular occlusion in rat models. Methods Totally 125 healthy clean-grade male SD rats weighing (300±25) g were sequentially numbered and then randomly divided into treatment group (n=60),control group (n=60) and blank group (n=5).Rats in the treatment group and control group received apical left ventricular injection of sodium laurate to establish rat models of coronary microvascular thrombosis. Then,rats in the control group were given distilled water by gavage one day before operation and after surgery. In contrast,rats in the treatment group were given qi-regulating,phlegm-resolving,and blood-promoting prescription by gavage one day before operation and after surgery. Five rats from both treatment group and control group were killed at each of six time points (1 hour,24th hour,7th day,14th day,21th day,and 28th day),and the myocardium specimens were harvested. The 5 rats in the blank group did not receive any special treatment and were given normal feeding;in the 28th day,they were sacrificed to obtain the myocardial specimens. Pathological sections of rat myocardial tissues were made to observe and compare the degrees of coronary microvascular thrombosis and coronary microvascular obstruction. Results In the treatment group and the control group,coronary microvascular thrombosis occurred 1 hour after apical sodium laurate injection and reached the peak at the 24th hour. Compared with the blank group,the treatment group and the control group showed different degree of coronary microvascular obstruction. Comparison between the treatment group and the control group at each time point showed that the coronary microvascular thrombosis in the treatment group was significantly lower than that in the control group (P<0.05 or P<0.01).The severity of coronary

  16. [Successful airway management using i-gel in 7 patients undergoing awake craniotomy].

    PubMed

    Matsunami, Katsuaki; Sanuki, Michiyoshi; Yasuuji, Masakazu; Nakanuno, Ryuichi; Kato, Takahiro; Kawamoto, Masashi

    2014-07-01

    In order to secure airway during awake craniotomy, we used i-gel to perform positive-pressure ventilation in 7 patients for their anesthetic management. During removal of a tumor around the motor speech center, anesthetic management including asleep-awake-asleep technique was applied for speech testing. The technique, insertion and re-insertion of i-gel, was needed and it was easy in all the patients. During positive-pressure ventilation, peak pressure, tidal volume both for inspiration and expiration, and endtidal-CO2 were not markedly altered. Leakage around i-gel, and its differences between inspiration and expiration were negligible, while the tidal volume was adequate. We conclude that i-gel is useful for anesthetic management for awake craniotomy procedure for both securing airway and ventilation.

  17. Plasma exudation. Correlation between Evans blue dye and radiolabeled albumin in guinea pig airways in vivo

    SciTech Connect

    Rogers, D.F.; Boschetto, P.; Barnes, P.J. )

    1989-07-01

    We quantified the tissue exudation and luminal transudation of two plasma markers, Evans blue (EB) dye and ({sup 125}I)-human serum albumin (HSA), into the airways of the anesthetized guinea pig in response to platelet activating factor (PAF). There was a highly significant correlation between the tissue content of EB and ({sup 125}I)-HSA in all airways studied. Significant correlation for transudation of the two markers was limited to high rates of plasma leakage. ({sup 125}I)-HSA was the more sensitive marker for the association between exudation and transudation and the effect of PAF on transudation. EB was the better marker for assessing the relationship between the dose of PAF and plasma exudation.

  18. Dietary nitrite prevents hypercholesterolemic microvascular inflammation and reverses endothelial dysfunction.

    PubMed

    Stokes, Karen Y; Dugas, Tammy R; Tang, Yaoping; Garg, Harsha; Guidry, Eric; Bryan, Nathan S

    2009-05-01

    The nitrite anion is an endogenous product of mammalian nitric oxide (NO) metabolism, a key intermediate in the nitrogen cycle in plants, and a constituent of many foods. Research over the past 6 years has revealed surprising biological and cytoprotective activity of this anion. Hypercholesterolemia causes a proinflammatory phenotype in the microcirculation. This phenotype appears to result from a decline in NO bioavailability that results from a reduction in NO biosynthesis, inactivation of NO by superoxide, or both. Since nitrite has been shown to be potently cytoprotective and restore NO biochemical homeostasis, we investigated if supplemental nitrite could attenuate microvascular inflammation caused by a high cholesterol diet. C57Bl/6J mice were fed either a normal diet or a high cholesterol diet for 3 wk to induce microvascular inflammation. Mice on the high cholesterol diet received either nitrite-free drinking water or supplemental nitrite at 33 or 99 mg/l ad libitum in their drinking water. The results from this investigation reveal that mice fed a cholesterol-enriched diet exhibited significantly elevated leukocyte adhesion to and emigration through the venular endothelium as well as impaired endothelium-dependent relaxation in arterioles. Administration of nitrite in the drinking water inhibited the leukocyte adhesion and emigration and prevented the arteriolar dysfunction. This was associated with sparing of reduced tetrahydrobiopterin and decreased levels of C-reactive protein. These data reveal novel anti-inflammatory properties of nitrite and implicate the use of nitrite as a new natural therapy for microvascular inflammation and endothelial dysfunction associated with hypercholesterolemia.

  19. Skeletal muscle microvascular function in girls with Turner syndrome

    PubMed Central

    West, Sarah L.; O'Gorman, Clodagh S.; Elzibak, Alyaa H.; Caterini, Jessica; Noseworthy, Michael D.; Rayner, Tammy; Hamilton, Jill; Wells, Greg D.

    2014-01-01

    Background Exercise intolerance is prevalent in individuals with Turner Syndrome (TS). We recently demonstrated that girls with TS have normal aerobic but altered skeletal muscle anaerobic metabolism compared to healthy controls (HC). The purpose of this study was to compare peripheral skeletal muscle microvascular function in girls with TS to HC after exercise. We hypothesized that girls with TS would have similar muscle blood-oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) signal responses during recovery from exercise compared to HC. Methods Thirteen TS participants and 8 HC completed testing. BOLD MRI was used to measure skeletal muscle microvascular response during 60 second recovery, following 60 s of exercise at 65% of maximal workload. Exercise and recovery were repeated four times, and the BOLD signal time course was fit to a four-parameter sigmoid function. Results Participants were 13.7 ± 3.1 years old and weighed 47.9 ± 14.6 kg. The mean change in BOLD signal intensity following exercise at the end of recovery, the mean response time of the function/the washout of deoxyhemoglobin, and the mean half-time of recovery were similar between the TS and HC groups. Conclusions Our results demonstrate that compared to HC, peripheral skeletal muscle microvascular function following exercise in girls with TS is not impaired. General significance This study supports the idea that the aerobic energy pathway is not impaired in children with TS in response to submaximal exercise. Other mechanisms are likely responsible for exercise intolerance in TS; this needs to be further investigated. PMID:26676172

  20. Upper Airway Injury in Dogs Secondary to Trauma: 10 Dogs (2000-2011).

    PubMed

    Basdani, Eleni; Papazoglou, Lysimachos G; Patsikas, Michail N; Kazakos, Georgios M; Adamama-Moraitou, Katerina K; Tsokataridis, Ioannis

    2016-01-01

    Ten dogs that presented with trauma-induced upper airway rupture or stenosis were reviewed. Tracheal rupture was seen in seven dogs, tracheal stenosis in one dog, and laryngeal rupture in two dogs. Clinical abnormalities included respiratory distress in five dogs, subcutaneous emphysema in eight, air leakage through the cervical wound in seven, stridor in three dogs, pneumomediastinum in four and pneumothorax in one dog. Reconstruction with simple interrupted sutures was performed in four dogs, tracheal resection and end-to-end anastomosis in five dogs, and one dog was euthanized intraoperatively. Complications were seen in three dogs including aspiration pneumonia in one and vocalization alterations in two dogs. PMID:27487354

  1. Antiproliferative effect of elevated glucose in human microvascular endothelial cells

    NASA Technical Reports Server (NTRS)

    Kamal, K.; Du, W.; Mills, I.; Sumpio, B. E.

    1998-01-01

    Diabetic microangiopathy has been implicated as a fundamental feature of the pathological complications of diabetes including retinopathy, neuropathy, and diabetic foot ulceration. However, previous studies devoted to examining the deleterious effects of elevated glucose on the endothelium have been performed largely in primary cultured cells of macrovessel origin. Difficulty in the harvesting and maintenance of microvascular endothelial cells in culture have hindered the study of this relevant population. Therefore, the objective of this study was to characterize the effect of elevated glucose on the proliferation and involved signaling pathways of an immortalized human dermal microvascular endothelial cell line (HMEC-1) that possess similar characteristics to their in vivo counterparts. Human dermal microvascular endothelial cells (HMEC-1) were grown in the presence of normal (5 mM) or high D-glucose (20 mM) for 14 days. The proliferative response of HMEC-1 was compared under these conditions as well as the cAMP and PKC pathways by in vitro assays. Elevated glucose significantly inhibited (P < 0.05) HMEC-1 proliferation after 7, 10, and 14 days. This effect was not mimicked by 20 mM mannitol. The antiproliferative effect was more pronounced with longer exposure (1-14 days) to elevated glucose and was irreversible 4 days after a 10-day exposure. The antiproliferative effect was partially reversed in the presence of a PKA inhibitor, Rp-cAMP (10-50 microM), and/or a PKC inhibitor, Calphostin C (10 nM). HMEC-1 exposed to elevated glucose (20 mM) for 14 days caused an increase in cyclic AMP accumulation, PKA, and PKC activity but was not associated with the activation of downstream events such as CRE and AP-1 binding activity. These data support the hypothesis that HMEC-1 is a suitable model to study the deleterious effects of elevated glucose on microvascular endothelial cells. Continued studies with HMEC-1 may prove advantageous in delineation of the molecular

  2. Quantifying Therapeutic and Diagnostic Efficacy in 2D Microvascular Images

    NASA Technical Reports Server (NTRS)

    Parsons-Wingerter, Patricia; Vickerman, Mary B.; Keith, Patricia A.

    2009-01-01

    VESGEN is a newly automated, user-interactive program that maps and quantifies the effects of vascular therapeutics and regulators on microvascular form and function. VESGEN analyzes two-dimensional, black and white vascular images by measuring important vessel morphology parameters. This software guides the user through each required step of the analysis process via a concise graphical user interface (GUI). Primary applications of the VESGEN code are 2D vascular images acquired as clinical diagnostic images of the human retina and as experimental studies of the effects of vascular regulators and therapeutics on vessel remodeling.

  3. Alternative venous outflow vessels in microvascular breast reconstruction.

    PubMed

    Mehrara, Babak J; Santoro, Timothy; Smith, Andrew; Arcilla, Eric A; Watson, James P; Shaw, William W; Da Lio, Andrew L

    2003-08-01

    The lack of adequate recipient vessels often complicates microvascular breast reconstruction in patients who have previously undergone mastectomy and irradiation. In addition, significant size mismatch, particularly in the outflow veins, is an important contributor to vessel thrombosis and flap failure. The purpose of this study was to review the authors' experience with alternative venous outflow vessels for microvascular breast reconstruction. In a retrospective analysis of 1278 microvascular breast reconstructions performed over a 10-year period, the authors identified all patients in whom the external jugular or cephalic veins were used as the outflow vessels. Patient demographics, flap choice, the reasons for the use of alternative venous drainage vessels, and the incidence of microsurgical complications were analyzed. The external jugular was used in 23 flaps performed in procedures with 22 patients. The superior gluteal and transverse rectus abdominis musculocutaneous (TRAM) flaps were used in the majority of the cases in which the external jugular vein was used (72 percent gluteal, 20 percent TRAM flap). The need for alternative venous outflow vessels was usually due to a significant vessel size mismatch between the superior gluteal and internal mammary veins (74 percent). For three of the external jugular vein flaps (13 percent), the vein was used for salvage after the primary draining vein thrombosed, and two of three flaps in these cases were eventually salvaged. In three patients, the external jugular vein thrombosed, resulting in two flap losses, while the third was salvaged using the cephalic vein. A total of two flaps were lost in the external jugular vein group. The cephalic vein was used in 11 flaps (TRAM, 64.3 percent; superior gluteal, 35.7 percent) performed in 11 patients. In five patients (54.5 percent), the cephalic vein was used to salvage a flap after the primary draining vein thrombosed; the procedure was successful in four cases. In three

  4. Microvascular alterations and the role of complement in dermatomyositis.

    PubMed

    Lahoria, Rajat; Selcen, Duygu; Engel, Andrew G

    2016-07-01

    Different mechanisms have been proposed to explain the pathological basis of perifascicular muscle fibre atrophy in dermatomyositis. These include ischaemia due to immune-mediated microvascular injury, enhanced expression of type 1 interferon-induced gene transcripts in perifascicular capillaries and muscle fibres, and occlusion of larger perimysial blood vessels. Microvascular complement deposition is a feature of dermatomyositis pathology but the trigger for complement activation, the predominant complement pathway involved, or its role in the pathogenesis of the disease, has not been clearly defined. In the first step of this study we examined the density of capillaries and transverse vessels and searched for occlusion or depletion of larger perimysial blood vessels in 10 patients with dermatomyositis. This revealed an invariable association of perifascicular atrophy with capillary and transverse vessel depletion. The capillary and transverse vessel densities in non-atrophic fibre regions were not significantly different from those in muscle specimens of 10 age-matched controls. Next, in the same 10, as well as in 40 additional dermatomyositis patients, we searched for vascular deposits of IgG, IgM, and the C5b-9 complement membrane attack complex. Thirty-one of 50 dermatomyositis specimens contained C5b-9 reactive endomysial microvessels but none of these or other vessels reacted for IgG. Ten of 50 specimens harboured IgM-positive capillaries but only a few of these reacted for C5b-9. Finally, we analysed and compared different pathways of complement activation in dermatomyositis, lupus nephritis, and necrotic muscle fibres in Duchenne dystrophy. In lupus nephritis, C5-b9 deposits co-localized with IgG, IgM, C1q, and C4d, consistent with immune complex dependent activation of the classical complement pathway. In both dermatomyositis and Duchenne dystrophy, C5-b9 deposits co-localized with C1q and C4d and rarely with IgM indicating activation of the classical

  5. Measurements of the atmospheric neutron leakage rate

    NASA Technical Reports Server (NTRS)

    Lockwood, J. A.; Ifedili, S. O.; Jenkins, R. W.

    1973-01-01

    The atmospheric neutron leakage rate in the energy range from 0.01 to 10,000,000 eV has been measured as a function of latitude, altitude, and time with a neutron detector on board the Ogo 6 satellite. The latitude dependence of the neutron leakage is in reasonable agreement with that predicted by Lingenfelter (1963) and Light et al. (1973) if the neutron energy spectrum has the shape calculated by Newkirk (1963). The change in the neutron latitude dependence with the cosmic ray modulation agrees with the predictions of Lingenfelter and Light et al. For several solar proton events enhancements were observed in the neutron counting rates at lambda greater than or equal to 70 deg. Such events, however, provide an insignificant injection of protons at E less than or equal to 20 MeV into the radiation belts. An isotropic angular distribution of the neutron leakage in the energy range from 0.1 keV to 10 MeV best fits the observed altitude dependence of the neutron leakage flux.

  6. Control of Air Leakage in Buildings.

    ERIC Educational Resources Information Center

    Wilson, A. Grant

    This discussion of air leakage emphasizes cause and provides suggestions for elimination of undesirable effects. Cause parameters described are--(1) pressure differential, (2) building shape, (3) temperature differential, (4) opening sizes, (5) mechanical system pressures, and (6) climatic factors. Effects discussed are--(1) increased mechanical…

  7. Seasonal variation in effective leakage area

    SciTech Connect

    Dickinson, J.B.; Feustel, H.E.

    1986-01-01

    Previous research on the seasonal changes in airtightness has been conducted by other researchers on one or two houses in one location. This paper describes air leakage rate measurements using the fan pressurization technique performed monthly over a period of one year in ten occupied houses in three different climates. The purpose of this study is to determine the seasonal variation in effective leakage area in houses in different climates. The three sets of houses included in this study are located in Reno, Nevada (semi-arid, high desert), Truckee, California (alpine, mountainous), and the San Francisco Bay Area (temperate, coastal). The houses are all wood-frame construction and range from one year to seventy years in age. Indoor and outdoor air temperatures, wind speed, and the moisture content of wood framing and other building components were measured at the time of each fan pressurization test. Indoor moisture levels were monitored by measuring the moisture content of a reference block of wood that was located indoors at each site. The results indicate a seasonal variation in effective leakage area in some but not all of the houses; the largest variations are seen in the Truckee houses with effective leakage areas up to 45% higher in the summer as compared to those measured in midwinter.

  8. Imaging inflammatory plasma leakage in vivo.

    PubMed

    Kenne, E; Lindbom, L

    2011-05-01

    Increased vascular permeability and consequent plasma leakage from postcapillary venules is a cardinal sign of inflammation. Although the movement of plasma constituents from the vasculature to the affected tissue aids in clearing the inflammatory stimulus, excessive plasma extravasation can lead to hospitalisation or death in cases such as influenza-induced pneumonia, burns or brain injury. The use of intravital imaging has significantly contributed to the understanding of the mechanisms controlling the vascular permeability alterations that occur during inflammation. Today, intravital imaging can be performed using optical and non-optical techniques. Optical techniques, which are generally used in experimental settings, include traditional intravital fluorescence microscopy and near-infrared fluorescence imaging. Magnetic resonance (MRI) and radioisotopic imaging are used mainly in the clinical setting, but are increasingly used in experimental work, and can detect plasma leakage without optics. Although these methods are all able to visualise inflammatory plasma leakage in vivo, the spatial and temporal resolution differs between the techniques. In addition, they vary with regards to invasiveness and availability. This overview discusses the use of imaging techniques in the visualisation of inflammatory plasma leakage. PMID:21437352

  9. Reduction of valve leakage - A concept

    NASA Technical Reports Server (NTRS)

    Doshi, N. H.; Salvinski, R. J.

    1971-01-01

    Leakage elimination occurs by increasing pressure on poppet seat, heating poppet plunger or cooling valve body, and then exerting force between 4.45 and 44.5 kN at poppet seat interface. Valves are useful in handling of corrosive fluids.

  10. Pressure Gauges Monitor Leakage Past Seals

    NASA Technical Reports Server (NTRS)

    Smith, Steven A.

    1990-01-01

    Method devised to measure leakage of gas past each of two sets of primary and secondary seals into common volume from which aggregate flow measured. Although method applicable only to specific combination of flow configuration and thermal conditions, it serves as example of more general approach involving use of statistical analysis to extract additional information from measurements.

  11. Bronchial Venular Leakage During Endotoxin Shock

    PubMed Central

    Pietra, G. G.; Szidon, J. P.; Carpenter, H. A.; Fishman, A. P.

    1974-01-01

    The pulmonary effects of endotoxin shock were investigated in dogs by a combination of anatomic and physiologic technics. Shock was produced in 14 dogs by injecting Escherichia coli lipopolysaccharide intravenously. Three dogs in hypovolemic shock and 6 untreated dogs served as controls. Colloidal carbon was injected intravenously to detect sites of pathologic increase in vascular permeability. During the first hour of endotoxin shock, bronchial venules allowed carbon and blood elements to traverse their walls, whereas no leakage of these large particles or ultrastructural changes could be detected in the alveolar walls. Only after the first hour was bronchial venular leakage accompanied by focal degenerative changes in the alveolar endothelium, focal interstitial edema in the alveolar septum and sequestration of damaged leukocytes in the alveolar capillaries. In contrast to these observations in endotoxin shock, control dogs in hypovolemic shock did not show bronchial venous leakage. Our findings suggest that the leakage of bronchial venules may be involved in the pathogenesis of pulmonary interstitial edema caused by endotoxin shock. ImagesFig 2Fig 3Fig 4Fig 1 PMID:4611225

  12. Obesity and upper airway control during sleep

    PubMed Central

    Patil, Susheel P.; Squier, Samuel; Schneider, Hartmut; Kirkness, Jason P.; Smith, Philip L.

    2010-01-01

    Mechanisms linking obesity with upper airway dysfunction in obstructive sleep apnea are reviewed. Obstructive sleep apnea is due to alterations in upper airway anatomy and neuromuscular control. Upper airway structural alterations in obesity are related to adipose deposition around the pharynx, which can increase its collapsibility or critical pressure (Pcrit). In addition, obesity and, particularly, central adiposity lead to reductions in resting lung volume, resulting in loss of caudal traction on upper airway structures and parallel increases in pharyngeal collapsibility. Metabolic and humoral factors that promote central adiposity may contribute to these alterations in upper airway mechanical function and increase sleep apnea susceptibility. In contrast, neural responses to upper airway obstruction can mitigate these mechanical loads and restore pharyngeal patency during sleep. Current evidence suggests that these responses can improve with weight loss. Improvements in these neural responses with weight loss may be related to a decline in systemic and local pharyngeal concentrations of specific inflammatory mediators with somnogenic effects. PMID:19875707

  13. Airway management in cervical spine injury

    PubMed Central

    Austin, Naola; Krishnamoorthy, Vijay; Dagal, Arman

    2014-01-01

    To minimize risk of spinal cord injury, airway management providers must understand the anatomic and functional relationship between the airway, cervical column, and spinal cord. Patients with known or suspected cervical spine injury may require emergent intubation for airway protection and ventilatory support or elective intubation for surgery with or without rigid neck stabilization (i.e., halo). To provide safe and efficient care in these patients, practitioners must identify high-risk patients, be comfortable with available methods of airway adjuncts, and know how airway maneuvers, neck stabilization, and positioning affect the cervical spine. This review discusses the risks and benefits of various airway management strategies as well as specific concerns that affect patients with known or suspected cervical spine injury. PMID:24741498

  14. Airway obstruction in congenital central hypoventilation syndrome.

    PubMed

    Reverdin, Alexandra K; Mosquera, Ricardo; Colasurdo, Giuseppe N; Jon, Cindy K; Clements, Roya M

    2014-01-01

    Congenital central hypoventilation syndrome (CCHS) is the failure of the autonomic system to control adequate ventilation while asleep with preserved ventilatory response while awake. We report a case of a patient with CCHS who presented with intrathoracic and extrathoracic airway obstruction after tracheostomy tube decannulation and phrenic nerve pacer placement. Nocturnal polysomnography (NPSG) revealed hypoxia, hypercapnia and obstructive sleep apnoea, which required bilevel positive airway pressure titration. Airway endoscopy demonstrated tracheomalacia and paretic true vocal cords in the paramedian position during diaphragmatic pacing. Laryngeal electromyography demonstrated muscular electrical impulses that correlated with diaphragmatic pacer settings. Thus, we surmise that the patient's upper and lower airway obstruction was secondary to diaphragmatic pacer activity. Thorough airway evaluation, including NPSG and endoscopy, may help identify the side effects of diaphragmatic pacing, such as airway obstruction, in patients with CCHS.

  15. Globular Adiponectin Enhances Muscle Insulin Action via Microvascular Recruitment and Increased Insulin Delivery

    PubMed Central

    Zhao, Lina; Chai, Weidong; Fu, Zhuo; Dong, Zhenhua; Aylor, Kevin W.; Barrett, Eugene J.; Cao, Wenhong; Liu, Zhenqi

    2014-01-01

    Rationale Adiponectin enhances insulin action and induces nitric oxide–dependent vasodilatation. Insulin delivery to muscle microcirculation and transendothelial transport are 2 discrete steps that limit insulin's action. We have shown that expansion of muscle microvascular surface area increases muscle insulin delivery and action. Objective To examine whether adiponectin modulates muscle microvascular recruitment thus insulin delivery and action in vivo. Methods and Results Overnight fasted adult male rats were studied. We determined the effects of adiponectin on muscle microvascular recruitment, using contrast-enhanced ultrasound, on insulin-mediated microvascular recruitment and whole-body glucose disposal, using contrast-enhanced ultrasound and insulin clamp, and on muscle insulin clearance and uptake with 125I-insulin. Globular adiponectin potently increased muscle microvascular blood volume without altering microvascular blood flow velocity, leading to a significantly increased microvascular blood flow. This was paralleled by a ≈30% to 40% increase in muscle insulin uptake and clearance, and ≈30% increase in insulin-stimulated whole-body glucose disposal. Inhibition of endothelial nitric oxide synthase abolished globular adiponectin-mediated muscle microvascular recruitment and insulin uptake. In cultured endothelial cells, globular adiponectin dose-dependently increased endothelial nitric oxide synthase phosphorylation but had no effect on endothelial cell internalization of insulin. Conclusions Globular adiponectin increases muscle insulin uptake by recruiting muscle microvasculature, which contributes to its insulin-sensitizing action. PMID:23459195

  16. Anatomic Optical Coherence Tomography of Upper Airways

    NASA Astrophysics Data System (ADS)

    Chin Loy, Anthony; Jing, Joseph; Zhang, Jun; Wang, Yong; Elghobashi, Said; Chen, Zhongping; Wong, Brian J. F.

    The upper airway is a complex and intricate system responsible for respiration, phonation, and deglutition. Obstruction of the upper airways afflicts an estimated 12-18 million Americans. Pharyngeal size and shape are important factors in the pathogenesis of airway obstructions. In addition, nocturnal loss in pharyngeal muscular tone combined with high pharyngeal resistance can lead to collapse of the airway and periodic partial or complete upper airway obstruction. Anatomical optical coherence tomography (OCT) has the potential to provide high-speed three-dimensional tomographic images of the airway lumen without the use of ionizing radiation. In this chapter we describe the methods behind endoscopic OCT imaging and processing to generate full three dimensional anatomical models of the human airway which can be used in conjunction with numerical simulation methods to assess areas of airway obstruction. Combining this structural information with flow dynamic simulations, we can better estimate the site and causes of airway obstruction and better select and design surgery for patients with obstructive sleep apnea.

