Low-level carbon monoxide exposure and work capacity at 1600 meters

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weiser, P.C.; Cropp, G.J.A.; Morrill, C.G.

At sea level, low-level carbon monoxide (CO) exposure impairs exercise performance. To determine if altitude residence at 1600 m augments this CO effect, two studies of graded treadmill work capacity were done. The Initial Study investigated nine, non-smoking male subjects breathing either filtered air (FA) or 28 ppm CO in filtered air. End-exercise carboxyhemoglobin (HbCO) levels averaged 0.9 %HbCO breathing FA and 4.7 %HbCO breathing CO. Total work performance and aerobic work capacity were reduced. Work heart rate was elevated, and post-exercise left ventricular ejection time breathing CO did not shorten to the same degree as with FA exposure. COmore » exposure resulted in a lower anaerobic threshold, and a greater minute ventilation occurred at work rates heavier than the anaerobic threshold due to an increased blood lactate level. The Dose-Response Study exposed twelve subjects to FA or CO such that the end-exercise HbCO levels were 0.7, 3.5, 5.4 and 8.7 %HbCO. Exercise performance and aerobic work capacity were impaired in proportion to the CO exposure. In both studies, maximal cardio-pulmonary responses were not different, but submaximal exercise changes were elevated breathing CO. Thus, in healthy young men residing near 1600 m, an increase in low-level CO exposure produced a linear decrement in maximal aerobic performance similar to that reported at sea level.« less

[Application of the breath hydrogen test in gastroenterology].

PubMed

Loranskaia, I D; Panina, N A; Zheltakova, O V

2006-01-01

The diagnostic capacities of the breath hydrogen test in gastroenterology are discussed in the article. The authors describe the results of their own research--determination of the intestinal bacterial contamination in patients with chronic biliary pancreatitis with the help of the Micro H2 breath hydrogen analyzer.

Heat and moisture exchange capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate.

PubMed

Scheenstra, Renske J; Muller, Sara H; Vincent, Andrew; Hilgers, Frans J M

2011-01-01

The aim of this study was to assess the heat and moisture exchange (HME) capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate in patients with head and neck cancer. We plotted the subglottic temperature and humidity measurements in 10 patients with head and neck cancer with a temporary precautionary tracheotomy during successive 10-minute periods of nose, mouth, and tracheotomy breathing in a randomized sequence. End-inspiratory temperatures of nose, mouth, and tracheotomy breathing were 31.1, 31.3, and 28.3°C, respectively. End-inspiratory humidity measurements of nose, mouth, and tracheotomy breathing were 29.3, 28.6, and 21.1 mgH₂O/L, respectively. There was a trend toward lower end-inspiratory humidity in patients with radiotherapy or with large surgery-induced oropharyngeal mucosal defects, whereas temperatures were similar. This study gives objective information about the HME capacity of the upper respiratory tract in patients with head and neck cancer with precautionary tracheotomy, and thus provides target values for HMEs for laryngectomized and tracheotomized patients. © 2010 Wiley Periodicals, Inc. Head Neck, 2011.

Breathing pattern and breathlessness in idiopathic pulmonary fibrosis: An observational study.

PubMed

Olukogbon, Kasope L; Thomas, Paul; Colasanti, Ricardo; Hope-Gill, Ben; Williams, Edgar Mark

2016-02-01

Idiopathic pulmonary fibrosis (IPF) is characterized by progressive decline in lung function and increasing dyspnoea. The aim of this study was to investigate the relationship among IPF, pulmonary function, resting tidal breathing patterns and level of breathlessness. Thirty-one participants with IPF and 17 matched healthy controls underwent lung function testing, followed by a 2-min period of resting tidal breathing. The IPF cohort was stratified according to disease severity, based on their forced vital capacity and diffusion capacity for carbon monoxide. In comparison to the healthy controls, the IPF cohort showed a higher tidal volume, VT , of 0.22 L (P = 0.026) and a raised minute ventilation in the severest IPF group, while no differences in the timing of inspiration or expiration were observed. In the IPF cohort, the ratio of VT to forced vital capacity was around 15% higher. These changes corresponded with an increase in the self-reported sensation of breathlessness. Those with IPF increased their depth of breathing with worsening disease severity, with IPF-induced changes in pulmonary function and breathlessness associated with an altered tidal breathing pattern. © 2015 Asian Pacific Society of Respirology.

Spirometry, Static Lung Volumes, and Diffusing Capacity.

PubMed

Vaz Fragoso, Carlos A; Cain, Hilary C; Casaburi, Richard; Lee, Patty J; Iannone, Lynne; Leo-Summers, Linda S; Van Ness, Peter H

2017-09-01

Spirometric Z-scores from the Global Lung Initiative (GLI) rigorously account for age-related changes in lung function and are thus age-appropriate when establishing spirometric impairments, including a restrictive pattern and air-flow obstruction. However, GLI-defined spirometric impairments have not yet been evaluated regarding associations with static lung volumes (total lung capacity [TLC], functional residual capacity [FRC], and residual volume [RV]) and gas exchange (diffusing capacity). We performed a retrospective review of pulmonary function tests in subjects ≥40 y old (mean age 64.6 y), including pre-bronchodilator measures for: spirometry ( n = 2,586), static lung volumes by helium dilution with inspiratory capacity maneuver ( n = 2,586), and hemoglobin-adjusted single-breath diffusing capacity ( n = 2,508). Using multivariable linear regression, adjusted least-squares means (adj LS Means) were calculated for TLC, FRC, RV, and hemoglobin-adjusted single-breath diffusing capacity. The adj LS Means were expressed with and without height-cubed standardization and stratified by GLI-defined spirometry, including normal ( n = 1,251), restrictive pattern ( n = 663), and air-flow obstruction (mild, [ n = 128]; moderate, [ n = 150]; and severe, [ n = 394]). Relative to normal spirometry, restrictive-pattern had lower adj LS Means for TLC, FRC, RV, and hemoglobin-adjusted single-breath diffusing capacity ( P ≤ .001). Conversely, relative to normal spirometry, mild, moderate, and severe air-flow obstruction had higher adj LS Means for FRC and RV ( P < .001). However, only mild and moderate air-flow obstruction had higher adj LS Means for TLC ( P < .001), while only moderate and severe air-flow obstruction had higher adj LS Means for RV/TLC ( P < .001) and lower adj LS Means for hemoglobin-adjusted single-breath diffusing capacity ( P < .001). Notably, TLC (calculated as FRC + inspiratory capacity) was not increased in severe air-flow obstruction ( P ≥ .11) because inspiratory capacity decreased with increasing air-flow obstruction ( P < .001), thus opposing the increased FRC ( P < .001). Finally, P values were similar whether adj LS Means were height-cubed standardized. A GLI-defined spirometric restrictive pattern is strongly associated with a restrictive ventilatory defect (decreased TLC, FRC, and RV), while GLI-defined spirometric air-flow obstruction is strongly associated with hyperinflation (increased FRC) and air trapping (increased RV and RV/TLC). Both spirometric impairments were strongly associated with impaired gas exchange (decreased hemoglobin-adjusted single-breath diffusing capacity). Copyright © 2017 by Daedalus Enterprises.

Nonuniformity of diffusing capacity from small alveolar gas samples is increased in smokers.

PubMed

Cotton, D J; Mink, J T; Graham, B L

1998-01-01

Although centrilobular emphysema, and small airway, interstitial and alveoli inflammation can be detected pathologically in the lungs of smokers with relatively well preserved lung function, these changes are difficult to assess using available physiological tests. Because submaximal single breath washout (SBWSM) manoeuvres improve the detection of abnormalities in ventilation inhomogeneity in the lung periphery in smokers compared with traditional vital capacity manoeuvres, SBWSM manoeuvres were used in this study to measure temporal differences in diffusing capacity using a rapid response carbon monoxide analyzer. To determine whether abnormalities in the lung periphery can be detected in smokers with normal forced expired volumes in 1 s using the three-equation diffusing capacity (DLcoSB-3EQ) among small alveolar gas samples and whether the abnormalities correlate with increases in peripheral ventilation inhomogeneity. Cross-sectional study in 21 smokers and 21 nonsmokers all with normal forced exhaled flow rates. Both smokers and nonsmokers performed SBWSM manoeuvres consisting of slow inhalation of test gas from functional residual capacity to one-half inspiratory capacity with either 0 or 10 s of breath holding and slow exhalation to residual volume (RV). They also performed conventional vital capacity single breath (SBWVC) manoeuvres consisting of slow inhalation of test gas from RV to total lung capacity and, without breath holding, slow exhalation to RV. DLcoSB-3EQ was calculated from the total alveolar gas sample. DLcoSB-3EQ was also calculated from four equal sequential, simulated aliquots of the total alveolar gas sample. DLcoSB-3EQ values from the four alveolar samples were normalized by expressing each as a percentge of DLcoSB-3EQ from the entire alveolar gas sample. An index of variation (DI) among the small-sample DLcoSB-3EQ values was correlated with the normalized phase III helium slope (Sn) and the mixing efficiency (Emix). For SBWSM, DI was increased in smokers at 0 s of breath holding compared with nonsmokers, and correlated with age, smoking pack-years and Sn. The decrease in DI with breath holding was greater in smokers and correlated with the change in Sn with breath holding. For SBWVC manoeuvres, there were no differences due to smoking in Sn or Emix, but DI was increased in smokers and correlated with age and smoking pack-years, but not with Sn. For SBWSM manoeuvres the increase in DI in smokers correlated with breath hold time-dependent increases in Sn, suggesting that the changes in DI reflected the same structural alterations that caused increases in peripheral ventilation inhomogeneity. For SBWVC manoeuvres, the increase in DI in smokers was not associated with changes in ventilation inhomogeneity, suggesting that the effect of smoking on DI during this manoeuvre was due to smoke-related changes in alveolar capillary diffusion, rather than due solely to alterations in the distribution of ventilation.

Respiratory system

NASA Technical Reports Server (NTRS)

Bartlett, R. G., Jr.

1973-01-01

The general anatomy and function of the human respiratory system is summarized. Breathing movements, control of breathing, lung volumes and capacities, mechanical relations, and factors relevant to respiratory support and equipment design are discussed.

Measurement of lung volume in mechanically ventilated monkeys with an ultrasonic flow meter and the nitrogen washout method.

PubMed

Schibler, Andreas; Hammer, Jürg; Isler, Ruedi; Buess, Christian; Newth, Christopher J L

2004-01-01

Measurement of functional residual capacity (FRC) during mechanical ventilation is important to standardise respiratory system compliance and adjust the ventilator settings to optimise lung recruitment. In the present study we compared three methods to measure FRC. The bias flow nitrogen washout technique (FRC(N2MC)), the multiple breath nitrogen washout (FRC(MBNW)) and the multiple breath sulphur-hexafluoride washout using the molar mass signal of an ultrasonic flow meter (FRC(MBSF6)) were compared in six adult monkeys after endotracheal intubation and during spontaneous breathing and mechanical ventilation at three different positive end-expiratory pressure (PEEP) levels of 0, 5 and 10 cmH2O. Animal research laboratory. We found good agreement between all three methods and they all accurately measured changes in FRC when PEEP was increased. The coefficients of variance of the three measurement techniques were in the same range (1.3-9.2%). The measurement of the tracer gas concentration with the molar mass signal of the ultrasonic flow meter provides a good and simple alternative to respiratory mass spectrometer for FRC measurements in ventilated subjects.

Factors influencing the measurement of closing volume.

PubMed

Make, B; Lapp, N L

1975-06-01

The various factors influencing closing volume were studied by performing the single-breath N2 test on 9 healthy nonsmokers. Time of day, day of the week, and preceding volume history had no effect on either closing volume or alveolar plateau. Slow inspiratory flow resulted in larger ratio of closing volume to vital capacity, ratio of closing capacity to total lung capacity, and change in N2 concentration than fast inspiratory flow. Voluntary regulation of the expiratory flow resulted in smaller ratios of closing volume to vital capacity and closing capacity to total lung capacity than when flow was regulated by a resistance. Prolonged breath holding of the inspired O2 led to larger ratio of closing volume to vital capacity and ratio of closing capacity to total lung capacity. To obtain uniform, comparable closing volumes, it is suggested that the subject inspire slowly, control expiratory flow (preferably voluntarily), and not pause between inspiration and expiration.

Anaesthetic management of sleep-disordered breathing in adults.

PubMed

Hillman, David R; Chung, Frances

2017-02-01

Anaesthesia and sleep are different states of unconsciousness with considerable physiological common ground. Because of their shared depressant effects on muscle activation and ventilatory drive, patients with anatomically compromised airways will tend to obstruct in either state and those with impaired ventilatory capacity will tend to hypoventilate. Breathing behaviour in one state is predictive of that in the other. An essential difference is that while arousal responses are preserved during sleep, they are depressed during sedation and abolished by anaesthesia. This renders patients with sleep-related breathing disorders vulnerable to hypoventilation and asphyxia when deeply sedated. Addressing this vulnerability requires a systematic approach to identification of patients and circumstances that magnify this risk, and methods of managing it that seek to reconcile the need for safety with cost-effective use of resources. © 2016 Asian Pacific Society of Respirology.

Assessing breathing motion by shape matching of lung and diaphragm surfaces

NASA Astrophysics Data System (ADS)

Urschler, Martin; Bischof, Horst

2005-04-01

Studying complex thorax breating motion is an important research topic for accurate fusion of functional and anatomical data, radiotherapy planning or reduction of breathing motion artifacts. We investigate segmented CT lung, airway and diaphragm surfaces at several different breathing states between Functional Residual and Total Lung Capacity. In general, it is hard to robustly derive corresponding shape features like curvature maxima from lung and diaphragm surfaces since diaphragm and rib cage muscles tend to deform the elastic lung tissue such that e.g. ridges might disappear. A novel registration method based on the shape context approach for shape matching is presented where we extend shape context to 3D surfaces. The shape context approach was reported as a promising method for matching 2D shapes without relying on extracted shape features. We use the point correspondences for a non-rigid thin-plate-spline registration to get deformation fields that describe the movement of lung and diaphragm. Our validation consists of experiments on phantom and real sheep thorax data sets. Phantom experiments make use of shapes that are manipulated with known transformations that simulate breathing behaviour. Real thorax data experiments use a data set showing lungs and diaphragm at 5 distinct breathing states, where we compare subsets of the data sets and qualitatively and quantitatively asses the registration performance by using manually identified corresponding landmarks.

Deep breathing exercises with positive expiratory pressure in patients with multiple sclerosis - a randomized controlled trial.

PubMed

Westerdahl, Elisabeth; Wittrin, Anna; Kånåhols, Margareta; Gunnarsson, Martin; Nilsagård, Ylva

2016-11-01

Breathing exercises with positive expiratory pressure are often recommended to patients with advanced neurological deficits, but the potential benefit in multiple sclerosis (MS) patients with mild and moderate symptoms has not yet been investigated in randomized controlled trials. To study the effects of 2 months of home-based breathing exercises for patients with mild to moderate MS on respiratory muscle strength, lung function, and subjective breathing and health status outcomes. Forty-eight patients with MS according to the revised McDonald criteria were enrolled in a randomized controlled trial. Patients performing breathing exercises (n = 23) were compared with a control group (n = 25) performing no breathing exercises. The breathing exercises were performed with a positive expiratory pressure device (10-15 cmH 2 O) and consisted of 30 slow deep breaths performed twice a day for 2 months. Respiratory muscle strength (maximal inspiratory and expiratory pressure at the mouth), spirometry, oxygenation, thoracic excursion, subjective perceptions of breathing and self-reported health status were evaluated before and after the intervention period. Following the intervention, there was a significant difference between the breathing group and the control group regarding the relative change in lung function, favoring the breathing group (vital capacity: P < 0.043; forced vital capacity: P < 0.025). There were no other significant differences between the groups. Breathing exercises may be beneficial in patients with mild to moderate stages of MS. However, the clinical significance needs to be clarified, and it remains to be seen whether a sustainable effect in delaying the development of respiratory dysfunction in MS can be obtained. © 2015 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd.

Development enhances hypometabolism in northern elephant seal pups (Mirounga angustirostris)

PubMed Central

Tift, Michael S.; Ranalli, Elizabeth C.; Houser, Dorian S.; Ortiz, Rudy M.; Crocker, Daniel E.

2013-01-01

Summary Investigation into the development of oxygen storage capacity in air-breathing marine predators has been performed, but little is known about the development of regulatory factors that influence oxygen utilization. Strategies for efficiently using oxygen stores should enable marine predators to optimize time spent foraging underwater. We describe the developmental patterns of oxygen use during voluntary breath-holds in northern elephant seals (Mirounga angustirostris) at 2 and 7 weeks post-weaning. We measured 1) changes in oxygen consumption (VO2), and 2) changes in venous pH, partial pressure of oxygen (pO2), haemoglobin saturation (sO2), oxygen content (O2ct), partial pressure of carbon dioxide (pCO2), haematocrit (Hct) and total haemoglobin (tHb). To examine the effect of the dive response on the development of oxygen utilization, voluntary breath-hold experiments were conducted in and out of water. Suppression of VO2 during voluntary breath-holds increased significantly between 2 and 7 weeks post-weaning, reaching a maximum suppression of 53% below resting metabolic rate and 56% below Kleiber’s standard metabolic rate. From 2 to 7 weeks post-weaning, breath-hold VO2 was reduced by 52%. Between the two age classes, this equates to a mean breath-hold VO2 reduction of 16% from resting VO2. Breath-hold VO2 also declined with increasing breath-hold duration, but there was no direct effect of voluntary submergence on reducing VO2. Age did not influence rates of venous pO2 depletion during breath-holds. However, voluntary submergence did result in slower pO2 depletion rates when compared to voluntary terrestrial apnoeas. The differences in whole body VO2 during breath-holds (measured at recovery) and venous pO2 (reflective of tissue O2-use measured during breath-holds), likely reflects metabolic suppression in hypoxic, vasoconstricted tissues. Consistent pCO2 values at the end of all voluntary breath-holds (59.0 ± 0.7 mmHg) suggests the physiological cue for stimulating respiration in northern elephant seal pups is the accumulation of CO2. Oxygen storage capacity and metabolic suppression directly limit diving capabilities and may influence foraging success in low-weaning weight seals forced to depart to sea prior to achieving full developmental diving capacity. PMID:24187422

Optimizing the Calculation of DM,CO and VC via the Single Breath Single Oxygen Tension DLCO/NO Method

PubMed Central

Coffman, Kirsten E.; Taylor, Bryan J.; Carlson, Alex R.; Wentz, Robert J.; Johnson, Bruce D.

2015-01-01

Alveolar-capillary membrane conductance (DM,CO) and pulmonary-capillary blood volume (VC) are calculated via lung diffusing capacity for carbon monoxide (DLCO) and nitric oxide (DLNO) using the single breath, single oxygen tension (single-FiO2) method. However, two calculation parameters, the reaction rate of carbon monoxide with blood (θCO) and the DM,NO/DM,CO ratio (α-ratio), are controversial. This study systematically determined optimal θCO and α-ratio values to be used in the single-FiO2 method that yielded the most similar DM,CO and VC values compared to the ‘gold-standard’ multiple-FiO2 method. Eleven healthy subjects performed single breath DLCO/DLNO maneuvers at rest and during exercise. DM,CO and VC were calculated via the single-FiO2 and multiple-FiO2 methods by implementing seven θCO equations and a range of previously reported α-ratios. The RP θCO equation (Reeves and Park, Respiration physiology 88:1–21, 1992.) and an α-ratio of 4.0–4.4 yielded DM,CO and VC values that were most similar between methods. The RP θCO equation and an experimental α-ratio should be used in future studies. PMID:26521031

Assessment of regional ventilation and deformation using 4D-CT imaging for healthy human lungs during tidal breathing

PubMed Central

Jahani, Nariman; Choi, Jiwoong; Iyer, Krishna; Hoffman, Eric A.

2015-01-01

This study aims to assess regional ventilation, nonlinearity, and hysteresis of human lungs during dynamic breathing via image registration of four-dimensional computed tomography (4D-CT) scans. Six healthy adult humans were studied by spiral multidetector-row CT during controlled tidal breathing as well as during total lung capacity and functional residual capacity breath holds. Static images were utilized to contrast static vs. dynamic (deep vs. tidal) breathing. A rolling-seal piston system was employed to maintain consistent tidal breathing during 4D-CT spiral image acquisition, providing required between-breath consistency for physiologically meaningful reconstructed respiratory motion. Registration-derived variables including local air volume and anisotropic deformation index (ADI, an indicator of preferential deformation in response to local force) were employed to assess regional ventilation and lung deformation. Lobar distributions of air volume change during tidal breathing were correlated with those of deep breathing (R2 ≈ 0.84). Small discrepancies between tidal and deep breathing were shown to be likely due to different distributions of air volume change in the left and the right lungs. We also demonstrated an asymmetric characteristic of flow rate between inhalation and exhalation. With ADI, we were able to quantify nonlinearity and hysteresis of lung deformation that can only be captured in dynamic images. Nonlinearity quantified by ADI is greater during inhalation, and it is stronger in the lower lobes (P < 0.05). Lung hysteresis estimated by the difference of ADI between inhalation and exhalation is more significant in the right lungs than that in the left lungs. PMID:26316512

Breathing metabolic simulator

NASA Technical Reports Server (NTRS)

Bartlett, R. G.; Hendricks, C. M.; Morison, W. B.

1972-01-01

The development of a breathing metabolic simulator (BMS) is reported. This BMS simulates all of the breathing and metabolic parameters required for complete evaluation and test of life support and resuscitation equipment. It is also useful for calibrating and validating mechanical and gaseous pulmonary function test procedures. Breathing rate, breathing depth, breath velocity contour, oxygen uptake, and carbon dioxide release are all variable over wide ranges simulating conditions from sleep to hard work with respiratory exchange ratios covering the range from hypoventilation. In addition, all of these parameters are remotely controllable to facilitate use of the device in hostile or remote environments. The exhaled breath is also maintained at body temperature and a high humidity. The simulation is accurate to the extent of having a variable functional residual capacity independent of other parameters.

Optimizing the calculation of DM,CO and VC via the single breath single oxygen tension DLCO/NO method.

PubMed

Coffman, Kirsten E; Taylor, Bryan J; Carlson, Alex R; Wentz, Robert J; Johnson, Bruce D

2016-01-15

Alveolar-capillary membrane conductance (D(M,CO)) and pulmonary-capillary blood volume (V(C)) are calculated via lung diffusing capacity for carbon monoxide (DL(CO)) and nitric oxide (DL(NO)) using the single breath, single oxygen tension (single-FiO2) method. However, two calculation parameters, the reaction rate of carbon monoxide with blood (θ(CO)) and the D(M,NO)/D(M,CO) ratio (α-ratio), are controversial. This study systematically determined optimal θ(CO) and α-ratio values to be used in the single-FiO2 method that yielded the most similar D(M,CO) and V(C) values compared to the 'gold-standard' multiple-FiO2 method. Eleven healthy subjects performed single breath DL(CO)/DL(NO) maneuvers at rest and during exercise. D(M,CO) and V(C) were calculated via the single-FiO2 and multiple-FiO2 methods by implementing seven θ(CO) equations and a range of previously reported α-ratios. The RP θ(CO) equation (Reeves, R.B., Park, H.K., 1992. Respiration Physiology 88 1-21) and an α-ratio of 4.0-4.4 yielded DM,CO and VC values that were most similar between methods. The RP θ(CO) equation and an experimental α-ratio should be used in future studies. Copyright © 2015 Elsevier B.V. All rights reserved.

Ventilatory Responses at Peak Exercise in Endurance-Trained Obese Adults

PubMed Central

Lorenzo, Santiago

2013-01-01

Background: Alterations in respiratory mechanics predispose healthy obese individuals to low lung volume breathing, which places them at risk of developing expiratory flow limitation (EFL). The high ventilatory demand in endurance-trained obese adults further increases their risk of developing EFL and increases their work of breathing. The objective of this study was to investigate the prevalence and magnitude of EFL in fit obese (FO) adults via measurements of breathing mechanics and ventilatory dynamics during exercise. Methods: Ten (seven women and three men) FO (mean ± SD, 38 ± 5 years, 38% ± 5% body fat) and 10 (seven women and three men) control obese (CO) (38 ± 5 years, 39% ± 5% body fat) subjects underwent hydrostatic weighing, pulmonary function testing, cycle exercise testing, and the determination of the oxygen cost of breathing during eucapnic voluntary hyperpnea. Results: There were no differences in functional residual capacity (43% ± 6% vs 40% ± 9% total lung capacity [TLC]), residual volume (21% ± 4% vs 21% ± 4% TLC), or FVC (111% ± 13% vs 104% ± 15% predicted) between FO and CO subjects, respectively. FO subjects had higher FEV1 (111% ± 13% vs 99% ± 11% predicted), TLC (106% ± 14% vs 94% ± 7% predicted), peak expiratory flow (123% ± 14% vs 106% ± 13% predicted), and maximal voluntary ventilation (128% ± 15% vs 106% ± 13% predicted) than did CO subjects. Peak oxygen uptake (129% ± 16% vs 86% ± 15% predicted), minute ventilation (128 ± 35 L/min vs 92 ± 25 L/min), and work rate (229 ± 54 W vs 166 ± 55 W) were higher in FO subjects. Mean inspiratory (4.65 ± 1.09 L/s vs 3.06 ± 1.21 L/s) and expiratory (4.15 ± 0.95 L/s vs 2.98 ± 0.76L/s) flows were greater in FO subjects, which yielded a greater breathing frequency (51 ± 8 breaths/min vs 41 ± 10 breaths/min) at peak exercise in FO subjects. Mechanical ventilatory constraints in FO subjects were similar to those in CO subjects despite the greater ventilatory demand in FO subjects. Conclusion: FO individuals achieve high ventilations by increasing breathing frequency, matching the elevated metabolic demand associated with high fitness. They do this without developing meaningful ventilatory constraints. Therefore, endurance-trained obese individuals with higher lung function are not limited by breathing mechanics during peak exercise, which may allow healthy obese adults to participate in vigorous exercise training. PMID:23722607

Comparison of Diaphragmatic Breathing Exercise, Volume and Flow Incentive Spirometry, on Diaphragm Excursion and Pulmonary Function in Patients Undergoing Laparoscopic Surgery: A Randomized Controlled Trial

PubMed Central

Anand, R.

2016-01-01

Objective. To evaluate the effects of diaphragmatic breathing exercises and flow and volume-oriented incentive spirometry on pulmonary function and diaphragm excursion in patients undergoing laparoscopic abdominal surgery. Methodology. We selected 260 patients posted for laparoscopic abdominal surgery and they were block randomization as follows: 65 patients performed diaphragmatic breathing exercises, 65 patients performed flow incentive spirometry, 65 patients performed volume incentive spirometry, and 65 patients participated as a control group. All of them underwent evaluation of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow Rate (PEFR), and diaphragm excursion measurement by ultrasonography before the operation and on the first and second postoperative days. With the level of significance set at p < 0.05. Results. Pulmonary function and diaphragm excursion showed a significant decrease on the first postoperative day in all four groups (p < 0.001) but was evident more in the control group than in the experimental groups. On the second postoperative day pulmonary function (Forced Vital Capacity) and diaphragm excursion were found to be better preserved in volume incentive spirometry and diaphragmatic breathing exercise group than in the flow incentive spirometry group and the control group. Pulmonary function (Forced Vital Capacity) and diaphragm excursion showed statistically significant differences between volume incentive spirometry and diaphragmatic breathing exercise group (p < 0.05) as compared to that flow incentive spirometry group and the control group. Conclusion. Volume incentive spirometry and diaphragmatic breathing exercise can be recommended as an intervention for all patients pre- and postoperatively, over flow-oriented incentive spirometry for the generation and sustenance of pulmonary function and diaphragm excursion in the management of laparoscopic abdominal surgery. PMID:27525116

Comparison of Diaphragmatic Breathing Exercise, Volume and Flow Incentive Spirometry, on Diaphragm Excursion and Pulmonary Function in Patients Undergoing Laparoscopic Surgery: A Randomized Controlled Trial.

PubMed

Alaparthi, Gopala Krishna; Augustine, Alfred Joseph; Anand, R; Mahale, Ajith

2016-01-01

Objective. To evaluate the effects of diaphragmatic breathing exercises and flow and volume-oriented incentive spirometry on pulmonary function and diaphragm excursion in patients undergoing laparoscopic abdominal surgery. Methodology. We selected 260 patients posted for laparoscopic abdominal surgery and they were block randomization as follows: 65 patients performed diaphragmatic breathing exercises, 65 patients performed flow incentive spirometry, 65 patients performed volume incentive spirometry, and 65 patients participated as a control group. All of them underwent evaluation of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow Rate (PEFR), and diaphragm excursion measurement by ultrasonography before the operation and on the first and second postoperative days. With the level of significance set at p < 0.05. Results. Pulmonary function and diaphragm excursion showed a significant decrease on the first postoperative day in all four groups (p < 0.001) but was evident more in the control group than in the experimental groups. On the second postoperative day pulmonary function (Forced Vital Capacity) and diaphragm excursion were found to be better preserved in volume incentive spirometry and diaphragmatic breathing exercise group than in the flow incentive spirometry group and the control group. Pulmonary function (Forced Vital Capacity) and diaphragm excursion showed statistically significant differences between volume incentive spirometry and diaphragmatic breathing exercise group (p < 0.05) as compared to that flow incentive spirometry group and the control group. Conclusion. Volume incentive spirometry and diaphragmatic breathing exercise can be recommended as an intervention for all patients pre- and postoperatively, over flow-oriented incentive spirometry for the generation and sustenance of pulmonary function and diaphragm excursion in the management of laparoscopic abdominal surgery.

Pulmonary gas exchange efficiency during exercise breathing normoxic and hypoxic gas in adults born very preterm with low diffusion capacity.

PubMed

Duke, Joseph W; Elliott, Jonathan E; Laurie, Steven S; Beasley, Kara M; Mangum, Tyler S; Hawn, Jerold A; Gladstone, Igor M; Lovering, Andrew T

2014-09-01

Adults with a history of very preterm birth (<32 wk gestational age; PRET) have reduced lung function and significantly lower lung diffusion capacity for carbon monoxide (DLCO) relative to individuals born at term (CONT). Low DLCO may predispose PRET to diffusion limitation during exercise, particularly while breathing hypoxic gas because of a reduced O2 driving gradient and pulmonary capillary transit time. We hypothesized that PRET would have significantly worse pulmonary gas exchange efficiency [i.e., increased alveolar-to-arterial Po2 difference (AaDO2)] during exercise breathing room air or hypoxic gas (FiO2 = 0.12) compared with CONT. To test this hypothesis, we compared the AaDO2 in PRET (n = 13) with a clinically mild reduction in DLCO (72 ± 7% of predicted) and CONT (n = 14) with normal DLCO (105 ± 10% of predicted) pre- and during exercise breathing room air and hypoxic gas. Measurements of temperature-corrected arterial blood gases, and direct measure of O2 saturation (SaO2), were made prior to and during exercise at 25, 50, and 75% of peak oxygen consumption (V̇o2peak) while breathing room air and hypoxic gas. In addition to DLCO, pulmonary function and exercise capacity were significantly less in PRET. Despite PRET having low DLCO, no differences were observed in the AaDO2 or SaO2 pre- or during exercise breathing room air or hypoxic gas compared with CONT. Although our findings were unexpected, we conclude that reduced pulmonary function and low DLCO resulting from very preterm birth does not cause a measureable reduction in pulmonary gas exchange efficiency. Copyright © 2014 the American Physiological Society.

Dyspnea on exertion in obese women: association with an increased oxygen cost of breathing.

PubMed

Babb, Tony G; Ranasinghe, Kamalini G; Comeau, Laurie A; Semon, Trisha L; Schwartz, Belinda

2008-07-15

Although exertional dyspnea in obesity is an important and prolific clinical concern, the underlying mechanism remains unclear. To investigate whether dyspnea on exertion in otherwise healthy obese women was associated with an increase in the oxygen cost of breathing or cardiovascular deconditioning. Obese women with and without dyspnea on exertion participated in two independent experiments (n = 16 and n = 14). All participants underwent pulmonary function testing, hydrostatic weighing, ratings of perceived breathlessness during cycling at 60 W, and determination of the oxygen cost of breathing during eucapnic voluntary hyperpnea at 40 and 60 L/min. Cardiovascular exercise capacity, fat distribution, and respiratory mechanics were determined in 14 women in experiment 2. Data were analyzed between groups by independent t test, and the relationship between the variables was determined by regression analysis. In both experiments, breathlessness during 60 W cycling was markedly increased in over 37% of the obese women (P < 0.01). Age, height, weight, lung function, and %body fat were not different between the groups in either experiment. In contrast, the oxygen cost of breathing was significantly (P < 0.01) and markedly (38-70%) greater in the obese women with dyspnea on exertion. The oxygen cost of breathing was significantly (P < 0.001) correlated with the rating of perceived breathlessness obtained during the 60 W exercise in experiment 1 (r(2) = 0.57) and experiment 2 (r(2) = 0.72). Peak cardiovascular exercise capacity, fat distribution, and respiratory mechanics were not different between groups in experiment 2. Dyspnea on exertion is prevalent in otherwise healthy obese women, which seems to be strongly associated with an increased oxygen cost of breathing. Exercise capacity is not reduced in obese women with dyspnea on exertion.

Use of an acoustic helium analyzer for measuring lung volumes.

PubMed

Krumpe, P E; MacDannald, H J; Finley, T N; Schear, H E; Hall, J; Cribbs, D

1981-01-01

We have evaluated the use of an acoustic gas analyzer (AGA) for the measurement of total lung capacity (TLC) by single-breath helium dilution. The AGA has a rapid response time (0-90% response = 160 ms for 10% He), is linear for helium concentration of 0.1-10%, is stable over a wide range of ambient temperatures, and is small and portable. We plotted the output of the AGA vs. expired lung volume after a vital capacity breath of 10% He. However, since the AGA is sensitive to changes in speed of sound relative to air, the AGA output signal also reports an artifact due to alveolar gases. We corrected for this artifact by replotting a single-breath expiration after a vital capacity breath of room air. Mean alveolar helium concentration (HeA) was then measured by planimetry, using this alveolar gas curve as the base line. TLC was calculated using the HeA from the corrected AGA output and compared with TLC calculated from HeA simultaneously measured using a mass spectrometer (MS). In 12 normal subjects and 9 patients with chronic obstructive pulmonary disease (COPD) TLC-AGA and TLC-MS were compared by linear regression analysis; correlation coefficient (r) was 0.973 for normals and 0.968 for COPD patients (P less than 0.001). This single-breath; estimation of TLC using the corrected signal of the AGA vs. Expired volume seems ideally suited for the measurement of subdivisions of lung volume in field studies.

Metabolic breath analyzer

NASA Technical Reports Server (NTRS)

Perry, C. L.

1971-01-01

Instrument measures metabolic breathing rate and dynamics of human beings in atmospheres ranging from normal air to 100 percent oxygen at ambient pressures from 14.7 to 3.0 psia. Measurements are made at rest or performing tasks up to maximum physical capacity under either zero or normal gravity.

Methods for Measuring Lung Volumes: Is There a Better One?

PubMed

Tantucci, Claudio; Bottone, Damiano; Borghesi, Andrea; Guerini, Michele; Quadri, Federico; Pini, Laura

2016-01-01

Accurate measurement of lung volumes is of paramount importance to establish the presence of ventilatory defects and give insights for diagnostic and/or therapeutic purposes. It was the aim of this study to measure lung volumes in subjects with respiratory disorders and in normal controls by 3 different techniques (plethysmographic, dilutional and radiographic methods), in an attempt to clarify the role of each of them in performing such a task, without any presumptive 'a priori' superiority of one method above others. Patients andMethods: In different groups of subjects with obstructive and restrictive ventilatory defects and in a normal control group, total lung capacity, functional residual capacity (FRC) and residual volume were measured by body plethysmography, multi-breath helium (He) dilution and radiographic CT scan method with spirometric gating. The 3 methods gave comparable results in normal subjects and in patients with a restrictive defect. In patients with an obstructive defect, CT scan and plethysmography showed similar lung volumes, while on average significantly lower lung volumes were obtained with the He dilution technique. Taking into account that the He dilution technique does primarily measure FRC during tidal breathing, our data suggest that in some patients with an obstructive defect, a number of small airways can be functionally closed at end-expiratory lung volume, preventing He to reach the lung regions subserved by these airways. In all circumstances, both CT scan with spirometric gating and plethysmographic methods provide similar values of lung volumes. In contrast, the He dilution method can measure lower lung volumes in some patients with chronic airflow obstruction. © 2016 S. Karger AG, Basel.

77 FR 14167 - Approval Tests and Standards for Closed-Circuit Escape Respirators

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-08

... Dioxide 3. Oxygen 4. Peak Breathing Pressures 5. Wet-Bulb Temperature L. Section 84.304 Capacity Test... oxygen storage or chemical carbon dioxide scrubber can be altered by impact or any other effect must... inhaled carbon dioxide, average inhaled oxygen, peak breathing pressures, and wet-bulb temperature...

30 CFR 49.16 - Equipment and maintenance requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... TRAINING MINE RESCUE TEAMS Mine Rescue Teams for Underground Coal Mines § 49.16 Equipment and maintenance... team members. (1) Twelve self-contained breathing apparatus, each with a minimum of 4 hours capacity... apparatus and sufficient to sustain each team for 8 hours while using the breathing apparatus during rescue...

30 CFR 49.16 - Equipment and maintenance requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... TRAINING MINE RESCUE TEAMS Mine Rescue Teams for Underground Coal Mines § 49.16 Equipment and maintenance... team members. (1) Twelve self-contained breathing apparatus, each with a minimum of 4 hours capacity... apparatus and sufficient to sustain each team for 8 hours while using the breathing apparatus during rescue...

30 CFR 49.16 - Equipment and maintenance requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... TRAINING MINE RESCUE TEAMS Mine Rescue Teams for Underground Coal Mines § 49.16 Equipment and maintenance... team members. (1) Twelve self-contained breathing apparatus, each with a minimum of 4 hours capacity... apparatus and sufficient to sustain each team for 8 hours while using the breathing apparatus during rescue...

30 CFR 49.16 - Equipment and maintenance requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TRAINING MINE RESCUE TEAMS Mine Rescue Teams for Underground Coal Mines § 49.16 Equipment and maintenance... team members. (1) Twelve self-contained breathing apparatus, each with a minimum of 4 hours capacity... apparatus and sufficient to sustain each team for 8 hours while using the breathing apparatus during rescue...

30 CFR 49.16 - Equipment and maintenance requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... TRAINING MINE RESCUE TEAMS Mine Rescue Teams for Underground Coal Mines § 49.16 Equipment and maintenance... team members. (1) Twelve self-contained breathing apparatus, each with a minimum of 4 hours capacity... apparatus and sufficient to sustain each team for 8 hours while using the breathing apparatus during rescue...

Improved ROS defense in the swimbladder of a facultative air-breathing erythrinid fish, jeju, compared to a non-air-breathing close relative, traira.

PubMed

Pelster, Bernd; Giacomin, Marina; Wood, Chris M; Val, Adalberto L

2016-07-01

The jeju Hoplerythrinus unitaeniatus and the traira Hoplias malabaricus are two closely related erythrinid fish, both possessing a two-chambered physostomous swimbladder. In the jeju the anterior section of the posterior bladder is highly vascularized and the swimbladder is used for aerial respiration; the traira, in turn, is a water-breather that uses the swimbladder as a buoyancy organ and not for aerial oxygen uptake. Observation of the breathing behavior under different levels of water oxygenation revealed that the traira started aquatic surface respiration only under severe hypoxic conditions and did not breathe air. In the jeju air-breathing behavior was observed under normoxic conditions, and the frequency of air-breathing was significantly increased under hypoxic conditions. Unexpectedly, even under hyperoxic conditions (30 mg O2 L(-1)) the jeju continued to take air breaths, and compared with normoxic conditions the frequency was not reduced. Because the frequently air-exposed swimbladder tissue faces higher oxygen partial pressures than normally experienced by other fish tissues, it was hypothesized that in the facultative air-breathing jeju, swimbladder tissue would have a higher antioxidative capacity than the swimbladder tissue of the water breathing traira. Measurement of total glutathione (GSSG/GSH) concentration in anterior and posterior swimbladder tissue revealed a higher concentration of this antioxidant in swimbladder tissue as compared to muscle tissue in the jeju. Furthermore, the GSSG/GSH concentration in jeju tissues was significantly higher than in traira tissues. Similarly, activities of enzymes involved in the breakdown of reactive oxygen species were significantly higher in the jeju swimbladder as compared to the traira swimbladder. The results show that the jeju, using the swimbladder as an additional breathing organ, has an enhanced antioxidative capacity in the swimbladder as compared to the traira, using the swimbladder only as a buoyancy organ.

Slow loaded breathing training improves blood pressure, lung capacity and arm exercise endurance for older people with treated and stable isolated systolic hypertension.

PubMed

Ublosakka-Jones, Chulee; Tongdee, Phailin; Pachirat, Orathai; Jones, David A

2018-03-28

Hypertension and reduced lung function are important features of aging. Slow loaded breathing training reduces resting blood pressure and the question is whether this can also improve lung function. Thirty-two people (67 ± 5 years, 16 male) with controlled isolated systolic hypertension undertook an eight weeks randomised controlled training trial with an inspiratory load of 25% maximum inspiratory pressure (MIP) at 6 breaths per minute (slow loaded breathing; SLB) or deep breathing control (CON). Outcome measures were resting blood pressure (BP) and heart rate; MIP; lung capacity; chest and abdominal expansion; arm cranking exercise endurance at 50% heart rate reserve. Home based measurement of resting systolic BP decreased by 20 mm Hg (15 to 25) (Mean and 95%CI) for SLB and by 5 mm Hg (1 to 7) for CON. Heart rate and diastolic BP also decreased significantly for SLB but not CON. MIP increased by 15.8 cm H 2 O (11.8 to 19.8) and slow vital capacity by 0.21 L (0.15 to 0.27) for SLB but not for CON. Chest and abdominal expansion increased by 2.3 cm (2.05 to 2.55) and 2.5 cm (2.15 to 2.85), respectively for SLB and by 0.5 cm (0.26 to 0.74) and 1.7 cm (1.32 to 2.08) for CON. Arm exercise time increased by 4.9 min (3.65 to 5.15) for SLB with no significant change for CON. Slow inspiratory muscle training is not only effective in reducing resting BP, even in older people with well controlled isolated systolic hypertension but also increases inspiratory muscle strength, lung capacity and arm exercise duration. Copyright © 2018. Published by Elsevier Inc.

Clinico-laboratory profile of breath-holding spells in children in Sohag University Hospital, Upper Egypt

PubMed Central

Sadek, Abdelrahim Abdrabou; Mohamed, Montaser Mohamed; Sharaf, El-Zahraa El-Said Ahmed; Magdy, Rofaida Mohamed; Allam, Ahmed Ahmed

2016-01-01

Introduction Breath-holding spells (BHSs) are involuntary pauses of breathing, sometimes accompanied by loss of consciousness. They usually occur in response to an upsetting or surprising situation. Breath-holding spells are usually caused by either a change in the usual breathing pattern or a slowing of the heart rate. In some children, BHSs may be related to iron deficiency anemia. The aim of the work was to study the clinical and laboratory profile of BPHs in children presented to the Neuropediatric Clinic at Sohag University Hospital. Methods An observational prospective study was done at Sohag University Hospital over a period of one year on children diagnosed as having BHSs by clinical history and laboratory evaluation, including complete blood count (CBC), serum iron, serum ferritin, total iron binding capacity, and Electroencephalography (EEG). Results During the period of study (one year), we reviewed data of 32 children who had been diagnosed as having BHSs. We found that cyanotic spells (71.88%) predominated over pallid spells. There were positive family histories (31.25%) and consanguinity (53.135) in the studied patients. We found a high incidence of iron deficiency anemia (62.5%) in association with BHS. Abnormal EEGs were found in (65.63%) of studied children. Conclusion BHS is a common, important problem associated with iron deficiency anemia, which is, in turn, a common nutritional problem in our country. PMID:27279996

[The influence of individually fitted controlled breathing frequency on the heart rate variability indexes].

PubMed

Chuian, O M; Biriukova, O O; Ravaieva, M Iu

2010-01-01

We studied the changes in indexes of variability of heart rate and fractal neurodynamics under conditions of controlled breathing on fluctuation frequency of a spectrum of heart rate. It is shown that the controlled breathing, which frequency corresponds to a frequency of localization of the maximum peak of capacity ofa heart rate in low-frequency is a powerful mechanism of management of heart rate and change of a functional condition of an organism as a whole.

Modeling and analysis of the effect of training on V O2 kinetics and anaerobic capacity.

PubMed

Stirling, J R; Zakynthinaki, M S; Billat, V

2008-07-01

In this paper, we present an application of a number of tools and concepts for modeling and analyzing raw, unaveraged, and unedited breath-by-breath oxygen uptake data. A method for calculating anaerobic capacity is used together with a model, in the form of a set of coupled nonlinear ordinary differential equations to make predictions of the VO(2) kinetics, the time to achieve a percentage of a certain constant oxygen demand, and the time limit to exhaustion at intensities other than those in which we have data. Speeded oxygen kinetics and increased time limit to exhaustion are also investigated using the eigenvalues of the fixed points of our model. We also use a way of analyzing the oxygen uptake kinetics using a plot of V O(2)(t) vs V O(2)(t) which allows one to observe both the fixed point solutions and also the presence of speeded oxygen kinetics following training. A method of plotting the eigenvalue versus oxygen demand is also used which allows one to observe where the maximum amplitude of the so-called slow component will be and also how training has changed the oxygen uptake kinetics by changing the strength of the attracting fixed point for a particular demand.

Controlled-frequency breath swimming improves swimming performance and running economy.

PubMed

Lavin, K M; Guenette, J A; Smoliga, J M; Zavorsky, G S

2015-02-01

Respiratory muscle fatigue can negatively impact athletic performance, but swimming has beneficial effects on the respiratory system and may reduce susceptibility to fatigue. Limiting breath frequency during swimming further stresses the respiratory system through hypercapnia and mechanical loading and may lead to appreciable improvements in respiratory muscle strength. This study assessed the effects of controlled-frequency breath (CFB) swimming on pulmonary function. Eighteen subjects (10 men), average (standard deviation) age 25 (6) years, body mass index 24.4 (3.7) kg/m(2), underwent baseline testing to assess pulmonary function, running economy, aerobic capacity, and swimming performance. Subjects were then randomized to either CFB or stroke-matched (SM) condition. Subjects completed 12 training sessions, in which CFB subjects took two breaths per length and SM subjects took seven. Post-training, maximum expiratory pressure improved by 11% (15) for all 18 subjects (P < 0.05) while maximum inspiratory pressure was unchanged. Running economy improved by 6 (9)% in CFB following training (P < 0.05). Forced vital capacity increased by 4% (4) in SM (P < 0.05) and was unchanged in CFB. These findings suggest that limiting breath frequency during swimming may improve muscular oxygen utilization during terrestrial exercise in novice swimmers. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Regulated Breathing Effect of Silicon Negative Electrode for Dramatically Enhanced Performance of Li-Ion Battery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xiao, Xingcheng; Zhou, Weidong; Kim, Youngnam

Si is an attractive negative electrode material for lithium ion batteries due to its high specifi c capacity (≈3600 mAh g –1 ). However, the huge volume swelling and shrinking during cycling, which mimics a breathing effect at the material/electrode/cell level, leads to several coupled issues including fracture of Si particles, unstable solid electrolyte interphase, and low Coulombic effi ciency. In this work, the regulation of the breathing effect is reported by using Si–C yolk–shell nanocomposite which has been well-developed by other researchers. The focus is on understanding how the nanoscaled materials design impacts the mechanical and electrochemical response atmore » electrode level. For the fi rst time, it is possible to observe one order of magnitude of reduction on breathing effect at the electrode level during cycling: the electrode thickness variation reduced down to 10%, comparing with 100% in the electrode with Si nanoparticles as active materials. The Si–C yolk–shell nanocomposite electrode exhibits excellent capacity retention and high cycle effi ciency. In situ transmission electron microscopy and fi nite element simulations consistently reveals that the dramatically enhanced performance is associated with the regulated breathing of the Si in the new composite, therefore the suppression of the overall electrode expansion.« less

Hypoxemia, hypercapnia, and breathing pattern in patients with chronic obstructive pulmonary disease.

PubMed

Parot, S; Miara, B; Milic-Emili, J; Gautier, H

1982-11-01

The results of lung function tests (total and functional residual capacities, residual volume/total lung capacity ratio, forced expiratory volume in one second) breathing patterns and arterial PO2 and PCO2 were studied in 651 ambulatory male patients with chronic obstructive pulmonary disease, functionally and clinically stable. Function tests were only loosely correlated with gas tensions: abnormalities in mechanics and in gas exchange are not necessarily related. In patients matched for the degree of obstruction, the breathing pattern depended upon both PaO2 and PaCO2. Isolated hypoxemia was accompanied by increased respiratory frequency without any variation in tidal volume: this suggests that the chemoreceptive systems still responded to changes in PaO2. Isolated hypercapnia was accompanied by a decrease in tidal volume and an increase in respiratory frequency. Consequently, the dead space/tidal volume ratio increased, leading to a drop in alveolar ventilation and to CO2 retention.

Comparing dynamic hyperinflation and associated dyspnea induced by metronome-paced tachypnea versus incremental exercise.

PubMed

Calligaro, Gregory L; Raine, Richard I; Bateman, Mary E; Bateman, Eric D; Cooper, Christopher B

2014-02-01

Dynamic hyperinflation (DH) during exercise is associated with both dyspnea and exercise limitation in COPD. Metronome-paced tachypnoea (MPT) is a simple alternative for studying DH. We compared MPT with exercise testing (XT) as methods of provoking DH, and assessed their relationship with dyspnea. We studied 24 patients with moderate COPD (FEV1 59 ± 9% predicted) after inhalation of ipratropium/salbutamol combination or placebo in a double-blind, crossover design. Inspiratory capacity (IC) was measured at baseline and after 30 seconds of MPT with breathing frequencies (fR) of 20, 30 and 40 breaths/min and metronome-defined I:E ratios of 1:1 and 1:2, in random sequence, followed by incremental cycle ergometry with interval determinations of IC. DH was defined as a decline in IC from baseline (∆IC) for both methods. Dyspnea was assessed using a Borg CR-10 scale. ∆IC during MPT was greater with higher fR and I:E ratio of 1:1 versus 1:2, and less when patients were treated with bronchodilator rather than placebo (P = 0.032). DH occurred during 19 (40%) XTs, and during 35 (73%) tests using MPT. Eleven of 18 (61%) non-congruent XTs (where DH occurred on MPT but not XT) terminated before fR of 40 breaths/min was reached. Although greater during XT, the intensity of dyspnea bore no relationship to DH during either MPT and XT. MPT at 40 breaths/min and I:E of 1:1 elicits the greatest ∆IC, and is a more sensitive method for demonstrating DH. The relationship between DH and dyspnea is complex and not determined by DH alone.

Reference values for pulmonary diffusing capacity for adult native Finns.

PubMed

Kainu, Annette; Toikka, Jyri; Vanninen, Esko; Timonen, Kirsi L

2017-04-01

Measurement standards for pulmonary diffusing capacity were updated in 2005 by the ATS/ERS Task Force. However, in Finland reference values published in 1982 by Viljanen et al. have been used to date. The main aim of this study was to produce updated reference models for single-breath diffusing capacity for carbon monoxide for Finnish adults. Single-breath diffusing capacity for carbon monoxide was measured in 631 healthy non-smoking volunteers (41.5% male). Reference values for diffusing capacity (DLCO), alveolar volume (VA), diffusing capacity per unit of lung volume (DLCO/VA), and lung volumes were calculated using a linear regression model. Previously used Finnish reference values were found to produce too low predicted values, with mean predicted DLCO 111.0 and 104.4%, and DLCO/VA of 103.5 and 102.7% in males and females, respectively. With the European Coalition for Steel and Coal (ECSC) reference values there was a significant sex difference in DLCO/VA with mean predicted 105.4% in males and 92.8% in females (p < .001). New reference values for DLCO, DLCO/VA, VA, vital capacity (VC), inspiratory vital capacity (IVC), and inspiratory capacity (IC) are suggested for clinical use to replace technically outdated reference values for clinical applications.

Effects of Mat Pilates training and habitual physical activity on thoracoabdominal expansion during quiet and vital capacity breathing in healthy women.

PubMed

Campos, Jeniffer L; Vancini, Rodrigo L; Zanoni, Graziely R; Barbosa DE Lira, Claudio A; Santos Andrade, Marilia; Sarro, Karine J

2017-10-27

Pilates is a body/mind method that requires different types of exercise (balance, endurance, strength, and flexibility) and attention to muscle control, posture, and breathing. The aim of the present study was to investigate the effects of 12 weeks of Mat Pilates training and habitual physical activity on thoracoabdominal motion of healthy and physically active women. Thirty-five women without experience in Pilates exercise, aged between 18 and 35 years, participated in the study (habitual physical activity group, n=14; and Mat Pilates group, n=21). Three- dimensional kinematic analysis was used to evaluate total and separate thoracoabdominal compartments' expansion (superior and inferior thorax and abdomen), contribution of each compartment to total thoracoabdominal expansion, and coordination between thoracoabdominal compartments. After 12 weeks of Mat Pilates training, thoracoabdominal expansion during quiet breathing was improved by increasing the expansion of abdomen by about 33% (P=0.01). Moreover, expansion of superior (P=0.04) and inferior thorax (P=0.02) and abdomen (P=0.01) was also improved in Pilates (35%, 33% and 37%, respectively) compared to the habitual physical activity group, after the experimental protocol. Finally, the habitual physical activity group presented a decrease of 13% in the expansion of abdomen (P = 0.002). The results suggest the capability of Mat Pilates in improving the action of respiratory and abdominal muscles during breathing and, thus, its benefits to breathing mechanics.

A probability-based multi-cycle sorting method for 4D-MRI: A simulation study.

PubMed

Liang, Xiao; Yin, Fang-Fang; Liu, Yilin; Cai, Jing

2016-12-01

To develop a novel probability-based sorting method capable of generating multiple breathing cycles of 4D-MRI images and to evaluate performance of this new method by comparing with conventional phase-based methods in terms of image quality and tumor motion measurement. Based on previous findings that breathing motion probability density function (PDF) of a single breathing cycle is dramatically different from true stabilized PDF that resulted from many breathing cycles, it is expected that a probability-based sorting method capable of generating multiple breathing cycles of 4D images may capture breathing variation information missing from conventional single-cycle sorting methods. The overall idea is to identify a few main breathing cycles (and their corresponding weightings) that can best represent the main breathing patterns of the patient and then reconstruct a set of 4D images for each of the identified main breathing cycles. This method is implemented in three steps: (1) The breathing signal is decomposed into individual breathing cycles, characterized by amplitude, and period; (2) individual breathing cycles are grouped based on amplitude and period to determine the main breathing cycles. If a group contains more than 10% of all breathing cycles in a breathing signal, it is determined as a main breathing pattern group and is represented by the average of individual breathing cycles in the group; (3) for each main breathing cycle, a set of 4D images is reconstructed using a result-driven sorting method adapted from our previous study. The probability-based sorting method was first tested on 26 patients' breathing signals to evaluate its feasibility of improving target motion PDF. The new method was subsequently tested for a sequential image acquisition scheme on the 4D digital extended cardiac torso (XCAT) phantom. Performance of the probability-based and conventional sorting methods was evaluated in terms of target volume precision and accuracy as measured by the 4D images, and also the accuracy of average intensity projection (AIP) of 4D images. Probability-based sorting showed improved similarity of breathing motion PDF from 4D images to reference PDF compared to single cycle sorting, indicated by the significant increase in Dice similarity coefficient (DSC) (probability-based sorting, DSC = 0.89 ± 0.03, and single cycle sorting, DSC = 0.83 ± 0.05, p-value <0.001). Based on the simulation study on XCAT, the probability-based method outperforms the conventional phase-based methods in qualitative evaluation on motion artifacts and quantitative evaluation on tumor volume precision and accuracy and accuracy of AIP of the 4D images. In this paper the authors demonstrated the feasibility of a novel probability-based multicycle 4D image sorting method. The authors' preliminary results showed that the new method can improve the accuracy of tumor motion PDF and the AIP of 4D images, presenting potential advantages over the conventional phase-based sorting method for radiation therapy motion management.

Decreased Exercise Capacity and Sleep-Disordered Breathing in Patients With Hypertrophic Cardiomyopathy

PubMed Central

Konecny, Tomas; Geske, Jeffrey B.; Ludka, Ondrej; Orban, Marek; Brady, Peter A.; Abudiab, Muaz M.; Albuquerque, Felipe N.; Placek, Alexander; Kara, Tomas; Sahakyan, Karine R.; Gersh, Bernard J.; Tajik, A. Jamil; Allison, Thomas G.; Ommen, Steve R.

2015-01-01

BACKGROUND: Mechanisms of decreased exercise capacity in patients with hypertrophic cardiomyopathy (HCM) are not well understood. Sleep-disordered breathing (SDB) is a highly prevalent but treatable disorder in patients with HCM. The role of comorbid SDB in the attenuated exercise capacity in HCM has not been studied previously. METHODS: Overnight oximetry, cardiopulmonary exercise testing, and echocardiographic studies were performed in consecutive patients with HCM seen at the Mayo Clinic. SDB was considered present if the oxygen desaturation index (number of ≥ 4% desaturations/h) was ≥ 10. Peak oxygen consumption (V.o2peak) (the most reproducible and prognostic measure of cardiovascular fitness) was then correlated with the presence and severity of SDB. RESULTS: A total of 198 patients with HCM were studied (age, 53 ± 16 years; 122 men), of whom 32% met the criteria for the SDB diagnosis. Patients with SDB had decreased V.o2peak compared with those without SDB (16 mL O2/kg/min vs 21 mL O2/kg/min, P < .001). SDB remained significantly associated with V.o2peak after accounting for confounding clinical variables (P < .001) including age, sex, BMI, atrial fibrillation, and coronary artery disease. CONCLUSIONS: In patients with HCM, the presence of SDB is associated with decreased V.o2peak. SDB may represent an important and potentially modifiable contributor to impaired exercise tolerance in this unique population. PMID:25633371

With age a lower individual breathing reserve is associated with a higher maximal heart rate.

PubMed

Burtscher, Martin; Gatterer, Hannes; Faulhaber, Martin; Burtscher, Johannes

2018-01-01

Maximal heart rate (HRmax) is linearly declining with increasing age. Regular exercise training is supposed to partly prevent this decline, whereas sex and habitual physical activity do not. High exercise capacity is associated with a high cardiac output (HR x stroke volume) and high ventilatory requirements. Due to the close cardiorespiratory coupling, we hypothesized that the individual ventilatory response to maximal exercise might be associated with the age-related HRmax. Retrospective analyses have been conducted on the results of 129 consecutively performed routine cardiopulmonary exercise tests. The study sample comprised healthy subjects of both sexes of a broad range of age (20-86 years). Maximal values of power output, minute ventilation, oxygen uptake and heart rate were assessed by the use of incremental cycle spiroergometry. Linear multivariate regression analysis revealed that in addition to age the individual breathing reserve at maximal exercise was independently predictive for HRmax. A lower breathing reserve due to a high ventilatory demand and/or a low ventilatory capacity, which is more pronounced at a higher age, was associated with higher HRmax. Age explained the observed variance in HRmax by 72% and was improved to 83% when the variable "breathing reserve" was entered. The presented findings indicate an independent association between the breathing reserve at maximal exercise and maximal heart rate, i.e. a low individual breathing reserve is associated with a higher age-related HRmax. A deeper understanding of this association has to be investigated in a more physiological scenario. Copyright © 2017 Elsevier B.V. All rights reserved.

A Four-Dimensional Computed Tomography Comparison of Healthy vs. Asthmatic Human Lungs

PubMed Central

Jahani, Nariman; Choi, Sanghun; Choi, Jiwoong; Haghighi, Babak; Hoffman, Eric A.; Comellas, Alejandro P.; Kline, Joel N.; Lin, Ching-Long

2017-01-01

The purpose of this study was to explore new insights in non-linearity, hysteresis and ventilation heterogeneity of asthmatic human lungs using four-dimensional computed tomography (4D-CT) image data acquired during tidal breathing. Volumetric image data were acquired for 5 non-severe and one severe asthmatic volunteers. Besides 4D-CT image data, function residual capacity and total lung capacity image data during breath-hold were acquired for comparison with dynamic scans. Quantitative results were compared with the previously reported analysis of five healthy human lungs. Using an image registration technique, local variables such as regional ventilation and anisotropic deformation index (ADI) were estimated. Regional ventilation characteristics of non-severe asthmatic subjects were similar to those of healthy subjects, but different from the severe asthmatic subject. Lobar airflow fractions were also well correlated between static and dynamic scans (R2 > 0.84). However, local ventilation heterogeneity significantly increased during tidal breathing in both healthy and asthmatic subjects relative to that of breath-hold perhaps because of airway resistance present only in dynamic breathing. ADI was used to quantify non-linearity and hysteresis of lung motion during tidal breathing. Nonlinearity was greater on inhalation than exhalation among all subjects. However, exhalation nonlinearity among asthmatic subjects was greater than healthy subjects and the difference diminished during inhalation. An increase of non-linearity during exhalation in asthmatic subjects accounted for lower hysteresis relative to that of healthy ones. Thus, assessment of nonlinearity differences between healthy and asthmatic lungs during exhalation may provide quantitative metrics for subject identification and outcome assessment of new interventions. PMID:28372795

A probability-based multi-cycle sorting method for 4D-MRI: A simulation study

PubMed Central

Liang, Xiao; Yin, Fang-Fang; Liu, Yilin; Cai, Jing

2016-01-01

Purpose: To develop a novel probability-based sorting method capable of generating multiple breathing cycles of 4D-MRI images and to evaluate performance of this new method by comparing with conventional phase-based methods in terms of image quality and tumor motion measurement. Methods: Based on previous findings that breathing motion probability density function (PDF) of a single breathing cycle is dramatically different from true stabilized PDF that resulted from many breathing cycles, it is expected that a probability-based sorting method capable of generating multiple breathing cycles of 4D images may capture breathing variation information missing from conventional single-cycle sorting methods. The overall idea is to identify a few main breathing cycles (and their corresponding weightings) that can best represent the main breathing patterns of the patient and then reconstruct a set of 4D images for each of the identified main breathing cycles. This method is implemented in three steps: (1) The breathing signal is decomposed into individual breathing cycles, characterized by amplitude, and period; (2) individual breathing cycles are grouped based on amplitude and period to determine the main breathing cycles. If a group contains more than 10% of all breathing cycles in a breathing signal, it is determined as a main breathing pattern group and is represented by the average of individual breathing cycles in the group; (3) for each main breathing cycle, a set of 4D images is reconstructed using a result-driven sorting method adapted from our previous study. The probability-based sorting method was first tested on 26 patients’ breathing signals to evaluate its feasibility of improving target motion PDF. The new method was subsequently tested for a sequential image acquisition scheme on the 4D digital extended cardiac torso (XCAT) phantom. Performance of the probability-based and conventional sorting methods was evaluated in terms of target volume precision and accuracy as measured by the 4D images, and also the accuracy of average intensity projection (AIP) of 4D images. Results: Probability-based sorting showed improved similarity of breathing motion PDF from 4D images to reference PDF compared to single cycle sorting, indicated by the significant increase in Dice similarity coefficient (DSC) (probability-based sorting, DSC = 0.89 ± 0.03, and single cycle sorting, DSC = 0.83 ± 0.05, p-value <0.001). Based on the simulation study on XCAT, the probability-based method outperforms the conventional phase-based methods in qualitative evaluation on motion artifacts and quantitative evaluation on tumor volume precision and accuracy and accuracy of AIP of the 4D images. Conclusions: In this paper the authors demonstrated the feasibility of a novel probability-based multicycle 4D image sorting method. The authors’ preliminary results showed that the new method can improve the accuracy of tumor motion PDF and the AIP of 4D images, presenting potential advantages over the conventional phase-based sorting method for radiation therapy motion management. PMID:27908178

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

Effects of water immersion to the neck on pulmonary circulation and tissue volume in man

NASA Technical Reports Server (NTRS)

Begin, R.; Epstein, M.; Sackner, M. A.; Levinson, R.; Dougherty, R.; Duncan, D.

1976-01-01

A rapid noninvasive breathing method is used to obtain serial measurements of the pulmonary capillary blood flow, diffusing capacity per unit of alveolar volume, combined pulmonary tissue plus capillary volume, functional residual capacity, and oxygen consumption in five normal subjects undergoing 6 h of sitting, 4 h of sitting while immersed to the neck in thermoneutral water, and 4 h of lying in thermoneutral water to the neck. The rebreathing method employed a test gas mixture containing 0.5% C2H2, 0.3% C(18)O, 10% He, 21% O2, and balance N2. It is shown that immersion to the neck in the seated posture results in significant increases in sodium excretion cardiac output, and diffusing capacity per unit of alveolar volume. The pulmonary tissue plus capillary volume did not change, demonstrating that the central vascular engorgement induced by water immersion is not accompanied by significant extravasation of fluid into the pulmonary interstitial space.

Calculation algorithms for breath-by-breath alveolar gas exchange: the unknowns!

PubMed

Golja, Petra; Cettolo, Valentina; Francescato, Maria Pia

2018-06-25

Several papers (algorithm papers) describe computational algorithms that assess alveolar breath-by-breath gas exchange by accounting for changes in lung gas stores. It is unclear, however, if the effects of the latter are actually considered in literature. We evaluated dissemination of algorithm papers and the relevant provided information. The list of documents investigating exercise transients (in 1998-2017) was extracted from Scopus database. Documents citing the algorithm papers in the same period were analyzed in full text to check consistency of the relevant information provided. Less than 8% (121/1522) of documents dealing with exercise transients cited at least one algorithm paper; the paper of Beaver et al. (J Appl Physiol 51:1662-1675, 1981) was cited most often, with others being cited tenfold less. Among the documents citing the algorithm paper of Beaver et al. (J Appl Physiol 51:1662-1675, 1981) (N = 251), only 176 cited it for the application of their algorithm/s; in turn, 61% (107/176) of them stated the alveolar breath-by-breath gas exchange measurement, but only 1% (1/107) of the latter also reported the assessment of volunteers' functional residual capacity, a crucial parameter for the application of the algorithm. Information related to gas exchange was provided consistently in the methods and in the results in 1 of the 107 documents. Dissemination of algorithm papers in literature investigating exercise transients is by far narrower than expected. The information provided about the actual application of gas exchange algorithms is often inadequate and/or ambiguous. Some guidelines are provided that can help to improve the quality of future publications in the field.

The effects of breathing exercise types on respiratory muscle activity and body function in patients with mild chronic obstructive pulmonary disease.

PubMed

Kang, Jeong-Il; Jeong, Dae-Keun; Choi, Hyun

2016-01-01

[Purpose] Fragmentary studies on characteristics of respiratory muscles are being done to increase respiratory capacity by classifying exercises into voluntary respiratory exercise which relieves symptoms and prevents COPD and exercise using breathing exercise equipment. But this study found changes on respiratory pattern through changes on the activity pattern of agonist and synergist respiratory muscles and studied what effect they can have on body function improvement. [Subjects and Methods] Fifteen subjects in experimental group I that respiratory exercise of diaphragm and 15 subjects in experimental group II that feedback respiratory exercise were randomly selected among COPD patients to find the effective intervention method for COPD patients. And intervention program was conducted for 5 weeks, three times a week, once a day and 30 minutes a session. They were measured with BODE index using respiratory muscle activity, pulmonary function, the six-minute walking test, dyspnea criteria and BMI Then the results obtained were compared and analyzed. [Results] There was a significant difference in sternocleidomastoid muscle and scalene muscle and in 6-minute walk and BODE index for body function. Thus the group performing feedback respiratory had more effective results for mild COPD patients. [Conclusion] Therefore, the improvement was significant regarding the activity of respiratory muscles synergists when breathing before doing breathing exercise. Although, it is valuable to reduce too much mobilization of respiratory muscles synergists through the proper intervention it is necessary to study body function regarding improvement of respiratory function for patients with COPD.

Evaluation of pulmonary function using single-breath-hold dual-energy computed tomography with xenon

PubMed Central

Kyoyama, Hiroyuki; Hirata, Yusuke; Kikuchi, Satoshi; Sakai, Kosuke; Saito, Yuriko; Mikami, Shintaro; Moriyama, Gaku; Yanagita, Hisami; Watanabe, Wataru; Otani, Katharina; Honda, Norinari; Uematsu, Kazutsugu

2017-01-01

Abstract Xenon-enhanced dual-energy computed tomography (xenon-enhanced CT) can provide lung ventilation maps that may be useful for assessing structural and functional abnormalities of the lung. Xenon-enhanced CT has been performed using a multiple-breath-hold technique during xenon washout. We recently developed xenon-enhanced CT using a single-breath-hold technique to assess ventilation. We sought to evaluate whether xenon-enhanced CT using a single-breath-hold technique correlates with pulmonary function testing (PFT) results. Twenty-six patients, including 11 chronic obstructive pulmonary disease (COPD) patients, underwent xenon-enhanced CT and PFT. Three of the COPD patients underwent xenon-enhanced CT before and after bronchodilator treatment. Images from xenon-CT were obtained by dual-source CT during a breath-hold after a single vital-capacity inspiration of a xenon–oxygen gas mixture. Image postprocessing by 3-material decomposition generated conventional CT and xenon-enhanced images. Low-attenuation areas on xenon images matched low-attenuation areas on conventional CT in 21 cases but matched normal-attenuation areas in 5 cases. Volumes of Hounsfield unit (HU) histograms of xenon images correlated moderately and highly with vital capacity (VC) and total lung capacity (TLC), respectively (r = 0.68 and 0.85). Means and modes of histograms weakly correlated with VC (r = 0.39 and 0.38), moderately with forced expiratory volume in 1 second (FEV1) (r = 0.59 and 0.56), weakly with the ratio of FEV1 to FVC (r = 0.46 and 0.42), and moderately with the ratio of FEV1 to its predicted value (r = 0.64 and 0.60). Mode and volume of histograms increased in 2 COPD patients after the improvement of FEV1 with bronchodilators. Inhalation of xenon gas caused no adverse effects. Xenon-enhanced CT using a single-breath-hold technique depicted functional abnormalities not detectable on thin-slice CT. Mode, mean, and volume of HU histograms of xenon images reflected pulmonary function. Xenon images obtained with xenon-enhanced CT using a single-breath-hold technique can qualitatively depict pulmonary ventilation. A larger study comprising only COPD patients should be conducted, as xenon-enhanced CT is expected to be a promising technique for the management of COPD. PMID:28099359

Evaluation of pulmonary function using single-breath-hold dual-energy computed tomography with xenon: Results of a preliminary study.

PubMed

Kyoyama, Hiroyuki; Hirata, Yusuke; Kikuchi, Satoshi; Sakai, Kosuke; Saito, Yuriko; Mikami, Shintaro; Moriyama, Gaku; Yanagita, Hisami; Watanabe, Wataru; Otani, Katharina; Honda, Norinari; Uematsu, Kazutsugu

2017-01-01

Xenon-enhanced dual-energy computed tomography (xenon-enhanced CT) can provide lung ventilation maps that may be useful for assessing structural and functional abnormalities of the lung. Xenon-enhanced CT has been performed using a multiple-breath-hold technique during xenon washout. We recently developed xenon-enhanced CT using a single-breath-hold technique to assess ventilation. We sought to evaluate whether xenon-enhanced CT using a single-breath-hold technique correlates with pulmonary function testing (PFT) results.Twenty-six patients, including 11 chronic obstructive pulmonary disease (COPD) patients, underwent xenon-enhanced CT and PFT. Three of the COPD patients underwent xenon-enhanced CT before and after bronchodilator treatment. Images from xenon-CT were obtained by dual-source CT during a breath-hold after a single vital-capacity inspiration of a xenon-oxygen gas mixture. Image postprocessing by 3-material decomposition generated conventional CT and xenon-enhanced images.Low-attenuation areas on xenon images matched low-attenuation areas on conventional CT in 21 cases but matched normal-attenuation areas in 5 cases. Volumes of Hounsfield unit (HU) histograms of xenon images correlated moderately and highly with vital capacity (VC) and total lung capacity (TLC), respectively (r = 0.68 and 0.85). Means and modes of histograms weakly correlated with VC (r = 0.39 and 0.38), moderately with forced expiratory volume in 1 second (FEV1) (r = 0.59 and 0.56), weakly with the ratio of FEV1 to FVC (r = 0.46 and 0.42), and moderately with the ratio of FEV1 to its predicted value (r = 0.64 and 0.60). Mode and volume of histograms increased in 2 COPD patients after the improvement of FEV1 with bronchodilators. Inhalation of xenon gas caused no adverse effects.Xenon-enhanced CT using a single-breath-hold technique depicted functional abnormalities not detectable on thin-slice CT. Mode, mean, and volume of HU histograms of xenon images reflected pulmonary function. Xenon images obtained with xenon-enhanced CT using a single-breath-hold technique can qualitatively depict pulmonary ventilation. A larger study comprising only COPD patients should be conducted, as xenon-enhanced CT is expected to be a promising technique for the management of COPD.

Whole-heart magnetic resonance coronary angiography with multiple breath-holds and automatic breathing-level tracking

NASA Astrophysics Data System (ADS)

Kuhara, Shigehide; Ninomiya, Ayako; Okada, Tomohisa; Kanao, Shotaro; Kamae, Toshikazu; Togashi, Kaori

2010-05-01

Whole-heart (WH) magnetic resonance coronary angiography (MRCA) studies are usually performed during free breathing while monitoring the position of the diaphragm with real-time motion correction. However, this results in a long scan time and the patient's breathing pattern may change, causing the study to be aborted. Alternatively, WH MRCA can be performed with multiple breath-holds (mBH). However, one problem in the mBH method is that patients cannot hold their breath at the same position every time, leading to image degradation. We have developed a new WH MRCA imaging method that employs both the mBH method and automatic breathing-level tracking to permit automatic tracking of the changes in breathing or breath-hold levels. Evaluation of its effects on WH MRCA image quality showed that this method can provide high-quality images within a shorter scan time. This proposed method is expected to be very useful in clinical WH MRCA studies.

Identifying decreased diaphragmatic mobility and diaphragm thickening in interstitial lung disease: the utility of ultrasound imaging

PubMed Central

Santana, Pauliane Vieira; Prina, Elena; Albuquerque, André Luis Pereira; Carvalho, Carlos Roberto Ribeiro; Caruso, Pedro

2016-01-01

Objective: To investigate the applicability of ultrasound imaging of the diaphragm in interstitial lung disease (ILD). Methods: Using ultrasound, we compared ILD patients and healthy volunteers (controls) in terms of diaphragmatic mobility during quiet and deep breathing; diaphragm thickness at functional residual capacity (FRC) and at total lung capacity (TLC); and the thickening fraction (TF, proportional diaphragm thickening from FRC to TLC). We also evaluated correlations between diaphragmatic dysfunction and lung function variables. Results: Between the ILD patients (n = 40) and the controls (n = 16), mean diaphragmatic mobility was comparable during quiet breathing, although it was significantly lower in the patients during deep breathing (4.5 ± 1.7 cm vs. 7.6 ± 1.4 cm; p < 0.01). The patients showed greater diaphragm thickness at FRC (p = 0.05), although, due to lower diaphragm thickness at TLC, they also showed a lower TF (p < 0.01). The FVC as a percentage of the predicted value (FVC%) correlated with diaphragmatic mobility (r = 0.73; p < 0.01), and an FVC% cut-off value of < 60% presented high sensitivity (92%) and specificity (81%) for indentifying decreased diaphragmatic mobility. Conclusions: Using ultrasound, we were able to show that diaphragmatic mobility and the TF were lower in ILD patients than in healthy controls, despite the greater diaphragm thickness at FRC in the former. Diaphragmatic mobility correlated with ILD functional severity, and an FVC% cut-off value of < 60% was found to be highly accurate for indentifying diaphragmatic dysfunction on ultrasound. PMID:27167428

LOW-LEVEL CARBON MONOXIDE EXPOSURE AND WORK CAPACITY AT 1600 METERS

EPA Science Inventory

At sea level, low-level carbon monoxide (CO) exposure impairs exercise performance. To determine if altitude residence at 1600 m augments this CO effect, two studies of graded treadmill work capacity were done. The Initial Study investigated nine, non-smoking male subjects breath...