  17. AIRWAY VISUALIZATION: EYES SEE WHAT MIND KNOWS.

    PubMed

    Sorbello, Massimiliano; Frova, Giulio; Zdravković, Ivana

    2016-03-01

    Airway management is basic for anesthesia practice, and sometimes it can represent a really dramatic scenario for both the patient and the physicians. Laryngoscopy has been the gold standard of airway visualization for more than 60 years, showing its limitations and failure rates with time. New technology has made available an opportunity to move the physician's eye inside patient airways thanks to video laryngoscopy and video assisted airway management technique. Undoubtedly, we have entered a new era of high resolution airway visualization and different approach in airway instrumentation. Nevertheless, each new technology needs time to be tested and considered reliable, and pitfalls and limitations may come out with careful and long lasting analysis, so it is probably not the right time yet to promote video assisted approach as a new gold standard for airway visualization, despite the fact that it certainly offers some new prospects. In any case, whatever the visualization approach, no patient dies because of missed airway visualization or failed intubation, but due to failed ventilation, which remains without doubt the gold standard of any patient safety goal and airway management technique.

  18. Method for 3D Airway Topology Extraction

    PubMed Central

    Grothausmann, Roman; Kellner, Manuela; Heidrich, Marko; Lorbeer, Raoul-Amadeus; Ripken, Tammo; Meyer, Heiko; Kuehnel, Mark P.; Ochs, Matthias; Rosenhahn, Bodo

    2015-01-01

    In lungs the number of conducting airway generations as well as bifurcation patterns varies across species and shows specific characteristics relating to illnesses or gene variations. A method to characterize the topology of the mouse airway tree using scanning laser optical tomography (SLOT) tomograms is presented in this paper. It is used to test discrimination between two types of mice based on detected differences in their conducting airway pattern. Based on segmentations of the airways in these tomograms, the main spanning tree of the volume skeleton is computed. The resulting graph structure is used to distinguish between wild type and surfactant protein (SP-D) deficient knock-out mice. PMID:25767561

  19. Sequential Stenting for Extensive Malignant Airway Stenosis

    PubMed Central

    Takahama, Makoto; Nakajima, Ryu; Kimura, Michitaka; Tei, Keiko; Yamamoto, Ryoji

    2014-01-01

    Purpose: Malignant airway stenosis extending from the bronchial bifurcation to the lower lobar orifice was treated with airway stenting. We herein examine the effectiveness of airway stenting for extensive malignant airway stenosis. Methods: Twelve patients with extensive malignant airway stenosis underwent placement of a silicone Dumon Y stent (Novatech, La Ciotat, France) at the tracheal bifurcation and a metallic Spiral Z-stent (Medico’s Hirata, Osaka, Japan) at either distal side of the Y stent. We retrospectively analyzed the therapeutic efficacy of the sequential placement of these silicone and metallic stents in these 12 patients. Results: The primary disease was lung cancer in eight patients, breast cancer in two patients, tracheal cancer in one patient, and thyroid cancer in one patient. The median survival period after airway stent placement was 46 days. The Hugh–Jones classification and performance status improved in nine patients after airway stenting. One patient had prolonged hemoptysis and died of respiratory tract hemorrhage 15 days after the treatment. Conclusion: Because the initial disease was advanced and aggressive, the prognosis after sequential airway stent placement was significantly poor. However, because respiratory distress decreased after the treatment in most patients, this treatment may be acceptable for selected patients with extensive malignant airway stenosis. PMID:25273272

  20. Physical principle of airway design in human lungs

    NASA Astrophysics Data System (ADS)

    Park, Keunhwan; Son, Taeho; Kim, Wonjung; Kim, Ho-Young

    2014-11-01

    From an engineering perspective, lungs are natural microfluidic devices that extract oxygen from air. In the bronchial tree, airways branch by dichotomy with a systematic reduction of their diameters. It is generally accepted that in conducting airways, which air passes on the way to the acinar airways from the atmosphere, the reduction ratio of diameter is closely related to the minimization of viscous dissipation. Such a principle is formulated as the Hess-Murray law. However, in acinar airways, where oxygen transfer to alveolae occurs, the diameter reduction with progressive generations is more moderate than in conducting airways. Noting that the dominant transfer mechanism in acinar airways is diffusion rather than advection, unlike conducting airways, we construct a mathematical model for oxygen transfer through a series of acinar airways. Our model allows us to predict the optimal airway reduction ratio that maximizes the oxygen transfer in a finite airway volume, thereby rationalizing the observed airway reduction ratio in acinar airways.

  1. Microvascular Perfusion and Intramuscular Temperature of the Calf During Cooling

    PubMed Central

    Selkow, Noelle M; Day, Carly; Liu, Zhenqi; Hart, Joseph M; Hertel, Jay; Saliba, Susan A

    2011-01-01

    Purpose To examine how the microvascularity of the gastrocnemius changed after a cryotherapy intervention based on subcutaneous tissue thickness. A secondary purpose was to compare intramuscular temperature change to subcutaneous tissue thickness. Methods This was a single-blinded crossover study; each subject received both conditions (cryotherapy or sham). Subjects had baseline measurements of blood flow, blood volume, and intramuscular temperature recorded at 1cm into the muscle belly of the medial gastrocnemius. The randomized condition was applied for 10, 25, 40, or 60min depending on subcutaneous tissue thickness. Immediate post treatment microvascular measures were taken. After a designated rewarm period, again based on subcutaneous tissue thickness, measurements were retaken. At least 48 hours separated the two conditions. Results There were significant condition by time interactions for blood flow (p=0.01), blood volume (p=0.022), and intramuscular temperature (p<0.001). For blood flow and volume, the cryotherapy condition maintained baseline levels, while the sham condition increased at immediate-post treatment and rewarm. For intramuscular temperature, the cryotherapy condition caused a decrease in intramuscular temperature from baseline compared to no change in the sham condition from baseline. Intramuscular temperature change was significantly correlated to subcutaneous tissue thickness (r=.49; p=0.05). Conclusions Cryotherapy did not decrease blood flow and blood volume from resting levels, even though the intramuscular temperature decreased. An intramuscular change of 7–9°C may not be cold enough to cause local vasoconstriction. PMID:21988932

  2. Mechanisms for microvascular damage induced by ultrasound-activated microbubbles

    NASA Astrophysics Data System (ADS)

    Chen, Hong; Brayman, Andrew A.; Evan, Andrew P.; Matula, Thomas J.

    2012-10-01

    To provide insight into the mechanisms of microvascular damage induced by ultrasound-activated microbubbles, experimental studies were performed to correlate microvascular damage to the dynamics of bubble-vessel interactions. High-speed photomicrography was used to record single microbubbles interacting with microvessels in ex vivo tissue, under the exposure of short ultrasound pulses with a center frequency of 1 MHz and peak negative pressures (PNP) ranging from 0.8-4 MPa. Vascular damage associated with observed bubble-vessel interactions was either indicated directly by microbubble extravasation or examined by transmission electron microscopy (TEM) analyses. As observed previously, the high-speed images revealed that ultrasound-activated microbubbles could cause distention and invagination of adjacent vessel walls, and could form liquid jets in microvessels. Vessel distention, invagination, and liquid jets were associated with the damage of microvessels whose diameters were smaller than those of maximally expanded microbubbles. However, vessel invagination appeared to be the dominant mechanism for the damage of relative large microvessels.

  3. Mechanisms for microvascular damage induced by ultrasound-activated microbubbles

    SciTech Connect

    Chen Hong; Brayman, Andrew A.; Evan, Andrew P.; Matula, Thomas J.

    2012-10-03

    To provide insight into the mechanisms of microvascular damage induced by ultrasound-activated microbubbles, experimental studies were performed to correlate microvascular damage to the dynamics of bubble-vessel interactions. High-speed photomicrography was used to record single microbubbles interacting with microvessels in ex vivo tissue, under the exposure of short ultrasound pulses with a center frequency of 1 MHz and peak negative pressures (PNP) ranging from 0.8-4 MPa. Vascular damage associated with observed bubble-vessel interactions was either indicated directly by microbubble extravasation or examined by transmission electron microscopy (TEM) analyses. As observed previously, the high-speed images revealed that ultrasound-activated microbubbles could cause distention and invagination of adjacent vessel walls, and could form liquid jets in microvessels. Vessel distention, invagination, and liquid jets were associated with the damage of microvessels whose diameters were smaller than those of maximally expanded microbubbles. However, vessel invagination appeared to be the dominant mechanism for the damage of relative large microvessels.

  4. Microvascular responsiveness in obesity: implications for therapeutic intervention

    PubMed Central

    Bagi, Zsolt; Feher, Attila; Cassuto, James

    2012-01-01

    Obesity has detrimental effects on the microcirculation. Functional changes in microvascular responsiveness may increase the risk of developing cardiovascular complications in obese patients. Emerging evidence indicates that selective therapeutic targeting of the microvessels may prevent life-threatening obesity-related vascular complications, such as ischaemic heart disease, heart failure and hypertension. It is also plausible that alterations in adipose tissue microcirculation contribute to the development of obesity. Therefore, targeting adipose tissue arterioles could represent a novel approach to reducing obesity. This review aims to examine recent studies that have been focused on vasomotor dysfunction of resistance arteries in obese humans and animal models of obesity. Particularly, findings in coronary resistance arteries are contrasted to those obtained in other vascular beds. We provide examples of therapeutic attempts, such as use of statins, ACE inhibitors and insulin sensitizers to prevent obesity-related microvascular complications. We further identify some of the important challenges and opportunities going forward. LINKED ARTICLES This article is part of a themed section on Fat and Vascular Responsiveness. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-3 PMID:21797844

  5. Tissue viability imaging for assessment of microvascular events

    NASA Astrophysics Data System (ADS)

    O'Doherty, Jim; Nilsson, Gert E.; Henricson, Joakim; Sjoberg, Folke; Leahy, Martin J.

    2005-08-01

    A new technique for the investigation of microvascular tissue blood concentration is presented, based on the method of polarisation spectroscopy of blood in superficial skin tissue. Linearly polarised light incident on the skin is partly reflected by the surface layers, and partly backscattered from the dermal tissue. Use of orthogonal polarisation filters over both a light source and a CCD suppresses the reflections from the surface, and only the depolarised light backscattered from the dermal matrix reaches the CCD array. By separating the colour planes of an image acquired in this manner and applying a dedicated image processing algorithm, spectroscopic information about the amount of red blood cells (RBCs) in the underlying area of tissue can be discovered. The algorithm incorporates theory that utilises the differences in light absorption of RBCs and dermal tissue in the red and green wavelength regions. In vitro fluid models compare well to computer simulations in describing a linear relationship between output signal (called TiViindex) and RBC concentration in the physiological range of 0%-4%. In vivo evaluation of the technique via transepidermal application of acetylcholine by iontophoresis displayed a heterogeneity pattern of vasodilation, which is typical of the vasoactive agent. Extension of the technique to capture and process continuous real-time data creates a new possibility of online real-time image processing. Application of tissue viability (TiVi) imaging include skin care products and drug development, as well as investigations of microvascular angiogenesis.

  6. Effects of hyperoxia on microvascular cells in vitro

    SciTech Connect

    D'Amore, P.A.; Sweet, E.

    1987-02-01

    Microvascular cells are most vulnerable to direct oxygen damage. Using an in vitro model system we have investigated the effect of elevated oxygen on the proliferation, morphology, and integrity of microvascular endothelial cells (EC) and pericytes. Cultivation of these cells at oxygen concentrations of 40% for 1 wk resulted in the inhibition of EC proliferation but had no effect on the growth of the pericytes. Similarly, hyperoxia induced a dramatic change in the shape of the EC, increasing their spread area by close to six-fold. Under the same conditions, the spread area of the pericytes was unaffected. To understand the effect of the hyperoxic treatment on the cells, the integrity of various membrane systems was assessed. /sup 51/Cr release was used to monitor plasma membrane integrity. There was no difference in chromium release by EC and pericytes over the 7 d of growth under normoxic and hyperoxic conditions. Mitochondrial integrity was examined by staining the cells with Rhodamine 123, which is selectively accumulated by the mitochondria. The staining pattern of the mitochondria of both EC and pericytes was altered by growth in the elevated oxygen. Finally, the lysosomes were visualized using acridine orange. The acridine orange staining pattern revealed enlarged and perinuclear lysosomes in the EC but no change in the pericyte lysosomal staining pattern. Thus, the cells of the microvasculature seem to be differentially affected by hyperoxia, a fact that may be significant in the etiology of reperfusion injury, ischemic disease, and pathologies associated with prematurity.

  7. Modulation of cerebral microvascular permeability by endothelial nicotinic acetylcholine receptors.

    PubMed

    Hawkins, Brian T; Egleton, Richard D; Davis, Thomas P

    2005-07-01

    Nicotine increases the permeability of the blood-brain barrier in vivo. This implies a possible role for nicotinic acetylcholine receptors in the regulation of cerebral microvascular permeability. Expression of nicotinic acetylcholine receptor subunits in cerebral microvessels was investigated with immunofluorescence microscopy. Positive immunoreactivity was found for receptor subunits alpha3, alpha5, alpha7, and beta2, but not subunits alpha4, beta3, or beta4. Blood-brain barrier permeability was assessed via in situ brain perfusion with [14C]sucrose. Nicotine increased the rate of sucrose entry into the brain from 0.3 +/- 0.1 to 1.1 +/- 0.2 microl.g(-1).min(-1), as previously described. This nicotine-induced increase in blood-brain barrier permeability was significantly attenuated by both the blood-brain barrier-permeant nicotinic antagonist mecamylamine and the blood-brain barrier-impermeant nicotinic antagonist hexamethonium to 0.5 +/- 0.2 and 0.3 +/- 0.2 microl.g(-1).min(-1), respectively. These data suggest that nicotinic acetylcholine receptors expressed on the cerebral microvascular endothelium mediate nicotine-induced changes in blood-brain barrier permeability.

  8. Optically measured microvascular blood flow contrast of malignant breast tumors.

    PubMed

    Choe, Regine; Putt, Mary E; Carlile, Peter M; Durduran, Turgut; Giammarco, Joseph M; Busch, David R; Jung, Ki Won; Czerniecki, Brian J; Tchou, Julia; Feldman, Michael D; Mies, Carolyn; Rosen, Mark A; Schnall, Mitchell D; DeMichele, Angela; Yodh, Arjun G

    2014-01-01

    Microvascular blood flow contrast is an important hemodynamic and metabolic parameter with potential to enhance in vivo breast cancer detection and therapy monitoring. Here we report on non-invasive line-scan measurements of malignant breast tumors with a hand-held optical probe in the remission geometry. The probe employs diffuse correlation spectroscopy (DCS), a near-infrared optical method that quantifies deep tissue microvascular blood flow. Tumor-to-normal perfusion ratios are derived from thirty-two human subjects. Mean (95% confidence interval) tumor-to-normal ratio using surrounding normal tissue was 2.25 (1.92-2.63); tumor-to-normal ratio using normal tissues at the corresponding tumor location in the contralateral breast was 2.27 (1.94-2.66), and using normal tissue in the contralateral breast was 2.27 (1.90-2.70). Thus, the mean tumor-to-normal ratios were significantly different from unity irrespective of the normal tissue chosen, implying that tumors have significantly higher blood flow than normal tissues. Therefore, the study demonstrates existence of breast cancer contrast in blood flow measured by DCS. The new, optically accessible cancer contrast holds potential for cancer detection and therapy monitoring applications, and it is likely to be especially useful when combined with diffuse optical spectroscopy/tomography. PMID:24967878

  9. Angina pectoris in women: focus on microvascular disease.

    PubMed

    Zuchi, Cinzia; Tritto, Isabella; Ambrosio, Giuseppe

    2013-02-20

    Ischemic heart disease (IHD) is the leading cause of death among women in Western countries, and it is associated with higher morbidity and mortality than in men. Nevertheless, IHD in women remains underdiagnosed and undertreated, and the misperception that females are "protected" against cardiovascular disease leads to underestimation of their cardiovascular risk; instead, women with chest pain have a high risk of cardiovascular events. Women suffering from angina pectoris tend to have different characteristics compared to men, with a high prevalence of non-significant coronary artery disease. Angina in women is more commonly microvascular in origin than in men, and therefore standard diagnostic algorithms may be suboptimal for women. This different pathophysiology impacts clinical management of IHD in women. While response to medical therapy may differ in women, they are scarcely represented in clinical trials. Therefore, solid data in terms of gender efficacy of antianginal drugs are lacking, and particularly when angina is microvascular in origin women often continue to be symptomatic despite maximal therapy with classical antianginal drugs. Recently, new molecules have shown promising results in women. In conclusion, women with angina are a group of patients in whom it seems appropriate to concentrate efforts aimed at reducing morbidity and improving quality of life.

  10. 40 CFR 91.324 - Analyzer leakage check.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Analyzer leakage check. (a) Vacuum side leak check. (1) Check any location within the analysis system where a vacuum leak could affect the test results. (2) The maximum allowable leakage rate on the...

  11. 40 CFR 91.324 - Analyzer leakage check.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Analyzer leakage check. (a) Vacuum side leak check. (1) Check any location within the analysis system where a vacuum leak could affect the test results. (2) The maximum allowable leakage rate on the...

  12. 40 CFR 91.324 - Analyzer leakage check.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Analyzer leakage check. (a) Vacuum side leak check. (1) Check any location within the analysis system where a vacuum leak could affect the test results. (2) The maximum allowable leakage rate on the...

  13. 40 CFR 91.324 - Analyzer leakage check.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Analyzer leakage check. (a) Vacuum side leak check. (1) Check any location within the analysis system where a vacuum leak could affect the test results. (2) The maximum allowable leakage rate on the...

  14. 40 CFR 91.324 - Analyzer leakage check.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Analyzer leakage check. (a) Vacuum side leak check. (1) Check any location within the analysis system where a vacuum leak could affect the test results. (2) The maximum allowable leakage rate on the...

  15. Reserves in Context: Planning for Leakage from Protected Areas.

    PubMed

    Renwick, Anna R; Bode, Michael; Venter, Oscar

    2015-01-01

    When protected areas reduce threats within their boundaries, they often displace a portion of these threats into adjacent areas through a process known as 'leakage', undermining conservation objectives. Using theoretical models and a case study of terrestrial mammals in Indonesia, we develop the first theoretical explanation of how leakage impacts conservation actions, and highlight conservation strategies that mitigate these impacts. Although leakage is a socio-economic process, we demonstrate that its negative impacts are also affected by the distribution of species, with leakage having larger impacts in landscapes with homogeneous distribution of species richness. Moreover, leakage has a greater negative effect when conservation strategies are implemented opportunistically, even creating the potential for perversely negative consequences from protected area establishment. Leakage thereby increases the relative benefits of systematic conservation planning over opportunism, especially in areas with high leakage and heterogeneously distributed species. Although leakage has the potential to undermine conservation actions, conservation planning can minimize this risk.

  16. Measuring Leakage in a Pressurized-Fluid Loop

    NASA Technical Reports Server (NTRS)

    Clarke, Brian D.

    1987-01-01

    Technique applied to systems with inaccessible parts and connections. Fluid added to system by fluid-injection assembly to make up for leakage. Amount required to restore pressure in system is measure of leakage rate.

  17. Salvianolic Acid B Ameliorates Lipopolysaccharide-Induced Albumin Leakage from Rat Mesenteric Venules through Src-Regulated Transcelluar Pathway and Paracellular Pathway

    PubMed Central

    Liu, Yu-Ying; Zhang, Yu; He, Ke; Yang, Xiao-Yuan; Hu, Bai-He; Chang, Xin; Wang, Ming-Xia; Wei, Xiao-Hong; Fan, Jing-Yu; Wu, Xin-Min; Han, Jing-Yan

    2015-01-01

    Lipopolysaccharide (LPS) causes microvascular barrier disruption, leading to albumin leakage from microvessels resulting in a range of disastrous sequels. Salvianolic acid B (SalB) is a major water-soluble component derived from Salvia miltiorrhiza. Previous studies showed its potential to attenuate microvascular barrier dysfunction, but the underlying mechanism is not fully understood. The present study was intended to investigate the impact of SalB on endothelial cell barrier in vivo in rat mesenteric venules as well as in vitro in human umbilical vein endothelial cells (HUVECs), aiming at disclosing the mechanism thereof, particularly the role of Src in its action. Male Wistar rats were challenged by infusion of LPS (2 mg/kg/h) through left femoral vein for 90 min. SalB (5 mg/kg/h) was administrated either simultaneously with LPS or 30 min after LPS infusion through the left jugular vein. Vesicles in venular walls were observed by electron microscopy. HUVECs were incubated with LPS with or without SalB. The expression of Zonula occluden-1 (ZO-1), VE-cadherin, caveolin-1 and Src in HUVECs was assessed by Western blot and confocal microscopy, binding of SalB to Src was measured using Surface Plasmon Resonance and BioLayer Interferometry. Treatment with SalB inhibited albumin leakage from rat mesenteric venules and inhibited the increase of vesicle number in venular endothelial cells induced by LPS. In addition, SalB inhibited the degradation of ZO-1, the phosphorylation and redistribution of VE-cadherin, the expression and phosphorylation of caveolin-1, and phosphoirylation of Src in HUVECs exposed to LPS. Furthermore, SalB was found able to bind to Src. This study demonstrates that protection of SalB against microvascular barrier disruption is a process involving both para- and trans-endothelial cell pathway, and highly suggests Src as the key enzyme for SalB to work. PMID:25992563

  18. Nonlinear Acoustics Used To Reduce Leakage Flow

    NASA Technical Reports Server (NTRS)

    Daniels, Christopher C.; Steinetz, Bruce M.

    2004-01-01

    Leakage and wear are two fundamental problems in all traditional turbine seals that contribute to an engine's inefficiency. The solutions to seal leakage and wear conflict in the conventional design space. Reducing the clearance between the seal and rotating shaft reduces leakage but increases wear because of increased contact incidents. Increasing the clearance to reduce the contact between parts reduces wear but increases parasitic leakage. The goal of this effort is to develop a seal that restricts leakage flow using acoustic pressure while operating in a noncontacting manner, thereby increasing life. In 1996, Dr. Timothy Lucas announced his discovery of a method to produce shock-free high-amplitude pressure waves. For the first time, the formation of large acoustic pressures was possible using dissonant resonators. A pre-prototype acoustic seal developed at the NASA Glenn Research Center exploits this fundamental acoustic discovery: a specially shaped cavity oscillated at the contained fluid's resonant frequency produces high-amplitude acoustic pressure waves of a magnitude approaching those required of today's seals. While the original researchers are continuing their development of acoustic pumps, refrigeration compressors, and electronic thermal management systems using this technology, the goal of researchers at Glenn is to apply these acoustic principles to a revolutionary sealing device. When the acoustic resonator shape is optimized for the sealing device, the flow from a high-pressure cavity to a low-pressure cavity will be restricted by a series of high-amplitude standing pressure waves of higher pressure than the pressure to be sealed. Since the sealing resonator cavity will not touch the adjacent sealing structures, seal wear will be eliminated, improving system life. Under a cooperative agreement between Glenn and the Ohio Aerospace Institute (OAI), an acoustic-based pre-prototype seal was demonstrated for the first time. A pressurized cavity was

  19. Trending of Overboard Leakage of ISS Cabin Atmosphere

    NASA Technical Reports Server (NTRS)

    Schaezler, Ryan N.; Cook, Anthony J.; Leonard, Daniel J.; Ghariani, Ahmed

    2011-01-01

    The International Space Station (ISS) overboard leakage of cabin atmosphere is continually tracked to identify new or aggravated leaks and to provide information for planning of nitrogen supply to the ISS. The overboard leakage is difficult to trend with various atmosphere constituents being added and removed. Changes to nitrogen partial pressure is the nominal means of trending the overboard leakage. This paper summarizes the method of the overboard leakage trending and presents findings from the trending.

  20. 49 CFR 178.345-13 - Pressure and leakage tests.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Pressure and leakage tests. 178.345-13 Section 178... Specifications for Containers for Motor Vehicle Transportation § 178.345-13 Pressure and leakage tests. (a) Each cargo tank must be pressure and leakage tested in accordance with this section and §§ 178.346-5,...

  1. 49 CFR 178.345-13 - Pressure and leakage tests.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Pressure and leakage tests. 178.345-13 Section 178... PACKAGINGS Specifications for Containers for Motor Vehicle Transportation § 178.345-13 Pressure and leakage tests. (a) Each cargo tank must be pressure and leakage tested in accordance with this section...

  2. 49 CFR 178.345-13 - Pressure and leakage tests.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Pressure and leakage tests. 178.345-13 Section 178... Specifications for Containers for Motor Vehicle Transportation § 178.345-13 Pressure and leakage tests. (a) Each cargo tank must be pressure and leakage tested in accordance with this section and §§ 178.346-5,...

  3. 49 CFR 178.345-13 - Pressure and leakage tests.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Pressure and leakage tests. 178.345-13 Section 178... Specifications for Containers for Motor Vehicle Transportation § 178.345-13 Pressure and leakage tests. (a) Each cargo tank must be pressure and leakage tested in accordance with this section and §§ 178.346-5,...

  4. 49 CFR 178.345-13 - Pressure and leakage tests.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Pressure and leakage tests. 178.345-13 Section 178... Specifications for Containers for Motor Vehicle Transportation § 178.345-13 Pressure and leakage tests. (a) Each cargo tank must be pressure and leakage tested in accordance with this section and §§ 178.346-5,...

  5. 42 CFR 84.92 - Exhalation valve leakage test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Exhalation valve leakage test. 84.92 Section 84.92... Breathing Apparatus § 84.92 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be...) Leakage between the valve and the valve seat shall not exceed 30 milliliters per minute....

  6. 42 CFR 84.123 - Exhalation valve leakage test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Exhalation valve leakage test. 84.123 Section 84....123 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be subjected to a suction of 25 mm. water-column height while in a normal operating position. (b) Leakage between the...

  7. 42 CFR 84.92 - Exhalation valve leakage test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Exhalation valve leakage test. 84.92 Section 84.92... Breathing Apparatus § 84.92 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be...) Leakage between the valve and the valve seat shall not exceed 30 milliliters per minute....

  8. 42 CFR 84.123 - Exhalation valve leakage test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Exhalation valve leakage test. 84.123 Section 84....123 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be subjected to a suction of 25 mm. water-column height while in a normal operating position. (b) Leakage between the...

  9. 46 CFR 98.30-17 - Leakage containment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Leakage containment. 98.30-17 Section 98.30-17 Shipping... Intermediate Bulk Containers § 98.30-17 Leakage containment. (a) No person may transfer a product to or from a... or more and must have a means of draining or removing any leakage without mixing...

  10. 47 CFR 76.1804 - Aeronautical frequencies: leakage monitoring (CLI).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 4 2013-10-01 2013-10-01 false Aeronautical frequencies: leakage monitoring... Aeronautical frequencies: leakage monitoring (CLI). An MVPD shall notify the Commission before transmitting any... to be used; and (g) For MVPDs subject to § 76.611, the cumulative signal leakage index derived...

  11. 47 CFR 76.1803 - Signal leakage monitoring.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 4 2012-10-01 2012-10-01 false Signal leakage monitoring. 76.1803 Section 76... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Reports and Filings § 76.1803 Signal leakage monitoring. MVPDs... of the method by which compliance with basic signal leakage criteria is achieved and the method...

  12. 46 CFR 98.30-15 - Leakage containment.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Leakage containment. 98.30-15 Section 98.30-15 Shipping... Leakage containment. (a) No person may transfer a product to or from a vessel unless there is a container... draining or removing any leakage without mixing incompatible products or discharging into the...

  13. 30 CFR 57.4102 - Spillage and leakage.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Spillage and leakage. 57.4102 Section 57.4102... Control Prohibitions/precautions/housekeeping § 57.4102 Spillage and leakage. Flammable or combustible liquid spillage or leakage shall be removed in a timely manner or controlled to prevent a fire hazard....

  14. 49 CFR 174.750 - Incidents involving leakage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 2 2014-10-01 2014-10-01 false Incidents involving leakage. 174.750 Section 174... Detailed Requirements for Class 7 (Radioactive) Materials § 174.750 Incidents involving leakage. (a) In... case of obvious leakage, or if it appears likely that the inside container may have been damaged,...

  15. 40 CFR 265.302 - Action leakage rate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Action leakage rate. 265.302 Section... FACILITIES Landfills § 265.302 Action leakage rate. (a) The owner or operator of landfill units subject to § 265.301(a) must submit a proposed action leakage rate to the Regional Administrator when...

  16. 49 CFR 174.750 - Incidents involving leakage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 2 2011-10-01 2011-10-01 false Incidents involving leakage. 174.750 Section 174... Detailed Requirements for Class 7 (Radioactive) Materials § 174.750 Incidents involving leakage. (a) In... case of obvious leakage, or if it appears likely that the inside container may have been damaged,...

  17. 47 CFR 76.1804 - Aeronautical frequencies: leakage monitoring (CLI).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 4 2011-10-01 2011-10-01 false Aeronautical frequencies: leakage monitoring... Aeronautical frequencies: leakage monitoring (CLI). An MVPD shall notify the Commission before transmitting any... to be used; and (g) For MVPDs subject to § 76.611, the cumulative signal leakage index derived...

  18. 40 CFR 265.302 - Action leakage rate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Action leakage rate. 265.302 Section... FACILITIES Landfills § 265.302 Action leakage rate. (a) The owner or operator of landfill units subject to § 265.301(a) must submit a proposed action leakage rate to the Regional Administrator when...

  19. 42 CFR 84.92 - Exhalation valve leakage test.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Exhalation valve leakage test. 84.92 Section 84.92... Breathing Apparatus § 84.92 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be...) Leakage between the valve and the valve seat shall not exceed 30 milliliters per minute....

  20. 30 CFR 56.4102 - Spillage and leakage.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Spillage and leakage. 56.4102 Section 56.4102... Control Prohibitions/precautions/housekeeping § 56.4102 Spillage and leakage. Flammable or combustible liquid spillage or leakage shall be removed in a timely manner or controlled to prevent a fire hazard....

  1. 40 CFR 265.222 - Action leakage rate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Action leakage rate. 265.222 Section... FACILITIES Surface Impoundments § 265.222 Action leakage rate. (a) The owner or operator of surface impoundment units subject to § 265.221(a) must submit a proposed action leakage rate to the...

  2. 30 CFR 56.4102 - Spillage and leakage.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Spillage and leakage. 56.4102 Section 56.4102... Control Prohibitions/precautions/housekeeping § 56.4102 Spillage and leakage. Flammable or combustible liquid spillage or leakage shall be removed in a timely manner or controlled to prevent a fire hazard....

  3. 30 CFR 57.4102 - Spillage and leakage.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Spillage and leakage. 57.4102 Section 57.4102... Control Prohibitions/precautions/housekeeping § 57.4102 Spillage and leakage. Flammable or combustible liquid spillage or leakage shall be removed in a timely manner or controlled to prevent a fire hazard....

  4. 46 CFR 98.30-15 - Leakage containment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Leakage containment. 98.30-15 Section 98.30-15 Shipping... Leakage containment. (a) No person may transfer a product to or from a vessel unless there is a container... draining or removing any leakage without mixing incompatible products or discharging into the water....

  5. 40 CFR 265.302 - Action leakage rate.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Action leakage rate. 265.302 Section... FACILITIES Landfills § 265.302 Action leakage rate. (a) The owner or operator of landfill units subject to § 265.301(a) must submit a proposed action leakage rate to the Regional Administrator when...

  6. 46 CFR 98.30-15 - Leakage containment.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Leakage containment. 98.30-15 Section 98.30-15 Shipping... Leakage containment. (a) No person may transfer a product to or from a vessel unless there is a container... draining or removing any leakage without mixing incompatible products or discharging into the water....

  7. 47 CFR 76.1803 - Signal leakage monitoring.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 4 2014-10-01 2014-10-01 false Signal leakage monitoring. 76.1803 Section 76... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Reports and Filings § 76.1803 Signal leakage monitoring. MVPDs... of the method by which compliance with basic signal leakage criteria is achieved and the method...

  8. 42 CFR 84.123 - Exhalation valve leakage test.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Exhalation valve leakage test. 84.123 Section 84....123 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be subjected to a suction of 25 mm. water-column height while in a normal operating position. (b) Leakage between the...

  9. 42 CFR 84.123 - Exhalation valve leakage test.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Exhalation valve leakage test. 84.123 Section 84....123 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be subjected to a suction of 25 mm. water-column height while in a normal operating position. (b) Leakage between the...

  10. 40 CFR 265.255 - Action leakage rates.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Action leakage rates. 265.255 Section... FACILITIES Waste Piles § 265.255 Action leakage rates. (a) The owner or operator of waste pile units subject to § 265.254 must submit a proposed action leakage rate to the Regional Administrator when...

  11. 40 CFR 265.222 - Action leakage rate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Action leakage rate. 265.222 Section... FACILITIES Surface Impoundments § 265.222 Action leakage rate. (a) The owner or operator of surface impoundment units subject to § 265.221(a) must submit a proposed action leakage rate to the...

  12. 40 CFR 265.222 - Action leakage rate.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Action leakage rate. 265.222 Section... FACILITIES Surface Impoundments § 265.222 Action leakage rate. (a) The owner or operator of surface impoundment units subject to § 265.221(a) must submit a proposed action leakage rate to the...

  13. 30 CFR 56.4102 - Spillage and leakage.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Spillage and leakage. 56.4102 Section 56.4102... Control Prohibitions/precautions/housekeeping § 56.4102 Spillage and leakage. Flammable or combustible liquid spillage or leakage shall be removed in a timely manner or controlled to prevent a fire hazard....

  14. 49 CFR 174.750 - Incidents involving leakage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 2 2012-10-01 2012-10-01 false Incidents involving leakage. 174.750 Section 174... Detailed Requirements for Class 7 (Radioactive) Materials § 174.750 Incidents involving leakage. (a) In... case of obvious leakage, or if it appears likely that the inside container may have been damaged,...

  15. 40 CFR 265.255 - Action leakage rates.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Action leakage rates. 265.255 Section... FACILITIES Waste Piles § 265.255 Action leakage rates. (a) The owner or operator of waste pile units subject to § 265.254 must submit a proposed action leakage rate to the Regional Administrator when...

  16. 47 CFR 76.1804 - Aeronautical frequencies: leakage monitoring (CLI).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Aeronautical frequencies: leakage monitoring... Aeronautical frequencies: leakage monitoring (CLI). An MVPD shall notify the Commission before transmitting any... to be used; and (g) For MVPDs subject to § 76.611, the cumulative signal leakage index derived...

  17. 46 CFR 98.30-15 - Leakage containment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Leakage containment. 98.30-15 Section 98.30-15 Shipping... Leakage containment. (a) No person may transfer a product to or from a vessel unless there is a container... draining or removing any leakage without mixing incompatible products or discharging into the water....

  18. 49 CFR 174.750 - Incidents involving leakage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Incidents involving leakage. 174.750 Section 174... Detailed Requirements for Class 7 (Radioactive) Materials § 174.750 Incidents involving leakage. (a) In... case of obvious leakage, or if it appears likely that the inside container may have been damaged,...

  19. 30 CFR 56.4102 - Spillage and leakage.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Spillage and leakage. 56.4102 Section 56.4102... Control Prohibitions/precautions/housekeeping § 56.4102 Spillage and leakage. Flammable or combustible liquid spillage or leakage shall be removed in a timely manner or controlled to prevent a fire hazard....

  20. 40 CFR 265.255 - Action leakage rates.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Action leakage rates. 265.255 Section... FACILITIES Waste Piles § 265.255 Action leakage rates. (a) The owner or operator of waste pile units subject to § 265.254 must submit a proposed action leakage rate to the Regional Administrator when...

  1. 30 CFR 57.4102 - Spillage and leakage.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Spillage and leakage. 57.4102 Section 57.4102... Control Prohibitions/precautions/housekeeping § 57.4102 Spillage and leakage. Flammable or combustible liquid spillage or leakage shall be removed in a timely manner or controlled to prevent a fire hazard....

  2. 49 CFR 174.750 - Incidents involving leakage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 2 2013-10-01 2013-10-01 false Incidents involving leakage. 174.750 Section 174... Detailed Requirements for Class 7 (Radioactive) Materials § 174.750 Incidents involving leakage. (a) In... case of obvious leakage, or if it appears likely that the inside container may have been damaged,...

  3. 47 CFR 76.1803 - Signal leakage monitoring.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 4 2013-10-01 2013-10-01 false Signal leakage monitoring. 76.1803 Section 76... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Reports and Filings § 76.1803 Signal leakage monitoring. MVPDs... of the method by which compliance with basic signal leakage criteria is achieved and the method...

  4. 30 CFR 57.4102 - Spillage and leakage.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Spillage and leakage. 57.4102 Section 57.4102... Control Prohibitions/precautions/housekeeping § 57.4102 Spillage and leakage. Flammable or combustible liquid spillage or leakage shall be removed in a timely manner or controlled to prevent a fire hazard....

  5. 30 CFR 56.4102 - Spillage and leakage.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Spillage and leakage. 56.4102 Section 56.4102... Control Prohibitions/precautions/housekeeping § 56.4102 Spillage and leakage. Flammable or combustible liquid spillage or leakage shall be removed in a timely manner or controlled to prevent a fire hazard....

  6. 40 CFR 265.255 - Action leakage rates.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Action leakage rates. 265.255 Section... FACILITIES Waste Piles § 265.255 Action leakage rates. (a) The owner or operator of waste pile units subject to § 265.254 must submit a proposed action leakage rate to the Regional Administrator when...

  7. 40 CFR 265.222 - Action leakage rate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Action leakage rate. 265.222 Section... FACILITIES Surface Impoundments § 265.222 Action leakage rate. (a) The owner or operator of surface impoundment units subject to § 265.221(a) must submit a proposed action leakage rate to the...

  8. 42 CFR 84.123 - Exhalation valve leakage test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Exhalation valve leakage test. 84.123 Section 84....123 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be subjected to a suction of 25 mm. water-column height while in a normal operating position. (b) Leakage between the...

  9. 40 CFR 265.302 - Action leakage rate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Action leakage rate. 265.302 Section... FACILITIES Landfills § 265.302 Action leakage rate. (a) The owner or operator of landfill units subject to § 265.301(a) must submit a proposed action leakage rate to the Regional Administrator when...

  10. 47 CFR 76.1804 - Aeronautical frequencies: leakage monitoring (CLI).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 4 2012-10-01 2012-10-01 false Aeronautical frequencies: leakage monitoring... Aeronautical frequencies: leakage monitoring (CLI). An MVPD shall notify the Commission before transmitting any... to be used; and (g) For MVPDs subject to § 76.611, the cumulative signal leakage index derived...

  11. 40 CFR 265.302 - Action leakage rate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Action leakage rate. 265.302 Section... FACILITIES Landfills § 265.302 Action leakage rate. (a) The owner or operator of landfill units subject to § 265.301(a) must submit a proposed action leakage rate to the Regional Administrator when...

  12. 40 CFR 265.222 - Action leakage rate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Action leakage rate. 265.222 Section... FACILITIES Surface Impoundments § 265.222 Action leakage rate. (a) The owner or operator of surface impoundment units subject to § 265.221(a) must submit a proposed action leakage rate to the...

  13. 47 CFR 76.1803 - Signal leakage monitoring.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 4 2011-10-01 2011-10-01 false Signal leakage monitoring. 76.1803 Section 76... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Reports and Filings § 76.1803 Signal leakage monitoring. MVPDs... of the method by which compliance with basic signal leakage criteria is achieved and the method...

  14. 42 CFR 84.92 - Exhalation valve leakage test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Exhalation valve leakage test. 84.92 Section 84.92... Breathing Apparatus § 84.92 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be...) Leakage between the valve and the valve seat shall not exceed 30 milliliters per minute....

  15. 40 CFR 265.255 - Action leakage rates.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Action leakage rates. 265.255 Section... FACILITIES Waste Piles § 265.255 Action leakage rates. (a) The owner or operator of waste pile units subject to § 265.254 must submit a proposed action leakage rate to the Regional Administrator when...

  16. 42 CFR 84.92 - Exhalation valve leakage test.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Exhalation valve leakage test. 84.92 Section 84.92... Breathing Apparatus § 84.92 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be...) Leakage between the valve and the valve seat shall not exceed 30 milliliters per minute....

  17. 30 CFR 57.4102 - Spillage and leakage.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Spillage and leakage. 57.4102 Section 57.4102... Control Prohibitions/precautions/housekeeping § 57.4102 Spillage and leakage. Flammable or combustible liquid spillage or leakage shall be removed in a timely manner or controlled to prevent a fire hazard....

  18. 47 CFR 76.1803 - Signal leakage monitoring.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Signal leakage monitoring. 76.1803 Section 76... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Reports and Filings § 76.1803 Signal leakage monitoring. MVPDs... of the method by which compliance with basic signal leakage criteria is achieved and the method...

  19. 47 CFR 76.1804 - Aeronautical frequencies: leakage monitoring (CLI).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 4 2014-10-01 2014-10-01 false Aeronautical frequencies: leakage monitoring... Aeronautical frequencies: leakage monitoring (CLI). An MVPD shall notify the Commission before transmitting any... to be used; and (g) For MVPDs subject to § 76.611, the cumulative signal leakage index derived...

  20. Airway hyperresponsiveness in elite athletes.

    PubMed

    Langdeau, J B; Turcotte, H; Bowie, D M; Jobin, J; Desgagné, P; Boulet, L P

    2000-05-01

    It has been suggested that high-level training could contribute to the development of airway hyperresponsiveness (AHR), but the comparative effects of different sports on airway function remains to be determined. We evaluated 150 nonsmoking volunteers 18 to 55 yr of age; 100 athletes divided into four subgroups of 25 subjects each according to the predominant estimated hydrocaloric characteristic of ambient air inhaled during training: dry air (DA), cold air (CA), humid air (HA) and a mixture of dry and humid air (MA), and 50 sedentary subjects. Each subject had a respiratory questionnaire, a methacholine challenge, allergy skin-prick tests, and heart rate variability recording for evaluation of parasympathetic tone. The athletes had a 49% prevalence of AHR (PC(20) < 16 mg/ml), with a mean PC(20) of 16.9 mg/ml, compared with 28% (PC(20): 35.4) in sedentary subjects (p = 0.009). The prevalence (%) of AHR and mean PC(20) (mg/ml) varied as followed in the four subgroups of athletes: DA: 32% and 30.9; CA: 52% and 15.8; HA: 76% and 7.3; and MA: 32% and 21.5 (p = 0.002). The estimated parasympathetic tone was higher in athletes (p < 0.001), but this parameter showed only a weak correlation with PC(20) (r = -0.17, p = 0.04). This study has shown a significantly higher prevalence of AHR in athletes than in the control group because of the higher prevalence in the CA and HA groups. Parasympathetic activity may act as modulator of airway responsiveness, but the increased prevalence of AHR in our athlete population may be related to the type and possibly the content of inhaled air during training.

  1. Simple leakage flow model for brush seals

    NASA Astrophysics Data System (ADS)

    Chupp, Raymond E.; Dowler, Constance A.; Holle, Glenn F.

    1991-06-01

    Brush seals are potential replacements for some or most of the air-to-air labyrinth seals in gas turbine engines. A simple flow model is presented to generalize brush seal leakage performance throughout the range of test and application environments. The model uses a single parameter, effective brush thickness, to correlate flow through the seal. This effective brush thickness is a measure of the compactness of the bristle bed. Initial model results have been obtained using leakage flow data from two investigators. The results indicate that this simple single parameter model gives insight into the active nature of a brush seal and approximately accounts for the effect of fluid temperature, especially at the higher pressure ratios, where brush seals are commonly applied.

  2. Airway smooth muscle dynamics: a common pathway of airway obstruction in asthma

    PubMed Central

    An, S.S.; Bai, T.R.; Bates, J.H.T.; Black, J.L.; Brown, R.H.; Brusasco, V.; Chitano, P.; Deng, L.; Dowell, M.; Eidelman, D.H.; Fabry, B.; Fairbank, N.J.; Ford, L.E.; Fredberg, J.J.; Gerthoffer, W.T.; Gilbert, S.H.; Gosens, R.; Gunst, S.J.; Halayko, A.J.; Ingram, R.H.; Irvin, C.G.; James, A.L.; Janssen, L.J.; King, G.G.; Knight, D.A.; Lauzon, A.M.; Lakser, O.J.; Ludwig, M.S.; Lutchen, K.R.; Maksym, G.N.; Martin, J.G.; Mauad, T.; McParland, B.E.; Mijailovich, S.M.; Mitchell, H.W.; Mitchell, R.W.; Mitzner, W.; Murphy, T.M.; Paré, P.D.; Pellegrino, R.; Sanderson, M.J.; Schellenberg, R.R.; Seow, C.Y.; Silveira, P.S.P.; Smith, P.G.; Solway, J.; Stephens, N.L.; Sterk, P.J.; Stewart, A.G.; Tang, D.D.; Tepper, R.S.; Tran, T.; Wang, L.

    2008-01-01

    Excessive airway obstruction is the cause of symptoms and abnormal lung function in asthma. As airway smooth muscle (ASM) is the effecter controlling airway calibre, it is suspected that dysfunction of ASM contributes to the pathophysiology of asthma. However, the precise role of ASM in the series of events leading to asthmatic symptoms is not clear. It is not certain whether, in asthma, there is a change in the intrinsic properties of ASM, a change in the structure and mechanical properties of the noncontractile components of the airway wall, or a change in the interdependence of the airway wall with the surrounding lung parenchyma. All these potential changes could result from acute or chronic airway inflammation and associated tissue repair and remodelling. Anti-inflammatory therapy, however, does not “cure” asthma, and airway hyperresponsiveness can persist in asthmatics, even in the absence of airway inflammation. This is perhaps because the therapy does not directly address a fundamental abnormality of asthma, that of exaggerated airway narrowing due to excessive shortening of ASM. In the present study, a central role for airway smooth muscle in the pathogenesis of airway hyperresponsiveness in asthma is explored. PMID:17470619

  3. 3DHZETRN: Neutron leakage in finite objects

    NASA Astrophysics Data System (ADS)

    Wilson, John W.; Slaba, Tony C.; Badavi, Francis F.; Reddell, Brandon D.; Bahadori, Amir A.

    2015-11-01

    The 3DHZETRN formalism was recently developed as an extension to HZETRN with an emphasis on 3D corrections for neutrons and light ions. Comparisons to Monte Carlo (MC) simulations were used to verify the 3DHZETRN methodology in slab and spherical geometry, and it was shown that 3DHZETRN agrees with MC codes to the degree that various MC codes agree among themselves. One limitation of such comparisons is that all of the codes (3DHZETRN and three MC codes) utilize different nuclear models/databases; additionally, using a common nuclear model is impractical due to the complexity of the software. It is therefore difficult to ascertain if observed discrepancies are caused by transport code approximations or nuclear model differences. In particular, an important simplification in the 3DHZETRN formalism assumes that neutron production cross sections can be represented as the sum of forward and isotropic components, where the forward component is subsequently solved within the straight-ahead approximation. In the present report, previous transport model results in specific geometries are combined with additional results in related geometries to study neutron leakage using the Webber 1956 solar particle event as a source boundary condition. A ratio is defined to quantify the fractional neutron leakage at a point in a finite object relative to a semi-infinite slab geometry. Using the leakage ratio removes some of the dependence on the magnitude of the neutron production and clarifies the effects of angular scattering and absorption with regard to differences between the models. Discussion is given regarding observed differences between the MC codes and conclusions drawn about the need for further code development. Although the current version of 3DHZETRN is reasonably accurate compared to MC simulations, this study shows that improved leakage estimates can be obtained by replacing the isotropic/straight-ahead approximation with more detailed descriptions.

  4. SUBCHRONIC ENDOTOXIN INHALATION CAUSES PERSISTENT AIRWAY DISEASE

    EPA Science Inventory

    ABSTRACT

    The endotoxin component of organic dusts causes acute reversible airflow obstruction and airway inflammation. To test the hypothesis that endotoxin alone causes airway remodeling, we have compared the response of two inbred mouse strains to subchronic endotoxin ...

  5. Airway and Extracellular Matrix Mechanics in COPD.

    PubMed

    Bidan, Cécile M; Veldsink, Annemiek C; Meurs, Herman; Gosens, Reinoud

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases worldwide, and is characterized by airflow obstruction that is not fully reversible with treatment. Even though airflow obstruction is caused by airway smooth muscle contraction, the extent of airway narrowing depends on a range of other structural and functional determinants that impact on active and passive tissue mechanics. Cells and extracellular matrix in the airway and parenchymal compartments respond both passively and actively to the mechanical stimulation induced by smooth muscle contraction. In this review, we summarize the factors that regulate airway narrowing and provide insight into the relative contributions of different constituents of the extracellular matrix and their biomechanical impact on airway obstruction. We then review the changes in extracellular matrix composition in the airway and parenchymal compartments at different stages of COPD, and finally discuss how these changes impact airway narrowing and the development of airway hyperresponsiveness. Finally, we position these data in the context of therapeutic research focused on defective tissue repair. As a conclusion, we propose that future works should primarily target mild or early COPD, prior to the widespread structural changes in the alveolar compartment that are more characteristic of severe COPD.

  6. Athletic Trainers' Knowledge Regarding Airway Adjuncts

    ERIC Educational Resources Information Center

    Edler, Jessica R.; Eberman, Lindsey E.; Kahanov, Leamor; Roman, Christopher; Mata, Heather Lynne

    2015-01-01

    Context: Research suggests that knowledge gaps regarding the appropriate use of airway adjuncts exist among various health care practitioners, and that knowledge is especially limited within athletic training. Objective: To determine the relationship between perceived knowledge (PK) and actual knowledge (AK) of airway adjunct use and the…

  7. 21 CFR 868.5110 - Oropharyngeal airway.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Oropharyngeal airway. 868.5110 Section 868.5110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5110 Oropharyngeal airway....

  8. 21 CFR 868.5100 - Nasopharyngeal airway.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Nasopharyngeal airway. 868.5100 Section 868.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5100 Nasopharyngeal airway....

  9. 21 CFR 868.5100 - Nasopharyngeal airway.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Nasopharyngeal airway. 868.5100 Section 868.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5100 Nasopharyngeal airway....

  10. 21 CFR 868.5110 - Oropharyngeal airway.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Oropharyngeal airway. 868.5110 Section 868.5110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5110 Oropharyngeal airway....