[Free from stress by autogenic therapy. Relaxation technique yielding peace of mind and self-insight].

PubMed

Broms, C

1999-02-10

The utilisation of self-regulatory capacity is one of the purposes of autogenic therapy, a method consisting of exercises focused on the limbs, lungs, heart, diaphragm and head. The physiological response is muscle relaxation, increased peripheral blood flow, lower heart rate and blood pressure, slower and deeper breathing, and reduced oxygen consumption. Autogenic training is applicable in most pathological conditions associated with stress, and can be used preventively or as a complement to conventional treatment.

13C-methacetin and 13C-galactose breath tests can assess restricted liver function even in early stages of primary biliary cirrhosis.

PubMed

Holtmeier, Julia; Leuschner, Maria; Schneider, Arne; Leuschner, Ulrich; Caspary, Wolfgang F; Braden, Barbara

2006-11-01

The 13C-methacetin breath test quantitatively evaluates cytochrome P450-dependent liver function. The 13C-galactose breath test non-invasively measures the galactose oxidation capacity of the liver. The aim of this study was to find out whether these breath tests are sensitive parameters also in non-cirrhotic patients with primary biliary cirrhosis. Nineteen patients with early-stage primary biliary cirrhosis (no cirrhotic alterations in the liver biopsy, Ludwig stage I-III) and 20 healthy controls underwent the 13C-methacetin and 13C-galactose breath tests. Patients with primary biliary cirrhosis metabolized less 13C-methacetin than controls (cumulative recovery within 30 min 7.5+/-2.4% versus 14.0+/-2.6%; p < 0.001). When a cut-off > 9.8% was used for the cumulative recovery after 30 min, the methacetin breath test reached 84.2% sensitivity and 95.0 specificity. In the 13C-galactose breath test, the percentage recovery at 60 min in patients was 3.1+/-1.3%/h, and 6.3+/-1.1%/h in controls (p < 0.001). Using a cut-off > 4.7%/h, the galactose breath test reached 89.5% sensitivity and 95.0 specificity. In non-cirrhotic, early-stage, primary biliary cirrhosis the 13C-methacetin breath test and the 13C-galactose breath test reliably indicate decreased liver function. The 13C-galactose breath test can also predict the histological score.

An automated system for pulmonary function testing

NASA Technical Reports Server (NTRS)

Mauldin, D. G.

1974-01-01

An experiment to quantitate pulmonary function was accepted for the space shuttle concept verification test. The single breath maneuver and the nitrogen washout are combined to reduce the test time. Parameters are defined from the forced vital capacity maneuvers. A spirometer measures the breath volume and a magnetic section mass spectrometer provides definition of gas composition. Mass spectrometer and spirometer data are analyzed by a PDP-81 digital computer.

Inflammatory Asthma Phenotype Discrimination Using an Electronic Nose Breath Analyzer.

PubMed

Plaza, V; Crespo, A; Giner, J; Merino, J L; Ramos-Barbón, D; Mateus, E F; Torrego, A; Cosio, B G; Agustí, A; Sibila, O

2015-01-01

Patients with persistent asthma have different inflammatory phenotypes. The electronic nose is a new technology capable of distinguishing volatile organic compound (VOC) breath-prints in exhaled breath. The aim of the study was to investigate the capacity of electronic nose breath-print analysis to discriminate between different inflammatory asthma phenotypes (eosinophilic, neutrophilic, paucigranulocytic) determined by induced sputum in patients with persistent asthma. Fifty-two patients with persistent asthma were consecutively included in a cross-sectional proof-of-concept study. Inflammatory asthma phenotypes (eosinophilic, neutrophilic and paucigranulocytic) were recognized by inflammatory cell counts in induced sputum. VOC breath-prints were analyzed using the electronic nose Cyranose 320 and assessed by discriminant analysis on principal component reduction, resulting in cross-validated accuracy values. Receiver operating characteristic (ROC) curves were calculated. VOC breath-prints were different in eosinophilic asthmatics compared with both neutrophilic asthmatics (accuracy 73%; P=.008; area under ROC, 0.92) and paucigranulocytic asthmatics (accuracy 74%; P=.004; area under ROC, 0.79). Likewise, neutrophilic and paucigranulocytic breath-prints were also different (accuracy 89%; P=.001; area under ROC, 0.88). An electronic nose can discriminate inflammatory phenotypes in patients with persistent asthma in a regular clinical setting. ClinicalTrials.gov identifier: NCT02026336.

Air-breathing adaptation in a marine Devonian lungfish.

PubMed

Clement, Alice M; Long, John A

2010-08-23

Recent discoveries of tetrapod trackways in 395 Myr old tidal zone deposits of Poland (Niedźwiedzki et al. 2010 Nature 463, 43-48 (doi:10.1038/nature.08623)) indicate that vertebrates had already ventured out of the water and might already have developed some air-breathing capacity by the Middle Devonian. Air-breathing in lungfishes is not considered to be a shared specialization with tetrapods, but evolved independently. Air-breathing in lungfishes has been postulated as starting in Middle Devonian times (ca 385 Ma) in freshwater habitats, based on a set of skeletal characters involved in air-breathing in extant lungfishes. New discoveries described herein of the lungfish Rhinodipterus from marine limestones of Australia identifies the node in dipnoan phylogeny where air-breathing begins, and confirms that lungfishes living in marine habitats had also developed specializations to breathe air by the start of the Late Devonian (ca 375 Ma). While invasion of freshwater habitats from the marine realm was previously suggested to be the prime cause of aerial respiration developing in lungfishes, we believe that global decline in oxygen levels during the Middle Devonian combined with higher metabolic costs is a more likely driver of air-breathing ability, which developed in both marine and freshwater lungfishes and tetrapodomorph fishes such as Gogonasus.

Air-breathing adaptation in a marine Devonian lungfish

PubMed Central

Clement, Alice M.; Long, John A.

2010-01-01

Recent discoveries of tetrapod trackways in 395 Myr old tidal zone deposits of Poland (Niedźwiedzki et al. 2010 Nature 463, 43–48 (doi:10.1038/nature.08623)) indicate that vertebrates had already ventured out of the water and might already have developed some air-breathing capacity by the Middle Devonian. Air-breathing in lungfishes is not considered to be a shared specialization with tetrapods, but evolved independently. Air-breathing in lungfishes has been postulated as starting in Middle Devonian times (ca 385 Ma) in freshwater habitats, based on a set of skeletal characters involved in air-breathing in extant lungfishes. New discoveries described herein of the lungfish Rhinodipterus from marine limestones of Australia identifies the node in dipnoan phylogeny where air-breathing begins, and confirms that lungfishes living in marine habitats had also developed specializations to breathe air by the start of the Late Devonian (ca 375 Ma). While invasion of freshwater habitats from the marine realm was previously suggested to be the prime cause of aerial respiration developing in lungfishes, we believe that global decline in oxygen levels during the Middle Devonian combined with higher metabolic costs is a more likely driver of air-breathing ability, which developed in both marine and freshwater lungfishes and tetrapodomorph fishes such as Gogonasus. PMID:20147310

Improved heat tolerance in air drives the recurrent evolution of air-breathing.

PubMed

Giomi, Folco; Fusi, Marco; Barausse, Alberto; Mostert, Bruce; Pörtner, Hans-Otto; Cannicci, Stefano

2014-05-07

The transition to air-breathing by formerly aquatic species has occurred repeatedly and independently in fish, crabs and other animal phyla, but the proximate drivers of this key innovation remain a long-standing puzzle in evolutionary biology. Most studies attribute the onset of air-breathing to the repeated occurrence of aquatic hypoxia; however, this hypothesis leaves the current geographical distribution of the 300 genera of air-breathing crabs unexplained. Here, we show that their occurrence is mainly related to high environmental temperatures in the tropics. We also demonstrate in an amphibious crab that the reduced cost of oxygen supply in air extends aerobic performance to higher temperatures and thus widens the animal's thermal niche. These findings suggest that high water temperature as a driver consistently explains the numerous times air-breathing has evolved. The data also indicate a central role for oxygen- and capacity-limited thermal tolerance not only in shaping sensitivity to current climate change but also in underpinning the climate-dependent evolution of animals, in this case the evolution of air-breathing.

Improved heat tolerance in air drives the recurrent evolution of air-breathing

PubMed Central

Giomi, Folco; Fusi, Marco; Barausse, Alberto; Mostert, Bruce; Pörtner, Hans-Otto; Cannicci, Stefano

2014-01-01

The transition to air-breathing by formerly aquatic species has occurred repeatedly and independently in fish, crabs and other animal phyla, but the proximate drivers of this key innovation remain a long-standing puzzle in evolutionary biology. Most studies attribute the onset of air-breathing to the repeated occurrence of aquatic hypoxia; however, this hypothesis leaves the current geographical distribution of the 300 genera of air-breathing crabs unexplained. Here, we show that their occurrence is mainly related to high environmental temperatures in the tropics. We also demonstrate in an amphibious crab that the reduced cost of oxygen supply in air extends aerobic performance to higher temperatures and thus widens the animal's thermal niche. These findings suggest that high water temperature as a driver consistently explains the numerous times air-breathing has evolved. The data also indicate a central role for oxygen- and capacity-limited thermal tolerance not only in shaping sensitivity to current climate change but also in underpinning the climate-dependent evolution of animals, in this case the evolution of air-breathing. PMID:24619438

Spirometry

MedlinePlus

... the bronchodilator improved your airflow. Results Key spirometry measurements include the following: Forced vital capacity (FVC). This is the largest amount of air that you can forcefully exhale after breathing in ...

Recovery of Breathing and Forelimb Function after Prolonged Exposure to Repetitive Acute Intermittent Hypoxia

DTIC Science & Technology

2017-03-01

breathing capacity (Aim 1) and forelimb function (Aim 2), without systemic hypertension or hippocampal pathology (Aim 3). SPECIFIC AIMS Aim 1 (Florida...benefits. On the other hand, there was no evidence for pathology ( hypertension or hippocampal pathology). We were not able to perform time-series... hypertension or hippocampal (CA1) pathology. However, we did see striking (and surprising) preliminary evidence that prolonged rAIH: 1) reduced volume of the

Dynamic measurements of CO diffusing capacity using discrete samples of alveolar gas.

PubMed

Graham, B L; Mink, J T; Cotton, D J

1983-01-01

It has been shown that measurements of the diffusing capacity of the lung for CO made during a slow exhalation [DLCO(exhaled)] yield information about the distribution of the diffusing capacity in the lung that is not available from the commonly measured single-breath diffusing capacity [DLCO(SB)]. Current techniques of measuring DLCO(exhaled) require the use of a rapid-responding (less than 240 ms, 10-90%) CO meter to measure the CO concentration in the exhaled gas continuously during exhalation. DLCO(exhaled) is then calculated using two sample points in the CO signal. Because DLCO(exhaled) calculations are highly affected by small amounts of noise in the CO signal, filtering techniques have been used to reduce noise. However, these techniques reduce the response time of the system and may introduce other errors into the signal. We have developed an alternate technique in which DLCO(exhaled) can be calculated using the concentration of CO in large discrete samples of the exhaled gas, thus eliminating the requirement of a rapid response time in the CO analyzer. We show theoretically that this method is as accurate as other DLCO(exhaled) methods but is less affected by noise. These findings are verified in comparisons of the discrete-sample method of calculating DLCO(exhaled) to point-sample methods in normal subjects, patients with emphysema, and patients with asthma.

High Oxygen Delivery to Preserve Exercise Capacity in Patients with Idiopathic Pulmonary Fibrosis Treated with Nintedanib. Methodology of the HOPE-IPF Study.

PubMed

Ryerson, Christopher J; Camp, Pat G; Eves, Neil D; Schaeffer, Michele; Syed, Nafeez; Dhillon, Satvir; Jensen, Dennis; Maltais, Francois; O'Donnell, Denis E; Raghavan, Natya; Roman, Michael; Stickland, Michael K; Assayag, Deborah; Bourbeau, Jean; Dion, Genevieve; Fell, Charlene D; Hambly, Nathan; Johannson, Kerri A; Kalluri, Meena; Khalil, Nasreen; Kolb, Martin; Manganas, Helene; Morán-Mendoza, Onofre; Provencher, Steve; Ramesh, Warren; Rolf, J Douglass; Wilcox, Pearce G; Guenette, Jordan A

2016-09-01

Pulmonary rehabilitation improves dyspnea and exercise capacity in idiopathic pulmonary fibrosis (IPF); however, it is unknown whether breathing high amounts of oxygen during exercise training leads to further benefits. Herein, we describe the design of the High Oxygen Delivery to Preserve Exercise Capacity in IPF Patients Treated with Nintedanib study (the HOPE-IPF study). The primary objective of this study is to determine the physiological and perceptual impact of breathing high levels of oxygen during exercise training in patients with IPF who are receiving antifibrotic therapy. HOPE-IPF is a two-arm double-blind multicenter randomized placebo-controlled trial of 88 patients with IPF treated with nintedanib. Patients will undergo 8 weeks of three times weekly aerobic cycle exercise training, breathing a hyperoxic gas mixture with a constant fraction of 60% inhaled oxygen, or breathing up to 40% oxygen as required to maintain an oxygen saturation level of at least 88%. End points will be assessed at baseline, postintervention (Week 8), and follow-up (Week 26). The primary analysis will compare the between-group baseline with post-training change in endurance time during constant work rate cycle exercise tests. Additional analyses will evaluate the impact of training with high oxygen delivery on 6-minute walk distance, dyspnea, physical activity, and quality of life. The HOPE-IPF study will lead to a comprehensive understanding of IPF exercise physiology, with the potential to change clinical practice by indicating the need for increased delivery of supplemental oxygen during pulmonary rehabilitation in patients with IPF. Clinical trial registered with www.clinicaltrials.gov (NCT02551068).

Effects of breathing exercises on breathing patterns in obese and non-obese subjects.

PubMed

Olsén, M F; Lönroth, H; Bake, B

1999-05-01

Chest physiotherapy in connection with abdominal surgery includes different deep-breathing exercises to prevent post-operative pulmonary complications. The therapy is effective in preventing pulmonary complications, especially in high-risk patients such as obese persons. The mechanisms behind the effect is unclear, but part of the effect may be explained by the changes in breathing patterns. The aim of this study was therefore to describe and to analyse the breathing patterns in obese and non-obese subjects during three different breathing techniques frequently used in the treatment of post-operative patients. Twenty-one severely obese [body mass index (BMI) > 40] and 21 non-obese (BMI 19-25) subjects were studied. All persons denied having any lung disease and were non-smokers. The breathing techniques investigated were: deep breaths without any resistance (DB), positive expiratory pressure (PEP) with an airway resistance of approximately +15 cmH2O (1.5 kPa) during expiration, inspiratory resistance positive expiratory pressure (IR-PEP) with a pressure of approximately -10 cmH2O (-1.0 kPa) during inspiration. Expiratory resistance as for PEP. Volume against time was monitored while the subjects were sitting in a body plethysmograph. Variables for volume and flow during the breathing cycle were determined. Tidal volume and alveolar ventilation were highest during DB, and peak inspiratory volume was significantly higher than during PEP and IR-PEP in the group of obese subjects. The breathing cycles were prolonged in all techniques but were most prolonged in PEP and IR-PEP. The functional residual capacity (FRC) was significantly lower during DB than during PEP and IR-PEP in the group of obese subjects. FRC as determined within 2 min of finishing each breathing technique was identical to before the breathing manoeuvres.

Determinants of dynamic hyperinflation during metronome-paced tachypnea in COPD and normal subjects.

PubMed

Cooper, C B; Calligaro, G L; Quinn, M M; Eshaghian, P; Coskun, F; Abrazado, M; Bateman, E D; Raine, R I

2014-01-01

In COPD, dynamic hyperinflation (DH) occurs during exercise and during metronome-paced tachypnea (MPT). We investigated the relationship of DH with breathing pattern and ventilation (V˙E) in COPD and normal subjects (NS). In 35 subjects with moderate COPD and 17 younger healthy volunteers we measured inspiratory capacity (IC), breathing frequency (fR), expiratory time (TE), ventilation (V˙E) and end-tidal carbon dioxide tension (PETCO2) at baseline and after 30s of MPT at 40breaths/min with metronome-defined I:E ratios of 1:1 and 1:2. A reduction in IC (ΔIC) was taken to indicate DH. In COPD subjects, DH correlated with TE but not with V˙E or PETCO2, and was best predicted by total lung capacity. NS also showed DH (although less than in COPD), which correlated with PETCO2 but not with fR, TE or V˙E. We conclude that MPT evokes DH in both NS and patients with COPD. TE is the most important determinant of DH during MPT in patients with COPD. Copyright © 2013 Elsevier B.V. All rights reserved.

Lung volume, breathing pattern and ventilation inhomogeneity in preterm and term infants.

PubMed

Latzin, Philipp; Roth, Stefan; Thamrin, Cindy; Hutten, Gerard J; Pramana, Isabelle; Kuehni, Claudia E; Casaulta, Carmen; Nelle, Matthias; Riedel, Thomas; Frey, Urs

2009-01-01

Morphological changes in preterm infants with bronchopulmonary dysplasia (BPD) have functional consequences on lung volume, ventilation inhomogeneity and respiratory mechanics. Although some studies have shown lower lung volumes and increased ventilation inhomogeneity in BPD infants, conflicting results exist possibly due to differences in sedation and measurement techniques. We studied 127 infants with BPD, 58 preterm infants without BPD and 239 healthy term-born infants, at a matched post-conceptional age of 44 weeks during quiet natural sleep according to ATS/ERS standards. Lung function parameters measured were functional residual capacity (FRC) and ventilation inhomogeneity by multiple breath washout as well as tidal breathing parameters. Preterm infants with BPD had only marginally lower FRC (21.4 mL/kg) than preterm infants without BPD (23.4 mL/kg) and term-born infants (22.6 mL/kg), though there was no trend with disease severity. They also showed higher respiratory rates and lower ratios of time to peak expiratory flow and expiratory time (t(PTEF)/t(E)) than healthy preterm and term controls. These changes were related to disease severity. No differences were found for ventilation inhomogeneity. Our results suggest that preterm infants with BPD have a high capacity to maintain functional lung volume during natural sleep. The alterations in breathing pattern with disease severity may reflect presence of adaptive mechanisms to cope with the disease process.

New approaches in the rehabilitation of the traumatic high level quadriplegic.

PubMed

Bach, J R

1991-02-01

The use of noninvasive alternatives to tracheostomy for ventilatory support have been described in the patient management of various neuromuscular disorders. The use of these techniques for patients with traumatic high level quadriplegia, however, is hampered by the resort to tracheostomy in the acute hospital setting. Twenty traumatic high level quadriplegic patients on intermittent positive pressure ventilation (IPPV) via tracheostomy with little or no ability for unassisted breathing were converted to noninvasive ventilatory support methods and had their tracheostomy sites closed. Four additional patients were ventilated by noninvasive methods without tracheostomy. These methods included the use of body ventilators and the noninvasive intermittent positive airway pressure alternatives of IPPV via the mouth, nose, or custom acrylic strapless oral-nasal interface (SONI). Overnight end-tidal pCO2 studies and monitoring of oxyhemoglobin saturation (SaO2) were used to adjust ventilator volumes and to document effective ventilation during sleep. No significant complications have resulted from the use of these methods over a period of 45 patient-years. Elimination of the tracheostomy permitted significant free time by glossopharyngeal breathing for four patients, two of whom had no measurable vital capacity. We conclude that noninvasive ventilatory support alternatives can be effective and deserve further study in this patient population.

Hypoxia tolerance and air-breathing ability correlate with habitat preference in coral-dwelling fishes

NASA Astrophysics Data System (ADS)

Nilsson, G. E.; Hobbs, J.-P. A.; Östlund-Nilsson, S.; Munday, P. L.

2007-06-01

Hypoxia tolerance and air-breathing occur in a range of freshwater, estuarine and intertidal fishes. Here it is shown for the first time that coral reef fishes from the genera Gobiodon, Paragobiodon and Caracanthus, which all have an obligate association with living coral, also exhibit hypoxia tolerance and a well-developed air-breathing capacity. All nine species maintained adequate respiration in water at oxygen concentrations down to 15-25% air saturation. This hypoxia tolerance is probably needed when the oxygen levels in the coral habitat drops sharply at night. Air-breathing abilities of the species correlated with habitat association, being greatest (equaling oxygen uptake in water) in species that occupy corals extending into shallow water, where they may become air exposed during extreme low tides. Air-breathing was less well-developed or absent in species inhabiting corals from deeper waters. Loss of scales and a network of subcutaneous capillaries appear to be key adaptations allowing cutaneous respiration in air. While hypoxia tolerance may be an ancestral trait in these fishes, air-breathing is likely to be a more recent adaptation exemplifying convergent evolution in the unrelated genera Gobiodon and Caracanthus in response to coral-dwelling lifestyles.

Effect of Aerobic Exercise Training on Ventilatory Efficiency and Respiratory Drive in Obese Subjects.

PubMed

Chlif, Mehdi; Chaouachi, Anis; Ahmaidi, Said

2017-07-01

Obese patients show a decline in exercise capacity and diverse degrees of dyspnea in association with mechanical abnormalities, increased ventilatory requirements secondary to the increased metabolic load, and a greater work of breathing. Consequently, obese patients may be particularly predisposed to the development of respiratory muscle fatigue during exercise. The aim of this study was to assess inspiratory muscle performance during incremental exercise in 19 obese male subjects (body mass index 41 ± 6 kg/m 2 ) after aerobic exercise training using the noninvasive, inspiratory muscle tension-time index (T T0.1 ). Measurements performed included anthropometric parameters, lung function assessed by spirometry, rate of perceived breathlessness with the modified Borg dyspnea scale (0-10), breathing pattern, maximal exercise capacity, and inspiratory muscle performance with a breath-by-breath automated exercise metabolic system during an incremental exercise test. T T0.1 was calculated using the equation, T T0.1 = P 0.1 /P Imax × T I /T tot (where P 0.1 represents mouth occlusion pressure, P Imax is maximal inspiratory pressure, and T I /T tot is the duty cycle). At rest, there was no statistically significant difference for spirometric parameters and cardiorespiratory parameters between pre- and post-training. At maximal exercise, the minute ventilation, the rate of exchange ratio, the rate of perceived breathlessness, and the respiratory muscle performance parameters were not significantly different pre- and post-training; in contrast, tidal volume ( P = .037, effect size = 1.51), breathing frequency ( P = .049, effect size = 0.97), power output ( P = .048, effect size = 0.79), peak oxygen uptake ( P = .02, effect size = 0.92) were significantly higher after training. At comparable work load, training induces lower minute ventilation, mouth occlusion pressure, ratio of occlusion pressure to maximal inspiratory pressure, T T0.1 , and rate of perceived breathlessness. Aerobic exercise at ventilatory threshold can induce significant improvement in respiratory muscle strength, maximal exercise capacity, and inspiratory muscle performance and decreased dyspnea perception in obese subjects. Copyright © 2017 by Daedalus Enterprises.

A Gaussian method to improve work-of-breathing calculations.

PubMed

Petrini, M F; Evans, J N; Wall, M A; Norman, J R

1995-01-01

The work of breathing is a calculated index of pulmonary function in ventilated patients that may be useful in deciding when to wean and when to extubate. However, the accuracy of the calculated work of breathing of the patient (WOBp) can suffer from artifacts introduced by coughing, swallowing, and other non-breathing maneuvers. The WOBp in this case will include not only the usual work of inspiration, but also the work of performing these non-breathing maneuvers. The authors developed a method to objectively eliminate the calculated work of these movements from the work of breathing, based on fitting to a Gaussian curve the variable P, which is obtained from the difference between the esophageal pressure change and the airway pressure change during each breath. In spontaneously breathing adults the normal breaths fit the Gaussian curve, while breaths that contain non-breathing maneuvers do not. In this Gaussian breath-elimination method (GM), breaths that are two standard deviations from that mean obtained by the fit are eliminated. For normally breathing control adult subjects, GM had little effect on WOBp, reducing it from 0.49 to 0.47 J/L (n = 8), while there was a 40% reduction in the coefficient of variation. Non-breathing maneuvers were simulated by coughing, which increased WOBp to 0.88 (n = 6); with the GM correction, WOBp was 0.50 J/L, a value not significantly different from that of normal breathing. Occlusion also increased WOBp to 0.60 J/L, but GM-corrected WOBp was 0.51 J/L, a normal value. As predicted, doubling the respiratory rate did not change the WOBp before or after the GM correction.(ABSTRACT TRUNCATED AT 250 WORDS)

Dusts and Molds

MedlinePlus

... almost impossible to avoid if you work in agriculture. But you can limit your exposure by taking ... such as the quartz dust common in California agriculture, can also lead to decreased breathing capacity over ...

Effects of microgravity on tissue perfusion and the efficacy of astronaut denitrogenation for EVA

NASA Technical Reports Server (NTRS)

Gerth, Wayne A.; Vann, Richard D.; Leatherman, Nelson E.; Feezor, Michael D.

1987-01-01

A potentially flight-applicable, breath-by-breath method for measuring N2 elimination from human subjects breathing 100 percent O2 for 2-3 hr periods has been developed. The present report describes this development with particular emphasis on required methodological accuracy and its achievement in view of certain properties of mass spectrometer performance. A method for the breath-by-breath analysis of errors in measured N2 elimination profiles is also described.

Exhaled human breath measurement method for assessing exposure to halogenated volatile organic compounds.

PubMed

Pleil, J D; Lindstrom, A B

1997-05-01

The organic constituents of exhaled human breath are representative of blood-borne concentrations through gas exchange in the blood/breath interface in the lungs. The presence of specific compounds can be an indicator of recent exposure or represent a biological response of the subject. For volatile organic compounds (VOCs), sampling and analysis of breath is preferred to direct measurement from blood samples because breath collection is noninvasive, potentially infectious waste is avoided, and the measurement of gas-phase analytes is much simpler in a gas matrix rather than in a complex biological tissue such as blood. To exploit these advantages, we have developed the "single breath canister" (SBC) technique, a simple direct collection method for individual alveolar breath samples, and adapted conventional gas chromatography-mass spectrometry analytical methods for trace-concentration VOC analysis. The focus of this paper is to describe briefly the techniques for making VOC measurements in breath, to present some specific applications for which these methods are relevant, and to demonstrate how to estimate exposure to example VOCs on the basis of breath elimination. We present data from three different exposure scenarios: (a) vinyl chloride and cis-1,2-dichloroethene from showering with contaminated water from a private well, (b) chloroform and bromodichloromethane from high-intensity swimming in chlorinated pool water, and (c) trichloroethene from a controlled exposure chamber experiment. In all cases, for all subjects, the experiment is the same: preexposure breath measurement, exposure to halogenated VOC, and a postexposure time-dependent series of breath measurements. Data are presented only to demonstrate the use of the method and how to interpret the analytical results.

Respiratory rate extraction from pulse oximeter and electrocardiographic recordings.

PubMed

Lee, Jinseok; Florian, John P; Chon, Ki H

2011-11-01

We present an algorithm of respiratory rate extraction using particle filter (PF), which is applicable to both photoplethysmogram (PPG) and electrocardiogram (ECG) signals. For the respiratory rate estimation, 1 min data are analyzed with combination of a PF method and an autoregressive model where among the resultant coefficients, the corresponding pole angle with the highest magnitude is searched since this reflects the closest approximation of the true breathing rate. The PPG data were collected from 15 subjects with the metronome breathing rate ranging from 24 to 36 breaths per minute in the supine and upright positions. The ECG data were collected from 11 subjects with spontaneous breathing ranging from 36 to 60 breaths per minute during treadmill exercises. Our method was able to accurately extract respiratory rates for both metronome and spontaneous breathing even during strenuous exercises. More importantly, despite slow increases in breathing rates concomitant with greater exercise vigor with time, our method was able to accurately track these progressive increases in respiratory rates. We quantified the accuracy of our method by using the mean, standard deviation and interquartile range of the error rates which all reflected high accuracy in estimating the true breathing rates. We are not aware of any other algorithms that are able to provide accurate respiratory rates directly from either ECG signals or PPG signals with spontaneous breathing during strenuous exercises. Our method is near real-time realizable because the computational time on 1 min data segment takes only 10 ms on a 2.66 GHz Intel Core2 microprocessor; the data are subsequently shifted every 10 s to obtain near-continuous breathing rates. This is an attractive feature since most other techniques require offline data analyses to estimate breathing rates.

Measurement of xenon diffusing capacity in the rat lung by hyperpolarized 129Xe MRI and dynamic spectroscopy in a single breath-hold.

PubMed

Abdeen, Nishard; Cross, Albert; Cron, Gregory; White, Steven; Rand, Thomas; Miller, David; Santyr, Giles

2006-08-01

We used the dual capability of hyperpolarized 129Xe for spectroscopy and imaging to develop new measures of xenon diffusing capacity in the rat lung that (analogously to the diffusing capacity of carbon monoxide or DLCO) are calculated as a product of total lung volume and gas transfer rate constants divided by the pressure gradient. Under conditions of known constant pressure breath-hold, the volume is measured by hyperpolarized 129Xe MRI, and the transfer rate is measured by dynamic spectroscopy. The new quantities (xenon diffusing capacity in lung parenchyma (DLXeLP)), xenon diffusing capacity in RBCs (DLXeRBC), and total lung xenon diffusing capacity (DLXe)) were measured in six normal rats and six rats with lung inflammation induced by instillation of fungal spores of Stachybotrys chartarum. DLXeLP, DLXeRBC, and DLXe were 56 +/- 10 ml/min/mmHg, 64 +/- 35 ml/min/mmHg, and 29 +/- 9 ml/min/mmHg, respectively, for normal rats, and 27 +/- 9 ml/min/mmHg, 42 +/- 27 ml/min/mmHg, and 16 +/- 7 ml/min/mmHg, respectively, for diseased rats. Lung volumes and gas transfer times for LP (TtrLP) were 16 +/- 2 ml and 22 +/- 3 ms, respectively, for normal rats and 12 +/- 2 ml and 35 +/- 8 ms, respectively, for diseased rats. Xenon diffusing capacities may be useful for measuring changes in gas exchange associated with inflammation and other lung diseases. Copyright 2006 Wiley-Liss, Inc.

SU-E-J-178: A Normalization Method Can Remove Discrepancy in Ventilation Function Due to Different Breathing Patterns

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qu, H; Yu, N; Stephans, K

2014-06-01

Purpose: To develop a normalization method to remove discrepancy in ventilation function due to different breathing patterns. Methods: Twenty five early stage non-small cell lung cancer patients were included in this study. For each patient, a ten phase 4D-CT and the voluntarily maximum inhale and exhale CTs were acquired clinically and retrospectively used for this study. For each patient, two ventilation maps were calculated from voxel-to-voxel CT density variations from two phases of the quiet breathing and two phases of the extreme breathing. For the quiet breathing, 0% (inhale) and 50% (exhale) phases from 4D-CT were used. An in-house toolmore » was developed to calculate and display the ventilation maps. To enable normalization, the whole lung of each patient was evenly divided into three parts in the longitude direction at a coronal image with a maximum lung cross section. The ratio of cumulated ventilation from the top one-third region to the middle one-third region of the lung was calculated for each breathing pattern. Pearson's correlation coefficient was calculated on the ratios of the two breathing patterns for the group. Results: For each patient, the ventilation map from the quiet breathing was different from that of the extreme breathing. When the cumulative ventilation was normalized to the middle one-third of the lung region for each patient, the normalized ventilation functions from the two breathing patterns were consistent. For this group of patients, the correlation coefficient of the normalized ventilations for the two breathing patterns was 0.76 (p < 0.01), indicating a strong correlation in the ventilation function measured from the two breathing patterns. Conclusion: For each patient, the ventilation map is dependent of the breathing pattern. Using a regional normalization method, the discrepancy in ventilation function induced by the different breathing patterns thus different tidal volumes can be removed.« less

[Evaluation of benefits of the course of positive pressure breathing training on exercise performance].

PubMed

Medvedev, D V; Gorbaneva, E P; Iumatova, S N; Kuznetsova, T Iu; Solopov, I N; Katuntsev, V P

2007-01-01

The purpose was to evaluate effects of muscle training combined with positive pressure breathing on exercise performance of 16 runners at the age of 18-20. All subjects had the first or second-class sport qualification. The 4-wk. training course for the experimental group (n=11) included 20-25% of exercises performed in an aperture mask creating an inspiration-expiration resistance of 8-10 mm H2O. The control group (n=5) worked on the same training course but w/o positive pressure breathing. The course began and ended with the PWC170 test in order to evaluate exercise performance. Indices of external respiration and gas exchange were determined on metabolograph Ergooxyscreen (Jaeger) and lung-tester Spirosift-3000 (Fukuda). Inspiration and expiration force of the breathing muscles (mm Hg) was measured isometrically with the help of a pneumomanometer. Heart rate was calculated from ECG R-R intervals. It was stated that positive pressure breathing during muscle training increases significantly sportsmen's exercise performance due to growth of the body spare capacities, and optimization of the body systems dependence structure and efficiency.

Ventilatory responses at peak exercise in endurance-trained obese adults.

PubMed

Lorenzo, Santiago; Babb, Tony G

2013-10-01

Alterations in respiratory mechanics predispose healthy obese individuals to low lung volume breathing, which places them at risk of developing expiratory flow limitation (EFL). The high ventilatory demand in endurance-trained obese adults further increases their risk of developing EFL and increases their work of breathing. The objective of this study was to investigate the prevalence and magnitude of EFL in fit obese (FO) adults via measurements of breathing mechanics and ventilatory dynamics during exercise. Ten (seven women and three men) FO (mean ± SD, 38 ± 5 years, 38% ± 5% body fat) and 10 (seven women and three men) control obese (CO) (38 ± 5 years, 39% ± 5% body fat) subjects underwent hydrostatic weighing, pulmonary function testing, cycle exercise testing, and the determination of the oxygen cost of breathing during eucapnic voluntary hyperpnea. There were no differences in functional residual capacity (43% ± 6% vs 40% ± 9% total lung capacity [TLC]), residual volume (21% ± 4% vs 21% ± 4% TLC), or FVC (111% ± 13% vs 104% ± 15% predicted) between FO and CO subjects, respectively. FO subjects had higher FEV1 (111% ± 13% vs 99% ± 11% predicted), TLC (106% ± 14% vs 94% ± 7% predicted), peak expiratory flow (123% ± 14% vs 106% ± 13% predicted), and maximal voluntary ventilation (128% ± 15% vs 106% ± 13% predicted) than did CO subjects. Peak oxygen uptake (129% ± 16% vs 86% ± 15% predicted), minute ventilation (128 ± 35 L/min vs 92 ± 25 L/min), and work rate (229 ± 54 W vs 166 ± 55 W) were higher in FO subjects. Mean inspiratory (4.65 ± 1.09 L/s vs 3.06 ± 1.21 L/s) and expiratory (4.15 ± 0.95 L/s vs 2.98 ± 0.76 L/s) flows were greater in FO subjects, which yielded a greater breathing frequency (51 ± 8 breaths/min vs 41 ± 10 breaths/min) at peak exercise in FO subjects. Mechanical ventilatory constraints in FO subjects were similar to those in CO subjects despite the greater ventilatory demand in FO subjects. FO individuals achieve high ventilations by increasing breathing frequency, matching the elevated metabolic demand associated with high fitness. They do this without developing meaningful ventilatory constraints. Therefore, endurance-trained obese individuals with higher lung function are not limited by breathing mechanics during peak exercise, which may allow healthy obese adults to participate in vigorous exercise training.

Balancing the competing requirements of air-breathing and display behaviour during male-male interactions in Siamese fighting fish Betta splendens.

PubMed

Alton, Lesley A; Portugal, Steven J; White, Craig R

2013-02-01

Air-breathing fish of the Anabantoidei group meet their metabolic requirements for oxygen through both aerial and aquatic gas exchange. Siamese fighting fish Betta splendens are anabantoids that frequently engage in aggressive male-male interactions which cause significant increases in metabolic rate and oxygen requirements. These interactions involve opercular flaring behaviour that is thought to limit aquatic oxygen uptake, and combines with the increase in metabolic rate to cause an increase in air-breathing behaviour. Air-breathing events interrupt display behaviour and increase risk of predation, raising the question of how Siamese fighting fish manage their oxygen requirements during agonistic encounters. Using open-flow respirometry, we measured rate of oxygen consumption in displaying fish to determine if males increase oxygen uptake per breath to minimise visits to the surface, or increase their reliance on aquatic oxygen uptake. We found that the increased oxygen requirements of Siamese fighting fish during display behaviour were met by increased oxygen uptake from the air with no significant changes in aquatic oxygen uptake. The increased aerial oxygen uptake was achieved almost entirely by an increase in air-breathing frequency. We conclude that limitations imposed by the reduced gill surface area of air-breathing fish restrict the ability of Siamese fighting fish to increase aquatic uptake, and limitations of the air-breathing organ of anabantoids largely restrict their capacity to increase oxygen uptake per breath. The resulting need to increase surfacing frequency during metabolically demanding agonistic encounters has presumably contributed to the evolution of the stereotyped surfacing behaviour seen during male-male interactions, during which one of the fish will lead the other to the surface, and each will take a breath of air. Copyright © 2012. Published by Elsevier Inc.

The distribution of mitochondria-rich cells in the gills of air-breathing fishes.

PubMed

Lin, Hui-Chen; Sung, Wen-Ting

2003-01-01

Respiration and ion regulation are the two principal functions of teleostean gills. Mainly found in the gill filaments of fish, mitochondria-rich cells (MRCs) proliferate to increase the ionoregulatory capacity of the gill in response to osmotic challenges. Gill lamellae consist mostly of pavement cells, which are the major site of gas exchange. Although lamellar MRCs have been reported in some fish species, there has been little discussion of which fish species are likely to have lamellar MRCs. In this study, we first compared the number of filament and lamellar MRCs in air-breathing and non-air-breathing fish species acclimated to freshwater and 5 g NaCl L(-1) conditions. An increase in filament MRCs was found in both air-breathing and non-air-breathing fish acclimated to freshwater. Lamellar MRCs were found only in air-breathing species, but the number of lamellar MRCs did not change significantly with water conditions, except in Periophthalmus cantonensis. Next, we surveyed the distribution of MRCs in the gills of 66 fish species (including 29 species from the previous literature) from 12 orders, 28 families, and 56 genera. Our hypothesis that lamellar MRCs are more likely to be found in air-breathing fishes was supported by a significant association between the presence of lamellar MRCs and the mode of breathing at three levels of systematic categories (species, genus, and family). Based on this integrative view of the multiple functions of fish gills, we should reexamine the role of MRCs in freshwater fish.

Collecting Protein Biomarkers in Breath Using Electret Filters: A Preliminary Method on New Technical Model and Human Study.

PubMed

Li, Wang; Pi, Xitian; Qiao, Panpan; Liu, Hongying

2016-01-01

Biomarkers in exhaled breath are useful for respiratory disease diagnosis in human volunteers. Conventional methods that collect non-volatile biomarkers, however, necessitate an extensive dilution and sanitation processes that lowers collection efficiencies and convenience of use. Electret filter emerged in recent decade to collect virus biomarkers in exhaled breath given its simplicity and effectiveness. To investigate the capability of electret filters to collect protein biomarkers, a model that consists of an atomizer that produces protein aerosol and an electret filter that collects albumin and carcinoembryonic antigen-a typical biomarker in lung cancer development- from the atomizer is developed. A device using electret filter as the collecting medium is designed to collect human albumin from exhaled breath of 6 volunteers. Comparison of the collecting ability between the electret filter method and other 2 reported methods is finally performed based on the amounts of albumin collected from human exhaled breath. In conclusion, a decreasing collection efficiency ranging from 17.6% to 2.3% for atomized albumin aerosol and 42% to 12.5% for atomized carcinoembryonic antigen particles is found; moreover, an optimum volume of sampling human exhaled breath ranging from 100 L to 200 L is also observed; finally, the self-designed collecting device shows a significantly better performance in collecting albumin from human exhaled breath than the exhaled breath condensate method (p<0.05) but is not significantly more effective than reported 3-stage impactor method (p>0.05). In summary, electret filters are potential in collecting non-volatile biomarkers in human exhaled breath not only because it was simpler, cheaper and easier to use than traditional methods but also for its better collecting performance.

Systems for Lung Volume Standardization during Static and Dynamic MDCT-based Quantitative Assessment of Pulmonary Structure and Function

PubMed Central

Fuld, Matthew K.; Grout, Randall; Guo, Junfeng; Morgan, John H.; Hoffman, Eric A.

2013-01-01

Rationale and Objectives Multidetector-row Computed Tomography (MDCT) has emerged as a tool for quantitative assessment of parenchymal destruction, air trapping (density metrics) and airway remodeling (metrics relating airway wall and lumen geometry) in chronic obstructive pulmonary disease (COPD) and asthma. Critical to the accuracy and interpretability of these MDCT-derived metrics is the assurance that the lungs are scanned during a breath-hold at a standardized volume. Materials and Methods A computer monitored turbine-based flow meter system was developed to control patient breath-holds and facilitate static imaging at fixed percentages of the vital capacity. Due to calibration challenges with gas density changes during multi-breath xenon-CT an alternative system was required. The design incorporated dual rolling seal pistons. Both systems were tested in a laboratory environment and human subject trials. Results The turbine-based system successfully controlled lung volumes in 32/37 subjects, having a linear relationship for CT measured air volume between repeated scans: for all scans, the mean and confidence interval of the differences (scan1-scan2) was −9 ml (−169, 151); for TLC alone 6 ml (−164, 177); for FRC alone, −23 ml (−172, 126). The dual-piston system successfully controlled lung volume in 31/41 subjects. Study failures related largely to subject non-compliance with verbal instruction and gas leaks around the mouthpiece. Conclusion We demonstrate the successful use of a turbine-based system for static lung volume control and demonstrate its inadequacies for dynamic xenon-CT studies. Implementation of a dual-rolling seal spirometer has been shown to adequately control lung volume for multi-breath wash-in xenon-CT studies. These systems coupled with proper patient coaching provide the tools for the use of CT to quantitate regional lung structure and function. The wash-in xenon-CT method for assessing regional lung function, while not necessarily practical for routine clinical studies, provides for a dynamic protocol against which newly emerging single breath, dual-energy xenon-CT measures can be validated. PMID:22555001

Forced vital capacity and not central chemoreflex predicts maximal hyperoxic breath-hold duration in elite apneists.

PubMed

Bain, Anthony R; Barak, Otto F; Hoiland, Ryan L; Drvis, Ivan; Bailey, Damian M; Dujic, Zeljko; Mijacika, Tanja; Santoro, Antoinette; DeMasi, Daniel K; MacLeod, David B; Ainslie, Philip N

2017-08-01

The determining mechanisms of a maximal hyperoxic apnea duration in elite apneists have remained unexplored. We tested the hypothesis that maximal hyperoxic apnea duration in elite apneists is related to forced vital capacity (FVC) but not the central chemoreflex (for CO 2 ). Eleven elite apneists performed a maximal dry static-apnea with prior hyperoxic (100% oxygen) pre-breathing, and a central chemoreflex test via a hyperoxic re-breathing technique (hyperoxic-hypercapnic ventilatory response: HCVR); expressed as the increase in ventilation (pneumotachometry) per increase in arterial CO 2 tension (PaCO 2 ; radial artery). FVC was assessed using standard spirometry. Maximal apnea duration ranged from 807 to 1262s (mean=1034s). Average HCVR was 2.0±1.2Lmin -1 mmHg -1 PaCO 2 . The hyperoxic apnea duration was related to the FVC (r 2 =0.45, p<0.05), but not the HCVR (r 2 <0.01, p>0.05). These findings were interpreted to suggest that during a hyperoxic apnea, a larger initial lung volume prolongs the time before reaching intolerable discomfort associated with pending lung squeeze, while CO 2 sensitivity has little impact. Copyright © 2017 Elsevier B.V. All rights reserved.

All puffed out: do pufferfish hold their breath while inflated?

PubMed Central

McGee, Georgia Evelyn; Clark, Timothy Darren

2014-01-01

The inflation response of pufferfishes is one of the most iconic predator defence strategies in nature. Current dogma suggests that pufferfish inflation represents a breath-holding response, whereby gill oxygen uptake ceases for the duration of inflation and cutaneous respiration increases to compensate. Here, we show that the black-saddled pufferfish (Canthigaster valentini) has an excellent capacity for oxygen uptake while inflated, with uptake rates increasing to five-times that of resting levels. Moreover, we show that this species has negligible capacity for cutaneous respiration, concluding that the gills are the primary site of oxygen uptake while inflated. Despite this, post-deflation recovery of aerobic metabolism took an average of 5.6 h, suggesting a contribution of anaerobic metabolism during pre-inflation activity and during the act of ingesting water to achieve inflation. PMID:25472941

Does air-breathing meet metabolic demands of the juvenile snakehead, Channa argus, in multiple conditions

PubMed Central

Li, Yongli; Lv, Xiao; Zhou, Jing; Shi, Chenchen; Duan, Ting

2017-01-01

ABSTRACT The objective of this study was to examine how the respiratory metabolism of the snakehead Channa argus changed when it shifted from breathing water to breathing air, and how increased metabolic demands caused by temperature, feeding, and exhaustive exercise affect its survival in air. The results demonstrated that the oxygen consumption rate (MO2) of the snakehead was lower for aerial respiration than aquatic respiration by 12.1, 24.5 and 20.4% at 20, 25, and 30°C, respectively. Survival time was significantly shortened with increasing temperature and was negatively correlated with the resting MO2 in air (MO2Air). No obvious feeding metabolic response was observed in the snakeheads fed at 1% and 3% body mass levels while breathing air. The maximum MO2Air of the snakehead after exhaustive exercise was significantly higher than the resting MO2Air of the control group. The results suggest that the snakehead could survive out of water by breathing air for varying lengths of time, depending on ambient temperature and metabolic demand. Additionally, some degree of metabolic depression occurs in the snakehead when breathing air. The metabolic demand associated with exercise in the snakehead, but not that associated with feeding, can be supported by its capacity for breathing air to some extent. PMID:28396489

Apparatus and method for monitoring breath acetone and diabetic diagnostics

DOEpatents

Duan, Yixiang [Los Alamos, NM; Cao, Wenqing [Los Alamos, NM

2008-08-26

An apparatus and method for monitoring diabetes through breath acetone detection and quantitation employs a microplasma source in combination with a spectrometer. The microplasma source provides sufficient energy to produce excited acetone fragments from the breath gas that emit light. The emitted light is sent to the spectrometer, which generates an emission spectrum that is used to detect and quantify acetone in the breath gas.

Robust optimization methods for cardiac sparing in tangential breast IMRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mahmoudzadeh, Houra, E-mail: houra@mie.utoronto.ca; Lee, Jenny; Chan, Timothy C. Y.

Purpose: In left-sided tangential breast intensity modulated radiation therapy (IMRT), the heart may enter the radiation field and receive excessive radiation while the patient is breathing. The patient’s breathing pattern is often irregular and unpredictable. We verify the clinical applicability of a heart-sparing robust optimization approach for breast IMRT. We compare robust optimized plans with clinical plans at free-breathing and clinical plans at deep inspiration breath-hold (DIBH) using active breathing control (ABC). Methods: Eight patients were included in the study with each patient simulated using 4D-CT. The 4D-CT image acquisition generated ten breathing phase datasets. An average scan was constructedmore » using all the phase datasets. Two of the eight patients were also imaged at breath-hold using ABC. The 4D-CT datasets were used to calculate the accumulated dose for robust optimized and clinical plans based on deformable registration. We generated a set of simulated breathing probability mass functions, which represent the fraction of time patients spend in different breathing phases. The robust optimization method was applied to each patient using a set of dose-influence matrices extracted from the 4D-CT data and a model of the breathing motion uncertainty. The goal of the optimization models was to minimize the dose to the heart while ensuring dose constraints on the target were achieved under breathing motion uncertainty. Results: Robust optimized plans were improved or equivalent to the clinical plans in terms of heart sparing for all patients studied. The robust method reduced the accumulated heart dose (D10cc) by up to 801 cGy compared to the clinical method while also improving the coverage of the accumulated whole breast target volume. On average, the robust method reduced the heart dose (D10cc) by 364 cGy and improved the optBreast dose (D99%) by 477 cGy. In addition, the robust method had smaller deviations from the planned dose to the accumulated dose. The deviation of the accumulated dose from the planned dose for the optBreast (D99%) was 12 cGy for robust versus 445 cGy for clinical. The deviation for the heart (D10cc) was 41 cGy for robust and 320 cGy for clinical. Conclusions: The robust optimization approach can reduce heart dose compared to the clinical method at free-breathing and can potentially reduce the need for breath-hold techniques.« less

Qualitative assessment of contrast-enhanced magnetic resonance angiography using breath-hold and non-breath-hold techniques in the portal venous system

NASA Astrophysics Data System (ADS)

Goo, Eun-Hoe; Kim, Sun-Ju; Dong, Kyung-Rae; Kim, Kwang-Choul; Chung, Woon-Kwan

2016-09-01

The purpose of this study is to evaluate the image quality in delineation of the portal venous systems with two different methods, breath-hold and non-breath-hold by using the 3D FLASH sequence. We used a 1.5 T system to obtain magnetic resonance(MR)images. Arterial and portal phase 3D FLASH images were obtained with breath-hold after a bolus injection of GD-DOTA. The detection of PVS on the MR angiograms was classified into three grades. First, the angiograms of the breath-hold method showed well the portal vein, the splenic vein and the superior mesenteric vein systems in 13 of 15 patients (86%) and the inferior mesenteric vein system in 6 of 15 patients (40%), Second, MR angiograms of the non-breath-hold method demonstrated the PVS and the SMV in 12 of 15 patients (80%) and the IMV in 5 of 15 patients (33%). Our study showed contrast-enhanced 3D FLASH MR angiography, together with the breath-hold technique, may provide reliable and accurate information on the portal venous system.

Effects of breathing exercises on lung capacity and muscle activities of elderly smokers.

PubMed

Jun, Hyun-Ju; Kim, Ki-Jong; Nam, Ki-Won; Kim, Chang-Heon

2016-06-01

[Purpose] Elderly smokers have a reduced chest diameter due to weakening of the respiratory muscles, and this results in decreased ventilation, leading to a vicious circle. Therefore, the present study investigated the effects of an intervention program to enhance the pulmonary function and muscle activity of elderly smokers. [Subjects and Methods] Participants were randomly assigned to one of two experimental groups or a control (CG) group. The experimental groups performed exercises three times per week for six weeks, whereas the CG performed no exercises. One of the experimental groups performed a Feedback Breathing Exercise (FBE) for 15 minutes, and the other repeated three sets of Balloon-Blowing Exercises (BBE) with sufficient rest of more than one minute between sets. [Results] In the experimental groups, FVC, FEV1/FVC, PEF and muscle activity of the rectus abdominis significantly improved after four weeks, but no significant differences were observed in FEV1 or VC after six weeks. [Conclusion] The results show that FBE and BBE improved the pulmonary functions of elderly smokers, demonstrating the potential benefits of the development of various training methods using balloons, and group programs, including recreational factors, for increasing respiratory muscles strength.

Effects of breathing exercises on lung capacity and muscle activities of elderly smokers

PubMed Central

Jun, Hyun-Ju; Kim, Ki-Jong; Nam, Ki-Won; Kim, Chang-Heon

2016-01-01

[Purpose] Elderly smokers have a reduced chest diameter due to weakening of the respiratory muscles, and this results in decreased ventilation, leading to a vicious circle. Therefore, the present study investigated the effects of an intervention program to enhance the pulmonary function and muscle activity of elderly smokers. [Subjects and Methods] Participants were randomly assigned to one of two experimental groups or a control (CG) group. The experimental groups performed exercises three times per week for six weeks, whereas the CG performed no exercises. One of the experimental groups performed a Feedback Breathing Exercise (FBE) for 15 minutes, and the other repeated three sets of Balloon-Blowing Exercises (BBE) with sufficient rest of more than one minute between sets. [Results] In the experimental groups, FVC, FEV1/FVC, PEF and muscle activity of the rectus abdominis significantly improved after four weeks, but no significant differences were observed in FEV1 or VC after six weeks. [Conclusion] The results show that FBE and BBE improved the pulmonary functions of elderly smokers, demonstrating the potential benefits of the development of various training methods using balloons, and group programs, including recreational factors, for increasing respiratory muscles strength. PMID:27390394

Sensorimotor control of breathing in the mdx mouse model of Duchenne muscular dystrophy.

PubMed

Burns, David P; Roy, Arijit; Lucking, Eric F; McDonald, Fiona B; Gray, Sam; Wilson, Richard J; Edge, Deirdre; O'Halloran, Ken D

2017-11-01

Respiratory failure is a leading cause of mortality in Duchenne muscular dystrophy (DMD), but little is known about the control of breathing in DMD and animal models. We show that young (8 weeks of age) mdx mice hypoventilate during basal breathing due to reduced tidal volume. Basal CO 2 production is equivalent in wild-type and mdx mice. We show that carotid bodies from mdx mice have blunted responses to hyperoxia, revealing hypoactivity in normoxia. However, carotid body, ventilatory and metabolic responses to hypoxia are equivalent in wild-type and mdx mice. Our study revealed profound muscle weakness and muscle fibre remodelling in young mdx diaphragm, suggesting severe mechanical disadvantage in mdx mice at an early age. Our novel finding of potentiated neural motor drive to breathe in mdx mice during maximal chemoactivation suggests compensatory neuroplasticity enhancing respiratory motor output to the diaphragm and probably other accessory muscles. Patients with Duchenne muscular dystrophy (DMD) hypoventilate with consequential arterial blood gas derangement relevant to disease progression. Whereas deficits in DMD diaphragm are recognized, there is a paucity of knowledge in respect of the neural control of breathing in dystrophinopathies. We sought to perform an analysis of respiratory control in a model of DMD, the mdx mouse. In 8-week-old male wild-type and mdx mice, ventilation and metabolism, carotid body afferent activity, diaphragm muscle force-generating capacity, and muscle fibre size, distribution and centronucleation were determined. Diaphragm EMG activity and responsiveness to chemostimulation was determined. During normoxia, mdx mice hypoventilated, owing to a reduction in tidal volume. Basal CO 2 production was not different between wild-type and mdx mice. Carotid sinus nerve responses to hyperoxia were blunted in mdx, suggesting hypoactivity. However, carotid body, ventilatory and metabolic responses to hypoxia were equivalent in wild-type and mdx mice. Diaphragm force was severely depressed in mdx mice, with evidence of fibre remodelling and damage. Diaphragm EMG responses to chemoactivation were enhanced in mdx mice. We conclude that there is evidence of chronic hypoventilation in young mdx mice. Diaphragm dysfunction confers mechanical deficiency in mdx resulting in impaired capacity to generate normal tidal volume at rest and decreased absolute ventilation during chemoactivation. Enhanced mdx diaphragm EMG responsiveness suggests compensatory neuroplasticity facilitating respiratory motor output, which may extend to accessory muscles of breathing. Our results may have relevance to emerging treatments for human DMD aiming to preserve ventilatory capacity. © 2017 The Authors. The Journal of Physiology © 2017 The Physiological Society.

Comparative ex vivo study on humidifying function of three speaking valves with integrated heat and moisture exchanger for tracheotomised patients.

PubMed

van den Boer, C; Lansaat, L; Muller, S H; van den Brekel, M W M; Hilgers, F J M

2015-12-01

Assessment of humidifying function of tracheotomy speaking valves with integrated heat and moisture exchanger. Ex vivo measurement of water exchange and storage capacity of three tracheotomy speaking valves: Humidiphon Plus, Spiro and ProTrach DualCare (with two different heat and moisture exchangers: XtraMoist and Regular). Comprehensive Cancer Centre. Healthy volunteer. Difference between end-inspiratory and end-expiratory weight as measure for water exchange capacity, weight after 10 min breathing as measure for water storage capacity, weighing at 1-min intervals to assess residual water exchange potential in speaking mode and absolute humidity in mg/L as measure for environmental and respiratory humidity. None of the tracheotomy speaking valves provides humidification while in speaking mode. Only the ProTrach DualCare allows blocking the speaking valve and breathing through the heat and moisture exchanger during inhalation and exhalation (heat and moisture exchanger mode). This leads to an increase in inspiratory humidity of 2.5 mg (XtraMoist) and 1.6 mg (Regular). There was no measurable water storage in speaking mode in any of the three tracheotomy speaking valves. In breathing mode, water storage in the DualCare heat and moisture exchangers was 47 and 37 mg, respectively. The remaining humidifying potential in speaking mode after 10 min breathing in heat and moisture exchanger mode for XtraMoist was 38%, 15% and 10% at 1, 2 and 3 min, respectively. For Regular, this was 47%, 24% and 13%, respectively. Tracheostoma valves with integrated heat and moisture exchanger have no humidification function in speaking mode. Only ProTrach DualCare, allowing blocking the speaking mode, in heat and moisture exchanger mode enables a significant increase in humidification. Regular switching between speaking and heat and moisture exchanger mode with this latter device prolongs the humidification in speaking mode. © 2015 John Wiley & Sons Ltd.

Quantification of Aerosol Hydrofluoroalkane HFA‐134a Elimination in the Exhaled Human Breath Following Inhaled Corticosteroids Administration

PubMed Central

Barletta, Barbara; Yoonessi, Leila; Meinardi, Simone; Leu, Szu‐Yun; Radom‐Aizik, Shlomit; Randhawa, Inderpal; Nussbaum, Eliezer; Blake, Donald R.; Cooper, Dan M.

2015-01-01

Abstract Inhaled corticosteroids (ICS) and β2‐agonists are the primary pharmacotherapies of asthma management. However, suboptimal medication compliance is common in asthmatics and is associated with increased morbidity. We hypothesized that exhaled breath measurements of the aerosol used in the inhaled medications might prove useful as surrogate marker for asthma medication compliance. To explore this, 10 healthy controls were recruited and randomly assigned to ICS (Flovent HFA) or short acting bronchodilators (Proventil HFA). Both inhalers contain HFA‐134a as aerosol propellant. Exhaled breath sampling and pulmonary function tests were performed prior to the inhaler medication dispersion, immediately after inhalation, then at 2, 4, 6, 8, 24, and 48 hours postadministration. At baseline, mean (SD) levels of HFA‐134a in the breath were 252 (156) pptv. Immediately after inhalation, HFA‐134a breath levels increased to 300 × 106 pptv and were still well above ambient levels 24 hours postadministration. The calculated ratio of forced expiratory volume in 1 second over forced vital capacity did not change over time following inhaler administration. This study demonstrates, for the first time, that breath HFA‐134a levels can be used to assess inhaler medication compliance. It may also be used to evaluate how effectively the medicine is delivered. PMID:26155923

Syllable-Related Breathing in Infants in the Second Year of Life

ERIC Educational Resources Information Center

Parham, Douglas F.; Buder, Eugene H.; Oller, D. Kimbrough; Boliek, Carol A.

2011-01-01

Purpose: This study explored whether breathing behaviors of infants within the 2nd year of life differ between tidal breathing and breathing supporting single unarticulated syllables and canonical/articulated syllables. Method: Vocalizations and breathing kinematics of 9 infants between 53 and 90 weeks of age were recorded. A strict selection…

Metabolism: The Physiological Power-Generating Process: A History of Methods to Test Human Beings' \\"Vital Capacity\\" [Retrospectroscope].

PubMed

Johnston, Richard; Valentinuzzi, Max E

2016-01-01

A previous "Retrospectroscope" note, published early in 2014, dealt with spirometry: it described many apparatuses used to measure the volume of inhaled and exhaled air that results from breathing [1]. Such machines, when adequately modified, are also able to measure the rate at which work is produced (specifically by an animal or a human being). Metabolism in that sense is the term used by physiologists and physicians, a word that in Greek, metabolismos, means "change" or "overthrow," in the sense of breaking down material, as in burning some stuff.

Solitons with Gaussian tails in dispersion-managed communication systems using gratings

NASA Astrophysics Data System (ADS)

Mezentsev, Vladimir K.; Turitsyn, Sergei K.

1997-02-01

We examine the transmission of optical pulses in fibre communication systems with dispersion management. It is shown that solitons with Gaussian tails may be formed by the adoption of gratings to periodically compensate a pulse chirp. Fast decaying Gaussian tails allow us to provide denser information packing in comparison with sech-type soliton transmission. The discovered pulse is an attractive candidate for use as information carrier in optical transmission systems with an ultra-large capacity of around 100 Gbit/s. It is shown that a variational method can be effectively used to describe the dynamics of the breathing soliton.

Neither Serotonin nor Adenosine-dependent Mechanisms Preserve Ventilatory Capacity in ALS rats

PubMed Central

Nichols, N.L.; Johnson, R.A.; Satriotomo, I.; Mitchell, G.S.

2014-01-01

In rats over-expressing SOD1G93A, ventilation is preserved despite significant loss of respiratory motor neurons. Thus, unknown forms of compensatory respiratory plasticity may offset respiratory motor neuron cell death. Although mechanisms of such compensation are unknown, other models of respiratory motor plasticity may provide a conceptual guide. Multiple cellular mechanisms give rise to phrenic motor facilitation; one mechanism requires spinal serotonin receptor and NADPH oxidase activity whereas another requires spinal adenosine receptor activation. Here, we studied whether these mechanisms contribute to compensatory respiratory plasticity in SOD1G93A rats. Using plethysmography, we assessed ventilation in end-stage SOD1G93A rats after: 1) serotonin depletion with parachlorophenylalanine (PCPA), 2) serotonin (methysergide) and A2A (MSX-3) receptor inhibition, 3) NADPH oxidase inhibition (apocynin), and 4) combined treatments. The ability to increase ventilation was not decreased by individual or combined treatments; thus, these mechanisms do not maintain breathing capacity at end-stage motor neuron disease. Possible mechanisms giving rise to enhanced breathing capacity with combined treatment in end-stage SOD1G93A rats are discussed. PMID:24681328

Predictive Criteria to Study the Pathogenesis of Malaria-Associated ALI/ARDS in Mice

PubMed Central

Ortolan, Luana S.; Sercundes, Michelle K.; Debone, Daniela; Hagen, Stefano C. F.; D' Império Lima, Maria Regina; Alvarez, José M.; Marinho, Claudio R. F.; Epiphanio, Sabrina

2014-01-01

Malaria-associated acute lung injury/acute respiratory distress syndrome (ALI/ARDS) often results in morbidity and mortality. Murine models to study malaria-associated ALI/ARDS have been described; we still lack a method of distinguishing which mice will develop ALI/ARDS before death. This work aimed to characterize malaria-associated ALI/ARDS in a murine model and to demonstrate the first method to predict whether mice are suffering from ALI/ARDS before death. DBA/2 mice infected with Plasmodium berghei ANKA developing ALI/ARDS or hyperparasitemia (HP) were compared using histopathology, PaO2 measurement, pulmonary X-ray, breathing capacity, lung permeability, and serum vascular endothelial growth factor (VEGF) levels according to either the day of death or the suggested predictive criteria. We proposed a model to predict malaria-associated ALI/ARDS using breathing patterns (enhanced pause and frequency respiration) and parasitemia as predictive criteria from mice whose cause of death was known to retrospectively diagnose the sacrificed mice as likely to die of ALI/ARDS as early as 7 days after infection. Using this method, we showed increased VEGF levels and increased lung permeability in mice predicted to die of ALI/ARDS. This proposed method for accurately identifying mice suffering from ALI/ARDS before death will enable the use of this model to study the pathogenesis of this disease. PMID:25276057

Ontogenetic changes and developmental adjustments in lactate dehydrogenase isozymes of an obligate air-breathing fish Channa punctatus during deprivation of air access.

PubMed

Ahmad, Riaz; Hasnain, Absar-Ul

2005-02-01

In air-breathing snakehead Channa punctatus, Ldh-B is expressed at all ontogenetic and developmental stages, while Ldh-A is expressed temporally in pre-hatchlings 12-13 days ahead of bimodal respiration marked by air-breathing. Remarkable differences are observed in the LDH isozyme expression among various ontogenetic and developmental stages upon denying air access. When denied air access, water-breathing larvae show two distinct characteristics: (i) they survive longer than transitory air-breathers due to independence from air-breathing and (ii) there is more transient induction of Ldh-B than Ldh-A. Transition to bimodal breathing, which occurred post-hatching in 15-day old larvae, is coincidental with inducibility of Ldh-A and concomitant down-regulation of Ldh-B. Heart tissue from air-breathing adults denied air access shows a preferential expression of LDH-A subunit and slight down-regulation of LDH-B. Heterotetramers of A and B subunits participate in adjusting LDH levels among those stages which either precede air-breathing switchover, or are subsequent to this transition. The contribution of heterotetramers depends on the stage-specific levels of LDH homotetramers A(4) or B(4). Scaling of muscle mass during growth, tolerance to extended deprivation of air access and induction of Ldh-A are correlated. Response to restoring air contact indicated that advanced air-breathing stages of C. punctatus possess an inherent capacity to sense surface air. In kinetic properties, LDH isozymes of C. punctatus are teleost-like but species specificity is displayed in oxidative potential by cardiac muscle and in L-lactate reduction by skeletal muscle.

Learned vocal and breathing behavior in an enculturated gorilla.

PubMed

Perlman, Marcus; Clark, Nathaniel

2015-09-01

We describe the repertoire of learned vocal and breathing-related behaviors (VBBs) performed by the enculturated gorilla Koko. We examined a large video corpus of Koko and observed 439 VBBs spread across 161 bouts. Our analysis shows that Koko exercises voluntary control over the performance of nine distinctive VBBs, which involve variable coordination of her breathing, larynx, and supralaryngeal articulators like the tongue and lips. Each of these behaviors is performed in the context of particular manual action routines and gestures. Based on these and other findings, we suggest that vocal learning and the ability to exercise volitional control over vocalization, particularly in a multimodal context, might have figured relatively early into the evolution of language, with some rudimentary capacity in place at the time of our last common ancestor with great apes.

Forced oscillometry track sites of airway obstruction in bronchial asthma.

PubMed

Hafez, Manal Refaat; Abu-Bakr, Samiha Mohamed; Mohamed, Alyaa Abdelnaser

2015-07-01

Spirometry is the most commonly used method for assessment of airway function in bronchial asthma but has several limitations. Forced oscillometry was developed as a patient-friendly test that requires passive cooperation of the patient breathing normally through the mouth. To compare spirometry with forced oscillometry to assess the role of forced oscillometry in the detection of the site of airway obstruction. This case-and-control study included 50 patients with known stable asthma and 50 age- and sex-matched healthy subjects. All participants underwent spirometry (ratio of force expiration volume in 1 second to forced vital capacity, percentage predicted for forced expiration volume in 1 second, percentage predicted for forced vital capacity, percentage predicted for vital capacity, and forced expiratory flow at 25-75%) and forced oscillometry (resistance at 5, 20, and 5-20 Hz). By spirometry, all patients with asthma had airway obstruction, 8% had isolated small airway obstruction, 10% had isolated large airway obstruction, and 82% had large and small airway obstruction. By forced oscillometry, 12% had normal airway resistance, 50% had isolated small airway obstruction with frequency-dependent resistance, and 38% had large and small airway obstruction with frequency-independent resistance. There was significant difference between techniques for the detection of the site of airway obstruction (P = .012). Forced oscillometry indices were negatively correlated with spirometric indices (P < .01). Forced oscillometry as an effortless test, conducted during quiet tidal breathing, and does not alter airway caliber; thus, it can detect normal airway function better than spirometry in patients with asthma. Forced oscillometry detects isolated small airway obstruction better than spirometry in bronchial asthma. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Inter- and intraobserver agreement of ADC measurements of lung cancer in free breathing, breath-hold and respiratory triggered diffusion-weighted MRI.

PubMed

Cui, Lei; Yin, Jian-Bing; Hu, Chun-Hong; Gong, Shen-Chu; Xu, Jun-Feng; Yang, Ju-Shun

2016-01-01

To prospectively evaluate the inter- and intraobserver agreement of apparent diffusion coefficient (ADC) measurements in free breathing, breath-hold, and respiratory triggered diffusion-weighted imaging (DWI) of lung cancer. Twenty-two patients with lung cancer (tumor size >2cm) underwent DWIs (3.0T) in three imaging methods. Lesion ADCs were measured twice by both of the two independent observers and compared. No statistical significance was found among methods, though respiratory-triggered DWI tended to have higher ADCs than breath-hold DWI. Great inter- and intraobserver agreement was shown. ADCs had good inter- and intraobserver agreement in all three DWI methods. Copyright © 2016 Elsevier Inc. All rights reserved.

Polio and Prevention

MedlinePlus

... polio More extensive paralysis, involving the trunk and muscles of the thorax and abdomen, can result in quadriplegia. In the most severe cases (bulbar polio), poliovirus attacks the nerve cells of the brain stem, reducing breathing capacity and causing difficulty in swallowing ...

Epiglottitis

MedlinePlus

... used. This examination is best done in the operating room or a similar setting where sudden breathing problems ... (ICU). Treatment involves methods to help the person breathe, including: Breathing tube ( ...

MO-FG-BRA-02: A Feasibility Study of Integrating Breathing Audio Signal with Surface Surrogates for Respiratory Motion Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lei, Y; Zhu, X; Zheng, D

Purpose: Tracking the surrogate placed on patient skin surface sometimes leads to problematic signals for certain patients, such as shallow breathers. This in turn impairs the 4D CT image quality and dosimetric accuracy. In this pilot study, we explored the feasibility of monitoring human breathing motion by integrating breathing sound signal with surface surrogates. Methods: The breathing sound signals were acquired though a microphone attached adjacently to volunteer’s nostrils, and breathing curve were analyzed using a low pass filter. Simultaneously, the Real-time Position Management™ (RPM) system from Varian were employed on a volunteer to monitor respiratory motion including both shallowmore » and deep breath modes. The similar experiment was performed by using Calypso system, and three beacons taped on volunteer abdominal region to capture breath motion. The period of each breathing curves were calculated with autocorrelation functions. The coherence and consistency between breathing signals using different acquisition methods were examined. Results: Clear breathing patterns were revealed by the sound signal which was coherent with the signal obtained from both the RPM system and Calypso system. For shallow breathing, the periods of breathing cycle were 3.00±0.19 sec (sound) and 3.00±0.21 sec (RPM); For deep breathing, the periods were 3.49± 0.11 sec (sound) and 3.49±0.12 sec (RPM). Compared with 4.54±0.66 sec period recorded by the calypso system, the sound measured 4.64±0.54 sec. The additional signal from sound could be supplement to the surface monitoring, and provide new parameters to model the hysteresis lung motion. Conclusion: Our preliminary study shows that the breathing sound signal can provide a comparable way as the RPM system to evaluate the respiratory motion. It’s instantaneous and robust characteristics facilitate it possibly to be a either independently or as auxiliary methods to manage respiratory motion in radiotherapy.« less

Comparison of the heart and breathing rate of acutely ill medical patients recorded by nursing staff with those measured over 5 min by a piezoelectric belt and ECG monitor at the time of admission to hospital.

PubMed

Kellett, John; Li, Min; Rasool, Shahzeb; Green, Geoffrey C; Seely, Andrew

2011-11-01

Heart and breathing rates are predictors of disease severity and of a poor outcome. However, few reports have compared their machine measurements with traditional manual methods. A small rural Irish hospital. The heart and breathing rates of 377 acutely ill medical patients (mean age 68.3 SD 16.8 years) recorded by nursing staff at the time of admission to hospital was compared with those measured over 5 min by a piezoelectric belt and ECG monitor (the BT16 acquisition system). The mean breathing rate measured by the nursing staff (20.9 SD 4.8 breaths per min) and that measured by the BT16 piezoelectric belt (19.9 SD 4.5 breaths per min) were significantly different (p 0.004), as were the nurse and BT16 measured heart rates (85.4 SD 21.3 vs. 81.2 SD 18.7, p 0.004), and the correlation coefficient between the two methods of breathing and heart rate measurement were low. Nurse measured breathing rate measurements were clustered around rates of 18, 20 and 22 breaths per min. Unlike those obtained by nurses, BT16 measured heart and breathing rates were shown by logistic regression to be independent predictors of in-hospital mortality. There is a poor correlation between breathing and heart rates measured by traditional methods and those obtained by the BT16 device. BT16 derived breathing and heart rates, but not those measured manually, were independent predictors of in-hospital mortality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Matter Over Mind: A Randomised-Controlled Trial of Single-Session Biofeedback Training on Performance Anxiety and Heart Rate Variability in Musicians

PubMed Central

Wells, Ruth; Outhred, Tim; Heathers, James A. J.; Quintana, Daniel S.; Kemp, Andrew H.

2012-01-01

Background Musical performance is a skilled activity performed under intense pressure, thus is often a profound source of anxiety. In other contexts, anxiety and its concomitant symptoms of sympathetic nervous system arousal have been successfully ameliorated with HRV biofeedback (HRV BF), a technique involving slow breathing which augments autonomic and emotional regulatory capacity. Objective: This randomised-controlled study explored the impact of a single 30-minute session of HRV BF on anxiety in response to a highly stressful music performance. Methods A total of 46 trained musicians participated in this study and were randomly allocated to a slow breathing with or without biofeedback or no-treatment control group. A 3 Group×2 Time mixed experimental design was employed to compare the effect of group before and after intervention on performance anxiety (STAI-S) and frequency domain measures of HRV. Results Slow breathing groups (n = 30) showed significantly greater improvements in high frequency (HF) and LF/HF ratio measures of HRV relative to control (n = 15) during 5 minute recordings of performance anticipation following the intervention (effect size: η2 = 0.122 and η2 = 0.116, respectively). The addition of biofeedback to a slow breathing protocol did not produce differential results. While intervention groups did not exhibit an overall reduction in self-reported anxiety, participants with high baseline anxiety who received the intervention (n = 15) displayed greater reductions in self-reported state anxiety relative to those in the control condition (n = 7) (r = 0.379). Conclusions These findings indicate that a single session of slow breathing, regardless of biofeedback, is sufficient for controlling physiological arousal in anticipation of psychosocial stress associated with music performance and that slow breathing is particularly helpful for musicians with high levels of anxiety. Future research is needed to further examine the effects of HRV BF as a low-cost, non-pharmacological treatment for music performance anxiety. PMID:23056361

[Electromyographic determination of the fatigability of respiratory and leg muscles before and after aortocoronary bypass operation].

PubMed

Worth, H; Grundmann, C; Goeckenjan, G; Smidt, U; Irlich, G; Loogen, F

1984-01-01

To study the effect of postoperative confinement to bed on respiratory muscle fatigue, 31 male subjects (age, 34-66 years) undergoing coronary artery revascularization were examined. Fatigue of both respiratory muscles (musculi intercostales externi) and leg muscles (musculus gastrocnemius) was determined by electromyography prior to and 7 and 12 days after operation. Additionally, oscillatory resistance to breathing and phase angle were measured. Pre- and postoperative routine lung function tests were performed. A comparison between preoperative and postoperative measurements reveals that respiratory as well as leg muscle fatigue occurred at higher loads during the preoperative and the second postoperative than during the first postoperative determination. After surgery vital capacity, total lung capacity, 1-second capacity, and, to a lower extent, thoracic gas volume were diminished, while specific airway conductance, oscillatory resistance to breathing, phase angle, residual volume, and relative 1-second capacity remained unchanged. The constancy of the latter parameters indicates that neither airway obstruction nor a significant restriction of the lung and/or thorax occurred due to surgery. Therefore, the increase of respiratory muscle fatigue after surgery may more probably be attributed to a lack of training of respiratory muscles which may contribute to limitation of ventilation in bedridden patients.