  11. 21 CFR 868.5110 - Oropharyngeal airway.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Oropharyngeal airway. 868.5110 Section 868.5110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5110 Oropharyngeal airway....

  12. 21 CFR 868.5110 - Oropharyngeal airway.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Oropharyngeal airway. 868.5110 Section 868.5110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5110 Oropharyngeal airway....

  13. 21 CFR 868.5100 - Nasopharyngeal airway.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Nasopharyngeal airway. 868.5100 Section 868.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5100 Nasopharyngeal airway....

  14. 21 CFR 868.5100 - Nasopharyngeal airway.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Nasopharyngeal airway. 868.5100 Section 868.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5100 Nasopharyngeal airway....

  15. 21 CFR 868.5110 - Oropharyngeal airway.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Oropharyngeal airway. 868.5110 Section 868.5110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5110 Oropharyngeal airway....

  16. 21 CFR 868.5100 - Nasopharyngeal airway.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nasopharyngeal airway. 868.5100 Section 868.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5100 Nasopharyngeal airway....

  17. Airway and Extracellular Matrix Mechanics in COPD

    PubMed Central

    Bidan, Cécile M.; Veldsink, Annemiek C.; Meurs, Herman; Gosens, Reinoud

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases worldwide, and is characterized by airflow obstruction that is not fully reversible with treatment. Even though airflow obstruction is caused by airway smooth muscle contraction, the extent of airway narrowing depends on a range of other structural and functional determinants that impact on active and passive tissue mechanics. Cells and extracellular matrix in the airway and parenchymal compartments respond both passively and actively to the mechanical stimulation induced by smooth muscle contraction. In this review, we summarize the factors that regulate airway narrowing and provide insight into the relative contributions of different constituents of the extracellular matrix and their biomechanical impact on airway obstruction. We then review the changes in extracellular matrix composition in the airway and parenchymal compartments at different stages of COPD, and finally discuss how these changes impact airway narrowing and the development of airway hyperresponsiveness. Finally, we position these data in the context of therapeutic research focused on defective tissue repair. As a conclusion, we propose that future works should primarily target mild or early COPD, prior to the widespread structural changes in the alveolar compartment that are more characteristic of severe COPD. PMID:26696894

  18. Atomic Oxygen Effects on Seal Leakage

    NASA Technical Reports Server (NTRS)

    Christensen, John R.; Underwood, Steve D.; Kamenetzky, Rachel R.; Vaughn, Jason A.

    1999-01-01

    Common Berthing Mechanism (CBM provides the structural interface between separate International Space Station (ISS) elements, such as the Laboratory and Node modules. The CBM consists of an active and a passive half that join together with structural bolts. The seal at this interface is the CBM-to-CBM molded seal. The CBM-to-CBM interface is assembled on orbit, thus the seals can be exposed to the space environment for up to 65 hours. Atomic Oxygen/Vacuum Ultraviolet radiation (AO/VUV) in space is a potential hazard to the seals. Testing was conducted to determine the effect on leakage of the CBM-to-CBM seal material exposed to AO/VUV. The sealing materials were S383 silicone and V835 fluorocarbon material. Control samples, which were not exposed to the AO/VUV environment, were used to ensure that ff any changes in leakage occurred, they could be attributed to the AO/VUV exposure. After exposure to the AO/VUV environment the leakage increase was dramatic for the fluorocarbon. This testing was a major contributing factor in selecting silicone as the CBM-to-CBM seal material.

  19. Atomic Oxygen Effects on Seal Leakage

    NASA Technical Reports Server (NTRS)

    Christensen, John R.; Underwood, Steve D.; Kamenetzky, Rachel R.; Vaughn, Jason A.

    1998-01-01

    Common Berthing Mechanism (CBM) provides the structural interface between separate International Space Station (ISS) elements, such as the Laboratory and Node modules. The CBM consists of an active and a passive half that join together with structural bolts. The seal at this interface is the CBM-to-CBM molded seal. The CBM-to-CBM interface is assembled on orbit, thus the seals can be exposed to the space environment for up to 65 hours. Atomic Oxygen/Vacuum Ultraviolet radiation (AO/VUV) in space is a potential hazard to the seals. Testing was conducted to determine the effect on leakage of the CBM-to-CBM seal material exposed to AO/VUV. The sealing materials were S383 silicone and V835 fluorocarbon material. Control samples, which were not exposed to the AO/VUV environment, were used to ensure that if any changes in leakage occurred, they could be attributed to the AO/VUV exposure. After exposure to the AO/VUV environment the leakage increase was dramatic for the fluorocarbon. This testing was a major contributing factor in selecting silicone as the CBM-to-CBM seal material.

  20. Difficult Airway Response Team: A Novel Quality Improvement Program for Managing Hospital-Wide Airway Emergencies

    PubMed Central

    Mark, Lynette J.; Herzer, Kurt R.; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I.; Berkow, Lauren C.; Haut, Elliott R.; Hillel, Alexander T.; Miller, Christina R.; Feller-Kopman, David J.; Schiavi, Adam J.; Xie, Yanjun J.; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W.; Mirski, Marek A.

    2015-01-01

    Background Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. Methods We developed a quality improvement program—the Difficult Airway Response Team (DART)—to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had three core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Results Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index > 40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous

  1. Directed assembly of three-dimensional microvascular networks

    NASA Astrophysics Data System (ADS)

    Therriault, Daniel

    Three-dimensional (3-D) microvascular networks with pervasive, interconnected channels less than 300 mum in diameter may find widespread application in microfluidic devices, biotechnology, sensors, and autonomic healing materials. Although microchannel arrays are readily constructed in two-dimensions by photolithographic or soft lithographic techniques, their construction in three-dimensions remains a challenging problem. The development of a microfabrication method to build 3-D microvascular networks based on direct-write assembly is described is this thesis. The method is based on the robotic deposition of a fugitive organic ink to form a free-standing scaffold structure. Secondary infiltration of a structural resin followed by setting of the matrix and removal of the scaffold yields an embedded pervasive network of smooth cylindrical channels (˜10--500 mum) with defined connectivity. Rheological and other material properties studies of fugitive organic ink were performed in order to identify the critical characteristics required for successful deposition of 3-D scaffolds by direct-write assembly. Guided by the results of these studies, several new ink formulations were screened for improved deposition performance. The most successful of these inks (40wt% microcrystalline wax, 60wt% petroleum jelly) showed excellent deposition and had an equilibrium modulus at room temperature (G 'eq ˜ 7.70 kPa 1 Hz) nearly two orders of magnitude higher than the original ink. The optimized ink was used to successfully build thick (i.e., ˜100 layers) scaffold structures at room temperature with negligible time-dependent deformation post-deposition. Secondary infiltration of the resin was accomplished at room temperature while maintaining the scaffold architecture. The optimized ink was also successfully extruded through small micronozzles (1 mum). The construction of 3-D microvascular networks enables microfluidic devices with unparallel geometric complexity. In one example, a

  2. Microvascular Injury in Ketamine-Induced Bladder Dysfunction

    PubMed Central

    Lin, Chih-Chieh; Lin, Alex Tong-Long; Yang, An-Hang; Chen, Kuang-Kuo

    2016-01-01

    The pathogenesis of ketamine-induced cystitis (KC) remains unclear. In this study, bladder microvascular injury was investigated as a possible contributing mechanism. A total of 36 KC patients with exposure to ketamine for more than 6 months, and 9 control subjects, were prospectively recruited. All participants completed questionnaires, including the O’Leary–Sant interstitial cystitis symptom index (ICSI) and the interstitial cystitis problem index (ICPI). All KC patients received a urodynamic study and radiological exams. Bladder tissues were obtained from cystoscopic biopsies in the control group and after hydrodistention in the KC group. Double-immunofluorescence staining of N-methyl-d-aspartate receptor subunit 1 (NMDAR1) and the endothelial marker, cluster of differentiation 31 (CD31), was performed to reveal the existence of NMDAR1 on the endothelium. Electron microscopy (EM) was applied to assess the microvascular change in the urinary bladder and to measure the thickening of the basement membrane (BM). A proximity ligation assay (PLA) was used to quantify the co-localization of the endothelial CD31 receptor and the mesenchymal marker [fibroblast-specific protein 1 (FSP-1)]. The Mann–Whitney U test and Spearman’s correlation coefficient were used for statistical analysis. The mean ICSI [14.38 (± 4.16)] and ICPI [12.67 (± 3.54)] scores of the KC group were significantly higher than those (0 and 0, respectively) of the control group (both p < 0.001). The KC patients had decreasing cystometric bladder capacity (CBC) with a mean volume of 65.38 (± 48.67) mL. NMDAR1 was expressed on endothelial cells in both groups under immunofluorescence staining. Moreover, KC patients had significant BM duplication of microvessels in the mucosa of the urinary bladder under EM. The co-expression of the endothelial marker CD31 and mesenchymal marker FSP1 was significantly stained and calculated under PLA. In conclusion, microvascular injury and mesenchymal phenotypic

  3. Intrinsic sex-specific differences in microvascular endothelial cell phosphodiesterases

    PubMed Central

    Bingaman, Susan; Huxley, Virginia H.

    2010-01-01

    The importance of gonadal hormones in the regulation of vascular function has been documented. An alternate and essential contribution of the sex chromosomes to sex differences in vascular function is poorly understood. We reported previously sex differences in microvessel permeability (Ps) responses to adenosine that were mediated by the cAMP signaling pathway (Wang J, PhD thesis, 2005; Wang J and Huxley V, Proceedings of the VIII World Congress of Microcirculation, 2007; Wang J and Huxley VH, Am J Physiol Heart Circ Physiol 291: H3094–H3105, 2006). The two cyclic nucleotides, cAMP and cGMP, central to the regulation of vascular barrier integrity, are hydrolyzed by phosphodiesterases (PDE). We hypothesized that microvascular endothelial cells (EC) would retain intrinsic and inheritable sexually dimorphic genes with respect to the PDEs modulating EC barrier function. Primary cultured microvascular EC from skeletal muscles isolated from male and female rats, respectively, were used. SRY (a sex-determining region Y gene) mRNA expression was observed exclusively in male, not female, cells. The predominant isoform among PDE1–5, present in both XY and XX EC, was PDE4. Expression mRNA levels of PDE1A (male > female) and PDE3B (male < female) were sex dependent; PDE2A, PDE4D, and PDE5A were sex independent. Barrier function, Ps, was determined from measures of albumin flux across confluent primary cultured microvessel XY and XX EC monolayers. Consistent with intact in situ microvessels, basal monolayer Ps did not differ between XY (1.7 ± 0.2 × 10−6 cm/s; n = 8) and XX (1.8 ± 0.1 × 10−6 cm/s; n = 10) EC. Cilostazol, a PDE3 inhibitor, reduced (11%, P < 0.05) Ps in XX, not XY, cells. These findings demonstrate the presence and maintenance of intrinsic sex-related differences in gene expression and cellular phenotype by microvascular EC in a gonadal-hormone-free environment. Furthermore, intrinsic cell-sex likely contributes significantly to sexual dimorphism in

  4. Microvascular Injury in Ketamine-Induced Bladder Dysfunction.

    PubMed

    Lin, Chih-Chieh; Lin, Alex Tong-Long; Yang, An-Hang; Chen, Kuang-Kuo

    2016-01-01

    The pathogenesis of ketamine-induced cystitis (KC) remains unclear. In this study, bladder microvascular injury was investigated as a possible contributing mechanism. A total of 36 KC patients with exposure to ketamine for more than 6 months, and 9 control subjects, were prospectively recruited. All participants completed questionnaires, including the O'Leary-Sant interstitial cystitis symptom index (ICSI) and the interstitial cystitis problem index (ICPI). All KC patients received a urodynamic study and radiological exams. Bladder tissues were obtained from cystoscopic biopsies in the control group and after hydrodistention in the KC group. Double-immunofluorescence staining of N-methyl-d-aspartate receptor subunit 1 (NMDAR1) and the endothelial marker, cluster of differentiation 31 (CD31), was performed to reveal the existence of NMDAR1 on the endothelium. Electron microscopy (EM) was applied to assess the microvascular change in the urinary bladder and to measure the thickening of the basement membrane (BM). A proximity ligation assay (PLA) was used to quantify the co-localization of the endothelial CD31 receptor and the mesenchymal marker [fibroblast-specific protein 1 (FSP-1)]. The Mann-Whitney U test and Spearman's correlation coefficient were used for statistical analysis. The mean ICSI [14.38 (± 4.16)] and ICPI [12.67 (± 3.54)] scores of the KC group were significantly higher than those (0 and 0, respectively) of the control group (both p < 0.001). The KC patients had decreasing cystometric bladder capacity (CBC) with a mean volume of 65.38 (± 48.67) mL. NMDAR1 was expressed on endothelial cells in both groups under immunofluorescence staining. Moreover, KC patients had significant BM duplication of microvessels in the mucosa of the urinary bladder under EM. The co-expression of the endothelial marker CD31 and mesenchymal marker FSP1 was significantly stained and calculated under PLA. In conclusion, microvascular injury and mesenchymal phenotypic

  5. Airway fires during surgery: Management and prevention

    PubMed Central

    Akhtar, Navaid; Ansar, Farrukh; Baig, Mirza Shahzad; Abbas, Akbar

    2016-01-01

    Airway fires pose a serious risk to surgical patients. Fires during surgery have been reported for many years with flammable anesthetic agents being the main culprits in the past. Association of airway fires with laser surgery is well-recognized, but there are reports of endotracheal tube fires ignited by electrocautery during pharyngeal surgery or tracheostomy or both. This uncommon complication has potentially grave consequences. While airway fires are relatively uncommon occurrences, they are very serious and can often be fatal. Success in preventing such events requires a thorough understanding of the components leading to a fire (fuel, oxidizer, and ignition source), as well as good communication between all members present to appropriately manage the fire and ensure patient safety. We present a case of fire in the airway during routine adenotonsillectomy. We will review the causes, preventive measures, and brief management for airway fires. PMID:27006554

  6. Airway fires during surgery: Management and prevention.

    PubMed

    Akhtar, Navaid; Ansar, Farrukh; Baig, Mirza Shahzad; Abbas, Akbar

    2016-01-01

    Airway fires pose a serious risk to surgical patients. Fires during surgery have been reported for many years with flammable anesthetic agents being the main culprits in the past. Association of airway fires with laser surgery is well-recognized, but there are reports of endotracheal tube fires ignited by electrocautery during pharyngeal surgery or tracheostomy or both. This uncommon complication has potentially grave consequences. While airway fires are relatively uncommon occurrences, they are very serious and can often be fatal. Success in preventing such events requires a thorough understanding of the components leading to a fire (fuel, oxidizer, and ignition source), as well as good communication between all members present to appropriately manage the fire and ensure patient safety. We present a case of fire in the airway during routine adenotonsillectomy. We will review the causes, preventive measures, and brief management for airway fires. PMID:27006554

  7. Awake Craniotomy: A New Airway Approach.

    PubMed

    Sivasankar, Chitra; Schlichter, Rolf A; Baranov, Dimitry; Kofke, W Andrew

    2016-02-01

    Awake craniotomies have been performed regularly at the University of Pennsylvania since 2004. Varying approaches to airway management are described for this procedure, including intubation with an endotracheal tube and use of a laryngeal mask airway, simple facemask, or nasal cannula. In this case series, we describe the successful use (i.e., no need for endotracheal intubation related to inadequate gas exchange) of bilateral nasopharyngeal airways in 90 patients undergoing awake craniotomies. The use of nasopharyngeal airways can ease the transition between the asleep and awake phases of the craniotomy without the need to stimulate the airway. Our purpose was to describe our experience and report adverse events related to this technique. PMID:26579845

  8. Anaesthetic management of acute airway obstruction

    PubMed Central

    Wong, Patrick; Wong, Jolin; Mok, May Un Sam

    2016-01-01

    The acutely obstructed airway is a medical emergency that can potentially result in serious morbidity and mortality. Apart from the latest advancements in anaesthetic techniques, equipment and drugs, publications relevant to our topic, including the United Kingdom’s 4th National Audit Project on major airway complications in 2011 and the updated American Society of Anesthesiologists’ difficult airway algorithm of 2013, have recently been published. The former contained many reports of adverse events associated with the management of acute airway obstruction. By analysing the data and concepts from these two publications, this review article provides an update on management techniques for the acutely obstructed airway. We discuss the principles and factors relevant to the decision-making process in formulating a logical management plan. PMID:26996162

  9. Investigating the geometry of pig airways using computed tomography

    NASA Astrophysics Data System (ADS)

    Mansy, Hansen A.; Azad, Md Khurshidul; McMurray, Brandon; Henry, Brian; Royston, Thomas J.; Sandler, Richard H.

    2015-03-01

    Numerical modeling of sound propagation in the airways requires accurate knowledge of the airway geometry. These models are often validated using human and animal experiments. While many studies documented the geometric details of the human airways, information about the geometry of pig airways is scarcer. In addition, the morphology of animal airways can be significantly different from that of humans. The objective of this study is to measure the airway diameter, length and bifurcation angles in domestic pigs using computed tomography. After imaging the lungs of 3 pigs, segmentation software tools were used to extract the geometry of the airway lumen. The airway dimensions were then measured from the resulting 3 D models for the first 10 airway generations. Results showed that the size and morphology of the airways of different animals were similar. The measured airway dimensions were compared with those of the human airways. While the trachea diameter was found to be comparable to the adult human, the diameter, length and branching angles of other airways were noticeably different from that of humans. For example, pigs consistently had an early airway branching from the trachea that feeds the superior (top) right lung lobe proximal to the carina. This branch is absent in the human airways. These results suggested that the human geometry may not be a good approximation of the pig airways and may contribute to increasing the errors when the human airway geometric values are used in computational models of the pig chest.

  10. Nucleotide release by airway epithelia.

    PubMed

    Lazarowski, Eduardo R; Sesma, Juliana I; Seminario, Lucia; Esther, Charles R; Kreda, Silvia M

    2011-01-01

    The purinergic events regulating the airways' innate defenses are initiated by the release of purines from the epithelium, which occurs constitutively and is enhanced by chemical or mechanical stimulation. While the external triggers have been reviewed exhaustively, this chapter focuses on current knowledge of the receptors and signaling cascades mediating nucleotide release. The list of secreted purines now includes ATP, ADP, AMP and nucleotide sugars, and involves at least three distinct mechanisms reflecting the complexity of airway epithelia. First, the constitutive mechanism involves ATP translocation to the ER/Golgi complex as energy source for protein folding, and fusion of Golgi-derived vesicles with the plasma membrane. Second, goblet cells package ATP with mucins into granules, which are discharged in response to P2Y(2)R activation and Ca(2+)-dependent signaling pathways. Finally, non-mucous cells support a regulated mechanism of ATP release involving protease activated receptor (PAR)-elicited G(12/13) activation, leading to the RhoGEF-mediated exchange of GDP for GTP on RhoA, and cytoskeleton rearrangement. Together, these pathways provide fine tuning of epithelial responses regulated by purinergic signaling events. PMID:21560042

  11. Puberty and Upper Airway Dynamics During Sleep

    PubMed Central

    Bandla, Preetam; Huang, Jingtao; Karamessinis, Laurie; Kelly, Andrea; Pepe, Michelle; Samuel, John; Brooks, Lee; Mason, Thornton. A.; Gallagher, Paul R.; Marcus, Carole L.

    2008-01-01

    Study Objectives: The upper airway compensatory response to subatmospheric pressure loading declines with age. The epidemiology of obstructive sleep apnea suggests that sex hormones play a role in modulating upper airway function. Sex hormones increase gradually during puberty, from minimally detectable to adult levels. We hypothesized that the upper airway response to subatmospheric pressure loading decreased with increasing pubertal Tanner stage in males but remained stable during puberty in females. Design: Upper airway dynamic function during sleep was measured over the course of puberty. Participants: Normal subjects of Tanner stages 1 to 5. Measurements: During sleep, maximal inspiratory airflow was measured while varying the level of nasal pressure. The slope of the upstream pressure-flow relationship (SPF) was measured. Results: The SPF correlated with age and Tanner stage. However, the relationship with Tanner stage became nonsignificant when the correlation due to the mutual association with age was removed. Females had a lower SPF than males. Conclusions: In both sexes, the upper airway compensatory response to subatmospheric pressure loading decreased with age rather than degree of pubertal development. Thus, changes in sex hormones are unlikely to be a primary modulator of upper airway function during the transition from childhood to adulthood. Although further studies of upper airway structural changes during puberty are needed, we speculate that the changes in upper airway function with age are due to the depressant effect of age on ventilatory drive, leading to a decrease in upper airway neuromotor tone. Citation: Bandla P; Huang J; Karamessinis L; Kelly A; Pepe M; Samuel J; Brooks L; Mason TA; Gallagher PR; Marcus CL. Puberty and Upper Airway Dynamics During Sleep. SLEEP 2008;31(4):534-541. PMID:18457241

  12. New technique to quantitate regional pulmonary microvascular transit times from dynamic x-ray CT images

    NASA Astrophysics Data System (ADS)

    Tajik, Jehangir K.; Tran, Binh Q.; Hoffman, Eric A.

    1998-07-01

    Microvascular red blood cell mean transit time is a crucial parameter underlying basic pulmonary physiology. Dynamic x-ray CT imaging during bolus radiopaque tracer injection offers the ability to make functional measurements throughout the lungs, but is not able to resolve individual microvascular beds. We have implemented a model-free Fast Fourier Transform deconvolution algorithm to extract the microvascular transport characteristics from the acquired time-intensity data. The deconvolved feeding arterial bolus input curves and corresponding regional pulmonary parenchymal 'response' functions provide measures of regional pulmonary tracer residence times, allowing calculation of microvascular transit times for different spatial regions of the pulmonary system. The acquired feeding (main) pulmonary artery and regional pulmonary parenchyma time-intensity curves were fit to gamma variate functions which were then sampled with a temporal resolution of 0.1 seconds. Deconvolution of the feeding arterial and regional parenchymal curves consistently results in bimodal regional residue functions. The two modes consist of a relatively large, sharp, narrow peak approximating a delta function followed by a smaller more dispersed curve. The sharp, narrow peak appears to be due to small artery inclusion in the sampled parenchymal region (partial volume effects). The magnitude of the dominant arterial peak decreases as sampling locations are moved from the less expanded dependent to the more expanded non-dependent lung regions of supine dogs. Mathematical separation of the two modes allowed isolation of the arterial and microvascular components. The shape and transit times of the putative microvascular components agree well with results from similar measurements via microfocal angiography and in vivo microscopy. Reconvolving the microvascular component with the input curve results in a corrected parenchymal curve representing the regional microvascular transport characteristics

  13. Blood flow in microvascular networks: A study in nonlinear biology

    PubMed Central

    Geddes, John B.; Carr, Russell T.; Wu, Fan; Lao, Yingyi; Maher, Meaghan

    2010-01-01

    Plasma skimming and the Fahraeus–Lindqvist effect are well-known phenomena in blood rheology. By combining these peculiarities of blood flow in the microcirculation with simple topological models of microvascular networks, we have uncovered interesting nonlinear behavior regarding blood flow in networks. Nonlinearity manifests itself in the existence of multiple steady states. This is due to the nonlinear dependence of viscosity on blood cell concentration. Nonlinearity also appears in the form of spontaneous oscillations in limit cycles. These limit cycles arise from the fact that the physics of blood flow can be modeled in terms of state dependent delay equations with multiple interacting delay times. In this paper we extend our previous work on blood flow in a simple two node network and begin to explore how topological complexity influences the dynamics of network blood flow. In addition we present initial evidence that the nonlinear phenomena predicted by our model are observed experimentally. PMID:21198135

  14. Diabetic microvascular complications: possible targets for improved macrovascular outcomes

    PubMed Central

    D’Elia, John A; Bayliss, George; Roshan, Bijan; Maski, Manish; Gleason, Ray E; Weinrauch, Larry A

    2011-01-01

    The results of recent outcome trials challenge hypotheses that tight control of both glycohemoglobin and blood pressure diminishes macrovascular events and survival among type 2 diabetic patients. Relevant questions exist regarding the adequacy of glycohemoglobin alone as a measure of diabetes control. Are we ignoring mechanisms of vasculotoxicity (profibrosis, altered angiogenesis, hypertrophy, hyperplasia, and endothelial injury) inherent in current antihyperglycemic medications? Is the polypharmacy for lowering cholesterol, triglyceride, glucose, and systolic blood pressure producing drug interactions that are too complex to be clinically identified? We review angiotensin–aldosterone mechanisms of tissue injury that magnify microvascular damage caused by hyperglycemia and hypertension. Many studies describe interruption of these mechanisms, without hemodynamic consequence, in the preservation of function in type 1 diabetes. Possible interactions between the renin–angiotensin–aldosterone system and physiologic glycemic control (through pulsatile insulin release) suggest opportunities for further clinical investigation. PMID:21694944

  15. Diagnosis of coronary microvascular dysfunction – Present status

    PubMed Central

    Mittal, S.R.

    2015-01-01

    Definite clinical diagnosis of microvascular angina is not possible with the existing knowledge. Resting electrocardiogram may be normal, and exercise electrocardiogram may be unremarkable. Echocardiography usually does not show regional wall motion abnormalities. Transthoracic Doppler echocardiography can satisfactorily evaluate only left anterior descending coronary artery and that too in some patients. Radio-isotope imaging can detect only severe localized disease. Noninvasive diagnosis needs high index of suspicion. At present, definite diagnosis is based on documentation of normal epicardial coronaries, coronary flow reserve less than 2.5 on adenosine induced hyperemia, and absence of spasm of epicardial coronaries on acetylcholine provocation. Invasive evaluation is costly, needs sophisticated equipments and expertise. Therapeutic and prognostic implications of various parameters remains to be evaluated. At present invasive evaluation is recommended only for patients with intractable symptoms with unconfirmed diagnosis, requiring repeated hospitalization and evaluation with failure of empirical therapy. PMID:26702685

  16. FELERION: a new approach for leakage power reduction

    NASA Astrophysics Data System (ADS)

    R, Anjana; Somkuwar, Ajay

    2014-12-01

    The circuit proposed in this paper simultaneously reduces the sub threshold leakage power and saves the state of art aspect of the logic circuits. Sleep transistors and PMOS-only logic are used to further reduce the leakage power. Sleep transistors are used as the keepers to reduce the sub threshold leakage current providing the low resistance path to the output. PMOS-only logic is used between the pull up and pull down devices to mitigate the leakage power further. Our proposed fast efficient leakage reduction circuit not only reduces the leakage current but also reduces the power dissipation. Power and delay are analyzed at the 32 nm BSIM4 model for a chain of four inverters, NAND, NOR and ISCAS-85 c17 benchmark circuits using DSCH3 and the Microwind tool. The simulation results reveal that our proposed approach mitigates leakage power by 90%-94% as compared to the conventional approach.

  17. Reserves in Context: Planning for Leakage from Protected Areas

    PubMed Central

    Renwick, Anna R.; Bode, Michael; Venter, Oscar

    2015-01-01

    When protected areas reduce threats within their boundaries, they often displace a portion of these threats into adjacent areas through a process known as ‘leakage’, undermining conservation objectives. Using theoretical models and a case study of terrestrial mammals in Indonesia, we develop the first theoretical explanation of how leakage impacts conservation actions, and highlight conservation strategies that mitigate these impacts. Although leakage is a socio-economic process, we demonstrate that its negative impacts are also affected by the distribution of species, with leakage having larger impacts in landscapes with homogeneous distribution of species richness. Moreover, leakage has a greater negative effect when conservation strategies are implemented opportunistically, even creating the potential for perversely negative consequences from protected area establishment. Leakage thereby increases the relative benefits of systematic conservation planning over opportunism, especially in areas with high leakage and heterogeneously distributed species. Although leakage has the potential to undermine conservation actions, conservation planning can minimize this risk. PMID:26053163

  18. Surgical variation of microvascular decompression for trigeminal neuralgia: A technical note and anatomical study

    PubMed Central

    da Silva, Otávio T.; de Almeida, César C.; Iglesio, Ricardo F.; de Navarro, Jessie M.; Teixeira, Manoel J.; Duarte, Kleber P.

    2016-01-01

    Background: In this article, the authors described their experience in microvascular decompression for trigeminal neuralgia. Methods: The microvascular decompression technique used in the authors’ institution is described in a step by step manner with some illustrative cases as well as a cadaver dissection to highlight the differences with other previously described techniques. Results: Since 2013, 107 patients were operated in the Neurosurgery Division of the University of São Paulo using the described technique, with a shorter operative time and avoiding cerebellar retractor compared with classic techniques. Conclusion: Our modified microvascular decompression technique for trigeminal neuralgia can be used with safety and efficiency for treating trigeminal neuralgia. PMID:27625893

  19. The Utility of Cardiopulmonary Exercise Testing in the Assessment of Suspected Microvascular Ischemia

    PubMed Central

    Chaudhry, Sundeep; Arena, Ross; Wasserman, Karlman; Hansen, James E.; Lewis, Gregory D.; Myers, Jonathan; Belardinelli, Romualdo; LaBudde, Brian; Menasco, Nicholas; Boden, William E.

    2010-01-01

    Evidence demonstrating the potential value of cardiopulmonary exercise testing (CPET) to accurately detect myocardial ischemia secondary to macro-vascular disease is beginning to emerge. Despite distinct mechanisms mediating ischemia in micro-vascular and macrovascular coronary artery disease (CAD), the net physiologic effect of exercise-induced left ventricular (LV) dysfunction is common to both. The abnormal physiologic response to CPET may, therefore, be similar in patients with macro- and micro-vascular ischemia. The following case report describes the CPET abnormalities in a patient with suspected microvascular CAD and the subsequent improvement in LV function following three weeks of medical therapy with the anti-ischemic drug ranolazine. PMID:19233492

  20. Surgical variation of microvascular decompression for trigeminal neuralgia: A technical note and anatomical study

    PubMed Central

    da Silva, Otávio T.; de Almeida, César C.; Iglesio, Ricardo F.; de Navarro, Jessie M.; Teixeira, Manoel J.; Duarte, Kleber P.

    2016-01-01

    Background: In this article, the authors described their experience in microvascular decompression for trigeminal neuralgia. Methods: The microvascular decompression technique used in the authors’ institution is described in a step by step manner with some illustrative cases as well as a cadaver dissection to highlight the differences with other previously described techniques. Results: Since 2013, 107 patients were operated in the Neurosurgery Division of the University of São Paulo using the described technique, with a shorter operative time and avoiding cerebellar retractor compared with classic techniques. Conclusion: Our modified microvascular decompression technique for trigeminal neuralgia can be used with safety and efficiency for treating trigeminal neuralgia.

  1. Microvascular dysfunction in schizophrenia: a case–control study

    PubMed Central

    Vetter, Martin W; Martin, Billie-Jean; Fung, Marinda; Pajevic, Milada; Anderson, Todd J; Raedler, Thomas J

    2015-01-01

    Background: Schizophrenia is a mental illness associated with cardiovascular disease at a younger age than in the general population. Endothelial dysfunction has predictive value for future cardiovascular events; however, the impact of a diagnosis of schizophrenia on this marker is unknown. Aims: We tested the hypothesis that subjects with schizophrenia have impaired endothelial function. Methods: A total of 102 subjects (34.5±7.5 years) participated in this study. This sample consisted of 51 subjects with a diagnosis of schizophrenia and 51 healthy subjects, who were matched for age (P=0.442), sex (P>0.999), and smoking status (P=0.842). Peripheral artery microvascular and conduit vessel endothelial function was measured using hyperemic velocity time integral (VTI), pulse arterial tonometry (PAT), and flow-mediated dilation (FMD). Results: Significantly lower values of VTI were noted in subjects with schizophrenia (104.9±33.0 vs. 129.1±33.8 cm, P<0.001), whereas FMD (P=0.933) and PAT (P=0.862) did not differ between the two groups. A multivariable-linear-regression analysis, built on data from univariate and partial correlations, showed that only schizophrenia, sex, lipid-lowering medications, antihypertensive medications, and low-density lipoprotein (LDL)-cholesterol were predictive of attenuated VTI, whereas age, ethnicity, family history of cardiovascular disease, smoking status, systolic blood pressure, waist circumference, HDL-cholesterol, triglycerides, C-reactive protein, and homeostatic model assessment-insulin resistance (HOMA-IR), antidiabetic medications, antidepressant medications, mood stabilizers, benzodiazepines, and anticholinergic medications did not predict VTI in this model (adjusted R 2=0.248). Conclusions: Our findings suggest that a diagnosis of schizophrenia is associated with impaired microvascular function as indicated by lower values of VTI, irrespective of many other clinical characteristics. It might be an early indicator of

  2. Oxidative stress modulates nucleobase transport in microvascular endothelial cells.

    PubMed

    Bone, Derek B J; Antic, Milica; Vilas, Gonzalo; Hammond, James R

    2014-09-01

    Purine nucleosides and nucleobases play key roles in the physiological response to vascular ischemia/reperfusion events. The intra- and extracellular concentrations of these compounds are controlled, in part, by equilibrative nucleoside transporter subtype 1 (ENT1; SLC29A1) and by equilibrative nucleobase transporter subtype 1 (ENBT1). These transporters are expressed at the membranes of numerous cell types including microvascular endothelial cells. We studied the impact of reactive oxygen species on the function of ENT1 and ENBT1 in primary (CMVEC) and immortalized (HMEC-1) human microvascular endothelial cells. Both cell types displayed similar transporter expression profiles, with the majority (>90%) of 2-chloro[(3)H]adenosine (nucleoside) uptake mediated by ENT1 and [(3)H]hypoxanthine (nucleobase) uptake mediated by ENBT1. An in vitro mineral oil-overlay model of ischemia/reperfusion had no effect on ENT1 function, but significantly reduced ENBT1 Vmax in both cell types. This decrease in transport function was mimicked by the intracellular superoxide generator menadione and could be reversed by the superoxide dismutase mimetic MnTMPyP. In contrast, neither the extracellular peroxide donor TBHP nor the extracellular peroxynitrite donor 3-morpholinosydnonimine (SIN-1) affected ENBT1-mediated [(3)H]hypoxanthine uptake. SIN-1 did, however, enhance ENT1-mediated 2-chloro[(3)H]adenosine uptake. Our data establish HMEC-1 as an appropriate model for study of purine transport in CMVEC. Additionally, these data suggest that the generation of intracellular superoxide in ischemia/reperfusion leads to the down-regulation of ENBT1 function. Modification of purine transport by oxidant stress may contribute to ischemia/reperfusion induced vascular damage and should be considered in the development of therapeutic strategies.

  3. Alteration of the sublingual microvascular glycocalyx in critically ill patients.

    PubMed

    Donati, Abele; Damiani, Elisa; Domizi, Roberta; Romano, Rocco; Adrario, Erica; Pelaia, Paolo; Ince, Can; Singer, Mervyn

    2013-11-01

    Glycocalyx degradation may contribute to microvascular dysfunction and tissue hypoperfusion during systemic inflammation and sepsis. In this observational study we evaluated the alteration of the sublingual microvascular glycocalyx in 16 healthy volunteers and 50 critically ill patients. Sidestream Dark Field images of the sublingual microcirculation were automatically analyzed by dedicated software. The Perfused Boundary Region (PBR) was calculated as the dimensions of the permeable part of the glycocalyx allowing the penetration of circulating red blood cells, providing an index of glycocalyx damage. The PBR was increased in ICU patients compared to healthy controls (2.7 [2.59-2.88] vs. 2.46 [2.37-2.59]μm, p<0.0001) and tended to be higher in the 32 septic patients compared to non-septics (2.77 [2.62-2.93] vs. 2.67 [2.55-2.75]μm, p=0.05), suggesting more severe glycocalyx alterations. A PBR of 2.76 showed the best discriminative ability towards the presence of sepsis (sensitivity: 50%, specificity: 83%; area under the receiver operating characteristic curve: 0.67, 95% CI 0.52-0.82, p=0.05). A weak positive correlation was found between PBR and heart rate (r=0.3, p=0.03). In 17 septic patients, a correlation was found between PBR and number of rolling leukocytes in post-capillary venules (RL/venule) (r=0.55, p=0.02), confirming that glycocalyx shedding enhances leukocyte-endothelium interaction.

  4. Evaluation of Microvascular Perfusion and Resuscitation after Severe Injury.

    PubMed

    Lee, Yann-Leei L; Simmons, Jon D; Gillespie, Mark N; Alvarez, Diego F; Gonzalez, Richard P; Brevard, Sidney B; Frotan, Mohammad A; Schneider, Andrew M; Richards, William O

    2015-12-01

    Achieving adequate perfusion is a key goal of treatment in severe trauma; however, tissue perfusion has classically been measured by indirect means. Direct visualization of capillary flow has been applied in sepsis, but application of this technology to the trauma population has been limited. The purpose of this investigation was to compare the efficacy of standard indirect measures of perfusion to direct imaging of the sublingual microcirculatory flow during trauma resuscitation. Patients with injury severity scores >15 were serially examined using a handheld sidestream dark-field video microscope. In addition, measurements were also made from healthy volunteers. The De Backer score, a morphometric capillary density score, and total vessel density (TVD) as cumulative vessel area within the image, were calculated using Automated Vascular Analysis (AVA3.0) software. These indices were compared against clinical and laboratory parameters of organ function and systemic metabolic status as well as mortality. Twenty severely injured patients had lower TVD (X = 14.6 ± 0.22 vs 17.66 ± 0.51) and De Backer scores (X = 9.62 ± 0.16 vs 11.55 ± 0.37) compared with healthy controls. These scores best correlated with serum lactate (TVD R(2) = 0.525, De Backer R(2) = 0.576, P < 0.05). Mean arterial pressure, heart rate, oxygen saturation, pH, bicarbonate, base deficit, hematocrit, and coagulation parameters correlated poorly with both TVD and De Backer score. Direct measurement of sublingual microvascular perfusion is technically feasible in trauma patients, and seems to provide real-time assessment of microcirculatory perfusion. This study suggests that in severe trauma, many indirect measurements of perfusion do not correlate with microvascular perfusion. However, visualized perfusion deficiencies do reflect a shift toward anaerobic metabolism. PMID:26736167

  5. Autonomic dysfunction and microvascular damage in systemic sclerosis.

    PubMed

    Di Franco, Manuela; Paradiso, Michele; Riccieri, Valeria; Basili, Stefania; Mammarella, Antonio; Valesini, Guido

    2007-08-01

    Systemic sclerosis (SSc) is a connective tissue disease characterized by vascular damage and interstizial fibrosis of many organs. Our interest was focused on the evaluation of cardiac autonomic function by measurements of heart rate variability (HRV) and microvascular damage detected by nailfold capillaroscopy (NC) in SSc patients. We examined 25 consecutive outpatients affected by systemic sclerosis and 25 healthy controls. Exclusion criteria were the presence of cardiac disease, hypertension, diabetes mellitus, or neurological diseases. All subjects underwent 24-h ambulatory ECG Holter recording and NC examination. Heart rate variability was evaluated in the time domain, using appropriate software, computing the time series of all normal-to-normal (NN) QRS intervals throughout the 24-h recording period. A semiquantitative rating scale was adopted to score the NC abnormalities, as well as a rating system for avascular areas and morphological NC patterns. In SSc patients, HRV analysis showed significantly lower values of SDNN (standard deviation of all NN intervals) (p=0.009), SDANN (standard deviation of the averages of NN intervals in all 5-min segments of the entire recording) (p=0.01), and pNN50 (the percentage of adjacent NN intervals that differed by more than 50 ms) (p=0.02), compared to the control group. These parameters in SSc patients significantly decreased with the worsening of semiquantitative capillaroscopy score. In conclusion, an abnormal autonomic nervous control of the heart might contribute to identify subclinical cardiac involvement in SSc patients. The coexistence of autonomic dysfunction with a more severe microvascular damage could be considered a potential prognostic tool in the identification of those patients particularly at risk for cardiac mortality.

  6. Radiation induced leakage current and stress induced leakage current in ultra-thin gate oxides

    SciTech Connect

    Ceschia, M.; Paccagnella, A. |; Cester, A.; Scarpa, A.; Ghidini, G.

    1998-12-01

    Low-field leakage current has been measured in thin oxides after exposure to ionizing radiation. This Radiation Induced Leakage Current (RILC) can be described as an inelastic tunneling process mediated by neutral traps in the oxide, with an energy loss of about 1 eV. The neutral trap distribution is influenced by the oxide field applied during irradiation, thus indicating that the precursors of the neutral defects are charged, likely being defects associated to trapped holes. The maximum leakage current is found under zero-field condition during irradiation, and it rapidly decreases as the field is enhanced, due to a displacement of the defect distribution across the oxide towards the cathodic interface. The RILC kinetics are linear with the cumulative dose, in contrast with the power law found on electrically stressed devices.

  7. Educating the Educator: Teaching Airway Adjunct Techniques in Athletic Training

    ERIC Educational Resources Information Center

    Berry, David C.; Seitz, S. Robert

    2011-01-01

    The 5th edition of the "Athletic Training Education Competencies" ("Competencies") now requires athletic training educators (ATEs) to introduce into the curriculum various types of airway adjuncts including: (1) oropharyngeal airways (OPA), (2) nasopharyngeal airways (NPA), (3) supraglottic airways (SGA), and (4) suction. The addition of these…

  8. Small particles disrupt postnatal airway development

    PubMed Central

    Lee, DongYoub; Wallis, Chris; Schelegle, Edward S.; Van Winkle, Laura S.; Plopper, Charles G.; Fanucchi, Michelle V.; Kumfer, Ben; Kennedy, Ian M.; Chan, Jackie K. W.

    2010-01-01

    Increasing numbers of epidemiologic studies associate air pollution exposure in children with decreased lung function development. The objective of this study was to examine the effects of exposure to combustion-generated fine [230 and 212 nm number mean aerodynamic particle diameter (NMAD)] to ultrafine (73 nm NMAD) particles differing in elemental (EC) and organic (OC) carbon content on postnatal airway development in rats. Neonatal Sprague-Dawley rats were exposed from postnatal day 7 through 25, and lung function and airway architecture were evaluated 81 days of age. In a separate group of rats, cell proliferation was examined after a single particle exposure at 7 days of age. Early life exposure to 73 nm high OC/EC particles altered distal airway architecture and resulted in subtle changes in lung mechanics. Early life exposure to 212 nm high OC/EC particles did not alter lung architecture but did alter lung mechanics in a manner suggestive of central airway changes. In contrast, early life exposure to 230 nm low OC/EC particles did not alter lung architecture or mechanics. A single 6-h exposure to 73 nm high OC/EC particle decreased airway cell proliferation, whereas 212 nm high OC/EC particles increased it and 230 nm low OC/EC particles did not. The early life exposure to ultrafine, high OC/EC particles results in persistent alterations in distal airway architecture that is characterized by an initial decrease in airway cell proliferation. PMID:20634362

  9. Comparison of analysis methods for airway quantification

    NASA Astrophysics Data System (ADS)

    Odry, Benjamin L.; Kiraly, Atilla P.; Novak, Carol L.; Naidich, David P.

    2012-03-01

    Diseased airways have been known for several years as a possible contributing factor to airflow limitation in Chronic Obstructive Pulmonary Diseases (COPD). Quantification of disease severity through the evaluation of airway dimensions - wall thickness and lumen diameter - has gained increased attention, thanks to the availability of multi-slice computed tomography (CT). Novel approaches have focused on automated methods of measurement as a faster and more objective means that the visual assessment routinely employed in the clinic. Since the Full-Width Half-Maximum (FWHM) method of airway measurement was introduced two decades ago [1], several new techniques for quantifying airways have been detailed in the literature, but no approach has truly become a standard for such analysis. Our own research group has presented two alternative approaches for determining airway dimensions, one involving a minimum path and the other active contours [2, 3]. With an increasing number of techniques dedicated to the same goal, we decided to take a step back and analyze the differences of these methods. We consequently put to the test our two methods of analysis and the FWHM approach. We first measured a set of 5 airways from a phantom of known dimensions. Then we compared measurements from the three methods to those of two independent readers, performed on 35 airways in 5 patients. We elaborate on the differences of each approach and suggest conclusions on which could be defined as the best one.

  10. EVA Suit Microbial Leakage Investigation Project

    NASA Technical Reports Server (NTRS)

    Falker, Jay; Baker, Christopher; Clayton, Ronald; Rucker, Michelle

    2016-01-01

    The objective of this project is to collect microbial samples from various EVA suits to determine how much microbial contamination is typically released during simulated planetary exploration activities. Data will be released to the planetary protection and science communities, and advanced EVA system designers. In the best case scenario, we will discover that very little microbial contamination leaks from our current or prototype suit designs, in the worst case scenario, we will identify leak paths, learn more about what affects leakage--and we'll have a new, flight-certified swab tool for our EVA toolbox.

  11. Predicting Envelope Leakage in Attached Dwellings (Fact Sheet)

    SciTech Connect

    Not Available

    2013-11-01

    The most common method of measuring air leakage is to perform single (or solo) blower door pressurization and/or depressurization test. In detached housing, the single blower door test measures leakage to the outside. In attached housing, however, this "solo" test method measures both air leakage to the outside and air leakage between adjacent units through common surfaces. Although minimizing leakage to neighboring units is highly recommended to avoid indoor air quality issues between units, reduce pressure differentials between units, and control stack effect, the energy benefits of air sealing can be significantly overpredicted if the solo air leakage number is used in the energy analysis. Guarded blower door testing is more appropriate for isolating and measuring leakage to the outside in attached housing. This method uses multiple blower doors to depressurize adjacent spaces to the same level as the unit being tested. Maintaining a neutral pressure across common walls, ceilings, and floors acts as a "guard" against air leakage between units. The resulting measured air leakage in the test unit is only air leakage to the outside. Although preferred for assessing energy impacts, the challenges of performing guarded testing can be daunting.

  12. Firefighting acutely increases airway responsiveness.

    PubMed

    Sherman, C B; Barnhart, S; Miller, M F; Segal, M R; Aitken, M; Schoene, R; Daniell, W; Rosenstock, L

    1989-07-01

    The acute effects of the products of combustion and pyrolysis on airway responsiveness among firefighters are poorly documented. To study this relationship, spirometry and methacholine challenge testing (MCT) were performed on 18 active Seattle firefighters before and 5 to 24 h after firefighting. Body plethysmography was used to measure changes in specific airway conductance (SGaw), and results of MCT were analyzed using PD35-SGaw, the cumulative dose causing a 35% decrease in SGaw. Subjects who did not react by the end of the protocol were assigned a value of 640 inhalational units, the largest cumulative dose. Fire exposure was defined as the total time (hours) spent without a self-contained breathing apparatus at the firesite and was categorized as mild (less than 1 h, n = 7), moderate (1 to 2 h, n = 5), or severe (greater than 2 h, n = 6). Mean age of the 18 firefighters was 36.7 +/- 6.7 yr (range, 25 to 51), with a mean of 9.1 +/- 7.9 active years in the trade (range, zero to 22). None was known to be asthmatic. After firefighting, FEV1 % predicted (%pred) and FEF25-75 %pred significantly decreased by means of 3.4 +/- 1.1% and 5.6 +/- 2.6%, respectively. The mean decline in PD35-SGaw after firefighting was 184.5 +/- 53.2 units (p = 0.003). This observed decline in PD35-SGaw could not be explained by decrements in prechallenge SGaw, FEV1, or FVC.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. SPONTANEOUSLY HYPERTENSIVE RATS ARE SUSCEPTIBLE TO MICROVASCULAR THROMBOSIS IN RESPONSE TO PARTICULATE MATTER EXPOSURE

    EPA Science Inventory

    SPONTANEOUSLY HYPERTENSIVE RATS ARE SUSCEPTIBLE TO MICROVASCULAR THROMBOSIS IN RESPONSE TO PARTICULATE MATTER EXPOSURE.
    PS Gilmour, MC Schladweiler, AD Ledbetter, and UP Kodavanti. US EPA, ORD, NHEERL, ETD, PTB, Research Triangle Park, NC USA.
    Environmental particles (PM...

  14. Genetic Studies on Diabetic Microvascular Complications: Focusing on Genome-Wide Association Studies

    PubMed Central

    Kwak, Soo Heon

    2015-01-01

    Diabetes is a common metabolic disorder with a worldwide prevalence of 8.3% and is the leading cause of visual loss, end-stage renal disease and amputation. Recently, genome-wide association studies (GWASs) have identified genetic risk factors for diabetic microvascular complications of retinopathy, nephropathy, and neuropathy. We summarized the recent findings of GWASs on diabetic microvascular complications and highlighted the challenges and our opinion on future directives. Five GWASs were conducted on diabetic retinopathy, nine on nephropathy, and one on neuropathic pain. The majority of recent GWASs were underpowered and heterogeneous in terms of study design, inclusion criteria and phenotype definition. Therefore, few reached the genome-wide significance threshold and the findings were inconsistent across the studies. Recent GWASs provided novel information on genetic risk factors and the possible pathophysiology of diabetic microvascular complications. However, further collaborative efforts to standardize phenotype definition and increase sample size are necessary for successful genetic studies on diabetic microvascular complications. PMID:26194074

  15. Geologic Carbon Sequestration: Leakage Potential and Policy Implications

    NASA Astrophysics Data System (ADS)

    Bielicki, J. M.; Peters, C. A.; Fitts, J. P.; Wilson, E. J.

    2014-12-01

    The geologic reservoirs that could be used for long-term sequestration of carbon dioxide (CO2) may have natural or manmade pathways that allow injected CO2, or the brine it displaces, to leak into overlying formations. Using a basin-scale leakage estimation model, we investigated the geophysical parameters that govern this leakage, and the resulting accumulations of leaked fluids in overlying formations. The results are discussed in the context of two polices aimed at governing long-term sequestration and protecting groundwater: the U.S. DOE guideline for storage permanence and the U.S. EPA UIC Program Class VI Rule. For a case study of CO2 injection into the Mt. Simon sandstone in the Michigan sedimentary basin, we showed that (1) the U.S. DOE guideline would allow for more leakage from larger injection projects than for smaller ones; (2) leakage amounts are determined mostly by well leakage permeability rather than by variation in formation permeabilities; (3) numerous leaking wells with anomalously high leakage permeabilities are necessary in order to achieve substantial leakage rates; (4) leakage can reach potable groundwater but intervening stratigraphic traps reduce the amount to be multiple orders of magnitude less than the leakage out of the reservoir, and (5) this leakage can reduce the Area of Review that is defined by the U.S. EPA as the area within which leakage can threaten groundwater. In summary, leakage that exceeds the U.S. DOE storage permanence goal would occur only under extreme conditions, the amount that reaches shallow potable groundwater may be inconsequential from a pollution standpoint, and leakage may be beneficial. Future federal policies should be harmonized to achieve the dual goals of protecting groundwater while allowing for adaptive management that incorporates uncertainties and imperfections inherent in geologic reservoirs.