Standardisation and application of the single-breath determination of nitric oxide uptake in the lung.

PubMed

Zavorsky, Gerald S; Hsia, Connie C W; Hughes, J Michael B; Borland, Colin D R; Guénard, Hervé; van der Lee, Ivo; Steenbruggen, Irene; Naeije, Robert; Cao, Jiguo; Dinh-Xuan, Anh Tuan

2017-02-01

Diffusing capacity of the lung for nitric oxide ( D LNO ), otherwise known as the transfer factor, was first measured in 1983. This document standardises the technique and application of single-breath D LNO This panel agrees that 1) pulmonary function systems should allow for mixing and measurement of both nitric oxide (NO) and carbon monoxide (CO) gases directly from an inspiratory reservoir just before use, with expired concentrations measured from an alveolar "collection" or continuously sampled via rapid gas analysers; 2) breath-hold time should be 10 s with chemiluminescence NO analysers, or 4-6 s to accommodate the smaller detection range of the NO electrochemical cell; 3) inspired NO and oxygen concentrations should be 40-60 ppm and close to 21%, respectively; 4) the alveolar oxygen tension ( P AO 2 ) should be measured by sampling the expired gas; 5) a finite specific conductance in the blood for NO (θNO) should be assumed as 4.5 mL·min -1 ·mmHg -1 ·mL -1 of blood; 6) the equation for 1/θCO should be (0.0062· P AO 2 +1.16)·(ideal haemoglobin/measured haemoglobin) based on breath-holding P AO 2 and adjusted to an average haemoglobin concentration (male 14.6 g·dL -1 , female 13.4 g·dL -1 ); 7) a membrane diffusing capacity ratio ( D MNO / D MCO ) should be 1.97, based on tissue diffusivity. Copyright ©ERS 2017.

Effects of Incentive Spirometry on Respiratory Motion in Healthy Subjects Using Cine Breathing Magnetic Resonance Imaging

PubMed Central

Akazawa, Tsutomu; Sakuma, Tsuyoshi; Nagaya, Shigeyuki; Sonoda, Masaru; Tanaka, Yuji; Katogi, Takehide; Nemoto, Tetsuharu; Minami, Shohei

2015-01-01

Objective To investigate the effectiveness of incentive spirometry on respiratory motion in healthy subjects using cine breathing magnetic resonance imaging (MRI). Methods Ten non-smoking healthy subjects without any history of respiratory disease were studied. Subjects were asked to perform pulmonary training using incentive spirometry every day for two weeks. To assess the effectiveness of this training, pulmonary function tests and cine breathing MRI were performed before starting pulmonary training and two weeks after its completion. Results After training, there were significant improvements in vital capacity (VC) from 3.58±0.8 L to 3.74±0.8 L and in %VC from 107.4±10.8 to 112.1±8.2. Significant changes were observed in the right diaphragm motion, right chest wall motion, and left chest wall motion, which were increased from 55.7±9.6 mm to 63.4±10.2 mm, from 15.6±6.1 mm to 23.4±10.4 mm, and from 16.3±7.6 mm to 22.0±9.8 mm, respectively. Conclusion Two weeks of training using incentive spirometry provided improvements in pulmonary function and respiratory motion, which suggested that incentive spirometry may be a useful preoperative modality for improving pulmonary function during the perioperative period. PMID:26161341

Effects of inhaled ipratropium bromide on breathing mechanics and gas exchange in exercising horses with chronic obstructive pulmonary disease.

PubMed

Bayly, W M; Duvivier, D H; Votion, D; Vandenput, S; Art, T; Lekeux, P

2002-01-01

Six Warmblood horses suffering an acute exacerbation of COPD were tested to investigate whether inhalation of ipratropium bromide (IB) dry powder (2,400 microg) 30 min preexercise would improve their exercise capacity. A cross-over protocol with an inert powder placebo (P) was used. Mechanics of breathing and arterial blood gases were determined before treatment, after treatment but pre-exercise, and during an incremental exercise test. Oxygen consumption (VO2) was also measured before and during exercise, and the time to fatigue recorded. Inhalation of IB reduced total pulmonary resistance (RL) and maximum intrapleural pressure changes (deltaPpl(max)) and increased dynamic compliance before exercise. The onset of exercise was associated with a marked decrease in RL in P-treated horses but not those receiving IB, so that RL during exercise was not affected by treatment. Although deltaPpl(max) was lower at 8,9 and 10 m/s with IB, there were no treatment-related changes in VO2, blood gases, time to fatigue or any other measurement of breathing mechanics. Therefore, although inhalation of IB prior to exercise may have improved deltaPpl(max), it had no apparent impact on the horses' capacity for exercise.

The trade-off between heat tolerance and metabolic cost drives the bimodal life strategy at the air-water interface

PubMed Central

Fusi, Marco; Cannicci, Stefano; Daffonchio, Daniele; Mostert, Bruce; Pörtner, Hans-Otto; Giomi, Folco

2016-01-01

The principle of oxygen and capacity limitation of thermal tolerance in ectotherms suggests that the long-term upper limits of an organism's thermal niche are equivalent to the upper limits of the organism's functional capacity for oxygen provision to tissues. Air-breathing ectotherms show wider thermal tolerances, since they can take advantage of the higher availability of oxygen in air than in water. Bimodal species move from aquatic to aerial media and switch between habitats in response to environmental variations such as cyclical or anomalous temperature fluctuations. Here we tested the prediction that bimodal species cope better with thermal stress than truly aquatic species using the crab Pachygrapsus marmoratus as a model species. When in water, oxygen consumption rates of P. marmoratus acutely rise during warming. Beyond a temperature threshold of 23 °C the crab's aerobic metabolism in air remains lower than in water. In parallel, the haemolymph oxygen partial pressure of submerged animals progressive decreases during warming, while it remains low but constant during emersion. Our results demonstrate the ability of a bimodal breathing ectotherm to extend its thermal tolerance during air-breathing, suggesting that there are temperature-related physiological benefits during the evolution of the bimodal life style. PMID:26758742

The trade-off between heat tolerance and metabolic cost drives the bimodal life strategy at the air-water interface.

PubMed

Fusi, Marco; Cannicci, Stefano; Daffonchio, Daniele; Mostert, Bruce; Pörtner, Hans-Otto; Giomi, Folco

2016-01-13

The principle of oxygen and capacity limitation of thermal tolerance in ectotherms suggests that the long-term upper limits of an organism's thermal niche are equivalent to the upper limits of the organism's functional capacity for oxygen provision to tissues. Air-breathing ectotherms show wider thermal tolerances, since they can take advantage of the higher availability of oxygen in air than in water. Bimodal species move from aquatic to aerial media and switch between habitats in response to environmental variations such as cyclical or anomalous temperature fluctuations. Here we tested the prediction that bimodal species cope better with thermal stress than truly aquatic species using the crab Pachygrapsus marmoratus as a model species. When in water, oxygen consumption rates of P. marmoratus acutely rise during warming. Beyond a temperature threshold of 23 °C the crab's aerobic metabolism in air remains lower than in water. In parallel, the haemolymph oxygen partial pressure of submerged animals progressive decreases during warming, while it remains low but constant during emersion. Our results demonstrate the ability of a bimodal breathing ectotherm to extend its thermal tolerance during air-breathing, suggesting that there are temperature-related physiological benefits during the evolution of the bimodal life style.

The Wagner-Nelson method can generate an accurate gastric emptying flow curve from CO2 data obtained by a 13C-labeled substrate breath test.

PubMed

Sanaka, Masaki; Yamamoto, Takatsugu; Ishii, Tarou; Kuyama, Yasushi

2004-01-01

In pharmacokinetics, the Wagner-Nelson (W-N) method can accurately estimate the rate of drug absorption from its urinary elimination rate. A stable isotope (13C) breath test attempts to estimate the rate of absorption of 13C, as an index of gastric emptying rate, from the rate of pulmonary elimination of 13CO2. The time-gastric emptying curve determined by the breath test is quite different from that determined by scintigraphy or ultrasonography. In this report, we have shown that the W-N method can adjust the difference. The W-N equation to estimate gastric emptying from breath data is as follows: the fractional cumulative amount of gastric contents emptied by time t = Abreath (t)/Abreath (infinity) + (1/0.65).d[Abreath (t)/Abreath (infinity) ]/dt, where Abreath (t) = the cumulative recovery of 13CO2 in breath by time t and Abreath ( infinity ) = the ultimate cumulative 13CO2 recovery. The emptying flow curve generated by ultrasonography was compared with that generated by the W-N method-adjusted breath test in 6 volunteers. The emptying curves by the W-N method were almost identical to those by ultrasound. The W-N method can generate an accurate emptying flow curve from 13CO2 data, and it can adjust the difference between ultrasonography and the breath test. Copyright 2004 S. Karger AG, Basel

Improved fireman's compressed air breathing system pressure vessel development program

NASA Technical Reports Server (NTRS)

King, H. A.; Morris, E. E.

1973-01-01

Prototype high pressure glass filament-wound, aluminum-lined pressurant vessels suitable for use in a fireman's compressed air breathing system were designed, fabricated, and acceptance tested in order to demonstrate the feasibility of producing such high performance, lightweight units. The 4000 psi tanks have a 60 standard cubic foot (SCF) air capacity, and have a 6.5 inch diamter, 19 inch length, 415 inch volume, weigh 13 pounds when empty, and contain 33 percent more air than the current 45 SCF (2250 psi) steel units. The current steel 60 SCF (3000 psi) tanks weigh approximately twice as much as the prototype when empty, and are 2 inches, or 10 percent shorter. The prototype units also have non-rusting aluminum interiors, which removes the hazard of corrosion, the need for internal coatings, and the possibility of rust particles clogging the breathing system.

Novel methodology to perform sulfur hexafluoride (SF6)-based multiple-breath wash-in and washout in infants using current commercially available equipment.

PubMed

Gustafsson, P M; Robinson, P D; Lindblad, A; Oberli, D

2016-11-01

Multiple-breath inert gas washout (MBW) is ideally suited for early detection and monitoring of serious lung disease, such as cystic fibrosis, in infants and young children. Validated commercial options for the MBW technique are limited, and suitability of nitrogen (N 2 )-based MBW is of concern given the detrimental effect of exposure to pure O 2 on infant breathing pattern. We propose novel methodology using commercially available N 2 MBW equipment to facilitate 4% sulfur hexafluoride (SF 6 ) multiple-breath inert gas wash-in and washout suitable for the infant age range. CO 2 , O 2 , and sidestream molar mass sensor signals were used to accurately calculate SF 6 concentrations. An improved dynamic method for synchronization of gas and respiratory flow was developed to take into account variations in sidestream sample flow during MBW measurement. In vitro validation of triplicate functional residual capacity (FRC) assessments was undertaken under dry ambient conditions using lung models ranging from 90 to 267 ml, with tidal volumes of 28-79 ml, and respiratory rates 20-60 per minute. The relative mean (SD, 95% confidence interval) error of triplicate FRC determinations by washout was -0.26 (1.84, -3.86 to +3.35)% and by wash-in was 0.57 (2.66, -4.66 to +5.79)%. The standard deviations [mean (SD)] of percentage error among FRC triplicates were 1.40 (1.14) and 1.38 (1.32) for washout and wash-in, respectively. The novel methodology presented achieved FRC accuracy as outlined by current MBW consensus recommendations (95% of measurements within 5% accuracy). Further clinical evaluation is required, but this new technique, using existing commercially available equipment, has exciting potential for research and clinical use. Copyright © 2016 the American Physiological Society.

Noncontact spirometry with a webcam

NASA Astrophysics Data System (ADS)

Liu, Chenbin; Yang, Yuting; Tsow, Francis; Shao, Dangdang; Tao, Nongjian

2017-05-01

We present an imaging-based method for noncontact spirometry. The method tracks the subtle respiratory-induced shoulder movement of a subject, builds a calibration curve, and determines the flow-volume spirometry curve and vital respiratory parameters, including forced expiratory volume in the first second, forced vital capacity, and peak expiratory flow rate. We validate the accuracy of the method by comparing the data with those simultaneously recorded with a gold standard reference method and examine the reliability of the noncontact spirometry with a pilot study including 16 subjects. This work demonstrates that the noncontact method can provide accurate and reliable spirometry tests with a webcam. Compared to the traditional spirometers, the present noncontact spirometry does not require using a spirometer, breathing into a mouthpiece, or wearing a nose clip, thus making spirometry test more easily accessible for the growing population of asthma and chronic obstructive pulmonary diseases.

Noncontact spirometry with a webcam.

PubMed

Liu, Chenbin; Yang, Yuting; Tsow, Francis; Shao, Dangdang; Tao, Nongjian

2017-05-01

We present an imaging-based method for noncontact spirometry. The method tracks the subtle respiratory-induced shoulder movement of a subject, builds a calibration curve, and determines the flow-volume spirometry curve and vital respiratory parameters, including forced expiratory volume in the first second, forced vital capacity, and peak expiratory flow rate. We validate the accuracy of the method by comparing the data with those simultaneously recorded with a gold standard reference method and examine the reliability of the noncontact spirometry with a pilot study including 16 subjects. This work demonstrates that the noncontact method can provide accurate and reliable spirometry tests with a webcam. Compared to the traditional spirometers, the present noncontact spirometry does not require using a spirometer, breathing into a mouthpiece, or wearing a nose clip, thus making spirometry test more easily accessible for the growing population of asthma and chronic obstructive pulmonary diseases.

Application of cabin atmosphere monitors to rapid screening of breath samples for the early detection of disease states

NASA Technical Reports Server (NTRS)

Valentine, J. L.; Bryant, P. J.

1975-01-01

Analysis of human breath is a nonintrusive method to monitor both endogenous and exogenous chemicals found in the body. Several technologies were investigated and developed which are applicable to monitoring some organic molecules important in both physiological and pathological states. Two methods were developed for enriching the organic molecules exhaled in the breath of humans. One device is based on a respiratory face mask fitted with a polyethylene foam wafer; while the other device is a cryogenic trap utilizing an organic solvent. Using laboratory workers as controls, two organic molecules which occurred in the enriched breath of all subjects were tentatively identified as lactic acid and contisol. Both of these substances occurred in breath in sufficient amounts that the conventional method of gas-liquid chromatography was adequate for detection and quantification. To detect and quantitate trace amounts of chemicals in breath, another type of technology was developed in which analysis was conducted using high pressure liquid chromatography and mass spectrometry.

Pilates Method for Lung Function and Functional Capacity in Obese Adults.

PubMed

Niehues, Janaina Rocha; Gonzáles, Inês; Lemos, Robson Rodrigues; Haas, Patrícia

2015-01-01

Obesity is defined as the condition in which the body mass index (BMI) is ≥ 30 kg/m2 and is responsible for decreased quality of life and functional limitations. The harmful effects on ventilatory function include reduced lung capacity and volume; diaphragmatic muscle weakness; decreased lung compliance and stiffness; and weakness of the abdominal muscles, among others. Pilates is a method of resistance training that works with low-impact muscle exercises and is based on isometric exercises. The current article is a review of the literature that aims to investigate the hypothesis that the Pilates method, as a complementary method of training, might be beneficial to pulmonary function and functional capacity in obese adults. The intent of the review was to evaluate the use of Pilates as an innovative intervention in the respiratory dysfunctions of obese adults. In studies with other populations, it has been observed that Pilates can be effective in improving chest capacity and expansion and lung volume. That finding is due to the fact that Pilates works through the center of force, made ​​up of the abdominal muscles and gluteus muscles lumbar, which are responsible for the stabilization of the static and dynamic body that is associated with breath control. It has been observed that different Pilates exercises increase the activation and recruitment of the abdominal muscles. Those muscles are important in respiration, both in expiration and inspiration, through the facilitation of diaphragmatic action. In that way, strengthening the abdominal muscles can help improve respiratory function, leading to improvements in lung volume and capacity. The results found in the current literature review support the authors' observations that Pilates promotes the strengthening of the abdominal muscles and that improvements in diaphragmatic function may result in positive outcomes in respiratory function, thereby improving functional capacity. However, the authors did not find specific studies with obese people, justifying the need for future studies.

Expiratory flow limitation relates to symptoms during COPD exacerbations requiring hospital admission.

PubMed

Jetmalani, Kanika; Timmins, Sophie; Brown, Nathan J; Diba, Chantale; Berend, Norbert; Salome, Cheryl M; Wen, Fu-Qiang; Chen, Peng; King, Gregory G; Farah, Claude S

2015-01-01

Expiratory flow limitation (EFL) is seen in some patients presenting with a COPD exacerbation; however, it is unclear how EFL relates to the clinical features of the exacerbation. We hypothesized that EFL when present contributes to symptoms and duration of recovery during a COPD exacerbation. Our aim was to compare changes in EFL with symptoms in subjects with and without flow-limited breathing admitted for a COPD exacerbation. A total of 29 subjects with COPD were recruited within 48 hours of admission to West China Hospital for an acute exacerbation. Daily measurements of post-bronchodilator spirometry, resistance, and reactance using the forced oscillation technique and symptom (Borg) scores until discharge were made. Flow-limited breathing was defined as the difference between inspiratory and expiratory respiratory system reactance (EFL index) greater than 2.8 cmH2O·s·L(-1). The physiological predictors of symptoms during recovery were determined by mixed-effect analysis. Nine subjects (31%) had flow-limited breathing on admission despite similar spirometry compared to subjects without flow-limited breathing. Spirometry and resistance measures did not change between enrolment and discharge. EFL index values improved in subjects with flow-limited breathing on admission, with resolution in four patients. In subjects with flow-limited breathing on admission, symptoms were related to inspiratory resistance and EFL index values. In subjects without flow-limited breathing, symptoms related to forced expiratory volume in 1 second/forced vital capacity. In the whole cohort, EFL index values at admission was related to duration of stay (Rs=0.4, P=0.03). The presence of flow-limited breathing as well as abnormal respiratory system mechanics contribute independently to symptoms during COPD exacerbations.

Breath Figure Method for Construction of Honeycomb Films

PubMed Central

Dou, Yingying; Jin, Mingliang; Zhou, Guofu; Shui, Lingling

2015-01-01

Honeycomb films with various building units, showing potential applications in biological, medical, physicochemical, photoelectric, and many other areas, could be prepared by the breath figure method. The ordered hexagonal structures formed by the breath figure process are related to the building units, solvents, substrates, temperature, humidity, air flow, and other factors. Therefore, by adjusting these factors, the honeycomb structures could be tuned properly. In this review, we summarized the development of the breath figure method of fabricating honeycomb films and the factors of adjusting honeycomb structures. The organic-inorganic hybrid was taken as the example building unit to discuss the preparation, mechanism, properties, and applications of the honeycomb films. PMID:26343734

Activity Patterns in Latissimus Dorsi and Sternocleidomastoid in Classical Singers

PubMed Central

Watson, Alan H.D.; Williams, Caitlin; James, Buddug V.

2012-01-01

Summary Objectives The aim of this study was to investigate and compare the roles of the accessory respiratory muscles, latissimus dorsi (LD), and sternocleidomastoid, in classical singing. Methods Electromyography was used to record the activity of these muscles in six classically trained female singers carrying out a number of singing and nonsinging tasks. Movements of the chest and abdominal walls were monitored simultaneously using inductive plethysmography, and the sound of the phonations was recorded. Results In normal breathing, LD is active transiently during very deep inhalations and in inhalation against resistance. During exhalation it becomes active again as residual capacity is approached or when air is expelled with great force. Sternocleidomastoid (SCM) supports inhalation when lung volume nears 100% vital capacity or when this is very rapid. All singers engaged LD in supported singing where it was associated with maintaining an expanded thorax. In coloratura singing, pulses of activity of increasing amplitude were often seen in LD toward the end of the breath. These were synchronized with each note. During a short phrase typical of the end of an aria, which was sung at full volume with the projected voice, both LD and SCM were active simultaneously. Spectral analysis of muscle activity demonstrated that in some singers, activity in LD and more rarely SCM, fluctuated in phase with vibrato. Conclusions LD appears to play a significant role in maintaining chest expansion and the dynamic processes underlying vibrato and coloratura singing in classically trained singers. PMID:21724365

Technologies for Clinical Diagnosis Using Expired Human Breath Analysis

PubMed Central

Mathew, Thalakkotur Lazar; Pownraj, Prabhahari; Abdulla, Sukhananazerin; Pullithadathil, Biji

2015-01-01

This review elucidates the technologies in the field of exhaled breath analysis. Exhaled breath gas analysis offers an inexpensive, noninvasive and rapid method for detecting a large number of compounds under various conditions for health and disease states. There are various techniques to analyze some exhaled breath gases, including spectrometry, gas chromatography and spectroscopy. This review places emphasis on some of the critical biomarkers present in exhaled human breath, and its related effects. Additionally, various medical monitoring techniques used for breath analysis have been discussed. It also includes the current scenario of breath analysis with nanotechnology-oriented techniques. PMID:26854142

Can simple mobile phone applications provide reliable counts of respiratory rates in sick infants and children? An initial evaluation of three new applications.

PubMed

Black, James; Gerdtz, Marie; Nicholson, Pat; Crellin, Dianne; Browning, Laura; Simpson, Julie; Bell, Lauren; Santamaria, Nick

2015-05-01

Respiratory rate is an important sign that is commonly either not recorded or recorded incorrectly. Mobile phone ownership is increasing even in resource-poor settings. Phone applications may improve the accuracy and ease of counting of respiratory rates. The study assessed the reliability and initial users' impressions of four mobile phone respiratory timer approaches, compared to a 60-second count by the same participants. Three mobile applications (applying four different counting approaches plus a standard 60-second count) were created using the Java Mobile Edition and tested on Nokia C1-01 phones. Apart from the 60-second timer application, the others included a counter based on the time for ten breaths, and three based on the time interval between breaths ('Once-per-Breath', in which the user presses for each breath and the application calculates the rate after 10 or 20 breaths, or after 60s). Nursing and physiotherapy students used the applications to count respiratory rates in a set of brief video recordings of children with different respiratory illnesses. Limits of agreement (compared to the same participant's standard 60-second count), intra-class correlation coefficients and standard errors of measurement were calculated to compare the reliability of the four approaches, and a usability questionnaire was completed by the participants. There was considerable variation in the counts, with large components of the variation related to the participants and the videos, as well as the methods. None of the methods was entirely reliable, with no limits of agreement better than -10 to +9 breaths/min. Some of the methods were superior to the others, with ICCs from 0.24 to 0.92. By ICC the Once-per-Breath 60-second count and the Once-per-Breath 20-breath count were the most consistent, better even than the 60-second count by the participants. The 10-breath approaches performed least well. Users' initial impressions were positive, with little difference between the applications found. This study provides evidence that applications running on simple phones can be used to count respiratory rates in children. The Once-per-Breath methods are the most reliable, outperforming the 60-second count. For children with raised respiratory rates the 20-breath version of the Once-per-Breath method is faster, so it is a more suitable option where health workers are under time pressure. Copyright © 2015 Elsevier Ltd. All rights reserved.

Patients' experiences of breathing retraining for asthma: a qualitative process analysis of participants in the intervention arms of the BREATHE trial.

PubMed

Arden-Close, Emily; Yardley, Lucy; Kirby, Sarah; Thomas, Mike; Bruton, Anne

2017-10-05

Poor symptom control and impaired quality of life are common in adults with asthma, and breathing retraining exercises may be an effective method of self-management. This study aimed to explore the experiences of participants in the intervention arms of the BREATHE trial, which investigated the effectiveness of breathing retraining as a mode of asthma management. Sixteen people with asthma (11 women, 8 per group) who had taken part in the intervention arms of the BREATHE trial (breathing retraining delivered by digital versatile disc (DVD) or face-to-face sessions with a respiratory physiotherapist) took part in semi-structured telephone interviews about their experiences. Interviews were analysed using thematic analysis. Breathing retraining was perceived positively as a method of asthma management. Motivations for taking part included being asked, to enhance progress in research, to feel better/reduce symptoms, and to reduce medication. Participants were positive about the physiotherapist, liked having the materials tailored, found meetings motivational, and liked the DVD and booklet. The impact of breathing retraining following regular practice included increased awareness of breathing and development of new habits. Benefits of breathing retraining included increased control over breathing, reduced need for medication, feeling more relaxed, and improved health and quality of life. Problems included finding time to practice the exercises, and difficulty mastering techniques. Breathing retraining was acceptable and valued by almost all participants, and many reported improved wellbeing. Face to face physiotherapy was well received. However, some participants in the DVD group mentioned being unable to master techniques. PATIENTS RECEPTIVE TO BREATHING RETRAINING: Patients with asthma taught how to change their unconscious breathing patterns generally like non-pharmacological interventions. Researchers in the UK, led by Mike Thomas from the University of Southampton, interviewed 16 people about their experiences in a trial that tested breathing retraining exercises delivered by DVD or face-to-face sessions with a respiratory physiotherapist. Overwhelmingly, trial participants reported that breathing retraining sessions gave them greater control over their symptoms, helped them relax, improved their quality of life and reduced the need for medications. Some participants who received DVD instruction said they had trouble mastering the techniques, and many in both groups found it hard to find time to practice the exercises. Overall, however, patients were positive about the experience. The authors conclude that breathing exercises are likely to be a well-received method of asthma management.

13C Methacetin Breath Test for Assessment of Microsomal Liver Function: Methodology and Clinical Application.

PubMed

Gorowska-Kowolik, Katarzyna; Chobot, Agata; Kwiecien, Jaroslaw

2017-01-01

Assessment of the liver function, and the need of constant monitoring of the organ's capacity, concerns not only patients with primary liver diseases, but also those at risk of hepatopathies secondary to other chronic diseases. Most commonly, the diagnostics is based on measurements of static biochemical parameters, which allow us to draw conclusions only indirectly about the function and the degree of damage of the organ. On the other hand, liver biopsy is an invasive procedure and therefore it is associated with a considerable risk of complications. Dynamic tests enable us to assess quantitatively the organ's functional reserve by analyzing the kinetics of the metabolization of the substrate by the liver. In practice applied are breath tests using substances such as aminopyrine, caffeine, methacetin, erythromycin (for assessment of the microsomal function); phenylalanine, galactose (for assessment of the cytosolic function); methionine, octanoate, ketoisocaproic acid (for assessment of the mitochondrial function). The test with 13 C methacetin belongs to the best described and most widely applied methods in noninvasive liver function assessment. Due to the rising availability of this method, knowledge concerning its limitations and controversies regarding the methodology, as well as its usefulness in chosen groups of patients, seems to be vital.

The relationship between alveolar oxygen tension and the single-breath carbon monoxide diffusing capacity.

PubMed

Kanner, R E; Crapo, R O

1986-04-01

The effects of alveolar oxygen tension (PAO2) on the single-breath carbon monoxide diffusing capacity (DLCO) were quantified and a factor was derived to accommodate for differences in PAO2 over commonly encountered altitudes and/or varying concentrations of oxygen in the test gas mixture (FIO2) We performed duplicate measurements of DLCO in 7 normal subjects with 6 different oxygen fractions (0.176, 0.196, 0.211, 0.22, 0.25, and 0.27). The PAO2 for each test was measured as the PO2 in the alveolar gas sample bag. DLCO varied inversely with PAO2 and changed by 0.35% for each mmHg change in PAO2 (r = -0.62, p less than 0.001). At an FIO2 of 0.25, PAO2 varied between subjects and was highly correlated with each subject's residual volume to total lung capacity ratio (r = -0.84, p less than 0.001). We suggest that laboratories can adjust the measured DLCO when PAO2 is not congruent to 120 mmHg by the following formula: DLCO (corrected = DLCO (measured) x [1.0 + 0.0035 (PAO2 - 120)].

Effectiveness of respiratory-gated radiotherapy with audio-visual biofeedback for synchrotron-based scanned heavy-ion beam delivery

NASA Astrophysics Data System (ADS)

He, Pengbo; Li, Qiang; Zhao, Ting; Liu, Xinguo; Dai, Zhongying; Ma, Yuanyuan

2016-12-01

A synchrotron-based heavy-ion accelerator operates in pulse mode at a low repetition rate that is comparable to a patient’s breathing rate. To overcome inefficiencies and interplay effects between the residual motion of the target and the scanned heavy-ion beam delivery process for conventional free breathing (FB)-based gating therapy, a novel respiratory guidance method was developed to help patients synchronize their breathing patterns with the synchrotron excitation patterns by performing short breath holds with the aid of personalized audio-visual biofeedback (BFB) system. The purpose of this study was to evaluate the treatment precision, efficiency and reproducibility of the respiratory guidance method in scanned heavy-ion beam delivery mode. Using 96 breathing traces from eight healthy volunteers who were asked to breathe freely and guided to perform short breath holds with the aid of BFB, a series of dedicated four-dimensional dose calculations (4DDC) were performed on a geometric model which was developed assuming a linear relationship between external surrogate and internal tumor motions. The outcome of the 4DDCs was quantified in terms of the treatment time, dose-volume histograms (DVH) and dose homogeneity index. Our results show that with the respiratory guidance method the treatment efficiency increased by a factor of 2.23-3.94 compared with FB gating, depending on the duty cycle settings. The magnitude of dose inhomogeneity for the respiratory guidance methods was 7.5 times less than that of the non-gated irradiation, and good reproducibility of breathing guidance among different fractions was achieved. Thus, our study indicates that the respiratory guidance method not only improved the overall treatment efficiency of respiratory-gated scanned heavy-ion beam delivery, but also had the advantages of lower dose uncertainty and better reproducibility among fractions.

Effect on lung function of mounthpiece ventilation in Steinert disease. A case report.

PubMed

Annunziata, Anna; Fiorentino, Giuseppe; Esquinas, Antonio

2017-03-01

In patients with muscular dystrophies both muscle length tension relationship changes and muscle elasticity and plasticity are decreased, resulting in impaired inspiratory muscle function and decreased vital capacity. Furthermore, the loss of deep breathing further increases the risk of alveolar collapse, hypoventilation and atelectasias. In this case report, a stable improvement of vital capacity after treatment with mounthpiece ventilation (MPV), was observed, suggesting that not invasive ventilation (NIV) might help to maintai lung and chest wall compliance, prevent hypoventilation and atelectasias which in turn may slow down the development of the restrictive respiratory pattern. The improvement of vital capacity may have a positive impact on alveolar ventilation by reducing the time with SaO2 values below 90%. This case illustrates that MPV is an effective method to improve respiratory function in patients non-tolerant of nasal mask and a valid alternative option for those who need NIV support for the most part of the day. Furthermore, the use of MPV, alone or combined with other interfaces, improves the quality of life of the neuromuscular patients and promotes a greater adherence to mechanical ventilation.

ERS technical standard on bronchial challenge testing: general considerations and performance of methacholine challenge tests.

PubMed

Coates, Allan L; Wanger, Jack; Cockcroft, Donald W; Culver, Bruce H; Diamant, Zuzana; Gauvreau, Gail; Hall, Graham L; Hallstrand, Teal S; Horvath, Ildiko; de Jongh, Frans H C; Joos, Guy; Kaminsky, David A; Laube, Beth L; Leuppi, Joerg D; Sterk, Peter J

2017-05-01

This international task force report updates general considerations for bronchial challenge testing and the performance of the methacholine challenge test. There are notable changes from prior recommendations in order to accommodate newer delivery devices. Rather than basing the test result upon a methacholine concentration (provocative concentration (PC 20 ) causing a 20% fall in forced expiratory volume in 1 s (FEV 1 )), the new recommendations base the result upon the delivered dose of methacholine causing a 20% fall in FEV 1 (provocative dose (PD 20 )). This end-point allows comparable results from different devices or protocols, thus any suitable nebuliser or dosimeter may be used, so long as the delivery characteristics are known. Inhalation may be by tidal breathing using a breath-actuated or continuous nebuliser for 1 min (or more), or by a dosimeter with a suitable breath count. Tests requiring maximal inhalations to total lung capacity are not recommended because the bronchoprotective effect of a deep breath reduces the sensitivity of the test. Copyright ©ERS 2017.

Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review.

PubMed

de Medeiros, Ana Irene Carlos; Fuzari, Helen Kerlen Bastos; Rattesa, Catarina; Brandão, Daniella Cunha; de Melo Marinho, Patrícia Érika

2017-04-01

Does inspiratory muscle training improve respiratory muscle strength, functional capacity, lung function and quality of life of patients with chronic kidney disease? Does inspiratory muscle training improve these outcomes more than breathing exercises? Systematic review and meta-analysis of randomised trials. People with chronic kidney disease undergoing dialysis treatment. The primary outcomes were: maximal inspiratory pressure, maximal expiratory pressure, and distance covered on the 6-minute walk test. The secondary outcomes were: forced vital capacity, forced expiratory volume in the first second (FEV 1 ), and quality of life. The search identified four eligible studies. The sample consisted of 110 participants. The inspiratory muscle training used a Threshold ® or PowerBreathe ® device, with a load ranging from 30 to 60% of the maximal inspiratory pressure and lasting from 6 weeks to 6 months. The studies showed moderate to high risk of bias, and the quality of the evidence was rated low or very low, due to the studies' methodological limitations. The meta-analysis showed that inspiratory muscle training significantly improved maximal inspiratory pressure (MD 23 cmH 2 O, 95% CI 16 to 29) and the 6-minute walk test distance (MD 80m, 95% CI 41 to 119) when compared with controls. Significant benefits in lung function and quality of life were also identified. When compared to breathing exercises, significant benefits were identified in maximal expiratory pressure (MD 6 cmH 2 O, 95% CI 2 to 10) and FEV 1 (MD 0.24litres 95% CI 0.14 to 0.34), but not maximal inspiratory pressure or forced vital capacity. In patients with chronic renal failure on dialysis, inspiratory muscle training with a fixed load significantly improves respiratory muscle strength, functional capacity, lung function and quality of life. The evidence for these benefits may be influenced by some sources of bias. PROSPERO (CRD 42015029986). [de Medeiros AIC, Fuzari HKB, Rattesa C, Brandão DC, de Melo Marinho PÉ (2017) Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review. Journal of Physiotherapy 63: 76-83]. Copyright © 2017 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

A prospective gating method to acquire a diverse set of free-breathing CT images for model-based 4DCT

NASA Astrophysics Data System (ADS)

O'Connell, D.; Ruan, D.; Thomas, D. H.; Dou, T. H.; Lewis, J. H.; Santhanam, A.; Lee, P.; Low, D. A.

2018-02-01

Breathing motion modeling requires observation of tissues at sufficiently distinct respiratory states for proper 4D characterization. This work proposes a method to improve sampling of the breathing cycle with limited imaging dose. We designed and tested a prospective free-breathing acquisition protocol with a simulation using datasets from five patients imaged with a model-based 4DCT technique. Each dataset contained 25 free-breathing fast helical CT scans with simultaneous breathing surrogate measurements. Tissue displacements were measured using deformable image registration. A correspondence model related tissue displacement to the surrogate. Model residual was computed by comparing predicted displacements to image registration results. To determine a stopping criteria for the prospective protocol, i.e. when the breathing cycle had been sufficiently sampled, subsets of N scans where 5  ⩽  N  ⩽  9 were used to fit reduced models for each patient. A previously published metric was employed to describe the phase coverage, or ‘spread’, of the respiratory trajectories of each subset. Minimum phase coverage necessary to achieve mean model residual within 0.5 mm of the full 25-scan model was determined and used as the stopping criteria. Using the patient breathing traces, a prospective acquisition protocol was simulated. In all patients, phase coverage greater than the threshold necessary for model accuracy within 0.5 mm of the 25 scan model was achieved in six or fewer scans. The prospectively selected respiratory trajectories ranked in the (97.5  ±  4.2)th percentile among subsets of the originally sampled scans on average. Simulation results suggest that the proposed prospective method provides an effective means to sample the breathing cycle with limited free-breathing scans. One application of the method is to reduce the imaging dose of a previously published model-based 4DCT protocol to 25% of its original value while achieving mean model residual within 0.5 mm.

Imaging Breathing Rate in the CO2Absorption Band.

PubMed

Fei, Jin; Zhu, Zhen; Pavlidis, Ioannis

2005-01-01

Following up on our previous work, we have developed one more non-contact method to measure human breathing rate. We have retrofitted our Mid-Wave Infra-Red (MWIR) imaging system with a narrow band-pass filter in the CO2absorption band (4.3 µm). This improves the contrast between the foreground (i.e., expired air) and background (e.g., wall). Based on the radiation information within the breath flow region, we get the mean dynamic thermal signal. This signal is quasi-periodic due to the interleaving of high and low intensities corresponding to expirations and inspirations respectively. We sample the signal at a constant rate and then determine the breathing frequency through Fourier analysis. We have performed experiments on 9 subjects at distances ranging from 6-8 ft. We compared the breathing rate computed by our novel method with ground-truth measurements obtained via a traditional contact device (PowerLab/4SP from ADInstruments with an abdominal transducer). The results show high correlation between the two modalities. For the first time, we report a Fourier based breathing rate computation method on a MWIR signal in the CO2absorption band. The method opens the way for desktop, unobtrusive monitoring of an important vital sign, that is, breathing rate. It may find widespread applications in preventive medicine as well as sustained physiological monitoring of subjects suffering from chronic ailments.

Respiratory cooling and thermoregulatory coupling in reptiles.

PubMed

Tattersall, Glenn J; Cadena, Viviana; Skinner, Matthew C

2006-11-01

Comparative physiological research on reptiles has focused primarily on the understanding of mechanisms of the control of breathing as they relate to respiratory gases or temperature itself. Comparatively less research has been done on the possible link between breathing and thermoregulation. Reptiles possess remarkable thermoregulatory capabilities, making use of behavioural and physiological mechanisms to regulate body temperature. The presence of thermal panting and gaping in numerous reptiles, coupled with the existence of head-body temperature differences, suggests that head temperature may be the primary regulated variable rather than body temperature. This review examines the preponderance of head and body temperature differences in reptiles, the occurrence of breathing patterns that possess putative thermoregulatory roles, and the propensity for head and brain temperature to be controlled by reptiles, particularly at higher temperatures. The available evidence suggests that these thermoregulatory breathing patterns are indeed present, though primarily in arid-dwelling reptiles. More importantly, however, it appears that the respiratory mechanisms that have the capacity to cool evolved initially in reptiles, perhaps as regulatory mechanisms for preventing overheating of the brain. Examining the control of these breathing patterns and their efficacy at regulating head or brain temperature may shed light on the evolution of thermoregulatory mechanisms in other vertebrates, namely the endothermic mammals and birds.

Electret filter collects more exhaled albumin than glass condenser: A method comparison based on human study.

PubMed

Jia, Ziru; Liu, Hongying; Li, Wang; Xie, Dandan; Cheng, Ke; Pi, Xitian

2018-02-01

In recent years, noninvasive diagnosis based on biomarkers in exhaled breath has been extensively studied. The procedure of biomarker collection is a key step. However, the traditional condenser method has low efficacy in collecting nonvolatile compounds especially the protein biomarkers in breath. To solve this deficiency, here we propose an electret filter method.Exhaled breath of 6 volunteers was collected with a glass condenser and an electret filter. The amount of albumin was analyzed. Furthermore, the difference of exhaled albumin between smokers and nonsmokers was evaluated.The electret filter method collected more albumin than the glass condenser method at the same breath volume level (P < .01). Smokers exhaling more albumin than nonsmokers were also observed (P < .01).The electret filter is capable of collecting proteins more effectively than the condenser method. In addition, smokers tend to exhale more albumin than nonsmokers.

Increasing conclusiveness of clinical breath analysis by improved baseline correction of multi capillary column - ion mobility spectrometry (MCC-IMS) data.

PubMed

Szymańska, Ewa; Tinnevelt, Gerjen H; Brodrick, Emma; Williams, Mark; Davies, Antony N; van Manen, Henk-Jan; Buydens, Lutgarde M C

2016-08-05

Current challenges of clinical breath analysis include large data size and non-clinically relevant variations observed in exhaled breath measurements, which should be urgently addressed with competent scientific data tools. In this study, three different baseline correction methods are evaluated within a previously developed data size reduction strategy for multi capillary column - ion mobility spectrometry (MCC-IMS) datasets. Introduced for the first time in breath data analysis, the Top-hat method is presented as the optimum baseline correction method. A refined data size reduction strategy is employed in the analysis of a large breathomic dataset on a healthy and respiratory disease population. New insights into MCC-IMS spectra differences associated with respiratory diseases are provided, demonstrating the additional value of the refined data analysis strategy in clinical breath analysis. Copyright © 2016 Elsevier B.V. All rights reserved.

Combined effects of inspired oxygen, carbon dioxide, and carbon monoxide on oxygen transport and aerobic capacity.

PubMed

Crocker, George H; Toth, Balazs; Jones, James H

2013-09-01

We hypothesized that breathing hypoxic, hypercapnic, and CO-containing gases together reduces maximal aerobic capacity (Vo2max) as the sum of each gas' individual effect on Vo2max. To test this hypothesis, goats breathed combinations of inspired O2 fraction (FiO2) of 0.06-0.21 and inspired CO2 fraction of 0.00 or 0.05, with and without inspired CO that elevated carboxyhemoglobin fraction (FHbCO) to 0.02-0.45, while running on a treadmill at speeds eliciting Vo2max. Individually, hypoxia and elevated FHbCO decreased fractional Vo2max (FVo2max, fraction of a goat's Vo2max breathing air) in linear, dose-dependent manners; hypercapnia did not change Vo2max. Concomitant hypoxia and elevated FHbCO decreased Vo2max less than the individual gas effects summed, indicating their combined effects on Vo2max are attenuated, fitting the following regression: FVo2max = 4.24 FiO2 + 0.519 FHbCO - 8.22 (FiO2 × FHbCO) + 0.117, (R(2) = 0.965, P < 0.001). The FVo2max correlated highly with total cardiopulmonary O2 delivery, not peripheral diffusing capacity, and with arterial O2 concentration (CaO2), not cardiac output. Hypoxia and elevated FHbCO decreased CaO2 by different mechanisms: hypoxia decreased arterial O2 saturation (SaO2), whereas elevated FHbCO decreased O2 capacitance {concentration of hemoglobin (Hb) available to bind O2 ([Hbavail])}. When breathing hypoxic gas (FiO2 0.12), CaO2 did not change with increasing FHbCO up to 0.30 because higher SaO2 of Hbavail offset decreased [Hbavail] due to the following: 1) hyperventilation with hypoxia and/or elevated FHbCO; 2) increased Hb affinity for O2 due to both Bohr and direct carboxyhemoglobin effects; and 3) the sigmoid relationship between O2 saturation and partial pressure elevating SaO2 more with hypoxia than normoxia.

Effects of Inspiratory Muscle Training and Calisthenics-and-Breathing Exercises in COPD With and Without Respiratory Muscle Weakness.

PubMed

Basso-Vanelli, Renata P; Di Lorenzo, Valéria A Pires; Labadessa, Ivana G; Regueiro, Eloisa M G; Jamami, Mauricio; Gomes, Evelim L F D; Costa, Dirceu

2016-01-01

Patients with COPD may experience respiratory muscle weakness. Two therapeutic approaches to the respiratory muscles are inspiratory muscle training and calisthenics-and-breathing exercises. The aims of the study are to compare the effects of inspiratory muscle training and calisthenics-and-breathing exercises associated with physical training in subjects with COPD as an additional benefit of strength and endurance of the inspiratory muscles, thoracoabdominal mobility, physical exercise capacity, and reduction in dyspnea on exertion. In addition, these gains were compared between subjects with and without respiratory muscle weakness. 25 subjects completed the study: 13 composed the inspiratory muscle training group, and 12 composed the calisthenics-and-breathing exercises group. Subjects were assessed before and after training by spirometry, measurements of respiratory muscle strength and test of inspiratory muscle endurance, thoracoabdominal excursion measurements, and the 6-min walk test. Moreover, scores for the Modified Medical Research Council dyspnea scale were reported. After intervention, there was a significant improvement in both groups of respiratory muscle strength and endurance, thoracoabdominal mobility, and walking distance in the 6-min walk test. Additionally, there was a decrease of dyspnea in the 6-min walk test peak. A difference was found between groups, with higher values of respiratory muscle strength and thoracoabdominal mobility and lower values of dyspnea in the 6-min walk test peak and the Modified Medical Research Council dyspnea scale in the inspiratory muscle training group. In the inspiratory muscle training group, subjects with respiratory muscle weakness had greater gains in inspiratory muscle strength and endurance. Both interventions increased exercise capacity and decreased dyspnea during physical effort. However, inspiratory muscle training was more effective in increasing inspiratory muscle strength and endurance, which could result in a decreased sensation of dyspnea. In addition, subjects with respiratory muscle weakness that performed inspiratory muscle training had higher gains in inspiratory muscle strength and endurance but not of dyspnea and submaximal exercise capacity. (ClinicalTrials.gov registration NCT01510041.). Copyright © 2016 by Daedalus Enterprises.

Simultaneous Measurement of Breathing and Heartbeat using Airborne Ultrasound in a Standing Position

NASA Astrophysics Data System (ADS)

Hoshiba, Kotaro; Hirata, Shinnosuke; Hachiya, Hiroyuki

We have been studied about non-contact measurement of respiration and heart rates. In previous papers, the measurement system of small velocity using the M-sequence-modulated signal and phase difference of reflected signals from the target has been proposed. In this paper, we describe measurement of breathing and heartbeat in a standing position using the proposed method. Body-surface velocities by breathing and heartbeat could be observed respectively when the volunteer was breathing and holding the breath. In addition, measured velocity of breathing volunteer includes the component by heartbeat. It is considered that it has possibility to measure breathing and heartbeat concurrently.

An open-loop controlled active lung simulator for preterm infants.

PubMed

Cecchini, Stefano; Schena, Emiliano; Silvestri, Sergio

2011-01-01

We describe the underlying theory, design and experimental evaluation of an electromechanical analogue infant lung to simulate spontaneous breathing patterns of preterm infants. The aim of this work is to test the possibility to obtain breathing patterns of preterm infants by taking into consideration the air compressibility. Respiratory volume function represents the actuation pattern, and pulmonary pressure and flow-rate waveforms are mathematically obtained through the application of the perfect gas and adiabatic laws. The mathematical model reduces the simulation interval into a step shorter than 1 ms, allowing to consider an entire respiratory act as composed of a large number of almost instantaneous adiabatic transformations. The device consists of a spherical chamber where the air is compressed by four cylinder-pistons, moved by stepper motors, and flows through a fluid-dynamic resistance, which also works as flow-rate sensor. Specifically designed software generates the actuators motion, based on the desired ventilation parameters, without controlling the gas pneumatic parameters with a closed-loop. The system is able to simulate tidal volumes from 3 to 8 ml, breathing frequencies from 60 to 120 bpm and functional residual capacities from 25 to 80 ml. The simulated waveforms appear very close to the measured ones. Percentage differences on the tidal volume waveform vary from 7% for the tidal volume of 3 ml, down to 2.2-3.5% for tidal volumes in the range of 4-7 ml, and 1.3% for the tidal volume equal to 8 ml in the whole breathing frequency and functional residual capacity ranges. The open-loop electromechanical simulator shows that gas compressibility can be theoretically assessed in the typical pneumatic variable range of preterm infant respiratory mechanics. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

Refinement of Speech Breathing in Healthy 4- to 6-Year-Old Children

ERIC Educational Resources Information Center

Boliek, Carol A.; Hixon, Thomas J.; Watson, Peter J.; Jones, Patricia B.

2009-01-01

Purpose: The purpose of this study was to offer a better understanding of the development of neuromotor control for speech breathing and provide a normative data set that can serve as a useful standard for clinical evaluation and management of young children with speech disorders involving the breathing subsystem. Method: Speech breathing was…

The Hyperventilation Syndrome - USSR -

DTIC Science & Technology

1960-07-28

elicited in all Patients a neurosis of the neurasthenic type and the absence of organ- ic changes of the nervous system. All patients were kept...capacity and maximum breathing capacity of the lungs in «*■ P"Ä^veS^^ «£? nation of the function of «^«»^JfgiJS during rest, oh- symptom is a...corti_ The hyperventilation syndrome ?®P™~;£ athenlc type of neur- cal impairment of respiration in a neurasthenic yv neuroses osis. It can be

Heart rate and pulmonary function while wearing the launch-entry crew escape suit (LES) during + Gx acceleration and simulated Shuttle launch

NASA Technical Reports Server (NTRS)

Krutz, Robert W., Jr.; Bagian, James P.; Burton, Russell R.; Meeker, Larry J.

1990-01-01

Space shuttle crewmembers have been equipped with a launch-entry crew escape system (LES) since the Challenger accident in 1986. Some crewmembers, wearing the new pressure suit, have reported breathing difficulties and increased effort to achieve the desired range of motion. This study was conducted to quantify the reported increased physical workloads and breathing difficulty associated with wearing the LES. Both veteran astronauts and centrifuge panel members were exposed to various + Gx profiles (including simulated shuttle launch) + Gx on the USAF School of Aerospace Medicine (USAFSAM) human-use centrifuge. Maximum heart rate data showed no increased workload associated with arm and head movement in the LES when compared to the flight suit/helmet ensemble (LEH). However, the LES did impose a significant increase in breathing difficulty beginning at +2.5 Gx which was demonstrated by a decrease in forced vital capacity and subjected questionnaries.

The effects of Pilates breathing trainings on trunk muscle activation in healthy female subjects: a prospective study

PubMed Central

Kim, Sung-Tae; Lee, Joon-Hee

2017-01-01

[Purpose] To investigate the effects of Pilates breathing on trunk muscle activation. [Subjects and Methods] Twenty-eight healthy female adults were selected for this study. Participants’ trunk muscle activations were measured while they performed curl-ups, chest-head lifts, and lifting tasks. Pilates breathing trainings were performed for 60 minutes per each session, 3 times per week for 2 weeks. Post-training muscle activations were measured by the same methods used for the pre-training muscle activations. [Results] All trunk muscles measured in this study had increased activities after Pilates breathing trainings. All activities of the transversus abdominis/internal abdominal oblique, and multifidus significantly increased. [Conclusion] Pilates breathing increased activities of the trunk stabilizer muscles. Activation of the trunk muscle indicates that practicing Pilates breathing while performing lifting tasks will reduce the risk of trunk injuries. PMID:28265138

The effects of Pilates breathing trainings on trunk muscle activation in healthy female subjects: a prospective study.

PubMed

Kim, Sung-Tae; Lee, Joon-Hee

2017-02-01

[Purpose] To investigate the effects of Pilates breathing on trunk muscle activation. [Subjects and Methods] Twenty-eight healthy female adults were selected for this study. Participants' trunk muscle activations were measured while they performed curl-ups, chest-head lifts, and lifting tasks. Pilates breathing trainings were performed for 60 minutes per each session, 3 times per week for 2 weeks. Post-training muscle activations were measured by the same methods used for the pre-training muscle activations. [Results] All trunk muscles measured in this study had increased activities after Pilates breathing trainings. All activities of the transversus abdominis/internal abdominal oblique, and multifidus significantly increased. [Conclusion] Pilates breathing increased activities of the trunk stabilizer muscles. Activation of the trunk muscle indicates that practicing Pilates breathing while performing lifting tasks will reduce the risk of trunk injuries.

Impact of respiratory therapy in vital capacity and functionality of patients undergoing abdominal surgery

PubMed Central

Fernandes, Shanlley Cristina da Silva; dos Santos, Rafaella Souza; Giovanetti, Erica Albanez; Taniguchi, Corinne; Silva, Cilene Saghabi de Medeiros; Eid, Raquel Afonso Caserta; Timenetsky, Karina Tavares; Carnieli-Cazati, Denise

2016-01-01

ABSTRACT Objective To evaluate the vital capacity after two chest therapy techniques in patients undergoing abdominal surgical. Methods A prospective randomized study carried out with patients admitted to the Intensive Care Unit after abdominal surgery. We checked vital capacity, muscular strength using the Medical Research Council scale, and functionality with the Functional Independence Measure the first time the patient was breathing spontaneously (D1), and also upon discharge from the Intensive Care Unit (Ddis). Between D1 and Ddis, respiratory therapy was carried out according to the randomized group. Results We included 38 patients, 20 randomized to Positive Intermittent Pressure Group and 18 to Volumetric Incentive Spirometer Group. There was no significant gain related to vital capacity of D1 and Ddis of Positive Intermittent Pressure Group (mean 1,410mL±547.2 versus 1,809mL±692.3; p=0.979), as in the Volumetric Incentive Spirometer Group (1,408.3mL±419.1 versus 1,838.8mL±621.3; p=0.889). We observed a significant improvement in vital capacity in D1 (p<0.001) and Ddis (p<0.001) and in the Functional Independence Measure (p<0.001) after respiratory therapy. The vital capacity improvement was not associated with gain of muscle strength. Conclusion Chest therapy, with positive pressure and volumetric incentive spirometer, was effective in improving vital capacity of patients submitted to abdominal surgery. PMID:27462894

Application of drug testing using exhaled breath for compliance monitoring of drug addicts in treatment.

PubMed

Carlsson, Sten; Olsson, Robert; Lindkvist, Irene; Beck, Olof

2015-04-01

Exhaled breath has recently been identified as a possible matrix for drug testing. This study explored the potential of this new method for compliance monitoring of patients being treated for dependence disorders. Outpatients in treatment programs were recruited for this study. Urine was collected as part of clinical routine and a breath sample was collected in parallel together with a questionnaire about their views of the testing procedure. Urine was analyzed for amphetamines, benzodiazepines, cannabis, cocaine, buprenorphine, methadone and opiates using CEDIA immunochemical screening and mass spectrometry confirmation. The exhaled breath was collected using the SensAbues device and analyzed by mass spectrometry for amphetamine, methamphetamine, diazepam, oxazepam, tetrahydrocannabinol, cocaine, benzoylecgonine, buprenorphine, methadone, morphine, codeine and 6-acetylmorphine. A total of 122 cases with parallel urine and breath samples were collected; 34 of these were negative both in urine and breath. Out of 88 cases with positive urine samples 51 (58%) were also positive in breath. Among the patients on methadone treatment, all were positive for methadone in urine and 83% were positive in breath. Among patients in treatment with buprenorphine, 92% were positive in urine and among those 80% were also positive in breath. The questionnaire response documented that in general, patients accepted drug testing well and that the breath sampling procedure was preferred. Compliance testing for the intake of prescribed and unprescribed drugs among patients in treatment for dependence disorders using the exhaled breath sampling technique is a viable method and deserves future attention.

Human breath metabolomics using an optimized noninvasive exhaled breath condensate sampler

PubMed Central

Zamuruyev, Konstantin O.; Aksenov, Alexander A.; Pasamontes, Alberto; Brown, Joshua F.; Pettit, Dayna R.; Foutouhi, Soraya; Weimer, Bart C.; Schivo, Michael; Kenyon, Nicholas J.; Delplanque, Jean-Pierre; Davis, Cristina E.

2017-01-01

Exhaled breath condensate (EBC) analysis is a developing field with tremendous promise to advance personalized, non-invasive health diagnostics as new analytical instrumentation platforms and detection methods are developed. Multiple commercially-available and researcher-built experimental samplers are reported in the literature. However, there is very limited information available to determine an effective breath sampling approach, especially regarding the dependence of breath sample metabolomic content on the collection device design and sampling methodology. This lack of an optimal standard procedure results in a range of reported results that are sometimes contradictory. Here, we present a design of a portable human EBC sampler optimized for collection and preservation of the rich metabolomic content of breath. The performance of the engineered device is compared to two commercially available breath collection devices: the RTube™ and TurboDECCS. A number of design and performance parameters are considered, including: condenser temperature stability during sampling, collection efficiency, condenser material choice, and saliva contamination in the collected breath samples. The significance of the biological content of breath samples, collected with each device, is evaluated with a set of mass spectrometry methods and was the primary factor for evaluating device performance. The design includes an adjustable mass-size threshold for aerodynamic filtering of saliva droplets from the breath flow. Engineering an inexpensive device that allows efficient collection of metalomic-rich breath samples is intended to aid further advancement in the field of breath analysis for non-invasive health diagnostic. EBC sampling from human volunteers was performed under UC Davis IRB protocol 63701-3 (09/30/2014-07/07/2017). PMID:28004639

Human breath metabolomics using an optimized non-invasive exhaled breath condensate sampler.

PubMed

Zamuruyev, Konstantin O; Aksenov, Alexander A; Pasamontes, Alberto; Brown, Joshua F; Pettit, Dayna R; Foutouhi, Soraya; Weimer, Bart C; Schivo, Michael; Kenyon, Nicholas J; Delplanque, Jean-Pierre; Davis, Cristina E

2016-12-22

Exhaled breath condensate (EBC) analysis is a developing field with tremendous promise to advance personalized, non-invasive health diagnostics as new analytical instrumentation platforms and detection methods are developed. Multiple commercially-available and researcher-built experimental samplers are reported in the literature. However, there is very limited information available to determine an effective breath sampling approach, especially regarding the dependence of breath sample metabolomic content on the collection device design and sampling methodology. This lack of an optimal standard procedure results in a range of reported results that are sometimes contradictory. Here, we present a design of a portable human EBC sampler optimized for collection and preservation of the rich metabolomic content of breath. The performance of the engineered device is compared to two commercially available breath collection devices: the RTube ™ and TurboDECCS. A number of design and performance parameters are considered, including: condenser temperature stability during sampling, collection efficiency, condenser material choice, and saliva contamination in the collected breath samples. The significance of the biological content of breath samples, collected with each device, is evaluated with a set of mass spectrometry methods and was the primary factor for evaluating device performance. The design includes an adjustable mass-size threshold for aerodynamic filtering of saliva droplets from the breath flow. Engineering an inexpensive device that allows efficient collection of metalomic-rich breath samples is intended to aid further advancement in the field of breath analysis for non-invasive health diagnostic. EBC sampling from human volunteers was performed under UC Davis IRB protocol 63701-3 (09/30/2014-07/07/2017).

Syllable-Related Breathing in Infants in the Second Year of Life

PubMed Central

Parham, Douglas F.; Buder, Eugene H.; Oller, D. Kimbrough; Boliek, Carol A.

2010-01-01

Purpose This study explored whether breathing behaviors of infants within the second year of life differ between tidal breathing and breathing supporting single unarticulated syllables and canonical/articulated syllables. Method Vocalizations and breathing kinematics of nine infants between 53 and 90 weeks of age were recorded. A strict selection protocol was used to identify analyzable breath cycles. Syllables were categorized based on consensus coding. Inspiratory and expiratory durations, excursions, and slopes were calculated for the three breath cycle types and normalized using mean tidal breath measures. Results Tidal breathing cycles were significantly different from syllable-related cycles on all breathing measures. There were no significant differences between unarticulated syllable cycles and canonical syllable cycles, even after controlling for utterance duration and sound pressure level. Conclusions Infants in the second year of life exhibit clear differences between tidal breathing and speech-related breathing, but categorically distinct breath support for syllable types with varying articulatory demands was not evident in the current findings. Speech development introduces increasingly complex utterances, so older infants may produce detectable articulation-related adaptations of breathing kinematics. For younger infants, breath support may vary systematically among utterance types, due more to phonatory variations than to articulatory demands. PMID:21173390

Benefits of supplemental oxygen in exercise training in nonhypoxemic chronic obstructive pulmonary disease patients.

PubMed

Emtner, Margareta; Porszasz, Janos; Burns, Mary; Somfay, Attila; Casaburi, Richard

2003-11-01

Supplemental oxygen improves exercise tolerance of normoxemic and hypoxemic chronic obstructive pulmonary disease (COPD) patients. We determined whether nonhypoxemic COPD patients undergoing exercise training while breathing supplemental oxygen achieve higher intensity and therefore improve exercise capacity more than patients breathing air. A double-blinded trial was performed involving 29 nonhypoxemic patients (67 years, exercise SaO2 > 88%) with COPD (FEV1 = 36% predicted). All exercised on cycle ergometers for 45 minutes, 3 times per week for 7 weeks at high-intensity targets. During exercise, they received oxygen (3 L/minute) (n = 14) or compressed air (3 L/minute) (n = 15). Both groups had a higher exercise tolerance after training and when breathing oxygen. However, the oxygen-trained group increased the training work rate more rapidly than the air-trained group. The mean +/- SD work rate during the last week was 62 +/- 19 W (oxygen-trained group) and 52 +/- 22 W (air-trained group) (p < 0.01). After training, endurance in constant work rate tests increased more in the oxygen-trained group (14.5 minutes) than in the air-trained group (10.5 minutes) (p < 0.05). At isotime, the breathing rate decreased four breaths per minute in the oxygen-trained group and one breath per minute in the air-trained group (p = 0.001). We conclude that supplemental oxygen provided during high-intensity training yields higher training intensity and evidence of gains in exercise tolerance in laboratory testing.

Performance Analysis of Air Breathing Proton Exchange Membrane Fuel Cell Stack (PEMFCS) At Different Operating Condition

NASA Astrophysics Data System (ADS)

Sunil, V.; Venkata siva, G.; Yoganjaneyulu, G.; Ravikumar, V. V.

2017-08-01

The answer for an emission free power source in future is in the form of fuel cells which combine hydrogen and oxygen producing electricity and a harmless by product-water. A proton exchange membrane (PEM) fuel cell is ideal for automotive applications. A single cell cannot supply the essential power for any application. Hence PEM fuel cell stacks are used. The effect of different operating parameters namely: type of convection, type of draught, hydrogen flow rate, hydrogen inlet pressure, ambient temperature and humidity, hydrogen humidity, cell orientation on the performance of air breathing PEM fuel cell stack was analyzed using a computerized fuel cell test station. Then, the fuel cell stack was subjected to different load conditions. It was found that the stack performs very poorly at full capacity (runs only for 30 min. but runs for 3 hours at 50% capacity). Hence, a detailed study was undertaken to maximize the duration of the stack’s performance at peak load.

Electret filter collects more exhaled albumin than glass condenser

PubMed Central

Jia, Ziru; Liu, Hongying; Li, Wang; Xie, Dandan; Cheng, Ke; Pi, Xitian

2018-01-01

Abstract In recent years, noninvasive diagnosis based on biomarkers in exhaled breath has been extensively studied. The procedure of biomarker collection is a key step. However, the traditional condenser method has low efficacy in collecting nonvolatile compounds especially the protein biomarkers in breath. To solve this deficiency, here we propose an electret filter method. Exhaled breath of 6 volunteers was collected with a glass condenser and an electret filter. The amount of albumin was analyzed. Furthermore, the difference of exhaled albumin between smokers and nonsmokers was evaluated. The electret filter method collected more albumin than the glass condenser method at the same breath volume level (P < .01). Smokers exhaling more albumin than nonsmokers were also observed (P < .01). The electret filter is capable of collecting proteins more effectively than the condenser method. In addition, smokers tend to exhale more albumin than nonsmokers. PMID:29384875

Nonlinear damage identification of breathing cracks in Truss system

NASA Astrophysics Data System (ADS)

Zhao, Jie; DeSmidt, Hans

2014-03-01

The breathing cracks in truss system are detected by Frequency Response Function (FRF) based damage identification method. This method utilizes damage-induced changes of frequency response functions to estimate the severity and location of structural damage. This approach enables the possibility of arbitrary interrogation frequency and multiple inputs/outputs which greatly enrich the dataset for damage identification. The dynamical model of truss system is built using the finite element method and the crack model is based on fracture mechanics. Since the crack is driven by tensional and compressive forces of truss member, only one damage parameter is needed to represent the stiffness reduction of each truss member. Assuming that the crack constantly breathes with the exciting frequency, the linear damage detection algorithm is developed in frequency/time domain using Least Square and Newton Raphson methods. Then, the dynamic response of the truss system with breathing cracks is simulated in the time domain and meanwhile the crack breathing status for each member is determined by the feedback from real-time displacements of member's nodes. Harmonic Fourier Coefficients (HFCs) of dynamical response are computed by processing the data through convolution and moving average filters. Finally, the results show the effectiveness of linear damage detection algorithm in identifying the nonlinear breathing cracks using different combinations of HFCs and sensors.

Air-breathing behavior, oxygen concentrations, and ROS defense in the swimbladders of two erythrinid fish, the facultative air-breathing jeju, and the non-air-breathing traira during normoxia, hypoxia and hyperoxia.

PubMed

Pelster, Bernd; Wood, Chris M; Jung, Ellen; Val, Adalberto L

2018-05-01

The jeju Hoplerythrinus unitaeniatus and the traira Hoplias malabaricus are two neighboring genera from the family of erythrinid fish, both possessing a two-chambered physostomous swimbladder. In the jeju the anterior section of the posterior bladder is highly vascularized, and the swimbladder is used for aerial respiration; the traira, in turn, is a water-breather that uses the swimbladder as a buoyancy organ and not for aerial oxygen uptake. Measurement of swimbladder oxygen partial pressure (PO 2 ) of fish kept at 26 °C in normoxic, hyperoxic (28-32 mg O 2 L - 1 ) or hypoxic (1-1.5 mg O 2 L - 1 ) water revealed constant values in traira swimbladder. Under normoxic conditions in the jeju swimbladder PO 2 was higher than in traira, and the PO 2 significantly increased under hyperoxic conditions, even in the absence of air breathing. In jeju, air-breathing activity increased significantly under hypoxic conditions. Hypoxic air-breathing activity was negatively correlated to swimbladder PO 2 , indicating that the swimbladder was intensely used for gas exchange under these conditions. In traira, the capacity of the ROS defense system, as assessed by measurement of activities of enzymes involved in ROS degradation and total glutathione (GSH + GSSG) concentration, was elevated after 4 h of hyperoxic and/or hypoxic exposure, although swimbladder PO 2 was not affected. In jeju, experiencing a higher variability in swimbladder PO 2 due to the air-breathing activity, only a reduced responsiveness of the ROS defense system to changing environmental PO 2 was detected.

Diagnostic Chemical Analysis of Exhaled Human Breath Using a Novel Sub-Millimeter Spectroscopic Approach

NASA Astrophysics Data System (ADS)

Fosnight, Alyssa M.; Moran, Benjamin L.; Branco, Daniela R.; Thomas, Jessica R.; Medvedev, Ivan R.

2013-06-01

As many as 3000 chemicals are reported to be found in exhaled human breath. Many of these chemicals are linked to certain health conditions and environmental exposures. Present state of the art techniques used for analysis of exhaled human breath include mass spectrometry based methods, infrared spectroscopic sensors, electro chemical sensors and semiconductor oxide based testers. Some of these techniques are commercially available but are somewhat limited in their specificity and exhibit fairly high probability of false alarm. Here, we present the results of our most recent study which demonstrated a novel application of a terahertz high resolutions spectroscopic technique to the analysis of exhaled human breath, focused on detection of ethanol in the exhaled breath of a person which consumed an alcoholic drink. This technique possesses nearly ``absolute'' specificity and we demonstrated its ability to uniquely identify ethanol, methanol, and acetone in human breath. This project is now complete and we are looking to extend this method of chemical analysis of exhaled human breath to a broader range of chemicals in an attempt to demonstrate its potential for biomedical diagnostic purposes.

A novel CT acquisition and analysis technique for breathing motion modeling

NASA Astrophysics Data System (ADS)

Low, Daniel A.; White, Benjamin M.; Lee, Percy P.; Thomas, David H.; Gaudio, Sergio; Jani, Shyam S.; Wu, Xiao; Lamb, James M.

2013-06-01

To report on a novel technique for providing artifact-free quantitative four-dimensional computed tomography (4DCT) image datasets for breathing motion modeling. Commercial clinical 4DCT methods have difficulty managing irregular breathing. The resulting images contain motion-induced artifacts that can distort structures and inaccurately characterize breathing motion. We have developed a novel scanning and analysis method for motion-correlated CT that utilizes standard repeated fast helical acquisitions, a simultaneous breathing surrogate measurement, deformable image registration, and a published breathing motion model. The motion model differs from the CT-measured motion by an average of 0.65 mm, indicating the precision of the motion model. The integral of the divergence of one of the motion model parameters is predicted to be a constant 1.11 and is found in this case to be 1.09, indicating the accuracy of the motion model. The proposed technique shows promise for providing motion-artifact free images at user-selected breathing phases, accurate Hounsfield units, and noise characteristics similar to non-4D CT techniques, at a patient dose similar to or less than current 4DCT techniques.

The respiratory system under weightlessness

NASA Technical Reports Server (NTRS)

Paiva, M.; Engel, L. A.; Hughes, J. M. B.; Guy, H. J.; Prisk, G. K.; West, J. B.

1987-01-01

Studies of pulmonary functions at rest to be studied on Spacelab mission D-2 are introduced. Gravity dependence of the distribution of ventilation (single breath washout, multibreath washout-washin); chest wall shape and motion; and the vascular compartment (lung blood flow, capillary volume, liquid content, diffusive capacity) are discussed.

Effect of Surgical Curve Correction on Exercise Tolerance and Physical Capacities in Patients of Severe Spinal Deformity.

PubMed

Patil, Prateek C; Rathod, Ashok K; Borde, Mandar; Singh, Vishwajeet; Singh, Hemant U

2016-12-01

Traditionally, surgical intervention for patients with a spinal deformity has been considered for cosmetic benefits, but surgical intervention can alter the lung physiology or volumes and in turn leads to increase in physical capacity and exercise tolerance. Therefore, we conducted this to determine whether a surgical correction would restore the lung physiology, physical capacity and exercise tolerance in patients with kyphoscoliosis. To evaluate the usage of six-minute walk test scores and modified Borg scores as tools/measures for exercise tolerance in patients with spinal deformity and to study the effects of surgical correction of spinal deformity on exercise tolerance with above parameters as the measures. Thirty patients with spinal deformity, who had undergone surgery for deformity correction, were evaluated. All patients were investigated pre-operatively with x-rays of the spine (anteroposterior and lateral views). Clinical tests like breath holding time (after full inspiration) in number of seconds, modified Borg scores, six-minute walk test scores (heart rate, respiratory rate, maximum distance walked); were recorded as measures of exercise tolerance. The patients were followed up on the first, third, sixth and twelfth month post-operatively and tested clinically for breath holding time, modified Borg scores, six-minute walk test scores (heart rate, respiratory rate, maximum distance walked) and x-rays of the spine (anteroposterior and lateral views). In our study, breath holding time (p-value = 0.001) and modified Borg scores (p-value = 0.012) showed a significant improvement at 12 months post-operatively. We noted similar findings with heart rate, respiratory rate and maximum distance walked after a six-minute walk test. Improvements were noted in all the parameters, especially in the group of patients with greater than 60 degrees of cobb angle. However, the differences between the two groups (pre-operative cobb angle less than 60 degrees and pre-operative cobb angle more than 60 degrees) were not significant. The results were analysed and tested for significance using Student's t-test (paired and unpaired as appropriate) and Wilcoxon signed rank test. Surgical correction in cases of spinal deformity improves the cosmetic appearance and balance in the patients. Favourable results of surgical intervention were found in exercise tolerance with improvements in modified Borg scores, six-minute walk test results and breath holding time. The above parameters appear to be good tools for the assessment of physical capacity and exercise tolerance in patients with spinal deformity.

Paced respiration with end-expiration technique offers superior BOLD signal repeatability for breath-hold studies.

PubMed

Scouten, A; Schwarzbauer, C

2008-11-01

As a simple, non-invasive method of blood oxygenation level-dependent (BOLD) signal calibration, the breath-hold task offers considerable potential for the quantification of neuronal activity from functional magnetic resonance imaging (fMRI) measurements. With an aim to improve the precision of this calibration method, the impact of respiratory rate control on the BOLD signal achieved with the breath-hold task was investigated. In addition to self-paced breathing, three different computer-paced breathing rates were imposed during the periods between end-expiration breath-hold blocks. The resulting BOLD signal timecourses and statistical activation maps were compared in eleven healthy human subjects. Results indicate that computer-paced respiration produces a larger peak BOLD signal increase with breath-hold than self-paced breathing, in addition to lower variability between trials. This is due to the more significant post-breath-hold signal undershoot present in self-paced runs, a characteristic which confounds the definition of baseline and is difficult to accurately model. Interestingly, the specific respiratory rate imposed between breath-hold periods generally does not have a statistically significant impact on the BOLD signal change. This result can be explained by previous reports of humans adjusting their inhalation depth to compensate for changes in rate, with the end-goal of maintaining homeostatic ventilation. The advantage of using end-expiration relative to end-inspiration breath-hold is apparent in view of the high repeatability of the BOLD signal in the present study, which does not suffer from the previously reported high variability associated with uncontrolled inspiration depth when using the end-inspiration technique.

Breath Analysis in Disease Diagnosis: Methodological Considerations and Applications

PubMed Central

Lourenço, Célia; Turner, Claire

2014-01-01

Breath analysis is a promising field with great potential for non-invasive diagnosis of a number of disease states. Analysis of the concentrations of volatile organic compounds (VOCs) in breath with an acceptable accuracy are assessed by means of using analytical techniques with high sensitivity, accuracy, precision, low response time, and low detection limit, which are desirable characteristics for the detection of VOCs in human breath. “Breath fingerprinting”, indicative of a specific clinical status, relies on the use of multivariate statistics methods with powerful in-built algorithms. The need for standardisation of sample collection and analysis is the main issue concerning breath analysis, blocking the introduction of breath tests into clinical practice. This review describes recent scientific developments in basic research and clinical applications, namely issues concerning sampling and biochemistry, highlighting the diagnostic potential of breath analysis for disease diagnosis. Several considerations that need to be taken into account in breath analysis are documented here, including the growing need for metabolomics to deal with breath profiles. PMID:24957037

Breath analysis in disease diagnosis: methodological considerations and applications.

PubMed

Lourenço, Célia; Turner, Claire

2014-06-20

Breath analysis is a promising field with great potential for non-invasive diagnosis of a number of disease states. Analysis of the concentrations of volatile organic compounds (VOCs) in breath with an acceptable accuracy are assessed by means of using analytical techniques with high sensitivity, accuracy, precision, low response time, and low detection limit, which are desirable characteristics for the detection of VOCs in human breath. "Breath fingerprinting", indicative of a specific clinical status, relies on the use of multivariate statistics methods with powerful in-built algorithms. The need for standardisation of sample collection and analysis is the main issue concerning breath analysis, blocking the introduction of breath tests into clinical practice. This review describes recent scientific developments in basic research and clinical applications, namely issues concerning sampling and biochemistry, highlighting the diagnostic potential of breath analysis for disease diagnosis. Several considerations that need to be taken into account in breath analysis are documented here, including the growing need for metabolomics to deal with breath profiles.

Effect of Time-of-Flight Information on PET/MR Reconstruction Artifacts: Comparison of Free-breathing versus Breath-hold MR-based Attenuation Correction.

PubMed

Delso, Gaspar; Khalighi, Mohammed; Ter Voert, Edwin; Barbosa, Felipe; Sekine, Tetsuro; Hüllner, Martin; Veit-Haibach, Patrick

2017-01-01

Purpose To evaluate the magnitude and anatomic extent of the artifacts introduced on positron emission tomographic (PET)/magnetic resonance (MR) images by respiratory state mismatch in the attenuation map. Materials and Methods The method was tested on 14 patients referred for an oncologic examination who underwent PET/MR imaging. The acquisition included standard PET and MR series for each patient, and an additional attenuation correction series was acquired by using breath hold. PET data were reconstructed with and without time-of-flight (TOF) information, first by using the standard free-breathing attenuation map and then again by using the additional breath-hold map. Two-tailed paired t testing and linear regression with 0 intercept was performed on TOF versus non-TOF and free-breathing versus breath-hold data for all detected lesions. Results Fluorodeoxyglucose-avid lesions were found in eight of the 14 patients included in the study. The uptake differences (maximum standardized uptake values) between PET reconstructions with free-breathing versus breath-hold attenuation ranged, for non-TOF reconstructions, from -18% to 26%. The corresponding TOF reconstructions yielded differences from -15% to 18%. Conclusion TOF information was shown to reduce the artifacts caused at PET/MR by respiratory mismatch between emission and attenuation data. © RSNA, 2016 Online supplemental material is available for this article.

Positioning of electrode plane systematically influences EIT imaging.

PubMed

Krueger-Ziolek, Sabine; Schullcke, Benjamin; Kretschmer, Jörn; Müller-Lisse, Ullrich; Möller, Knut; Zhao, Zhanqi

2015-06-01

Up to now, the impact of electrode positioning on electrical impedance tomography (EIT) had not been systematically analyzed due to the lack of a reference method. The aim of the study was to determine the impact of electrode positioning on EIT imaging in spontaneously breathing subjects at different ventilation levels with our novel lung function measurement setup combining EIT and body plethysmography. EIT measurements were conducted in three transverse planes between the 3rd and 4th intercostal space (ICS), at the 5th ICS and between the 6th and 7th ICS (named as cranial, middle and caudal) on 12 healthy subjects. Pulmonary function tests were performed simultaneously by body plethysmography to determine functional residual capacity (FRC), vital capacity (VC), tidal volume (VT), expiratory reserve volume (ERV), and inspiratory reserve volume (IRV). Ratios of impedance changes and body plethysmographic volumes were calculated for every thorax plane (ΔIERV/ERV, ΔIVT/VT and ΔIIRV/IRV). In all measurements of a subject, FRC values and VC values differed ≤5%, which confirmed that subjects were breathing at comparable end-expiratory levels and with similar efforts. In the cranial thorax plane the normalized ΔIERV/ERV ratio in all subjects was significantly higher than the normalized ΔIIRV/IRV ratio whereas the opposite was found in the caudal chest plane. No significant difference between the two normalized ratios was found in the middle thoracic plane. Depending on electrode positioning, impedance to volume ratios may either increase or decrease in the same lung condition, which may lead to opposite clinical decisions.

The role of size in synchronous air breathing of Hoplosternum littorale.

PubMed

Sloman, Katherine A; Sloman, Richard D; De Boeck, Gudrun; Scott, Graham R; Iftikar, Fathima I; Wood, Chris M; Almeida-Val, Vera M F; Val, Adalberto L

2009-01-01

Synchronized air breathing may have evolved as a way of minimizing the predation risk known to be associated with air breathing in fish. Little is known about how the size of individuals affects synchronized air breathing and whether some individuals are required to surface earlier than necessary in support of conspecifics, while others delay air intake. Here, the air-breathing behavior of Hoplosternum littorale held in groups or in isolation was investigated in relation to body mass, oxygen tensions, and a variety of other physiological parameters (plasma lactate, hepatic glycogen, hematocrit, hemoglobin, and size of heart, branchial basket, liver, and air-breathing organ [ABO]). A mass-specific relationship with oxygen tension of first surfacing was seen when fish were held in isolation; smaller individuals surfaced at higher oxygen tensions. However, this relationship was lost when the same individuals were held in social groups of four, where synchronous air breathing was observed. In isolation, 62% of fish first surfaced at an oxygen tension lower than the calculated P(crit) (8.13 kPa), but in the group environment this was reduced to 38% of individuals. Higher oxygen tensions at first surfacing in the group environment were related to higher levels of activity rather than any of the physiological parameters measured. In fish held in isolation but denied access to the water surface for 12 h before behavioral testing, there was no mass-specific relationship with oxygen tension at first surfacing. Larger individuals with a greater capacity to store air in their ABOs may, therefore, remain in hypoxic waters for longer periods than smaller individuals when held in isolation unless prior access to the air is prevented. This study highlights how social interaction can affect air-breathing behaviors and the importance of considering both behavioral and physiological responses of fish to hypoxia to understand the survival mechanisms they employ.

Use of the single-breath method of estimating cardiac output during exercise-stress testing.

NASA Technical Reports Server (NTRS)

Buderer, M. C.; Rummel, J. A.; Sawin, C. F.; Mauldin, D. G.

1973-01-01

The single-breath cardiac output measurement technique of Kim et al. (1966) has been modified for use in obtaining cardiac output measurements during exercise-stress tests on Apollo astronauts. The modifications involve the use of a respiratory mass spectrometer for data acquisition and a digital computer program for data analysis. The variation of the modified method for triplicate steady-state cardiac output measurements was plus or minus 1 liter/min. The combined physiological and methodological variation seen during a set of three exercise tests on a series of subjects was 1 to 2.5 liter/min. Comparison of the modified method with the direct Fick technique showed that although the single-breath values were consistently low, the scatter of data was small and the correlation between the two methods was high. Possible reasons for the low single-breath cardiac output values are discussed.

A model study of periodic breathing, stability of the neonatal respiratory system, and causes of sudden infant death syndrome.

PubMed

Tehrani, F T

1997-09-01

A mathematical model of the neonatal respiratory system has been modified and used to examine the system under various physiological conditions at different stages of maturity. The respiratory responses in hypoxia, periodic breathing and following a sign have been analyzed. The effects of different respiratory parameters on the stability of the system for normal and premature infants have been investigated. The causes of periodic breathing, apnea spells and sudden infant death syndrome for full-term and premature infants have been studied, and the results compared with the available experimental findings. The response of the infant respiratory system has been found to be highly sensitive to several parameters of the system, as indicated by the results of this study. These significant parameters are sensitivity factor of central receptors to carbon dioxide, sensitivity factor of arterial receptors to carbon dioxide, sensitivity factor of arterial receptors to oxygen, functional residual capacity of the lungs, the alveolar-arterial oxygen difference and the lungs shunt ratio. It has been shown that different parts of the respiratory controller have antagonistic effects on hypoxic periodic breathing and apnea of infancy.

An emerging role for gasotransmitters in the control of breathing and ionic regulation in fish.

PubMed

Perry, Steve; Kumai, Y; Porteus, C S; Tzaneva, V; Kwong, R W M

2016-02-01

Three gases comprising nitric oxide, carbon monoxide and hydrogen sulphide, collectively are termed gasotransmitters. The gasotransmitters control several physiological functions in fish by acting as intracellular signaling molecules. Hydrogen sulphide, first implicated in vasomotor control in fish, plays a critical role in oxygen chemoreception owing to its production and downstream effects within the oxygen chemosensory cells, the neuroepithelial cells. Indeed, there is emerging evidence that hydrogen sulphide may contribute to oxygen sensing in both fish and mammals by promoting membrane depolarization of the chemosensory cells. Unlike hydrogen sulphide which stimulates breathing in zebrafish, carbon monoxide inhibits ventilation in goldfish and zebrafish whereas nitric oxide stimulates breathing in zebrafish larvae while inhibiting breathing in adults. Gasotransmitters also modulate ionic uptake in zebrafish. Though nothing is known about the role of CO, reduced activities of branchial Na(+)/K(+)-ATPase and H(+)-ATPase activities in the presence of NO donors suggest an inhibitory role of NO in fish osmoregulation. Hydrogen sulphide inhibits Na(+) uptake in zebrafish larvae and contributes to lowering Na(+) uptake capacity in fish acclimated to Na(+)-enriched water whereas it stimulates Ca(2+) uptake in larvae exposed to Ca(2+)-poor water.

Preliminary observations on the effect of hypoxic and hyperbaric stress on pulmonary gas exchange in breath-hold divers.

PubMed

Garbella, Erika; Piarulli, Andrea; Fornai, Edo; Pingitore, Alessandro; Prediletto, Renato

2011-06-01

To evaluate pulmonary alveolar-capillary membrane integrity and ventilation/perfusion mismatch after breath-hold diving. Pulmonary diffusing capacity to carbon monoxide (DLCO) and nitric oxide (DLNO), haemoglobin (Hb) and haematocrit (Hct) were measured in six elite divers before and at 2, 10 and 25 minutes after a maximal breath-hold dive to a depth of 10 metres' sea water. Compared to pre-dive, DLCO showed a slight increase at 2 minutes in five subjects and a tendency to decrease at 25 minutes (P < 0.001) in all subjects. DLNO showed an increase at 10 minutes in three divers and a slight decrease at 25 minutes in five subjects. There was a small but significant (P < 0.001) increase in Hb and Hct at 2 minutes, possibly affecting the DLCO measurements. An early but transient increase in DLCO in five divers may reflect the central shift in blood volume during a breath-hold dive. The late parallel decrease in DLCO and DLNO likely reflects alveolar-capillary distress (interstitial oedema). The DLNO increase in three subjects at 10 minutes may suggest ventilation/perfusion mismatch.

Validation of 13C-acetic acid breath test by measuring effects of loperamide, morphine, mosapride, and itopride on gastric emptying in mice.

PubMed

Matsumoto, Kenjiro; Kimura, Hiroshi; Tashima, Kimihito; Uchida, Masayuki; Horie, Syunji

2008-10-01

Several methods are used to evaluate gastric motility in rodents, but they all have technical limitations. Recent technical developments enable a convenient method to evaluate gastric motility. The (13)C-acetic acid breath test in rodents is a non-invasive and repeatable method that can be used without physical restraints. The present study aimed to validate the (13)C-acetic acid breath test by measuring the effects of loperamide, morphine, mosapride, and itopride on gastric emptying in mice. Loperamide (1-10 mg/kg) and morphine (1.25-10 mg/kg) slowed gastric emptying and decreased the maximum concentration (C(max)) and area under the curve (AUC(90 min)) value in a dose-dependent manner. Mosapride (0.2-5 mg/kg) accelerated gastric emptying and increased C(max) value. Mosapride (20 mg/kg) did not accelerate gastric emptying on the (13)C-breath test. Itopride (30 mg/kg, per os) significantly accelerated gastric emptying compared with the vehicle group. In a comparison with the conventional phenol red test, there was a correlation between the C(max) value of breath test and gastric emptying (%) of phenol red tests in treatment with loperamide or mosapride. These results indicate that the (13)C-acetic acid breath test is an accurate, noninvasive, and simple method for monitoring gastric emptying in mice. This method is useful to assess the effect of drugs and gut function pharmacologically.

Analysis of breath volatile organic compounds as a screening tool for detection of Tuberculosis in cattle

USDA-ARS?s Scientific Manuscript database

• Keywords: bovine tuberculosis; Mycobacterium bovis; breath analysis; volatile organic compound; gas chromatography; mass spectrometry; NaNose • Introduction: This presentation describes two studies exploring the use of breath VOCs to identify Mycobacterium bovis infection in cattle. • Methods: ...

Effects of side lying on lung function in older individuals.

PubMed

Manning, F; Dean, E; Ross, J; Abboud, R T

1999-05-01

Body positioning exerts a strong effect on pulmonary function, but its effect on other components of the oxygen transport pathway are less well understood, especially the effects of side-lying positions. This study investigated the interrelationships between side-lying positions and indexes of lung function such as spirometry, alveolar diffusing capacity, and inhomogeneity of ventilation in older individuals. Nineteen nonsmoking subjects (mean age=62.8 years, SD=6.8, range=50-74) with no history of cardiac or pulmonary disease were tested over 2 sessions. The test positions were sitting and left side lying in one session and sitting and right side lying in the other session. In each of the positions, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), single-breath pulmonary diffusing capacity (DLCO/VA), and the slope of phase III (DN2%/L) of the single-breath nitrogen washout test to determine inhomogeneity of ventilation were measured. Compared with measurements obtained in the sitting position, FVC and FEV1 were decreased equally in the side-lying positions, but no change was observed in DLCO/VA or DN2%/L. Side-lying positions resulted in decreases in FVC and FEV1, which is consistent with the well-documented effects of the supine position. These findings further support the need for prescriptive rather than routine body positioning of patients with risks of cardiopulmonary compromise and the need to use upright positions in which lung volumes and capacities are maximized.

Modelling mixing within the dead space of the lung improves predictions of functional residual capacity.

PubMed

Harrison, Chris D; Phan, Phi Anh; Zhang, Cathy; Geer, Daniel; Farmery, Andrew D; Payne, Stephen J

2017-08-01

Routine estimation of functional residual capacity (FRC) in ventilated patients has been a long held goal, with many methods previously proposed, but none have been used in routine clinical practice. This paper proposes three models for determining FRC using the nitrous oxide concentration from the entire expired breath in order to improve the precision of the estimate. Of the three models proposed, a dead space with two mixing compartments provided the best results, reducing the mean limits of agreement with the FRC measured by whole body plethysmography by up to 41%. This moves away from traditional lung models, which do not account for mixing within the dead space. Compared to literature values for FRC, the results are similar to those obtained using helium dilution and better than the LUFU device (Dräger Medical, Lubeck, Germany), with significantly better limits of agreement compared to plethysmography. Copyright © 2017 Elsevier B.V. All rights reserved.

Is breath acetone a biomarker of diabetes? A historical review on breath acetone measurements.

PubMed

Wang, Zhennan; Wang, Chuji

2013-09-01

Since the ancient discovery of the 'sweet odor' in human breath gas, pursuits of the breath analysis-based disease diagnostics have never stopped. Actually, the 'smell' of the breath, as one of three key disease diagnostic techniques, has been used in Eastern-Medicine for more than three thousand years. With advancement of measuring technologies in sensitivity and selectivity, more specific breath gas species have been identified and established as a biomarker of a particular disease. Acetone is one of the breath gases and its concentration in exhaled breath can now be determined with high accuracy using various techniques and methods. With the worldwide prevalence of diabetes that is typically diagnosed through blood testing, human desire to achieve non-blood based diabetic diagnostics and monitoring has never been quenched. Questions, such as is breath acetone a biomarker of diabetes and how is the breath acetone related to the blood glucose (BG) level (the golden criterion currently used in clinic for diabetes diagnostic, monitoring, and management), remain to be answered. A majority of current research efforts in breath acetone measurements and its technology developments focus on addressing the first question. The effort to tackle the second question has begun recently. The earliest breath acetone measurement in clearly defined diabetic patients was reported more than 60 years ago. For more than a half-century, as reviewed in this paper, there have been more than 41 independent studies of breath acetone using various techniques and methods, and more than 3211 human subjects, including 1581 healthy people, 242 Type 1 diabetic patients, 384 Type 2 diabetic patients, 174 unspecified diabetic patients, and 830 non-diabetic patients or healthy subjects who are under various physiological conditions, have been used in the studies. The results of the breath acetone measurements collected in this review support that many conditions might cause changes to breath acetone concentrations; however, the results from the six independent studies using clearly-defined Type 1 and Type 2 diabetic patients unanimously support that an elevated mean breath acetone concentration exists in Type 1 diabetes. Note that there is some overlap between the ranges of breath acetone concentration in individual T1D patients and healthy subjects; this reminds one to be careful when using an acetone breath test on T1D diagnostics. Comparatively, it is too early to draw a general conclusion on the relationship between a breath acetone level and a BG level from the very limited data in the literature.

Comparison of voiding function and nociceptive behavior in two rat models of cystitis induced by cyclophosphamide or acetone

PubMed Central

Saitoh, Chikashi; Yokoyama, Hitoshi; Chancellor, Michael B.; de Groat, William C.; Yoshimura, Naoki

2009-01-01

Aims Nociceptive behavior and its relationship with bladder dysfunction were investigated in two cystitis models, which were induced by intraperitoneal (ip) injection of cyclophosphamide (CYP) or intravesical instillation of acetone, using freely moving, non-catheterized conscious rats. Methods Female Sprague-Dawley rats were used. Cystitis was induced by ip injection of CYP (100 and 200mg/kg) or intravesical instillation of acetone (10, 30 and 50%) via a polyethylene catheter temporarily inserted into the bladder through the urethra. Then the incidence of nociceptive behavior (immobility with decreased breathing rates) was scored. Voided urine was collected simultaneously and continuously to measure bladder capacity. The plasma extravasation in the bladder was quantified by an evans blue (EB) dye leakage technique. Results CYP (100mg/kg, ip) induced nociceptive behavior without affecting bladder capacity or EB concentration in the bladder. A higher dose of CYP (200mg/kg, ip) decreased bladder capacity and increased EB levels as well as nociceptive behavior. In contrast, intravesical instillation of acetone (30%) decreased bladder capacity and increased EB levels, but evoked nociceptive behavior less frequently compared with CYP-treated animals. In capsaicin pretreated rats, nociceptive behavior induced by CYP or acetone was reduced; however, the overall effects of CYP or acetone on bladder capacity and bladder EB levels were unaffected. Conclusions These results suggest that there is a difference in the induction process of nociceptive behavior and small bladder capacity after two different types of bladder irritation and that C-fiber sensitization is more directly involved in pain sensation than reduced bladder capacity. PMID:19618450

Analysis of Exhaled Breath for Disease Detection

NASA Astrophysics Data System (ADS)

Amann, Anton; Miekisch, Wolfram; Schubert, Jochen; Buszewski, Bogusław; Ligor, Tomasz; Jezierski, Tadeusz; Pleil, Joachim; Risby, Terence

2014-06-01

Breath analysis is a young field of research with great clinical potential. As a result of this interest, researchers have developed new analytical techniques that permit real-time analysis of exhaled breath with breath-to-breath resolution in addition to the conventional central laboratory methods using gas chromatography-mass spectrometry. Breath tests are based on endogenously produced volatiles, metabolites of ingested precursors, metabolites produced by bacteria in the gut or the airways, or volatiles appearing after environmental exposure. The composition of exhaled breath may contain valuable information for patients presenting with asthma, renal and liver diseases, lung cancer, chronic obstructive pulmonary disease, inflammatory lung disease, or metabolic disorders. In addition, oxidative stress status may be monitored via volatile products of lipid peroxidation. Measurement of enzyme activity provides phenotypic information important in personalized medicine, whereas breath measurements provide insight into perturbations of the human exposome and can be interpreted as preclinical signals of adverse outcome pathways.

A REVIEW OF THE US EPA'S SINGLE BREATH CANISTER (SBC) METHOD FOR EXHALED VOLATILE ORGANIC BIOMARKERS

EPA Science Inventory

Exhaled alveolar breath can provide a great deal of information about an individual?s health and previous exposure to potentially harmful xenobiotic materials. Because breath can be obtained noninvasively and its constituents directly reflect concentrations in the blood, its us...

Air breathing and aquatic gas exchange during hypoxia in armoured catfish.

PubMed

Scott, Graham R; Matey, Victoria; Mendoza, Julie-Anne; Gilmour, Kathleen M; Perry, Steve F; Almeida-Val, Vera M F; Val, Adalberto L

2017-01-01

Air breathing in fish is commonly believed to have arisen as an adaptation to aquatic hypoxia. The effectiveness of air breathing for tissue O 2 supply depends on the ability to avoid O 2 loss as oxygenated blood from the air-breathing organ passes through the gills. Here, we evaluated whether the armoured catfish (Hypostomus aff. pyreneusi)-a facultative air breather-can avoid branchial O 2 loss while air breathing in aquatic hypoxia, and we measured various other respiratory and metabolic traits important for O 2 supply and utilization. Fish were instrumented with opercular catheters to measure the O 2 tension (PO 2 ) of expired water, and air breathing and aquatic respiration were measured during progressive stepwise hypoxia in the water. Armoured catfish exhibited relatively low rates of O 2 consumption and gill ventilation, and gill ventilation increased in hypoxia due primarily to increases in ventilatory stroke volume. Armoured catfish began air breathing at a water PO 2 of 2.5 kPa, and both air-breathing frequency and hypoxia tolerance (as reflected by PO 2 at loss of equilibrium, LOE) was greater in individuals with a larger body mass. Branchial O 2 loss, as reflected by higher PO 2 in expired than in inspired water, was observed in a minority (4/11) of individuals as water PO 2 approached that at LOE. Armoured catfish also exhibited a gill morphology characterized by short filaments bearing short fused lamellae, large interlamellar cell masses, low surface area, and a thick epithelium that increased water-to-blood diffusion distance. Armoured catfish had a relatively low blood-O 2 binding affinity when sampled in normoxia (P 50 of 3.1 kPa at pH 7.4), but were able to rapidly increase binding affinity during progressive hypoxia exposure (to a P 50 of 1.8 kPa). Armoured catfish also had low activities of several metabolic enzymes in white muscle, liver, and brain. Therefore, low rates of metabolism and gill ventilation, and a reduction in branchial gas-exchange capacity, may help minimize branchial O 2 loss in armoured catfish while air breathing in aquatic hypoxia.

Hydrogen breath test in schoolchildren.

PubMed Central

Douwes, A C; Schaap, C; van der Klei-van Moorsel, J M

1985-01-01

The frequency of negative hydrogen breath tests due to colonic bacterial flora which are unable to produce hydrogen was determined after oral lactulose challenge in 98 healthy Dutch schoolchildren. There was a negative result in 9.2%. The probability of a false normal lactose breath test (1:77) was calculated from these results together with those from a separate group of children with lactose malabsorption (also determined by hydrogen breath test). A study of siblings and mothers of subjects with a negative breath test did not show familial clustering of this condition. Faecal incubation tests with various sugars showed an increase in breath hydrogen greater than 100 parts per million in those with a positive breath test while subjects with a negative breath test also had a negative faecal incubation test. The frequency of a false negative hydrogen breath test was higher than previously reported, but this does not affect the superiority of this method of testing over the conventional blood glucose determination. PMID:4004310

Morphometric partitioning of the respiratory surface area and diffusion capacity of the gills and swim bladder in juvenile Amazonian air-breathing fish, Arapaima gigas.

PubMed

Fernandes, Marisa Narciso; da Cruz, André Luis; da Costa, Oscar Tadeu Ferreira; Perry, Steven Franklin

2012-09-01

The gills and the respiratory swim bladders of juvenile specimens (mean body mass 100g) of the basal teleost Arapaima gigas (Cuvier 1829) were evaluated using stereological methods in vertical sections. The surface areas, harmonic mean barrier thicknesses and morphometric diffusing capacities for oxygen and carbon dioxide were estimated. The average respiratory surface area of the swim bladder (2173 cm² kg⁻¹) exceeded that of the gills (780 cm² kg⁻¹) by a factor of 2.79. Due to the extremely thin air-blood barrier in the swim bladder (harmonic mean 0.22 μm) and the much thicker water-blood barrier of the gills (9.61 μm), the morphometric diffusing capacity for oxygen and carbon dioxide was 88 times greater in the swim bladder than in the gills. These data clearly indicate the importance of the swim bladder, even in juvenile A. gigas that still engage in aquatic respiration. Because of the much greater diffusion constant of CO₂ than O₂ in water, the gills also remain important for CO₂ release. Copyright © 2012 Elsevier Ltd. All rights reserved.

The change of longitudinal relaxation rate in oxygen enhanced pulmonary MRI depends on age and BMI but not diffusing capacity of carbon monoxide in healthy never-smokers.

PubMed

Kindvall, Simon Sven Ivan; Diaz, Sandra; Svensson, Jonas; Wollmer, Per; Olsson, Lars E

2017-01-01

Oxygen enhanced pulmonary MRI is a promising modality for functional lung studies and has been applied to a wide range of pulmonary conditions. The purpose of this study was to characterize the oxygen enhancement effect in the lungs of healthy, never-smokers, in light of a previously established relationship between oxygen enhancement and diffusing capacity of carbon monoxide in the lung (DL,CO) in patients with lung disease. In 30 healthy never-smoking volunteers, an inversion recovery with gradient echo read-out (Snapshot-FLASH) was used to quantify the difference in longitudinal relaxation rate, while breathing air and 100% oxygen, ΔR1, at 1.5 Tesla. Measurements were performed under multiple tidal inspiration breath-holds. In single parameter linear models, ΔR1 exhibit a significant correlation with age (p = 0.003) and BMI (p = 0.0004), but not DL,CO (p = 0.33). Stepwise linear regression of ΔR1 yields an optimized model including an age-BMI interaction term. In this healthy, never-smoking cohort, age and BMI are both predictors of the change in MRI longitudinal relaxation rate when breathing oxygen. However, DL,CO does not show a significant correlation with the oxygen enhancement. This is possibly because oxygen transfer in the lung is not diffusion limited at rest in healthy individuals. This work stresses the importance of using a physiological model to understand results from oxygen enhanced MRI.

Toward Anatomical Simulation for Breath Training in Mind/Body Medicine

NASA Astrophysics Data System (ADS)

Sanders, Benjamin; Dilorenzo, Paul; Zordan, Victor; Bakal, Donald

The use of breath in healing is poorly understood by patients and professionals alike. Dysfunctional breathing is a characteristic of many unexplained symptoms and mind/body medical professionals seek methods for breath training to alleviate such problems. Our approach is to re-purpose and evolve a recently developed anatomically inspired respiration simulation which was created for synthesizing motion in entertainment for the use of visualization in breath training. In mind/body medicine, problems are often created from patients being advised to breathe according to some standard based on pace or volume. However, a breathing pattern that is comfortable and effortless for one person may not have the same benefits for the next person. The breathing rhythm which is most effortless for each person needs to be dynamically identified. To this end, in this chapter, we employ optimization to modify a generic model of respiration to fit the breath patterns of specific individuals. In practice, the corresponding visualization which is specific to individual patients could be used to train proper breath behavior, both by showing specific (abnormal) practice and recommended modification(s).

Breathing Maneuvers as a Vasoactive Stimulus for Detecting Inducible Myocardial Ischemia – An Experimental Cardiovascular Magnetic Resonance Study

PubMed Central

Fischer, Kady; Guensch, Dominik P; Shie, Nancy; Lebel, Julie; Friedrich, Matthias G

2016-01-01

Background Breathing maneuvers can elicit a similar vascular response as vasodilatory agents like adenosine; yet, their potential diagnostic utility in the presence of coronary artery stenosis is unknown. The objective of the study is to investigate if breathing maneuvers can non-invasively detect inducible ischemia in an experimental animal model when the myocardium is imaged with oxygenation-sensitive cardiovascular magnetic resonance (OS-CMR). Methods and Findings In 11 anesthetised swine with experimentally induced significant stenosis (fractional flow reserve <0.75) of the left anterior descending coronary artery (LAD) and 9 control animals, OS-CMR at 3T was performed during two different breathing maneuvers, a long breath-hold; and a combined maneuver of 60s of hyperventilation followed by a long breath-hold. The resulting change of myocardial oxygenation was compared to the invasive measurements of coronary blood flow, blood gases, and oxygen extraction. In control animals, all breathing maneuvers could significantly alter coronary blood flow as hyperventilation decreased coronary blood flow by 34±23%. A long breath-hold alone led to an increase of 97±88%, while the increase was 346±327% (p<0.001), when the long breath-hold was performed after hyperventilation. In stenosis animals, the coronary blood flow response was attenuated after both hyperventilation and the following breath-hold. This was matched by the observed oxygenation response as breath-holds following hyperventilation consistently yielded a significant difference in the signal of the MRI images between the perfusion territory of the stenosis LAD and remote myocardium. There was no difference between the coronary territories during the other breathing maneuvers or in the control group at any point. Conclusion In an experimental animal model, the response to a combined breathing maneuver of hyperventilation with subsequent breath-holding is blunted in myocardium subject to significant coronary artery stenosis. This maneuver may allow for detecting severe coronary artery stenosis and have a significant clinical potential as a non-pharmacological method for diagnostic testing in patients with suspected coronary artery disease. PMID:27741282

Better control with less effort: The advantage of using focused-breathing strategy over focused-distraction strategy on thought suppression.

PubMed

Ju, Yu-Jeng; Lien, Yunn-Wen

2016-02-01

It has been suggested that unwanted thoughts usually intrude during mind wandering due to a shortage of mental resources. However, strategies for suppressing such thoughts have never been examined from a mind wandering perspective. Here, we compare the effectiveness of two types of attention distraction strategies that either redirect users' attention to their own breathing (focused-breathing strategy, FBS) or to a mental image (focused-distraction strategy, FDS) as related to working memory capacities. Eighty-two undergraduates were randomly assigned into a FBS or FDS group. They completed a concentration task and a thought suppression task, in which mind wandering and thought intrusions were each measured. Our results support the hypothesis that mind wandering is positively correlated to thought intrusions and shows that FBS is more effective than FDS in reducing mind wandering and thought intrusions. Moreover, in contrast to FDS, the effect of FBS is independent of users' mental resources. Copyright © 2015 Elsevier Inc. All rights reserved.

Cardiac or Other Implantable Electronic Devices and Sleep-disordered Breathing – Implications for Diagnosis and Therapy

PubMed Central

Bitter, Thomas; Gutleben, Klaus-Jürgen; Horstkotte, Dieter; Oldenburg, Olaf

2014-01-01

Sleep-disordered breathing (SDB) is of growing interest in cardiology because SDB is a highly prevalent comorbidity in patients with a variety of cardiovascular diseases. The prevalence of SDB is particularly high in patients with cardiac dysrhythmias and/or heart failure. In this setting, many patients now have implantable cardiac devices, such as pacemakers, implantable cardioverter-defibrillators or implanted cardiac resynchronisation therapy devices (CRT). Treatment of SDB using implantable cardiac devices has been studied previously, with atrial pacing and CRT being shown not to bring about satisfactory results in SDB care. The latest generations of these devices have the capacity to determine transthoracic impedance, to detect and quantify breathing efforts and to identify SDB. The capability of implantable cardiac devices to detect SDB is of potential importance for patients with cardiovascular disease, allowing screening for SDB, monitoring of the course of SDB in relation to cardiac status, and documenting of the effects of treatment. PMID:26835077

Heat Exchanger Design in Combined Cycle Engines

NASA Astrophysics Data System (ADS)

Webber, H.; Feast, S.; Bond, A.

Combined cycle engines employing both pre-cooled air-breathing and rocket modes of operation are the most promising propulsion system for achieving single stage to orbit vehicles. The air-breathing phase is purely for augmentation of the mission velocity required in the rocket phase and as such must be mass effective, re-using the components of the rocket cycle, whilst achieving adequate specific impulse. This paper explains how the unique demands placed on the air-breathing cycle results in the need for sophisticated thermodynamics and the use of a series of different heat exchangers to enable precooling and high pressure ratio compression of the air for delivery to the rocket combustion chambers. These major heat exchanger roles are; extracting heat from incoming air in the precooler, topping up cycle flow temperatures to maintain constant turbine operating conditions and extracting rejected heat from the power cycle via regenerator loops for thermal capacity matching. The design solutions of these heat exchangers are discussed.

Cardiac or Other Implantable Electronic Devices and Sleep-disordered Breathing - Implications for Diagnosis and Therapy.

PubMed

Fox, Henrik; Bitter, Thomas; Gutleben, Klaus-Jürgen; Horstkotte, Dieter; Oldenburg, Olaf

2014-08-01

Sleep-disordered breathing (SDB) is of growing interest in cardiology because SDB is a highly prevalent comorbidity in patients with a variety of cardiovascular diseases. The prevalence of SDB is particularly high in patients with cardiac dysrhythmias and/or heart failure. In this setting, many patients now have implantable cardiac devices, such as pacemakers, implantable cardioverter-defibrillators or implanted cardiac resynchronisation therapy devices (CRT). Treatment of SDB using implantable cardiac devices has been studied previously, with atrial pacing and CRT being shown not to bring about satisfactory results in SDB care. The latest generations of these devices have the capacity to determine transthoracic impedance, to detect and quantify breathing efforts and to identify SDB. The capability of implantable cardiac devices to detect SDB is of potential importance for patients with cardiovascular disease, allowing screening for SDB, monitoring of the course of SDB in relation to cardiac status, and documenting of the effects of treatment.

Breathing silicon anodes for durable high-power operations

NASA Astrophysics Data System (ADS)

Hwang, Chihyun; Joo, Sehun; Kang, Na-Ri; Lee, Ungju; Kim, Tae-Hee; Jeon, Yuju; Kim, Jieun; Kim, Young-Jin; Kim, Ju-Young; Kwak, Sang-Kyu; Song, Hyun-Kon

2015-09-01

Silicon anode materials have been developed to achieve high capacity lithium ion batteries for operating smart phones and driving electric vehicles for longer time. Serious volume expansion induced by lithiation, which is the main drawback of silicon, has been challenged by multi-faceted approaches. Mechanically rigid and stiff polymers (e.g. alginate and carboxymethyl cellulose) were considered as the good choices of binders for silicon because they grab silicon particles in a tight and rigid way so that pulverization and then break-away of the active mass from electric pathways are suppressed. Contrary to the public wisdom, in this work, we demonstrate that electrochemical performances are secured better by letting silicon electrodes breathe in and out lithium ions with volume change rather than by fixing their dimensions. The breathing electrodes were achieved by using a polysaccharide (pullulan), the conformation of which is modulated from chair to boat during elongation. The conformational transition of pullulan was originated from its α glycosidic linkages while the conventional rigid polysaccharide binders have β linkages.

The Effect of Vocal Training Methods on Improving Turkish Accent Defects

ERIC Educational Resources Information Center

Aycan, Kivanc; Evren, Gul Fahriye

2016-01-01

Problem Statement: Despite analyses of how vocal training methods can correct or improve Turkish-language accent defects, for most voice educators, the most important methods continue to be breathe management control and correct vocalization exercises. We therefore sought to demonstrate the relationship of song lyrics to breathe control, accent…

Automatic Recognition of Breathing Route During Sleep Using Snoring Sounds

NASA Astrophysics Data System (ADS)

Mikami, Tsuyoshi; Kojima, Yohichiro

This letter classifies snoring sounds into three breathing routes (oral, nasal, and oronasal) with discriminant analysis of the power spectra and k-nearest neighbor method. It is necessary to recognize breathing route during snoring, because oral snoring is a typical symptom of sleep apnea but we cannot know our own breathing and snoring condition during sleep. As a result, about 98.8% classification rate is obtained by using leave-one-out test for performance evaluation.

Reduced exercise capacity in genetic haemochromatosis.

PubMed

Davidsen, Einar Skulstad; Liseth, Knut; Omvik, Per; Hervig, Tor; Gerdts, Eva

2007-06-01

Many patients with genetic haemochromatosis complain about fatigue and reduced physical capacity. Exercise capacity, however, has not been evaluated in larger series of haemochromatosis patients treated with repeated phlebotomy. We performed exercise echocardiography in 152 treated haemochromatosis patients (48+/-13 years, 26% women) and 50 healthy blood donors (49+/-13 years, 30% women), who served as controls. Echocardiography was performed at rest and during exercise in a semiupright position on a chair bicycle, starting from 20 W, increasing by 20 W/min. Transmitral early and atrial velocity and isovolumic relaxation time were measured at each step. Ventilatory gas exchange was measured by the breath-to-breath-technique. Compared with healthy controls, haemochromatosis patients were more obese and less trained. More of them smoked, and 17% had a history of cardiovascular or pulmonary disease. Adjusted for training, the left ventricular function and dimensions at rest did not differ between the groups. During exercise the haemochromatosis patients obtained a significantly lower peak oxygen (O2) uptake (28.1 vs. 34.4 ml/kg per min, P<0.001). In a multiple regression analysis haemochromatosis predicted lower peak O2 uptake independently of significant contributions of sex, age, and height, as well as of systolic blood pressure and log-transformed isovolumic relaxation time at peak exercise, whereas no independent association was found with weight or physical activity (multiple R=0.74, P<0.001). Adding genotype, s-ferritin, prevalence of smoking, or history of cardiopulmonary disease among the covariates in subsequent models did not change the results. Genetic haemochromatosis, even when treated with regular phlebotomy, is associated with lower exercise capacity independently of other covariates of exercise capacity.

Mapping cerebrovascular reactivity using concurrent fMRI and near infrared spectroscopy

NASA Astrophysics Data System (ADS)

Tong, Yunjie; Bergethon, Peter R.; Frederick, Blaise d.

2011-02-01

Cerebrovascular reactivity (CVR) reflects the compensatory dilatory capacity of cerebral vasculature to a dilatory stimulus and is an important indicator of brain vascular reserve. fMRI has been proven to be an effective imaging technique to obtain the CVR map when the subjects perform CO2 inhalation or the breath holding task (BH). However, the traditional data analysis inaccurately models the BOLD using a boxcar function with fixed time delay. We propose a novel way to process the fMRI data obtained during a blocked BH by using the simultaneously collected near infrared spectroscopy (NIRS) data as regressor1. In this concurrent NIRS and fMRI study, 6 healthy subjects performed a blocked BH (5 breath holds with 20s durations intermitted by 40s of regular breathing). A NIRS probe of two sources and two detectors separated by 3 cm was placed on the right side of prefrontal area of the subjects. The time course of changes in oxy-hemoglobin (Δ[HbO]) was calculated from NIRS data and shifted in time by various amounts, and resampled to the fMRI acquisition rate. Each shifted time course was used as regressor in FEAT (the analysis tool in FSL). The resulting z-statistic maps were concatenated in time and the maximal value was taken along the time for all the voxels to generate a 3-D CVR map. The new method produces more accurate and thorough CVR maps; moreover, it enables us to produce a comparable baseline cerebral vascular map if applied to resting state (RS) data.

Should chest examination be reinstated in the early diagnosis of chronic obstructive pulmonary disease?

PubMed Central

Oshaug, Katja; Halvorsen, Peder A; Melbye, Hasse

2013-01-01

Background Although proven to be associated with bronchial obstruction, chest signs are not listed among cues that should prompt spirometry in the early diagnosis of chronic obstructive pulmonary disease (COPD) in established guidelines. Aims We aimed to explore how chest findings add to respiratory symptoms and a history of smoking in the diagnosis of COPD. Methods In a cross-sectional study, patients aged 40 years or older, previously diagnosed with either asthma or COPD in primary care, answered questionnaires and underwent physical chest examination and spirometry. Results Among the 375 patients included, 39.7% had forced expiratory volume in 1 second/forced vital capacity <0.7. Hyperresonance to percussion was the strongest predictor of COPD, with a sensitivity of 20.8, a specificity of 97.8, and likelihood ratio of 9.5. In multivariate logistic regression, where pack-years, shortness of breath, and chest findings were among the explanatory variables, three physical chest findings were independent predictors of COPD. Hyperresonance to percussion yielded the highest odds ratio (OR = 6.7), followed by diminished breath sounds (OR = 5.0), and thirdly wheezes (OR = 2.3). These three chest signs also gave significant diagnostic information when added to shortness of breath and pack-years in receiver operating-characteristic curve analysis. Conclusion We found that chest signs may add to respiratory symptoms and a history of smoking in the diagnosis of COPD, and we conclude that chest signs should be reinstated as cues to early diagnosis of COPD in patients 40 years or older. PMID:23983462

Treatment response of airway clearance assessed by single-breath washout in children with cystic fibrosis.

PubMed

Abbas, Chiara; Singer, Florian; Yammine, Sophie; Casaulta, Carmen; Latzin, Philipp

2013-12-01

We studied the ability of 4 single-breath gas washout (SBW) tests to measure immediate effects of airway clearance in children with CF. 25 children aged 4-16 years with CF performed pulmonary function tests to assess short-term variability at baseline and response to routine airway clearance. Tidal helium and sulfur hexafluoride (double-tracer gas: DTG) SBW, tidal capnography, tidal and vital capacity nitrogen (N2) SBW and spirometry were applied. We analyzed the gasses' phase III slope (SnIII--normalized for tidal volume) and FEV1 from spirometry. SnIII from tidal DTG-SBW, SnIII from vital capacity N2-SBW, and FEV1 improved significantly after airway clearance. From these tests, individual change of SnIII from tidal DTG-SBW and FEV1 exceeded short-term variability in 10 and 6 children. With the tidal DTG-SBW, an easy and promising test for peripheral gas mixing efficiency, immediate pulmonary function response to airway clearance can be assessed in CF children. Copyright © 2013 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Four-dimensional dose distributions of step-and-shoot IMRT delivered with real-time tumor tracking for patients with irregular breathing: Constant dose rate vs dose rate regulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang Xiaocheng; Han-Oh, Sarah; Gui Minzhi

2012-09-15

Purpose: Dose-rate-regulated tracking (DRRT) is a tumor tracking strategy that programs the MLC to track the tumor under regular breathing and adapts to breathing irregularities during delivery using dose rate regulation. Constant-dose-rate tracking (CDRT) is a strategy that dynamically repositions the beam to account for intrafractional 3D target motion according to real-time information of target location obtained from an independent position monitoring system. The purpose of this study is to illustrate the differences in the effectiveness and delivery accuracy between these two tracking methods in the presence of breathing irregularities. Methods: Step-and-shoot IMRT plans optimized at a reference phase weremore » extended to remaining phases to generate 10-phased 4D-IMRT plans using segment aperture morphing (SAM) algorithm, where both tumor displacement and deformation were considered. A SAM-based 4D plan has been demonstrated to provide better plan quality than plans not considering target deformation. However, delivering such a plan requires preprogramming of the MLC aperture sequence. Deliveries of the 4D plans using DRRT and CDRT tracking approaches were simulated assuming the breathing period is either shorter or longer than the planning day, for 4 IMRT cases: two lung and two pancreatic cases with maximum GTV centroid motion greater than 1 cm were selected. In DRRT, dose rate was regulated to speed up or slow down delivery as needed such that each planned segment is delivered at the planned breathing phase. In CDRT, MLC is separately controlled to follow the tumor motion, but dose rate was kept constant. In addition to breathing period change, effect of breathing amplitude variation on target and critical tissue dose distribution is also evaluated. Results: Delivery of preprogrammed 4D plans by the CDRT method resulted in an average of 5% increase in target dose and noticeable increase in organs at risk (OAR) dose when patient breathing is either 10% faster or slower than the planning day. In contrast, DRRT method showed less than 1% reduction in target dose and no noticeable change in OAR dose under the same breathing period irregularities. When {+-}20% variation of target motion amplitude was present as breathing irregularity, the two delivery methods show compatible plan quality if the dose distribution of CDRT delivery is renormalized. Conclusions: Delivery of 4D-IMRT treatment plans, stemmed from 3D step-and-shoot IMRT and preprogrammed using SAM algorithm, is simulated for two dynamic MLC-based real-time tumor tracking strategies: with and without dose-rate regulation. Comparison of cumulative dose distribution indicates that the preprogrammed 4D plan is more accurately and efficiently conformed using the DRRT strategy, as it compensates the interplay between patient breathing irregularity and tracking delivery without compromising the segment-weight modulation.« less

An accurate method to quantify breathing-induced prostate motion for patients implanted with electromagnetic transponders.

PubMed

Giandini, Tommaso; Panaino, Costanza M V; Avuzzi, Barbara; Morlino, Sara; Villa, Sergio; Bedini, Nice; Carabelli, Gabriele; Frasca, Sarah C; Romanyukha, Anna; Rosenfeld, Anatoly; Pignoli, Emanuele; Valdagni, Riccardo; Carrara, Mauro

2017-03-24

To validate and apply a method for the quantification of breathing-induced prostate motion (BIPM) for patients treated with radiotherapy and implanted with electromagnetic transponders for prostate localization and tracking. For the analysis of electromagnetic transponder signal, dedicated software was developed and validated with a programmable breathing simulator phantom. The software was then applied to 1,132 radiotherapy fractions of 30 patients treated in supine position, and to a further 61 fractions of 2 patients treated in prone position. Application of the software in phantom demonstrated reliability of the developed method in determining simulated breathing frequencies and amplitudes. For supine patients, the in vivo analysis of BIPM resulted in median (maximum) amplitudes of 0.10 mm (0.35 mm), 0.24 mm (0.66 mm), and 0.17 mm (0.61 mm) in the left-right (LR), cranio-caudal (CC), and anterior-posterior (AP) directions, respectively. Breathing frequency ranged between 7.73 and 29.43 breaths per minute. For prone patients, the ranges of the BIPM amplitudes were 0.1-0.5 mm, 0.5-1.3 mm, and 0.7-1.7 mm in the LR, CC, and AP directions, respectively. The developed method was able to detect the BIPM with sub-millimeter accuracy. While for patients treated in supine position the BIPM represents a reduced source of treatment uncertainty, for patients treated in prone position, it can be higher than 3 mm.

MEASUREMENT OF VOLATILE ORGANIC COMPOUNDS IN EXHALED BREATH AS COLLECTED IN EVACUATED ELECTROPOLISHED CANISTERS

EPA Science Inventory

A set of three complementary analytical methods were developed specifically for exhaled breath as collected in evacuated stainless steel canisters using gas chromatography - mass spectrometry detection. The first is a screening method to quantify the carbon dioxide component (gen...

Determination of breath acetone in 149 type 2 diabetic patients using a ringdown breath-acetone analyzer.

PubMed

Sun, Meixiu; Chen, Zhuying; Gong, Zhiyong; Zhao, Xiaomeng; Jiang, Chenyu; Yuan, Yuan; Wang, Zhennang; Li, Yingxin; Wang, Chuji

2015-02-01

Over 90% of diabetic patients have Type 2 diabetes. Although an elevated mean breath acetone concentration has been found to exist in Type 1 diabetes (T1D), information on breath acetone in Type 2 diabetes (T2D) has yet to be obtained. In this study, we first used gas chromatography-mass spectrometry (GC-MS) to validate a ringdown breath-acetone analyzer based on the cavity-ringdown-spectroscopy technique, through comparing breath acetone concentrations in the range 0.5-2.5 ppm measured using both methods. The linear fitting of R = 0.99 suggests that the acetone concentrations obtained using both methods are consistent with a largest standard deviation of ±0.4 ppm in the lowest concentration of the range. Next, 620 breath samples from 149 T2D patients and 42 healthy subjects were collected and tested using the breath analyzer. Four breath samples were taken from each subject under each of four different conditions: fasting, 2 h post-breakfast, 2 h post-lunch, and 2 h post-dinner. Simultaneous blood glucose levels were also measured using a standard diabetic-management blood-glucose meter. For the 149 T2D subjects, their exhaled breath acetone concentrations ranged from 0.1 to 19.8 ppm; four different ranges of breath acetone concentration, 0.1-19.8, 0.1-7.1, 0.1-6.3, and 0.1-9.5 ppm, were obtained for the subjects under the four different conditions, respectively. For the 42 healthy subjects, their breath acetone concentration ranged from 0.1 to 2.6 ppm; four different ranges of breath acetone concentration, 0.3-2.6, 0.1-2.6, 0.1-1.7, and 0.3-1.6 ppm, were obtained for the four different conditions. The mean breath acetone concentration of the 149 T2D subjects was determined to be 1.5 ± 1.5 ppm, which was 1.5 times that of 1.0 ± 0.6 ppm for the 42 healthy subjects. No correlation was found between the breath acetone concentration and the blood glucose level of the T2D subjects and the healthy volunteers. This study using a relatively large number of subjects provides new data regarding breath acetone in diabetes (T1D and T2D) and suggests that an elevated mean breath acetone concentration also exists in T2D.

News from the Breath Analysis Summit 2011.

PubMed

Corradi, Massimo; Mutti, Antonio

2012-06-01

This special section highlights some of the important work presented at the Breath Analysis Summit 2011, which was held in Parma (Italy) from 11 to 14 September 2011. The meeting, which was jointly organized by the International Association for Breath Research and the University of Parma, was attended by more than 250 delegates from 33 countries, and offered 34 invited lectures and 64 unsolicited scientific contributions. The summit was organized to provide a forum to scientists, engineers and clinicians to present their latest findings and to meet industry executives and entrepreneurs to discuss key trends, future directions and technologies available for breath analysis. A major focus was on nitric oxide, exhaled breath condensate, electronic nose, mass spectrometry and newer sensor technologies. Medical applications ranged from asthma and other respiratory diseases to gastrointestinal disease, occupational diseases, critical care and cancer. Most people identify breath tests with breathalysers used by police to estimate ethanol concentration in blood. However, breath testing has far more sophisticated applications. Breath analysis is rapidly evolving as a new frontier in medical testing for disease states in the lung and beyond. Every individual has a breath fingerprint-or 'breathprint'-that can provide useful information about his or her state of health. This breathprint comprises the many thousands of molecules that are expelled with each breath we exhale. Breath research in the past few years has uncovered the scientific and molecular basis for such clinical observations. Relying on mass spectrometry, we have been able to identify many such unique substances in exhaled breath, including gases, such as nitric oxide (NO) and carbon monoxide (CO), and a wide array of volatile organic compounds. Exhaled breath also carries aerosolized droplets that can be collected as an exhaled breath condensate that contains endogenously produced non-volatile compounds. Breath analysis is now used to diagnose and monitor asthma, check for transplant organ rejection, detect lung cancer and test for Helicobacter pyloriinfection-and the list is growing. A major milestone in the scientific study of breath was marked in the 1970s when Linus Pauling demonstrated that there is more to exhaled breath than the classic gases of nitrogen, oxygen, carbon dioxide and water vapour-a lot more. Based on the gas-liquid partition chromatography analysis, Pauling reported the presence of 250 substances in exhaled breath. We now have the technology to test for any and all of these components. The field of breath analysis has made considerable advances in the 21st century and the utility of breath analysis in health care is advancing quickly. The science is rapidly expanding, the technology is improving and several new applications have been developed or are under commercial development. Breath analysis may rely on both direct (on line) and indirect (off line) reading methods: in the on-line method, breath analysis is immediately available, whereas the use of indirect methods generally involves collecting and trapping the breath sample and subsequently transferring it to an analytical instrument for analysis. Various kinds of breath samples have been used in biological monitoring, including mixed expired air and end expired air: end exhaled air represents the alveolar air concentration and mixed exhaled air represents the gas mixture coming from the dead space of the bronchial tree and the alveolar gas-exchange space. Exhaled breath analysis is an area where the modern day advances in technology and engineering meet the ever expanding need in medicine for more sensitive, specific and non-invasive tests which makes this area a major front in the interface between medicine and engineering. A major breakthrough over the past decade has been the increase in breath-based tests approved by the US Food and Drug Administration (FDA). Devices measuring common breath gases (oxygen, nitrogen, water vapour and CO(2)) in patient respiratory monitoring have served as a platform for technological growth in clinical breath-testing applications. A few exhaled breath tests have demonstrated clinical utility and are in widespread use, and several FDA-approved devices are available. These widely used exhaled breath tests include detection of blood alcohol concentration and exhaled CO(2). Other clinical applications of exhaled breath analysis include testing for H. pylori infection, lactose intolerance, heart transplant rejection and, more recently, monitoring of airway inflammation by means of exhaled NO. Examination of exhaled breath has the potential to change the existing routine approaches in human medicine. The rapidly developing new analytical and computer technologies along with novel, unorthodox ideas are prerequisites for future advances in this field. Scientists who participated in the Breath Analysis Summit 2011 were invited to submit a full length paper to the Journal of Breath Research and this issue includes eight articles which describe the different applications of breath analysis. We thank all the authors for their valuable contribution and we trust that this collection will provide useful information and an update to this rapidly evolving field, giving an example of integration among scientists who address the same topic-breath analysis-from different and complementary perspectives, from basic to clinical research.

In vitro validation of an ultrasonic flowmeter in order to measure the functional residual capacity in newborns.

PubMed

Wauer, Juliane; Leier, Tim U; Henschen, Matthias; Wauer, Roland R; Schmalisch, Gerd

2003-05-01

Ultrasonic transit-time airflow meters (UFM) allow simultaneous measurements of volume flow V'(t) and molar mass MM(t) of the breathing gas in the mainstream. Consequently, by using a suitable tracer gas the functional residual capacity (FRC) of the lungs can be measured by a gas wash-in/wash-out technique. The aim of this study was to investigate the in vitro accuracy of a multiple-breath wash-in/wash-out technique for FRC measurements using 4% sulphur hexafluoride (SF6) in air. V'(t) and MM(t) were measured with a Spiroson SCIENTIFIC flowmeter (ECO Medics, CH) with 1.3 ml dead space. Linearity of airflow and MM were tested using different tidal volumes (V(T)) and breathing gases with different O2 and SF6 concentrations. To determine the accuracy of FRC measurements SF6 wash-in and wash-out curves from four mechanical lung models (FRC of 22, 53, 102 and 153 ml) were evaluated by the Spiroson. For each model five measurements were performed with a physiological V(T)/FRC ratio of 0.3 and constant respiratory rate of 30 min(-1). The error of measured V(T) (range 4-60 ml) was <2.5%. There was a strong correlation between the measured and calculated MM of different breathing gases (r = 0.989), and the measuring accuracy was better than 1%. The measured FRC of the four models were 20.3, 49.7, 104.3 and 153.4 ml with a coefficient of variation of 16.5%, 4.5%, 4.9% and 3%. Accordingly, for FRC <100 ml the in vitro accuracy was better than 8% and for FRC >100 ml better than 2.5%. The determination of FRC by MM measurements using the UFM is a simple and cost-effective alternative to conventionally used gas analysers with an acceptable accuracy for many clinical purposes.

Outcome of breath tests in adult patients with suspected small intestinal bacterial overgrowth

PubMed Central

Mattsson, Johanna; Minaya, Maria Teresa; Monegro, Milka; Lebwohl, Benjamin; Lewis, Suzanne K.; Green, Peter HR; Stenberg, Reidun

2017-01-01

Aim: The aim was to investigate breath test outcomes in patients with suspected SIBO and indicative symptoms of SIBO, diagnosed by breath testing. Background: Breath testing is used to detect small intestinal bacterial overgrowth (SIBO) by measuring hydrogen and methane produced by intestinal bacteria. Methods: This retrospective cross sectional study included 311 patients with gastrointestinal symptoms who underwent the breath test for evaluation of SIBO at Celiac Disease Center at Columbia University, New York, in 2014-2015. The patients were divided into two groups based on the physician’s choice: lactulose breath test group (72%) and glucose breath test group (28%). Among them, 38% had a history of celiac disease or non-celiac gluten sensitivity. Results: In total, 46% had a positive breath test: 18% were positive for methane, 24 % positive for hydrogen and 4% positive for both gases (p=0.014). Also, 50% had a positive lactulose breath result and 37% had a positive glucose breath result (p=0.036). The most common symptom for performing the breath test was bloating and the only clinical symptom that significantly showed a positive glucose breath test was increased gas (p=0.028). Conclusion: Lactulose breath test was more often positive than glucose breath test. Positivity for hydrogen was more common than methane. Bloating was the most frequently perceived symptom of the patients undergoing the breath test but the only statistically significant clinical symptom for a positive glucose breath test was increased gas. Furthermore, the results showed that there was no significant association between positive breath test result and gender, age, non-celiac gluten sensitivity or celiac disease. PMID:29118931

Free-breathing volumetric fat/water separation by combining radial sampling, compressed sensing, and parallel imaging.

PubMed

Benkert, Thomas; Feng, Li; Sodickson, Daniel K; Chandarana, Hersh; Block, Kai Tobias

2017-08-01

Conventional fat/water separation techniques require that patients hold breath during abdominal acquisitions, which often fails and limits the achievable spatial resolution and anatomic coverage. This work presents a novel approach for free-breathing volumetric fat/water separation. Multiecho data are acquired using a motion-robust radial stack-of-stars three-dimensional GRE sequence with bipolar readout. To obtain fat/water maps, a model-based reconstruction is used that accounts for the off-resonant blurring of fat and integrates both compressed sensing and parallel imaging. The approach additionally enables generation of respiration-resolved fat/water maps by detecting motion from k-space data and reconstructing different respiration states. Furthermore, an extension is described for dynamic contrast-enhanced fat-water-separated measurements. Uniform and robust fat/water separation is demonstrated in several clinical applications, including free-breathing noncontrast abdominal examination of adults and a pediatric subject with both motion-averaged and motion-resolved reconstructions, as well as in a noncontrast breast exam. Furthermore, dynamic contrast-enhanced fat/water imaging with high temporal resolution is demonstrated in the abdomen and breast. The described framework provides a viable approach for motion-robust fat/water separation and promises particular value for clinical applications that are currently limited by the breath-holding capacity or cooperation of patients. Magn Reson Med 78:565-576, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Real time chemical exposure and risk monitor

DOEpatents

Thrall, Karla D.; Kenny, Donald V.; Endres, George W. R.; Sisk, Daniel R.

1997-01-01

The apparatus of the present invention is a combination of a breath interface and an external exposure dosimeter interface to a chemical analysis device, all controlled by an electronic processor for quantitatively analyzing chemical analysis data from both the breath interface and the external exposure dosimeter for determining internal tissue dose. The method of the present invention is a combination of steps of measuring an external dose, measuring breath content, then analyzing the external dose and breath content and determining internal tissue dose.

Real time chemical exposure and risk monitor

DOEpatents

Thrall, K.D.; Kenny, D.V.; Endres, G.W.R.; Sisk, D.R.

1997-07-08

The apparatus of the present invention is a combination of a breath interface and an external exposure dosimeter interface to a chemical analysis device, all controlled by an electronic processor for quantitatively analyzing chemical analysis data from both the breath interface and the external exposure dosimeter for determining internal tissue dose. The method of the present invention is a combination of steps of measuring an external dose, measuring breath content, then analyzing the external dose and breath content and determining internal tissue dose. 7 figs.

Reliability of breath by breath spirometry and relative flow-time indices for pulmonary function testing in horses.

PubMed

Burnheim, K; Hughes, K J; Evans, D L; Raidal, S L

2016-11-28

Respiratory problems are common in horses, and are often diagnosed as a cause of poor athletic performance. Reliable, accurate and sensitive spirometric tests of airway function in resting horses would assist with the diagnosis of limitations to breathing and facilitate investigations of the effects of various treatments on breathing capacity. The evaluation of respiratory function in horses is challenging and suitable procedures are not widely available to equine practitioners. The determination of relative flow or flow-time measures is used in paediatric patients where compliance may limit conventional pulmonary function techniques. The aim of the current study was to characterise absolute and relative indices of respiratory function in healthy horses during eupnoea (tidal breathing) and carbon dioxide (CO 2 )-induced hyperpnoea (rebreathing) using a modified mask pneumotrachographic technique well suited to equine practice, and to evaluate the reliability of this technique over three consecutive days. Coefficients of variation, intra-class correlations, mean differences and 95% confidence intervals across all days of testing were established for each parameter. The technique provided absolute measures of respiratory function (respiratory rate, tidal volume, peak inspiratory and expiratory flows, time to peak flow) consistent with previous studies and there was no significant effect of day on any measure of respiratory function. Variability of measurements was decreased during hyperpnea caused by rebreathing CO 2 , but a number of relative flow-time variables demonstrated good agreement during eupnoeic respiration. The technique was well tolerated by horses and study findings suggest the technique is suitable for evaluation of respiratory function in horses. The use of relative flow-time variables provided reproducible (consistent) results, suggesting the technique may be of use for repeated measures studies in horses during tidal breathing or rebreathing.

Air breathing in the Arctic: influence of temperature, hypoxia, activity and restricted air access on respiratory physiology of the Alaska blackfish Dallia pectoralis

PubMed Central

Lefevre, Sjannie; Damsgaard, Christian; Pascale, Desirae R.; Nilsson, Göran E.; Stecyk, Jonathan A. W.

2014-01-01

The Alaska blackfish (Dallia pectoralis) is an air-breathing fish native to Alaska and the Bering Sea islands, where it inhabits lakes that are ice-covered in the winter, but enters warm and hypoxic waters in the summer to forage and reproduce. To understand the respiratory physiology of this species under these conditions and the selective pressures that maintain the ability to breathe air, we acclimated fish to 5°C and 15°C and used respirometry to measure: standard oxygen uptake () in normoxia (19.8 kPa PO2) and hypoxia (2.5 kPa), with and without access to air; partitioning of standard in normoxia and hypoxia; maximum and partitioning after exercise; and critical oxygen tension (Pcrit). Additionally, the effects of temperature acclimation on haematocrit, haemoglobin oxygen affinity and gill morphology were assessed. Standard was higher, but air breathing was not increased, at 15°C or after exercise at both temperatures. Fish acclimated to 5°C or 15°C increased air breathing to compensate and fully maintain standard in hypoxia. Fish were able to maintain through aquatic respiration when air was denied in normoxia, but when air was denied in hypoxia, standard was reduced by ∼30–50%. Pcrit was relatively high (5 kPa) and there were no differences in Pcrit, gill morphology, haematocrit or haemoglobin oxygen affinity at the two temperatures. Therefore, Alaska blackfish depends on air breathing in hypoxia and additional mechanisms must thus be utilised to survive hypoxic submergence during the winter, such as hypoxia-induced enhancement in the capacities for carrying and binding blood oxygen, behavioural avoidance of hypoxia and suppression of metabolic rate. PMID:25394628

Breathing and Singing: Objective Characterization of Breathing Patterns in Classical Singers

PubMed Central

Salomoni, Sauro; van den Hoorn, Wolbert; Hodges, Paul

2016-01-01

Singing involves distinct respiratory kinematics (i.e. movements of rib cage and abdomen) to quiet breathing because of different demands on the respiratory system. Professional classical singers often advocate for the advantages of an active control of the abdomen on singing performance. This is presumed to prevent shortening of the diaphragm, elevate the rib cage, and thus promote efficient generation of subglottal pressure during phonation. However, few studies have investigated these patterns quantitatively and inter-subject variability has hindered the identification of stereotypical patterns of respiratory kinematics. Here, seven professional classical singers and four untrained individuals were assessed during quiet breathing, and when singing both a standard song and a piece of choice. Several parameters were extracted from respiratory kinematics and airflow, and principal component analysis was used to identify typical patterns of respiratory kinematics. No group differences were observed during quiet breathing. During singing, both groups adapted to rhythmical constraints with decreased time of inspiration and increased peak airflow. In contrast to untrained individuals, classical singers used greater percentage of abdominal contribution to lung volume during singing and greater asynchrony between movements of rib cage and abdomen. Classical singers substantially altered the coordination of rib cage and abdomen during singing from that used for quiet breathing. Despite variations between participants, principal component analysis revealed consistent pre-phonatory inward movements of the abdominal wall during singing. This contrasted with untrained individuals, who demonstrated synchronous respiratory movements during all tasks. The inward abdominal movements observed in classical singers elevates intra-abdominal pressure and may increase the length and the pressure-generating capacity of rib cage expiratory muscles for potential improvements in voice quality. PMID:27159498

Breathing and Singing: Objective Characterization of Breathing Patterns in Classical Singers.

PubMed

Salomoni, Sauro; van den Hoorn, Wolbert; Hodges, Paul

2016-01-01

Singing involves distinct respiratory kinematics (i.e. movements of rib cage and abdomen) to quiet breathing because of different demands on the respiratory system. Professional classical singers often advocate for the advantages of an active control of the abdomen on singing performance. This is presumed to prevent shortening of the diaphragm, elevate the rib cage, and thus promote efficient generation of subglottal pressure during phonation. However, few studies have investigated these patterns quantitatively and inter-subject variability has hindered the identification of stereotypical patterns of respiratory kinematics. Here, seven professional classical singers and four untrained individuals were assessed during quiet breathing, and when singing both a standard song and a piece of choice. Several parameters were extracted from respiratory kinematics and airflow, and principal component analysis was used to identify typical patterns of respiratory kinematics. No group differences were observed during quiet breathing. During singing, both groups adapted to rhythmical constraints with decreased time of inspiration and increased peak airflow. In contrast to untrained individuals, classical singers used greater percentage of abdominal contribution to lung volume during singing and greater asynchrony between movements of rib cage and abdomen. Classical singers substantially altered the coordination of rib cage and abdomen during singing from that used for quiet breathing. Despite variations between participants, principal component analysis revealed consistent pre-phonatory inward movements of the abdominal wall during singing. This contrasted with untrained individuals, who demonstrated synchronous respiratory movements during all tasks. The inward abdominal movements observed in classical singers elevates intra-abdominal pressure and may increase the length and the pressure-generating capacity of rib cage expiratory muscles for potential improvements in voice quality.

Screening of exhaled breath by low-resolution multicomponent FT-IR spectrometry in patients attending emergency departments.

PubMed

Laakso, Olli; Haapala, Matti; Kuitunen, Tapio; Himberg, Jaakko-Juhani

2004-03-01

Interest in noninvasive methods for disease diagnosis is increasing. In this study, we tested the utility and potential of a portable Fourier transform infrared (FT-IR) multicomponent analyzer in the emergency rooms (ERs) of two Finnish hospitals. Major detected breath volatiles in this population were ethanol, carbon monoxide, methane, and acetone, in addition to carbon dioxide and water. The analysis of breath revealed an ethanol concentration of over 25 ppm (0.1 g/L in blood) in 56 out of 589 patients (9.5%). During nightshifts the proportion was 30% for all and 63% for trauma patients. Five-hundred eighty-four patients had measurable carbon monoxide in their breath. A breath carbon monoxide of over 4 ppm (4.4 micro g/L) differentiated smokers from nonsmokers. Methane over 2 ppm (1.3 micro g/L) was detected in the breath of 32% of the participants. Methane concentration was higher among aged patients. Two-hundred ninety-eight participants had detectable acetone in their breath. Elevated exhaled acetone [10-76 ppm (23-75 micro g/L)] was detected in 10 patients. The FT-IR method proved functional in the ER setting. A major advantage over blood sampling was fast and easy analysis performed by nonlaboratory personnel.

The application of chromatographic breath analysis in the search of volatile biomarkers of chronic kidney disease and coexisting type 2 diabetes mellitus.

PubMed

Grabowska-Polanowska, B; Skowron, M; Miarka, P; Pietrzycka, A; Śliwka, I

2017-08-15

Chromatographic studies on breath composition are aimed at finding volatile markers useful for medical diagnostics or in screening investigations. Studies leading to the development of screening breath tests are especially important for the diagnostics of chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). The aim of the presented study was to confirm diagnostic usefulness of chosen volatile compounds detected in breath, which are suggested as potential biomarkers of renal dysfunction and diabetes. Breath analysis were carried out in three groups: 10 healthy volunteers, 10 patients with CKD and 10 patients with CKD and T2DM. All exhaled air samples were analyzed using gas chromatograph (Agilent 6890GC) coupled with mass spectrometer (5975MSD). Thermal desorption was applied as the enrichment method. TMA was detected only in CKD patients. Higher breath concentrations of methanethiol (MeSH) were observed in CKD patients with coexisting diabetes than in patients with renal dysfunction only or in the healthy group. There was a tendency of increasing MeSH concentration in breath with increasing total glutathione in plasma (r=0.53, p=0.0026). Also, a trend of increasing dimethylsulfide (DMS) levels detected in breath was noticed with an increase of hydrogen sulfide concentration in plasma (r=0.74; p=0.00001) as well as with aspartate aminotransferase (AST), (r=0.61; p=0.001). The presented results suggest the possibility of applying TMA, MeSH, and DMS detection in breath as diagnostic methods. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of Fractional Regional Ventilation Using 4D-CT and Effects of Breathing Maneuvers on Ventilation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mistry, Nilesh N., E-mail: nmistry@som.umaryland.edu; Diwanji, Tejan; Shi, Xiutao

2013-11-15

Purpose: Current implementations of methods based on Hounsfield units to evaluate regional lung ventilation do not directly incorporate tissue-based mass changes that occur over the respiratory cycle. To overcome this, we developed a 4-dimensional computed tomography (4D-CT)-based technique to evaluate fractional regional ventilation (FRV) that uses an individualized ratio of tidal volume to end-expiratory lung volume for each voxel. We further evaluated the effect of different breathing maneuvers on regional ventilation. The results from this work will help elucidate the relationship between global and regional lung function. Methods and Materials: Eight patients underwent 3 sets of 4D-CT scans during 1more » session using free-breathing, audiovisual guidance, and active breathing control. FRV was estimated using a density-based algorithm with mass correction. Internal validation between global and regional ventilation was performed by use of the imaging data collected during the use of active breathing control. The impact of breathing maneuvers on FRV was evaluated comparing the tidal volume from 3 breathing methods. Results: Internal validation through comparison between the global and regional changes in ventilation revealed a strong linear correlation (slope of 1.01, R{sup 2} of 0.97) between the measured global lung volume and the regional lung volume calculated by use of the “mass corrected” FRV. A linear relationship was established between the tidal volume measured with the automated breathing control system and FRV based on 4D-CT imaging. Consistently larger breathing volumes were observed when coached breathing techniques were used. Conclusions: The technique presented improves density-based evaluation of lung ventilation and establishes a link between global and regional lung ventilation volumes. Furthermore, the results obtained are comparable with those of other techniques of functional evaluation such as spirometry and hyperpolarized-gas magnetic resonance imaging. These results were demonstrated on retrospective analysis of patient data, and further research using prospective data is under way to validate this technique against established clinical tests.« less

Ammonia and ethylene biomarkers in the respiration of the people with schizophrenia using photoacoustic spectroscopy

NASA Astrophysics Data System (ADS)

Popa, Cristina; Petrus, Mioara; Bratu, Ana Maria

2015-05-01

Oxidative stress has become an exciting area of schizophrenia (SCZ) research, and provides ample opportunities and hope for a better understanding of its pathophysiology, which may lead to new treatment strategies. The first objective of the present study was to analyze the oxidative stress markers in breath samples of patients with SCZ before and after the treatment with Levomepromazine. The second objective was to analyze the deficiency of amino acids marker in breath samples of patients with SCZ before and after the treatment. Exhaled breath was collected from 15 SCZ patients and 19 healthy controls; subsequently, CO2 laser photoacoustic spectroscopy was used to assess the exhaled breath compounds of the study subjects. One of the main breath biomarkers of the oxidative stress is ethylene, while one of the main breath biomarkers of the amino acids deficiency is ammonia. The breath biomarkers in the exhalation of SCZ patients exhibited significant differences from the breath biomarkers in the exhalation of healthy controls. Analysis of breath ethylene and breath ammonia provides a related model of SCZ exhalation that could represent an effective and convenient screening method for this intellectual disability.

Clinical applications of breath testing

PubMed Central

Paschke, Kelly M; Mashir, Alquam

2010-01-01

Breath testing has the potential to benefit the medical field as a cost-effective, non-invasive diagnostic tool for diseases of the lung and beyond. With growing evidence of clinical worth, standardization of methods, and new sensor and detection technologies the stage is set for breath testing to gain considerable attention and wider application in upcoming years. PMID:21173863

Asystole and increased serum myoglobin levels associated with 'packing blackout' in a competitive breath-hold diver.

PubMed

Andersson, Johan P A; Linér, Mats H; Jönsson, Henrik

2009-11-01

Many competitive breath-hold divers use 'glossopharyngeal insufflation', also called 'lung packing', to overfill their lungs above normal total lung capacity. This increases intrathoracic pressure, decreases venous return, compromises cardiac pumping, and reduces arterial blood pressure, possibly resulting in a syncope breath-hold divers call 'packing blackout'. We report a case with a breath-hold diver who inadvertently experienced a packing blackout. During the incident, an electrocardiogram (ECG) and blood pressure were recorded, and blood samples for determinations of biomarkers of cardiac muscle perturbation (creatine kinase-MB isoenzyme (CK-MB), cardiac troponin-T (TnT), and myoglobin) were collected. The ECG revealed short periods of asystole during the period of 'packing blackout', simultaneous with pronounced reductions in systolic, diastolic, and pulse pressures. Serum myoglobin concentration was elevated 40 and 150 min after the incident, whereas there were no changes in CK-MB or TnT. The ultimate cause of syncope in this diver probably was a decrease in cerebral perfusion following glossopharyngeal insufflation. The asystolic periods recorded in this diver could possibly indicate that susceptible individuals may be put at risk of a serious cardiac incident if the lungs are excessively overinflated by glossopharyngeal insufflation. This concern is further substantiated by the observed increase in serum myoglobin concentration after the event.

Air-breathing behavior and physiological responses to hypoxia and air exposure in the air-breathing loricariid fish, Pterygoplichthys anisitsi.

PubMed

da Cruz, André Luis; da Silva, Hugo Ribeiro; Lundstedt, Lícia Maria; Schwantes, Arno Rudi; Moraes, Gilberto; Klein, Wilfried; Fernandes, Marisa Narciso

2013-04-01

Hypoxic water and episodic air exposure are potentially life-threatening conditions that fish in tropical regions can face during the dry season. This study investigated the air-breathing behavior, oxygen consumption, and respiratory responses of the air-breathing (AB) armored catfish Pterygoplichthys anisitsi. The hematological parameters and oxygen-binding characteristics of whole blood and stripped hemoglobin and the intermediate metabolism of selected tissue in normoxia, different hypoxic conditions, and after air exposure were also examined. In normoxia, this species exhibited high activity at night and AB behavior (2-5 AB h(-1)). The exposure to acute severe hypoxia elicited the AB behavior (4 AB h(-1)) during the day. Under progressive hypoxia without access to the water surface, the fish were oxyregulators with a critical O2 tension, calculated as the inspired water O2 pressure, as 47 ± 2 mmHg. At water O2 tensions lower than 40 mmHg, the fish exhibited continuous apnea behavior. The blood exhibited high capacity for transporting O2, having a cathodic hemoglobin component with a high Hb-O2 affinity. Under severe hypoxia, the fish used anaerobic metabolism to maintain metabolic rate. Air exposure revealed physiological and biochemical traits similar to those observed under normoxic conditions.

Predictive equations for total lung capacity and residual volume calculated from radiographs in a random sample of the Michigan population.

PubMed Central

Kilburn, K H; Warshaw, R H; Thornton, J C; Thornton, K; Miller, A

1992-01-01

BACKGROUND: Published predicted values for total lung capacity and residual volume are often based on a small number of subjects and derive from different populations from predicted spirometric values. Equations from the only two large studies gave smaller predicted values for total lung capacity than the smaller studies. A large number of subjects have been studied from a population which has already provided predicted values for spirometry and transfer factor for carbon monoxide. METHODS: Total lung capacity was measured from standard posteroanterior and lateral chest radiographs and forced vital capacity by spirometry in a population sample of 771 subjects. Prediction equations were developed for total lung capacity (TLC), residual volume (RV) and RV/TLC in two groups--normal and total. Subjects with signs or symptoms of cardiopulmonary disease were combined with the normal subjects and equations for all subjects were also modelled. RESULTS: Prediction equations for TLC and RV in non-smoking normal men and women were square root transformations which included height and weight but not age. They included a coefficient for duration of smoking in current smokers. The predictive equation for RV/TLC included weight, age, age and duration of smoking for current smokers and ex-smokers of both sexes. For the total population the equations took the same form but the height coefficients and constants were slightly different. CONCLUSION: These population based prediction equations for TLC, RV and RV/TLC provide reference standards in a population that has provided reference standards for spirometry and single breath transfer factor for carbon monoxide. PMID:1412094

A Novel Method to Compute Breathing Volumes via Motion Capture Systems: Design and Experimental Trials.

PubMed

Massaroni, Carlo; Cassetta, Eugenio; Silvestri, Sergio

2017-10-01

Respiratory assessment can be carried out by using motion capture systems. A geometrical model is mandatory in order to compute the breathing volume as a function of time from the markers' trajectories. This study describes a novel model to compute volume changes and calculate respiratory parameters by using a motion capture system. The novel method, ie, prism-based method, computes the volume enclosed within the chest by defining 82 prisms from the 89 markers attached to the subject chest. Volumes computed with this method are compared to spirometry volumes and to volumes computed by a conventional method based on the tetrahedron's decomposition of the chest wall and integrated in a commercial motion capture system. Eight healthy volunteers were enrolled and 30 seconds of quiet breathing data collected from each of them. Results show a better agreement between volumes computed by the prism-based method and the spirometry (discrepancy of 2.23%, R 2  = .94) compared to the agreement between volumes computed by the conventional method and the spirometry (discrepancy of 3.56%, R 2  = .92). The proposed method also showed better performances in the calculation of respiratory parameters. Our findings open up prospects for the further use of the new method in the breathing assessment via motion capture systems.

Multifrequency high precise subTHz-THz-IR spectroscopy for exhaled breath research

NASA Astrophysics Data System (ADS)

Vaks, Vladimir L.; Domracheva, Elena G.; Pripolzin, Sergey I.; Chernyaeva, Mariya B.

2016-09-01

Nowadays the development of analytical spectroscopy with high performance, sensitivity and spectral resolution for exhaled breath research is attended. The method of two-frequency high precise THz spectroscopy and the method of high precise subTHz-THz-IR spectroscopy are presented. Development of a subTHz-THz-IR gas analyzer increases the number of gases that can be identified and the reliability of the detection by confirming the signature in both THz and MIR ranges. The testing measurements have testified this new direction of analytical spectroscopy to open widespread trends of its using for various problems of medicine and biology. First of all, there are laboratory investigations of the processes in exhaled breath and studying of their dynamics. Besides, the methods presented can be applied for detecting intermediate and short time living products of reactions in exhaled breath. The spectrometers have been employed for investigations of acetone, methanol and ethanol in the breath samples of healthy volunteers and diabetes patients. The results have demonstrated an increased concentration of acetone in breath of diabetes patients. The dynamic of changing the acetone concentration before and after taking the medicines is discovered. The potential markers of pre-cancer states and oncological diseases of gastrointestinal tract organs have been detected. The changes in the NO concentration in exhaled breath of cancer patients during radiotherapy as well as increase of the NH3 concentration at gastrointestinal diseases have been revealed. The preliminary investigations of biomarkers in three frequency ranges have demonstrated the advantages of the multifrequency high precise spectroscopy for noninvasive medical diagnostics.