  16. Mechanisms Linking Advanced Airway Management and Cardiac Arrest Outcomes

    PubMed Central

    Benoit, Justin L.; Prince, David K.; Wang, Henry E.

    2015-01-01

    Advanced airway management – such as endotracheal intubation (ETI) or supraglottic airway (SGA) insertion – is one of the most prominent interventions in out-of-hospital cardiac arrest (OHCA) resuscitation. While randomized controlled trials are currently in progress to identify the best advanced airway technique in OHCA, the mechanisms by which airway management may influence OHCA outcomes remain unknown. We provide a conceptual model describing potential mechanisms linking advanced airway management with OHCA outcomes. PMID:26073275

  17. Interactions of the Gasotransmitters Contribute to Microvascular Tone (Dys)regulation in the Preterm Neonate

    PubMed Central

    Dyson, Rebecca M.; Palliser, Hannah K.; Latter, Joanna L.; Kelly, Megan A.; Chwatko, Grazyna; Glowacki, Rafal; Wright, Ian M. R.

    2015-01-01

    Background & Aims Hydrogen sulphide (H2S), nitric oxide (NO), and carbon monoxide (CO) are involved in transitional microvascular tone dysregulation in the preterm infant; however there is conflicting evidence on the interaction of these gasotransmitters, and their overall contribution to the microcirculation in newborns is not known. The aim of this study was to measure the levels of all 3 gasotransmitters, characterise their interrelationships and elucidate their combined effects on microvascular blood flow. Methods 90 preterm neonates were studied at 24h postnatal age. Microvascular studies were performed by laser Doppler. Arterial COHb levels (a measure of CO) were determined through co-oximetry. NO was measured as nitrate and nitrite in urine. H2S was measured as thiosulphate by liquid chromatography. Relationships between levels of the gasotransmitters and microvascular blood flow were assessed through partial correlation controlling for the influence of gestational age. Structural equation modelling was used to examine the combination of these effects on microvascular blood flow and derive a theoretical model of their interactions. Results No relationship was observed between NO and CO (p = 0.18, r = 0.18). A positive relationship between NO and H2S (p = 0.008, r = 0.28) and an inverse relationship between CO and H2S (p = 0.01, r = -0.33) exists. Structural equation modelling was used to examine the combination of these effects on microvascular blood flow. The model with the best fit is presented. Conclusions The relationships between NO and H2S, and CO and H2S may be of importance in the preterm newborn, particularly as NO levels in males are associated with higher H2S levels and higher microvascular blood flow and CO in females appears to convey protection against vascular dysregulation. Here we present a theoretical model of these interactions and their overall effects on microvascular flow in the preterm newborn, upon which future mechanistic studies may

  18. Visualization of microvascularity in glioblastoma multiforme with 8-T high-spatial-resolution MR imaging.

    PubMed

    Christoforidis, Gregory A; Grecula, John C; Newton, Herbert B; Kangarlu, Allahyar; Abduljalil, Amir M; Schmalbrock, Petra; Chakeres, Donald W

    2002-10-01

    We used 8-T high-spatial-resolution gradient-echo MR imaging to directly visualize microvascularity in pathologically proved glioblastoma multiforme. Images were compared with 1.5-T high-spatial-resolution fast spin-echo T2-weighted images and digital subtraction angiograms. Preliminary data indicate that 8-T high-spatial-resolution MR imaging may enable the identification of areas of abnormal microvascularity in glioblastoma multiforme that are not visible with other routine clinical techniques.

  19. [THE AGING OF MICROVASCULAR NETWORK FORMED IN CORTEX FOLLOWING INTRACEREBRAL TRANSPLANTATION OF MESENCHYMAL STEM CELLS].

    PubMed

    Sokolova, I B; Anisimov, S V; Puzanov, M V; Sergeev, I V; Dvoretskiĭ, D P

    2015-01-01

    Using a TV device to study microcirculation in brain we found that intracerebral transplantation of mesenchymal stem cells to 12-months old rats led to a significant increase (circa 1,5-fold times) of microvascular density in pia tissue and to increased constriction reactions of pia arterioles in response to noradrenalin application on a brain surface. Both microvascular density and pia arterioles reactivity was completely preserved in aging until 22-24 months. PMID:26390610

  20. Microvascular patterns in the blubber of shallow and deep diving odontocetes.

    PubMed

    McClelland, Sara J; Gay, Mark; Pabst, D Ann; Dillaman, Richard; Westgate, Andrew J; Koopman, Heather N

    2012-08-01

    Blubber, a specialized form of subdermal adipose tissue, surrounds marine mammal bodies. Typically, adipose tissue is perfused by capillaries but information on blubber vascularization is lacking. This study's goals were to: 1) describe and compare the microvasculature (capillaries, microarterioles, and microvenules) of blubber across odontocete species; 2) compare microvasculature of blubber to adipose tissue; and 3) examine relationships between blubber's lipid composition and its microvasculature. Percent microvascularity, distribution, branching pattern, and diameter of microvessels were determined from images of histochemically stained blubber sections from shallow-diving bottlenose dolphins (Tursiops truncatus), deeper-diving pygmy sperm whales (Kogia breviceps), deep-diving beaked whales (Mesoplodon densirostris; Ziphius cavirostris), and the subdermal adipose tissue of domestic pigs (Sus scrofa). Tursiops blubber showed significant stratification in percent microvascularity among the superficial, middle, and deep layers and had a significantly higher percent microvascularity than all other animals analyzed, in which the microvasculature was more uniformly distributed. The percent microvasculature of Kogia blubber was lower than that of Tursiops but higher than that of beaked whales and the subdermal adipose tissue of domestic pigs. Tursiops had the most microvascular branching. Microvessel diameter was relatively uniform in all species. There were no clear patterns associating microvascular and lipid characteristics. The microvascular characteristics of the superficial layer of blubber resembled the adipose tissue of terrestrial mammals, suggesting some conservation of microvascular patterns in mammalian adipose tissue. The middle and deep layers of blubber, particularly in Tursiops, showed the greatest departure from typical mammalian microvascular arrangement. Factors such as metabolics or thermoregulation may be influencing the microvasculature in these

  1. EM information leakage from display unit and visual inspection for its leakage source

    NASA Astrophysics Data System (ADS)

    Watanabe, Takashi; Sako, Hiroshi

    2013-05-01

    Display unit emits a small amount of electromagnetic wave. Although it is weak enough to prevent interference with human body, information leaks through it. This paper presents an experiment on exploring the leakage source by visually inspecting the screen images reconstructed from captured electromagnetic waves. Additionally, some countermeasures are investigated to avoid the problem.

  2. Nasal airway responses to nasal continuous positive airway pressure breathing: An in-vivo pilot study.

    PubMed

    White, David E; Bartley, Jim; Shakeel, Muhammad; Nates, Roy J; Hankin, Robin K S

    2016-06-14

    The nasal cycle, through variation in nasal airflow partitioning, allows the upper airway to accommodate the contrasting demands of air conditioning and removal of entrapped air contaminants. The purpose of this study was to investigate the influence of nasal continuous positive airway pressure (nCPAP) breathing has on both nasal airflow partitioning and nasal geometry. Using a custom-made nasal mask, twenty healthy participants had the airflow in each naris measured during normal nasal breathing followed by nCPAP breathing. Eight participants also underwent magnetic resonance imaging (MRI) of the nasal region during spontaneous nasal breathing, and then nCPAP breathing over a range of air pressures. During nCPAP breathing, a simultaneous reduction in airflow through the patent airway together with a corresponding increase in airway flow within the congested nasal airway were observed in sixteen of the twenty participants. Nasal airflow resistance is inversely proportional to airway cross-sectional area. MRI data analysis during nCPAP breathing confirmed airway cross-sectional area reduced along the patent airway while the congested airway experienced an increase in this parameter. During awake breathing, nCPAP disturbs the normal inter-nasal airflow partitioning. This could partially explain the adverse nasal drying symptoms frequently reported by many users of this therapy. PMID:27173595

  3. Deeper Penetration of Erythrocytes into the Endothelial Glycocalyx Is Associated with Impaired Microvascular Perfusion

    PubMed Central

    Lee, Dae Hyun; Dane, Martijn J. C.; van den Berg, Bernard M.; Boels, Margien G. S.; van Teeffelen, Jurgen W.; de Mutsert, Renée; den Heijer, Martin; Rosendaal, Frits R.; van der Vlag, Johan; van Zonneveld, Anton Jan; Vink, Hans; Rabelink, Ton J.

    2014-01-01

    Changes in endothelial glycocalyx are one of the earliest changes in development of cardiovascular disease. The endothelial glycocalyx is both an important biological modifier of interactions between flowing blood and the vessel wall, and a determinant of organ perfusion. We hypothesize that deeper penetration of erythrocytes into the glycocalyx is associated with reduced microvascular perfusion. The population-based prospective cohort study (the Netherlands Epidemiology of Obesity [NEO] study) includes 6,673 middle-aged individuals (oversampling of overweight and obese individuals). Within this cohort, we have imaged the sublingual microvasculature of 915 participants using sidestream darkfield (SDF) imaging together with a recently developed automated acquisition and analysis approach. Presence of RBC (as a marker of microvascular perfusion) and perfused boundary region (PBR), a marker for endothelial glycocalyx barrier properties for RBC accessibility, were assessed in vessels between 5 and 25 µm RBC column width. A wide range of variability in PBR measurements, with a mean PBR of 2.14 µm (range: 1.43–2.86 µm), was observed. Linear regression analysis showed a marked association between PBR and microvascular perfusion, reflected by RBC filling percentage (regression coefficient β: −0.034; 95% confidence interval: −0.037 to −0.031). We conclude that microvascular beds with a thick (“healthy”) glycocalyx (low PBR), reflects efficient perfusion of the microvascular bed. In contrast, a thin (“risk”) glycocalyx (high PBR) is associated with a less efficient and defective microvascular perfusion. PMID:24816787

  4. Drag-Reducing Polymer Enhances Microvascular Perfusion in the Traumatized Brain with Intracranial Hypertension.

    PubMed

    Bragin, Denis E; Thomson, Susan; Bragina, Olga; Statom, Gloria; Kameneva, Marina V; Nemoto, Edwin M

    2016-01-01

    Current treatments for traumatic brain injury (TBI) have not focused on improving microvascular perfusion. Drag-reducing polymers (DRP), linear, long-chain, blood-soluble, nontoxic macromolecules, may offer a new approach to improving cerebral perfusion by primary alteration of the fluid dynamic properties of blood. Nanomolar concentrations of DRP have been shown to improve hemodynamics in animal models of ischemic myocardium and ischemic limb, but have not yet been studied in the brain. We recently demonstrated that DRP improved microvascular perfusion and tissue oxygenation in a normal rat brain. We hypothesized that DRP could restore microvascular perfusion in hypertensive brain after TBI. Using in vivo two-photon laser scanning microscopy we examined the effect of DRP on microvascular blood flow and tissue oxygenation in hypertensive rat brains with and without TBI. DRP enhanced and restored capillary flow, decreased microvascular shunt flow, and, as a result, reduced tissue hypoxia in both nontraumatized and traumatized rat brains at high intracranial pressure. Our study suggests that DRP could constitute an effective treatment for improving microvascular flow in brain ischemia caused by high intracranial pressure after TBI. PMID:27165871

  5. Deeper penetration of erythrocytes into the endothelial glycocalyx is associated with impaired microvascular perfusion.

    PubMed

    Lee, Dae Hyun; Dane, Martijn J C; van den Berg, Bernard M; Boels, Margien G S; van Teeffelen, Jurgen W; de Mutsert, Renée; den Heijer, Martin; Rosendaal, Frits R; van der Vlag, Johan; van Zonneveld, Anton Jan; Vink, Hans; Rabelink, Ton J

    2014-01-01

    Changes in endothelial glycocalyx are one of the earliest changes in development of cardiovascular disease. The endothelial glycocalyx is both an important biological modifier of interactions between flowing blood and the vessel wall, and a determinant of organ perfusion. We hypothesize that deeper penetration of erythrocytes into the glycocalyx is associated with reduced microvascular perfusion. The population-based prospective cohort study (the Netherlands Epidemiology of Obesity [NEO] study) includes 6,673 middle-aged individuals (oversampling of overweight and obese individuals). Within this cohort, we have imaged the sublingual microvasculature of 915 participants using sidestream darkfield (SDF) imaging together with a recently developed automated acquisition and analysis approach. Presence of RBC (as a marker of microvascular perfusion) and perfused boundary region (PBR), a marker for endothelial glycocalyx barrier properties for RBC accessibility, were assessed in vessels between 5 and 25 µm RBC column width. A wide range of variability in PBR measurements, with a mean PBR of 2.14 µm (range: 1.43-2.86 µm), was observed. Linear regression analysis showed a marked association between PBR and microvascular perfusion, reflected by RBC filling percentage (regression coefficient β: -0.034; 95% confidence interval: -0.037 to -0.031). We conclude that microvascular beds with a thick ("healthy") glycocalyx (low PBR), reflects efficient perfusion of the microvascular bed. In contrast, a thin ("risk") glycocalyx (high PBR) is associated with a less efficient and defective microvascular perfusion.

  6. Drag-Reducing Polymer Enhances Microvascular Perfusion in the Traumatized Brain with Intracranial Hypertension.

    PubMed

    Bragin, Denis E; Thomson, Susan; Bragina, Olga; Statom, Gloria; Kameneva, Marina V; Nemoto, Edwin M

    2016-01-01

    Current treatments for traumatic brain injury (TBI) have not focused on improving microvascular perfusion. Drag-reducing polymers (DRP), linear, long-chain, blood-soluble, nontoxic macromolecules, may offer a new approach to improving cerebral perfusion by primary alteration of the fluid dynamic properties of blood. Nanomolar concentrations of DRP have been shown to improve hemodynamics in animal models of ischemic myocardium and ischemic limb, but have not yet been studied in the brain. We recently demonstrated that DRP improved microvascular perfusion and tissue oxygenation in a normal rat brain. We hypothesized that DRP could restore microvascular perfusion in hypertensive brain after TBI. Using in vivo two-photon laser scanning microscopy we examined the effect of DRP on microvascular blood flow and tissue oxygenation in hypertensive rat brains with and without TBI. DRP enhanced and restored capillary flow, decreased microvascular shunt flow, and, as a result, reduced tissue hypoxia in both nontraumatized and traumatized rat brains at high intracranial pressure. Our study suggests that DRP could constitute an effective treatment for improving microvascular flow in brain ischemia caused by high intracranial pressure after TBI.

  7. Thiel embalming technique: a valuable method for microvascular exercise and teaching of flap raising.

    PubMed

    Wolff, Klaus-D; Kesting, Marco; Mücke, Thomas; Rau, Andrea; Hölzle, Frank

    2008-01-01

    Because of its high requirements on dexterity and microsurgical skills and the need of complete understanding of flap anatomy, microvascular free flap transfer belongs to the most demanding surgical procedures. Therefore, courses for flap raising and microvascular exercise are considered a prerequisite to prepare for clinical practise. To achieve teaching conditions as realistic as possible we used a novel cadaver embalming method enabling tissue dissection comparable to the living body. Thirty cadavers which were offered to us by the Institute of Anatomy for the purpose of running flap raising courses were embalmed in the technique described by Thiel. On each cadaver, nine free flaps were dissected according to a structured protocol by each course participant and afterwards used for microvascular exercise. The conservation of fine vascular structures and the suitability of the embalmed tissue for microvascular suturing were observed and photographically documented. The Thiel embalming technique provided flap raising procedures to be performed under realistic conditions similar to the living body. Vessels and nerves could be exposed and dissected up to a diameter of 1 mm and allowed for microvascular suturing even after weeks like fresh specimens. The Thiel embalming method is a unique technique and ideally suited to teach flap raising and microvascular suturing on human material.

  8. Added Qualifications in Microsurgery: Consideration for Subspecialty Certification in Microvascular Surgery in Europe.

    PubMed

    Heidekrueger, Paul I; Tanna, Neil; Weichman, Katie E; Szpalski, Caroline; Tos, Pierluigi; Ninkovic, Milomir; Broer, P Niclas

    2016-07-01

    Background While implementation of subspecializations may increase expertise in a certain area of treatment, there also exist downsides. Aim of this study was, across several disciplines, to find out if the technique of microsurgery warrants the introduction of a "Certificate of Added Qualifications (CAQ) in microsurgery." Methods An anonymous, web-based survey was administered to directors of microsurgical departments in Europe (n = 205). Respondents were asked, among other questions, whether they had completed a 12-month microvascular surgery fellowship and whether they believed a CAQ in microvascular surgery should be instituted. Results The response rate was 57%, and 33% of the respondents had completed a 12-month microvascular surgery fellowship.A total of 61% of all surgeons supported a CAQ in microsurgery. Answers ranged from 47% of support to 100% of support, depending on the countries surveyed. Discussion This is one of the few reports to evaluate the potential role of subspecialty certification of microvascular surgery across several European countries. The data demonstrate that the majority of directors of microsurgical departments support such a certificate. There was significantly greater support for a CAQ in microsurgery among those who have completed a formal microvascular surgery fellowship themselves. Conclusion This study supports the notion that further discussion and consideration of subspecialty certification in microvascular surgery appears necessary. There are multiple concerns surrounding this issue. Similar to the evolution of hand surgery certification, an exploratory committee of executive members of the respective medical boards and official societies may be warranted.

  9. Therapeutic bronchoscopic interventions for malignant airway obstruction

    PubMed Central

    Dalar, Levent; Özdemir, Cengiz; Abul, Yasin; Karasulu, Levent; Sökücü, Sinem Nedime; Akbaş, Ayşegül; Altın, Sedat

    2016-01-01

    Abstract There is no definitive consensus about the factors affecting the choice of interventional bronchoscopy in the management of malignant airway obstruction. The present study defines the choice of the interventional bronchoscopic modality and analyzes the factors influencing survival in patients with malignant central airway obstruction. Totally, over 7 years, 802 interventional rigid bronchoscopic procedures were applied in 547 patients having malignant airway obstruction. There was a significant association between the type of stent and the site of the lesion in the present study. Patients with tracheal involvement and/or involvement of the main bronchi had the worst prognosis. The sites of the lesion and endobronchial treatment modality were independent predictors of survival in the present study. The selection of different types of airway stents can be considered on the base of site of the lesion. Survival can be estimated based on the site of the lesion and endobronchial brochoscopic modality used. PMID:27281104

  10. 21 CFR 868.5810 - Airway connector.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... airway connector is a device intended to connect a breathing gas source to a tracheal tube, tracheostomy tube, or mask. (b) Classification. Class I (general controls). The device is exempt from the...

  11. 21 CFR 868.5810 - Airway connector.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... airway connector is a device intended to connect a breathing gas source to a tracheal tube, tracheostomy tube, or mask. (b) Classification. Class I (general controls). The device is exempt from the...

  12. 21 CFR 868.5810 - Airway connector.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... airway connector is a device intended to connect a breathing gas source to a tracheal tube, tracheostomy tube, or mask. (b) Classification. Class I (general controls). The device is exempt from the...

  13. Virtual Airway Skills Trainer (VAST) Simulator

    PubMed Central

    DEMIREL, Doga; YU, Alexander; HALIC, Tansel; SANKARANARAYANAN, Ganesh; RYASON, Adam; SPINDLER, David; BUTLER, Kathryn L.; CAO, Caroline; PETRUSA, Emil; MOLINA, Marcos; JONES, Dan; DE, Suvranu; DEMOYA, Marc; JONES, Stephanie

    2016-01-01

    This paper presents a simulation of Virtual Airway Skill Trainer (VAST) tasks. The simulated tasks are a part of two main airway management techniques; Endotracheal Intubation (ETI) and Cricothyroidotomy (CCT). ETI is a simple nonsurgical airway management technique, while CCT is the extreme surgical alternative to secure the airway of a patient. We developed identification of Mallampati class, finding the optimal angle for positioning pharyngeal/mouth axes tasks for ETI and identification of anatomical landmarks and incision tasks for CCT. Both ETI and CCT simulators were used to get physicians’ feedback at Society for Education in Anesthesiology and Association for Surgical Education spring meetings. In this preliminary validation study, total 38 participants for ETI and 48 for CCT performed each simulation task and completed pre and post questionnaires. In this work, we present the details of the simulation for the tasks and also the analysis of the collected data from the validation study. PMID:27046559

  14. 21 CFR 868.5810 - Airway connector.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... airway connector is a device intended to connect a breathing gas source to a tracheal tube, tracheostomy tube, or mask. (b) Classification. Class I (general controls). The device is exempt from the...

  15. Diesel exhaust particles and airway inflammation

    EPA Science Inventory

    Purpose of review. Epidemiologic investigation has associated traffic-related air pollution with adverse human health outcomes. The capacity ofdiesel exhaust particles (DEP), a major emission source air pollution particle, to initiate an airway inflammation has subsequently been ...

  16. Airway clearance therapy: finding the evidence.

    PubMed

    Volsko, Teresa A

    2013-10-01

    Disease processes can impair ciliary function, alter secretion production and mucus rheology, and interfere with the cough reflex. Airway clearance therapy has been a cornerstone of therapy aimed at minimizing the devastating effects of airway obstruction, infection, and inflammation due to mucus stasis on the conducting airways and lung parenchyma. Although challenges to performing clinical studies evaluating the effectiveness of airway clearance therapeutic modalities exist, resources are available in the literature. In addition to device evaluations and original clinical research, the expert opinion, systematic reviews, and evidence-based practice guidelines can be found. These tools can be used to develop protocols and pathways to guide our practice. Monitoring and reporting patient, process, and financial outcomes are essential steps germane to the implementation of evidence-based care.

  17. Optical imaging to map blood-brain barrier leakage

    NASA Astrophysics Data System (ADS)

    Jaffer, Hayder; Adjei, Isaac M.; Labhasetwar, Vinod

    2013-11-01

    Vascular leakage in the brain is a major complication associated with brain injuries and certain pathological conditions due to disruption of the blood-brain barrier (BBB). We have developed an optical imaging method, based on excitation and emission spectra of Evans Blue dye, that is >1000-fold more sensitive than conventional ultraviolet spectrophotometry. We used a rat thromboembolic stroke model to validate the usefulness of our method for vascular leakage. Optical imaging data show that vascular leakage varies in different areas of the post-stroke brain and that administering tissue plasminogen activator causes further leakage. The new method is quantitative, simple to use, requires no tissue processing, and can map the degree of vascular leakage in different brain locations. The high sensitivity of our method could potentially provide new opportunities to study BBB leakage in different pathological conditions and to test the efficacy of various therapeutic strategies to protect the BBB.

  18. Residential Forced Air System Cabinet Leakage and Blower Performance

    SciTech Connect

    Walker, Iain S.; Dickerhoff, Darryl J.; Delp, William W.

    2010-03-01

    This project evaluated the air leakage and electric power consumption of Residential HVAC components, with a particular focus on air leakage of furnace cabinets. Laboratory testing of HVAC components indicated that air leakage can be significant and highly variable from unit to unit ? indicating the need for a standard test method and specifying maximum allowable air leakage in California State energy codes. To further this effort, this project provided technical assistance for the development of a national standard for Residential HVAC equipment air leakage. This standard is being developed by ASHRAE and is called"ASHRAE Standard 193P - Method of test for Determining the Air Leakage Rate of HVAC Equipment". The final part of this project evaluated techniques for measurement of furnace blower power consumption. A draft test procedure for power consumption was developed in collaboration with the Canadian General Standards Board: CSA 823"Performance Standard for air handlers in residential space conditioning systems".