Tidal volume single-breath washin of SF6 and CH4 in transient microgravity

NASA Technical Reports Server (NTRS)

Dutrieue, Brigitte; Paiva, Manuel; Verbanck, Sylvia; Le Gouic, Marine; Darquenne, Chantal; Prisk, G. Kim

2003-01-01

We performed tidal volume single-breath washins (SBW) by using tracers of different diffusivity and varied the time spent in microgravity (microG) before the start of the tests to look for time-dependent effects. SF(6) and CH(4) phase III slopes decreased by 35 and 26%, respectively, in microG compared with 1 G (P < 0.05), and the slope difference between gases disappeared. There was no effect of time in microG, suggesting that neither the hypergravity period preceding microG nor the time spent in microG affected gas mixing at volumes near functional residual capacity. In previous studies using SF(6) and He (Lauzon A-M, Prisk GK, Elliott AR, Verbanck S, Paiva M, and West JB. J Appl Physiol 82: 859-865, 1997), the vital capacity SBW showed an increase in slope difference between gases in transient microG, the opposite of the decrease in sustained microG. In contrast, tidal volume SBW showed a decrease in slope difference in both microG conditions. Because it is only the behavior of the more diffusive gas that differed between maneuvers and microG conditions, we speculate that, in the previous vital capacity SBW, the hypergravity period preceding the test in transient microG provoked conformational changes at low lung volumes near the acinar entrance.

Decreased exercise capacity and sleep-disordered breathing in patients with hypertrophic cardiomyopathy.

PubMed

Konecny, Tomas; Geske, Jeffrey B; Ludka, Ondrej; Orban, Marek; Brady, Peter A; Abudiab, Muaz M; Albuquerque, Felipe N; Placek, Alexander; Kara, Tomas; Sahakyan, Karine R; Gersh, Bernard J; Tajik, A Jamil; Allison, Thomas G; Ommen, Steve R; Somers, Virend K

2015-06-01

Mechanisms of decreased exercise capacity in patients with hypertrophic cardiomyopathy (HCM) are not well understood. Sleep-disordered breathing (SDB) is a highly prevalent but treatable disorder in patients with HCM. The role of comorbid SDB in the attenuated exercise capacity in HCM has not been studied previously. Overnight oximetry, cardiopulmonary exercise testing, and echocardiographic studies were performed in consecutive patients with HCM seen at the Mayo Clinic. SDB was considered present if the oxygen desaturation index (number of ≥ 4% desaturations/h) was ≥ 10. Peak oxygen consumption (VO2 peak) (the most reproducible and prognostic measure of cardiovascular fitness) was then correlated with the presence and severity of SDB. A total of 198 patients with HCM were studied (age, 53 ± 16 years; 122 men), of whom 32% met the criteria for the SDB diagnosis. Patients with SDB had decreased VO2 peak compared with those without SDB (16 mL O2/kg/min vs 21 mL O2/kg/min, P < .001). SDB remained significantly associated with VO2 peak after accounting for confounding clinical variables (P < .001) including age, sex, BMI, atrial fibrillation, and coronary artery disease. In patients with HCM, the presence of SDB is associated with decreased VO2 peak. SDB may represent an important and potentially modifiable contributor to impaired exercise tolerance in this unique population.

A rapid method for the chromatographic analysis of volatile organic compounds in exhaled breath of tobacco cigarette and electronic cigarette smokers.

PubMed

Marco, Esther; Grimalt, Joan O

2015-09-04

A method for the rapid analysis of volatile organic compounds (VOCs) in smoke from tobacco and electronic cigarettes and in exhaled breath of users of these smoking systems has been developed. Both disposable and rechargeable e-cigarettes were considered. Smoke or breath were collected in Bio-VOCs. VOCs were then desorbed in Tenax cartridges which were subsequently analyzed by thermal desorption coupled to gas chromatography-mass spectrometry. The method provides consistent results when comparing the VOC compositions from cigarette smoke and the equivalent exhaled breath of the smokers. The differences in composition of these two sample types are useful to ascertain which compounds are retained in the respiratory system after tobacco cigarette or e-cigarette smoking. Strong differences were observed in the VOC composition of tobacco cigarette smoke and exhaled breath when comparing with those of e-cigarette smoking. The former involved transfers of a much larger burden of organic compounds into smokers, including benzene, toluene, naphthalene and other pollutants of general concern. e-Cigarettes led to strong absorptions of propylene glycol and glycerin in the users of these systems. Tobacco cigarettes were also those showing highest concentration differences between nicotine concentrations in smoke and exhaled breath. The results from disposable e-cigarettes were very similar to those from rechargeable e-cigarettes. Copyright © 2015 Elsevier B.V. All rights reserved.

A Modified Carbon Monoxide Breath Test for Measuring Erythrocyte Lifespan in Small Animals

PubMed Central

Ma, Yong-Jian; Zhang, Hou-De; Ji, Yong-Qiang; Zhu, Guo-Liang; Huang, Jia-Liang; Du, Li-Tao; Cao, Ping; Zang, De-Yue; Du, Ji-Hui; Li, Rong; Wang, Lei

2016-01-01

This study was to develop a CO breath test for RBC lifespan estimation of small animals. The ribavirin induced hemolysis rabbit models were placed individually in a closed rebreath cage and air samples were collected for measurement of CO concentration. RBC lifespan was calculated from accumulated CO, blood volume, and hemoglobin concentration data. RBC lifespan was determined in the same animals with the standard biotin-labeling method. RBC lifespan data obtained by the CO breath test method for control (CON, 49.0 ± 5.9 d) rabbits, rabbits given 10 mg/kg·d−1 of ribavirin (RIB10, 31.0 ± 4.0 d), and rabbits given 20 mg/kg·d−1 of ribavirin (RIB20, 25.0 ± 2.9 d) were statistically similar (all p > 0.05) to and linearly correlated (r = 0.96, p < 0.01) with the RBC lifespan data obtained for the same rabbits by the standard biotin-labeling method (CON, 51.0 ± 2.7 d; RIB10, 33.0 ± 1.3 d; and RIB20, 27.0 ± 0.8 d). The CO breath test method takes less than 3 h to complete, whereas the standard method requires at least several weeks. In conclusion, the CO breath test method provides a simple and rapid means of estimating RBC lifespan and is feasible for use with small animal models. PMID:27294128

[Measurement of CO diffusion capacity (II): Standardization and quality criteria].

PubMed

Salcedo Posadas, A; Villa Asensi, J R; de Mir Messa, I; Sardón Prado, O; Larramona, H

2015-08-01

The diffusion capacity is the technique that measures the ability of the respiratory system for gas exchange, thus allowing a diagnosis of the malfunction of the alveolar-capillary unit. The most important parameter to assess is the CO diffusion capacity (DLCO). New methods are currently being used to measure the diffusion using nitric oxide (NO). There are other methods for measuring diffusion, although in this article the single breath technique is mainly referred to, as it is the most widely used and best standardized. Its complexity, its reference equations, differences in equipment, inter-patient variability and conditions in which the DLCO is performed, lead to a wide inter-laboratory variability, although its standardization makes this a more reliable and reproductive method. The practical aspects of the technique are analyzed, by specifying the recommendations to carry out a suitable procedure, the calibration routine, calculations and adjustments. Clinical applications are also discussed. An increase in the transfer of CO occurs in diseases in which there is an increased volume of blood in the pulmonary capillaries, such as in the polycythemia and pulmonary hemorrhage. There is a decrease in DLCO in patients with alveolar volume reduction or diffusion defects, either by altered alveolar-capillary membrane (interstitial diseases) or decreased volume of blood in the pulmonary capillaries (pulmonary embolism or primary pulmonary hypertension). Other causes of decreased or increased DLCO are also highlighted. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Advances in Fabrication Materials of Honeycomb Structure Films by the Breath-Figure Method

PubMed Central

Heng, Liping; Wang, Bin; Li, Muchen; Zhang, Yuqi; Jiang, Lei

2013-01-01

Creatures in nature possess almost perfect structures and properties, and exhibit harmonization and unification between structure and function. Biomimetics, mimicking nature for engineering solutions, provides a model for the development of functional surfaces with special properties. Recently, honeycomb structure materials have attracted wide attention for both fundamental research and practical applications and have become an increasingly hot research topic. Though progress in the field of breath-figure formation has been reviewed, the advance in the fabrication materials of bio-inspired honeycomb structure films has not been discussed. Here we review the recent progress of honeycomb structure fabrication materials which were prepared by the breath-figure method. The application of breath figures for the generation of all kinds of honeycomb is discussed. PMID:28809319

Evolution of clinical and environmental health applications of exhaled breath research: Review of methods and instrumentation for gas-phase, condensate, and aerosols

EPA Science Inventory

Human breath, along with urine and blood, has long been one of the three major biological media for assessing human health and environmental exposure. In fact, the detection of odor on human breath, as described by Hippocrates in 400 BC, is considered the first analytical healt...

Whole left ventricular functional assessment from two minutes free breathing multi-slice CINE acquisition

NASA Astrophysics Data System (ADS)

Usman, M.; Atkinson, D.; Heathfield, E.; Greil, G.; Schaeffter, T.; Prieto, C.

2015-04-01

Two major challenges in cardiovascular MRI are long scan times due to slow MR acquisition and motion artefacts due to respiratory motion. Recently, a Motion Corrected-Compressed Sensing (MC-CS) technique has been proposed for free breathing 2D dynamic cardiac MRI that addresses these challenges by simultaneously accelerating MR acquisition and correcting for any arbitrary motion in a compressed sensing reconstruction. In this work, the MC-CS framework is combined with parallel imaging for further acceleration, and is termed Motion Corrected Sparse SENSE (MC-SS). Validation of the MC-SS framework is demonstrated in eight volunteers and three patients for left ventricular functional assessment and results are compared with the breath-hold acquisitions as reference. A non-significant difference (P > 0.05) was observed in the volumetric functional measurements (end diastolic volume, end systolic volume, ejection fraction) and myocardial border sharpness values obtained with the proposed and gold standard methods. The proposed method achieves whole heart multi-slice coverage in 2 min under free breathing acquisition eliminating the time needed between breath-holds for instructions and recovery. This results in two-fold speed up of the total acquisition time in comparison to the breath-hold acquisition.

SU-E-T-326: The Oxygen Saturation (SO2) and Breath-Holding Time Variation Applied Active Breathing Control (ABC)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gong, G; Yin, Y

Purpose: To study the oxygen saturation (SO2) and breath-holding time variation applied active breathing control (ABC) in radiotherapy of tumor. Methods: 24 volunteers were involved in our trials, and they all did breath-holding motion assisted by ELEKTA Active Breathing Coordinator 2.0 for 10 times respectively. And the patient monitor was used to observe the oxygen saturation (SO2) variation. The variation of SO2, and length of breath-holding time and the time for recovering to the initial value of SO2 were recorded and analyzed. Results: (1) The volunteers were divided into two groups according to the SO2 variation in breath-holding: A group,more » 14 cases whose SO2 reduction were more than 2% (initial value was 97% to 99%, while termination value was 91% to 96%); B group, 10 cases were less than 2% in breath-holding without inhaling oxygen. (2) The interfraction breath holding time varied from 8 to 20s for A group compared to the first breath-holding time, and for B group varied from 4 to 14s. (3) The breathing holding time of B group prolonged mean 8s, compared to A group. (4) The time for restoring to the initial value of SO2 was from 10s to 30s. And the breath-holding time shortened obviously for patients whose SO2 did not recover to normal. Conclusion: It is very obvious that the SO2 reduction in breath-holding associated with ABC for partial people. It is necessary to check the SO2 variation in breath training, and enough time should be given to recover SO2.« less

Association of expiratory airway dysfunction with marked obesity in healthy adult dogs.

PubMed

Bach, Jonathan F; Rozanski, Elizabeth A; Bedenice, Daniela; Chan, Daniel L; Freeman, Lisa M; Lofgren, Jennifer L S; Oura, Trisha J; Hoffman, Andrew M

2007-06-01

To evaluate the effects of obesity on pulmonary function in healthy adult dogs. 36 Retrievers without cardiopulmonary disease. Dogs were assigned to 1 of 3 groups on the basis of body condition score (1 through 9): nonobese (score, 4.5 to 5.5), moderately obese (score, 6.0 to 6.5), and markedly obese (score, 7.0 to 9.0). Pulmonary function tests performed in conscious dogs included spirometry and measurement of inspiratory and expiratory airway resistance (R(aw)) and specific R(aw) (sR(aw)) during normal breathing and during hyperpnea via head-out whole-body plethysmography. Functional residual capacity (FRC; measured by use of helium dilution), diffusion capacity of lungs for carbon monoxide (DLCO), and arterial blood gas variables (PaO(2), PaCO(2), and alveolar-arterial gradient) were assessed. During normal breathing, body condition score did not influence airway function, DLCO, or arterial blood gas variables. During hyperpnea, expiratory sR(aw) was significantly greater in markedly obese dogs than nonobese dogs and R(aw) was significantly greater in markedly obese dogs, compared with nonobese and moderately obese dogs. Although not significantly different, markedly obese dogs had a somewhat lower FRC, compared with other dogs. In dogs, obesity appeared to cause airflow limitation during the expiratory phase of breathing, but this was only evident during hyperpnea. This suggests that flow limitation is dynamic and likely occurs in the distal (rather than proximal) portions of the airways. Further studies are warranted to localize the flow-limited segment and understand whether obesity is linked to exercise intolerance via airway dysfunction in dogs.

Oxygen dependence of upper thermal limits in fishes.

PubMed

Ern, Rasmus; Norin, Tommy; Gamperl, A Kurt; Esbaugh, Andrew J

2016-11-01

Temperature-induced limitations on the capacity of the cardiorespiratory system to transport oxygen from the environment to the tissues, manifested as a reduced aerobic scope (maximum minus standard metabolic rate), have been proposed as the principal determinant of the upper thermal limits of fishes and other water-breathing ectotherms. Consequently, the upper thermal niche boundaries of these animals are expected to be highly sensitive to aquatic hypoxia and other environmental stressors that constrain their cardiorespiratory performance. However, the generality of this dogma has recently been questioned, as some species have been shown to maintain aerobic scope at thermal extremes. Here, we experimentally tested whether reduced oxygen availability due to aquatic hypoxia would decrease the upper thermal limits (i.e. the critical thermal maximum, CT max ) of the estuarine red drum (Sciaenops ocellatus) and the marine lumpfish (Cyclopterus lumpus). In both species, CT max was independent of oxygen availability over a wide range of oxygen levels despite substantial (>72%) reductions in aerobic scope. These data show that the upper thermal limits of water-breathing ectotherms are not always linked to the capacity for oxygen transport. Consequently, we propose a novel metric for classifying the oxygen dependence of thermal tolerance; the oxygen limit for thermal tolerance (P CT max ), which is the water oxygen tension (Pw O 2 ) where an organism's CT max starts to decline. We suggest that this metric can be used for assessing the oxygen sensitivity of upper thermal limits in water-breathing ectotherms, and the susceptibility of their upper thermal niche boundaries to environmental hypoxia. © 2016. Published by The Company of Biologists Ltd.

Patient training in respiratory-gated radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kini, Vijay R.; Vedam, Subrahmanya S.; Keall, Paul J.

2003-03-31

Respiratory gating is used to counter the effects of organ motion during radiotherapy for chest tumors. The effects of variations in patient breathing patterns during a single treatment and from day to day are unknown. We evaluated the feasibility of using patient training tools and their effect on the breathing cycle regularity and reproducibility during respiratory-gated radiotherapy. To monitor respiratory patterns, we used a component of a commercially available respiratory-gated radiotherapy system (Real Time Position Management (RPM) System, Varian Oncology Systems, Palo Alto, CA 94304). This passive marker video tracking system consists of reflective markers placed on the patient's chestmore » or abdomen, which are detected by a wall-mounted video camera. Software installed on a PC interfaced to this camera detects the marker motion digitally and records it. The marker position as a function of time serves as the motion signal that may be used to trigger imaging or treatment. The training tools used were audio prompting and visual feedback, with free breathing as a control. The audio prompting method used instructions to 'breathe in' or 'breathe out' at periodic intervals deduced from patients' own breathing patterns. In the visual feedback method, patients were shown a real-time trace of their abdominal wall motion due to breathing. Using this, they were asked to maintain a constant amplitude of motion. Motion traces of the abdominal wall were recorded for each patient for various maneuvers. Free breathing showed a variable amplitude and frequency. Audio prompting resulted in a reproducible frequency; however, the variability and the magnitude of amplitude increased. Visual feedback gave a better control over the amplitude but showed minor variations in frequency. We concluded that training improves the reproducibility of amplitude and frequency of patient breathing cycles. This may increase the accuracy of respiratory-gated radiation therapy.« less

Chemical sensors for breath gas analysis: the latest developments at the Breath Analysis Summit 2013.

PubMed

Tisch, Ulrike; Haick, Hossam

2014-06-01

Profiling the body chemistry by means of volatile organic compounds (VOCs) in the breath opens exciting new avenues in medical diagnostics. Gas sensors could provide ideal platforms for realizing portable, hand-held breath testing devices in the near future. This review summarizes the latest developments and applications in the field of chemical sensors for diagnostic breath testing that were presented at the Breath Analysis Summit 2013 in Wallerfangen, Germany. Considerable progress has been made towards clinically applicable breath testing devices, especially by utilizing chemo-sensitive nanomaterials. Examples of several specialized breath testing applications are presented that are either based on stand-alone nanomaterial-based sensors being highly sensitive and specific to individual breath compounds over others, or on combinations of several highly specific sensors, or on experimental nanomaterial-based sensors arrays. Other interesting approaches include the adaption of a commercially available MOx-based sensor array to indirect breath testing applications, using a sample pre-concentration method, and the development of compact integrated GC-sensor systems. The recent trend towards device integration has led to the development of fully integrated prototypes of point-of-care devices. We describe and compare the performance of several prototypes that are based on different sensing technologies and evaluate their potential as low-cost and readily available next-generation medical devices.

An acetone breath analyzer using cavity ringdown spectroscopy: an initial test with human subjects under various situations

NASA Astrophysics Data System (ADS)

Wang, Chuji; Surampudi, Anand B.

2008-10-01

We have developed a portable breath acetone analyzer using cavity ringdown spectroscopy (CRDS). The instrument was initially tested by measuring the absorbance of breath gases at a single wavelength (266 nm) from 32 human subjects under various conditions. A background subtraction method, implemented to obtain absorbance differences, from which an upper limit of breath acetone concentration was obtained, is described. The upper limits of breath acetone concentration in the four Type 1 diabetes (T1D) subjects, tested after a 14 h overnight fast, range from 0.80 to 3.97 parts per million by volume (ppmv), higher than the mean acetone concentration (0.49 ppmv) in non-diabetic healthy breath reported in the literature. The preliminary results show that the instrument can tell distinctive differences between the breath from individuals who are healthy and those with T1D. On-line monitoring of breath gases in healthy people post-exercise, post-meals and post-alcohol-consumption was also conducted. This exploratory study demonstrates the first CRDS-based acetone breath analyzer and its potential application for point-of-care, non-invasive, diabetic monitoring.

New breathing functions for the transverse breathing crack of the cracked rotor system: Approach for critical and subcritical harmonic analysis

NASA Astrophysics Data System (ADS)

Al-Shudeifat, Mohammad A.; Butcher, Eric A.

2011-01-01

The actual breathing mechanism of the transverse breathing crack in the cracked rotor system that appears due to the shaft weight is addressed here. As a result, the correct time-varying area moments of inertia for the cracked element cross-section during shaft rotation are also determined. Hence, two new breathing functions are identified to represent the actual breathing effect on the cracked element stiffness matrix. The new breathing functions are used in formulating the time-varying finite element stiffness matrix of the cracked element. The finite element equations of motion are then formulated for the cracked rotor system and solved via harmonic balance method for response, whirl orbits and the shift in the critical and subcritical speeds. The analytical results of this approach are compared with some previously published results obtained using approximate formulas for the breathing mechanism. The comparison shows that the previously used breathing function is a weak model for the breathing mechanism in the cracked rotor even for small crack depths. The new breathing functions give more accurate results for the dynamic behavior of the cracked rotor system for a wide range of the crack depths. The current approach is found to be efficient for crack detection since the critical and subcritical shaft speeds, the unique vibration signature in the neighborhood of the subcritical speeds and the sensitivity to the unbalance force direction all together can be utilized to detect the breathing crack before further damage occurs.

Drinking influences exhaled breath condensate acidity.

PubMed

Kullmann, Tamás; Barta, Imre; Antus, Balázs; Horváth, Ildikó

2008-01-01

Exhaled breath condensate analysis is a developing method for investigating airway pathology. Impact of food and drink on breath condensate composition has not been systematically addressed. The aim of the study was to follow exhaled breath condensate pH after drinking an acidic and a neutral beverage. Breath condensate, capillary blood, and urine of 12 healthy volunteers were collected before and after drinking either 1 l of coke or 1 l of mineral water. The pH of each sample was determined with a blood gas analyzer. The mean difference between the pH of two breath condensate samples collected within 15 min before drinking was 0.13+/-0.03. Condensate pH decreased significantly from 6.29+/-0.02 to 6.24+/-0.02 (p<0.03) after drinking coke and from 6.37+/-0.03 to 6.22+/-0.04 (p<0.003) after drinking water. Drinking coke induced significant changes in blood and urine pH as well. Drinking influences exhaled breath condensate composition and may contribute to the variability of exhaled breath condensate pH.

Dew inspired breathing-based detection of genetic point mutation visualized by naked eye

PubMed Central

Xie, Liping; Wang, Tongzhou; Huang, Tianqi; Hou, Wei; Huang, Guoliang; Du, Yanan

2014-01-01

A novel label-free method based on breathing-induced vapor condensation was developed for detection of genetic point mutation. The dew-inspired detection was realized by integration of target-induced DNA ligation with rolling circle amplification (RCA). The vapor condensation induced by breathing transduced the RCA-amplified variances in DNA contents into visible contrast. The image could be recorded by a cell phone for further or even remote analysis. This green assay offers a naked-eye-reading method potentially applied for point-of-care liver cancer diagnosis in resource-limited regions. PMID:25199907

Dew inspired breathing-based detection of genetic point mutation visualized by naked eye

NASA Astrophysics Data System (ADS)

Xie, Liping; Wang, Tongzhou; Huang, Tianqi; Hou, Wei; Huang, Guoliang; Du, Yanan

2014-09-01

A novel label-free method based on breathing-induced vapor condensation was developed for detection of genetic point mutation. The dew-inspired detection was realized by integration of target-induced DNA ligation with rolling circle amplification (RCA). The vapor condensation induced by breathing transduced the RCA-amplified variances in DNA contents into visible contrast. The image could be recorded by a cell phone for further or even remote analysis. This green assay offers a naked-eye-reading method potentially applied for point-of-care liver cancer diagnosis in resource-limited regions.

Dew inspired breathing-based detection of genetic point mutation visualized by naked eye.

PubMed

Xie, Liping; Wang, Tongzhou; Huang, Tianqi; Hou, Wei; Huang, Guoliang; Du, Yanan

2014-09-09

A novel label-free method based on breathing-induced vapor condensation was developed for detection of genetic point mutation. The dew-inspired detection was realized by integration of target-induced DNA ligation with rolling circle amplification (RCA). The vapor condensation induced by breathing transduced the RCA-amplified variances in DNA contents into visible contrast. The image could be recorded by a cell phone for further or even remote analysis. This green assay offers a naked-eye-reading method potentially applied for point-of-care liver cancer diagnosis in resource-limited regions.

Photoacoustic sensor for medical diagnostics

NASA Astrophysics Data System (ADS)

Wolff, Marcus; Groninga, Hinrich G.; Harde, Hermann

2004-03-01

The development of new optical sensor technologies has a major impact on the progress of diagnostic methods. Of the permanently increasing number of non-invasive breath tests, the 13C-Urea Breath Test (UBT) for the detection of Helicobacter pylori is the most prominent. However, many recent developments, like the detection of cancer by breath test, go beyond gastroenterological applications. We present a new detection scheme for breath analysis that employs an especially compact and simple set-up. Photoacoustic Spectroscopy (PAS) represents an offset-free technique that allows for short absorption paths and small sample cells. Using a single-frequency diode laser and taking advantage of acoustical resonances of the sample cell, we performed extremely sensitive and selective measurements. The smart data processing method contributes to the extraordinary sensitivity and selectivity as well. Also, the reasonable acquisition cost and low operational cost make this detection scheme attractive for many biomedical applications. The experimental set-up and data processing method, together with exemplary isotope-selective measurements on carbon dioxide, are presented.

A simple method to reconstruct the molar mass signal of respiratory gas to assess small airways with a double-tracer gas single-breath washout.

PubMed

Port, Johannes; Tao, Ziran; Junger, Annika; Joppek, Christoph; Tempel, Philipp; Husemann, Kim; Singer, Florian; Latzin, Philipp; Yammine, Sophie; Nagel, Joachim H; Kohlhäufl, Martin

2017-11-01

For the assessment of small airway diseases, a noninvasive double-tracer gas single-breath washout (DTG-SBW) with sulfur hexafluoride (SF 6 ) and helium (He) as tracer components has been proposed. It is assumed that small airway diseases may produce typical ventilation inhomogeneities which can be detected within one single tidal breath, when using two tracer components. Characteristic parameters calculated from a relative molar mass (MM) signal of the airflow during the washout expiration phase are analyzed. The DTG-SBW signal is acquired by subtracting a reconstructed MM signal without tracer gas from the signal measured with an ultrasonic sensor during in- and exhalation of the double-tracer gas for one tidal breath. In this paper, a simple method to determine the reconstructed MM signal is presented. Measurements on subjects with and without obstructive lung diseases including the small airways have shown high reliability and reproducibility of this method.

Micropreconcentrator in LTCC Technology with Mass Spectrometry for the Detection of Acetone in Healthy and Type-1 Diabetes Mellitus Patient Breath

PubMed Central

Rydosz, Artur

2014-01-01

Breath analysis has long been recognized as a potentially attractive method for the diagnosis of several diseases. The main advantage over other diagnostic methods such as blood or urine analysis is that breath analysis is fully non-invasive, comfortable for patients and breath samples can be easily obtained. One possible future application of breath analysis may be the diagnosing and monitoring of diabetes. It is, therefore, essential, to firstly determine a relationship between exhaled biomarker concentration and glucose in blood as well as to compare the results with the results obtained from non-diabetic subjects. Concentrations of molecules which are biomarkers of diseases’ states, or early indicators of disease should be well documented, i.e., the variations of abnormal concentrations of breath biomarkers with age, gender and ethnic issues need to be verified. Furthermore, based on performed measurements it is rather obvious that analysis of exhaled acetone as a single biomarker of diabetes is unrealistic. In this paper, the author presents results of his research conducted on samples of breath gas from eleven healthy volunteers (HV) and fourteen type-1 diabetic patients (T1DM) which were collected in 1-l SKC breath bags. The exhaled acetone concentration was measured using mass spectrometry (HPR-20 QIC, Hiden Analytical, Warrington, UK) coupled with a micropreconcentrator in LTCC (Low Temperature Cofired Ceramic). However, as according to recent studies the level of acetone varies to a significant extent for each blood glucose concentration of single individuals, a direct and absolute relationship between blood glucose and acetone has not been proved. Nevertheless, basing on the research results acetone in diabetic breath was found to be higher than 1.11 ppmv, while its average concentration in normal breath was lower than 0.83 ppmv. PMID:25310087

Analytical methodologies for broad metabolite coverage of exhaled breath condensate.

PubMed

Aksenov, Alexander A; Zamuruyev, Konstantin O; Pasamontes, Alberto; Brown, Joshua F; Schivo, Michael; Foutouhi, Soraya; Weimer, Bart C; Kenyon, Nicholas J; Davis, Cristina E

2017-09-01

Breath analysis has been gaining popularity as a non-invasive technique that is amenable to a broad range of medical uses. One of the persistent problems hampering the wide application of the breath analysis method is measurement variability of metabolite abundances stemming from differences in both sampling and analysis methodologies used in various studies. Mass spectrometry has been a method of choice for comprehensive metabolomic analysis. For the first time in the present study, we juxtapose the most commonly employed mass spectrometry-based analysis methodologies and directly compare the resultant coverages of detected compounds in exhaled breath condensate in order to guide methodology choices for exhaled breath condensate analysis studies. Four methods were explored to broaden the range of measured compounds across both the volatile and non-volatile domain. Liquid phase sampling with polyacrylate Solid-Phase MicroExtraction fiber, liquid phase extraction with a polydimethylsiloxane patch, and headspace sampling using Carboxen/Polydimethylsiloxane Solid-Phase MicroExtraction (SPME) followed by gas chromatography mass spectrometry were tested for the analysis of volatile fraction. Hydrophilic interaction liquid chromatography and reversed-phase chromatography high performance liquid chromatography mass spectrometry were used for analysis of non-volatile fraction. We found that liquid phase breath condensate extraction was notably superior compared to headspace extraction and differences in employed sorbents manifested altered metabolite coverages. The most pronounced effect was substantially enhanced metabolite capture for larger, higher-boiling compounds using polyacrylate SPME liquid phase sampling. The analysis of the non-volatile fraction of breath condensate by hydrophilic and reverse phase high performance liquid chromatography mass spectrometry indicated orthogonal metabolite coverage by these chromatography modes. We found that the metabolite coverage could be enhanced significantly with the use of organic solvent as a device rinse after breath sampling to collect the non-aqueous fraction as opposed to neat breath condensate sample. Here, we show the detected ranges of compounds in each case and provide a practical guide for methodology selection for optimal detection of specific compounds. Copyright © 2017 Elsevier B.V. All rights reserved.

Pulmonary function in workers exposed to diesel exhausts: the effect of control measures.

PubMed

Ulfvarson, U; Alexandersson, R; Dahlqvist, M; Ekholm, U; Bergström, B

1991-01-01

To assess the protective effect of exhausts pipe filters or respirators on pulmonary function, 15 workers in a tunnel construction site, truck and loading machine drivers, rock workers, and others were studied. The total and respirable dust, combustible matter in respirable dust, carbon monoxide, nitrogen monoxide and nitrogen dioxide were measured for each subject during entire work shifts. The effect of the exposure on the lung function variables was measured by dynamic spirometry, carbon monoxide single breath technique, and nitrogen single breath wash-out. The exhaust pipe filtering had a protective effect, directly discernible in the drivers on vital capacity and FEV1.0 and for the whole group on FEV% and TLco. The dust respirators had no effect, probably because of the difficulties in correctly using personal protection under the circumstances in the tunnel. In the absence of a true exposure assessment, control measures for diesel exhausts can be tested by medical effect studies. Catalytic particle filters of diesel exhausts are one method of rendering the emissions less irritant, although they will not remove irritant gases. An indicator of diesel exhaust exposure should include the particle fraction of the diesel exhausts, but a discrimination between different sources of organic dust must be possible.

Diaphragmatic fatigue in man.

PubMed

Roussos, C S; Macklem, P T

1977-08-01

The time required (tlim) to produce fatigue of the diaphragm was determined in three normal seated subjects, breathing through a variety of high alinear, inspiratory resistances. During each breath in all experimental runs the subject generated a transdiaphragmatic pressure (Pdi) which was a predetermined fraction of his maximum inspiratory Pdi (Pdimax) at functional residual capacity. The breathing test was performed until the subject was unable to generate this Pdi. The relationship between Pdi/Pdimax and tlim was curvilinear so that when Pdi/Pdimax was small tlim increased markedly for little changes in Pdi/Pdimax. The value of Pdi/Pdimax that could be generated indefinitely (Pdicrit) was around 0.4. Hypoxia appeared to have no influence on Pdicrit, but probably led to a reduction in tlim at Pdi greater than Pdicrit for equal rates of energy consumption. Insofar as the behavior of the diaphragm reflects that of other respiratory muscles it appears that quite high inspiratory loads can be tolerated indefinitely. However, when the energy consumption of the respiratory muscles exceeds a critical level, fatigue should develop. This may be a mechanism of respiratory failure in a variety in a variety of lung diseases.

Anxiety is associated with diminished exercise performance and quality of life in severe emphysema: a cross-sectional study

PubMed Central

2010-01-01

Background Anxiety in patients with chronic obstructive pulmonary disease (COPD) is associated with self-reported disability. The purpose of this study is to determine whether there is an association between anxiety and functional measures, quality of life and dyspnea. Methods Data from 1828 patients with moderate to severe emphysema enrolled in the National Emphysema Treatment Trial (NETT), collected prior to rehabilitation and randomization, were used in linear regression models to test the association between anxiety symptoms, measured by the Spielberger State Trait Anxiety Inventory (STAI) and: (a) six-minute walk distance test (6 MWD), (b) cycle ergometry peak workload, (c) St. Georges Respiratory Questionnaire (SRGQ), and (d) UCSD Shortness of Breath Questionnaire (SOBQ), after controlling for potential confounders including age, gender, FEV1 (% predicted), DLCO (% predicted), and the Beck Depression Inventory (BDI). Results Anxiety was significantly associated with worse functional capacity [6 MWD (B = -0.944, p < .001), ergometry peak workload (B = -.087, p = .04)], quality of life (B = .172, p < .001) and shortness of breath (B = .180, p < .001). Regression coefficients show that a 10 point increase in anxiety score is associated with a mean decrease in 6 MWD of 9 meters, a 1 Watt decrease in peak exercise workload, and an increase of almost 2 points on both the SGRQ and SOBQ. Conclusion In clinically stable patients with moderate to severe emphysema, anxiety is associated with worse exercise performance, quality of life and shortness of breath, after accounting for the influence of demographic and physiologic factors known to affect these outcomes. Trail Registration ClinicalTrials.gov NCT00000606 PMID:20214820

CPAP of 4 cm H(2)O Has no short-term benefit at term in infants with BPD.

PubMed

Sandberg, Kenneth L; Hjalmarson, Ola

2012-01-01

Lung development and function is compromised at term in infants with bronchopulmonary dysplasia (BPD), characterized by reduced functional residual capacity (FRC) and impaired gas-mixing efficiency in distal airways. To determine whether continuous positive airway pressure (CPAP) improves FRC, ventilation, distal airway function, and gas exchange in spontaneously breathing infants with BPD. Twenty-one infants with BPD (median birth weight 0.72 kg (range 0.50-1.27) and median gestational age 26 weeks (range 23-28)) were studied before and after CPAP of 4 cm H(2)O was applied by a facemask system. A multiple-breath nitrogen washout method was used to assess FRC, ventilation, and gas-mixing efficiency. Moment analysis and lung clearance index was calculated from the nitrogen-decay curve for assessment of gas-mixing efficiency. Transcutaneous (Tc) PO(2)/PCO(2) was monitored during stable infant conditions before each washout test. When CPAP was raised from 0 to 4 cm H(2)O, FRC increased significantly together with a significant increase in moment ratios (M(1)/M(0) and M(2)/M(0)). Tc PO(2) decreased significantly and the breathing pattern changed, with significantly reduced respiratory rate, minute ventilation, and alveolar ventilation. There was also an increase in tidal volume and dead space. CPAP of 4 cm H(2)O applied with a facemask at term to infants with BPD did not improve ventilation, gas-mixing efficiency in distal airways, or oxygenation despite an increase in FRC. We speculate that instead of promoting recruitment of unventilated lung volumes, increasing the end-expiratory pressure in infants with BPD may lead to an overexpansion of already ventilated parts of the lung, causing further compromise of lung function. Copyright © 2012 S. Karger AG, Basel.

A Portable Real-Time Ringdown Breath Acetone Analyzer: Toward Potential Diabetic Screening and Management.

PubMed

Jiang, Chenyu; Sun, Meixiu; Wang, Zhennan; Chen, Zhuying; Zhao, Xiaomeng; Yuan, Yuan; Li, Yingxin; Wang, Chuji

2016-07-30

Breath analysis has been considered a suitable tool to evaluate diseases of the respiratory system and those that involve metabolic changes, such as diabetes. Breath acetone has long been known as a biomarker for diabetes. However, the results from published data by far have been inconclusive regarding whether breath acetone is a reliable index of diabetic screening. Large variations exist among the results of different studies because there has been no "best-practice method" for breath-acetone measurements as a result of technical problems of sampling and analysis. In this mini-review, we update the current status of our development of a laser-based breath acetone analyzer toward real-time, one-line diabetic screening and a point-of-care instrument for diabetic management. An integrated standalone breath acetone analyzer based on the cavity ringdown spectroscopy technique has been developed. The instrument was validated by using the certificated gas chromatography-mass spectrometry. The linear fittings suggest that the obtained acetone concentrations via both methods are consistent. Breath samples from each individual subject under various conditions in total, 1257 breath samples were taken from 22 Type 1 diabetic (T1D) patients, 312 Type 2 diabetic (T2D) patients, which is one of the largest numbers of T2D subjects ever used in a single study, and 52 non-diabetic healthy subjects. Simultaneous blood glucose (BG) levels were also tested using a standard diabetic management BG meter. The mean breath acetone concentrations were determined to be 4.9 ± 16 ppm (22 T1D), and 1.5 ± 1.3 ppm (312 T2D), which are about 4.5 and 1.4 times of the one in the 42 non-diabetic healthy subjects, 1.1 ± 0.5 ppm, respectively. A preliminary quantitative correlation (R = 0.56, p < 0.05) between the mean individual breath acetone concentration and the mean individual BG levels does exist in 20 T1D subjects with no ketoacidosis. No direct correlation is observed in T1D subjects, T2D subjects, and healthy subjects. The results from a relatively large number of subjects tested indicate that an elevated mean breath acetone concentration exists in diabetic patients in general. Although many physiological parameters affect breath acetone, under a specifically controlled condition fast (<1 min) and portable breath acetone measurement can be used for screening abnormal metabolic status including diabetes, for point-of-care monitoring status of ketone bodies which have the signature smell of breath acetone, and for breath acetone related clinical studies requiring a large number of tests.

Motion induced interplay effects for VMAT radiotherapy.

PubMed

Edvardsson, Anneli; Nordström, Fredrik; Ceberg, Crister; Ceberg, Sofie

2018-04-19

The purpose of this study was to develop a method to simulate breathing motion induced interplay effects for volumetric modulated arc therapy (VMAT), to verify the proposed method with measurements, and to use the method to investigate how interplay effects vary with different patient- and machine specific parameters. VMAT treatment plans were created on a virtual phantom in a treatment planning system (TPS). Interplay effects were simulated by dividing each plan into smaller sub-arcs using an in-house developed software and shifting the isocenter for each sub-arc to simulate a sin 6 breathing motion in the superior-inferior direction. The simulations were performed for both flattening-filter (FF) and flattening-filter free (FFF) plans and for different breathing amplitudes, period times, initial breathing phases, dose levels, plan complexities, CTV sizes, and collimator angles. The resulting sub-arcs were calculated in the TPS, generating a dose distribution including the effects of motion. The interplay effects were separated from dose blurring and the relative dose differences to 2% and 98% of the CTV volume (ΔD 98% and ΔD 2% ) were calculated. To verify the simulation method, measurements were carried out, both static and during motion, using a quasi-3D phantom and a motion platform. The results of the verification measurements during motion were comparable to the results of the static measurements. Considerable interplay effects were observed for individual fractions, with the minimum ΔD 98% and maximum ΔD 2% being  -16.7% and 16.2%, respectively. The extent of interplay effects was larger for FFF compared to FF and generally increased for higher breathing amplitudes, larger period times, lower dose levels, and more complex treatment plans. Also, the interplay effects varied considerably with the initial breathing phase, and larger variations were observed for smaller CTV sizes. In conclusion, a method to simulate motion induced interplay effects was developed and verified with measurements, which allowed for a large number of treatment scenarios to be investigated. The simulations showed large interplay effects for individual fractions and that the extent of interplay effects varied with the breathing pattern, FFF/FF, dose level, CTV size, collimator angle, and the complexity of the treatment plan.

Motion induced interplay effects for VMAT radiotherapy

NASA Astrophysics Data System (ADS)

Edvardsson, Anneli; Nordström, Fredrik; Ceberg, Crister; Ceberg, Sofie

2018-04-01

The purpose of this study was to develop a method to simulate breathing motion induced interplay effects for volumetric modulated arc therapy (VMAT), to verify the proposed method with measurements, and to use the method to investigate how interplay effects vary with different patient- and machine specific parameters. VMAT treatment plans were created on a virtual phantom in a treatment planning system (TPS). Interplay effects were simulated by dividing each plan into smaller sub-arcs using an in-house developed software and shifting the isocenter for each sub-arc to simulate a sin6 breathing motion in the superior–inferior direction. The simulations were performed for both flattening-filter (FF) and flattening-filter free (FFF) plans and for different breathing amplitudes, period times, initial breathing phases, dose levels, plan complexities, CTV sizes, and collimator angles. The resulting sub-arcs were calculated in the TPS, generating a dose distribution including the effects of motion. The interplay effects were separated from dose blurring and the relative dose differences to 2% and 98% of the CTV volume (ΔD98% and ΔD2%) were calculated. To verify the simulation method, measurements were carried out, both static and during motion, using a quasi-3D phantom and a motion platform. The results of the verification measurements during motion were comparable to the results of the static measurements. Considerable interplay effects were observed for individual fractions, with the minimum ΔD98% and maximum ΔD2% being  ‑16.7% and 16.2%, respectively. The extent of interplay effects was larger for FFF compared to FF and generally increased for higher breathing amplitudes, larger period times, lower dose levels, and more complex treatment plans. Also, the interplay effects varied considerably with the initial breathing phase, and larger variations were observed for smaller CTV sizes. In conclusion, a method to simulate motion induced interplay effects was developed and verified with measurements, which allowed for a large number of treatment scenarios to be investigated. The simulations showed large interplay effects for individual fractions and that the extent of interplay effects varied with the breathing pattern, FFF/FF, dose level, CTV size, collimator angle, and the complexity of the treatment plan.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, D; Kang, S; Kim, T

Purpose: Patient breathing-related sorting method of projections in 4D digital tomosythesis (DTS) can be suffered from severe artifacts due to non-uniform angle distribution of projections and noncoplanar reconstructed images for each phase. In this study, we propose a method for optimally acquiring projection images in 4D DTS. Methods: In this method every pair of projections at x-ray tube’s gantry angles symmetrical with respect to the center of the range of gantry rotation is obtained at the same respiration amplitude. This process is challenging but becomes feasible with visual-biofeedback using a patient specific respiration guide wave which is in sinusoidal shapemore » (i.e., smooth and symmetrical enough). Depending on scan parameters such as the number of acquisition points per cycle, total scan angle and projections per acquisition amplitude, acquisition sequence is pre-determined. A simulation study for feasibility test was performed. To mimic actual situation closely, a group of volunteers were recruited and breathing data were acquired both with/without biofeedback. Then, x-ray projections for a humanoid phantom were virtually performed following (1) the breathing data from volunteers without guide, (2) the breathing data with guide and (3) the planned breathing data (i.e., ideal situation). Images from all of 3 scenarios were compared. Results: Scenario #2 showed significant artifact reduction compared to #1 while did minimal increase from the ideal situation (i.e., scenario #3). We verified the performance of the method with regard to the degree of inaccuracy during respiratory guiding. Also, the scan angle dependence-related differences in the DTS images could reduce between using the proposed method and the established patient breathing-related sorting method. Conclusion: Through the proposed 4D DTS method, it is possible to improve the accuracy of image guidance between intra/inter fractions with relatively low imaging dose. This research was supported by the Mid-career Researcher Program through NRF funded by the Ministry of Science, ICT & Future Planning of Korea (NRF-2014R1A2A1A10050270) and by the Radiation Technology R&D program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (No. 2013M2A2A7038291)« less

A Non-Invasive Method for Estimating Cardiopulmonary Variables Using Breath-by-Breath Injection of Two Tracer Gases.

PubMed

Clifton, Lei; Clifton, David A; Hahn, Clive E W; Farmeryy, Andrew D

2013-01-01

Conventional methods for estimating cardiopulmonary variables usually require complex gas analyzers and the active co-operation of the patient. Therefore, they are not compatible with the crowded environment of the intensive care unit (ICU) or operating theatre, where patient co-operation is typically impossible. However, it is these patients that would benefit the most from accurate estimation of cardiopulmonary variables, because of their critical condition. This paper describes the results of a collaborative development between an anesthesiologists and biomedical engineers to create a compact and non-invasive system for the measurement of cardiopulmonary variables such as lung volume, airway dead space volume, and pulmonary blood flow. In contrast with conventional methods, the compact apparatus and non-invasive nature of the proposed method allow it to be used in the ICU, as well as in general clinical settings. We propose the use of a non-invasive method, in which tracer gases are injected into the patient's inspired breath, and the concentration of the tracer gases is subsequently measured. A novel breath-by-breath tidal ventilation model is then used to estimate the value of a patient's cardiopulmonary variables. Experimental results from an artificial lung demonstrate minimal error in the estimation of known parameters using the proposed method. Results from analysis of a cohort of 20 healthy volunteers (within the Oxford University Hospitals NHS Trust) show that the values of estimated cardiopulmonary variables from these subjects lies within the expected ranges. Advantages of this method are that it is non-invasive, compact, portable, and can perform analysis in real time with less than 1 min of acquired respiratory data.

CO[subscript 2] Rebreathing: An Undergraduate Laboratory to Study the Chemical Control of Breathing

ERIC Educational Resources Information Center

Domnik, N. J.; Turcotte, S. E.; Yuen, N. Y.; Iscoe, S.; Fisher, J. T.

2013-01-01

The Read CO[subscript]2 rebreathing method (Read DJ. "A clinical method for assessing the ventilatory response to carbon dioxide." "Australas Ann Med" 16: 20-32, 1967) provides a simple and reproducible approach for studying the chemical control of breathing. It has been widely used since the modifications made by Duffin and…

Detection of creatinine in exhaled breath of humans with chronic kidney disease by extractive electrospray ionization mass spectrometry.

PubMed

Zeng, Qian; Li, Penghui; Cai, Yunfeng; Zhou, Wei; Wang, Haidong; Luo, Jiao; Ding, Jianhua; Chen, Huanwen

2016-02-09

Exhaled breath contains chemicals that have a diagnostic value in human pathologies. Here in vivo breath analysis of creatinine has been demonstrated by constructing a novel platform based on extractive electrospray ionization mass spectrometry (EESI-MS) without sample pretreatment. Under optimized experimental conditions, the limit of creatinine detection in breath was 30.57 ng L(-1), and the linear range of detection was from 0.3 μg L(-1) to 100 μg L(-1). The concentration range of creatinine in the exhaled breath of 50 volunteers with chronic kidney disease was from 42 pptv to 924 pptv, and the range of the relative standard deviations was from 9.3% to 19.2%. The method provides high sensitivity, high specificity and high speed for semi-quantitative analysis of creatinine in exhaled human breath.

Effects of deep breathing on internal oblique and multifidus muscle activity in three sitting postures

PubMed Central

Ko, Min-Joo; Jung, Eun-Joo; Kim, Moon-Hwan; Oh, Jae-Seop

2018-01-01

[Purpose] This study was to investigate differences in the level of activity of the external oblique (EO), internal oblique (IO), and multifidus (MF) muscles with deep breathing in three sitting postures. [Subjects and Methods] Sixteen healthy women were recruited. The muscle activity (EO, IO, MF) of all subjects was measured in three sitting postures (slumped, thoracic upright, and lumbo-pelvic upright sitting postures) using surface electromyography. The activity of the same muscles was then remeasured in the three sitting postures during deep breathing. [Results] Deep breathing significantly increased activity in the EO, IO, and MF compared with normal breathing. Comparing postures, the activity of the MF and IO muscles was highest in the lumbo-pelvic upright sitting posture. [Conclusion] An lumbo-pelvic upright sitting posture with deep breathing could increase IO and MF muscle activity, thus improving lumbo-pelvic region stability. PMID:29706695

Applications of principal component analysis to breath air absorption spectra profiles classification

NASA Astrophysics Data System (ADS)

Kistenev, Yu. V.; Shapovalov, A. V.; Borisov, A. V.; Vrazhnov, D. A.; Nikolaev, V. V.; Nikiforova, O. Y.

2015-12-01

The results of numerical simulation of application principal component analysis to absorption spectra of breath air of patients with pulmonary diseases are presented. Various methods of experimental data preprocessing are analyzed.

Tests for H. pylori

MedlinePlus

Peptic ulcer disease - H. pylori ; PUD - H. pylori ... There are several methods to test for H. pylori infection. Breath Test (Carbon Isotope-urea Breath Test, or UBT) Up to 2 weeks before the test, you need to stop taking ...

Automated measurement of respiratory gas exchange by an inert gas dilution technique

NASA Technical Reports Server (NTRS)

Sawin, C. F.; Rummel, J. A.; Michel, E. L.

1974-01-01

A respiratory gas analyzer (RGA) has been developed wherein a mass spectrometer is the sole transducer required for measurement of respiratory gas exchange. The mass spectrometer maintains all signals in absolute phase relationships, precluding the need to synchronize flow and gas composition as required in other systems. The RGA system was evaluated by comparison with the Douglas bag technique. The RGA system established the feasibility of the inert gas dilution method for measuring breath-by-breath respiratory gas exchange. This breath-by-breath analytical capability permits detailed study of transient respiratory responses to exercise.

Breath acidification in adolescent runners exposed to atmospheric pollution: A prospective, repeated measures observational study

PubMed Central

Ferdinands, Jill M; Crawford, Carol A Gotway; Greenwald, Roby; Van Sickle, David; Hunter, Eric; Teague, W Gerald

2008-01-01

Background Vigorous outdoors exercise during an episode of air pollution might cause airway inflammation. The purpose of this study was to examine the effects of vigorous outdoor exercise during peak smog season on breath pH, a biomarker of airway inflammation, in adolescent athletes. Methods We measured breath pH both pre- and post-exercise on ten days during peak smog season in 16 high school athletes engaged in daily long-distance running in a downwind suburb of Atlanta. The association of post-exercise breath pH with ambient ozone and particulate matter concentrations was tested with linear regression. Results We collected 144 pre-exercise and 146 post-exercise breath samples from 16 runners (mean age 14.9 years, 56% male). Median pre-exercise breath pH was 7.58 (interquartile range: 6.90 to 7.86) and did not change significantly after exercise. We observed no significant association between ambient ozone or particulate matter and post-exercise breath pH. However both pre- and post-exercise breath pH were strikingly low in these athletes when compared to a control sample of 14 relatively sedentary healthy adults and to published values of breath pH in healthy subjects. Conclusion Although we did not observe an acute effect of air pollution exposure during exercise on breath pH, breath pH was surprisingly low in this sample of otherwise healthy long-distance runners. We speculate that repetitive vigorous exercise may induce airway acidification. PMID:18328105

3D Late Gadolinium Enhancement in a Single Prolonged Breath-hold using Supplemental Oxygenation and Hyperventilation

PubMed Central

Roujol, Sébastien; Basha, Tamer A.; Akçakaya, Mehmet; Foppa, Murilo; Chan, Raymond H.; Kissinger, Kraig V.; Goddu, Beth; Berg, Sophie; Manning, Warren J.; Nezafat, Reza

2013-01-01

Purpose: To evaluate the feasibility of 3D single breath-hold late gadolinium enhancement (LGE) of the left ventricle (LV) using supplemental oxygen and hyperventilation and compressed-sensing acceleration. Methods: Breath-hold metrics (breath-hold duration, diaphragmatic/LV position drift, and maximum variation of RR interval) without and with supplemental oxygen and hyperventilation were assessed in healthy adult subjects using a real time single shot acquisition. Ten healthy subjects and 13 patients then underwent assessment of the proposed 3D breath-hold LGE acquisition (FOV=320×320×100 mm3, resolution=1.6×1.6×5.0 mm3, acceleration rate of 4) and a free breathing acquisition with right hemidiaphragm navigator (NAV) respiratory gating. Semi-quantitative grading of overall image quality, motion artifact, myocardial nulling, and diagnostic value was performed by consensus of two blinded observers. Results: Supplemental oxygenation and hyperventilation increased the breath-hold duration (35±11 s to 58±21 s, p<0.0125) without significant impact on diaphragmatic/LV position drift or maximum variation of RR interval (both p>0.01). LGE images were of similar quality when compared to free breathing acquisitions but with reduced total scan time (85±22 s to 35±6 s, p<0.001). Conclusions: Supplemental oxygenation and hyperventilation allow for prolonged breath-holding and enable single breath-hold 3D accelerated LGE with similar image quality as free breathing with NAV. PMID:24186772

Efficiency of lung ventilation for people performing wind instruments.

PubMed

Brzęk, Anna; Famuła, Anna; Kowalczyk, Anna; Plinta, Ryszard

Wind instruments musicians are particularly prone to excessive respiratory efforts. Prolonged wind instruments performing may lead to changes in respiratory tracts and thus to respiratory muscles overload. It may result in decreasing lung tissue pliability and, as a consequence, in emphysema. Aim of the research has been to describe basic spirometric parameters for wind players and causes of potential changes. Slow and forced spirometry with the use of Micro Lab Viasys (Micro Medical, Great Britain) was conducted on 31 wind musicians (group A). A survey concerning playing time and frequency, weight of instruments, and education on diaphragmatic breathing was conducted. The control group included 34 healthy persons at similar age (group B). The results were statistically described using Excel and Statistica programmes. The respiratory parameters were within the range of physiological norms and forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC) exceeded in both groups the values of 100%. Forced vital capacity and expiratory vital capacity (EVC) values were significantly lower in the group of musicians than in the control group (p < 0.001). In 45% the group A used diaphragmatic breathing, in 31% of examinees mixed respiratory tract was observed. The significant discrepancy of individual parameters was obtained regarding age and the length of time when performing wind instrument. Spirometric parameters relative to standards may prove a good respiratory capacity. Peak expiratory flow (PEF) and FEV1 may indicate that a proper technique of respiration during performance was acquired. The length of time when performing wind instrument may influence parameters of dynamic spirometry. Med Pr 2016;67(4):427-433. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Diving in a warming world: the thermal sensitivity and plasticity of diving performance in juvenile estuarine crocodiles (Crocodylus porosus)

PubMed Central

Rodgers, Essie M.; Schwartz, Jonathon J.; Franklin, Craig E.

2015-01-01

Air-breathing, diving ectotherms are a crucial component of the biodiversity and functioning of aquatic ecosystems, but these organisms may be particularly vulnerable to the effects of climate change on submergence times. Ectothermic dive capacity is thermally sensitive, with dive durations significantly reduced by acute increases in water temperature; it is unclear whether diving performance can acclimate/acclimatize in response to long-term exposure to elevated water temperatures. We assessed the thermal sensitivity and plasticity of ‘fright-dive’ capacity in juvenile estuarine crocodiles (Crocodylus porosus; n = 11). Crocodiles were exposed to one of three long-term thermal treatments, designed to emulate water temperatures under differing climate change scenarios (i.e. current summer, 28°C; ‘moderate’ climate warming, 31.5°C; ‘high’ climate warming, 35°C). Dive trials were conducted in a temperature-controlled tank across a range of water temperatures. Dive durations were independent of thermal acclimation treatment, indicating a lack of thermal acclimation response. Acute increases in water temperature resulted in significantly shorter dive durations, with mean submergence times effectively halving with every 3.5°C increase in water temperature (Q10 0.17, P < 0.001). Maximal dive performances, however, were found to be thermally insensitive across the temperature range of 28–35°C. These results suggest that C. porosus have a limited or non-existent capacity to thermally acclimate sustained ‘fright-dive’ performance. If the findings here are applicable to other air-breathing, diving ectotherms, the functional capacity of these organisms will probably be compromised under climate warming. PMID:27293738

[Personal sports training in the management of obese boys aged 12 to 16 years].

PubMed

Dupuis, J M; Vivant, J F; Daudet, G; Bouvet, A; Clément, M; Dazord, A; Dumet, N; David, M; Bellon, G

2000-11-01

Estimation of both physical and psychological effects of an adapted physical training on children undergoing an obesity treatment. The survey was carried out on 36 obese boys (ages = 12-16 years) who stayed in the medical center for at least four months. Eighteen of them were trained with the SELF method (the SELF-training is global, progressive, adapted to each boy, controlled and takes place within a ten-week period with five sessions a fortnight, each session lasting 30 to 40 minutes). The parameters that were studied concerned auxology, breathing function exploration, aerobic and anaerobic capacities, muscle strength and psychomotor qualities; the subjective effects of the training were estimated with a questionnaire about life quality, and the hand test. At inclusion the results were reported to a standard kind of population. At the end of the training the results of the 18 boys that were trained were compared to those of the 18 controls. Compared to a standard population, the obese children' aerobic capacity is diminished for the maximum power but is identical in absolute value for the VO2 max; their anaerobic capacities, muscle strength and psychomotor capacities are lower and their psyche is affected by the disease. After a three-month training period and after comparison with the 'control' group, there can be noticed a significant improvement in the psychomotor capacities, a major tendency for the improvement of the aerobic capacities and very positive effects on the psyche. SELF-training in association with dietetics appears to be very useful in the therapeutic care of obese children. For the follow-up at home it would need to be registered within the domain of physiotherapy.

Design of a breath analysis system for diabetes screening and blood glucose level prediction.

PubMed

Yan, Ke; Zhang, David; Wu, Darong; Wei, Hua; Lu, Guangming

2014-11-01

It has been reported that concentrations of several biomarkers in diabetics' breath show significant difference from those in healthy people's breath. Concentrations of some biomarkers are also correlated with the blood glucose levels (BGLs) of diabetics. Therefore, it is possible to screen for diabetes and predict BGLs by analyzing one's breath. In this paper, we describe the design of a novel breath analysis system for this purpose. The system uses carefully selected chemical sensors to detect biomarkers in breath. Common interferential factors, including humidity and the ratio of alveolar air in breath, are compensated or handled in the algorithm. Considering the intersubject variance of the components in breath, we build subject-specific prediction models to improve the accuracy of BGL prediction. A total of 295 breath samples from healthy subjects and 279 samples from diabetic subjects were collected to evaluate the performance of the system. The sensitivity and specificity of diabetes screening are 91.51% and 90.77%, respectively. The mean relative absolute error for BGL prediction is 21.7%. Experiments show that the system is effective and that the strategies adopted in the system can improve its accuracy. The system potentially provides a noninvasive and convenient method for diabetes screening and BGL monitoring as an adjunct to the standard criteria.

Breath Group Analysis for Reading and Spontaneous Speech in Healthy Adults

PubMed Central

Wang, Yu-Tsai; Green, Jordan R.; Nip, Ignatius S.B.; Kent, Ray D.; Kent, Jane Finley

2010-01-01

Aims The breath group can serve as a functional unit to define temporal and fundamental frequency (f0) features in continuous speech. These features of the breath group are determined by the physiologic, linguistic, and cognitive demands of communication. Reading and spontaneous speech are two speaking tasks that vary in these demands and are commonly used to evaluate speech performance for research and clinical applications. The purpose of this study is to examine differences between reading and spontaneous speech in the temporal and f0 aspects of their breath groups. Methods Sixteen participants read two passages and answered six questions while wearing a circumferentially vented mask connected to a pneumotach. The aerodynamic signal was used to identify inspiratory locations. The audio signal was used to analyze task differences in breath group structure, including temporal and f0 components. Results The main findings were that spontaneous speech task exhibited significantly more grammatically inappropriate breath group locations and longer breath group duration than did the passage reading task. Conclusion The task differences in the percentage of grammatically inadequate breath group locations and in breath group duration for healthy adult speakers partly explain the differences in cognitive-linguistic load between the passage reading and spontaneous speech. PMID:20588052

Measurement and prediction of indoor air quality using a breathing thermal manikin.

PubMed

Melikov, A; Kaczmarczyk, J

2007-02-01

The analyses performed in this paper reveal that a breathing thermal manikin with realistic simulation of respiration including breathing cycle, pulmonary ventilation rate, frequency and breathing mode, gas concentration, humidity and temperature of exhaled air and human body shape and surface temperature is sensitive enough to perform reliable measurement of characteristics of air as inhaled by occupants. The temperature, humidity, and pollution concentration in the inhaled air can be measured accurately with a thermal manikin without breathing simulation if they are measured at the upper lip at a distance of <0.01 m from the face. Body surface temperature, shape and posture as well as clothing insulation have impact on the measured inhaled air parameters. Proper simulation of breathing, especially of exhalation, is needed for studying the transport of exhaled air between occupants. A method for predicting air acceptability based on inhaled air parameters and known exposure-response relationships established in experiments with human subjects is suggested. Recommendations for optimal simulation of human breathing by means of a breathing thermal manikin when studying pollution concentration, temperature and humidity of the inhaled air as well as the transport of exhaled air (which may carry infectious agents) between occupants are outlined. In order to compare results obtained with breathing thermal manikins, their nose and mouth geometry should be standardized.

Pure-rotational spectrometry: a vintage analytical method applied to modern breath analysis.

PubMed

Hrubesh, Lawrence W; Droege, Michael W

2013-09-01

Pure-rotational spectrometry (PRS) is an established method, typically used to study structures and properties of polar gas-phase molecules, including isotopic and isomeric varieties. PRS has also been used as an analytical tool where it is particularly well suited for detecting or monitoring low-molecular-weight species that are found in exhaled breath. PRS is principally notable for its ultra-high spectral resolution which leads to exceptional specificity to identify molecular compounds in complex mixtures. Recent developments using carbon aerogel for pre-concentrating polar molecules from air samples have extended the sensitivity of PRS into the part-per-billion range. In this paper we describe the principles of PRS and show how it may be configured in several different modes for breath analysis. We discuss the pre-concentration concept and demonstrate its use with the PRS analyzer for alcohols and ammonia sampled directly from the breath.

Real-time continuous visual biofeedback in the treatment of speech breathing disorders following childhood traumatic brain injury: report of one case.

PubMed

Murdoch, B E; Pitt, G; Theodoros, D G; Ward, E C

1999-01-01

The efficacy of traditional and physiological biofeedback methods for modifying abnormal speech breathing patterns was investigated in a child with persistent dysarthria following severe traumatic brain injury (TBI). An A-B-A-B single-subject experimental research design was utilized to provide the subject with two exclusive periods of therapy for speech breathing, based on traditional therapy techniques and physiological biofeedback methods, respectively. Traditional therapy techniques included establishing optimal posture for speech breathing, explanation of the movement of the respiratory muscles, and a hierarchy of non-speech and speech tasks focusing on establishing an appropriate level of sub-glottal air pressure, and improving the subject's control of inhalation and exhalation. The biofeedback phase of therapy utilized variable inductance plethysmography (or Respitrace) to provide real-time, continuous visual biofeedback of ribcage circumference during breathing. As in traditional therapy, a hierarchy of non-speech and speech tasks were devised to improve the subject's control of his respiratory pattern. Throughout the project, the subject's respiratory support for speech was assessed both instrumentally and perceptually. Instrumental assessment included kinematic and spirometric measures, and perceptual assessment included the Frenchay Dysarthria Assessment, Assessment of Intelligibility of Dysarthric Speech, and analysis of a speech sample. The results of the study demonstrated that real-time continuous visual biofeedback techniques for modifying speech breathing patterns were not only effective, but superior to the traditional therapy techniques for modifying abnormal speech breathing patterns in a child with persistent dysarthria following severe TBI. These results show that physiological biofeedback techniques are potentially useful clinical tools for the remediation of speech breathing impairment in the paediatric dysarthric population.

Breath biomarkers in toxicology.

PubMed

Pleil, Joachim D

2016-11-01

Exhaled breath has joined blood and urine as a valuable resource for sampling and analyzing biomarkers in human media for assessing exposure, uptake metabolism, and elimination of toxic chemicals. This article focuses current use of exhaled gas, aerosols, and vapor in human breath, the methods for collection, and ultimately the use of the resulting data. Some advantages of breath are the noninvasive and self-administered nature of collection, the essentially inexhaustible supply, and that breath sampling does not produce potentially infectious waste such as needles, wipes, bandages, and glassware. In contrast to blood and urine, breath samples can be collected on demand in rapid succession and so allow toxicokinetic observations of uptake and elimination in any time frame. Furthermore, new technologies now allow capturing condensed breath vapor directly, or just the aerosol fraction alone, to gain access to inorganic species, lung pH, proteins and protein fragments, cellular DNA, and whole microorganisms from the pulmonary microbiome. Future applications are discussed, especially the use of isotopically labeled probes, non-targeted (discovery) analysis, cellular level toxicity testing, and ultimately assessing "crowd breath" of groups of people and the relation to dose of airborne and other environmental chemicals at the population level.

Association between the rapid shallow breathing index and extubation success in patients with traumatic brain injury

PubMed Central

dos Reis, Helena França Correia; Almeida, Mônica Lajana Oliveira; da Silva, Mário Ferreira; Moreira, Julião Oliveira; Rocha, Mário de Seixas

2013-01-01

Objective To investigate the association between the rapid shallow breathing index and successful extubation in patients with traumatic brain injury. Methods This study was a prospective study conducted in patients with traumatic brain injury of both genders who underwent mechanical ventilation for at least two days and who passed a spontaneous breathing trial. The minute volume and respiratory rate were measured using a ventilometer, and the data were used to calculate the rapid shallow breathing index (respiratory rate/tidal volume). The dependent variable was the extubation outcome: reintubation after up to 48 hours (extubation failure) or not (extubation success). The independent variable was the rapid shallow breathing index measured after a successful spontaneous breathing trial. Results The sample comprised 119 individuals, including 111 (93.3%) males. The average age of the sample was 35.0±12.9 years old. The average duration of mechanical ventilation was 8.1±3.6 days. A total of 104 (87.4%) participants achieved successful extubation. No association was found between the rapid shallow breathing index and extubation success. Conclusion The rapid shallow breathing index was not associated with successful extubation in patients with traumatic brain injury. PMID:24213084

Free-breathing cine DENSE MRI using phase cycling with matchmaking and stimulated-echo image-based navigators.

PubMed

Cai, Xiaoying; Epstein, Frederick H

2018-04-01

This study aimed to develop a self-navigated method for free-breathing spiral cine displacement encoding with stimulated echoes (DENSE), a myocardial strain imaging technique that uses phase-cycling for artifact suppression. The method needed to address 2 consequences of motion for DENSE: striping artifacts from incomplete suppression of the T 1 -relaxation echo and blurring. The method identifies phase-cycled spiral interleaves at matched respiratory phases by minimizing the residual signal due to T 1 relaxation after phase-cycling subtraction. Next, the method reconstructs image-based navigators from matched phase-cycled interleaves that are comprised of the stimulated echo (ste-iNAVs). Ste-iNAVs are used for motion estimation and compensation of k-space data. The method was demonstrated in phantoms and compared to diaphragm-based navigator (dNAV) and conventional iNAV (c-iNAV) methods for the reconstruction of free-breathing volunteer data sets (N = 10). Phantom experiments demonstrated that the proposed method removes striping artifacts and blurring due to motion. Volunteer results showed that respiratory motion measured by ste-iNAVs was better correlated than c-iNAVs to dNAV data (R 2  = 0.82 ± 0.03 vs. 0.70 ± 0.05, P < 0.05). Match-making reconstructions of free-breathing data sets achieved lower residual T 1 -relaxation echo energy (1.04 ± 0.01 vs. 1.18 ± 0.04 for dNAV and 1.18 ± 0.03 for c-iNAV, P < 0.05), higher apparent SNR (11.93 ± 1.05 vs. 10.68 ± 1.06 for dNAV and 10.66 ± 0.99 for c-iNAV, P < 0.05), and better phase quality (0.147 ± 0.012 vs. 0.166 ± 0.017 for dNAV, P = 0.06, and 0.168 ± 0.015 for c-iNAV, P < 0.05) than dNAV and c-iNAV methods. For free-breathing cine DENSE, the proposed method addresses both types of breathing-induced artifacts and provides better quality images than conventional dNAV and iNAV methods. © 2018 International Society for Magnetic Resonance in Medicine.

Pulmonary function in men after oxygen breathing at 3.0 ATA for 3.5 h

NASA Technical Reports Server (NTRS)

Clark, J. M.; Jackson, R. M.; Lambertsen, C. J.; Gelfand, R.; Hiller, W. D. B.; Unger, M.

1991-01-01

A complete description of pulmonary measurements obtained after continuous O2 exposure of 13 healthy men at 3.0 ATA for 3.5 h is presented. Measurements included flow-volume loops, spirometry, and airway resistance(n = 12); CO diffusing capacity (n = 11); closing volumes (n= 6); and air vs. HeO2 forced vital capacity maneuvers (n = 5). The average difference in maximum mid expiratory flows at 50 percent vital capacity on air and HeO2 was found to be significantly reduced postexposure by 18 percent. Raw and CO diffusing capacity were not changed postexposure. It is concluded that the relatively large change in forced expiratory flow at 25-75 percent of vital capacity compared with the mean forced expiratory volume in 1 s, the reduction in density dependence of flow, and the normal Raw postexposure are all consistent with flow limitation in peripheral airways as a major cause of the observed reduction in expiratory flow.

Prognostic Role of Exhaled Breath Condensate pH and Fraction Exhaled Nitric Oxide in Systemic Sclerosis Related Interstitial Lung Disease.

PubMed

Guillen-Del Castillo, Alfredo; Sánchez-Vidaurre, Sara; Simeón-Aznar, Carmen P; Cruz, María J; Fonollosa-Pla, Vicente; Muñoz, Xavier

2017-03-01

Interstitial lung disease (ILD) is one of the major causes of death in systemic sclerosis (SSc). This study investigated exhaled breath (EB) and exhaled breath condensate (EBC) biomarkers in patients with SSc and analyzed their role as a prognostic tool in SSc-related ILD. Fraction exhaled nitric oxide (FeNO) and exhaled carbon monoxide (eCO) measured in EB, together with pH, nitrite, nitrate and interleukin-6 levels measured in EBC were prospectively analyzed in 35 patients with SSc. Twelve patients had established ILD by chest high-resolution computed tomography (HRCT), and 23 patients showed no evidence of ILD. EB and EBC biomarkers were determined at inclusion, and pulmonary function tests were annually performed during 4 years of follow-up. No differences at baseline biomarkers levels were found between groups. In all patients studied, low EBC pH levels were associated with a decreased diffusing capacity for carbon monoxide (DLCO) during follow-up. Low FeNO levels were correlated with lower forced vital capacity (FVC) at baseline, 4years of follow-up and with a decrease in FVC and DLCO during monitoring. Among ILD patients, high eCO levels were correlated with lower baseline FVC. In the global cohort, a worse progression-free survival was identified in patients with EBC pH values lower than 7.88 and FeNO levels lower than 10.75ppb (Log Rank P=.03 and P<.01, respectively). EB and EBC could help to detect patients likely to present a deterioration on lung function during follow up. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Navigating under sea ice promotes rapid maturation of diving physiology and performance in beluga whales.

PubMed

Noren, Shawn R; Suydam, Robert

2016-09-15

Little is known about the postnatal development of the physiological characteristics that support breath-hold in cetaceans, despite their need to swim and dive at birth. Arctic species have the additional demand of avoiding entrapment while navigating under sea ice, where breathing holes are patchily distributed and ephemeral. This is the first investigation of the ontogeny of the biochemistry of the locomotor muscle in a year-round Arctic-dwelling cetacean (beluga whale, Delphinapterus leucas). Compared with what we know about other cetaceans, belugas are born with high myoglobin content (1.56±0.02 g 100 g -1 wet muscle mass, N=2) that matures rapidly. Myoglobin increased by 452% during the first year after birth and achieved adult levels (6.91±0.35 g 100 g -1 wet muscle mass, N=9) by 14 months postpartum. Buffering capacity was 48.88±0.69 slykes (N=2) at birth; adult levels (84.31±1.38 slykes, N=9) were also achieved by 14 months postpartum. As the oxygen stores matured, calculated aerobic dive limit more than doubled over the first year of life, undoubtedly facilitating the movements of calves under sea ice. Nonetheless, small body size theoretically continues to constrain the diving ability of newly weaned 2 year olds, as they only had 74% and 69% of the aerobic breath-hold capacity of larger adult female and male counterparts. These assessments enhance our knowledge of the biology of cetaceans and provide insight into age-specific flexibility to alter underwater behaviors, as may be required with the ongoing alterations in the Arctic marine ecosystem associated with climate change and increased anthropogenic activities. © 2016. Published by The Company of Biologists Ltd.

Air breathing in the Arctic: influence of temperature, hypoxia, activity and restricted air access on respiratory physiology of the Alaska blackfish Dallia pectoralis.

PubMed

Lefevre, Sjannie; Damsgaard, Christian; Pascale, Desirae R; Nilsson, Göran E; Stecyk, Jonathan A W

2014-12-15

The Alaska blackfish (Dallia pectoralis) is an air-breathing fish native to Alaska and the Bering Sea islands, where it inhabits lakes that are ice-covered in the winter, but enters warm and hypoxic waters in the summer to forage and reproduce. To understand the respiratory physiology of this species under these conditions and the selective pressures that maintain the ability to breathe air, we acclimated fish to 5°C and 15°C and used respirometry to measure: standard oxygen uptake (Ṁ(O₂)) in normoxia (19.8 kPa P(O₂)) and hypoxia (2.5 kPa), with and without access to air; partitioning of standard Ṁ(O₂) in normoxia and hypoxia; maximum Ṁ(O₂) and partitioning after exercise; and critical oxygen tension (P(crit)). Additionally, the effects of temperature acclimation on haematocrit, haemoglobin oxygen affinity and gill morphology were assessed. Standard Ṁ(O₂) was higher, but air breathing was not increased, at 15°C or after exercise at both temperatures. Fish acclimated to 5°C or 15°C increased air breathing to compensate and fully maintain standard Ṁ(O₂) in hypoxia. Fish were able to maintain Ṁ(O₂) through aquatic respiration when air was denied in normoxia, but when air was denied in hypoxia, standard Ṁ(O₂) was reduced by ∼30-50%. P(crit) was relatively high (5 kPa) and there were no differences in P(crit), gill morphology, haematocrit or haemoglobin oxygen affinity at the two temperatures. Therefore, Alaska blackfish depends on air breathing in hypoxia and additional mechanisms must thus be utilised to survive hypoxic submergence during the winter, such as hypoxia-induced enhancement in the capacities for carrying and binding blood oxygen, behavioural avoidance of hypoxia and suppression of metabolic rate. © 2014. Published by The Company of Biologists Ltd.

Matter over mind: a randomised-controlled trial of single-session biofeedback training on performance anxiety and heart rate variability in musicians.

PubMed

Wells, Ruth; Outhred, Tim; Heathers, James A J; Quintana, Daniel S; Kemp, Andrew H

2012-01-01

Musical performance is a skilled activity performed under intense pressure, thus is often a profound source of anxiety. In other contexts, anxiety and its concomitant symptoms of sympathetic nervous system arousal have been successfully ameliorated with HRV biofeedback (HRV BF), a technique involving slow breathing which augments autonomic and emotional regulatory capacity. This randomised-controlled study explored the impact of a single 30-minute session of HRV BF on anxiety in response to a highly stressful music performance. A total of 46 trained musicians participated in this study and were randomly allocated to a slow breathing with or without biofeedback or no-treatment control group. A 3 Group×2 Time mixed experimental design was employed to compare the effect of group before and after intervention on performance anxiety (STAI-S) and frequency domain measures of HRV. Slow breathing groups (n=30) showed significantly greater improvements in high frequency (HF) and LF/HF ratio measures of HRV relative to control (n=15) during 5 minute recordings of performance anticipation following the intervention (effect size: η(2) =0.122 and η(2) =0.116, respectively). The addition of biofeedback to a slow breathing protocol did not produce differential results. While intervention groups did not exhibit an overall reduction in self-reported anxiety, participants with high baseline anxiety who received the intervention (n=15) displayed greater reductions in self-reported state anxiety relative to those in the control condition (n=7) (r=0.379). These findings indicate that a single session of slow breathing, regardless of biofeedback, is sufficient for controlling physiological arousal in anticipation of psychosocial stress associated with music performance and that slow breathing is particularly helpful for musicians with high levels of anxiety. Future research is needed to further examine the effects of HRV BF as a low-cost, non-pharmacological treatment for music performance anxiety.

Lactose (mal)digestion evaluated by the 13C-lactose digestion test.

PubMed

Vonk, R J; Lin, Y; Koetse, H A; Huang, C; Zeng, G; Elzinga, H; Antoine, J; Stellaard, F

2000-02-01

The prevalence of genetically determined lactase nonpersistence is based on the results of the lactose H2 breath test. This test, however, is an indirect test, which might lead to misinterpretation. We determined lactase activity in healthy Chinese and Dutch students using a novel 13C-lactose digestion test. The cut-off value of this test was established in a Chinese population with a homogenous genetic background of lactase nonpersistence and was compared with the results obtained in a Caucasian population. Twenty-five grams of a 13C-lactose solution was consumed by 12 known H2-positive and 5 H2-negative Chinese students and 48 Dutch students and, subsequently, 13C-glucose concentration in plasma and H2 excretion in breath were measured. A similar 13C-glucose response curve was found in all Chinese students. The mean response curve in the Dutch students was more pronounced (P < 0.01). The 1 h (peak) plasma 13C-glucose concentration was the best discriminator between lactose digesting and maldigesting subjects. The cut-off level of 2 mmol L-1 13C-glucose in plasma was defined in the H2-positive Chinese students group. Based on the 13C-glucose response the prevalence of lactose maldigestion in the Dutch subjects was 25%; based on the lactose H2 breath test 17%. Using the 13C-lactose digestion test the results demonstrate a higher prevalence of lactose maldigestion in a Caucasian population than indicated by the results of the H2 breath test. A moderate increase in the plasma 13C-glucose concentration after consumption of 13C-lactose in the young adult Chinese subjects indicates a residual lactase activity in that age group, even when a positive H2 breath test result is obtained. These results indicate that the 13C-glucose concentration in plasma more accurately reflects the small intestinal lactose digestion capacity than the lactose H2 breath test.

A Method for Assessing Ground-Truth Accuracy of the 5DCT Technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dou, Tai H., E-mail: tdou@mednet.ucla.edu; Thomas, David H.; O'Connell, Dylan P.

2015-11-15

Purpose: To develop a technique that assesses the accuracy of the breathing phase-specific volume image generation process by patient-specific breathing motion model using the original free-breathing computed tomographic (CT) scans as ground truths. Methods: Sixteen lung cancer patients underwent a previously published protocol in which 25 free-breathing fast helical CT scans were acquired with a simultaneous breathing surrogate. A patient-specific motion model was constructed based on the tissue displacements determined by a state-of-the-art deformable image registration. The first image was arbitrarily selected as the reference image. The motion model was used, along with the free-breathing phase information of the originalmore » 25 image datasets, to generate a set of deformation vector fields that mapped the reference image to the 24 nonreference images. The high-pitch helically acquired original scans served as ground truths because they captured the instantaneous tissue positions during free breathing. Image similarity between the simulated and the original scans was assessed using deformable registration that evaluated the pointwise discordance throughout the lungs. Results: Qualitative comparisons using image overlays showed excellent agreement between the simulated images and the original images. Even large 2-cm diaphragm displacements were very well modeled, as was sliding motion across the lung–chest wall boundary. The mean error across the patient cohort was 1.15 ± 0.37 mm, and the mean 95th percentile error was 2.47 ± 0.78 mm. Conclusion: The proposed ground truth–based technique provided voxel-by-voxel accuracy analysis that could identify organ-specific or tumor-specific motion modeling errors for treatment planning. Despite a large variety of breathing patterns and lung deformations during the free-breathing scanning session, the 5-dimensionl CT technique was able to accurately reproduce the original helical CT scans, suggesting its applicability to a wide range of patients.« less

Instrumentation development for drug detection on the breath

DOT National Transportation Integrated Search

1972-09-01

Based on a survey of candidate analytical methods, mass spectrometry was identified as a promising technique for drug detection on the breath. To demonstrate its capabilities, an existing laboratory mass spectrometer was modified by the addition of a...

MEASUREMENT METHOD FOR VOLATILE METABOLIC BIOMARKERS IN EXHALED BREATH CONDENSATE

EPA Science Inventory

EPA is developing biomarker methodology to interpret spot biological measurements and their linkage to previous environmental pollutants exposures for individuals. This work explores the use of a promising biological media, exhaled breath condensate (EBC), which contains trapped...

[Examination of gastric emptying rate by means of 13C-octanoic acid breath test. Methods of the test for adults and results of the investigation of healthy volunteers].

PubMed

Bures, J; Kopácová, M; Vorísek, V; Bukac, J; Neumann, D; Rejchrt, S; Pozler, O; Douda, T; Zivný, P; Palicka, V

2005-01-01

13C-octanoic acid breath test (13C-OABT) is a simple, safe and non-invasive technique for measuring gastric emptying. However, the method has not been standardized yet. Aim of the study was to work up, introduce and evaluate our own method of the 13C-OABT for adults. Ten healthy volunteers entered the study (5 men, 5 women, mean age 32 years, 50 % Helicobacter pylori positive). Standard test meals (with 100 mg 13C-sodium octanoate) were used three times within 3 weeks. The same solid meal (1,178 kJ) for Tests 1 and 2 contained scrambled egg (+ 3 g oil), white bread (40 g), butter (10 g) and distilled water (200 ml). Semi-solid meal (1,020 kJ) for Test 3 contained milk pudding (200 g) and distilled water (200 ml). Duplicate breath samples were obtained before and every 15 minutes after eating the test meal during 255 minutes. Altogether 1,080 breath samples were analysed twice (isotope ratio mass spectrometry, AP2003 Analytical Precision, UK). To assess the half-life of elimination (t1/2 E), we modelled the process of elimination with the incomplete gamma-function, which has a convenient form for the empiric plotting of breath test data. Mean t1/2E was 136+/-10 minutes (Test 1), 134+/-14 (Test 2) and 123+/-16 minutes (Test 3). Clinical reproducibility of 13C-OABT in particular persons was 98.2% (18 breath samples series), 90.8 % (15 samples) and 87.1% (9 breath samples series). There was a significant correlation between Test 1 and Test 2 results (r=0.887, p<0.0001). Mean difference of duplicate breath sample analysis was 1.460 % (in 540 pairs), mean baseline one-day analysis difference was 0.0982 (99.9274% accuracy). In healthy volunteers, normal range of t1/2E is 110-160 minutes for solids and 91-155 minutes for semisolid test meal. Using our own computed mean time of intermediate metabolism of 13C-octanoic acid (76.5+/-7.5 minutes), gastric emptying half-time is 33.5-83.5 minutes for solids and 14.5-78.5 minutes for semisolid test meal in healthy volunteers. The 13C-OABT is accurate non-invasive method for gastric emptying measurement.

Neck breathing: a form of voluntary respiration for the spine-injured ventilator-dependent quadriplegic child.

PubMed

Gilgoff, I S; Barras, D M; Jones, M S; Adkins, H V

1988-11-01

Children with respirator-dependent quadriplegia because of C-2 spinal cord injuries are now surviving the acute stages of their injury. The major cause of mortality and morbidity in the chronic stage is due to respiratory complications. Surveillance, 24 h/d, is the best way to prevent accidental disconnection of respirator equipment from the patient and its inherent catastrophic consequences. The constant risk of disconnection adds tension to the home environment and takes away from the patient any degree of independence or privacy. Because of this, an alternative method of respiration using neck accessory muscles was developed to restore a patient-controlled, voluntary system of respiration. This method, neck breathing, is described in detail in seven children varying in age from 3 years to 16 years 3 months. All seven patients had complete paralysis of the intercostal muscles and the diaphragm. An eighth patient who was unable to learn the technique is also described. Neck breathing is also compared to glossopharygeal breathing, an alternative method of respiration developed during the polio era.

Exercise Ventilatory Limitation: The Role Of Expiratory Flow Limitation

PubMed Central

Babb, Tony G.

2012-01-01

Ventilatory limitation to exercise remains an important unresolved clinical issue; as a result, many individuals misinterpret the effects of expiratory flow limitation as an all-or-nothing phenomenon. Expiratory flow limitation is not all-or-none; approaching maximal expiratory flow can have important effects not only on ventilatory capacity but also on breathing mechanics, ventilatory control, and possibly exertional dyspnea and exercise intolerance. PMID:23038244

An electronic nose in the discrimination of patients with non-small cell lung cancer and COPD.

PubMed

Dragonieri, Silvano; Annema, Jouke T; Schot, Robert; van der Schee, Marc P C; Spanevello, Antonio; Carratú, Pierluigi; Resta, Onofrio; Rabe, Klaus F; Sterk, Peter J

2009-05-01

Exhaled breath contains thousands of gaseous volatile organic compounds (VOCs) that may be used as non-invasive markers of lung disease. The electronic nose analyzes VOCs by composite nano-sensor arrays with learning algorithms. It has been shown that an electronic nose can distinguish the VOCs pattern in exhaled breath of lung cancer patients from healthy controls. We hypothesized that an electronic nose can discriminate patients with lung cancer from COPD patients and healthy controls by analyzing the VOC-profile in exhaled breath. 30 subjects participated in a cross-sectional study: 10 patients with non-small cell lung cancer (NSCLC, [age 66.4+/-9.0, FEV(1) 86.3+/-20.7]), 10 patients with COPD (age 61.4+/-5.5, FEV(1) 70.0+/-14.8) and 10 healthy controls (age 58.3+/-8.1, FEV(1) 108.9+/-14.6). After 5 min tidal breathing through a non-rebreathing valve with inspiratory VOC-filter, subjects performed a single vital capacity maneuver to collect dried exhaled air into a Tedlar bag. The bag was connected to the electronic nose (Cyranose 320) within 10 min, with VOC-filtered room air as baseline. The smellprints were analyzed by onboard statistical software. Smellprints from NSCLC patients clustered distinctly from those of COPD subjects (cross validation value [CVV]: 85%; M-distance: 3.73). NSCLC patients could also be discriminated from healthy controls in duplicate measurements (CVV: 90% and 80%, respectively; M-distance: 2.96 and 2.26). VOC-patterns of exhaled breath discriminates patients with lung cancer from COPD patients as well as healthy controls. The electronic nose may qualify as a non-invasive diagnostic tool for lung cancer in the future.

Effects of aerial hypoxia and temperature on pulmonary breathing pattern and gas exchange in the South American lungfish, Lepidosiren paradoxa.

PubMed

da Silva, Glauber S F; Ventura, Daniela A D N; Zena, Lucas A; Giusti, Humberto; Glass, Mogens L; Klein, Wilfried

2017-05-01

The South American lungfish Lepidosiren paradoxa is an obligatory air-breathing fish possessing well-developed bilateral lungs, and undergoing seasonal changes in its habitat, including temperature changes. In the present study we aimed to evaluate gas exchange and pulmonary breathing pattern in L. paradoxa at different temperatures (25 and 30°C) and different inspired O 2 levels (21, 12, 10, and 7%). Normoxic breathing pattern consisted of isolated ventilatory cycles composed of an expiration followed by 2.4±0.2 buccal inspirations. Both expiratory and inspiratory tidal volumes reached a maximum of about 35mlkg -1 , indicating that L. paradoxa is able to exchange nearly all of its lung air in a single ventilatory cycle. At both temperatures, hypoxia caused a significant increase in pulmonary ventilation (V̇ E ), mainly due to an increase in respiratory frequency. Durations of the ventilatory cycle and expiratory and inspiratory tidal volumes were not significantly affected by hypoxia. Expiratory time (but not inspiratory) was significantly shorter at 30°C and at all O 2 levels. While a small change in oxygen consumption (V̇O 2 ) could be noticed, the carbon dioxide release (V̇CO 2 , P=0.0003) and air convection requirement (V̇ E /V̇O 2 , P=0.0001) were significantly affected by hypoxia (7% O 2 ) at both temperatures, when compared to normoxia, and pulmonary diffusion capacity increased about four-fold due to hypoxic exposure. These data highlight important features of the respiratory system of L. paradoxa, capable of matching O 2 demand and supply under different environmental change, as well as help to understand the evolution of air breathing in lungfish. Copyright © 2017 Elsevier Inc. All rights reserved.

An analysis of estimation of pulmonary blood flow by the single-breath method

NASA Technical Reports Server (NTRS)

Srinivasan, R.

1986-01-01

The single-breath method represents a simple noninvasive technique for the assessment of capillary blood flow across the lung. However, this method has not gained widespread acceptance, because its accuracy is still being questioned. A rigorous procedure is described for estimating pulmonary blood flow (PBF) using data obtained with the aid of the single-breath method. Attention is given to the minimization of data-processing errors in the presence of measurement errors and to questions regarding a correction for possible loss of CO2 in the lung tissue. It is pointed out that the estimations are based on the exact solution of the underlying differential equations which describe the dynamics of gas exchange in the lung. The reported study demonstrates the feasibility of obtaining highly reliable estimates of PBF from expiratory data in the presence of random measurement errors.

RECENT DEVELOPMENTS IN EXHALED BREATH ANALYSIS AND HUMAN EXPOSURE ASSESSMENT RESEARCH

EPA Science Inventory

This presentation will explore historical and newly emerging methods for the collection and analysis of exhaled breath for use in environmental exposure assessment studies. We will discuss their applicability and limitations with respect to environmental research. Particular em...

Automatic control of arterial carbon dioxide tension in mechanically ventilated patients.

PubMed

Fernando, Tyrone; Cade, John; Packer, John

2002-12-01

This paper presents a method of controlling the arterial carbon dioxide tension of patients receiving mechanical ventilation. Controlling of the CO2 tension is achieved by regulating the ventilator initiated breath frequency and also volume per breath.

Breathing regulation and blood gas homeostasis after near complete lesions of the retrotrapezoid nucleus in adult rats.

PubMed

Souza, George M P R; Kanbar, Roy; Stornetta, Daniel S; Abbott, Stephen B G; Stornetta, Ruth L; Guyenet, Patrice G

2018-04-18

The retrotrapezoid nucleus (RTN) is one of several CNS nuclei that contribute, in various capacities (e.g. CO 2 detection, neuronal modulation) to the central respiratory chemoreflex (CRC). Here we test how important the RTN is to PCO 2 homeostasis and breathing during sleep or wake. RTN Nmb positive neurons were killed with targeted microinjections of substance-P-saporin conjugate in adult rats. Under normoxia, rats with large RTN lesions (92 ± 4 % cell loss) had normal blood pressure (BP) and arterial pH but were hypoxic (-8 mmHg PaO 2 ) and hypercapnic (+10 mmHg PaCO 2 ). In resting conditions, minute-volume (V E ) was normal but breathing frequency (f R ) was elevated and tidal volume (V T ) reduced. Resting O 2 consumption and CO 2 production were normal. The hypercapnic ventilatory reflex in 65% FiO 2 had an inverse exponential relationship with the number of surviving RTN neurons and was decreased by up to 92%. The hypoxic ventilatory reflex (HVR; FiO 2 21-10%) persisted after RTN lesions, hypoxia-induced sighing was normal and hypoxia-induced hypotension reduced. In rats with RTN lesions, breathing was lowest during slow-wave sleep (SWS), especially under hyperoxia, but apneas and sleep-disordered breathing were not observed. In conclusion, near complete RTN destruction in rats virtually eliminates the CRC but HVR persists and sighing and the state-dependence of breathing are unchanged. Under normoxia, RTN lesions cause no change in V E but alveolar ventilation is reduced by at least 21%, probably because of increased physiological dead volume. RTN lesions do not cause sleep apnea during SWS, even under hyperoxia. Background: the retrotrapezoid nucleus (RTN) drives breathing proportionally to brain PCO 2 but its role during various states of vigilance needed clarification. New result: Under normoxia, RTN lesions increase the arterial PCO 2 set-point, lower the PO 2 set-point and reduce alveolar ventilation relative to CO 2 production. Tidal volume is reduced and breathing frequency increased to a comparable degree during wake, slow-wave sleep and REM sleep. RTN lesions do not produce apneas or disordered breathing during sleep. New result: RTN lesions in rats virtually eliminate the central respiratory chemoreflex (CRC) while preserving the cardiorespiratory responses to hypoxia; the relationship between CRC and number of surviving RTN Nmb neurons is an inverse exponential. the CRC does not function without the RTN. In the quasi-complete absence of the RTN and CRC, alveolar ventilation is reduced despite an increased drive to breathe from the carotid bodies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Photoacoustic sensor for VOCs: first step towards a lung cancer breath test

NASA Astrophysics Data System (ADS)

Wolff, Marcus; Groninga, Hinrich G.; Dressler, Matthias; Harde, Hermann

2005-08-01

Development of new optical sensor technologies has a major impact on the progression of diagnostic methods. Specifically, the optical analysis of breath is an extraordinarily promising technique. Spectroscopic sensors for the non-invasive 13C-breath tests (the Urea Breath Test for detection of Helicobacter pylori is most prominent) are meanwhile well established. However, recent research and development go beyond gastroenterological applications. Sensitive and selective detection of certain volatile organic compounds (VOCs) in a patient's breath, could enable the diagnosis of diseases that are very difficult to diagnose with contemporary techniques. For instance, an appropriate VOC biomarker for early-stage bronchial carcinoma (lung cancer) is n-butane (C4H10). We present a new optical detection scheme for VOCs that employs an especially compact and simple set-up based on photoacoustic spectroscopy (PAS). This method makes use of the transformation of absorbed modulated radiation into a sound wave. Employing a wavelength-modulated distributed feedback (DFB) diode laser and taking advantage of acoustical resonances of the sample cell, we performed very sensitive and selective measurements on butane. A detection limit for butane in air in the ppb range was achieved. In subsequent research the sensitivity will be successively improved to match the requirements of the medical application. Upon optimization, our photoacoustic sensor has the potential to enable future breath tests for early-stage lung cancer diagnostics.

Real-time breath analysis with active capillary plasma ionization-ambient mass spectrometry.

PubMed

Bregy, Lukas; Sinues, Pablo Martinez-Lozano; Nudnova, Maryia M; Zenobi, Renato

2014-06-01

On-line analysis of exhaled human breath is a growing area in analytical science, for applications such as fast and non-invasive medical diagnosis and monitoring. In this work, we present a novel approach based on ambient ionization of compounds in breath and subsequent real-time mass spectrometric analysis. We introduce a plasma ionization source for this purpose, which has no need for additional gases, is very small, and is easily interfaced with virtually any commercial atmospheric pressure ionization mass spectrometer (API-MS) without major modifications. If an API-MS instrument exists in a laboratory, the cost to implement this technology is only around [Formula: see text]500, far less than the investment for a specialized mass spectrometric system designed for volatile organic compounds (VOCs) analysis. In this proof-of-principle study we were able to measure mass spectra of exhaled human breath and found these to be comparable to spectra obtained with other electrospray-based methods. We detected over 100 VOCs, including relevant metabolites like fatty acids, with molecular weights extending up to 340 Da. In addition, we were able to monitor the time-dependent evolution of the peaks and show the enhancement of the metabolism after a meal. We conclude that this approach may complement current methods to analyze breath or other types of vapors, offering an affordable option to upgrade any pre-existing API-MS to a real-time breath analyzer.

Obstructive sleep apnea screening by NIRS imaging

NASA Astrophysics Data System (ADS)

Kashefi, Feraydune; Watenpaugh, Donald E.; Liu, Hanli

2007-02-01

This study aimed at determining cerebral hemodynamic parameters in human subjects during breath holding using near infrared spectroscopy (NIRS). Breath holding serves as a method of simulation OSA (Obstructive Sleep Apnea). Data was acquired non-invasively from 40 subjects, twenty OSA sufferers (10 females, 10 males, age 20-70 years), and twenty normal volunteers (10 females, 10 males, age 20-65 years). Measurements were conducted using a LED Imager (LEDI) during breath holding. In comparing OSA subjects with controls during breath holding, a consistent increase or even a decrease in oxy- ([O IIHb]), deoxy- ([HHb]), total hemoglobin ([tHb]) concentrations, and tissue hemoglobin oxygen saturation (SO II) in the regional brain tissue were observed. The LEDI probe consists of 4 sources and 10 detectors serving as 4 sets of 1 source and 4 detectors each. A three wavelength (730, 805, and 850 nm) LED was used and the wavelengths were switched sequentially. The distance between sources and the source-detector separation were 2.5 cm. Data acquisition consisted of three segments, baseline for one minute, followed by a period of breath holding, and then 2 minutes of recovery time. The duration of the breath holding was subject-dependent. Our investigation proves that NIR spectroscopy could be used as a tool for detecting cerebral hemodynamics and also serves as a method of screening patients with OSA.

Additional Value of CH4 Measurement in a Combined 13C/H2 Lactose Malabsorption Breath Test: A Retrospective Analysis

PubMed Central

Houben, Els; De Preter, Vicky; Billen, Jaak; Van Ranst, Marc; Verbeke, Kristin

2015-01-01

The lactose hydrogen breath test is a commonly used, non-invasive method for the detection of lactose malabsorption and is based on an abnormal increase in breath hydrogen (H2) excretion after an oral dose of lactose. We use a combined 13C/H2 lactose breath test that measures breath 13CO2 as a measure of lactose digestion in addition to H2 and that has a better sensitivity and specificity than the standard test. The present retrospective study evaluated the results of 1051 13C/H2 lactose breath tests to assess the impact on the diagnostic accuracy of measuring breath CH4 in addition to H2 and 13CO2. Based on the 13C/H2 breath test, 314 patients were diagnosed with lactase deficiency, 138 with lactose malabsorption or small bowel bacterial overgrowth (SIBO), and 599 with normal lactose digestion. Additional measurement of CH4 further improved the accuracy of the test as 16% subjects with normal lactose digestion and no H2-excretion were found to excrete CH4. These subjects should have been classified as subjects with lactose malabsorption or SIBO. In conclusion, measuring CH4-concentrations has an added value to the 13C/H2 breath test to identify methanogenic subjects with lactose malabsorption or SIBO. PMID:26371034

How to deal with morning bad breath: A randomized, crossover clinical trial

PubMed Central

Oliveira-Neto, Jeronimo M.; Sato, Sandra; Pedrazzi, Vinícius

2013-01-01

Context: The absence of a protocol for the treatment of halitosis has led us to compare mouthrinses with mechanical oral hygiene procedures for treating morning breath by employing a hand-held sulfide monitor. Aims: To compare the efficacy of five modalities of treatment for controlling morning halitosis in subjects with no dental or periodontal disease. Settings and Design: This is a five-period, randomized, crossover clinical trial. Materials and Methods: Twenty volunteers were randomly assigned to the trial. Testing involved the use of a conventional tongue scraper, a tongue scraper joined to the back of a toothbrush's head, two mouthrinses (0.05% cetylpyridinium chloride and 0.12% chlorhexidine digluconate) and a soft-bristled toothbrush and fluoride toothpaste for practicing oral hygiene. Statistical Analysis Used: Data analysis was performed using SPSS version 17 for Windows and NCSS 2007 software (P < 0.05). The products and the periods were compared with each other using the Friedman's test. When significant differences (P < 0.05) were determined, the products and periods were compared in pairs by using the Wilcoxon's test and by adjusting the original significance level (0.05) for multiple comparisons by using the Bonferroni's method. Results: The toothbrush's tongue scraper was able to significantly reduce bad breath for up to 2 h. Chlorhexidine reduced bad breath only at the end of the second hour, an effect that lasted for 3 h. Conclusions: Mechanical tongue cleaning was able to immediately reduce bad breath for a short period, whereas chlorhexidine and mechanical oral hygiene reduced bad breath for longer periods, achieving the best results against morning breath. PMID:24554886

Comprehensive integrated spirometry using raised volume passive and forced expirations and multiple-breath nitrogen washout in infants

PubMed Central

Morris, Mohy G.

2009-01-01

With the rapid somatic growth and development in infants, simultaneous accurate measurements of lung volume and airway function are essential. Raised volume rapid thoracoabdominal compression (RTC) is widely used to generate forced expiration from an airway opening pressure of 30 cm H2O (V30). The (dynamic) functional residual capacity (FRCdyn) remains the lung volume most routinely measured. The aim of this study was to develop comprehensive integrated spirometry that included all subdivisions of lung volume at V30 or total lung capacity (TLC30). Measurements were performed on seventeen healthy infants aged 8.6–119.7 weeks. A commercial system for multiple-breath nitrogen washout (MBNW) to measure lung volumes and a custom made system to perform RTC were used in unison. A refined automated raised volume RTC and the following two novel single maneuvers with dual volume measurements were performed from V30 during a brief post-hyperventilation apneic pause: (1) the passive expiratory flow was integrated to produce the inspiratory capacity (IC) and the static (passive) FRC (FRCst) was estimated by initiating MBNW after end-passive expiration; (2) RTC was initiated late during passive expiration, flow was integrated to produce the slow vital capacity (jSVC) and the residual volume (RV) was measured by initiating MBNW after end-expiration while the jacket (j) was inflated. Intrasubject FRCdyn and FRCst measurements overlapped (p= 0.6420) but neither did with the RV (p<0.0001). Means (95% confidence interval) of FRCdyn, IC, FRCst, jSVC, RV, forced vital capacity and tidal volume were 21.2 (19.7–22.7), 36.7 (33.0–40.4), 21.2 (19.6–22.8), 40.7 (37.2–44.2), 18.1 (16.6–19.7), 40.7 (37.1–44.2) and 10.2 (9.6–10.7) ml/kg, respectively. Static lung volumes and capacities at V30 and variables from the best forced expiratory flow-volume curve were dependent on age, body length and weight. In conclusion, we developed a comprehensive physiologically-integrated approach for in-depth investigation of lung function at V30 in infants. PMID:19897058

Cubic PdNP-based air-breathing cathodes integrated in glucose hybrid biofuel cells

NASA Astrophysics Data System (ADS)

Faggion Junior, D.; Haddad, R.; Giroud, F.; Holzinger, M.; Maduro de Campos, C. E.; Acuña, J. J. S.; Domingos, J. B.; Cosnier, S.

2016-05-01

Cubic Pd nanoparticles (PdNPs) were synthesized using ascorbic acid as a reducing agent and were evaluated for the catalytic oxygen reduction reaction. PdNPs were confined with multiwalled carbon nanotube (MWCNT) dispersions to form black suspensions and these inks were dropcast onto glassy carbon electrodes. Different nanoparticle sizes were synthesized and investigated upon oxygen reduction capacities (onset potential and electrocatalytic current densities) under O2 saturated conditions at varying pH values. Strong evidence of O2 diffusion limitation was demonstrated. In order to overcome oxygen concentration and diffusion limitations in solution, we used a gas diffusion layer to create a PdNP-based air-breathing cathode, which delivered -1.5 mA cm-2 at 0.0 V with an onset potential of 0.4 V. This air-breathing cathode was combined with a specially designed phenanthrolinequinone/glucose dehydrogenase-based anode to form a complete glucose/O2 hybrid bio-fuel cell providing an open circuit voltage of 0.554 V and delivering a maximal power output of 184 +/- 21 μW cm-2 at 0.19 V and pH 7.0.Cubic Pd nanoparticles (PdNPs) were synthesized using ascorbic acid as a reducing agent and were evaluated for the catalytic oxygen reduction reaction. PdNPs were confined with multiwalled carbon nanotube (MWCNT) dispersions to form black suspensions and these inks were dropcast onto glassy carbon electrodes. Different nanoparticle sizes were synthesized and investigated upon oxygen reduction capacities (onset potential and electrocatalytic current densities) under O2 saturated conditions at varying pH values. Strong evidence of O2 diffusion limitation was demonstrated. In order to overcome oxygen concentration and diffusion limitations in solution, we used a gas diffusion layer to create a PdNP-based air-breathing cathode, which delivered -1.5 mA cm-2 at 0.0 V with an onset potential of 0.4 V. This air-breathing cathode was combined with a specially designed phenanthrolinequinone/glucose dehydrogenase-based anode to form a complete glucose/O2 hybrid bio-fuel cell providing an open circuit voltage of 0.554 V and delivering a maximal power output of 184 +/- 21 μW cm-2 at 0.19 V and pH 7.0. Electronic supplementary information (ESI) available: Physical characterization, Fig. S1-S4 electrochemical experiments Fig. S5-S11. See DOI: 10.1039/c6nr01245k

Fast and Accurate Exhaled Breath Ammonia Measurement

PubMed Central

Solga, Steven F.; Mudalel, Matthew L.; Spacek, Lisa A.; Risby, Terence H.

2014-01-01

This exhaled breath ammonia method uses a fast and highly sensitive spectroscopic method known as quartz enhanced photoacoustic spectroscopy (QEPAS) that uses a quantum cascade based laser. The monitor is coupled to a sampler that measures mouth pressure and carbon dioxide. The system is temperature controlled and specifically designed to address the reactivity of this compound. The sampler provides immediate feedback to the subject and the technician on the quality of the breath effort. Together with the quick response time of the monitor, this system is capable of accurately measuring exhaled breath ammonia representative of deep lung systemic levels. Because the system is easy to use and produces real time results, it has enabled experiments to identify factors that influence measurements. For example, mouth rinse and oral pH reproducibly and significantly affect results and therefore must be controlled. Temperature and mode of breathing are other examples. As our understanding of these factors evolves, error is reduced, and clinical studies become more meaningful. This system is very reliable and individual measurements are inexpensive. The sampler is relatively inexpensive and quite portable, but the monitor is neither. This limits options for some clinical studies and provides rational for future innovations. PMID:24962141

Evaluation of the Impact of Alveolar Nitrogen Excretion on Indices Derived from Multiple Breath Nitrogen Washout

PubMed Central

Nielsen, Niklas; Nielsen, Jorgen G.; Horsley, Alex R.

2013-01-01

Background A large body of evidence has now accumulated describing the advantages of multiple breath washout tests over conventional spirometry in cystic fibrosis (CF). Although the majority of studies have used exogenous sulphur hexafluoride (SF6) as the tracer gas this has also led to an increased interest in nitrogen washout tests, despite the differences between these methods. The impact of body nitrogen excreted across the alveoli has previously been ignored. Methods A two-compartment lung model was developed that included ventilation heterogeneity and dead space (DS) effects, but also incorporated experimental data on nitrogen excretion. The model was used to assess the impact of nitrogen excretion on washout progress and accuracy of functional residual capacity (FRC) and lung clearance index (LCI) measurements. Results Excreted nitrogen had a small effect on accuracy of FRC (1.8%) in the healthy adult model. The error in LCI calculated with true FRC was greater (6.3%), and excreted nitrogen contributed 21% of the total nitrogen concentration at the end of the washout. Increasing DS and ventilation heterogeneity both caused further increase in measurement error. LCI was increased by 6–13% in a CF child model, and excreted nitrogen increased the end of washout nitrogen concentration by 24–49%. Conclusions Excreted nitrogen appears to have complex but clinically significant effects on washout progress, particularly in the presence of abnormal gas mixing. This may explain much of the previously described differences in washout outcomes between SF6 and nitrogen. PMID:24039916

Clinical use of Heliox in asthma and COPD.

PubMed

Valli, G; Paoletti, P; Savi, D; Martolini, D; Palange, P

2007-09-01

Heliox is a low density gas mixture of helium and oxygen commonly used in deep diving (> 6 ATM). This mixture has been also used for clinical purposes, particularly in the critical care setting. Due to of its physical proprieties, Heliox breathing reduces air flow resistances within the bronchial tree; in patients with obstructive lung diseases Heliox may also reduce the work of breathing and improve pulmonary gas exchange efficiency. Beneficial effects have been documented in severe asthma attacks and in patients with chronic obstructive pulmonary disease. A reduction in WOB during mechanical ventilation and an increase in exercise endurance capacity have also been described in COPD. Heliox has been also used in the treatment of upper airways obstruction, bronchiolitis and bronchopulmonary dysplasia. Despite the encouraging results, Heliox use in routine practice remains controversial because of technical implications and high costs.

Technology transfer from space to earth - The NASA Firefighter's Breathing System

NASA Technical Reports Server (NTRS)

Mclaughlan, P. B.; Anuskiewicz, T.; Keune, F. A.

1976-01-01

Responding to the recent demand of fire services for a better equipment, NASA has prepared two improved versions of Firefighter's Breathing System (FBS) by taking advantage of the spacesuit design. In the new FBS, the conventional oxygen tube is replaced by a 40% lighter air tube with twice as much pressure. The load is attached to a wide waist belt and distributed on the hips instead of the shoulder, thus making it easier to carry. The two versions of the FBS are essentially the same, the only difference being the capacities of the air tubes. Also the face mask used is smaller, lighter and provides better vision and mobility. The FBS had a notable impact, with the fire departments reporting improved efficiency. Unlike other technology transfer cases, the FBS concept is commercially successful in finding diverse fields of application.

Nondispersive infrared spectrometry for 13CO2/12CO2-measurements: a clinically feasible analyzer for stable isotope breath tests in gastroenterology.

PubMed

Braden, B; Caspary, W F; Lembcke, B

1999-06-01

13C-urea breath tests have become clinical routine for the diagnosis of Helicobacter pylori infection and other isotope breath tests have been invented e.g. for gastric emptying or quantitative liver function testing. Recently, isotope-selective nondispersive infrared spectrometers (NDIRS) have been developed for the analysis of the 13CO2/12CO2-enrichment in breath. In this study, we prospectively tested the validity of a newly developed NDIRS in comparison to isotope ratio mass spectrometry (IRMS). 142 patients with dyspeptic symptoms were tested for Helicobacter pylori infection using the 13C-urea breath test. The isotope ratio analysis of the breath samples was performed in duplicate both using IRMS and NDIRS. The results of the baseline-corrected 13CO2-exhalation values between IRMS and NDIRS were in excellent agreement. The mean difference between both methods was 0.28 +/- 1.93 delta/1000. Evaluating the qualitative urea breath test results in reference to IRMS as the reference the NDIRS had a sensitivity of 97.8% and a specificity of 98.9%. The isotope-selective nondispersive infrared spectroscopy is going to become a reliable, but low-cost and easy-to-operate alternative to expensive isotope ratio mass spectrometry in the analysis of 13C-breath tests.

ENHANCED CONCENTRATION AND ANALYSIS METHOD FOR MEASURING WATER SOLUABLE ENDOGENOUS COMPOUNDS IN HUMAN BREATH

EPA Science Inventory

Exhaled human breath analysis has become a standard technique for assessing exposure to exogenous volatile organic compounds (VOCs) such as trihalomethanes from water chlorination; aromatics, hydrocarbons, and oxygenates from fuels usage; and various chlorinated solvents from i...

NONINVASIVE APPROACHES FOR TOXICOLOICAL RESEARCH OF THE LUNG

EPA Science Inventory

Four presentations are planned to overview this topic: 1) a review of gas chromatographic and mass spectrometric methods and sensitivity of these measures of volatile molecules present in exhaled breath. Molecular species present in breath have been predictive markers in a number...

SU-E-J-158: Audiovisual Biofeedback Reduces Image Artefacts in 4DCT: A Digital Phantom Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pollock, S; Kipritidis, J; Lee, D

2015-06-15

Purpose: Irregular breathing motion has a deleterious impact on 4DCT image quality. The breathing guidance system: audiovisual biofeedback (AVB) is designed to improve breathing regularity, however, its impact on 4DCT image quality has yet to be quantified. The purpose of this study was to quantify the impact of AVB on thoracic 4DCT image quality by utilizing the digital eXtended Cardiac Torso (XCAT) phantom driven by lung tumor motion patterns. Methods: 2D tumor motion obtained from 4 lung cancer patients under two breathing conditions (i) without breathing guidance (free breathing), and (ii) with guidance (AVB). There were two breathing sessions, yieldingmore » 8 tumor motion traces. This tumor motion was synchronized with the XCAT phantom to simulate 4DCT acquisitions under two acquisition modes: (1) cine mode, and (2) prospective respiratory-gated mode. Motion regularity was quantified by the root mean square error (RMSE) of displacement. The number of artefacts was visually assessed for each 4DCT and summed up for each breathing condition. Inter-session anatomic reproducibility was quantified by the mean absolute difference (MAD) between the Session 1 4DCT and Session 2 4DCT. Results: AVB improved tumor motion regularity by 30%. In cine mode, the number of artefacts was reduced from 61 in free breathing to 40 with AVB, in addition to AVB reducing the MAD by 34%. In gated mode, the number of artefacts was reduced from 63 in free breathing to 51 with AVB, in addition to AVB reducing the MAD by 23%. Conclusion: This was the first study to compare the impact of breathing guidance on 4DCT image quality compared to free breathing, with AVB reducing the amount of artefacts present in 4DCT images in addition to improving inter-session anatomic reproducibility. Results thus far suggest that breathing guidance interventions could have implications for improving radiotherapy treatment planning and interfraction reproducibility.« less

Real-time 3D visualization of the thoraco-abdominal surface during breathing with body movement and deformation extraction.

PubMed

Povšič, K; Jezeršek, M; Možina, J

2015-07-01

Real-time 3D visualization of the breathing displacements can be a useful diagnostic tool in order to immediately observe the most active regions on the thoraco-abdominal surface. The developed method is capable of separating non-relevant torso movement and deformations from the deformations that are solely related to breathing. This makes it possible to visualize only the breathing displacements. The system is based on the structured laser triangulation principle, with simultaneous spatial and color data acquisition of the thoraco-abdominal region. Based on the tracking of the attached passive markers, the torso movement and deformation is compensated using rigid and non-rigid transformation models on the three-dimensional (3D) data. The total time of 3D data processing together with visualization equals 20 ms per cycle.In vitro verification of the rigid movement extraction was performed using the iterative closest point algorithm as a reference. Furthermore, a volumetric evaluation on a live subject was performed to establish the accuracy of the rigid and non-rigid model. The root mean square deviation between the measured and the reference volumes shows an error of  ±0.08 dm(3) for rigid movement extraction. Similarly, the error was calculated to be  ±0.02 dm(3) for torsional deformation extraction and  ±0.11 dm(3) for lateral bending deformation extraction. The results confirm that during the torso movement and deformation, the proposed method is sufficiently accurate to visualize only the displacements related to breathing. The method can be used, for example, during the breathing exercise on an indoor bicycle or a treadmill.

Prospective targeting and control of end-tidal CO2 and O2 concentrations

PubMed Central

Slessarev, Marat; Han, Jay; Mardimae, Alexandra; Prisman, Eitan; Preiss, David; Volgyesi, George; Ansel, Cliff; Duffin, James; Fisher, Joseph A

2007-01-01

Current methods of forcing end-tidal PCO2 (PETCO2) and PO2 (PETO2) rely on breath-by-breath adjustment of inspired gas concentrations using feedback loop algorithms. Such servo-control mechanisms are complex because they have to anticipate and compensate for the respiratory response to a given inspiratory gas concentration on a breath-by-breath basis. In this paper, we introduce a low gas flow method to prospectively target and control PETCO2 and PETO2 independent of each other and of minute ventilation in spontaneously breathing humans. We used the method to change PETCO2 from control (40 mmHg for PETCO2 and 100 mmHg for PETO2) to two target PETCO2 values (45 and 50 mmHg) at iso-oxia (100 mmHg), PETO2 to two target values (200 and 300 mmHg) at normocapnia (40 mmHg), and PETCO2 with PETO2 simultaneously to the same targets (45 with 200 mmHg and 50 with 300 mmHg). After each targeted value, PETCO2 and PETO2 were returned to control values. Each state was maintained for 30 s. The average difference between target and measured values for PETCO2 was ± 1 mmHg, and for PETO2 was ± 4 mmHg. PETCO2 varied by ± 1 mmHg and PETO2 by ± 5.6 mmHg (s.d.) over the 30 s stages. This degree of control was obtained despite considerable variability in minute ventilation between subjects (± 7.6 l min−1). We conclude that targeted end-tidal gas concentrations can be attained in spontaneously breathing subjects using this prospective, feed-forward, low gas flow system. PMID:17446225

SU-E-T-247: Determinations of the Optimal Phase for Respiratory Gated Radiotherapy From Statistical Analysis Using a Visible Guidance System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oh, S; Yea, J; Kang, M

Purpose: Respiratory gated radiation therapy (RGRT) is used to minimize the radiation dose to normal tissue in lung cancer patients. Determination of the optimal point in the respiratory phase of a patient is important in RGRT but it is not easy. The goal of the present study was to see if a visible guidance system is helpful in determining the optimal phase in respiratory gated therapy. Methods: The breathing signals of 23 lung cancer patients were recorded with a Real-time Position Management (RPM) respiratory gating system (Varian, USA). The patients underwent breathing training with our visible guidance system, after whichmore » their breathing signals were recorded during 5 min of free breathing and 5 min of guided breathing. The breathing signals recorded between 3 and 5 min before and after training were compared. We performed statistical analysis of the breathing signals to find the optimal duty cycle in guided breathing for RGRT. Results: The breathing signals aided by the visible guidance system had more regular cycles over time and smaller variations in the positions of the marker block than the free breathing signals. Of the 23 lung cancer patients, 19 showed statistically significant differences by time when the values obtained before and after breathing were compared (p < 0.05); 30% and 40% of the duty cycle, respectively, was determined to be the most effective, and the corresponding phases were 30 60% (duty cycle, 30%; p < 0.05) and 30 70% (duty cycle, 40%; p < 0.05). Conclusion: Respiratory regularity was significantly improved with the use of the RPM with our visible guiding system; therefore, it would help improve the accuracy and efficiency of RGRT.« less

Breath Tests in Respiratory and Critical Care Medicine: From Research to Practice in Current Perspectives

PubMed Central

Cheepsattayakorn, Attapon; Cheepsattayakorn, Ruangrong

2013-01-01

Today, exhaled nitric oxide has been studied the most, and most researches have now focusd on asthma. More than a thousand different volatile organic compounds have been observed in low concentrations in normal human breath. Alkanes and methylalkanes, the majority of breath volatile organic compounds, have been increasingly used by physicians as a novel method to diagnose many diseases without discomforts of invasive procedures. None of the individual exhaled volatile organic compound alone is specific for disease. Exhaled breath analysis techniques may be available to diagnose and monitor the diseases in home setting when their sensitivity and specificity are improved in the future. PMID:24151617

Respiratory rate estimation from the built-in cameras of smartphones and tablets.

PubMed

Nam, Yunyoung; Lee, Jinseok; Chon, Ki H

2014-04-01

This paper presents a method for respiratory rate estimation using the camera of a smartphone, an MP3 player or a tablet. The iPhone 4S, iPad 2, iPod 5, and Galaxy S3 were used to estimate respiratory rates from the pulse signal derived from a finger placed on the camera lens of these devices. Prior to estimation of respiratory rates, we systematically investigated the optimal signal quality of these 4 devices by dividing the video camera's resolution into 12 different pixel regions. We also investigated the optimal signal quality among the red, green and blue color bands for each of these 12 pixel regions for all four devices. It was found that the green color band provided the best signal quality for all 4 devices and that the left half VGA pixel region was found to be the best choice only for iPhone 4S. For the other three devices, smaller 50 × 50 pixel regions were found to provide better or equally good signal quality than the larger pixel regions. Using the green signal and the optimal pixel regions derived from the four devices, we then investigated the suitability of the smartphones, the iPod 5 and the tablet for respiratory rate estimation using three different computational methods: the autoregressive (AR) model, variable-frequency complex demodulation (VFCDM), and continuous wavelet transform (CWT) approaches. Specifically, these time-varying spectral techniques were used to identify the frequency and amplitude modulations as they contain respiratory rate information. To evaluate the performance of the three computational methods and the pixel regions for the optimal signal quality, data were collected from 10 healthy subjects. It was found that the VFCDM method provided good estimates of breathing rates that were in the normal range (12-24 breaths/min). Both CWT and VFCDM methods provided reasonably good estimates for breathing rates that were higher than 26 breaths/min but their accuracy degraded concomitantly with increased respiratory rates. Overall, the VFCDM method provided the best results for accuracy (smaller median error), consistency (smaller interquartile range of the median value), and computational efficiency (less than 0.5 s on 1 min of data using a MATLAB implementation) to extract breathing rates that varied from 12 to 36 breaths/min. The AR method provided the least accurate respiratory rate estimation among the three methods. This work illustrates that both heart rates and normal breathing rates can be accurately derived from a video signal obtained from smartphones, an MP3 player and tablets with or without a flashlight.

Comparison of heliox and oxygen as washing gases for the nitrogen washout technique in preterm infants.

PubMed

Poets, C F; Rau, G A; Gappa, M; Seidenberg, J

1996-06-01

The nitrogen washout technique usually involves exposure of the patient to 100% oxygen for several minutes. This may be dangerous in preterm infants who are at risk of retinopathy of prematurity (ROP). We wanted to know whether heliox (79% He, 21% O2) can be used instead of oxygen when determining functional residual capacity (FRC). FRC measurements were made in 14 preterm infants [median (range) gestational age at birth 34 wk (27-37 wk), and at time of study 36 wk (33-40 wk)] who were breathing room air. FRC was measured using a computerized infant pulmonary function system, beginning in random order with either 100% O2 followed by heliox or vice versa. There was no systematic difference between the two methods with regard to lung volume measurements: mean (SD) FRC values, corrected for body weight, were 22.9 (7.1) mL/kg for O2 and 23.4 (7.0) mL/kg for heliox. We did not observe a systematic influence of the type of washing gas used (heliox or oxygen) on FRC in these infants. Our results suggest that the use of heliox instead of pure oxygen may be a suitable and safer alternative for FRC measurements with the nitrogen washout technique in preterm infants who are breathing low concentrations of inspired oxygen and are still at risk of ROP.

Optimising hydrogen peroxide measurement in exhaled breath condensate.

PubMed

Brooks, Wendy M; Lash, Heath; Kettle, Anthony J; Epton, Michael J

2006-01-01

Exhaled breath condensate (EBC) analysis has been proposed as a non-invasive method of assessing airway pathology. A number of substances, including hydrogen peroxide (H2O2), have been measured in EBC, without adequate published details of validation and optimisation. To explore factors that affect accurate quantitation of H2O2 in EBC. H2O2 was measured in EBC samples using fluorometry with 4-hydroxyphenylacetic acid. A number of factors that might alter quantitation were studied including pH and buffering conditions, reagent storage, and assay temperature. Standard curve slope was significantly altered by pH, leading to a potential difference in H2O2 quantification of up to 42%. These differences were resolved by increasing the buffering capacity of the reaction mix. H2O2 added to EBC remained stable for 1 h when stored on ice. The assay was unaffected by freezing assay reagents. The limit of detection for H2O2 ranged from 3.4 nM to 8.8 nM depending on the buffer used. The reagents required for this assay can be stored for several months allowing valuable consistency in longitudinal studies. The quantitation of H2O2 in EBC is pH-dependent but increasing assay buffering reduces this effect. Sensitive reproducible quantitation of H2O2 in EBC requires rigorous optimisation.

Inefficient skeletal muscle oxidative function flanks impaired motor neuron recruitment in Amyotrophic Lateral Sclerosis during exercise.

PubMed

Lanfranconi, F; Ferri, A; Corna, G; Bonazzi, R; Lunetta, C; Silani, V; Riva, N; Rigamonti, A; Maggiani, A; Ferrarese, C; Tremolizzo, L

2017-06-07

This study aimed to evaluate muscle oxidative function during exercise in amyotrophic lateral sclerosis patients (pALS) with non-invasive methods in order to assess if determinants of reduced exercise tolerance might match ALS clinical heterogeneity. 17 pALS, who were followed for 4 months, were compared with 13 healthy controls (CTRL). Exercise tolerance was assessed by an incremental exercise test on cycle ergometer measuring peak O 2 uptake ([Formula: see text]O 2peak ), vastus lateralis oxidative function by near infrared spectroscopy (NIRS) and breathing pattern ([Formula: see text]E peak ). pALS displayed: (1) 44% lower [Formula: see text]O 2peak vs. CTRL (p < 0.0001), paralleled by a 43% decreased peak skeletal muscle oxidative function (p < 0.01), with a linear regression between these two variables (r 2  = 0.64, p < 0.0001); (2) 46% reduced [Formula: see text]E peak vs. CTRL (p < 0.0001), achieved by using an inefficient breathing pattern (increasing respiratory frequency) from the onset until the end of exercise. Inefficient skeletal muscle O 2 function, when flanking the impaired motor units recruitment, is a major determinant of pALS clinical heterogeneity and working capacity exercise tolerance. CPET and NIRS are useful tools for detecting early stages of oxidative deficiency in skeletal muscles, disclosing individual impairments in the O 2 transport and utilization chain.

Measurement of Respiration Rate and Depth Through Difference in Temperature Between Skin Surface and Nostril by Using Thermal Image.

PubMed

Jeong, Hieyong; Matsuura, Yutaka; Ohno, Yuko

2017-01-01

The purpose of the present study was to propose a method to measure a respiration rate (RR) and depth at once through difference in temperature between the skin surface and nostril by using a thermal image. Although there have been a lot of devices for contact RR monitoring, it was considered that the subjects could be inconvenienced by having the sensing device in contact with their body. Our algorithm enabled us to make a breathing periodic function (BPF) under the non-contact and non-invasive condition through temperature differences near the nostril during the breath. As a result, it was proved that our proposed method was able to classify differences in breathing pattern between normal, deep, and shallow breath (P < 0.001). These results lead us to conclude that the RR and depth is simultaneously measured by the proposed algorithm of BPF without any contact or invasive procedure.

Breathing gas perfluorocarbon measurements using an absorber filled with zeolites.

PubMed

Proquitté, H; Rüdiger, M; Wauer, R R; Schmalisch, G

2003-11-01

Perfluorocarbon (PFC) has been widely used in the treatment of respiratory diseases; however, PFC content of the breathing gases remains unknown. Therefore, we developed an absorber using PFC selective zeolites for PFC measurement in gases and investigated its accuracy. To generate a breathing gas with different PFC contents a heated flask was rinsed with a constant air flow of 4 litre x min(-1) and 1, 5, 10, and 20 ml of PFC were infused over 20 min using an infusor. The absorber was placed on an electronic scale and the total PFC volume was calculated from the weight gain. Steady-state increase in weight was achieved 3.5 min after stopping the infusion. The calculated PFC volume was slightly underestimated but the measuring error did not exceed -1% for PFC less than 1 ml. The measurement error decreased with increasing PFC volume. This zeolite absorber is an accurate method to quantitatively determine PFC in breathing gases and can be used as a reference method to validate other PFC sensors.

Cardiac Repolarization Changes in the Children with Breath-Holding Spells

PubMed Central

Amoozgar, Hamid; Saleh, Fazl; Farhani, Nahal; Rafiei, Mohammad; Inaloo, Soroor; Asadipooya, Ali-Akbar

2013-01-01

Objective Breath-holding spells are known as benign attacks, frequencies of which decrease by the development of the autonomic nervous system. The present study aims to compare the electrocardiographic repolarization in children with breath-holding spells. Methods In this study, QT dispersion, QTc dispersion, T peak to T end dispersion, and P wave dispersion of the twelve-lead surface electrocardiography of fifty children who had breath-holding spells were measured and compared with normal children from April 2011 to August 2012. Findings Forty-four (88%) patients had cyanotic spells, while 6 (12%) had pallid spells. QTc dispersion was increased in the patients with breath-holding spells (148.2±33.1) compared to the healthy children (132±27.3) and the difference was statically significant (P = 0.01). Meanwhile, no statistically significant differences were observed between the patients and the control subjects regarding the other parameters (P > 0.05). Conclusion QTc dispersion was significantly increased in the patients with breath-holding spells compared to normal children and this is a sign of cardiac repolarization abnormality as well as the increased risk of cardiac arrhythmia in patients with breath-holding spells. PMID:24910749

Computerized tomography and pulmonary diffusing capacity in highly trained athletes after performing a triathlon.

PubMed

Caillaud, C; Serre-Cousiné, O; Anselme, F; Capdevilla, X; Préfaut, C

1995-10-01

We investigated the computerized tomographies (CTs) of the thorax and the pulmonary diffusing capacity for CO (DLCO) in eight male athletes before and after a triathlon. DLCO and alveolar volume (VA) were simultaneously measured during 9 s of breath holding. The transfer coefficient (KCO = DLCO/VA) was then calculated. CT scanning was performed during breath holding with the subjects in the supine position. Scanner analysis was done by 1) counting the linear and polygonal opacities (index of interstitial fluid accumulation) and 2) calculating the physical mean lung density and the mean slice mass. Results showed a significant reduction in DLCO (44.9 +/- 2.3 vs. 42.9 +/- 1.7 ml.min-1.mmHg-1; P < 0.05) and KCO (6.0 +/- 0.3 vs. 5.6 +/- 0.3 ml.min-1.mmHg-1.l of VA-1; P < 0.05) after the triathlon and an increase in mean lung density (0.21 +/- 0.009 vs. 0.25 +/- 0.01 g/cm3; P < 0.0001). The number of polygonal and linear opacities increased after the race (P < 0.001). This study confirmed that DLCO and KCO decrease in elite athletes after a long-distance race and showed a concomitant increase in CT lung density and in the number of opacities.

Comparison of hydrostatic weighing at residual volume and total lung capacity.

PubMed

Weltman, A; Katch, V

1981-01-01

Hydrostatic weighing (HW) was performed at both residual volume (RV) and total lung capacity (TLC) (both measured on land) to determine if underwater weighting at extreme lung volumes affected the measurement of body density. Subjects were 72 middle-aged males (mean age = 43.4 yr) and 51 middle-aged females (mean age = 40.2 yr). Subjects were first assessed for underwater weight at RV for at least 10 trials. Subjects were than instructed to inspire maximally and hold their breath underwater for as long as they could. Three trials at TLC were used for assessment of underwater weight. Forced vital capacity and residual volume (oxygen dilution) were determined separately on land. Small but statistically significant differences in body density (Db) were observed with the use of RV (1.0354 g/ml for men and 1.0196 g/ml for women) vs TLC (1.0367 g/ml for men and 1.0221 g/ml for women) (p less than 0.05). Percent fat values for the RV and TLD data differed by only 0.5% for men and 0.9% for women. Results indicated that the difference between percent fat determination by HW at RV and TLC, was negligible. It was concluded that HW at TLC may be the method of choice for subjects who are uncomfortable with performing the technique of underwater weighing at RV.

Inward Lithium-Ion Breathing of Hierarchically Porous Silicon Anodes

DOE PAGES

Xiao, Qiangfeng; Gu, Meng; Yang, Hui; ...

2015-11-05

Silicon has been identified as one of the most promising candidates as anode for high performance lithium-ion batteries. The key challenge for Si anodes is the large volume change induced chemomechanical fracture and subsequent rapid capacity fading upon cyclic charge and discharge. Improving capacity retention thus critically relies on smart accommodation of the volume changes through nanoscale structural design. In this work, we report a novel fabrication method for hierarchically porous Si nanospheres (hp-SiNSs), which consist of a porous shell and a hollow core. Upon charge/discharge cycling, the hp-SiNSs accommodate the volume change through reversible inward expansion/contraction with negligible particle-levelmore » outward expansion. Our mechanics analysis revealed that such a unique volume-change accommodation mechanism is enabled by the much stiffer modulus of the lithiated layer than the unlithiated porous layer and the low flow stress of the porous structure. Such inward expansion shields the hp-SiNSs from fracture, opposite to the outward expansion in solid Si during lithiation. Lithium ion battery assembled with this new nanoporous material exhibits high capacity, high power, long cycle life and high coulombic efficiency, which is superior to the current commercial Si-based anode materials. We find the low cost synthesis approach reported here provides a new avenue for the rational design of hierarchically porous structures with unique materials properties.« less

Clinical evaluation of Krimidanta Pratishedha (anti-caries) activity of Triphaladi Gandusha in high risk dental caries patients

PubMed Central

Atara, Achyuta G.; Manjusha, R.; Shukla, Vinay J.; Vaghela, Dharmendra B.; Rooparalia, Brijesh

2014-01-01

Background: Dental caries is the most common complaint encountered in clinical practice. Virtually every adult in the world has experience of dental caries. It affects almost 80% of the population. It is now being viewed in dual perspective- “caries as a disease” and “caries as a lesion”. Aims: To evaluate the efficacy of Triphaladi Gandusha for its anti-caries activity and improvement in Oral Hygiene Index in high risk patients of dental caries and to compare the efficacy of prevalent method of mouth rinsing and classical method of Gandusha. Materials and Methods: The study was conducted in 40 patients, 20 in each Group-1 and 2. Group -1 was given prepared Triphaladi mouthwash (mouth rinse) while Group-2 was given Triphaladi Kwath for Gandusha (retention). Results: The effect of treatment was assessed by subjective and objective parameters (like salivary pH, buffering capacity and microbial count). Triphaladi Gandusha (retention) in Group - 2 provided better results in the improvement of Ruja (toothache), Dantaharsha (tooth sensitivity), Sarambha (inflammation), pH of saliva, microbial count in salivary sample. And Triphaladi Mouthwash in Group - 1 provided better results in Srava (discharge), bad breath, pH of saliva and buffering capacity of salivary sample. There was no improvement in Chidrata (cavity formation), Krishnata (discoloration) and Chaladanta (mobility) with Triphaladi Gandusha and mouthwash. Conclusion: Study concluded that although both groups were effective, but Gandusha group patients’ got better relief in subjective symptoms compared to mouthwash group. PMID:25364198

Respiratory diseases and their effects on respiratory function and exercise capacity.

PubMed

Van Erck-Westergren, E; Franklin, S H; Bayly, W M

2013-05-01

Given that aerobic metabolism is the predominant energy pathway for most sports, the respiratory system can be a rate-limiting factor in the exercise capacity of fit and healthy horses. Consequently, respiratory diseases, even in mild forms, are potentially deleterious to any athletic performance. The functional impairment associated with a respiratory condition depends on the degree of severity of the disease and the equestrian discipline involved. Respiratory abnormalities generally result in an increase in respiratory impedance and work of breathing and a reduced level of ventilation that can be detected objectively by deterioration in breathing mechanics and arterial blood gas tensions and/or lactataemia. The overall prevalence of airway diseases is comparatively high in equine athletes and may affect the upper airways, lower airways or both. Diseases of the airways have been associated with a wide variety of anatomical and/or inflammatory conditions. In some instances, the diagnosis is challenging because conditions can be subclinical in horses at rest and become clinically relevant only during exercise. In such cases, an exercise test may be warranted in the evaluation of the patient. The design of the exercise test is critical to inducing the clinical signs of the problem and establishing an accurate diagnosis. Additional diagnostic techniques, such as airway sampling, can be valuable in the diagnosis of subclinical lower airway problems that have the capacity to impair performance. As all these techniques become more widely used in practice, they should inevitably enhance veterinarians' diagnostic capabilities and improve their assessment of treatment effectiveness and the long-term management of equine athletes. © 2013 EVJ Ltd.

Breath-Figure Self-Assembly, a Versatile Method of Manufacturing Membranes and Porous Structures: Physical, Chemical and Technological Aspects

PubMed Central

2017-01-01

The review is devoted to the physical, chemical, and technological aspects of the breath-figure self-assembly process. The main stages of the process and impact of the polymer architecture and physical parameters of breath-figure self-assembly on the eventual pattern are covered. The review is focused on the hierarchy of spatial and temporal scales inherent to breath-figure self-assembly. Multi-scale patterns arising from the process are addressed. The characteristic spatial lateral scales of patterns vary from nanometers to dozens of micrometers. The temporal scale of the process spans from microseconds to seconds. The qualitative analysis performed in the paper demonstrates that the process is mainly governed by interfacial phenomena, whereas the impact of inertia and gravity are negligible. Characterization and applications of polymer films manufactured with breath-figure self-assembly are discussed. PMID:28813026

A novel 13C-urea breath test device for the diagnosis of Helicobacter pylori infection: continuous online measurements allow for faster test results with high accuracy.

PubMed

Israeli, Eran; Ilan, Yaron; Meir, Shimon Bar; Buenavida, Claudia; Goldin, Eran

2003-08-01

The aim of this study is to determine the accuracy of a novel laptop sized 13C-Urea breath test analyzer that continuously measures expired breath and to use its advantages to decrease testing time. One hundred and eighty-six subjects (mean age of 47.8 years) were tested simultaneously by the BreathID system (Oridion, Israel), and by the traditional IRMS. BreathID continuously measured the expired breath for a ratio of 13CO(2):12CO(2.) This value was expressed as delta over baseline (DOB) and displayed graphically on a screen in real time. One hundred and one subjects were positive and 85 were negative for H. pylori by isotope ratio mass spectrometry (IRMS). The correlation for the BreathID system at 30 minutes was 100% for positive cases and 98% for negative cases. Analysis of the continuous curves generated by the BreathID for all patients permitted definition of different DOB thresholds for a positive or negative result at shorter time intervals. Thus, after 6 minutes a conclusive test result could be obtained for 64% of subjects, and after 10 minutes for 92% of subjects. The 13C-Urea breath test utilizing the technology of molecular correlation spectrometry is an accurate method for determining infection by H. pylori. The advantage of continuous measurements can shorten testing time without compromising accuracy.

Evaluation of the monitor cursor-line method for measuring pulmonary artery and central venous pressures.

PubMed

Pasion, Editha; Good, Levell; Tizon, Jisebelle; Krieger, Staci; O'Kier, Catherine; Taylor, Nicole; Johnson, Jennifer; Horton, Carrie M; Peterson, Mary

2010-11-01

To determine if the monitor cursor-line feature on bedside monitors is accurate for measuring central venous and pulmonary artery pressures in cardiac surgery patients. Central venous and pulmonary artery pressures were measured via 3 methods (end-expiratory graphic recording, monitor cursor-line display, and monitor digital display) in a convenience sample of postoperative cardiac surgery patients. Pressures were measured twice during both mechanical ventilation and spontaneous breathing. Analysis of variance was used to determine differences between measurement methods and the percentage of monitor pressures that differed by 4 mm Hg or more from the measurement obtained from the graphic recording. Significance level was set at P less than .05. Twenty-five patients were studied during mechanical ventilation (50 measurements) and 21 patients during spontaneous breathing (42 measurements). Measurements obtained via the 3 methods did not differ significantly for either type of pressure (P > .05). Graphically recorded pressures and measurements obtained via the monitor cursor-line or digital display methods differed by 4 mm Hg or more in 4% and 6% of measurements, respectively, during mechanical ventilation and 4% and 11%, respectively, during spontaneous breathing. The monitor cursor-line method for measuring central venous and pulmonary artery pressures may be a reasonable alternative to the end-expiratory graphic recording method in hemodynamically stable, postoperative cardiac surgery patients. Use of the digital display on the bedside monitor may result in larger discrepancies from the graphically recorded pressures than when the cursor-line method is used, particularly in spontaneously breathing patients.

Establishment of a Quick and Highly Accurate Breath Test for ALDH2 Genotyping

PubMed Central

Aoyama, Ikuo; Ohashi, Shinya; Amanuma, Yusuke; Hirohashi, Kenshiro; Mizumoto, Ayaka; Funakoshi, Makiko; Tsurumaki, Mihoko; Nakai, Yukie; Tanaka, Katsuyuki; Hanada, Mariko; Uesaka, Aki; Chiba, Tsutomu; Muto, Manabu

2017-01-01

Objectives: Acetaldehyde, the first metabolite of ethanol, is a definite carcinogen for the esophagus, head, and neck; and aldehyde dehydrogenase 2 (ALDH2) is a mitochondrial enzyme that catalyzes the metabolism of acetaldehyde. The ALDH2 genotype exists as ALDH2*1/*1 (active ALDH2), ALDH2*1/*2 (heterozygous inactive ALDH2), and ALDH2*2/*2 (homozygous inactive ALDH2). Many epidemiological studies have reported that ALDH2*2 carriers are at high risk for esophageal or head and neck squamous cell carcinomas by habitual drinking. Therefore, identification of ALDH2*2 carriers would be helpful for the prevention of those cancers, but there have been no methods suitable for mass screening to identify these individuals. Methods: One hundred and eleven healthy volunteers (ALDH2*1/*1 carriers: 53; ALDH2*1/*2 carriers: 48; and ALDH2*2/*2 carriers: 10) were recruited. Breath samples were collected after drinking 100 ml of 0.5% ethanol using specially designed gas bags, and breath ethanol and acetaldehyde levels were measured by semiconductor gas chromatography. Results: The median (range) breath acetaldehyde levels at 1 min after alcohol ingestion were 96.1 (18.1–399.0) parts per billion (p.p.b.) for the ALDH2*1/*1 genotype, 333.5 (78.4–1218.4) p.p.b. for the ALDH2*1/*2 genotype, and 537.1 (213.2–1353.8) p.p.b. for the ALDH2*2/*2 genotype. The breath acetaldehyde levels in ALDH2*2 carriers were significantly higher than for the ALDH2*1/*1 genotype. Notably, the ratio of breath acetaldehyde level-to-breath ethanol level could identify carriers of the ALDH2*2 allele very accurately (whole accuracy; 96.4%). Conclusions: Our novel breath test is a useful tool for identifying ALDH2*2 carriers, who are at high risk for esophageal and head and neck cancers. PMID:28594397

Mechanisms of Enhanced Phrenic Long-Term Facilitation in SOD1G93A Rats

PubMed Central

Satriotomo, Irawan; Grebe, Ashley M.

2017-01-01

Amyotrophic lateral sclerosis (ALS) is a degenerative motor neuron disease, causing muscle paralysis and death from respiratory failure. Effective means to preserve/restore ventilation are necessary to increase the quality and duration of life in ALS patients. At disease end-stage in a rat ALS model (SOD1G93A), acute intermittent hypoxia (AIH) restores phrenic nerve activity to normal levels via enhanced phrenic long-term facilitation (pLTF). Mechanisms enhancing pLTF in end-stage SOD1G93A rats are not known. Moderate AIH-induced pLTF is normally elicited via cellular mechanisms that require the following: Gq-protein-coupled 5-HT2 receptor activation, new BDNF synthesis, and MEK/ERK signaling (the Q pathway). In contrast, severe AIH elicits pLTF via a distinct mechanism that requires the following: Gs-protein-coupled adenosine 2A receptor activation, new TrkB synthesis, and PI3K/Akt signaling (the S pathway). In end-stage male SOD1G93A rats and wild-type littermates, we investigated relative Q versus S pathway contributions to enhanced pLTF via intrathecal (C4) delivery of small interfering RNAs targeting BDNF or TrkB mRNA, and MEK/ERK (U0126) or PI3 kinase/Akt (PI828) inhibitors. In anesthetized, paralyzed and ventilated rats, moderate AIH-induced pLTF was abolished by siBDNF and UO126, but not siTrkB or PI828, demonstrating that enhanced pLTF occurs via the Q pathway. Although phrenic motor neuron numbers were decreased in end-stage SOD1G93A rats (∼30% survival; p < 0.001), BDNF and phosphorylated ERK expression were increased in spared phrenic motor neurons (p < 0.05), consistent with increased Q-pathway contributions to pLTF. Our results increase understanding of respiratory plasticity and its potential to preserve/restore breathing capacity in ALS. SIGNIFICANCE STATEMENT Since neuromuscular disorders, such as amyotrophic lateral sclerosis (ALS), end life via respiratory failure, the ability to harness respiratory motor plasticity to improve breathing capacity could increase the quality and duration of life. In a rat ALS model (SOD1G93A) we previously demonstrated that spinal respiratory motor plasticity elicited by acute intermittent hypoxia is enhanced at disease end-stage, suggesting greater potential to preserve/restore breathing capacity. Here we demonstrate that enhanced intermittent hypoxia-induced phrenic motor plasticity results from amplification of normal cellular mechanisms versus addition/substitution of alternative mechanisms. Greater understanding of mechanisms underlying phrenic motor plasticity in ALS may guide development of new therapies to preserve and/or restore breathing in ALS patients. PMID:28500219

Volatile organic compounds as breath biomarkers for active and passive smoking.

PubMed

Gordon, Sydney M; Wallace, Lance A; Brinkman, Marielle C; Callahan, Patrick J; Kenny, Donald V

2002-07-01

We used real-time breath measurement technology to investigate the suitability of some volatile organic compounds (VOCs) as breath biomarkers for active and passive smoking and to measure actual exposures and resulting breath concentrations for persons exposed to tobacco smoke. Experiments were conducted with five smoker/nonsmoker pairs. The target VOCs included benzene, 1,3-butadiene, and the cigarette smoke biomarker 2,5-dimethylfuran. This study includes what we believe to be the first measurements of 1,3-butadiene in smokers' and nonsmokers' breath. The 1,3-butadiene and 2,5-dimethylfuran peak levels in the smokers' breath were similar (360 and 376 microg/m(3), respectively); the average benzene peak level was 522 microg/m(3). We found higher peak values of the target chemicals and shorter residence times in the body than previously reported, probably because of the improved time resolution made possible by the continuous breath measurement method. The real-time breath analyzer also showed the presence of the chemicals after exposure in the breath of the nonsmokers, but at greatly reduced levels. Single breath samples collected in evacuated canisters and analyzed independently with gas chromatography/mass spectrometry confirmed the presence of the target compounds in the postexposure breath of the nonsmokers but indicated that there was some contamination of the breath analyzer measurements. This was likely caused by desorption of organics from condensed tar in the analyzer tubing and on the quartz fiber filter used to remove particles. We used the decay data from the smokers to estimate residence times for the target chemicals. A two-compartment exponential model generally gave a better fit to the experimental decay data from the smokers than a single-compartment model. Residence times for benzene, 1,3-butadiene, and 2,5-dimethylfuran ranged from 0.5 (1,3-butadiene) to 0.9 min (benzene) for tau1 and were essentially constant (14 min) for tau2. These findings will be useful in models of environmental tobacco smoke exposure and risk.

Breathing exercises for dysfunctional breathing/hyperventilation syndrome in adults.

PubMed

Jones, Mandy; Harvey, Alex; Marston, Louise; O'Connell, Neil E

2013-05-31

Dysfunctional breathing/hyperventilation syndrome (DB/HVS) is a respiratory disorder, psychologically or physiologically based, involving breathing too deeply and/or too rapidly (hyperventilation) or erratic breathing interspersed with breath-holding or sighing (DB). DB/HVS can result in significant patient morbidity and an array of symptoms including breathlessness, chest tightness, dizziness, tremor and paraesthesia. DB/HVS has an estimated prevalence of 9.5% in the general adult population, however, there is little consensus regarding the most effective management of this patient group. (1) To determine whether breathing exercises in patients with DB/HVS have beneficial effects as measured by quality of life indices (2) To determine whether there are any adverse effects of breathing exercises in patients with DB/HVS SEARCH METHODS: We identified trials for consideration using both electronic and manual search strategies. We searched CENTRAL, MEDLINE, EMBASE, and four other databases. The latest search was in February 2013. We planned to include randomised, quasi-randomised or cluster randomised controlled trials (RCTs) in which breathing exercises, or a combined intervention including breathing exercises as a key component, were compared with either no treatment or another therapy that did not include breathing exercises in patients with DB/HVS. Observational studies, case studies and studies utilising a cross-over design were not eligible for inclusion.We considered any type of breathing exercise for inclusion in this review, such as breathing control, diaphragmatic breathing, yoga breathing, Buteyko breathing, biofeedback-guided breathing modification, yawn/sigh suppression. Programs where exercises were either supervised or unsupervised were eligible as were relaxation techniques and acute-episode management, as long as it was clear that breathing exercises were a key component of the intervention.We excluded any intervention without breathing exercises or where breathing exercises were not key to the intervention. Two review authors independently checked search results for eligible studies, assessed all studies that appeared to meet the selection criteria and extracted data. We used standard procedures recommended by The Cochrane Collaboration. We included a single RCT assessed at unclear risk of bias, which compared relaxation therapy (n = 15) versus relaxation therapy and breathing exercises (n = 15) and a no therapy control group (n = 15).Quality of life was not an outcome measure in this RCT, and no numerical data or statistical analysis were presented in this paper. A significant reduction in the frequency and severity of hyperventilation attacks in the breathing exercise group compared with the control group was reported. In addition, a significant difference in frequency and severity of hyperventilation attacks between the breathing and relaxation group was reported. However, no information could be extracted from the paper regarding the size of the treatment effects. The results of this systematic review are unable to inform clinical practice, based on the inclusion of only one small, poorly reported RCT. There is no credible evidence regarding the effectiveness of breathing exercises for the clinical symptoms of DB/HVS. It is currently unknown whether these interventions offer any added value in this patient group or whether specific types of breathing exercise demonstrate superiority over others. Given that breathing exercises are frequently used to treat DB/HVS, there is an urgent need for further well designed clinical trials in this area. Future trials should conform to the CONSORT statement for standards of reporting and use appropriate, validated outcome measures. Trial reports should also ensure full disclosure of data for all important clinical outcomes.

Breath alcohol analysis incorporating standardization to water vapour is as precise as blood alcohol analysis.

PubMed

Grubb, D; Rasmussen, B; Linnet, K; Olsson, S G; Lindberg, L

2012-03-10

A novel breath-alcohol analyzer based on the standardization of the breath alcohol concentration (BrAC) to the alveolar-air water vapour concentration has been developed and evaluated. The present study compares results with this particular breath analyzer with arterial blood alcohol concentrations (ABAC), the most relevant quantitative measure of brain alcohol exposure. The precision of analysis of alcohol in arterial blood and breath were determined as well as the agreement between ABAC and BrAC over time post-dosing. Twelve healthy volunteers were administered 0.6g alcohol/kg bodyweight via an orogastric tube. Duplicate breath and arterial blood samples were obtained simultaneously during the absorption, distribution and elimination phases of the alcohol metabolism with particular emphasis on the absorption phase. The precision of the breath analyzer was similar to the determination of blood alcohol concentration by headspace gas chromatography (CV 2.40 vs. 2.38%, p=0.43). The ABAC/BrAC ratio stabilized 30min post-dosing (2089±99; mean±SD). Before this the BrAC tended to underestimate the coexisting ABAC. In conclusion, breath alcohol analysis utilizing standardization of alcohol to water vapour was as precise as blood alcohol analysis, the present "gold standard" method. The BrAC reliably predicted the coexisting ABAC from 30min onwards after the intake of alcohol. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The effects of inspiratory diaphragm breathing exercise and expiratory pursed-lip breathing exercise on chronic stroke patients' respiratory muscle activation.

PubMed

Seo, KyoChul; Hwan, Park Seung; Park, KwangYong

2017-03-01

[Purpose] The purpose of this study is to examine the effects of inspiratory diaphragm breathing exercise and expiratory pursed-lip breathing exercise on chronic stroke patients' respiratory muscle activation. [Subjects and Methods] All experimental subjects performed exercises five times per week for four weeks. Thirty chronic stroke patients were randomly assign to an experimental group of 15 patients and a control group of 15 patients. The experimental group underwent exercises consisting of basic exercise treatment for 15 minutes and inspiratory diaphragm breathing exercise and expiratory pursed-lip breathing exercise for 15 minutes and the control group underwent exercises consisting of basic exercise treatment for 15 minutes and auto-med exercise for 15 minutes. The activation levels of respiratory muscles were measured before and after the experiment using MP 150WSW to obtain the results of the experiment. [Results] In the present study, when the pulmonary functions of the experimental group and the control group before and after the experiment were compared, whereas the experimental group showed significant differences in all sections. In the verification of intergroup differences between the experimental group and the control group before and after the experiment. [Conclusion] The respiratory rehabilitation exercise is considered to be capable of inducing positive effects on stroke patients' respiratory muscles through diaphragm breathing exercise and lip puckering breathing exercise.

Direct analysis of human breath ammonia using corona discharge ion mobility spectrometry.