  19. Atorvastatin reduces endotoxin-induced microvascular inflammation via NOSII.

    PubMed

    McGown, Caroline C; Brookes, Zoë L S; Hellewell, Paul G; Ross, Jonathan J; Brown, Nicola J

    2015-05-01

    In a lipopolysaccharide (LPS)-induced rat model of sepsis (endotoxaemia), we previously demonstrated that pravastatin reduced microvascular inflammation via increased endothelial nitric oxide synthase III (NOSIII). This study aimed to determine whether atorvastatin, the most commonly used statin for lowering cholesterol, exerted beneficial pleiotropic effects via a similar mechanism. The mesenteric microcirculation of anaesthetised male Wistar rats (308 ± 63 g, n = 54) was prepared for fluorescent intravital microscopy. Over 4 h, animals received intravenous (i.v.) administration of either saline, LPS (150 μg kg(-1) h(-1)) or LPS + atorvastatin (200 μg kg(-1) s.c., 18 and 3 h before LPS), with/without the non-specific NOS inhibitor L-NG-Nitroarginine Methyl Ester (L-NAME) (10 μg kg(-1) h(-1)) or NOSII-specific inhibitor 1400 W (20 μg kg(-1) min(-1)). LPS decreased mean arterial blood pressure (MAP) (4 h, control 113 ± 20 mmHg; LPS 70 ± 23 mmHg), being reversed by atorvastatin (105 ± 3 mmHg) (p < 0.05). LPS also increased macromolecular leak measured after 100 mg kg(-1) of i.v FITC-BSA (arbitrary grey level adjacent to venules), which again was attenuated by atorvastatin (control 1.9 ± 4.0; LPS 12.0 ± 2.4; LPS + atorvastatin 4.5 ± 2.2) (p < 0.05). Furthermore, immunohistochemistry identified that atorvastatin decreased LPS-induced upregulation of endothelial cell NOSII expression, but NOSIII was unchanged in all groups. Atorvastatin improved MAP and reduced microvascular inflammation during endotoxaemia, associated with a reduction of pro-inflammatory NOSII. This differs from previous studies, whereby pravastatin increased expression of NOSIII. Thus preoperative statins have beneficial anti-inflammatory effects during endotoxaemia, but careful consideration must be given to the specific statin being used. PMID:25678054

  20. Evaluation of coronary microvascular function in patients with vasospastic angina

    PubMed Central

    Teragawa, Hiroki; Mitsuba, Naoya; Ishibashi, Ken; Nishioka, Kenji; Kurisu, Satoshi; Kihara, Yasuki

    2013-01-01

    AIM: To investigate endothelium-dependent and -independent coronary microvascular functions in patients with vasospastic angina (VSA). METHODS: Thirty-six patients with VSA (30 men and 6 women; mean age, 58 years) were enrolled in this study. VSA was defined as ≥ 90% narrowing of the epicardial coronary arteries on angiography performed during a spasm provocation test, presence of chest pain, and/or ST-segment deviation on an electrocardiogram (ECG). Patients (n = 36) with negative spasm provocation test results and those matched for age and sex were enrolled as a control group (nonVSA group). Low-dose acetylcholine (ACh; 3 μg/min) was infused into the left coronary ostium for 2 min during the spasm provocation test. Following the spasm provocation test, nitroglycerin (0.2 mg) was administered intracoronally. Coronary blood flow (was calculated from quantitative angiography and Doppler flow velocity measurements, and the coronary flow reserve was calculated as the ratio of coronary flow velocity after injection of adenosine triphosphate (20 μg) to the baseline value. Changes in the coronary artery diameter in response to ACh and nitroglycerin infusion were expressed as percentage changes from baseline measurements. RESULTS: Body mass index was significantly lower in the VSA group than in the nonVSA group. The frequency of conventional coronary risk factors and the rate of statin use were similar between the 2 groups. The left ventricular ejection fraction as evaluated by echocardiography was similar between the 2 groups. The duration of angina was 9 ± 2 mo. The results of blood chemistry analysis were similar between the 2 groups. Low-dose ACh did not cause coronary spasms. The change in coronary artery diameter in response to ACh was lower in the VSA group (-1.4% ± 9.3%) than in the nonVSA group (3.1% ± 6.5%, P < 0.05), whereas nitroglycerin-induced coronary artery dilatation and coronary blood flow increase in response to ACh or coronary flow reserve did

  1. Airway obstruction secondary to rhinoscleroma during pregnancy.

    PubMed

    Armstrong, W B; Peskind, S P; Bressler, K L; Crockett, D M

    1995-11-01

    Dyspnea is a fairly common complaint during pregnancy. However, if one excludes allergic nasal congestion of pregnancy, upper airway obstruction is a distinctly uncommon cause of dyspnea in the pregnant patient. Three cases of laryngeal rhinoscleroma in pregnant women requiring tracheostomy for airway management are reported. All three delivered healthy infants vaginally. Postpartum, two of the three were successfully decannulated, while the third became pregnant again before decannulation was accomplished. Treatment options and a review of the literature are presented.

  2. Small Airway Dysfunction and Abnormal Exercise Responses

    PubMed Central

    Petsonk, Edward L.; Stansbury, Robert C.; Beeckman-Wagner, Lu-Ann; Long, Joshua L.; Wang, Mei Lin

    2016-01-01

    Rationale Coal mine dust exposure can cause symptoms and loss of lung function from multiple mechanisms, but the roles of each disease process are not fully understood. Objectives We investigated the implications of small airway dysfunction for exercise physiology among a group of workers exposed to coal mine dust. Methods Twenty coal miners performed spirometry, first breathing air and then helium-oxygen, single-breath diffusing capacity, and computerized chest tomography, and then completed cardiopulmonary exercise testing. Measurements and Main Results Six participants meeting criteria for small airway dysfunction were compared with 14 coal miners who did not. At submaximal workload, miners with small airway dysfunction used a higher proportion of their maximum voluntary ventilation and had higher ventilatory equivalents for both O2 and CO2. Regression modeling indicated that inefficient ventilation was significantly related to small airway dysfunction but not to FEV1 or diffusing capacity. At the end of exercise, miners with small airway dysfunction had 27% lower O2 consumption. Conclusions Small airway abnormalities may be associated with important inefficiency of exercise ventilation. In dust-exposed individuals with only mild abnormalities on resting lung function tests or chest radiographs, cardiopulmonary exercise testing may be important in defining causes of exercise intolerance. PMID:27073987

  3. Migration of Airway Smooth Muscle Cells

    PubMed Central

    Gerthoffer, William T.

    2008-01-01

    Migration of smooth muscle cells is a process fundamental to development of hollow organs, including blood vessels and the airways. Migration is also thought to be part of the response to tissue injury. It has also been suggested to contribute to airways remodeling triggered by chronic inflammation. In both nonmuscle and smooth muscle cells numerous external signaling molecules and internal signal transduction pathways contribute to cell migration. The review includes evidence for the functional significance of airway smooth muscle migration, a summary of promigratory and antimigratory agents, and summaries of important signaling pathways mediating migration. Important signaling pathways and effector proteins described include small G proteins, phosphatidylinositol 3-kinases (PI3-K), Rho activated protein kinase (ROCK), p21-activated protein kinases (PAK), Src family tyrosine kinases, and mitogen-activated protein kinases (MAPK). These signaling modules control multiple critical effector proteins including actin nucleating, capping and severing proteins, myosin motors, and proteins that remodel microtubules. Actin filament remodeling, focal contact remodeling and propulsive force of molecular motors are all coordinated to move cells along gradients of chemical cues, matrix adhesiveness, or matrix stiffness. Airway smooth muscle cell migration can be modulated in vitro by drugs commonly used in pulmonary medicine including β-adrenergic agonists and corticosteroids. Future studies of airway smooth muscle cell migration may uncover novel targets for drugs aimed at modifying airway remodeling. PMID:18094091

  4. Trichobezoar Causing Airway Compromise during Esophagogastroduodenoscopy

    PubMed Central

    Kao, Erica Y.; Scalzitti, Nicholas J.; Dion, Gregory R.; Bowe, Sarah N.

    2015-01-01

    Objectives. (1) Report the case of a 5-year-old female with trichotillomania and trichophagia that suffered airway compromise during esophagogastroduodenoscopy for removal of a trichobezoar. (2) Provide management recommendations for an unusual foreign body causing extubation and partial airway obstruction. Methods. Case report of a rare situation of airway compromise caused by a trichobezoar. Results. A 5-year-old patient underwent endoscopic retrieval of a gastric trichobezoar (hairball) by the gastroenterology service under general endotracheal anesthesia in a sedation unit. During removal, the hairball, due to its large size, dislodged the endotracheal tube, effectively extubating the patient. The bezoar became lodged at the cricopharyngeus muscle. Attempts to remove the bezoar or reintubation were unsuccessful. The child was able to be mask ventilated while the otolaryngology service was called. Direct laryngoscopy revealed a hairball partially obstructing the view of the glottis from its position in the postcricoid area. The hairball, still entrapped in the snare from the esophagoscope, was grasped with Magill forceps and slowly extracted. The patient was then reintubated and the airway and esophagus were reevaluated. Conclusions. Trichobezoar is an uncommon cause of airway foreign body. Careful attention to airway management during these and similar foreign body extractions can prevent inadvertent extubations. PMID:26457086

  5. Taste Receptors in Upper Airway Immunity.

    PubMed

    Carey, Ryan M; Lee, Robert J; Cohen, Noam A

    2016-01-01

    Taste receptors are well known for their role in communicating information from the tongue to the brain about nutritional value or potential toxicity of ingested substances. More recently, it has been shown that taste receptors are expressed in other locations throughout the body, including the airway, gastrointestinal tract, brain and pancreas. The roles of some 'extraoral' taste receptors are largely unknown, but emerging research suggests that bitter and sweet taste receptors in the airway are capable of sensing bacteria and modulating innate immunity. This chapter focuses on the role of bitter and sweet taste receptors in human airway innate immunity and their clinical relevance to rhinosinusitis. The bitter taste receptor T2R38 expressed in sinonasal cilia detects bitter bacterial quorum-sensing molecules and activates a nitric oxide-dependent innate immune response; moreover, there are polymorphisms in T2R38 that underlie susceptibility to chronic rhinosinusitis (CRS). Bitter and sweet receptors in sinonasal solitary chemosensory cells control secretion of antimicrobial peptides in the upper airway and may have a profound impact on airway infections in patients with CRS and diabetes. Future research on taste receptors in the airway has enormous potential to expand our understanding of host-pathogen immune interactions and provide novel therapeutic targets. PMID:27466851

  6. Mechanical Properties of the Upper Airway

    PubMed Central

    Strohl, Kingman P.; Butler, James P.; Malhotra, Atul

    2013-01-01

    The importance of the upper airway (nose, pharynx, and larynx) in health and in the pathogenesis of sleep apnea, asthma, and other airway diseases, discussed elsewhere in the Comprehensive Physiology series, prompts this review of the biomechanical properties and functional aspects of the upper airway. There is a literature based on anatomic or structural descriptions in static circumstances, albeit studied in limited numbers of individuals in both health and disease. As for dynamic features, the literature is limited to studies of pressure and flow through all or parts of the upper airway and to the effects of muscle activation on such features; however, the links between structure and function through airway size, shape, and compliance remain a topic that is completely open for investigation, particularly through analyses using concepts of fluid and structural mechanics. Throughout are included both historically seminal references, as well as those serving as signposts or updated reviews. This article should be considered a resource for concepts needed for the application of biomechanical models of upper airway physiology, applicable to understanding the pathophysiology of disease and anticipated results of treatment interventions. PMID:23723026

  7. Postoperative Cerebrospinal Fluid Leakage Associated With Total En Bloc Spondylectomy.

    PubMed

    Yokogawa, Noriaki; Murakami, Hideki; Demura, Satoru; Kato, Satoshi; Yoshioka, Katsuhito; Hayashi, Hiroyuki; Ishii, Takayoshi; Igarashi, Takashi; Fang, Xiang; Tsuchiya, Hiroyuki

    2015-07-01

    Cerebrospinal fluid (CSF) leakage is a serious postoperative complication associated with total en bloc spondylectomy. The authors examined the risk factors for CSF leakage after this procedure. A total of 72 patients underwent total en bloc spondylectomy at the authors' institution between May 2010 and April 2013. Postoperative CSF leakage was observed in 17 of the 72 patients (23.6%). The results of univariate analysis suggested that age 54 years or older, preoperative surgical site irradiation, resection of 3 or more vertebral bodies, and dural injury were significant risk factors for postoperative CSF leakage after total en bloc spondylectomy. Multivariate analysis showed that preoperative surgical site irradiation was the only significant risk factor for postoperative CSF leakage (adjusted odds ratio, 5.22; 95% confidence interval, 1.03-26.45, P=.046). The authors also assessed the course of treatment for postoperative CSF leakage in each patient. Of 17 patients with postoperative CSF leakage, 13 recovered without further complications, but 4 required reoperation (2 for wound dehiscence, 1 for surgical site infection, and 1 for severe intracranial hypotension). All 4 patients who required reoperation had a history of surgical site irradiation. Thus, this study suggests that careful consideration should be given to postoperative CSF leakage in patients with a history of surgical site irradiation. These findings may contribute to the management of postoperative CSF leakage associated with total en bloc spondylectomy and supplement the information given to the patient in the process of obtaining informed consent.

  8. Microvascular protective activity of flavonoid glucuronides fraction from Tulipa gesneriana.

    PubMed

    Budzianowski, J; Korzeniowska, K; Chmara, E; Mrozikiewicz, A

    1999-03-01

    A mixture of flavonoid glucuronides, consisting of 7-O-glucuronides of kaempferol and quercetin 3-O-rutinosides, 3-O-gentiobiosides and 3-O-glucosides, was isolated from the perianths of Tulipa gesneriana L. var. 'Paradae'. It showed protective activity against the increased (both chloroform and histamine) skin vascular permeability in rabbits. The protective effect, measured as the reduction in leakage of Evans blue, was 59.8% after peritoneal treatment at a dose of 25 mg/kg, while that of troxerutin was 45.5%.

  9. Brain microvascular endothelial cell transplantation ameliorates ischemic white matter damage.

    PubMed

    Puentes, Sandra; Kurachi, Masashi; Shibasaki, Koji; Naruse, Masae; Yoshimoto, Yuhei; Mikuni, Masahiko; Imai, Hideaki; Ishizaki, Yasuki

    2012-08-21

    Ischemic insults affecting the internal capsule result in sensory-motor disabilities which adversely affect the patient's life. Cerebral endothelial cells have been reported to exert a protective effect against brain damage, so the transplantation of healthy endothelial cells might have a beneficial effect on the outcome of ischemic brain damage. In this study, endothelin-1 (ET-1) was injected into the rat internal capsule to induce lacunar infarction. Seven days after ET-1 injection, microvascular endothelial cells (MVECs) were transplanted into the internal capsule. Meningeal cells or 0.2% bovine serum albumin-Hank's balanced salt solution were injected as controls. Two weeks later, the footprint test and histochemical analysis were performed. We found that MVEC transplantation improved the behavioral outcome based on recovery of hind-limb rotation angle (P<0.01) and induced remyelination (P<0.01) compared with the control groups. Also the inflammatory response was repressed by MVEC transplantation, judging from fewer ED-1-positive activated microglial cells in the MVEC-transplanted group than in the other groups. Elucidation of the mechanisms by which MVECs ameliorate ischemic damage of the white matter may provide important information for the development of effective therapies for white matter ischemia.

  10. Isolation and characterization of equine microvascular endothelial cells in vitro.

    PubMed

    Bochsler, P N; Slauson, D O; Chandler, S K; Suyemoto, M M

    1989-10-01

    The use of cultured tissue has not yet become widespread in research involving equine disease, and this may be attributable in part to the scarcity of published reports concerning tissue culture methods for this species. We report here the isolation of equine microvascular endothelium (EMVE) from fresh omental tissue of horses and ponies. Fresh donor tissue was minced, subjected to collagenase digestion, and filtered. Cells were layered on 5% bovine serum albumin for gravity sedimentation, the bottom layer was collected, and the cells were plated onto fibronectin-coated flasks. Medium consisted of Dulbecco modified Eagle medium with 10% whole fetal bovine serum (wFBS) and 20 micrograms of endothelial cell growth supplement/ml. The EMVE grew readily in culture, had the cobblestone morphologic feature at confluence, stained positively for factor VIII-related antigen, and metabolized acetylated low-density lipoprotein. Fibroblast and smooth muscle cell contamination was minimal in primary cell cultures, which were successfully passed and maintained in culture for 3 to 5 serial passages, using various media and substrates. Preliminary studies were undertaken to determine optimal growth conditions with a range of variables: serum concentration, extracellular matrix components, and growth factors, Optimal conditions were achieved with a minimum of 10% wFBS, and with either fibronectin or laminin as extracellular matrix substrates. The EMVE grew adequately in Dulbecco modified Eagle medium plus 10% wFBS, and the added growth factors or serum supplements did not appear necessary for growth of EMVE.

  11. Macro- and microvascular effects of nitrous oxide in the rat.

    PubMed Central

    Matheny, J. L.; Westphal, K. A.; Richardson, D. R.; Roth, G. I.

    1991-01-01

    The aims of this study were: (1) to determine the macro- and microvascular actions of nitrous oxide (N2O) in the rat, and (2) to determine whether the vascular actions of N2O involved specific interaction with alpha-adrenergic receptors or opioid receptors. Systolic blood pressure, heart rat, total tail blood flow, blood cell velocity in subepidermal capillaries of the tail, and percentage of capillaries exhibiting flow were monitored in conscious rats during the administration of N2O before and after administration of clonidine (an alpha 2-adrenergic agonist), prazosin (an alpha 1-adrenergic antagonist) or naloxone (an opioid antagonist). Total tail blood flow increased significantly in a dose-dependent manner with N2O at 20% and 40% with oxygen. This action of N2O was not blocked by clonidine, prazosin, or naloxone. Capillary flow velocity increased during 20% and 40% N2O compared to 100% O2, but the changes were not statistically significant nor did they correlate with the changes in tail blood flow. These data suggest that the peripheral vascular action of N2O does not involve specific actions at alpha-adrenergic receptors or opioid receptors and may be the result of direct actions on the peripheral vasculature. PMID:1667350

  12. Cardiac microvascular endothelial cells express a functional Ca+ -sensing receptor.

    PubMed

    Berra Romani, Roberto; Raqeeb, Abdul; Laforenza, Umberto; Scaffino, Manuela Federica; Moccia, Francesco; Avelino-Cruz, Josè Everardo; Oldani, Amanda; Coltrini, Daniela; Milesi, Veronica; Taglietti, Vanni; Tanzi, Franco

    2009-01-01

    The mechanism whereby extracellular Ca(2+) exerts the endothelium-dependent control of vascular tone is still unclear. In this study, we assessed whether cardiac microvascular endothelial cells (CMEC) express a functional extracellular Ca(2+)-sensing receptor (CaSR) using a variety of techniques. CaSR mRNA was detected using RT-PCR, and CaSR protein was identified by immunocytochemical analysis. In order to assess the functionality of the receptor, CMEC were loaded with the Ca(2+)-sensitive fluorochrome, Fura-2/AM. A number of CaSR agonists, such as spermine, Gd(3+), La(3+) and neomycin, elicited a heterogeneous intracellular Ca(2+) signal, which was abolished by disruption of inositol 1,4,5-trisphosphate (InsP(3)) signaling and by depletion of intracellular stores with cyclopiazonic acid. The inhibition of the Na(+)/Ca(2+) exchanger upon substitution of extracellular Na(+) unmasked the Ca(2+) signal triggered by an increase in extracellular Ca(2+) levels. Finally, aromatic amino acids, which function as allosteric activators of CaSR, potentiated the Ca(2+) response to the CaSR agonist La(3+). These data provide evidence that CMEC express CaSR, which is able to respond to physiological agonists by mobilizing Ca(2+) from intracellular InsP(3)-sensitive stores.

  13. Syndecan-2 downregulation impairs angiogenesis in human microvascular endothelial cells

    SciTech Connect

    Noguer, Oriol Villena, Joan; Lorita, Jordi; Vilaro, Senen; Reina, Manuel

    2009-03-10

    The formation of new blood vessels, or angiogenesis, is a necessary process during development but also for tumour growth and other pathologies. It is promoted by different growth factors that stimulate endothelial cells to proliferate, migrate, and generate new tubular structures. Syndecans, transmembrane heparan sulphate proteoglycans, bind such growth factors through their glycosaminoglycan chains and could transduce the signal to the cytoskeleton, thus regulating cell behaviour. We demonstrated that syndecan-2, the major syndecan expressed by human microvascular endothelial cells, is regulated by growth factors and extracellular matrix proteins, in both bidimensional and tridimensional culture conditions. The role of syndecan-2 in 'in vitro' tumour angiogenesis was also examined by inhibiting its core protein expression with antisense phosphorothioate oligonucleotides. Downregulation of syndecan-2 reduces spreading and adhesion of endothelial cells, enhances their migration, but also impairs the formation of capillary-like structures. These results suggest that syndecan-2 has an important function in some of the necessary steps that make up the angiogenic process. We therefore propose a pivotal role of this heparan sulphate proteoglycan in the formation of new blood vessels.

  14. Review: Cerebral microvascular pathology in aging and neurodegeneration

    PubMed Central

    Brown, William R.; Thore, Clara R.

    2010-01-01

    This review of age-related brain microvascular pathologies focuses on topics studied by this laboratory, including anatomy of the blood supply, tortuous vessels, venous collagenosis, capillary remnants, vascular density, and microembolic brain injury. Our studies feature thick sections, large blocks embedded in celloidin, and vascular staining by alkaline phosphatase (AP). This permits study of the vascular network in three dimensions, and the differentiation of afferent from efferent vessels. Current evidence suggests that there is decreased vascular density in aging, Alzheimer’s disease (AD), and leukoaraiosis (LA), and cerebrovascular dysfunction precedes and accompanies cognitive dysfunction and neurodegeneration. A decline in cerebrovascular angiogenesis may inhibit recovery from hypoxia-induced capillary loss. Cerebral blood flow (CBF) is inhibited by tortuous arterioles and deposition of excessive collagen in veins and venules. Misery perfusion due to capillary loss appears to occur before cell loss in LA, and CBF is also reduced in the normal-appearing white matter. Hypoperfusion occurs early in AD, inducing white matter lesions and correlating with dementia. In vascular dementia, cholinergic reductions are correlated with cognitive impairment, and cholinesterase inhibitors have some benefit. Most lipid microemboli from cardiac surgery pass through the brain in a few days, but some remain for weeks. They can cause what appears to be a type of vascular dementia years after surgery. Donepezil has shown some benefit. Emboli, such as clots, cholesterol crystals, and microspheres can be extruded through the walls of cerebral vessels, but there is no evidence yet that lipid emboli undergo such extravasation. PMID:20946471

  15. Brain microvascular endothelial cell transplantation ameliorates ischemic white matter damage.

    PubMed

    Puentes, Sandra; Kurachi, Masashi; Shibasaki, Koji; Naruse, Masae; Yoshimoto, Yuhei; Mikuni, Masahiko; Imai, Hideaki; Ishizaki, Yasuki

    2012-08-21

    Ischemic insults affecting the internal capsule result in sensory-motor disabilities which adversely affect the patient's life. Cerebral endothelial cells have been reported to exert a protective effect against brain damage, so the transplantation of healthy endothelial cells might have a beneficial effect on the outcome of ischemic brain damage. In this study, endothelin-1 (ET-1) was injected into the rat internal capsule to induce lacunar infarction. Seven days after ET-1 injection, microvascular endothelial cells (MVECs) were transplanted into the internal capsule. Meningeal cells or 0.2% bovine serum albumin-Hank's balanced salt solution were injected as controls. Two weeks later, the footprint test and histochemical analysis were performed. We found that MVEC transplantation improved the behavioral outcome based on recovery of hind-limb rotation angle (P<0.01) and induced remyelination (P<0.01) compared with the control groups. Also the inflammatory response was repressed by MVEC transplantation, judging from fewer ED-1-positive activated microglial cells in the MVEC-transplanted group than in the other groups. Elucidation of the mechanisms by which MVECs ameliorate ischemic damage of the white matter may provide important information for the development of effective therapies for white matter ischemia. PMID:22771710

  16. Holographic laser Doppler imaging of microvascular blood flow.

    PubMed

    Magnain, C; Castel, A; Boucneau, T; Simonutti, M; Ferezou, I; Rancillac, A; Vitalis, T; Sahel, J A; Paques, M; Atlan, M

    2014-12-01

    We report on local superficial blood flow monitoring in biological tissue from laser Doppler holographic imaging. In time-averaging recording conditions, holography acts as a narrowband bandpass filter, which, combined with a frequency-shifted reference beam, permits frequency-selective imaging in the radio frequency range. These Doppler images are acquired with an off-axis Mach-Zehnder interferometer. Microvascular hemodynamic components mapping is performed in the cerebral cortex of the mouse and the eye fundus of the rat with near-infrared laser light without any exogenous marker. These measures are made from a basic inverse-method analysis of local first-order optical fluctuation spectra at low radio frequencies, from 0 Hz to 100 kHz. Local quadratic velocity is derived from Doppler broadenings induced by fluid flows, with elementary diffusing wave spectroscopy formalism in backscattering configuration. We demonstrate quadratic mean velocity assessment in the 0.1-10 mm/s range in vitro and imaging of superficial blood perfusion with a spatial resolution of about 10 micrometers in rodent models of cortical and retinal blood flow.

  17. Normal Muscle Oxygen Consumption and Fatigability in Sickle Cell Patients Despite Reduced Microvascular Oxygenation and Hemorheological Abnormalities

    PubMed Central

    Waltz, Xavier; Pichon, Aurélien; Lemonne, Nathalie; Mougenel, Danièle; Lalanne-Mistrih, Marie-Laure; Lamarre, Yann; Tarer, Vanessa; Tressières, Benoit; Etienne-Julan, Maryse; Hardy-Dessources, Marie-Dominique; Hue, Olivier; Connes, Philippe

    2012-01-01

    Background/Aim Although it has been hypothesized that muscle metabolism and fatigability could be impaired in sickle cell patients, no study has addressed this issue. Methods We compared muscle metabolism and function (muscle microvascular oxygenation, microvascular blood flow, muscle oxygen consumption and muscle microvascular oxygenation variability, which reflects vasomotion activity, maximal muscle force and local muscle fatigability) and the hemorheological profile at rest between 16 healthy subjects (AA), 20 sickle cell-hemoglobin C disease (SC) patients and 16 sickle cell anemia (SS) patients. Results Muscle microvascular oxygenation was reduced in SS patients compared to the SC and AA groups and this reduction was not related to hemorhelogical abnormalities. No difference was observed between the three groups for oxygen consumption and vasomotion activity. Muscle microvascular blood flow was higher in SS patients compared to the AA group, and tended to be higher compared to the SC group. Multivariate analysis revealed that muscle oxygen consumption was independently associated with muscle microvascular blood flow in the two sickle cell groups (SC and SS). Finally, despite reduced muscle force in sickle cell patients, their local muscle fatigability was similar to that of the healthy subjects. Conclusions Sickle cell patients have normal resting muscle oxygen consumption and fatigability despite hemorheological alterations and, for SS patients only, reduced muscle microvascular oxygenation and increased microvascular blood flow. Two alternative mechanisms can be proposed for SS patients: 1) the increased muscle microvascular blood flow is a way to compensate for the lower muscle microvascular oxygenation to maintain muscle oxygen consumption to normal values or 2) the reduced microvascular oxygenation coupled with a normal resting muscle oxygen consumption could indicate that there is slight hypoxia within the muscle which is not sufficient to limit

  18. Information Leakage Analysis by Abstract Interpretation

    NASA Astrophysics Data System (ADS)

    Zanioli, Matteo; Cortesi, Agostino

    Protecting the confidentiality of information stored in a computer system or transmitted over a public network is a relevant problem in computer security. The approach of information flow analysis involves performing a static analysis of the program with the aim of proving that there will not be leaks of sensitive information. In this paper we propose a new domain that combines variable dependency analysis, based on propositional formulas, and variables' value analysis, based on polyhedra. The resulting analysis is strictly more accurate than the state of the art abstract interpretation based analyses for information leakage detection. Its modular construction allows to deal with the tradeoff between efficiency and accuracy by tuning the granularity of the abstraction and the complexity of the abstract operators.