PubMed

Jazan, Elham; Mirzaei, Hadi

2014-01-01

In this study, ammonia in human breath was directly determined using corona discharge ionization ion mobility spectrometry (CD-IMS) technique with several important advantages including high sensitivity, low cost, high speed, and ease of maintenance. The temperature effect on the ammonia signal was evaluated too. The results indicated that the best temperature for the investigation of breath ammonia was 150°C. The analytical results showed that the linear dynamic range was between 12 and 810ppb and the detection limit was 6.6ppb. The relative standard deviation (RSD) was obtained to be 5, 3, and 3 for 290, 348, and 522ppb, respectively. The amounts of ammonia in breath of eight healthy volunteers were measured. The values were between 236 and 1218ppb. Also, the inequality in breath ammonia levels was scrutinized over a 6h working day for three healthy volunteers. The results showed a drop in breath ammonia from the morning amount to the mid-day measurement and then, a progressive increase while the day continued. In addition, the amounts of ammonia were determined to be 1494-1553ppb in exhaled breath of two renal failure patients. The results obtained in this work revealed that the method was conveniently established without any considerable sample pretreatment for direct analysis of ammonia in human breath. Copyright © 2013 Elsevier B.V. All rights reserved.

Feedback linearization for control of air breathing engines

NASA Technical Reports Server (NTRS)

Phillips, Stephen; Mattern, Duane

1991-01-01

The method of feedback linearization for control of the nonlinear nozzle and compressor components of an air breathing engine is presented. This method overcomes the need for a large number of scheduling variables and operating points to accurately model highly nonlinear plants. Feedback linearization also results in linear closed loop system performance simplifying subsequent control design. Feedback linearization is used for the nonlinear partial engine model and performance is verified through simulation.

Proposal of Screening Method of Sleep Disordered Breathing Using Fiber Grating Vision Sensor

NASA Astrophysics Data System (ADS)

Aoki, Hirooki; Nakamura, Hidetoshi; Nakajima, Masato

Every conventional respiration monitoring technique requires at least one sensor to be attached to the body of the subject during measurement, thereby imposing a sense of restraint that results in aversion against measurements that would last over consecutive days. To solve this problem, we developed a respiration monitoring system for sleepers, and it uses a fiber-grating vision sensor, which is a type of active image sensor to achieve non-contact respiration monitoring. In this paper, we verified the effectiveness of the system, and proposed screening method of the sleep disordered breathing. It was shown that our system could equivalently measure the respiration with thermistor and accelerograph. And, the respiratory condition of sleepers can be grasped by our screening method in one look, and it seems to be useful for the support of the screening of sleep disordered breathing.

Accuracy of the dose-shift approximation in estimating the delivered dose in SBRT of lung tumors considering setup errors and breathing motions.

PubMed

Karlsson, Kristin; Lax, Ingmar; Lindbäck, Elias; Poludniowski, Gavin

2017-09-01

Geometrical uncertainties can result in a delivered dose to the tumor different from that estimated in the static treatment plan. The purpose of this project was to investigate the accuracy of the dose calculated to the clinical target volume (CTV) with the dose-shift approximation, in stereotactic body radiation therapy (SBRT) of lung tumors considering setup errors and breathing motion. The dose-shift method was compared with a beam-shift method with dose recalculation. Included were 10 patients (10 tumors) selected to represent a variety of SBRT-treated lung tumors in terms of tumor location, CTV volume, and tumor density. An in-house developed toolkit within a treatment planning system allowed the shift of either the dose matrix or a shift of the beam isocenter with dose recalculation, to simulate setup errors and breathing motion. Setup shifts of different magnitudes (up to 10 mm) and directions as well as breathing with different peak-to-peak amplitudes (up to 10:5:5 mm) were modeled. The resulting dose-volume histograms (DVHs) were recorded and dose statistics were extracted. Generally, both the dose-shift and beam-shift methods resulted in calculated doses lower than the static planned dose, although the minimum (D 98% ) dose exceeded the prescribed dose in all cases, for setup shifts up to 5 mm. The dose-shift method also generally underestimated the dose compared with the beam-shift method. For clinically realistic systematic displacements of less than 5 mm, the results demonstrated that in the minimum dose region within the CTV, the dose-shift method was accurate to 2% (root-mean-square error). Breathing motion only marginally degraded the dose distributions. Averaged over the patients and shift directions, the dose-shift approximation was determined to be accurate to approximately 2% (RMS) within the CTV, for clinically relevant geometrical uncertainties for SBRT of lung tumors.

Molecular and Microscopic Analysis of Bacteria and Viruses in Exhaled Breath Collected Using a Simple Impaction and Condensing Method

PubMed Central

Xu, Zhenqiang; Shen, Fangxia; Li, Xiaoguang; Wu, Yan; Chen, Qi; Jie, Xu; Yao, Maosheng

2012-01-01

Exhaled breath condensate (EBC) is increasingly being used as a non-invasive method for disease diagnosis and environmental exposure assessment. By using hydrophobic surface, ice, and droplet scavenging, a simple impaction and condensing based collection method is reported here. Human subjects were recruited to exhale toward the device for 1, 2, 3, and 4 min. The exhaled breath quickly formed into tiny droplets on the hydrophobic surface, which were subsequently scavenged into a 10 µL rolling deionized water droplet. The collected EBC was further analyzed using culturing, DNA stain, Scanning Electron Microscope (SEM), polymerase chain reaction (PCR) and colorimetry (VITEK 2) for bacteria and viruses. Experimental data revealed that bacteria and viruses in EBC can be rapidly collected using the method developed here, with an observed efficiency of 100 µL EBC within 1 min. Culturing, DNA stain, SEM, and qPCR methods all detected high bacterial concentrations up to 7000 CFU/m3 in exhaled breath, including both viable and dead cells of various types. Sphingomonas paucimobilis and Kocuria variants were found dominant in EBC samples using VITEK 2 system. SEM images revealed that most bacteria in exhaled breath are detected in the size range of 0.5–1.0 µm, which is able to enable them to remain airborne for a longer time, thus presenting a risk for airborne transmission of potential diseases. Using qPCR, influenza A H3N2 viruses were also detected in one EBC sample. Different from other devices restricted solely to condensation, the developed method can be easily achieved both by impaction and condensation in a laboratory and could impact current practice of EBC collection. Nonetheless, the reported work is a proof-of-concept demonstration, and its performance in non-invasive disease diagnosis such as bacterimia and virus infections needs to be further validated including effects of its influencing matrix. PMID:22848436

Speaking-Related Dyspnea in Healthy Adults

ERIC Educational Resources Information Center

Hoit, Jeannette D.; Lansing, Robert W.; Perona, Kristen E.

2007-01-01

Purpose: To reveal the qualities and intensity of speaking-related dyspnea in healthy adults under conditions of high ventilatory drive, in which the behavioral and metabolic control of breathing must compete. Method: Eleven adults read aloud while breathing different levels of inspired carbon dioxide (CO[subscript 2]). After the highest level,…

Application of Novel Method to Measure Endogenous VOCs in Exhaled Breath Condensate Before and After Exposure to Diesel Exhaust

EPA Science Inventory

Polar volatile organic compounds (PVOCs) such as aldehydes, ketones, and alcohols are byproducts of normal human metabolism and are present in exhaled breath and blood. Environmental exposures, individual activities, and disease states can perturb normal metabolic processes and ...

Online recording of ethane traces in human breath via infrared laser spectroscopy.

PubMed

von Basum, Golo; Dahnke, Hannes; Halmer, Daniel; Hering, Peter; Mürtz, Manfred

2003-12-01

A method is described for rapidly measuring the ethane concentration in exhaled human breath. Ethane is considered a volatile marker for lipid peroxidation. The breath samples are analyzed in real time during single exhalations by means of infrared cavity leak-out spectroscopy. This is an ultrasensitive laser-based method for the analysis of trace gases on the sub-parts per billion level. We demonstrate that this technique is capable of online quantifying of ethane traces in exhaled human breath down to 500 parts per trillion with a time resolution of better than 800 ms. This study includes what we believe to be the first measured expirograms for trace fractions of ethane. The expirograms were recorded after a controlled inhalation exposure to 1 part per million of ethane. The normalized slope of the alveolar plateau was determined, which shows a linear increase over the first breathing cycles and ends in a mean value between 0.21 and 0.39 liter-1. The washout process was observed for a time period of 30 min and was modelled by a threefold exponential decay function, with decay times ranging from 12 to 24, 341 to 481, and 370 to 1770 s. Our analyzer provides a promising noninvasive tool for online monitoring of the oxidative stress status.

The impact of breathing on HRV measurements: implications for the longitudinal follow-up of athletes.

PubMed

Saboul, Damien; Pialoux, Vincent; Hautier, Christophe

2013-01-01

The purpose of the present work was to compare daily variations of heart rate variability (HRV) parameters between controlled breathing (CB) and spontaneous breathing (SB) sessions during a longitudinal follow-up of athletes. HRV measurements were performed daily on 10 healthy male runners for 21 consecutive days. The signals were recorded during two successive randomised 5-minutes sessions. One session was performed in CB and the other in SB. The results showed significant differences between the two respiration methods in the temporal, nonlinear and frequency domains. However, significant correlations were observed between CB and SB (higher than 0.70 for RMSSD and SD1), demonstrating that during a longitudinal follow-up, these markers provide the same HRV variations regardless of breathing pattern. By contrast, independent day-to-day variations were observed with HF and LF/HF frequency markers, indicating no significant relationship between SB and CB data over time. Therefore, we consider that SB and CB may be used for HRV longitudinal follow-ups only for temporal and nonlinear markers. Indeed, the same daily increases and decreases were observed whatever the breathing method employed. Conversely, frequency markers did not provide the same variations between SB and CB and we propose that these indicators are not reliable enough to be used for day-to-day HRV monitoring.

Cellular respiration: replicating in vivo systems biology for in ...

EPA Pesticide Factsheets

This editorial develops a philosophy for expanding the scope of Journal of Breath Research (JBR) into the realm of cellular level study, and links certain topics back to more traditional systemic research for understanding human health based on exhaled breath constituents. The express purpose is to provide a publication outlet for novel breath related research that includes in vitro studies, especially those that explore the biological origin and expression of compounds that may ultimately influence the constituents of exhaled breath. The new topics include all manner of methods and instrumentations for making in vivo and in vitro measurements, the use of different biological media (blood, urine saliva, swabs) including human and microbial cell-lines, in vitro kinetic studies of metabolism, and advances in ex vivo methods for maintaining metabolic competency and viability of biological samples. Traditionally, JBR has published articles on human breath analysis for diagnosing disease, tracking health state, assessing the dose and effect of exogenous chemicals, and contributions of malodorous compounds from the oral/nasal cavity. These have also included research describing novel sampling and analytical technologies, most notably those implementing mass spectrometry, chemical sensors and optical measurement instrumentation (Amann and Smith 2013). The journal’s original scope has also embraced animal models as surrogates for human sampling, new mathematical and

Effects of a sustained inflation in preterm infants at birth.

PubMed

van Vonderen, Jeroen J; Hooper, Stuart B; Hummler, Helmut D; Lopriore, Enrico; te Pas, Arjan B

2014-11-01

To assess the clinical effect of an initial sustained inflation of 10 seconds and 25 cmH2O in preterm infants at birth. In this observational study inflation pressures and tidal volumes were recorded with the use of respiratory function monitoring of preterm infants <32 weeks' gestation receiving a sustained inflation. Inspiratory tidal volume (Vti) and expiratory tidal volume (Vte) of sustained inflation and cumulative Vti and Vte of breaths during sustained inflation were determined. Heart rate and oxygen saturation were measured before and after the sustained inflation. Seventy infants were included (median [IQR]: gestational age 29 [27-30] weeks). Mean (SD) sustained inflation duration was 10.5 seconds (2.9 seconds) with positive inflation pressure 24.2 cmH2O (2.3 cmH2O) and positive end-expiratory pressure 6.0 cmH2O (1.8 cmH2O). In 20 of 70 infants, no volumes were delivered during the sustained inflation because of mask leak. No leak occurred in 50 of 70 infants, of whom 36 of 50 breathed during the sustained inflation. In 14 of the infants who did not breathe, Vti and Vte were 0.9 mL/kg (0.4-2.7 mL/kg) and 0.6 mL/kg (0.1-2.0 mL/kg) with a functional residual capacity (FRC) gain of 0.0 (-0.5 to 0.6) mL/kg. In 36 of 50 infants who breathed during the sustained inflation, Vti was 2.9 mL/kg (0.9-9.2 mL/kg) and Vte 3.8 mL/kg (1.0-5.9 mL/kg), whereas cumulative Vti of breaths was 16.4 mL/kg (6.8-23.3 mL/kg) and cumulative Vte of breaths was 5.8 mL/kg (1.2-16.8 mL/kg) with an FRC gain of 7.1 mL/kg (1.7-15.9 mL/kg). Heart rate and oxygen saturation did not increase immediately after the sustained inflation. A sustained inflation of 10 seconds and 25 cmH2O in preterm infants at birth was not effective unless infants breathed. Although large mask leak accounted for approximately one-third of failures, as FRC gain was only associated with breathing, we speculate that active glottic adduction may be responsible for most failures. Copyright © 2014 Elsevier Inc. All rights reserved.

The weighty issue of obesity in paediatric respiratory medicine.

PubMed

Fitzgerald, Dominic A

2017-09-01

Some have observed that developed world is fat and getting fatter. This is even extending into the developing world, and it is important to appreciate that the consequences of childhood obesity last into adulthood and are associated with premature death. From the paediatric respiratory perspective, the deposition of excess adipose tissue in the thoraco-abdominal region begins early in life and is believed to alter diaphragm mobility and chest wall expansion, reduce lung compliance, and result in a rapid shallow breathing pattern with an increased work of breathing and reduction in maximum ventilatory capacity. This results in respiratory symptoms of exertional dyspnoea related to deconditioning which may present as exercise limitation, leading to confusion with common lung diseases such as asthma. The manifestations of the increasingly prevalent problems of overweight and obesity in young people and their interaction with common conditions of asthma and obstructive sleep apnoea will be discussed. Copyright © 2017. Published by Elsevier Ltd.

Acute symptoms following exposure to grain dust in farming.

PubMed Central

Manfreda, J; Holford-Strevens, V; Cheang, M; Warren, C P

1986-01-01

History of acute symptoms (cough, wheezing, shortness of breath, fever, stuffy nose, and skin itching/rash) following exposure to grain dust was obtained from 661 male and 535 female current and former farmers. These symptoms were relatively common: 60% of male and 25% of female farmers reported at least one such symptom on exposure to grain dust. Association of cough, wheezing, shortness of breath, and stuffy nose with skin reactivity and capacity to form IgE is consistent with an allergic nature of these symptoms. Barley and oats dust were perceived as dust most often producing symptoms. On the other hand, grain fever showed a different pattern, i.e., it was not associated with either skin reactivity or total IgE. Smoking might modify the susceptibility to react to grain dust with symptoms. Only those who reported wheezing on exposure to grain dust may have an increased risk to develop chronic airflow obstruction. PMID:3709486

Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise.

PubMed

Tedjasaputra, Vincent; van Diepen, Sean; Collins, Sophie É; Michaelchuk, Wade M; Stickland, Michael K

2017-02-20

Exercise is a stress to the pulmonary vasculature. With incremental exercise, the pulmonary diffusing capacity (DLCO) must increase to meet the increased oxygen demand; otherwise, a diffusion limitation may occur. The increase in DLCO with exercise is due to increased capillary blood volume (Vc) and membrane diffusing capacity (Dm). Vc and Dm increase secondary to the recruitment and distension of pulmonary capillaries, increasing the surface area for gas exchange and decreasing pulmonary vascular resistance, thereby attenuating the increase in pulmonary arterial pressure. At the same time, the recruitment of intrapulmonary arteriovenous anastomoses (IPAVA) during exercise may contribute to gas exchange impairment and/or prevent large increases in pulmonary artery pressure. We describe two techniques to evaluate pulmonary diffusion and circulation at rest and during exercise. The first technique uses multiple-fraction of inspired oxygen (FIO2) DLCO breath holds to determine Vc and Dm at rest and during exercise. Additionally, echocardiography with intravenous agitated saline contrast is used to assess IPAVAs recruitment. Representative data showed that the DLCO, Vc, and Dm increased with exercise intensity. Echocardiographic data showed no IPAVA recruitment at rest, while contrast bubbles were seen in the left ventricle with exercise, suggesting exercise-induced IPAVA recruitment. The evaluation of pulmonary capillary blood volume, membrane diffusing capacity, and IPAVA recruitment using echocardiographic methods is useful to characterize the ability of the lung vasculature to adapt to the stress of exercise in health as well as in diseased groups, such as those with pulmonary arterial hypertension and chronic obstructive pulmonary disease.

Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise

PubMed Central

Tedjasaputra, Vincent; van Diepen, Sean; Collins, Sophie É; Michaelchuk, Wade M.; Stickland, Michael K.

2017-01-01

Exercise is a stress to the pulmonary vasculature. With incremental exercise, the pulmonary diffusing capacity (DLCO) must increase to meet the increased oxygen demand; otherwise, a diffusion limitation may occur. The increase in DLCO with exercise is due to increased capillary blood volume (Vc) and membrane diffusing capacity (Dm). Vc and Dm increase secondary to the recruitment and distension of pulmonary capillaries, increasing the surface area for gas exchange and decreasing pulmonary vascular resistance, thereby attenuating the increase in pulmonary arterial pressure. At the same time, the recruitment of intrapulmonary arteriovenous anastomoses (IPAVA) during exercise may contribute to gas exchange impairment and/or prevent large increases in pulmonary artery pressure. We describe two techniques to evaluate pulmonary diffusion and circulation at rest and during exercise. The first technique uses multiple-fraction of inspired oxygen (FIO2) DLCO breath holds to determine Vc and Dm at rest and during exercise. Additionally, echocardiography with intravenous agitated saline contrast is used to assess IPAVAs recruitment. Representative data showed that the DLCO, Vc, and Dm increased with exercise intensity. Echocardiographic data showed no IPAVA recruitment at rest, while contrast bubbles were seen in the left ventricle with exercise, suggesting exercise-induced IPAVA recruitment. The evaluation of pulmonary capillary blood volume, membrane diffusing capacity, and IPAVA recruitment using echocardiographic methods is useful to characterize the ability of the lung vasculature to adapt to the stress of exercise in health as well as in diseased groups, such as those with pulmonary arterial hypertension and chronic obstructive pulmonary disease. PMID:28287506

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rubinstein, A; Kingsley, C; Melancon, A

Purpose: To evaluate the use of post-irradiation changes in respiratory rate and CBCT-based morphology as predictors of survival in mice. Methods: C57L/J mice underwent whole-thorax irradiation with a Co-60 beam to four different doses [0Gy (n=3), 9Gy (n=5), 11Gy (n=7), and 13Gy (n=5)] in order to induce varying levels of pneumonitis. Respiratory rate measurements, breath-hold CBCTs, and free-breathing CBCTs were acquired pre-irradiation and at six time points between two and seven months post-irradiation. For respiratory rate measurements, we developed a novel computer-vision-based technique. We recorded mice sleeping in standard laboratory cages with a 30 fps, 1080p webcam (Logitech C920). Wemore » calculated respiratory rate using corner detection and optical flow to track cyclical motion in the fur in the recorded video. Breath-hold and free-breathing CBCTs were acquired on the X-RAD225Cx system. For breathhold imaging, the mice were intubated and their breath was held at full-inhale for 20 seconds. Healthy lung tissue was delineated in the scans using auto-threshold contouring (0–0.7 g/cm{sup 3}). The volume of healthy lung was measured in each of the scans. Next, lung density was measured in a 6-mm{sup 2} ROI in a fixed anatomic location in each of the scans. Results: Day-to-day variability in respiratory rate with our technique was 13%. All metrics except for breath-hold lung volume were correlated with survival: lung density on free-breathing (r=−0.7482,p<0.01) and breath-hold images (r=−0.5864,p<0.01), free-breathing lung volume (r=0.7179,p<0.01), and respiratory rate (r= 0.6953,p<0.01). Lung density on free-breathing scans was correlated with respiratory rate (r=0.7142,p<0.01) and lung density on breath-hold scans (r=0.5543,p<0.01). One significant practical hurdle in the CBCT measurements was that at least one lobe of the lung was collapsed in 36% of free-breathing scans and 45% of breath-hold scans. Conclusion: Lung density and lung volume on free-breathing CBCTs and respiratory rate outperform breath-hold CBCT measurements as indicators for survival from radiation-induced pneumonitis. This work was partially funded by Elekta.« less

Anatomic and Pathologic Variability During Radiotherapy for a Hybrid Active Breath-Hold Gating Technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Glide-Hurst, Carri K.; Gopan, Ellen; Department of Radiation Oncology Wayne State University, Detroit, MI

2010-07-01

Purpose: To evaluate intra- and interfraction variability of tumor and lung volume and position using a hybrid active breath-hold gating technique. Methods and Materials: A total of 159 repeat normal inspiration active breath-hold CTs were acquired weekly during radiotherapy for 9 lung cancer patients (12-21 scans per patient). A physician delineated the gross tumor volume (GTV), lungs, and spinal cord on the first breath-hold CT, and contours were propagated semiautomatically. Intra- and interfraction variability of tumor and lung position and volume were evaluated. Tumor centroid and border variability were quantified. Results: On average, intrafraction variability of lung and GTV centroidmore » position was <2.0 mm. Interfraction population variability was 3.6-6.7 mm (systematic) and 3.1-3.9 mm (random) for the GTV centroid and 1.0-3.3 mm (systematic) and 1.5-2.6 mm (random) for the lungs. Tumor volume regressed 44.6% {+-} 23.2%. Gross tumor volume border variability was patient specific and demonstrated anisotropic shape change in some subjects. Interfraction GTV positional variability was associated with tumor volume regression and contralateral lung volume (p < 0.05). Inter-breath-hold reproducibility was unaffected by time point in the treatment course (p > 0.1). Increases in free-breathing tidal volume were associated with increases in breath-hold ipsilateral lung volume (p < 0.05). Conclusions: The breath-hold technique was reproducible within 2 mm during each fraction. Interfraction variability of GTV position and shape was substantial because of tumor volume and breath-hold lung volume change during therapy. These results support the feasibility of a hybrid breath-hold gating technique and suggest that online image guidance would be beneficial.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thrall, Karla D.; Schwartz, Ronald E.; Weitz, Karl K.

Nasal dosimetry models have become increasingly quantitative as insights into tissue deposition/clearance and computational fluid dynamics have become available. Validation of these models requires sufficient experimental data. However, investigations into respiratory deposition, particularly in human volunteers, have been historically limited due to methodological limitations. To overcome this, a method for evaluating the nasal wash-in, wash-out phenomena of a highly water-soluble compound in human volunteers was developed and characterized. This methodology was assessed using controlled human inhalation exposures to uniformly labeled 13C-acetone at approximately 1 ppm concentration for 30 minutes under different breathing maneuvers (inhale nose/exhale nose; inhale nose/exhale mouth; inhalemore » mouth/exhale nose). A small-diameter air-sampling probe inserted in the nasopharyngeal cavity of the volunteer was connected directly to an ion-trap mass spectrometer capable of sampling every 0.8 sec. A second ion-trap mass spectrometer simultaneously sampled from the volunteer?s exhaled breath stream via a breath-inlet device interface. Together, the two mass spectrometers provided real-time appraisal of the 13C-acetone concentrations in the nasopharyngeal region and in the exhaled breath stream before, during, and after the different breathing maneuvers. The breathing cycle (depth and frequency) and heart rate were concurrently monitored throughout the exposure using a heart rate monitor and a human plethysmograph to differentiate inhalation and exhalation. Graphical overlay of the plethysmography results with the mass spectrometer measurements show clear quantifiable differences in 13C-acetone levels at the nasal probe as a function of breathing maneuvers. Breath-by-breath analysis of 13C-acetone concentrations indicate that between 40-75% of the compound is absorbed upon inhalation and nearly all of that absorbed released back into the breath stream during exhalation.« less

Inhaled Hydrogen Sulfide

PubMed Central

Volpato, Gian Paolo; Searles, Robert; Yu, Binglan; Scherrer-Crosbie, Marielle; Bloch, Kenneth D.; Ichinose, Fumito; Zapol, Warren M.

2010-01-01

Background Breathing hydrogen sulfide (H2S) has been reported to induce a suspended animation–like state with hypothermia and a concomitant metabolic reduction in rodents. However, the impact of H2S breathing on cardiovascular function remains incompletely understood. In this study, the authors investigated the cardiovascular and metabolic effects of inhaled H2S in a murine model. Methods The impact of breathing H2S on cardiovascular function was examined using telemetry and echocardiography in awake mice. The effects of breathing H2S on carbon dioxide production and oxygen consumption were measured at room temperature and in a warmed environment. Results Breathing H2S at 80 parts per million by volume at 27°C ambient temperature for 6 h markedly reduced heart rate, core body temperature, respiratory rate, and physical activity, whereas blood pressure remained unchanged. Echocardiography demonstrated that H2S exposure decreased both heart rate and cardiac output but preserved stroke volume. Breathing H2S for 6 h at 35°C ambient temperature (to prevent hypothermia) decreased heart rate, physical activity, respiratory rate, and cardiac output without altering stroke volume or body temperature. H2S breathing seems to induce bradycardia by depressing sinus node activity. Breathing H2S for 30 min decreased whole body oxygen consumption and carbon dioxide production at either 27° or 35°C ambient temperature. Both parameters returned to baseline levels within 10 min after the cessation of H2S breathing. Conclusions Inhalation of H2S at either 27° or 35°C reversibly depresses cardiovascular function without changing blood pressure in mice. Breathing H2S also induces a rapidly reversible reduction of metabolic rate at either body temperature. PMID:18362598

Microsoft Kinect Visual and Depth Sensors for Breathing and Heart Rate Analysis

PubMed Central

Procházka, Aleš; Schätz, Martin; Vyšata, Oldřich; Vališ, Martin

2016-01-01

This paper is devoted to a new method of using Microsoft (MS) Kinect sensors for non-contact monitoring of breathing and heart rate estimation to detect possible medical and neurological disorders. Video sequences of facial features and thorax movements are recorded by MS Kinect image, depth and infrared sensors to enable their time analysis in selected regions of interest. The proposed methodology includes the use of computational methods and functional transforms for data selection, as well as their denoising, spectral analysis and visualization, in order to determine specific biomedical features. The results that were obtained verify the correspondence between the evaluation of the breathing frequency that was obtained from the image and infrared data of the mouth area and from the thorax movement that was recorded by the depth sensor. Spectral analysis of the time evolution of the mouth area video frames was also used for heart rate estimation. Results estimated from the image and infrared data of the mouth area were compared with those obtained by contact measurements by Garmin sensors (www.garmin.com). The study proves that simple image and depth sensors can be used to efficiently record biomedical multidimensional data with sufficient accuracy to detect selected biomedical features using specific methods of computational intelligence. The achieved accuracy for non-contact detection of breathing rate was 0.26% and the accuracy of heart rate estimation was 1.47% for the infrared sensor. The following results show how video frames with depth data can be used to differentiate different kinds of breathing. The proposed method enables us to obtain and analyse data for diagnostic purposes in the home environment or during physical activities, enabling efficient human–machine interaction. PMID:27367687

Microsoft Kinect Visual and Depth Sensors for Breathing and Heart Rate Analysis.

PubMed

Procházka, Aleš; Schätz, Martin; Vyšata, Oldřich; Vališ, Martin

2016-06-28

This paper is devoted to a new method of using Microsoft (MS) Kinect sensors for non-contact monitoring of breathing and heart rate estimation to detect possible medical and neurological disorders. Video sequences of facial features and thorax movements are recorded by MS Kinect image, depth and infrared sensors to enable their time analysis in selected regions of interest. The proposed methodology includes the use of computational methods and functional transforms for data selection, as well as their denoising, spectral analysis and visualization, in order to determine specific biomedical features. The results that were obtained verify the correspondence between the evaluation of the breathing frequency that was obtained from the image and infrared data of the mouth area and from the thorax movement that was recorded by the depth sensor. Spectral analysis of the time evolution of the mouth area video frames was also used for heart rate estimation. Results estimated from the image and infrared data of the mouth area were compared with those obtained by contact measurements by Garmin sensors (www.garmin.com). The study proves that simple image and depth sensors can be used to efficiently record biomedical multidimensional data with sufficient accuracy to detect selected biomedical features using specific methods of computational intelligence. The achieved accuracy for non-contact detection of breathing rate was 0.26% and the accuracy of heart rate estimation was 1.47% for the infrared sensor. The following results show how video frames with depth data can be used to differentiate different kinds of breathing. The proposed method enables us to obtain and analyse data for diagnostic purposes in the home environment or during physical activities, enabling efficient human-machine interaction.

Performance of Various Models in Predicting Vital Capacity Changes Caused by Breathing High Oxygen Partial Pressures

DTIC Science & Technology

2007-10-01

conditions or for various individuals. Furthermore, indirect effects such as absorption atelectasis following surfactant depletion or an alteration of the...Thus, repeated measurable AVC can be expected only from alveolar edema, airway closure, or atelectasis . Alveolar edema occurs when lymphatic drainage...with the maximum recovery rate equal to that of lymphatic drainage. VC decreases also if airways or alveoli close. Alveolar atelectasis occurs if no

Dynamic volume vs respiratory correlated 4DCT for motion assessment in radiation therapy simulation.

PubMed

Coolens, Catherine; Bracken, John; Driscoll, Brandon; Hope, Andrew; Jaffray, David

2012-05-01

Conventional (i.e., respiratory-correlated) 4DCT exploits the repetitive nature of breathing to provide an estimate of motion; however, it has limitations due to binning artifacts and irregular breathing in actual patient breathing patterns. The aim of this work was to evaluate the accuracy and image quality of a dynamic volume, CT approach (4D(vol)) using a 320-slice CT scanner to minimize these limitations, wherein entire image volumes are acquired dynamically without couch movement. This will be compared to the conventional respiratory-correlated 4DCT approach (RCCT). 4D(vol) CT was performed and characterized on an in-house, programmable respiratory motion phantom containing multiple geometric and morphological "tumor" objects over a range of regular and irregular patient breathing traces obtained from 3D fluoroscopy and compared to RCCT. The accuracy of volumetric capture and breathing displacement were evaluated and compared with the ground truth values and with the results reported using RCCT. A motion model was investigated to validate the number of motion samples needed to obtain accurate motion probability density functions (PDF). The impact of 4D image quality on this accuracy was then investigated. Dose measurements using volumetric and conventional scan techniques were also performed and compared. Both conventional and dynamic volume 4DCT methods were capable of estimating the programmed displacement of sinusoidal motion, but patient breathing is known to not be regular, and obvious differences were seen for realistic, irregular motion. The mean RCCT amplitude error averaged at 4 mm (max. 7.8 mm) whereas the 4D(vol) CT error stayed below 0.5 mm. Similarly, the average absolute volume error was lower with 4D(vol) CT. Under irregular breathing, the 4D(vol) CT method provides a close description of the motion PDF (cross-correlation 0.99) and is able to track each object, whereas the RCCT method results in a significantly different PDF from the ground truth, especially for smaller tumors (cross-correlation ranging between 0.04 and 0.69). For the protocols studied, the dose measurements were higher in the 4D(vol) CT method (40%), but it was shown that significant mAs reductions can be achieved by a factor of 4-5 while maintaining image quality and accuracy. 4D(vol) CT using a scanner with a large cone-angle is a promising alternative for improving the accuracy with which respiration-induced motion can be characterized, particularly for patients with irregular breathing motion. This approach also generates 4DCT image data with a reduced total scan time compared to a RCCT scan, without the need for image binning or external respiration signals within the 16 cm scan length. Scan dose can be made comparable to RCCT by optimization of the scan parameters. In addition, it provides the possibility of measuring breathing motion for more than one breathing cycle to assess stability and obtain a more accurate motion PDF, which is currently not feasible with the conventional RCCT approach.

Changes in the palatal dimensions of mouth breathing children caused by nasal obstruction

NASA Astrophysics Data System (ADS)

Indiarti, I. S.; Setyanto, D. B.; Kusumaningrum, A.; Budiardjo, S. B.

2017-08-01

During children’s growth and development, the breathing process plays an important role in craniofacial growth, especially of the palate. Nose breathing can stimulate the lateral growth of the maxilla, thus making the palate flat. Disturbances in nose breathing caused by nasal obstruction such as allergic rhinitis, adenoid hypertrophy, rhinosinusitis, nasal polyps, and obstructive sleep apnea can lead to a mouth breathing habit in children. This habit can cause palatal dimension changes such as a narrow V-shaped maxillary arch and a high palatal vault. This study analyzed the relationship between the mouth breathing habit in children who have nasal obstruction and palatal dimension changes. A cross-sectional descriptive study was conducted with a consecutive sampling method on children 7-18 years old with a history of allergic rhinitis, adenoid hypertrophy, rhinosinusitis, nasal polyps, and obstructive sleep apnea in the Pediatric Respirology and Pediatric Immunology Allergy Outpatient Clinic Kiara Maternal and Child Health Center at Cipto Mangunkusumo Hospital in Jakarta. The palatal dimensions were measured by the height and transversal width of the hard palate of castings of each child’s upper dental arch using vernier calipers. Palatal dimension changes were found in children with a mouth breathing habit due to nasal obstruction.

Volatile Biomarkers in Breath Associated With Liver Cirrhosis — Comparisons of Pre- and Post-liver Transplant Breath Samples

PubMed Central

Fernández del Río, R.; O'Hara, M.E.; Holt, A.; Pemberton, P.; Shah, T.; Whitehouse, T.; Mayhew, C.A.

2015-01-01

Background The burden of liver disease in the UK has risen dramatically and there is a need for improved diagnostics. Aims To determine which breath volatiles are associated with the cirrhotic liver and hence diagnostically useful. Methods A two-stage biomarker discovery procedure was used. Alveolar breath samples of 31 patients with cirrhosis and 30 healthy controls were mass spectrometrically analysed and compared (stage 1). 12 of these patients had their breath analysed after liver transplant (stage 2). Five patients were followed longitudinally as in-patients in the post-transplant period. Results Seven volatiles were elevated in the breath of patients versus controls. Of these, five showed statistically significant decrease post-transplant: limonene, methanol, 2-pentanone, 2-butanone and carbon disulfide. On an individual basis limonene has the best diagnostic capability (the area under a receiver operating characteristic curve (AUROC) is 0.91), but this is improved by combining methanol, 2-pentanone and limonene (AUROC curve 0.95). Following transplant, limonene shows wash-out characteristics. Conclusions Limonene, methanol and 2-pentanone are breath markers for a cirrhotic liver. This study raises the potential to investigate these volatiles as markers for early-stage liver disease. By monitoring the wash-out of limonene following transplant, graft liver function can be non-invasively assessed. PMID:26501124

Optimization of single shot 3D breath-hold non-enhanced MR angiography of the renal arteries.

PubMed

Tan, Huan; Koktzoglou, Ioannis; Glielmi, Christopher; Galizia, Mauricio; Edelman, Robert R

2012-05-19

Cardiac and navigator-gated, inversion-prepared non-enhanced magnetic resonance angiography techniques can accurately depict the renal arteries without the need for contrast administration. However, the scan time and effectiveness of navigator-gated techniques depend on the subject respiratory pattern, which at times results in excessively prolonged scan times or suboptimal image quality. A single-shot 3D magnetization-prepared steady-state free precession technique was implemented to allow the full extent of the renal arteries to be depicted within a single breath-hold. Technical optimization of the breath-hold technique was performed with fourteen healthy volunteers. An alternative magnetization preparation scheme was tested to maximize inflow signal. Quantitative and qualitative comparisons were made between the breath-hold technique and the clinically accepted navigator-gated technique in both volunteers and patients on a 1.5 T scanner. The breath-hold technique provided an average of seven fold reduction in imaging time, without significant loss of image quality. Comparable single-to-noise and contrast-to-noise ratios of intra- and extra-renal arteries were found between the breath-hold and the navigator-gated techniques in volunteers. Furthermore, the breath-hold technique demonstrated good image quality for diagnostic purposes in a small number of patients in a pilot study. The single-shot, breath-hold technique offers an alternative to navigator-gated methods for non-enhanced renal magnetic resonance angiography. The initial results suggest a potential supplementary clinical role for the breath-hold technique in the evaluation of suspected renal artery diseases.

Usefulness of Guided Breathing for Dose Rate-Regulated Tracking

DOE Office of Scientific and Technical Information (OSTI.GOV)

Han-Oh, Sarah; Department of Radiation Oncology, University of Maryland Medical System, Baltimore, MD; Yi, Byong Yong

2009-02-01

Purpose: To evaluate the usefulness of guided breathing for dose rate-regulated tracking (DRRT), a new technique to compensate for intrafraction tumor motion. Methods and Materials: DRRT uses a preprogrammed multileaf collimator sequence that tracks the tumor motion derived from four-dimensional computed tomography and the corresponding breathing signals measured before treatment. Because the multileaf collimator speed can be controlled by adjusting the dose rate, the multileaf collimator positions are adjusted in real time during treatment by dose rate regulation, thereby maintaining synchrony with the tumor motion. DRRT treatment was simulated with free, audio-guided, and audiovisual-guided breathing signals acquired from 23 lungmore » cancer patients. The tracking error and duty cycle for each patient were determined as a function of the system time delay (range, 0-1.0 s). Results: The tracking error and duty cycle averaged for all 23 patients was 1.9 {+-} 0.8 mm and 92% {+-} 5%, 1.9 {+-} 1.0 mm and 93% {+-} 6%, and 1.8 {+-} 0.7 mm and 92% {+-} 6% for the free, audio-guided, and audiovisual-guided breathing, respectively, for a time delay of 0.35 s. The small differences in both the tracking error and the duty cycle with guided breathing were not statistically significant. Conclusion: DRRT by its nature adapts well to variations in breathing frequency, which is also the motivation for guided-breathing techniques. Because of this redundancy, guided breathing does not result in significant improvements for either the tracking error or the duty cycle when DRRT is used for real-time tumor tracking.« less

Δ(9)-Tetrahydrocannabinol concentrations in exhaled breath and physiological effects following cannabis intake - A pilot study using illicit cannabis.

PubMed

Coucke, Line; Massarini, Enrico; Ostijn, Zachery; Beck, Olof; Verstraete, Alain G

2016-09-01

Δ(9)-Tetrahydrocannabinol (THC) can be measured in exhaled breath by using an aerosol particle collection device. The sampling procedure is simple, non-invasive and takes only 2-3min. In the present study we measured the amount of THC in exhaled breath of cannabis users at specific time intervals up to 3h after smoking one cannabis cigarette. The breath concentration-effect relationship was studied by measuring the pulse rate and the pupil diameter to assess physiological changes. THC and the main metabolite 11-nor-9-carboxy-Δ(9)-tetrahydrocannabinol were analyzed in exhaled breath by a liquid chromatography-tandem mass spectrometry method. Thirteen subjects (9 males and 4 females, aged 23-24years) participated. Five of those were using cannabis more frequently than monthly. THC was detected in most subjects already at baseline, concentrations increased following smoking and remained detectable for over 3h (mean THC concentration in breath at 3h: 1479pg/sample). Pulse rate (p=0.015) and pupil diameter (p=0.044) were significantly altered up to 30min after smoking. The detection window of cannabis in breath after smoking one cannabis cigarette in occasional and chronic smokers was at least 3h. Only THC was detected, and not the metabolite. The THC concentration in exhaled breath was related to the physiological changes that occur over time. Exhaled breath can be used to detect recent cannabis exposure. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

(13)C-Breath testing in animals: theory, applications, and future directions.

PubMed

McCue, Marshall D; Welch, Kenneth C

2016-04-01

The carbon isotope values in the exhaled breath of an animal mirror the carbon isotope values of the metabolic fuels being oxidized. The measurement of stable carbon isotopes in carbon dioxide is called (13)C-breath testing and offers a minimally invasive method to study substrate oxidation in vivo. (13)C-breath testing has been broadly used to study human exercise, nutrition, and pathologies since the 1970s. Owing to reduced use of radioactive isotopes and the increased convenience and affordability of (13)C-analyzers, the past decade has witnessed a sharp increase in the use of breath testing throughout comparative physiology--especially to answer questions about how and when animals oxidize particular nutrients. Here, we review the practical aspects of (13)C-breath testing and identify the strengths and weaknesses of different methodological approaches including the use of natural abundance versus artificially-enriched (13)C tracers. We critically compare the information that can be obtained using different experimental protocols such as diet-switching versus fuel-switching. We also discuss several factors that should be considered when designing breath testing experiments including extrinsic versus intrinsic (13)C-labelling and different approaches to model nutrient oxidation. We use case studies to highlight the myriad applications of (13)C-breath testing in basic and clinical human studies as well as comparative studies of fuel use, energetics, and carbon turnover in multiple vertebrate and invertebrate groups. Lastly, we call for increased and rigorous use of (13)C-breath testing to explore a variety of new research areas and potentially answer long standing questions related to thermobiology, locomotion, and nutrition.

Real-time tracking of respiratory-induced tumor motion by dose-rate regulation

NASA Astrophysics Data System (ADS)

Han-Oh, Yeonju Sarah

We have developed a novel real-time tumor-tracking technology, called Dose-Rate-Regulated Tracking (DRRT), to compensate for tumor motion caused by breathing. Unlike other previously proposed tumor-tracking methods, this new method uses a preprogrammed dynamic multileaf collimator (MLC) sequence in combination with real-time dose-rate control. This new scheme circumvents the technical challenge in MLC-based tumor tracking, that is to control the MLC motion in real time, based on real-time detected tumor motion. The preprogrammed MLC sequence describes the movement of the tumor, as a function of breathing phase, amplitude, or tidal volume. The irregularity of tumor motion during treatment is handled by real-time regulation of the dose rate, which effectively speeds up or slows down the delivery of radiation as needed. This method is based on the fact that all of the parameters in dynamic radiation delivery, including MLC motion, are enslaved to the cumulative dose, which, in turn, can be accelerated or decelerated by varying the dose rate. Because commercially available MLC systems do not allow the MLC delivery sequence to be modified in real time based on the patient's breathing signal, previously proposed tumor-tracking techniques using a MLC cannot be readily implemented in the clinic today. By using a preprogrammed MLC sequence to handle the required motion, the task for real-time control is greatly simplified. We have developed and tested the pre- programmed MLC sequence and the dose-rate regulation algorithm using lung-cancer patients breathing signals. It has been shown that DRRT can track the tumor with an accuracy of less than 2 mm for a latency of the DRRT system of less than 0.35 s. We also have evaluated the usefulness of guided breathing for DRRT. Since DRRT by its very nature can compensate for breathing-period changes, guided breathing was shown to be unnecessary for real-time tracking when using DRRT. Finally, DRRT uses the existing dose-rate control system that is provided for current linear accelerators. Therefore, DRRT can be achieved with minimal modification of existing technology, and this can shorten substantially the time necessary to establish DRRT in clinical practice.

Evaluation of model-based methods in estimating respiratory mechanics in the presence of variable patient effort.

PubMed

Redmond, Daniel P; Chiew, Yeong Shiong; Major, Vincent; Chase, J Geoffrey

2016-09-23

Monitoring of respiratory mechanics is required for guiding patient-specific mechanical ventilation settings in critical care. Many models of respiratory mechanics perform poorly in the presence of variable patient effort. Typical modelling approaches either attempt to mitigate the effect of the patient effort on the airway pressure waveforms, or attempt to capture the size and shape of the patient effort. This work analyses a range of methods to identify respiratory mechanics in volume controlled ventilation modes when there is patient effort. The models are compared using 4 Datasets, each with a sample of 30 breaths before, and 2-3 minutes after sedation has been administered. The sedation will reduce patient efforts, but the underlying pulmonary mechanical properties are unlikely to change during this short time. Model identified parameters from breathing cycles with patient effort are compared to breathing cycles that do not have patient effort. All models have advantages and disadvantages, so model selection may be specific to the respiratory mechanics application. However, in general, the combined method of iterative interpolative pressure reconstruction, and stacking multiple consecutive breaths together has the best performance over the Dataset. The variability of identified elastance when there is patient effort is the lowest with this method, and there is little systematic offset in identified mechanics when sedation is administered. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Electrospun polystyrene/graphene nanofiber film as a novel adsorbent of thin film microextraction for extraction of aldehydes in human exhaled breath condensates.

PubMed

Huang, Jing; Deng, Hongtao; Song, Dandan; Xu, Hui

2015-06-09

In the current study, we introduced a novel polystyrene/graphene (PS/G) composite nanofiber film for thin film microextraction (TFME) for the first time. The PS/G nanofiber film was fabricated on the surface of filter paper by a facile electrospinning method. The morphology and extraction performance of the resultant composite film were investigated systematically. The PS/G nanofiber film exhibited porous fibrous structure, large surface area and strong hydrophobicity. A new thin film microextraction-high performance liquid chromatography (TFME-HPLC) method was developed for the determination of six aldehydes in human exhaled breath condensates. The method showed high enrichment efficiency and fast analysis speed. Under the optimal conditions, the linear ranges of the analytes were in the range of 0.02-30 μmol L(-1) with correlation coefficients above 0.9938, and the recoveries were between 79.8% and 105.6% with the relative standard deviation values lower than 16.3% (n=5). The limits of quantification of six aldehydes ranged from 13.8 to 64.6 nmol L(-1). The established method was successfully applied for the quantification of aldehyde metabolites in exhaled breath condensates of lung cancer patients and healthy people. Taken together, the TFME-HPLC method provides a simple, rapid, sensitive, cost-effective, non-invasion approach for the analysis of linear aliphatic aldehydes in human exhaled breath condensates. Copyright © 2015 Elsevier B.V. All rights reserved.

The air-conditioning capacity of the human nose.

PubMed

Naftali, Sara; Rosenfeld, Moshe; Wolf, Michael; Elad, David

2005-04-01

The nose is the front line defender of the respiratory system. Unsteady simulations in three-dimensional models have been developed to study transport patterns in the human nose and its overall air-conditioning capacity. The results suggested that the healthy nose can efficiently provide about 90% of the heat and the water fluxes required to condition the ambient inspired air to near alveolar conditions in a variety of environmental conditions and independent of variations in internal structural components. The anatomical replica of the human nose showed the best performance and was able to provide 92% of the heating and 96% of the moisture needed to condition the inspired air to alveolar conditions. A detailed analysis explored the relative contribution of endonasal structural components to the air-conditioning process. During a moderate breathing effort, about 11% reduction in the efficacy of nasal air-conditioning capacity was observed.

Disturbances of Pulmonary Function in Mitral Valve Disease

PubMed Central

Palmer, Wilfred H.; Gee, J. B. L.; Mills, F. C.; Bates, D. V.

1963-01-01

To study the sequence of changes in respiratory function that occur in the natural history of mitral stenosis, and the physiological basis of “cardiac dyspnea”, 30 patients with chronic mitral valve disease were subjected to detailed pulmonary function tests. There was no significant change in vital capacity and functional residual capacity. The reduction in maximal mid-expiratory flow rate showed excellent correlation with the respiratory symptoms. The pulmonary capillary blood volume was increased in moderately advanced cases but was consistently reduced in the severest cases. Hyperventilation was due to an increased respiratory rate. Dyspnea was associated with increased respiratory work owing to the interrelation between the reduction in diffusion capacity, compliance, cardiac output, the increase in airway resistance, and the uneven ventilation and perfusion of the lungs. The amount of “effort” required to breathe is incommensurate with the external load in these patients. PMID:14060164

SU-E-J-185: A Systematic Review of Breathing Guidance in Radiation Oncology and Radiology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pollock, S; Keall, P; Keall, R

Purpose: The advent of image-guided radiation therapy (IGRT) has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion is the use of breathing guidance systems during imaging and treatment. A review of such research had not yet been performed, it was therefore our aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: Results of online database searches were filtered in accordance tomore » a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with the PRISMAStatement reporting standard (Preferred Reporting Items for Systematic reviews and Meta-Analyses) utilizing the PICOS approach (Participants, Intervention, Comparison, Outcome, Study design). Participants: Cancer patients, healthy volunteers. Intervention: Biofeedback breathing guidance systems. Comparison: No breathing guidance of the same breathing type. Outcome: Regularity of breathing signal and anatomic/tumor motion, medical image quality, radiation treatment margins and coverage, medical imaging and radiation treatment times. Study design: Quantitative and controlled prospective or retrospective trials. Results: The systematic search yielded a total of 479 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. The vast majority of investigated outcomes were significantly positively impacted by the use of breathing guidance; however, this was dependent upon the nature of the breathing guidance system and study design. In 25/27 studies significant improvements from the use of breathing guidance were observed. Conclusion: The results found here indicate that further clinical studies are warranted which quantify more comprehensively the clinical impact of The results found here indicate that further clinical studies are warranted which quantify more comprehensively the clinical impact of breathing guidance interventions.« less

Reliable quantification of BOLD fMRI cerebrovascular reactivity despite poor breath-hold performance.

PubMed

Bright, Molly G; Murphy, Kevin

2013-12-01

Cerebrovascular reactivity (CVR) can be mapped using BOLD fMRI to provide a clinical insight into vascular health that can be used to diagnose cerebrovascular disease. Breath-holds are a readily accessible method for producing the required arterial CO2 increases but their implementation into clinical studies is limited by concerns that patients will demonstrate highly variable performance of breath-hold challenges. This study assesses the repeatability of CVR measurements despite poor task performance, to determine if and how robust results could be achieved with breath-holds in patients. Twelve healthy volunteers were scanned at 3 T. Six functional scans were acquired, each consisting of 6 breath-hold challenges (10, 15, or 20 s duration) interleaved with periods of paced breathing. These scans simulated the varying breath-hold consistency and ability levels that may occur in patient data. Uniform ramps, time-scaled ramps, and end-tidal CO2 data were used as regressors in a general linear model in order to measure CVR at the grey matter, regional, and voxelwise level. The intraclass correlation coefficient (ICC) quantified the repeatability of the CVR measurement for each breath-hold regressor type and scale of interest across the variable task performances. The ramp regressors did not fully account for variability in breath-hold performance and did not achieve acceptable repeatability (ICC<0.4) in several regions analysed. In contrast, the end-tidal CO2 regressors resulted in "excellent" repeatability (ICC=0.82) in the average grey matter data, and resulted in acceptable repeatability in all smaller regions tested (ICC>0.4). Further analysis of intra-subject CVR variability across the brain (ICCspatial and voxelwise correlation) supported the use of end-tidal CO2 data to extract robust whole-brain CVR maps, despite variability in breath-hold performance. We conclude that the incorporation of end-tidal CO2 monitoring into scanning enables robust, repeatable measurement of CVR that makes breath-hold challenges suitable for routine clinical practice. © 2013.

eAMI: A Qualitative Quantification of Periodic Breathing Based on Amplitude of Oscillations

PubMed Central

Fernandez Tellez, Helio; Pattyn, Nathalie; Mairesse, Olivier; Dolenc-Groselj, Leja; Eiken, Ola; Mekjavic, Igor B.; Migeotte, P. F.; Macdonald-Nethercott, Eoin; Meeusen, Romain; Neyt, Xavier

2015-01-01

Study Objectives: Periodic breathing is sleep disordered breathing characterized by instability in the respiratory pattern that exhibits an oscillatory behavior. Periodic breathing is associated with increased mortality, and it is observed in a variety of situations, such as acute hypoxia, chronic heart failure, and damage to respiratory centers. The standard quantification for the diagnosis of sleep related breathing disorders is the apnea-hypopnea index (AHI), which measures the proportion of apneic/hypopneic events during polysomnography. Determining the AHI is labor-intensive and requires the simultaneous recording of airflow and oxygen saturation. In this paper, we propose an automated, simple, and novel methodology for the detection and qualification of periodic breathing: the estimated amplitude modulation index (eAMI). Patients or Participants: Antarctic cohort (3,800 meters): 13 normal individuals. Clinical cohort: 39 different patients suffering from diverse sleep-related pathologies. Measurements and Results: When tested in a population with high levels of periodic breathing (Antarctic cohort), eAMI was closely correlated with AHI (r = 0.95, P < 0.001). When tested in the clinical setting, the proposed method was able to detect portions of the signal in which subclinical periodic breathing was validated by an expert (n = 93; accuracy = 0.85). Average eAMI was also correlated with the loop gain for the combined clinical and Antarctica cohorts (r = 0.58, P < 0.001). Conclusions: In terms of quantification and temporal resolution, the eAMI is able to estimate the strength of periodic breathing and the underlying loop gain at any given time within a record. The impaired prognosis associated with periodic breathing makes its automated detection and early diagnosis of clinical relevance. Citation: Fernandez Tellez H, Pattyn N, Mairesse O, Dolenc-Groselj L, Eiken O, Mekjavic IB, Migeotte PF, Macdonald-Nethercott E, Meeusen R, Neyt X. eAMI: a qualitative quantification of periodic breathing based on amplitude of oscillations. SLEEP 2015;38(3):381–389. PMID:25581914

Investigation of Exhaled Breath Samples from Patients with Alzheimer's Disease Using Gas Chromatography-Mass Spectrometry and an Exhaled Breath Sensor System.

PubMed

Lau, Hui-Chong; Yu, Joon-Boo; Lee, Ho-Won; Huh, Jeung-Soo; Lim, Jeong-Ok

2017-08-03

Exhaled breath is a body secretion, and the sampling process of this is simple and cost effective. It can be non-invasively collected for diagnostic procedures. Variations in the chemical composition of exhaled breath resulting from gaseous exchange in the extensive capillary network of the body are proposed to be associated with pathophysiological changes. In light of the foreseeable potential of exhaled breath as a diagnostic specimen, we used gas chromatography and mass spectrometry (GC-MS) to study the chemical compounds present in exhaled breath samples from patients with Alzheimer's disease (AD), Parkinson's disease (PD), and from healthy individuals as a control group. In addition, we also designed and developed a chemical-based exhaled breath sensor system to examine the distribution pattern in the patient and control groups. The results of our study showed that several chemical compounds, such as 1-phenantherol and ethyl 3-cyano-2,3-bis (2,5,-dimethyl-3-thienyl)-acrylate, had a higher percentage area in the AD group than in the PD and control groups. These results may indicate an association of these chemical components in exhaled breath with the progression of disease. In addition, in-house fabricated exhaled breath sensor systems, containing several types of gas sensors, showed significant differences in terms of the normalized response of the sensitivity characteristics between the patient and control groups. A subsequent clustering analysis was able to distinguish between the AD patients, PD patients, and healthy individuals using principal component analysis, Sammon's mapping, and a combination of both methods, in particular when using the exhaled breath sensor array system A consisting of eight sensors. With this in mind, the exhaled breath sensor system could provide alternative option for diagnosis and be applied as a useful, effective tool for the screening and diagnosis of AD in the near future.

Comparative analysis between the alveolar recruitment maneuver and breath stacking technique in patients with acute lung injury

PubMed Central

Porto, Elias Ferreira; Tavolaro, Kelly Cristiani; Kumpel, Claudia; Oliveira, Fernanda Augusta; Sousa, Juciaria Ferreira; de Carvalho, Graciele Vieira; de Castro, Antonio Adolfo Mattos

2014-01-01

Objective To compare the effectiveness of the alveolar recruitment maneuver and the breath stacking technique with respect to lung mechanics and gas exchange in patients with acute lung injury. Methods Thirty patients were distributed into two groups: Group 1 - breath stacking; and Group 2 - alveolar recruitment maneuver. After undergoing conventional physical therapy, all patients received both treatments with an interval of 1 day between them. In the first group, the breath stacking technique was used initially, and subsequently, the alveolar recruitment maneuver was applied. Group 2 patients were initially subjected to alveolar recruitment, followed by the breath stacking technique. Measurements of lung compliance and airway resistance were evaluated before and after the use of both techniques. Gas analyses were collected before and after the techniques were used to evaluate oxygenation and gas exchange. Results Both groups had a significant increase in static compliance after breath stacking (p=0.021) and alveolar recruitment (p=0.03), but with no significant differences between the groups (p=0.95). The dynamic compliance did not increase for the breath stacking (p=0.22) and alveolar recruitment (p=0.074) groups, with no significant difference between the groups (p=0.11). The airway resistance did not decrease for either groups, i.e., breath stacking (p=0.91) and alveolar recruitment (p=0.82), with no significant difference between the groups (p=0.39). The partial pressure of oxygen increased significantly after breath stacking (p=0.013) and alveolar recruitment (p=0.04), but there was no significant difference between the groups (p=0.073). The alveolar-arterial O2 difference decreased for both groups after the breath stacking (p=0.025) and alveolar recruitment (p=0.03) interventions, and there was no significant difference between the groups (p=0.81). Conclusion Our data suggest that the breath stacking and alveolar recruitment techniques are effective in improving the lung mechanics and gas exchange in patients with acute lung injury. PMID:25028951

[The repercussions of pulmonary congestion on ventilatory volumes, capacities and flows].

PubMed

Carmo, M M; Ferreira, T; Lousada, N; Bárbara, C; Neves, P R; Correia, J M; Rendas, A B

1994-10-01

To evaluate the effects of pulmonary congestion on pulmonary function. Prospective study performed in patients with left ventricular failure or mitral stenosis. Forty-eight hospitalized patients were included suffering from pulmonary congestion either from left ventricular failure or mitral stenosis. While in hospital all patients were submitted to right heart catheterization by the Swan-Ganz method and also to an echocardiographic examination. Within 48 hours after the patients were submitted to the following lung function studies: lung volumes and capacities by the multi-breath helium dilution method and airway flows by pneumotachography. Respiratory symptoms were evaluated by the Medical Research Council Questionnaire and the functional class classified according to the NYHA. Correlations were made between the functional and clinical data. Regarding the cardiac evaluation patients presented with a mean pulmonary wedge pressure of 19.9 +/- 8.6 mmHg, a cardiac index of 2.5 +/- 0.8 l/min/m2, an end diastolic dimension of the left ventricle of 65.9 +/- 10.1 mm, and end systolic dimension of 51.2 +/- 12.2 mm, with a shortening fraction of 21.8 +/- 9.5%. The pulmonary evaluation showed a restrictive syndrome with a reduction in the mean values of the following parameters: total pulmonary capacity 71 +/- 14.4% of the predicted value (pv), forced vital capacity (FVC) 69.8 +/- 20.5% pv, and forced expiratory volume (FEV1) of 64 +/- 21.8% vp. The index FEV1/FVC was within the normal value of 72.7 +/- 9.7%. These lung function results did not correlate significantly with either the clinical, the hemodynamic or echocardiographic findings. In these group of patients pulmonary congestion led to the development of a restrictive syndrome which failed to correlate in severity with the duration of the disease, the pulmonary wedge pressure and the left ventricular function.

Long-Term Follow-Up after Phrenic Nerve Reconstruction for Diaphragmatic Paralysis: A Review of 180 Patients.

PubMed

Kaufman, Matthew R; Elkwood, Andrew I; Brown, David; Cece, John; Martins, Catarina; Bauer, Thomas; Weissler, Jason; Rezzadeh, Kameron; Jarrahy, Reza

2017-01-01

Background  Phrenic nerve reconstruction has been evaluated as a method of restoring functional activity and may be an effective alternative to diaphragm plication. Longer follow-up and a larger cohort for analysis are necessary to confirm the efficacy of this procedure for diaphragmatic paralysis. Methods  A total of 180 patients treated with phrenic nerve reconstruction for chronic diaphragmatic paralysis were followed for a median 2.7 years. Assessment parameters included: 36-Item Short Form Health Survey (SF-36) physical functioning survey, spirometry, chest fluoroscopy, electrodiagnostic evaluation, a five-item questionnaire to assess specific functional issues, and overall patient-reported outcome. Results  Overall, 134 males and 46 females with an average age of 56 years (range: 10-79 years) were treated. Mean baseline percent predicted values for forced expiratory volume in 1 second, forced vital capacity, vital capacity, and total lung capacity, were 61, 63, 67, and 75%, respectively. The corresponding percent improvements in percent predicted values were: 11, 6, 9, and 13% ( p ≤ 0.01; ≤ 0.01; ≤ 0.05; ≤ 0.01). Mean preoperative SF-36 physical functioning survey scores were 39%, and an improvement to 65% was demonstrated following surgery ( p  ≤ 0.0001). Nerve conduction latency, improved by an average 23% ( p  ≤ 0.005), and there was a corresponding 125% increase in diaphragm motor amplitude ( p  ≤ 0.0001). A total of 89% of patients reported an overall improvement in breathing function. Conclusion  Long-term assessment of phrenic nerve reconstruction for diaphragmatic paralysis indicates functional correction and symptomatic relief. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Exercise on-transition uncoupling of ventilatory, gas exchange and cardiac hemodynamic kinetics accompany pulmonary oxygen stores depletion to impact exercise intolerance in human heart failure.

PubMed

Van Iterson, E H; Smith, J R; Olson, T P

2018-03-25

In contrast to knowledge that heart failure (HF) patients demonstrate peak exercise uncoupling across ventilation, gas exchange and cardiac haemodynamics, whether this dyssynchrony follows that at the exercise on-transition is unclear. This study tested whether exercise on-transition temporal lag for ventilation relative to gas exchange and oxygen pulse (O 2 pulse) couples with effects from abnormal pulmonary gaseous oxygen store (O 2store ) contributions to V˙O 2 to interdependently precipitate persistently elevated ventilatory demand and low oxidative metabolic capacity in HF. Beat-to-beat HR and breath-to-breath ventilation and gas exchange were continuously acquired in HF (N = 9, ejection fraction = 30 ± 9%) and matched controls (N = 10) during square-wave ergometry at 60% V˙O 2peak (46 ± 14 vs 125 ± 54-W, P < .001). Temporal responses across V˙ E , V˙O 2 and O 2 pulse were assessed for the exercise on-transition using single exponential model Phase II on-kinetic time constants (τ = time to reach 63% steady-state rise). Breath-to-breath gas fractions and respiratory flows were used to determine O 2stores . HF vs controls: τ for V˙ E (137 ± 93 vs 74 ± 40-seconds, P = .03), V˙O 2 (60 ± 40 vs 23 ± 5-seconds, P = .03) and O 2 pulse (28 ± 18 vs 23 ± 15-seconds, P = .59). Within HF, τ for V˙ E differed from O 2 pulse (P < .02), but not V˙O 2 . Exercise V˙ E rise (workload indexed) differed in HF vs controls (545 ± 139 vs 309 ± 88-mL min -1 W -1 , P < .001). Exercise on-transition O 2store depletion in HF exceeded controls, generally persisting to end-exercise. These data suggest HF demonstrated exercise on-transition O 2store depletion (high O 2store contribution to V˙O 2 ) coupled with dyssynchronous V˙ E , V˙O 2 and O 2 pulse kinetics-not attributable to prolonged cardiac haemodynamics. Persistent high ventilatory demand and low oxidative metabolic capacity in HF may be precipitated by physiological uncoupling occurring within the exercise on-transition. © 2018 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

Nasal and Oral Inspiration during Natural Speech Breathing

ERIC Educational Resources Information Center

Lester, Rosemary A.; Hoit, Jeannette D.

2014-01-01

Purpose: The purpose of this study was to determine the typical pattern for inspiration during speech breathing in healthy adults, as well as the factors that might influence it. Method: Ten healthy adults, 18-45 years of age, performed a variety of speaking tasks while nasal ram pressure, audio, and video recordings were obtained. Inspirations…

Sleep-Disordered Breathing and Cognitive Functioning in Preschool Children with and without Down Syndrome

ERIC Educational Resources Information Center

Joyce, A.; Dimitriou, D.

2017-01-01

Background: Sleep affects children's cognitive development, preparedness for school and future academic outcomes. People with Down syndrome (DS) are particularly at risk for sleep-disordered breathing (SDB). To our knowledge, the association between SDB and cognition in preschoolers with DS is unknown. Methods: We assessed sleep by using…

Prevention of the pulmonary vasoconstrictor effects of HBOC-201 in awake lambs by continuously breathing nitric oxide.

PubMed

Yu, Binglan; Volpato, Gian Paolo; Chang, Keqin; Bloch, Kenneth D; Zapol, Warren M

2009-01-01

Hemoglobin-based oxygen-carrying solutions (HBOC) provide emergency alternatives to blood transfusion to carry oxygen to tissues without the risks of disease transmission or transfusion reaction. Two primary concerns hampering the clinical acceptance of acellular HBOC are the occurrence of systemic and pulmonary vasoconstriction and the maintenance of the heme-iron in the reduced state (Fe2+). We recently demonstrated that pretreatment with inhaled nitric oxide prevents the systemic hypertension induced by HBOC-201 (polymerized bovine hemoglobin) infusion in awake mice and sheep without causing methemoglobinemia. However, the impact of HBOC-201 infusion with or without inhaled nitric oxide on pulmonary vascular tone has not yet been examined. The pulmonary and systemic hemodynamic effects of breathing nitric oxide both before and after the administration of HBOC-201 were determined in healthy, awake lambs. Intravenous administration of HBOC-201 (12 ml/kg) induced prolonged systemic and pulmonary vasoconstriction. Pretreatment with inhaled nitric oxide (80 parts per million [ppm] for 1 h) prevented the HBOC-201--induced increase in mean arterial pressure but not the increase of pulmonary arterial pressure, systemic vascular resistance, or pulmonary vascular resistance. Pretreatment with inhaled nitric oxide (80 ppm for 1 h) followed by breathing a lower concentration of nitric oxide (5 ppm) during and after HBOC-201 infusion prevented systemic and pulmonary vasoconstriction without increasing methemoglobin levels. These findings demonstrate that pretreatment with inhaled nitric oxide followed by breathing a lower concentration of the gas during and after administration of HBOC-201 may enable administration of an acellular hemoglobin substitute without vasoconstriction while preserving its oxygen-carrying capacity.

Impact of varying physical activity levels on airway sensitivity and bronchodilation in healthy humans.

PubMed

Smith, Joshua R; Kurti, Stephanie P; Johnson, Ariel M; Kolmer, Sarah A; Harms, Craig

2015-12-01

The purpose of this study was to determine if the amount of physical activity influences airway sensitivity and bronchodilation in healthy subjects across a range of physical activity levels. Thirty healthy subjects (age, 21.9 ± 2.6 years; 13 men/17 women) with normal pulmonary function reported to the laboratory on 2 separate occasions where they were randomized to breathe either hypertonic saline (HS) (nebulized hypertonic saline (25%) for 20 min) or HS followed by 5 deep inspirations (DIs), which has been reported to bronchodilate the airways. Pulmonary function tests (PFTs) were performed prior to both conditions and following the HS breathing or 5 DIs. Moderate to vigorous physical activity (MVPA) level was measured via accelerometer worn for 7 days. Following the HS breathing, forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) significantly decreased from baseline by -11.8% ± 8.4% and -9.3% ± 6.7%, respectively. A 2-segment linear model determined significant relationships between MVPA and percent change in FEV1 (r = 0.50) and FVC (r = 0.55). MVPA above ∼497 and ∼500 min/week for FEV1 and FVC, respectively, resulted in minor additional improvements (p > 0.05) in PFTs following the HS breathing. Following the DIs, FEV1 and FVC decreased (p < 0.05) by -7.3% ± 8.6% and -5.7% ± 5.7%, respectively, from baseline, but were not related (p > 0.05) to MVPA. In conclusion, these data demonstrate that higher MVPA levels attenuated airway sensitivity but not bronchodilation in healthy subjects.

Insulin sensitivity index (ISI0, 120) potentially linked to carbon isotopes of breath CO2 for pre-diabetes and type 2 diabetes

PubMed Central

Ghosh, Chiranjit; Mukhopadhyay, Prabuddha; Ghosh, Shibendu; Pradhan, Manik

2015-01-01

New strategies for an accurate and early detection of insulin resistance are important to delay or prevent the acute onset of type 2 diabetes (T2D). Currently, insulin sensitivity index (ISI0,120) is considered to be a viable invasive method of whole-body insulin resistance for use in clinical settings in comparison with other invasive sensitivity indexes like homeostasis model assessment (HOMA), and quantitative insulin sensitivity check index (QUICKI). To investigate how these sensitivity indexes link the 13C/12C-carbon isotopes of exhaled breath CO2 to pre-diabetes (PD) and type 2 diabetes in response to glucose ingestion, we studied excretion dynamics of 13C/12C-isotopic fractionations of breath CO2. Here, we show that 13C/12C-isotope ratios of breath CO2 were well correlated with blood glucose, insulin, glycosylated-hemoglobin as well as with HOMA-IR and 1/QUICKI. Conversely, the strongest correlation was observed between 1/ISI0,120 and breath CO2 isotopes. Consequently, we determined several optimal diagnostic cut-off points of 1/ISI0,120 and 13CO2/12CO2-isotope ratios to distinctively track the evolution of PD prior to the onset of T2D. Our findings suggest that isotopic breath CO2 is a novel method for accurate estimation of ISI0,120 and thus may open new perspectives into the isotope-specific non-invasive evaluation of insulin resistance for large-scale real-time diabetes screening purposes. PMID:26148706

Liver diffusivity in healthy volunteers and patients with chronic liver disease: Comparison of breath-hold and free-breathing techniques

PubMed Central

Eatesam, Mamak; Noworolski, Susan M; Tien, Phyllis C; Nystrom, Michelle; Dodge, Jennifer L.; Merriman, Raphael B.; Qayyum, Aliya

2011-01-01

Purpose To compare liver ADC obtained with breath-hold and free-breathing diffusion weighted imaging (DWI) in healthy volunteers and patients with liver disease. Materials and Methods Twenty-eight subjects, 12 healthy volunteers and 16 patients (9 NAFLD, 7 chronic active HCV), underwent breath-hold (BH) and free-breathing (FB) DWI MRI at 1.5T. Pearson’s correlation coefficient was used to determine correlation while paired t-tests assessed differences between BH and FB ADC. Estimated bias was calculated using the Bland-Altman method. Results Liver ADC (×10−3 mm2/sec) was lower on BH for all groups (mean difference 0.36±0.20; p<0.01). ADC was higher in healthy volunteers (BH 1.80±0.18; FB 2.24±0.20) compared to NAFLD patients (BH 1.43±0.27; FB 1.78±0.28) (p<0.001) and HCV patients (BH 1.63±0.191; FB 1.88±0.12). Overall correlation between BH and FB ADC was (r =0.75), greatest in NAFLD (r =0.90) compared to the correlation in HCV (r =0.24) and healthy subjects (r =0.34). Bland-Altman plots did not show agreement in mean absolute difference and estimated bias between subjects. Conclusion Correlation between BH and FB liver ADC is moderate indicating that BH and FB should not be used interchangeably. Additionally, the lower ADC values in BH versus FB should be accounted for when comparing different liver DWI studies. PMID:22034200

Frequency of rhinitis and orofacial disorders in patients with dental malocclusion

PubMed Central

Imbaud, Tamara Christine de Souza; Mallozi, Márcia Carvalho; Domingos, Vanda Beatriz Teixeira Coelho; Solé, Dirceu

2016-01-01

Abstract Objective: To describe the frequency and etiology of rhinitis, oral breathing, types of malocclusion and orofacial disorders in patients treated for dental malocclusion. Methods: Patients with poor dental occlusion (n=89, 8-15 years) undergoing orthodontic treatment at the Postgraduate Orthodontics Center (São Paulo, Brazil) participated in the study. Rhinitis and oral breathing were diagnosed by anamnesis, clinical assessment and allergic etiology of rhinitis through immediate hypersensitivity skin prick test with airborne allergens. The association between types of breathing (oral or nasal), rhinitis and types of dental malocclusion, bruxism and cephalometric alterations (increased Y axis of facial growth) compared to standard cephalometric tracing (Escola de Odontologia da Universidade de São Paulo) were assessed. Results: The frequency of rhinitis in patients with dental malocclusion was 76.4% (68), and, of these, 81.7% were allergic (49/60 positive skin prick test), whereas the frequency of oral breathing was 62.9%. There was a significant association between an increased Y axis of facial growth and oral breathing (p<0.001), as well as between oral breathing and rhinitis (p=0.009). There was no association between rhinitis and bruxism. Conclusions: The frequency of rhinitis in children with dental malocclusion is higher than that in the general population, which is approximately 30%. Patients with oral breathing have a tendency to a dolichofacial growth pattern (increased Y axis of facial growth). In patients with rhinitis, regardless of the presence of oral breathing, the dolichofacial growth tendency was not observed. PMID:26631324

Breath carbon stable isotope ratios identify changes in energy balance and substrate utilization in humans.

PubMed

Whigham, L D; Butz, D E; Johnson, L K; Schoeller, D A; Abbott, D H; Porter, W P; Cook, M E

2014-09-01

Rapid detection of shifts in substrate utilization and energy balance would provide a compelling biofeedback tool for individuals attempting weight loss. As a proof of concept, we tested whether the natural abundance of exhaled carbon stable isotope ratios (breath δ(13)C) reflects shifts between negative and positive energy balance. Volunteers (n=5) consumed a 40% energy-restricted diet for 6 days followed by 50% excess on day 7. Breath was sampled immediately before and 1 h and 2 h after breakfast, lunch and dinner. Exhaled breath δ(13)C values were measured by cavity ring-down spectroscopy. Using repeated measures analysis of variance (ANOVA) followed by Dunnett's contrasts, pre-breakfast breath values on days 2-6 were compared with day 1, and postprandial day 7 time points were compared with pre-breakfast day 7. Energy restriction diminished pre-breakfast breath δ(13)C by day 3 (P<0.05). On day 7, increased energy intake was first detected immediately before dinner (-23.8±0.6 vs -21.9±0.7‰, P=0.002 (means±s.d.)), and breath δ(13)C remained elevated at least 2 h post dinner. In conclusion, when shifting between negative and positive energy balance, breath δ(13)C showed anticipated isotopic changes. Although additional research is needed to determine specificity and repeatability, this method may provide a biomarker for marked increases in caloric intake.

Solid-state gas sensors for breath analysis: a review.

PubMed

Di Natale, Corrado; Paolesse, Roberto; Martinelli, Eugenio; Capuano, Rosamaria

2014-05-08

The analysis of volatile compounds is an efficient method to appraise information about the chemical composition of liquids and solids. This principle is applied to several practical applications, such as food analysis where many important features (e.g. freshness) can be directly inferred from the analysis of volatile compounds. The same approach can also be applied to a human body where the volatile compounds, collected from the skin, the breath or in the headspace of fluids, might contain information that could be used to diagnose several kinds of diseases. In particular, breath is widely studied and many diseases can be potentially detected from breath analysis. The most fascinating property of breath analysis is the non-invasiveness of the sample collection. Solid-state sensors are considered the natural complement to breath analysis, matching the non-invasiveness with typical sensor features such as low-cost, easiness of use, portability, and the integration with the information networks. Sensors based breath analysis is then expected to dramatically extend the diagnostic capabilities enabling the screening of large populations for the early diagnosis of pathologies. In the last years there has been an increased attention to the development of sensors specifically aimed to this purpose. These investigations involve both specific sensors designed to detect individual compounds and non-specific sensors, operated in array configurations, aimed at clustering subjects according to their health conditions. In this paper, the recent significant applications of these sensors to breath analysis are reviewed and discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

An Ultrasonic Contactless Sensor for Breathing Monitoring

PubMed Central

Arlotto, Philippe; Grimaldi, Michel; Naeck, Roomila; Ginoux, Jean-Marc

2014-01-01

The monitoring of human breathing activity during a long period has multiple fundamental applications in medicine. In breathing sleep disorders such as apnea, the diagnosis is based on events during which the person stops breathing for several periods during sleep. In polysomnography, the standard for sleep disordered breathing analysis, chest movement and airflow are used to monitor the respiratory activity. However, this method has serious drawbacks. Indeed, as the subject should sleep overnight in a laboratory and because of sensors being in direct contact with him, artifacts modifying sleep quality are often observed. This work investigates an analysis of the viability of an ultrasonic device to quantify the breathing activity, without contact and without any perception by the subject. Based on a low power ultrasonic active source and transducer, the device measures the frequency shift produced by the velocity difference between the exhaled air flow and the ambient environment, i.e., the Doppler effect. After acquisition and digitization, a specific signal processing is applied to separate the effects of breath from those due to subject movements from the Doppler signal. The distance between the source and the sensor, about 50 cm, and the use of ultrasound frequency well above audible frequencies, 40 kHz, allow monitoring the breathing activity without any perception by the subject, and therefore without any modification of the sleep quality which is very important for sleep disorders diagnostic applications. This work is patented (patent pending 2013-7-31 number FR.13/57569). PMID:25140632

Comparison and reproducibility of ADC measurements in breathhold, respiratory triggered, and free-breathing diffusion-weighted MR imaging of the liver.