  19. Fluid leakage near the percolation threshold

    NASA Astrophysics Data System (ADS)

    Dapp, Wolf B.; Müser, Martin H.

    2016-02-01

    Percolation is a concept widely used in many fields of research and refers to the propagation of substances through porous media (e.g., coffee filtering), or the behaviour of complex networks (e.g., spreading of diseases). Percolation theory asserts that most percolative processes are universal, that is, the emergent powerlaws only depend on the general, statistical features of the macroscopic system, but not on specific details of the random realisation. In contrast, our computer simulations of the leakage through a seal—applying common assumptions of elasticity, contact mechanics, and fluid dynamics—show that the critical behaviour (how the flow ceases near the sealing point) solely depends on the microscopic details of the last constriction. It appears fundamentally impossible to accurately predict from statistical properties of the surfaces alone how strongly we have to tighten a water tap to make it stop dripping and also how it starts dripping once we loosen it again.

  20. Fluid leakage near the percolation threshold.

    PubMed

    Dapp, Wolf B; Müser, Martin H

    2016-01-01

    Percolation is a concept widely used in many fields of research and refers to the propagation of substances through porous media (e.g., coffee filtering), or the behaviour of complex networks (e.g., spreading of diseases). Percolation theory asserts that most percolative processes are universal, that is, the emergent powerlaws only depend on the general, statistical features of the macroscopic system, but not on specific details of the random realisation. In contrast, our computer simulations of the leakage through a seal--applying common assumptions of elasticity, contact mechanics, and fluid dynamics--show that the critical behaviour (how the flow ceases near the sealing point) solely depends on the microscopic details of the last constriction. It appears fundamentally impossible to accurately predict from statistical properties of the surfaces alone how strongly we have to tighten a water tap to make it stop dripping and also how it starts dripping once we loosen it again. PMID:26839261

  1. Torque Transmission Device at Zero Leakage

    NASA Technical Reports Server (NTRS)

    Hendricks, R. C.; Mullen, R. L.

    2005-01-01

    In a few critical applications, mechanical transmission of power by rotation at low speed is required without leakage at an interface. Herein we examine a device that enables torque to be transmitted across a sealed environmental barrier. The barrier represents the restraint membrane through which the torque is transmitted. The power is transferred through elastic deformation of a circular tube into an elliptical cross-section. Rotation of the principle axis of the ellipse at one end results in a commensurate rotation of an elliptical cross section at the other end of the tube. This transfer requires no rigid body rotation of the tube allowing a membrane to seal one end from the other. Both computational and experimental models of the device are presented.

  2. Fluid leakage near the percolation threshold

    PubMed Central

    Dapp, Wolf B.; Müser, Martin H.

    2016-01-01

    Percolation is a concept widely used in many fields of research and refers to the propagation of substances through porous media (e.g., coffee filtering), or the behaviour of complex networks (e.g., spreading of diseases). Percolation theory asserts that most percolative processes are universal, that is, the emergent powerlaws only depend on the general, statistical features of the macroscopic system, but not on specific details of the random realisation. In contrast, our computer simulations of the leakage through a seal—applying common assumptions of elasticity, contact mechanics, and fluid dynamics—show that the critical behaviour (how the flow ceases near the sealing point) solely depends on the microscopic details of the last constriction. It appears fundamentally impossible to accurately predict from statistical properties of the surfaces alone how strongly we have to tighten a water tap to make it stop dripping and also how it starts dripping once we loosen it again. PMID:26839261

  3. Full Airway Drainage by Fiber Bronchoscopy Through Artificial Airway in the Treatment of Occult Traumatic Atelectasis.

    PubMed

    Zhao, Xue Hong; Zhang, Yun; Liang, Zhong Yan; Zhang, Shao Yang; Yu, Wen Qiao; Huang, Fang-Fang

    2015-12-01

    The objective of this study is to investigate the effects of full airway drainage by fiber bronchoscopy through artificial airway in the treatment of traumatic atelectasis with occult manifestations. From May 2006 to May 2011, 40 cases of occult traumatic atelectasis were enrolled into our prospective study. Group A (n = 18) received drainage by nasal bronchoscope; group B underwent airway drainage by fiber bronchoscopy through artificial airway (n = 22). The effects of treatment were evaluated by the incidence of adult respiratory distress syndrome (ARDS), lung abscess, and the average length of hospital stay. Compared with nasal fiber-optic treatment, airway drainage by fiber bronchoscopy through artificial airway reduced the incidence of ARDS (p = 0.013) and lung abscess (p = 0.062) and shortened the mean length of stay (p = 0.018). Making the decision to create an artificial airway timely and carry out lung lavage by fiber bronchoscopy through artificial airway played a significant role in the treatment of occult traumatic atelectasis. PMID:27011511

  4. Full Airway Drainage by Fiber Bronchoscopy Through Artificial Airway in the Treatment of Occult Traumatic Atelectasis.

    PubMed

    Zhao, Xue Hong; Zhang, Yun; Liang, Zhong Yan; Zhang, Shao Yang; Yu, Wen Qiao; Huang, Fang-Fang

    2015-12-01

    The objective of this study is to investigate the effects of full airway drainage by fiber bronchoscopy through artificial airway in the treatment of traumatic atelectasis with occult manifestations. From May 2006 to May 2011, 40 cases of occult traumatic atelectasis were enrolled into our prospective study. Group A (n = 18) received drainage by nasal bronchoscope; group B underwent airway drainage by fiber bronchoscopy through artificial airway (n = 22). The effects of treatment were evaluated by the incidence of adult respiratory distress syndrome (ARDS), lung abscess, and the average length of hospital stay. Compared with nasal fiber-optic treatment, airway drainage by fiber bronchoscopy through artificial airway reduced the incidence of ARDS (p = 0.013) and lung abscess (p = 0.062) and shortened the mean length of stay (p = 0.018). Making the decision to create an artificial airway timely and carry out lung lavage by fiber bronchoscopy through artificial airway played a significant role in the treatment of occult traumatic atelectasis.

  5. The relation of airway size to lung function

    NASA Astrophysics Data System (ADS)

    Leader, J. Ken; Zheng, Bin; Sciurba, Frank C.; Fuhrman, Carl R.; Bon, Jessica M.; Park, Sang C.; Pu, Jiantao; Gur, David

    2008-03-01

    Chronic obstructive pulmonary disease may cause airway remodeling, and small airways are the mostly likely site of associated airway flow obstruction. Detecting and quantifying airways depicted on a typical computed tomography (CT) images is limited by spatial resolution. In this study, we examined the association between lung function and airway size. CT examinations and spirometry measurement of forced expiratory volume in one second as a percent predicted (FEV I%) from 240 subjects were used in this study. Airway sections depicted in axial CT section were automatically detected and quantified. Pearson correlation coefficients (PCC) were computed to compare lung function across three size categories: (1) all detected airways, (2) the smallest 50% of detected airways, and (3) the largest 50% of detected airways using the CORANOVA test. The mean number of all airways detected per subject was 117.4 (+/- 40.1) with mean size ranging from 20.2 to 50.0 mm2. The correlation between lung function (i.e., FEV I) and airway morphometry associated with airway remodeling and airflow obstruction (i.e., lumen perimeter and wall area as a percent of total airway area) was significantly stronger for smaller compared to larger airways (p < 0.05). The PCCs between FEV I and all airways, the smallest 50%, and the largest 50% were 0.583, 0.617, 0.523, respectively, for lumen perimeter and -0.560, -0.584, and -0.514, respectively, for wall area percent. In conclusion, analyzing a set of smaller airways compared to larger airways may improve detection of an association between lung function and airway morphology change.

  6. Epigalloccatechin-3-gallate inhibits ocular neovascularization and vascular permeability in human retinal pigment epithelial and human retinal microvascular endothelial cells via suppression of MMP-9 and VEGF activation.

    PubMed

    Lee, Hak Sung; Jun, Jae-Hyun; Jung, Eun-Ha; Koo, Bon Am; Kim, Yeong Shik

    2014-08-13

    Epigalloccatechin-3-gallate (EGCG) is the main polyphenol component of green tea (leaves of Camellia sinensis). EGCG is known for its antioxidant, anti-inflammatory, antiviral, and anti-carcinogenic properties. Here, we identify EGCG as a new inhibitor of ocular angiogenesis and its vascular permeability. Matrix metalloproteinases (MMPs) and vascular endothelial growth factor (VEGF) play a key role in the processes of extracellular matrix (ECM) remodeling and microvascular permeability during angiogenesis. We investigated the inhibitory effects of EGCG on ocular neovascularization and vascular permeability using the retina oriented cells and animal models induced by VEGF and alkaline burn. EGCG treatment significantly decreased mRNA and protein expression levels of MMP-9 in the presence of 12-O-tetradecanoylphorbol-13-acetate (TPA) and tumor necrosis factor alpha (TNF-α) in human retinal pigment epithelial cells (HRPECs). EGCG also effectively protected ARPE-19 cells from cell death and attenuated mRNA expressions of key angiogenic factors (MMP-9, VEGF, VEGF Receptor-2) by inhibiting generation of reactive oxygen species (ROS). EGCG significantly inhibited proliferation, vascular permeability, and tube formation in VEGF-induced human retinal microvascular endothelial cells (HRMECs). Furthermore, EGCG significantly reduced vascular leakage and permeability by blood-retinal barrier breakdown in VEGF-induced animal models. In addition, EGCG effectively limited upregulation of MMP-9 and platelet endothelial cell adhesion molecule (PECAM/CD31) on corneal neovascularization (CNV) induced by alkaline burn. Our data suggest that MMP-9 and VEGF are key therapeutic targets of EGCG for treatment and prevention of ocular angiogenic diseases such as age-related macular degeneration, diabetic retinopathy, and corneal neovascularization.

  7. Early microvascular changes in the preterm neonate: a comparative study of the human and guinea pig

    PubMed Central

    Dyson, Rebecca M.; Palliser, Hannah K.; Lakkundi, Anil; de Waal, Koert; Latter, Joanna L.; Clifton, Vicki L.; Wright, Ian M. R.

    2014-01-01

    Abstract Dysfunction of the transition from fetal to neonatal circulatory systems may be a major contributor to poor outcome following preterm birth. Evidence exists in the human for both a period of low flow between 5 and 11 h and a later period of increased flow, suggesting a hypoperfusion–reperfusion cycle over the first 24 h following birth. Little is known about the regulation of peripheral blood flow during this time. The aim of this study was to conduct a comparative study between the human and guinea pig to characterize peripheral microvascular behavior during circulatory transition. Very preterm (≤28 weeks GA), preterm (29–36 weeks GA), and term (≥37 weeks GA) human neonates underwent laser Doppler analysis of skin microvascular blood flow at 6 and 24 h from birth. Guinea pig neonates were delivered prematurely (62 day GA) or at term (68–71 day GA) and laser Doppler analysis of skin microvascular blood flow was assessed every 2 h from birth. In human preterm neonates, there is a period of high microvascular flow at 24 h after birth. No period of low flow was observed at 6 h. In preterm animals, microvascular flow increased after birth, reaching a peak at 10 h postnatal age. Blood flow then steadily decreased, returning to delivery levels by 24 h. Preterm birth was associated with higher baseline microvascular flow throughout the study period in both human and guinea pig neonates. The findings do not support a hypoperfusion–reperfusion cycle in the microcirculation during circulatory transition. The guinea pig model of preterm birth will allow further investigation of the mechanisms underlying microvascular function and dysfunction during the initial extrauterine period. PMID:25350751

  8. Endurance, interval sprint, and resistance exercise training: impact on microvascular dysfunction in type 2 diabetes.

    PubMed

    Olver, T Dylan; Laughlin, M Harold

    2016-02-01

    Type 2 diabetes (T2D) alters capillary hemodynamics, causes capillary rarefaction in skeletal muscle, and alters endothelial and vascular smooth muscle cell phenotype, resulting in impaired vasodilatory responses. These changes contribute to altered blood flow responses to physiological stimuli, such as exercise and insulin secretion. T2D-induced microvascular dysfunction impairs glucose and insulin delivery to skeletal muscle (and other tissues such as skin and nervous), thereby reducing glucose uptake and perpetuating hyperglycemia and hyperinsulinemia. In patients with T2D, exercise training (EX) improves microvascular vasodilator and insulin signaling and attenuates capillary rarefaction in skeletal muscle. EX-induced changes subsequently augment glucose and insulin delivery as well as glucose uptake. If these adaptions occur in a sufficient amount of tissue, and skeletal muscle in particular, chronic exposure to hyperglycemia and hyperinsulinemia and the risk of microvascular complications in all vascular beds will decrease. We postulate that EX programs that engage as much skeletal muscle mass as possible and recruit as many muscle fibers within each muscle as possible will generate the greatest improvements in microvascular function, providing that the duration of the stimulus is sufficient. Primary improvements in microvascular function occur in tissues (skeletal muscle primarily) engaged during exercise, and secondary improvements in microvascular function throughout the body may result from improved blood glucose control. We propose that the added benefit of combined resistance and aerobic EX programs and of vigorous intensity EX programs is not simply "more is better." Rather, we believe the additional benefit is the result of EX-induced adaptations in and around more muscle fibers, resulting in more muscle mass and the associated microvasculature being changed. Thus, to acquire primary and secondary improvements in microvascular function and improved

  9. 49 CFR 178.348-5 - Pressure and leakage test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Pressure and leakage test. 178.348-5 Section 178... Specifications for Containers for Motor Vehicle Transportation § 178.348-5 Pressure and leakage test. (a) Each cargo tank must be tested in accordance with § 178.345-13 and this section. (b) Pressure test....

  10. 49 CFR 178.346-5 - Pressure and leakage tests.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... is equipped with vapor recovery equipment may be leakage tested in accordance with 40 CFR 63.425(e). To satisfy the leakage test requirements of this paragraph, the test specified in 40 CFR 63.425(e)(1) must be conducted using air. The hydrostatic test alternative permitted under Appendix A to 40 CFR...

  11. 49 CFR 178.348-5 - Pressure and leakage test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Pressure and leakage test. 178.348-5 Section 178... PACKAGINGS Specifications for Containers for Motor Vehicle Transportation § 178.348-5 Pressure and leakage test. (a) Each cargo tank must be tested in accordance with § 178.345-13 and this section. (b)...

  12. 49 CFR 178.347-5 - Pressure and leakage test.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Pressure and leakage test. 178.347-5 Section 178... Specifications for Containers for Motor Vehicle Transportation § 178.347-5 Pressure and leakage test. (a) Each cargo tank must be tested in accordance with § 178.345-13 and this section. (b) Pressure test....

  13. 49 CFR 178.346-5 - Pressure and leakage tests.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... is equipped with vapor recovery equipment may be leakage tested in accordance with 40 CFR 63.425(e). To satisfy the leakage test requirements of this paragraph, the test specified in 40 CFR 63.425(e)(1) must be conducted using air. The hydrostatic test alternative permitted under Appendix A to 40 CFR...

  14. 49 CFR 178.347-5 - Pressure and leakage test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Pressure and leakage test. 178.347-5 Section 178... PACKAGINGS Specifications for Containers for Motor Vehicle Transportation § 178.347-5 Pressure and leakage test. (a) Each cargo tank must be tested in accordance with § 178.345-13 and this section. (b)...

  15. 49 CFR 178.348-5 - Pressure and leakage test.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Pressure and leakage test. 178.348-5 Section 178... Specifications for Containers for Motor Vehicle Transportation § 178.348-5 Pressure and leakage test. (a) Each cargo tank must be tested in accordance with § 178.345-13 and this section. (b) Pressure test....

  16. 49 CFR 178.348-5 - Pressure and leakage test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Pressure and leakage test. 178.348-5 Section 178... Specifications for Containers for Motor Vehicle Transportation § 178.348-5 Pressure and leakage test. (a) Each cargo tank must be tested in accordance with § 178.345-13 and this section. (b) Pressure test....

  17. 49 CFR 178.346-5 - Pressure and leakage tests.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... is equipped with vapor recovery equipment may be leakage tested in accordance with 40 CFR 63.425(e). To satisfy the leakage test requirements of this paragraph, the test specified in 40 CFR 63.425(e)(1) must be conducted using air. The hydrostatic test alternative permitted under Appendix A to 40 CFR...

  18. 49 CFR 178.347-5 - Pressure and leakage test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Pressure and leakage test. 178.347-5 Section 178... Specifications for Containers for Motor Vehicle Transportation § 178.347-5 Pressure and leakage test. (a) Each cargo tank must be tested in accordance with § 178.345-13 and this section. (b) Pressure test....

  19. 49 CFR 178.347-5 - Pressure and leakage test.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Pressure and leakage test. 178.347-5 Section 178... Specifications for Containers for Motor Vehicle Transportation § 178.347-5 Pressure and leakage test. (a) Each cargo tank must be tested in accordance with § 178.345-13 and this section. (b) Pressure test....

  20. 49 CFR 178.347-5 - Pressure and leakage test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Pressure and leakage test. 178.347-5 Section 178... Specifications for Containers for Motor Vehicle Transportation § 178.347-5 Pressure and leakage test. (a) Each cargo tank must be tested in accordance with § 178.345-13 and this section. (b) Pressure test....

  1. 49 CFR 178.348-5 - Pressure and leakage test.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Pressure and leakage test. 178.348-5 Section 178... Specifications for Containers for Motor Vehicle Transportation § 178.348-5 Pressure and leakage test. (a) Each cargo tank must be tested in accordance with § 178.345-13 and this section. (b) Pressure test....

  2. 49 CFR 178.346-5 - Pressure and leakage tests.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... is equipped with vapor recovery equipment may be leakage tested in accordance with 40 CFR 63.425(e). To satisfy the leakage test requirements of this paragraph, the test specified in 40 CFR 63.425(e)(1) must be conducted using air. The hydrostatic test alternative permitted under Appendix A to 40 CFR...

  3. 40 CFR 89.316 - Analyzer leakage and response time.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Equipment Provisions § 89.316 Analyzer leakage and response time. (a) Vacuum side leak check. (1) Any location within the analysis system where a vacuum leak could affect the test results must be checked. (2) The maximum allowable leakage rate on the vacuum side is 0.5 percent of the in-use flow rate for...

  4. 40 CFR 90.324 - Analyzer leakage check.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Provisions § 90.324 Analyzer leakage check. (a) Vacuum side leak check. (1) Check any location within the analysis system where a vacuum leak could affect the test results. (2) The maximum allowable leakage rate on the vacuum side is 0.5 percent of the in-use flow rate for the portion of the system being...

  5. 40 CFR 89.316 - Analyzer leakage and response time.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Equipment Provisions § 89.316 Analyzer leakage and response time. (a) Vacuum side leak check. (1) Any location within the analysis system where a vacuum leak could affect the test results must be checked. (2) The maximum allowable leakage rate on the vacuum side is 0.5 percent of the in-use flow rate for...

  6. 40 CFR 90.324 - Analyzer leakage check.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Provisions § 90.324 Analyzer leakage check. (a) Vacuum side leak check. (1) Check any location within the analysis system where a vacuum leak could affect the test results. (2) The maximum allowable leakage rate on the vacuum side is 0.5 percent of the in-use flow rate for the portion of the system being...

  7. 40 CFR 89.316 - Analyzer leakage and response time.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Equipment Provisions § 89.316 Analyzer leakage and response time. (a) Vacuum side leak check. (1) Any location within the analysis system where a vacuum leak could affect the test results must be checked. (2) The maximum allowable leakage rate on the vacuum side is 0.5 percent of the in-use flow rate for...

  8. 40 CFR 89.316 - Analyzer leakage and response time.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Equipment Provisions § 89.316 Analyzer leakage and response time. (a) Vacuum side leak check. (1) Any location within the analysis system where a vacuum leak could affect the test results must be checked. (2) The maximum allowable leakage rate on the vacuum side is 0.5 percent of the in-use flow rate for...

  9. 40 CFR 90.324 - Analyzer leakage check.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Provisions § 90.324 Analyzer leakage check. (a) Vacuum side leak check. (1) Check any location within the analysis system where a vacuum leak could affect the test results. (2) The maximum allowable leakage rate on the vacuum side is 0.5 percent of the in-use flow rate for the portion of the system being...

  10. 40 CFR 89.316 - Analyzer leakage and response time.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Equipment Provisions § 89.316 Analyzer leakage and response time. (a) Vacuum side leak check. (1) Any location within the analysis system where a vacuum leak could affect the test results must be checked. (2) The maximum allowable leakage rate on the vacuum side is 0.5 percent of the in-use flow rate for...

  11. 40 CFR 90.324 - Analyzer leakage check.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Provisions § 90.324 Analyzer leakage check. (a) Vacuum side leak check. (1) Check any location within the analysis system where a vacuum leak could affect the test results. (2) The maximum allowable leakage rate on the vacuum side is 0.5 percent of the in-use flow rate for the portion of the system being...

  12. 40 CFR 90.324 - Analyzer leakage check.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Provisions § 90.324 Analyzer leakage check. (a) Vacuum side leak check. (1) Check any location within the analysis system where a vacuum leak could affect the test results. (2) The maximum allowable leakage rate on the vacuum side is 0.5 percent of the in-use flow rate for the portion of the system being...

  13. Improved Steam Turbine Leakage Control with a Brush Seal Design

    NASA Astrophysics Data System (ADS)

    Turnquist, Norman; Chupp, Raymond E.; Pastrana, Ryan; Wolfe, Chris; Burnett, Mark

    2002-10-01

    This paper presents an improved steam turbine leakage control system with a brush seal design. The contents include: 1) Typical Design Characteristics; 2) Typical Brush Seal Locations; 3) Reduced Leakage Rates; 4) Performance Benefits; 5) System Considerations; 6) Rotor Dynamics; 7) Laboratory Tests and 8) Field Experience.

  14. 42 CFR 84.158 - Exhalation valve leakage test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Exhalation valve leakage test. 84.158 Section 84... Respirators § 84.158 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be... between the valve and valve seat shall not exceed 30 milliliters per minute....

  15. 42 CFR 84.158 - Exhalation valve leakage test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Exhalation valve leakage test. 84.158 Section 84... Respirators § 84.158 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be... between the valve and valve seat shall not exceed 30 milliliters per minute....

  16. A CONCEPTUAL UNDERSTANDING OF LEAKAGE DURING SOIL-GAS SAMPLING

    EPA Science Inventory

    A heuristic model is developed to develop a conceptual understanding of leakage during soil-gas sampling. Leakage is shown to be simply a function of the permeability contrast between the formation and borehole and geometric factors. As the ratio of formation to borehole permea...

  17. 42 CFR 84.158 - Exhalation valve leakage test.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Exhalation valve leakage test. 84.158 Section 84... Respirators § 84.158 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be subjected to a suction of 25 mm. water-column height while in a normal operating position. (b)...

  18. 42 CFR 84.158 - Exhalation valve leakage test.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Exhalation valve leakage test. 84.158 Section 84... Respirators § 84.158 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be subjected to a suction of 25 mm. water-column height while in a normal operating position. (b)...

  19. 42 CFR 84.158 - Exhalation valve leakage test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Exhalation valve leakage test. 84.158 Section 84... Respirators § 84.158 Exhalation valve leakage test. (a) Dry exhalation valves and valve seats will be subjected to a suction of 25 mm. water-column height while in a normal operating position. (b)...

  20. Technology Solutions Case Study: Predicting Envelope Leakage in Attached Dwellings

    SciTech Connect

    2013-11-01

    The most common method of measuring air leakage is to perform single (or solo) blower door pressurization and/or depressurization test. In detached housing, the single blower door test measures leakage to the outside. In attached housing, however, this “solo” test method measures both air leakage to the outside and air leakage between adjacent units through common surfaces. In an attempt to create a simplified tool for predicting leakage to the outside, Building America team Consortium for Advanced Residential Buildings (CARB) performed a preliminary statistical analysis on blower door test results from 112 attached dwelling units in four apartment complexes. Although the subject data set is limited in size and variety, the preliminary analyses suggest significant predictors are present and support the development of a predictive model. Further data collection is underway to create a more robust prediction tool for use across different construction types, climate zones, and unit configurations.