PubMed

Kwee, Thomas C; Takahara, Taro; Koh, Dow-Mu; Nievelstein, Rutger A J; Luijten, Peter R

2008-11-01

To compare and determine the reproducibility of apparent diffusion coefficient (ADC) measurements of the normal liver parenchyma in breathhold, respiratory triggered, and free-breathing diffusion-weighted magnetic resonance imaging (DWI). Eleven healthy volunteers underwent three series of DWI. Each DWI series consisted of one breathhold, one respiratory triggered, and two free-breathing (thick and thin slice acquisition) scans of the liver, at b-values of 0 and 500 s/mm2. ADCs of the liver parenchyma were compared by using nonparametric tests. Reproducibility was assessed by the Bland-Altman method. Mean ADCs (in 10(-3) mm2/sec) in respiratory triggered DWI (2.07-2.27) were significantly higher than mean ADCs in breathhold DWI (1.57-1.62), thick slice free-breathing DWI (1.62-1.65), and thin slice free-breathing DWI (1.57-1.66) (P<0.005). Ranges of mean difference in ADC measurement+/-limits of agreement between two scans were -0.02-0.05+/-0.16-0.24 in breathhold DWI, -0.14-0.20+/-0.59-0.60 in respiratory triggered DWI, -0.03-0.03+/-0.20-0.29 in thick slice free-breathing DWI, and -0.01-0.09+/-0.21-0.29 in thin slice free-breathing DWI. ADC measurements of the normal liver parenchyma in respiratory triggered DWI are significantly higher and less reproducible than in breathhold and free-breathing DWI. Copyright (c) 2008 Wiley-Liss, Inc.

A method of reconstruction of clinical gas-analyzer signals corrupted by positive-pressure ventilation.

PubMed

Farmery, A D; Hahn, C E

2001-04-01

The use of sidestream infrared and paramagnetic clinical gas analyzers is widespread in anesthesiology and respiratory medicine. For most clinical applications, these instruments are entirely satisfactory. However, their ability to measure breath-by-breath volumetric gas fluxes, as required for measurement of airway dead space, oxygen uptake, and so on, is usually inferior to that of the mass spectrometer, and this is thought to be due, in part, to their slower response times. We describe how volumetric gas analysis with the Datex Ultima analyzer, although reasonably accurate for spontaneous ventilation, gives very inaccurate results in conditions of positive-pressure ventilation. We show that this problem is a property of the gas sampling system rather than the technique of gas analysis itself. We examine the source of this error and describe how cyclic changes in airway pressure result in variations in the flow rate of the gas within the sampling catheter. This results in the phenomenon of "time distortion," and the resultant gas concentration signal becomes a nonlinear time series. This corrupted signal cannot be aligned or integrated with the measured flow signal. We describe a method to correct for this effect. With the use of this method, measurements required for breath-by-breath gas-exchange models can be made easily and reliably in the clinical setting.

A simple, remote, video based breathing monitor.

PubMed

Regev, Nir; Wulich, Dov

2017-07-01

Breathing monitors have become the all-important cornerstone of a wide variety of commercial and personal safety applications, ranging from elderly care to baby monitoring. Many such monitors exist in the market, some, with vital signs monitoring capabilities, but none remote. This paper presents a simple, yet efficient, real time method of extracting the subject's breathing sinus rhythm. Points of interest are detected on the subject's body, and the corresponding optical flow is estimated and tracked using the well known Lucas-Kanade algorithm on a frame by frame basis. A generalized likelihood ratio test is then utilized on each of the many interest points to detect which is moving in harmonic fashion. Finally, a spectral estimation algorithm based on Pisarenko harmonic decomposition tracks the harmonic frequency in real time, and a fusion maximum likelihood algorithm optimally estimates the breathing rate using all points considered. The results show a maximal error of 1 BPM between the true breathing rate and the algorithm's calculated rate, based on experiments on two babies and three adults.

Nutritional status, fecal elastase-1, and 13C-labeled mixed triglyceride breath test in the long-term after pancreaticoduodenectomy.

PubMed

Muniz, Cinara Knychala; dos Santos, José Sebastião; Pfrimer, Karina; Ferrioli, Eduardo; Kemp, Rafael; Marchini, Júlio Sérgio; Cunha, Selma Freire

2014-04-01

This study aimed to compare the body composition, dietary intake and serum levels of vitamins and minerals, and exocrine pancreatic function in patients late after pancreaticoduodenectomy (PD) and healthy subjects. Fifteen patients (PD group) who had undergone PD over 1 year before the study and 15 health volunteers (control group) were included in the study. All volunteers underwent dietary intake evaluation, body composition, laboratory data, exocrine pancreatic function by elastase-1, and carbon (C )-labeled triglycerides in breath tests. The PD group subjects also underwent upper gastrointestinal endoscopy and small intestinal bacterial overgrowth analysis. Nutrient intake was adequate, and there were no differences in body mass index and mineral serum levels between the groups. The PD group showed lower serum levels of retinol, α-tocopherol, and ascorbic acid. Small intestinal bacterial overgrowth occurred in 39% of the patients. Fecal elastase-1 was lower in the PD group. The PD group had a higher C peak time; the cumulative label C recovery in 7 hours was similar in both groups. Fecal elastase-1 decreased, and the excretion of C in breath was similar to healthy controls. Although the data point toward an adaptation in the absorptive capacity of fats, A, C, and E hypovitaminosis indicate that some absorptive insufficiency persists late after PD.

Short-term effect of volume recruitment-derecruitment manoeuvre on chest-wall motion in Duchenne muscular dystrophy.

PubMed

Meric, Henri; Falaize, Line; Pradon, Didier; Lacombe, Matthieu; Petitjean, Michel; Orlikowski, David; Prigent, Hélène; Lofaso, Frédéric

2017-05-01

Because progressive respiratory muscle weakness leads to decreased chest-wall motion with eventual ribcage stiffening, the purpose was to compare vital capacity (VC) and contributions of chest-wall compartments before and after volume recruitment-derecruitment manoeuvres (VRDM) in Duchenne muscular dystrophy (DMD). We studied nine patients with DMD and VC lower than 30% of predicted. VRDM was performed using 15 insufflations-exsufflations of +30 to -30 cmH 2 O. VC and three-dimensional chest-wall motion were measured, as well as oxygen saturation, transcutaneous partial pressure of carbon dioxide and the rapid shallow breathing index (respiratory rate/tidal volume) before (baseline) and immediately and 1 hour after VRDM. VC increased significantly immediately after VRDM (108% ± 7% of baseline, p = 0.018) but returned to baseline within 1 hour, and the rapid shallow breathing index increased significantly. The non-dominant side systematically increased immediately after VRDM ( p = 0.0077), and in the six patients with abnormal breathing asymmetry (difference >10% of VC) at baseline, this asymmetry was corrected immediately and/or 1 hour after VRDM. VRDM improved VC and reduced chest-wall motion asymmetry, but this beneficial effect waned rapidly with respiratory muscle fatigue, suggesting that VRDM may need to be repeated during the day to produce lasting benefits.

Effects of Incentive Spirometry on Respiratory Motion in Healthy Subjects Using Cine Breathing Magnetic Resonance Imaging.

PubMed

Kotani, Toshiaki; Akazawa, Tsutomu; Sakuma, Tsuyoshi; Nagaya, Shigeyuki; Sonoda, Masaru; Tanaka, Yuji; Katogi, Takehide; Nemoto, Tetsuharu; Minami, Shohei

2015-06-01

To investigate the effectiveness of incentive spirometry on respiratory motion in healthy subjects using cine breathing magnetic resonance imaging (MRI). Ten non-smoking healthy subjects without any history of respiratory disease were studied. Subjects were asked to perform pulmonary training using incentive spirometry every day for two weeks. To assess the effectiveness of this training, pulmonary function tests and cine breathing MRI were performed before starting pulmonary training and two weeks after its completion. After training, there were significant improvements in vital capacity (VC) from 3.58±0.8 L to 3.74±0.8 L and in %VC from 107.4±10.8 to 112.1±8.2. Significant changes were observed in the right diaphragm motion, right chest wall motion, and left chest wall motion, which were increased from 55.7±9.6 mm to 63.4±10.2 mm, from 15.6±6.1 mm to 23.4±10.4 mm, and from 16.3±7.6 mm to 22.0±9.8 mm, respectively. Two weeks of training using incentive spirometry provided improvements in pulmonary function and respiratory motion, which suggested that incentive spirometry may be a useful preoperative modality for improving pulmonary function during the perioperative period.

Incentive spirometry for preventing pulmonary complications after coronary artery bypass graft.

PubMed

Freitas, Eliane R F S; Soares, Bernardo G O; Cardoso, Jefferson R; Atallah, Álvaro N

2012-09-12

Incentive spirometry (IS) is a treatment technique that uses a mechanical device to reduce pulmonary complications during postoperative care. This is an update of a Cochrane review first published in 2007. Update the previously published systematic review to compare the effects of IS for preventing postoperative pulmonary complications in adults undergoing coronary artery bypass graft (CABG). We searched CENTRAL and DARE on The Cochrane Library (Issue 2 of 4 2011), MEDLINE OVID (1948 to May 2011), EMBASE (1980 to Week 20 2011), LILACS (1982 to July 2011) , the Physiotherapy Evidence Database (PEDro) (1980 to July 2011), Allied & Complementary Medicine (AMED) (1985 to May 2011), CINAHL (1982 to May 2011). Randomised controlled trials comparing IS with any type of prophylactic physiotherapy for prevention of postoperative pulmonary complications in adults undergoing CABG. Two reviewers independently evaluated trial quality using the guidelines of the Cochrane Handbook for Systematic Reviews and extracted data from included trials. For continuous outcomes, we used the generic inverse variance method for meta-analysis and for dichotomous data we used the Peto Odds Ratio. This update included 592 participants from seven studies (two new and one that had been excluded in the previous review in 2007. There was no evidence of a difference between groups in the incidence of any pulmonary complications and functional capacity between treatment with IS and treatment with physical therapy, positive pressure breathing techniques (including continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP) and intermittent positive pressure breathing (IPPB), active cycle of breathing techniques (ACBT) or preoperative patient education. Patients treated with IS had worse pulmonary function and arterial oxygenation compared with positive pressure breathing. Based on these studies there was no improvement in the muscle strength between groups who received IS demonstrated by maximal inspiratory pressure and maximal expiratory pressure . Our update review suggests there is no evidence of benefit from IS in reducing pulmonary complications and in decreasing the negative effects on pulmonary function in patients undergoing CABG. In view of the modest number of patients studied, methodological shortcomings and poor reporting of the included trials, these results should still be interpreted cautiously. An appropriately powered trial of high methodological rigour is needed to determine if there are patients who may derive benefit from IS following CABG.

Lung cancer detection by proton transfer reaction mass-spectrometric analysis of human breath gas

NASA Astrophysics Data System (ADS)

Wehinger, Andreas; Schmid, Alex; Mechtcheriakov, Sergei; Ledochowski, Maximilian; Grabmer, Christoph; Gastl, Guenther A.; Amann, Anton

2007-08-01

Background Determination of the diagnostic usefulness of proton transfer reaction mass spectrometry (PTR-MS) for detecting primary lung cancer through analysis of volatile organic compounds (VOCs) in exhaled human breath was demonstrated in this investigation. Unlike, for example, gas-chromatographic analyses, PTR-MS can be used without time-consuming preconcentration of the gas samples.Methods By means of PTR-MS, exhaled breath samples from primary lung cancer patients (n = 17) were analyzed and compared with both an overall control collective (controls total, n = 170) and three sub-collectives: hospital personnel (controls hospital, n = 35), age-matched persons (controls age, n = 25), and smokers (controls s, n = 60), respectively.Results Among the VOCs present at reasonably high concentrations, the ones leading to the product ion at m/z = 31 (VOC-31, tentatively protonated formaldehyde) and m/z = 43 (VOC-43, tentatively a fragment of protonated iso-propanol), were found at significantly higher concentrations in the breath gas of the primary lung cancer patients as compared to the healthy controls at the following median concentrations (with interquartile distance, iqr): For VOC-31 the median concentrations were 7.0 ppb (iqr, 15.5 ppb) versus 3.0 ppb (iqr, 1.9 ppb) with P < 10-4. For VOC-43 the median concentrations were 244.1 ppb (iqr, 236.2 ppb) versus 94.1 ppb (iqr, 55.2 ppb) with P < 10-6. The discriminative power between the two collectives was further assessed by ROC-curves obtained upon variation of the chosen threshold concentration and by Fisher's Quadratic Discriminant Method.Conclusions Within the limits of pilot study, VOC-31 and -43 were found to best discriminate between exhaled breath of primary lung cancer cases and healthy controls. Simple and time-saving breath gas analysis by PTR-MS makes this method attractive for a larger clinical evaluation. It may become a new valuable tool for diagnosing primary lung cancer.

Breath-holding times in various phases of respiration and effect of respiratory training in lung cancer patients.

PubMed

Tibdewal, Anil; Munshi, Anusheel; Pathak, Rima; Misra, Shagun; Daptardar, Anuradha; Singh, Vincent; Agarwal, Jai Prakash

2015-08-01

Breath-holding (BH) technique is used for reducing the intrafraction-tumour motion in mobile lung tumours treated with radiotherapy (RT). There is paucity of literature evaluating differences in BH times in various phases of respiration in patients with lung cancer. One hundred consecutive patients with lung cancer planned for radical RT/chemoradiation were accrued in the study. Eighty-seven patients were eligible for analysis at RT conclusion. Baseline pulmonary function test (PFT) were performed in all patients, and respiratory training was given from the day of RT planning. Deep inspiration breath hold (DIBH), deep expiration breath hold (DEBH) and mid-ventilation breath hold (MVBH) were recorded manually with a stopwatch for each patient at four time points (RT planning/baseline, RT starting, during RT and RT conclusion). Median DIBH times at RT planning, RT starting, during RT and RT conclusion were 21.2, 20.6, 20.1 and 21.1 s, respectively. The corresponding median DEBH and MVBH times were 16.3, 18.2, 18.3, 18.5 s and 19.9, 20.5, 21.3, 22.1 s, respectively. Respiratory training increased MVBH time at RT conclusion compared to baseline, which was statistically significant (19.9-22.1 s, P = 0.002). DIBH or DEBH times were stable at various time points with neither a significant improvement nor decline. Among various patient and tumour factors Forced Vital Capacity pre-bronchodilation (FVCpre ) was the only factor that consistently predicted DIBH, DEBH and MVBH at all four time points with P value <0.05. BH was well tolerated by most lung cancer patients with minimum median BH time of at least 16 s in any of the three phases of respiration. Respiratory training improved MVBH time while consistently maintaining DIBH and DEBH times throughout the course of radiotherapy. © 2015 The Royal Australian and New Zealand College of Radiologists.

Bench experiments comparing simulated inspiratory effort when breathing helium-oxygen mixtures to that during positive pressure support with air

PubMed Central

2012-01-01

Background Inhalation of helium-oxygen (He/O2) mixtures has been explored as a means to lower the work of breathing of patients with obstructive lung disease. Non-invasive ventilation (NIV) with positive pressure support is also used for this purpose. The bench experiments presented herein were conducted in order to compare simulated patient inspiratory effort breathing He/O2 with that breathing medical air, with or without pressure support, across a range of adult, obstructive disease patterns. Methods Patient breathing was simulated using a dual-chamber mechanical test lung, with the breathing compartment connected to an ICU ventilator operated in NIV mode with medical air or He/O2 (78/22 or 65/35%). Parabolic or linear resistances were inserted at the inlet to the breathing chamber. Breathing chamber compliance was also varied. The inspiratory effort was assessed for the different gas mixtures, for three breathing patterns, with zero pressure support (simulating unassisted spontaneous breathing), and with varying levels of pressure support. Results Inspiratory effort increased with increasing resistance and decreasing compliance. At a fixed resistance and compliance, inspiratory effort increased with increasing minute ventilation, and decreased with increasing pressure support. For parabolic resistors, inspiratory effort was lower for He/O2 mixtures than for air, whereas little difference was measured for nominally linear resistance. Relatively small differences in inspiratory effort were measured between the two He/O2 mixtures. Used in combination, reductions in inspiratory effort provided by He/O2 and pressure support were additive. Conclusions The reduction in inspiratory effort afforded by breathing He/O2 is strongly dependent on the severity and type of airway obstruction. Varying helium concentration between 78% and 65% has small impact on inspiratory effort, while combining He/O2 with pressure support provides an additive reduction in inspiratory effort. In addition, breathing He/O2 alone may provide an alternative to pressure support in circumstances where NIV is not available or poorly tolerated. PMID:23031537

Breath air measurement using wide-band frequency tuning IR laser photo-acoustic spectroscopy

NASA Astrophysics Data System (ADS)

Kistenev, Yury V.; Borisov, Alexey V.; Kuzmin, Dmitry A.; Bulanova, Anna A.; Boyko, Andrey A.; Kostyukova, Nadezhda Y.; Karapuzikov, Alexey A.

2016-03-01

The results of measuring of biomarkers in breath air of patients with broncho-pulmonary diseases using wide-band frequency tuning IR laser photo-acoustic spectroscopy and the methods of data mining are presented. We will discuss experimental equipment and various methods of intellectual analysis of the experimental spectra in context of above task. The work was carried out with partial financial support of the FCPIR contract No 14.578.21.0082 (ID RFMEFI57814X0082).

[Analysis of breath hydrogen (H2) in diagnosis of gastrointestinal function: validation of a pocket breath H2 test analyzer].

PubMed

Braden, B; Braden, C P; Klutz, M; Lembcke, B

1993-04-01

Breath hydrogen (H2) analysis, as used in gastroenterologic function tests, requires a stationary analysis system equipped with a gaschromatograph or an electrochemical sensor cell. Now a portable breath H2-analyzer has been miniaturized to pocket size (104 mm x 62 mm x 29 mm). The application of this device in clinical practice has been assessed in comparison to the standard GMI-exhaled monitor. The pocket analyzer showed a linear response to standards with H2-concentrations ranging from 0-100 ppm (n = 7), which was not different from the GMI-apparatus. The correlation of both methods during clinical application (lactose tolerance tests, mouth-to-coecum transit time determined with lactulose) was excellent (Y = 1.08 X + 0.96; r = 0.959). Using the new device, both, analysis (3 s vs. 90 s) and the reset-time (43 s vs. 140 s) were shorter whereas calibration was more feasible with the GMI-apparatus. It is concluded, that the considerably cheaper pocket-sized breath H2-analyzer is as precise and sensitive as the GMI-exhaled monitor, and thus presents a valid alternative for H2-breath tests.

Determination of volatile organic compounds in human breath for Helicobacter pylori detection by SPME-GC/MS.

PubMed

Ulanowska, Agnieszka; Kowalkowski, Tomasz; Hrynkiewicz, Katarzyna; Jackowski, Marek; Buszewski, Bogusław

2011-03-01

Helicobacter pylori living in the human stomach release volatile organic compounds (VOCs) that can be detected in expired air. The aim of the study was the application of breath analysis for bacteria detection. It was accomplished by determination of VOCs characteristic for patients with H. pylori and the analysis of gases released by bacteria in suspension. Solid-phase microextraction was applied as a selective technique for preconcentration and isolation of analytes. Gas chromatography coupled with mass spectrometry was used for the separation and identification of volatile analytes in breath samples and bacterial headspace. For data calculation and processing, discriminant and factor analyses were used. Endogenous substances such as isobutane, 2-butanone and ethyl acetate were detected in the breath of persons with H. pylori in the stomach and in the gaseous mixture released by the bacteria strain but they were not identified in the breath of healthy volunteers. The canonical analysis of discrimination functions showed a strong difference between the three examined groups. Knowledge of substances emitted by H. pylori with the application of an optimized breath analysis method might become a very useful tool for noninvasive detection of this bacterium. Copyright © 2010 John Wiley & Sons, Ltd.

Removing respiratory artefacts from transthoracic bioimpedance spectroscopy measurements

NASA Astrophysics Data System (ADS)

Cuba-Gyllensten, I.; Abtahi, F.; Bonomi, A. G.; Lindecrantz, K.; Seoane, F.; Amft, O.

2013-04-01

Transthoracic impedance spectroscopy (TIS) measurements from wearable textile electrodes provide a tool to remotely and non-invasively monitor patient health. However, breathing and cardiac processes inevitably affect TIS measurements, since they are sensitive to changes in geometry and air or fluid volumes in the thorax. This study aimed at investigating the effect of respiration on Cole parameters extracted from TIS measurements and developing a method to suppress artifacts. TIS data were collected from 10 participants at 16 frequencies (range: 10 kHz - 1 MHz) using a textile electrode system (Philips Technologie Gmbh). Simultaneously, breathing volumes and frequency were logged using an electronic spirometer augmented with data from a breathing belt. The effect of respiration on TIS measurements was studied at paced (10 and 16 bpm) deep and shallow breathing. These measurements were repeated for each subject in three different postures (lying down, reclining and sitting). Cole parameter estimation was improved by assessing the tidal expiration point thus removing breathing artifacts. This leads to lower intra-subject variability between sessions and a need for less measurements points to accurately assess the spectra. Future work should explore algorithmic artifacts compensation models using breathing and posture or patient contextual information to improve ambulatory transthoracic impedance measurements.

Comprehensive integrated spirometry using raised volume passive and forced expirations and multiple-breath nitrogen washout in infants.

PubMed

Morris, Mohy G

2010-02-28

With the rapid somatic growth and development in infants, simultaneous accurate measurements of lung volume and airway function are essential. Raised volume rapid thoracoabdominal compression (RTC) is widely used to generate forced expiration from an airway opening pressure of 30 cmH(2)O (V(30)). The (dynamic) functional residual capacity (FRC(dyn)) remains the lung volume most routinely measured. The aim of this study was to develop comprehensive integrated spirometry that included all subdivisions of lung volume at V(30) or total lung capacity (TLC(30)). Measurements were performed on 17 healthy infants aged 8.6-119.7 weeks. A commercial system for multiple-breath nitrogen washout (MBNW) to measure lung volumes and a custom made system to perform RTC were used in unison. A refined automated raised volume RTC and the following two novel single maneuvers with dual volume measurements were performed from V(30) during a brief post-hyperventilation apneic pause: (1) the passive expiratory flow was integrated to produce the inspiratory capacity (IC) and the static (passive) FRC (FRC(st)) was estimated by initiating MBNW after end-passive expiration; (2) RTC was initiated late during passive expiration, flow was integrated to produce the slow vital capacity ((j)SVC) and the residual volume (RV) was measured by initiating MBNW after end-expiration while the jacket (j) was inflated. Intrasubject FRC(dyn) and FRC(st) measurements overlapped (p=0.6420) but neither did with the RV (p<0.0001). Means (95% confidence interval) of FRC(dyn), IC, FRC(st), (j)SVC, RV, forced vital capacity and tidal volume were 21.2 (19.7-22.7), 36.7 (33.0-40.4), 21.2 (19.6-22.8), 40.7 (37.2-44.2), 18.1 (16.6-19.7), 40.7 (37.1-44.2) and 10.2 (9.6-10.7)ml/kg, respectively. Static lung volumes and capacities at V(30) and variables from the best forced expiratory flow-volume curve were dependent on age, body length and weight. In conclusion, we developed a comprehensive physiologically integrated approach for in-depth investigation of lung function at V(30) in infants. Copyright 2009 Elsevier B.V. All rights reserved.

Detection of bronchial breathing caused by pneumonia.

PubMed

Gross, V; Fachinger, P; Penzel, Th; Koehler, U; von Wichert, P; Vogelmeier, C

2002-06-01

The classic auscultation with stethoscope is the established clinical method for the detection of lung diseases. The interpretation of the sounds depends on the experience of the investigating physician. Therefore, a new computer-based method has been developed to classify breath sounds from digital lung sound recordings. Lung sounds of 11 patients with one-sided pneumonia and bronchial breathing were recorded on both the pneumonia side and on contralateral healthy side simultaneously using two microphones. The spectral power for the 300-600 Hz frequency band was computed for four respiratory cycles and normalized. For each breath, the ratio R between the time-segments (duration = 0.1 s) with the highest inspiratory and highest expiratory flow was calculated and averaged. We found significant differences in R between the pneumonia side (R = 1.4 +/- 1.3) and the healthy side (R = 0.5 +/- 0.5; p = 0.003 Wilcoxon-test) of lung. In 218 healthy volunteers we found R = 0.3 +/- 0.2 as a reference-value. The differences of ratio R (delta R) between the pneumonia side and the healthy side (delta R = 1.0 +/- 0.9) were significantly higher compared to follow-up studies after recovery (delta R = 0.0 +/- 0.1, p = 0.005 Wilcoxon-test). The computer based detection of bronchial breathing can be considered useful as part of a quantitative monitoring of patients at risk to develop pneumonia.

Exploring the Waveform Characteristics of Tidal Breathing Carbon Dioxide, Measured Using the N-Tidal C Device in Different Breathing Conditions (The General Breathing Record Study): Protocol for an Observational, Longitudinal Study

PubMed Central

Rupani, Hitasha; Kalra, Paul R; Adeniji, Kayode; Quint, Matthew; De Vos, Ruth; Begum, Selina; Mottershaw, Mark; Fogg, Carole; Jones, Thomas L; Lanning, Eleanor; Bassett, Paul; Chauhan, Anoop J

2018-01-01

Background In an increasingly comorbid population, there are significant challenges to diagnosing the cause of breathlessness, and once diagnosed, considerable difficulty in detecting deterioration early enough to provide effective intervention. The burden of the breathless patient on the health care economy is substantial, with asthma, chronic heart failure, and pneumonia affecting over 6 million people in the United Kingdom alone. Furthermore, these patients often have more than one contributory factor to their breathlessness symptoms, with conditions such as dysfunctional breathing pattern disorders—an under-recognized component. Current methods of diagnosing and monitoring breathless conditions can be extensive and difficult to perform. As a consequence, home monitoring is poorly complied with. In contrast, capnography (the measurement of tidal breath carbon dioxide) is performed during normal breathing. There is a need for a simple, easy-to-use, personal device that can aid in the diagnosis and monitoring of respiratory and cardiac causes of breathlessness. Objective The aim of this study was to explore the use of a new, handheld capnometer (called the N-Tidal C) in different conditions that cause breathlessness. We will study whether the tidal breath carbon dioxide (TBCO2) waveform, as measured by the N-Tidal C, has different characteristics in a range of respiratory and cardiac conditions. Methods We will perform a longitudinal, observational study of the TBCO2 waveform (capnogram) as measured by the N-Tidal C capnometer. Participants with a confirmed diagnosis of asthma, breathing pattern disorders, chronic heart failure, motor neurone disease, pneumonia, as well as volunteers with no history of lung disease will be asked to provide twice daily, 75-second TBCO2 collection via the N-Tidal C device for 6 months duration. The collated capnograms will be correlated with the underlying diagnosis and disease state (stable or exacerbation) to determine if there are different TBCO2 characteristics that can distinguish different respiratory and cardiac causes of breathlessness. Results This study’s recruitment is ongoing. It is anticipated that the results will be available in late 2018. Conclusions The General Breathing Record Study will provide an evaluation of the use of capnography as a diagnostic and home-monitoring tool for various diseases. Registered Report Identifier RR1-10.2196/9767 PMID:29798833

TH-CD-202-09: Free-Breathing Proton MRI Functional Lung Avoidance Maps to Guide Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Capaldi, D; Sheikh, K; Parraga, G

Purpose: Pulmonary functional MRI using inhaled gas contrast agents was previously investigated as a way to identify well-functioning lung in patients with NSCLC who are clinical candidates for radiotherapy. Hyperpolarized noble-gas ({sup 3}He and {sup 129}Xe) MRI has also been optimized to measure functional lung information, but for a number of reasons, the clinical translation of this approach to guide radiotherapy planning has been limited. As an alternative, free-breathing pulmonary 1H MRI using clinically available MRI systems and pulse sequences provides a non-contrast-enhanced method to generate both ventilation and perfusion maps. Free-breathing {sup 1}H MRI exploits non-rigid registration and Fouriermore » decomposition of MRI signal intensity differences (Bauman et al., MRM, 2009) that may be generated during normal tidal breathing. Here, our objective was to generate free-breathing {sup 1}H MRI ventilation and lung function avoidance maps in patients with NSCLC as a way to guide radiation therapy planning. Methods: Stage IIIA/IIIB NSCLC patients (n=8, 68±9yr) provided written informed consent to a randomized controlled clinical trial ( https://clinicaltrials.gov/ct2/show/NCT02002052 ) that aimed to compare outcomes related to image-guided versus conventional radiation therapy planning. Hyperpolarized {sup 3}He/{sup 129}Xe and dynamic free tidal-breathing {sup 1}H MRI were acquired as previously described (Capaldi et al., Acad Radiol, 2015). Non-rigid registration was performed using the modality-independent-neighbourhood-descriptor (MIND) deformable approach (Heinrich et al., Med Image Anal, 2012). Ventilation-defect-percent ({sup 3}He:VDP{sub He}, {sup 129}Xe:VDP{sub Xe}, Free-breathing-{sup 1}H:VDP{sub FB}) and the corresponding ventilation maps were compared using Pearson correlation coefficients (r) and the Dice similarity coefficient (DSC). Results: VDP{sub FB} was significantly related to VDP{sub He} (r=.71; p=.04) and VDP{sub Xe} (r=.80; p=.01) and there were also strong spatial relationships (DSC{sub He}/DSC{sub Xe}=89±3%/77±11%). Conclusion: In this proof of concept study in NSCLC patients, free-breathing {sup 1}H MRI ventilation defects were quantitatively and spatially related to inhaled-noble-gas MRI ventilation defects. Free-breathing {sup 1}H MRI measures lung function/ventilation that can be used to optimize radiotherapy planning in NSCLC patients.« less

An Electrochemical Gas Biosensor Based on Enzymes Immobilized on Chromatography Paper for Ethanol Vapor Detection.

PubMed

Kuretake, Tatsumi; Kawahara, Shogo; Motooka, Masanobu; Uno, Shigeyasu

2017-02-01

This paper presents a novel method of fabricating an enzymatic biosensor for breath analysis using chromatography paper as enzyme supporting layer and a liquid phase layer on top of screen printed carbon electrodes. We evaluated the performance with ethanol vapor being one of the breathing ingredients. The experimental results show that our sensor is able to measure the concentration of ethanol vapor within the range of 50 to 500 ppm. These results suggest the ability of detecting breath ethanol, and it can possibly be applied as a generic vapor biosensor to a wide range of diseases.

Off-axis integrated cavity output spectroscopy with a mid-infrared interband cascade laser for real-time breath ethane measurements.

PubMed

Parameswaran, Krishnan R; Rosen, David I; Allen, Mark G; Ganz, Alan M; Risby, Terence H

2009-02-01

Cavity-enhanced tunable diode laser absorption spectroscopy is an attractive method for measuring small concentrations of gaseous species. Ethane is a breath biomarker of lipid peroxidation initiated by reactive oxygen species. A noninvasive means of quickly quantifying oxidative stress status has the potential for broad clinical application. We present a simple, compact system using off-axis integrated cavity output spectroscopy with an interband cascade laser and demonstrate its use in real-time measurements of breath ethane. We demonstrate a detection sensitivity of 0.48 ppb/Hz(1/2).

Effect of physical therapy scoliosis specific exercises using breathing pattern on adolescent idiopathic scoliosis.

PubMed

Yoon, Sungyoung; Rhee, Min-Hyung

2016-11-01

[Purpose] This study was performed to confirm physical therapy scoliosis specific exercises on adolescent idiopathic scoliosis patients. [Subject and Methods] A 15-year-old male middle school student with scoliosis. Cobb's angle, angle of rotation of the spine, and breathing pattern were measured before and after 8 weeks training. [Results] After 8 weeks training, Cobb's angle, angle of rotation of the spine, and breathing pattern were improved better. [Conclusion] These results indicate that physical therapy scoliosis specific exercises improves scoliosis curves and could provide an effective intervention and management of scoliosis.

Diagnosis of acute respiratory distress syndrome by exhaled breath analysis

PubMed Central

2018-01-01

The acute respiratory distress syndrome (ARDS) is a complication of critical illness that is characterized by acute onset, protein rich, pulmonary edema. There is no treatment for ARDS, other than the reduction of additional ventilator induced lung injury. Prediction or earlier recognition of ARDS could result in preventive measurements and might decrease mortality and morbidity. Exhaled breath contains volatile organic compounds (VOCs), a collection of hundreds of small molecules linked to several physiological and pathophysiological processes. Analysis of exhaled breath through gas-chromatography and mass-spectrometry (GC-MS) has resulted in an accurate diagnosis of ARDS in several studies. Most identified markers are linked to lipid peroxidation. Octane is one of the few markers that was validated as a marker of ARDS and is pathophysiologically likely to be increased in ARDS. None of the currently studied breath analysis methods is directly applicable in clinical practice. Two steps have to be taken before any breath test can be allowed into the intensive care unit. External validation in a multi-center study is a prerequisite for any of the candidate breath markers and the breath test should outperform clinical prediction scores. Second, the technology for breath analysis should be adapted so that it is available at a decentralized lab inside the intensive care unit and can be operated by trained nurses, in order to reduce the analysis time. In conclusion, exhaled analysis might be used for the early diagnosis and prediction of ARDS in the near future but several obstacles have to be taken in the coming years. Most of the candidate markers can be linked to lipid peroxidation. Only octane has been validated in a temporal external validation cohort and is, at this moment, the top-ranking breath biomarker for ARDS. PMID:29430450

Photoplethysmography as a single source for analysis of sleep-disordered breathing in patients with severe cardiovascular disease.

PubMed

Amir, Offer; Barak-Shinar, Deganit; Henry, Antonietta; Smart, Frank W

2012-02-01

Sleep-disordered breathing and Cheyne-Stokes breathing are often not diagnosed, especially in cardiovascular patients. An automated system based on photoplethysmographic signals might provide a convenient screening and diagnostic solution for patient evaluation at home or in an ambulatory setting. We compared event detection and classification obtained by full polysomnography (the 'gold standard') and by an automated new algorithm system in 74 subjects. Each subject underwent overnight polysomnography, 60 in a hospital cardiology department and 14 while being tested for suspected sleep-disordered breathing in a sleep laboratory. The sleep-disordered breathing and Cheyne-Stokes breathing parameters measured by a new automated algorithm system correlated very well with the corresponding results obtained by full polysomnography. The sensitivity of the Cheyne-Stokes breathing detected from the system compared to full polysomnography was 92% [95% confidence interval (CI): 78.6-98.3%] and specificity 94% (95% CI: 81.3-99.3%). Comparison of the Apnea Hyponea Index with a cutoff level of 15 shows a sensitivity of 98% (95% CI: 87.1-99.6%) and specificity of 96% (95% CI: 79.8-99.3%). The detection of respiratory events showed agreement of approximately 80%. Regression and Bland-Altman plots revealed good agreement between the two methods. Relative to gold-standard polysomnography, the simply used automated system in this study yielded an acceptable analysis of sleep- and/or cardiac-related breathing disorders. Accordingly, and given the convenience and simplicity of its application, this system can be considered as a suitable platform for home and ambulatory screening and diagnosis of sleep-disordered breathing in patients with cardiovascular disease. © 2011 European Sleep Research Society.

Unloading work of breathing during high-frequency oscillatory ventilation: a bench study

PubMed Central

van Heerde, Marc; Roubik, Karel; Kopelent, Vitek; Plötz, Frans B; Markhorst, Dick G

2006-01-01

Introduction With the 3100B high-frequency oscillatory ventilator (SensorMedics, Yorba Linda, CA, USA), patients' spontaneous breathing efforts result in a high level of imposed work of breathing (WOB). Therefore, spontaneous breathing often has to be suppressed during high-frequency oscillatory ventilation (HFOV). A demand-flow system was designed to reduce imposed WOB. Methods An external gas flow controller (demand-flow system) accommodates the ventilator fresh gas flow during spontaneous breathing simulation. A control algorithm detects breathing effort and regulates the demand-flow valve. The effectiveness of this system has been evaluated in a bench test. The Campbell diagram and pressure time product (PTP) are used to quantify the imposed workload. Results Using the demand-flow system, imposed WOB is considerably reduced. The demand-flow system reduces inspiratory imposed WOB by 30% to 56% and inspiratory imposed PTP by 38% to 59% compared to continuous fresh gas flow. Expiratory imposed WOB was decreased as well by 12% to 49%. In simulations of shallow to normal breathing for an adult, imposed WOB is 0.5 J l-1 at maximum. Fluctuations in mean airway pressure on account of spontaneous breathing are markedly reduced. Conclusion The use of the demand-flow system during HFOV results in a reduction of both imposed WOB and fluctuation in mean airway pressure. The level of imposed WOB was reduced to the physiological range of WOB. Potentially, this makes maintenance of spontaneous breathing during HFOV possible and easier in a clinical setting. Early initiation of HFOV seems more possible with this system and the possibility of weaning of patients directly on a high-frequency oscillatory ventilator is not excluded either. PMID:16848915

Imposed Work of Breathing for Flow Meters with In-Line versus Flow-Through Technique during Simulated Neonatal Breathing

PubMed Central

2015-01-01

Background The ability to determine airflow during nasal CPAP (NCPAP) treatment without adding dead space or resistance would be useful when investigating the physiologic effects of different NCPAP systems on breathing. The aim of this study was to investigate the effect on pressure stability of different flow measuring devices at the in-line and flow-through position, using simulated neonatal breathing. Methods Six different flow measure devices were evaluated by recording pressure changes and imposed work of breathing for breaths with 16 and 32 ml tidal volumes. The tests were performed initially with the devices in an in line position and with 5 and 10 L/min using flow through technique, without CPAP. The flow meters were then subsequently tested with an Infant Flow CPAP system at 3, 5 and 8 cm H2O pressure using flow through technique. The quality of the recorded signals was compared graphically. Results The resistance of the measuring devices generated pressure swings and imposed work of breathing. With bias flow, the resistance also generated CPAP pressure. Three of the devices had low resistance and generated no changes in pressure stability or CPAP pressure. The two devices intended for neonatal use had the highest measured resistance. Conclusion The importance of pressure stability and increased work of breathing during non-invasive respiratory support are insufficiently studied. Clinical trials using flow-through technique have not focused on pressure stability. Our results indicate that a flow-through technique might be a way forward in obtaining a sufficiently high signal quality without the added effects of rebreathing and increased work of breathing. The results should stimulate further research and the development of equipment for dynamic flow measurements in neonates. PMID:26192188

Exhaled breath profiling using broadband quantum cascade laser-based spectroscopy in healthy children and children with asthma and cystic fibrosis.

PubMed

van Mastrigt, E; Reyes-Reyes, A; Brand, K; Bhattacharya, N; Urbach, H P; Stubbs, A P; de Jongste, J C; Pijnenburg, M W

2016-04-08

Exhaled breath analysis is a potential non-invasive tool for diagnosing and monitoring airway diseases. Gas chromatography-mass spectrometry and electrochemical sensor arrays are the main techniques to detect volatile organic compounds (VOC) in exhaled breath. We developed a broadband quantum cascade laser spectroscopy technique for VOC detection and identification. The objective of this study was to assess the repeatability of exhaled breath profiling with broadband quantum cascade laser-based spectroscopy and to explore the clinical applicability by comparing exhaled breath samples from healthy children with those from children with asthma or cystic fibrosis (CF). Healthy children and children with stable asthma or stable CF, aged 6-18 years, were included. Two to four exhaled breath samples were collected in Tedlar bags and analyzed by quantum cascade laser spectroscopy to detect VOCs with an absorption profile in the wavenumber region between 832 and 1262.55 cm(-1). We included 35 healthy children, 39 children with asthma and 15 with CF. Exhaled breath VOC profiles showed poor repeatability (Spearman's rho  =  0.36 to 0.46) and agreement of the complete profiles. However, we were able to discriminate healthy children from children with stable asthma or stable CF and identified VOCs that were responsible for this discrimination. Broadband quantum cascade laser-based spectroscopy detected differences in VOC profiles in exhaled breath samples between healthy children and children with asthma or CF. The combination of a relatively easy and fast method and the possibility of molecule identification makes broadband quantum cascade laser-based spectroscopy attractive to investigate the diagnostic and prognostic potential of volatiles in exhaled breath.

The classification of the patients with pulmonary diseases using breath air samples spectral analysis

NASA Astrophysics Data System (ADS)

Kistenev, Yury V.; Borisov, Alexey V.; Kuzmin, Dmitry A.; Bulanova, Anna A.

2016-08-01

Technique of exhaled breath sampling is discussed. The procedure of wavelength auto-calibration is proposed and tested. Comparison of the experimental data with the model absorption spectra of 5% CO2 is conducted. The classification results of three study groups obtained by using support vector machine and principal component analysis methods are presented.

Impact of Typical Aging and Parkinson's Disease on the Relationship among Breath Pausing, Syntax, and Punctuation

ERIC Educational Resources Information Center

Huber, Jessica E.; Darling, Meghan; Francis, Elaine J.; Zhang, Dabao

2012-01-01

Purpose: The present study examines the impact of typical aging and Parkinson's disease (PD) on the relationship among breath pausing, syntax, and punctuation. Method: Thirty young adults, 25 typically aging older adults, and 15 individuals with PD participated. Fifteen participants were age- and sex-matched to the individuals with PD.…

Breath-based biomarkers for tuberculosis

NASA Astrophysics Data System (ADS)

Kolk, Arend H. J.; van Berkel, Joep J. B. N.; Claassens, Mareli M.; Walters, Elisabeth; Kuijper, Sjoukje; Dallinga, Jan W.; van Schooten, Fredrik-Jan

2012-06-01

We investigated the potential of breath analysis by gas chromatography - mass spectrometry (GC-MS) to discriminate between samples collected prospectively from patients with suspected tuberculosis (TB). Samples were obtained in a TB endemic setting in South Africa where 28% of the culture proven TB patients had a Ziehl-Neelsen (ZN) negative sputum smear. A training set of breath samples from 50 sputum culture proven TB patients and 50 culture negative non-TB patients was analyzed by GC-MS. A classification model with 7 compounds resulted in a training set with a sensitivity of 72%, specificity of 86% and accuracy of 79% compared with culture. The classification model was validated with an independent set of breath samples from 21 TB and 50 non-TB patients. A sensitivity of 62%, specificity of 84% and accuracy of 77% was found. We conclude that the 7 volatile organic compounds (VOCs) that discriminate breath samples from TB and non-TB patients in our study population are probably host-response related VOCs and are not derived from the VOCs secreted by M. tuberculosis. It is concluded that at present GC-MS breath analysis is able to differentiate between TB and non-TB breath samples even among patients with a negative ZN sputum smear but a positive culture for M. tuberculosis. Further research is required to improve the sensitivity and specificity before this method can be used in routine laboratories.

Detection of response to command using voluntary control of breathing in disorders of consciousness

PubMed Central

Charland-Verville, Vanessa; Lesenfants, Damien; Sela, Lee; Noirhomme, Quentin; Ziegler, Erik; Chatelle, Camille; Plotkin, Anton; Sobel, Noam; Laureys, Steven

2014-01-01

Background: Detecting signs of consciousness in patients in a vegetative state/unresponsive wakefulness syndrome (UWS/VS) or minimally conscious state (MCS) is known to be very challenging. Plotkin et al. (2010) recently showed the possibility of using a breathing-controlled communication device in patients with locked in syndrome. We here aim to test a breathing-based “sniff controller” that could be used as an alternative diagnostic tool to evaluate response to command in severely brain damaged patients with chronic disorders of consciousness (DOC). Methods: Twenty-five DOC patients were included. Patients’ resting breathing-amplitude was measured during a 5 min resting condition. Next, they were instructed to end the presentation of a music sequence by sniffing vigorously. An automated detection of changes in breathing amplitude (i.e., >1.5 SD of resting) ended the music and hence provided positive feedback to the patient. Results: None of the 11 UWS/VS patients showed a sniff-based response to command. One out of 14 patients with MCS was able to willfully modulate his breathing pattern to answer the command on 16/19 trials (accuracy 84%). Interestingly, this patient failed to show any other motor response to command. Discussion: We here illustrate the possible interest of using breathing-dependent response to command in the detection of residual cognition in patients with DOC after severe brain injury. PMID:25566035

A dosimetric study of cardiac dose sparing using the reverse semi-decubitus technique for left breast and internal mammary chain irradiation.

PubMed

Niglas, Mark; McCann, Claire; Keller, Brian M; Makhani, Nadiya; Presutti, Joseph; Vesprini, Danny; Rakovitch, Eileen; Elzibak, Alyaa; Mashouf, Shahram; Lee, Justin

2016-01-01

Breath-hold techniques can reduce cardiac dose in breast radiotherapy. The reverse semi-decubitus (RSD) technique is an alternative free-breathing method used at our centre. This study compares the dosimetry of free-breathing supine, RSD and moderate deep inspiration breath-hold (mDIBH) techniques. Twelve patients with left-sided breast cancer who were simulated using standard supine, RSD and mDIBH techniques were identified retrospectively. New plans using standard breast tangents and techniques for internal mammary chain (IMC) nodal coverage were assessed. Using standard tangents, mean heart dose, heart V25Gy and mean left anterior descending artery (LAD) dose were found to be significantly lower for RSD and mDIBH when compared to free-breathing supine (p ⩽ 0.03). Using wide-tangents, the maximum LAD point dose was also lower for RSD and mDIBH (p ⩽ 0.02). There were no statistically significant dosimetric differences found between the RSD and mDIBH simulation techniques for standard breast-tangent plans, though organ-at-risk doses were lower for mDIBH in wide-tangent plans. There was no improvement in cardiac dosimetry between RSD and free-breathing supine when using an electron field IMC plan. For patients unable to tolerate breath-hold, the RSD technique is an alternative approach that can reduce cardiac dose. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

SU-F-P-14: Oxygen Inhalation Should Be the Conventional Approach in the Treatment of Thoracic and Abdominal Cancer by Radiotherapy with Active Breathing Control (ABC)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gong, G; Guo, Y; Yin, Y

Purpose: To investigate the feasibility and potential benefit of oxygen inhalation (OI) during radiotherapy applying an active breathing control (ABC) device, by analyzing the blood oxygen saturation (SpO2) and the instantaneous heart rate (IHR) variation in breath holding with OI and oxygen non-inhalation (ONI). Methods: The 27 healthy volunteers (16 males, 11 females) who were involved in this trial were all required to hold their breath for 10 times, non-inhaling and inhaling oxygen successively. The breath-holding time (BHT), rest time (RT), SpO2 and IHR under different oxygen status were recorded and compared. Results: The volunteers were divided into two groupsmore » according to SpO2 variations in breath-holding: group A (12 cases), with less than2% decline of SpO2; group B (15 cases), with a decline that surpassed 2%, and which could reach 3–6%. The BHT of group A, without inhaling oxygen, was significantly longer than that of group B (mean 33.77s Vs 30.51s, p<0.05); and was extended by 26.6% and 27.85%, after inhaling oxygen, in groups A and B, respectively. The SpO2 decreased in all volunteers during RT with ONI, to an extent that could reach up to 6%. The IHR of all volunteers showed the fast-slow-fast variation rule, and the oxygen had little effect. More than 70% of the volunteers stated that oxygen made them feel more comfortable and were more cooperative when ABC was used. Conclusion: The SpO2 declines during breath holding and RT could not be ignored while applying ABC, oxygen inhalation should become a conventional method with lengthening BHT and shortening RT, which yielded the benefit of improving the stability and reproducibility.« less

Pulmonary blood flow distribution in sheep: effects of anesthesia, mechanical ventilation, and change in posture

NASA Technical Reports Server (NTRS)

Walther, S. M.; Domino, K. B.; Glenny, R. W.; Hlastala, M. P.

1997-01-01

BACKGROUND: Recent studies providing high-resolution images of pulmonary perfusion have questioned the classical zone model of pulmonary perfusion. Hence the present work was undertaken to provide detailed maps of regional pulmonary perfusion to examine the influence of anesthesia, mechanical ventilation, and posture. METHODS: Pulmonary perfusion was analyzed with intravenous fluorescent microspheres (15 microm) in six sheep studied in four conditions: prone and awake, prone with pentobarbital-anesthesia and breathing spontaneously, prone with anesthesia and mechanical ventilation, and supine with anesthesia and mechanical ventilation. Lungs were air dried at total lung capacity and sectioned into approximately 1,100 pieces (about 2 cm3) per animal. The pieces were weighed and assigned spatial coordinates. Fluorescence was read on a spectrophotometer, and signals were corrected for piece weight and normalized to mean flow. Pulmonary blood flow heterogeneity was assessed using the coefficient of variation of flow data. RESULTS: Pentobarbital anesthesia and mechanical ventilation did not influence perfusion heterogeneity, but heterogeneity increased when the animals were in the supine posture (P < 0.01). Gravitational flow gradients were absent in the prone position but present in the supine (P < 0.001 compared with zero). Pulmonary perfusion was distributed with a hilar-to-peripheral gradient in animals breathing spontaneously (P < 0.05). CONCLUSIONS: The influence of pentobarbital anesthesia and mechanical ventilation on pulmonary perfusion heterogeneity is small compared with the effect of changes in posture. Analysis of flow gradients indicate that gravity plays a small role in determining pulmonary blood flow distribution.

Portable method of measuring gaseous acetone concentrations.

PubMed

Worrall, Adam D; Bernstein, Jonathan A; Angelopoulos, Anastasios P

2013-08-15

Measurement of acetone in human breath samples has been previously shown to provide significant non-invasive diagnostic insight into the control of a patient's diabetic condition. In patients with diabetes mellitus, the body produces excess amounts of ketones such as acetone, which are then exhaled during respiration. Using various breath analysis methods has allowed for the accurate determination of acetone concentrations in exhaled breath. However, many of these methods require instrumentation and pre-concentration steps not suitable for point-of-care use. We have found that by immobilizing resorcinol reagent into a perfluorosulfonic acid polymer membrane, a controlled organic synthesis reaction occurs with acetone in a dry carrier gas. The immobilized, highly selective product of this reaction (a flavan) is found to produce a visible spectrum color change which could measure acetone concentrations to less than ppm. We here demonstrate how this approach can be used to produce a portable optical sensing device for real-time, non-invasive acetone analysis. Copyright © 2013 Elsevier B.V. All rights reserved.

Attempts at estimating mixed venous carbon dioxide tension by the single-breath method.

PubMed

Ohta, H; Takatani, O; Matsuoka, T

1989-01-01

The single-breath method was originally proposed by Kim et al. [1] for estimating the blood carbon dioxide tension and cardiac output. Its reliability has not been proven. The present study was undertaken, using dogs, to compare the mixed venous carbon dioxide tension (PVCO2) calculated by the single-breath method with the PVCO2 measured in mixed venous blood, and to evaluate the influence of variations in the exhalation duration and the volume of expired air usually discarded from computations as the deadspace. Among the exhalation durations of 15, 30 and 45 s tested, the 15 s duration was found to be too short to obtain an analyzable O2-CO2 curve, but at either 30 or 45 s, the calculated values of PVCO2 were comparable to the measured PVCO2. A significant agreement between calculated and measured PVCO2 was obtained when the expired gas with PCO2 less than 22 Torr was considered as deadspace gas.

Improved workflow for quantification of left ventricular volumes and mass using free-breathing motion corrected cine imaging.

PubMed

Cross, Russell; Olivieri, Laura; O'Brien, Kendall; Kellman, Peter; Xue, Hui; Hansen, Michael

2016-02-25

Traditional cine imaging for cardiac functional assessment requires breath-holding, which can be problematic in some situations. Free-breathing techniques have relied on multiple averages or real-time imaging, producing images that can be spatially and/or temporally blurred. To overcome this, methods have been developed to acquire real-time images over multiple cardiac cycles, which are subsequently motion corrected and reformatted to yield a single image series displaying one cardiac cycle with high temporal and spatial resolution. Application of these algorithms has required significant additional reconstruction time. The use of distributed computing was recently proposed as a way to improve clinical workflow with such algorithms. In this study, we have deployed a distributed computing version of motion corrected re-binning reconstruction for free-breathing evaluation of cardiac function. Twenty five patients and 25 volunteers underwent cardiovascular magnetic resonance (CMR) for evaluation of left ventricular end-systolic volume (ESV), end-diastolic volume (EDV), and end-diastolic mass. Measurements using motion corrected re-binning were compared to those using breath-held SSFP and to free-breathing SSFP with multiple averages, and were performed by two independent observers. Pearson correlation coefficients and Bland-Altman plots tested agreement across techniques. Concordance correlation coefficient and Bland-Altman analysis tested inter-observer variability. Total scan plus reconstruction times were tested for significant differences using paired t-test. Measured volumes and mass obtained by motion corrected re-binning and by averaged free-breathing SSFP compared favorably to those obtained by breath-held SSFP (r = 0.9863/0.9813 for EDV, 0.9550/0.9685 for ESV, 0.9952/0.9771 for mass). Inter-observer variability was good with concordance correlation coefficients between observers across all acquisition types suggesting substantial agreement. Both motion corrected re-binning and averaged free-breathing SSFP acquisition and reconstruction times were shorter than breath-held SSFP techniques (p < 0.0001). On average, motion corrected re-binning required 3 min less than breath-held SSFP imaging, a 37% reduction in acquisition and reconstruction time. The motion corrected re-binning image reconstruction technique provides robust cardiac imaging that can be used for quantification that compares favorably to breath-held SSFP as well as multiple average free-breathing SSFP, but can be obtained in a fraction of the time when using cloud-based distributed computing reconstruction.

A Portable Real-Time Ringdown Breath Acetone Analyzer: Toward Potential Diabetic Screening and Management

PubMed Central

Jiang, Chenyu; Sun, Meixiu; Wang, Zhennan; Chen, Zhuying; Zhao, Xiaomeng; Yuan, Yuan; Li, Yingxin; Wang, Chuji

2016-01-01

Breath analysis has been considered a suitable tool to evaluate diseases of the respiratory system and those that involve metabolic changes, such as diabetes. Breath acetone has long been known as a biomarker for diabetes. However, the results from published data by far have been inconclusive regarding whether breath acetone is a reliable index of diabetic screening. Large variations exist among the results of different studies because there has been no “best-practice method” for breath-acetone measurements as a result of technical problems of sampling and analysis. In this mini-review, we update the current status of our development of a laser-based breath acetone analyzer toward real-time, one-line diabetic screening and a point-of-care instrument for diabetic management. An integrated standalone breath acetone analyzer based on the cavity ringdown spectroscopy technique has been developed. The instrument was validated by using the certificated gas chromatography-mass spectrometry. The linear fittings suggest that the obtained acetone concentrations via both methods are consistent. Breath samples from each individual subject under various conditions in total, 1257 breath samples were taken from 22 Type 1 diabetic (T1D) patients, 312 Type 2 diabetic (T2D) patients, which is one of the largest numbers of T2D subjects ever used in a single study, and 52 non-diabetic healthy subjects. Simultaneous blood glucose (BG) levels were also tested using a standard diabetic management BG meter. The mean breath acetone concentrations were determined to be 4.9 ± 16 ppm (22 T1D), and 1.5 ± 1.3 ppm (312 T2D), which are about 4.5 and 1.4 times of the one in the 42 non-diabetic healthy subjects, 1.1 ± 0.5 ppm, respectively. A preliminary quantitative correlation (R = 0.56, p < 0.05) between the mean individual breath acetone concentration and the mean individual BG levels does exist in 20 T1D subjects with no ketoacidosis. No direct correlation is observed in T1D subjects, T2D subjects, and healthy subjects. The results from a relatively large number of subjects tested indicate that an elevated mean breath acetone concentration exists in diabetic patients in general. Although many physiological parameters affect breath acetone, under a specifically controlled condition fast (<1 min) and portable breath acetone measurement can be used for screening abnormal metabolic status including diabetes, for point-of-care monitoring status of ketone bodies which have the signature smell of breath acetone, and for breath acetone related clinical studies requiring a large number of tests. PMID:27483281

Effectiveness of different rescanning techniques for scanned proton radiotherapy in lung cancer patients

NASA Astrophysics Data System (ADS)

Engwall, E.; Glimelius, L.; Hynning, E.

2018-05-01

Non-small cell lung cancer (NSCLC) is a tumour type thought to be well-suited for proton radiotherapy. However, the lung region poses many problems related to organ motion and can for actively scanned beams induce severe interplay effects. In this study we investigate four mitigating rescanning techniques: (1) volumetric rescanning, (2) layered rescanning, (3) breath-sampled (BS) layered rescanning, and (4) continuous breath-sampled (CBS) layered rescanning. The breath-sampled methods will spread the layer rescans over a full breathing cycle, resulting in an improved averaging effect at the expense of longer treatment times. In CBS, we aim at further improving the averaging by delivering as many rescans as possible within one breathing cycle. The interplay effect was evaluated for 4D robustly optimized treatment plans (with and without rescanning) for seven NSCLC patients in the treatment planning system RayStation. The optimization and final dose calculation used a Monte Carlo dose engine to account for the density heterogeneities in the lung region. A realistic treatment delivery time structure given from the IBA ScanAlgo simulation tool served as basis for the interplay evaluation. Both slow (2.0 s) and fast (0.1 s) energy switching times were simulated. For all seven studied patients, rescanning improves the dose conformity to the target. The general trend is that the breath-sampled techniques are superior to layered and volumetric rescanning with respect to both target coverage and variability in dose to OARs. The spacing between rescans in our breath-sampled techniques is set at planning, based on the average breathing cycle length obtained in conjunction with CT acquisition. For moderately varied breathing cycle lengths between planning and delivery (up to 15%), the breath-sampled techniques still mitigate the interplay effect well. This shows the potential for smooth implementation at the clinic without additional motion monitoring equipment.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Conroy, L; Quirk, S; Smith, WL

Purpose: We used Real-Time Position Management (RPM) to evaluate breath hold amplitude and variability when gating with a visually monitored deep inspiration breath hold technique (VM-DIBH) with retrospective cine image chest wall position verification. Methods: Ten patients with left-sided breast cancer were treated using VM-DIBH. Respiratory motion was passively collected once weekly using RPM with the marker block positioned at the xiphoid process. Cine images on the tangent medial field were acquired on fractions with RPM monitoring for retrospective verification of chest wall position during breath hold. The amplitude and duration of all breath holds on which treatment beams weremore » delivered were extracted from the RPM traces. Breath hold position coverage was evaluated for symmetric RPM gating windows from ± 1 to 5 mm centered on the average breath hold amplitude of the first measured fraction as a baseline. Results: The average (range) breath hold amplitude and duration was 18 mm (3–36 mm) and 19 s (7–34 s). The average (range) of amplitude standard deviation per patient over all breath holds was 2.7 mm (1.2–5.7 mm). With the largest allowable RPM gating window (± 5 mm), 4 of 10 VM-DIBH patients would have had ≥ 10% of their breath hold positions excluded by RPM. Cine verification of the chest wall position during the medial tangent field showed that the chest wall was greater than 5 mm from the baseline in only 1 out of 4 excluded patients. Cine images verify the chest wall/breast position only, whether this variation is acceptable in terms of heart sparing is a subject of future investigation. Conclusion: VM-DIBH allows for greater breath hold amplitude variability than using a 5 mm gating window with RPM, while maintaining chest wall positioning accuracy within 5 mm for the majority of patients.« less

A Novel Fast Helical 4D-CT Acquisition Technique to Generate Low-Noise Sorting Artifact–Free Images at User-Selected Breathing Phases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thomas, David, E-mail: dhthomas@mednet.ucla.edu; Lamb, James; White, Benjamin

2014-05-01

Purpose: To develop a novel 4-dimensional computed tomography (4D-CT) technique that exploits standard fast helical acquisition, a simultaneous breathing surrogate measurement, deformable image registration, and a breathing motion model to remove sorting artifacts. Methods and Materials: Ten patients were imaged under free-breathing conditions 25 successive times in alternating directions with a 64-slice CT scanner using a low-dose fast helical protocol. An abdominal bellows was used as a breathing surrogate. Deformable registration was used to register the first image (defined as the reference image) to the subsequent 24 segmented images. Voxel-specific motion model parameters were determined using a breathing motion model. Themore » tissue locations predicted by the motion model in the 25 images were compared against the deformably registered tissue locations, allowing a model prediction error to be evaluated. A low-noise image was created by averaging the 25 images deformed to the first image geometry, reducing statistical image noise by a factor of 5. The motion model was used to deform the low-noise reference image to any user-selected breathing phase. A voxel-specific correction was applied to correct the Hounsfield units for lung parenchyma density as a function of lung air filling. Results: Images produced using the model at user-selected breathing phases did not suffer from sorting artifacts common to conventional 4D-CT protocols. The mean prediction error across all patients between the breathing motion model predictions and the measured lung tissue positions was determined to be 1.19 ± 0.37 mm. Conclusions: The proposed technique can be used as a clinical 4D-CT technique. It is robust in the presence of irregular breathing and allows the entire imaging dose to contribute to the resulting image quality, providing sorting artifact–free images at a patient dose similar to or less than current 4D-CT techniques.« less

Exercise tolerance and selected motor skills in young females with idiopathic scoliosis treated with different physiotherapeutic methods.

PubMed

Fabian, Krzysztof Marek; Rożek-Piechura, Krystyna

2014-01-01

Scoliosis is a disorder that leads to dysfunction of a number of systems in the body, especially in young females. Physical capacity is one of the most important elements of good health as well as ofbiological development. Adolescence is a time when physical capacity develops intensively, and the condition of the respiratory system is one of many factors that have an impact on the level of physical capacity. This paper aims to evaluate a short-term application of two methods of physiotherapy and their influence on the level of exercise tolerance in young females suffering from idiopathic scoliosis. The study involved a group of 49 young females aged 14-15 years diagnosed with (2040°) thoracic and lumbar scoliosis who were in-patients at the rehabilitation ward of the Regional Paediatric Rehabilitation Hospital in Jastrzębie Zdrój. The group was divided into two subgroups depending on the method of rehabilitation employed: the first subgroup received asymmetric breathing exercise therapy by Dobosiewicz and the second subgroup practised symmetric remedial exercises. Cobb's angle, the degree of skeletal maturity, i.e. the Risser sign and the degree trunk rotation of the apex of the curvature by means of Raimondi's coefficient were determined once in an x-ray image. Basic somatic features, maximal voluntary ventilation (MVV parameter), selected motor skills and exercise tolerance were assessed on two occasions (before beginning and after completion of the rehabilitation treatment). 1. Young females suffering from (20-40°) thoracic and lumbar scoliosis demonstrate respiratory dysfunction, as shown by decreased maximal voluntary ventilation (MVV) in the two subgroups in the present study. Exercises according to Dobosiewicz's method brought about a significantly higher degree of improvement in this parameter. 2. The physiotherapeutic regimen administered to the young girls with scoliosis significantly improved their strength motor skills and exercise tolerance. A significantly higher improvement was observed in the subgroup treated using Dobosiewicz's method, in particular, in the strength of abdominal muscles, which play an important role in both respiratory function and body posture maintenance.

Status of selected ion flow tube MS: accomplishments and challenges in breath analysis and other areas.

PubMed

Smith, David; Španěl, Patrik

2016-06-01

This article reflects our observations of recent accomplishments made using selected ion flow tube MS (SIFT-MS). Only brief descriptions are given of SIFT-MS as an analytical method and of the recent extensions to the underpinning analytical ion chemistry required to realize more robust analyses. The challenge of breath analysis is given special attention because, when achieved, it renders analysis of other air media relatively straightforward. Brief overviews are given of recent SIFT-MS breath analyses by leading research groups, noting the desirability of detection and quantification of single volatile biomarkers rather than reliance on statistical analyses, if breath analysis is to be accepted into clinical practice. A 'strengths, weaknesses, opportunities and threats' analysis of SIFT-MS is made, which should help to increase its utility for trace gas analysis.

Wrist sensor for warfighter status monitor

NASA Astrophysics Data System (ADS)

Chen, Wuping

2000-04-01

There is a pressing need to improve human status monitoring in the medical and military communities. The heart rate and breading rate are the most important human vital signs. The current heart rate and breading rate monitors are rather cumbersome, expensive, and usually confined to the intensive care unit or ambulatory setting. These techniques are therefore unavailable to certain applications, such as home care and military applications. The purpose of this work is to develop new methods and new technologies for heart rate and breathing rate monitoring. To accomplish this task, a novel optical acoustic laser sensor (OALS) is characterized and used to generate an optical signal corresponding to human heart beat and breathing. An application specific integrated circuit (ASIC) is developed for this unique compact human status monitor Extensive experimental data analysis and simulation are conducted to investigate robust digital signal processing (DSP) methods. The Gauss-Hermite wavelet transform (GHWT) is utilized as a time-frequency representative technique to provide a method for the detection of the very low frequency heart rate and breathing rate from the large and noisy biomedical lasergram (BLG) signal. A 915MHz RF transceiver provides a reliable wireless link for the monitor to receive commands or transmit the measurement results to a remote commander center. A complete micro-instrument based on the ideas and methods above are developed and tested. The results show that the heart rate and breathing rate could be measured under difficult environmental situations.

Autocalibrating motion-corrected wave-encoding for highly accelerated free-breathing abdominal MRI.

PubMed

Chen, Feiyu; Zhang, Tao; Cheng, Joseph Y; Shi, Xinwei; Pauly, John M; Vasanawala, Shreyas S

2017-11-01

To develop a motion-robust wave-encoding technique for highly accelerated free-breathing abdominal MRI. A comprehensive 3D wave-encoding-based method was developed to enable fast free-breathing abdominal imaging: (a) auto-calibration for wave-encoding was designed to avoid extra scan for coil sensitivity measurement; (b) intrinsic butterfly navigators were used to track respiratory motion; (c) variable-density sampling was included to enable compressed sensing; (d) golden-angle radial-Cartesian hybrid view-ordering was incorporated to improve motion robustness; and (e) localized rigid motion correction was combined with parallel imaging compressed sensing reconstruction to reconstruct the highly accelerated wave-encoded datasets. The proposed method was tested on six subjects and image quality was compared with standard accelerated Cartesian acquisition both with and without respiratory triggering. Inverse gradient entropy and normalized gradient squared metrics were calculated, testing whether image quality was improved using paired t-tests. For respiratory-triggered scans, wave-encoding significantly reduced residual aliasing and blurring compared with standard Cartesian acquisition (metrics suggesting P < 0.05). For non-respiratory-triggered scans, the proposed method yielded significantly better motion correction compared with standard motion-corrected Cartesian acquisition (metrics suggesting P < 0.01). The proposed methods can reduce motion artifacts and improve overall image quality of highly accelerated free-breathing abdominal MRI. Magn Reson Med 78:1757-1766, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Improved CT-based estimate of pulmonary gas trapping accounting for scanner and lung-volume variations in a multicenter asthmatic study.

PubMed

Choi, Sanghun; Hoffman, Eric A; Wenzel, Sally E; Castro, Mario; Lin, Ching-Long

2014-09-15

Lung air trapping is estimated via quantitative computed tomography (CT) using density threshold-based measures on an expiration scan. However, the effects of scanner differences and imaging protocol adherence on quantitative assessment are known to be problematic. This study investigates the effects of protocol differences, such as using different CT scanners and breath-hold coaches in a multicenter asthmatic study, and proposes new methods that can adjust intersite and intersubject variations. CT images of 50 healthy subjects and 42 nonsevere and 52 severe asthmatics at total lung capacity (TLC) and functional residual capacity (FRC) were acquired using three different scanners and two different coaching methods at three institutions. A fraction threshold-based approach based on the corrected Hounsfield unit of air with tracheal density was applied to quantify air trapping at FRC. The new air-trapping method was enhanced by adding a lung-shaped metric at TLC and the lobar ratio of air-volume change between TLC and FRC. The fraction-based air-trapping method is able to collapse air-trapping data of respective populations into distinct regression lines. Relative to a constant value-based clustering scheme, the slope-based clustering scheme shows the improved performance and reduced misclassification rate of healthy subjects. Furthermore, both lung shape and air-volume change are found to be discriminant variables for differentiating among three populations of healthy subjects and nonsevere and severe asthmatics. In conjunction with the lung shape and air-volume change, the fraction-based measure of air trapping enables differentiation of severe asthmatics from nonsevere asthmatics and nonsevere asthmatics from healthy subjects, critical for the development and evaluation of new therapeutic interventions. Copyright © 2014 the American Physiological Society.

Improved CT-based estimate of pulmonary gas trapping accounting for scanner and lung-volume variations in a multicenter asthmatic study

PubMed Central

Choi, Sanghun; Hoffman, Eric A.; Wenzel, Sally E.; Castro, Mario

2014-01-01

Lung air trapping is estimated via quantitative computed tomography (CT) using density threshold-based measures on an expiration scan. However, the effects of scanner differences and imaging protocol adherence on quantitative assessment are known to be problematic. This study investigates the effects of protocol differences, such as using different CT scanners and breath-hold coaches in a multicenter asthmatic study, and proposes new methods that can adjust intersite and intersubject variations. CT images of 50 healthy subjects and 42 nonsevere and 52 severe asthmatics at total lung capacity (TLC) and functional residual capacity (FRC) were acquired using three different scanners and two different coaching methods at three institutions. A fraction threshold-based approach based on the corrected Hounsfield unit of air with tracheal density was applied to quantify air trapping at FRC. The new air-trapping method was enhanced by adding a lung-shaped metric at TLC and the lobar ratio of air-volume change between TLC and FRC. The fraction-based air-trapping method is able to collapse air-trapping data of respective populations into distinct regression lines. Relative to a constant value-based clustering scheme, the slope-based clustering scheme shows the improved performance and reduced misclassification rate of healthy subjects. Furthermore, both lung shape and air-volume change are found to be discriminant variables for differentiating among three populations of healthy subjects and nonsevere and severe asthmatics. In conjunction with the lung shape and air-volume change, the fraction-based measure of air trapping enables differentiation of severe asthmatics from nonsevere asthmatics and nonsevere asthmatics from healthy subjects, critical for the development and evaluation of new therapeutic interventions. PMID:25103972

A real-time respiration position based passive breath gating equipment for gated radiotherapy: A preclinical evaluation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hu Weigang; Xu Anjie; Li Guichao

2012-03-15

Purpose: To develop a passive gating system incorporating with the real-time position management (RPM) system for the gated radiotherapy. Methods: Passive breath gating (PBG) equipment, which consists of a breath-hold valve, a controller mechanism, a mouthpiece kit, and a supporting frame, was designed. A commercial real-time positioning management system was implemented to synchronize the target motion and radiation delivery on a linear accelerator with the patient's breathing cycle. The respiratory related target motion was investigated by using the RPM system for correlating the external markers with the internal target motion while using PBG for passively blocking patient's breathing. Six patientsmore » were enrolled in the preclinical feasibility and efficiency study of the PBG system. Results: PBG equipment was designed and fabricated. The PBG can be manually triggered or released to block or unblock patient's breathing. A clinical workflow was outlined to integrate the PBG with the RPM system. After implementing the RPM based PBG system, the breath-hold period can be prolonged to 15-25 s and the treatment delivery efficiency for each field can be improved by 200%-400%. The results from the six patients showed that the diaphragm motion caused by respiration was reduced to less than 3 mm and the position of the diaphragm was reproducible for difference gating periods. Conclusions: A RPM based PBG system was developed and implemented. With the new gating system, the patient's breath-hold time can be extended and a significant improvement in the treatment delivery efficiency can also be achieved.« less

The Effect of Breathing Exercises on the Nocturnal Enuresis in the Children with the Sleep-Disordered Breathing

PubMed Central

Khaleghipour, Shahnaz; Masjedi, Mohsen; Kelishadi, Roya

2013-01-01

Background The nocturnal enuresis is one of the most common complaints of childhood. Upper airway obstruction and nocturnal snoring affect the nocturnal enuresis in children. Objectives The aim of this study was to investigate the effects of breathing exercises on the nocturnal enuresis in the children with the sleep-disordered breathing. Patients and Methods This study was conducted in year of 2011 by a semi-experimental design with the control group among 40 children, aged 6 - 12 years, who had the nocturnal enuresis. Participants were examined based on the criteria of nocturnal enuresis, oral breathing, and nocturnal snoring. Subsequently, they were randomly assigned to the case and control groups. In the case group, the breathing exercises were performed for 45 minutes, and were pursued for four weeks in the morning following and prior to sleeping, and subsequently the arterial blood gases were measured and the frequency of enuresis and the respiratory rates (RR) were recorded. Results After intervention the means of PaCO2 and RR in the control group were significantly higher than the case group (P < 0.0001). Likewise, O2sat, PaO2 in the case group were higher than the control group (P < 0.0001). The nocturnal enuresis decreased significantly in the case group, compared to the control group (P < 0.0001). Conclusions This study suggests that the breathing exercises may reduce the frequency of nocturnal enuresis in the patients with the oral breathing and nocturnal snore. The clinical implications of these findings should be verified in the future longitudinal studies. PMID:24719691

Drug detection in breath: non-invasive assessment of illicit or pharmaceutical drugs.

PubMed

Trefz, Phillip; Kamysek, Svend; Fuchs, Patricia; Sukul, Pritam; Schubert, Jochen K; Miekisch, Wolfram

2017-03-20

Breath analysis not only holds great potential for the development of new non-invasive diagnostic methods, but also for the identification and follow up of drug levels in breath. This is of interest for both, forensic and medical science. On the one hand, the detection of drugs of abuse in exhaled breath-similar to the well-known breath alcohol tests-would be highly desirable as an alternative to blood or urine analysis in situations such as police controls for drugged driving. The non-invasive detection of drugs and their metabolites is thus of great interest in forensic science, especially since marijuana is becoming legalized in certain parts of the US and the EU. The detection and monitoring of medical drugs in exhaled breath without the need of drawing blood samples on the other hand, is of high relevance in the clinical environment. This could facilitate a more precise medication and enable therapy control without any burden to the patient. Furthermore, it could be a step towards personalized medicine. This review gives an overview of the current state of drug detection in breath, including both volatile and non-volatile substances. The review is divided into two sections. The first section deals with qualitative detection of drugs (drugs of abuse), while the second is related to quantitative drug detection (medical drugs). Chances and limitations are discussed for both aspects. The detection of the intravenous anesthetic propofol is presented as a detailed example that demonstrates the potential, requirements, pitfalls and limitations of therapeutic drug monitoring by means of breath analysis.

Postural disorders in mouth breathing children: a systematic review.

PubMed

Neiva, Patricia Dayrell; Kirkwood, Renata Noce; Mendes, Polyana Leite; Zabjek, Karl; Becker, Helena Gonçalves; Mathur, Sunita

Mouth breathing syndrome can cause sleep disturbances that compromise the performance of children in school. It might also cause postural abnormalities involving the head and cervical spine; however, the association between postural abnormalities and mouth breathing in children is unclear. To assess the methodological quality of studies and determine if there is an association between mouth breathing and postural disorders in children. Databases comprised MEDLINE, CINAHL, PEDro, LILACS, EMBASE and Cochrane Central Registrar of Controlled Trials. Searches were until March 2016 and included studies that evaluated postural disorders in children diagnosed with mouth breathing. The Downs and Black checklist was used to evaluate the quality of the evidences. Ten studies were included totaling 417 children from 5 to 14 years. Two studies used the New York State Postural Rating Scale, seven used photography and one used motion capture to measure posture. The methods used to analyze the data included the Postural Analysis Software (SAPO), Fisiometer, ALCimagem and routines in MATLAB program. Quality assessment resulted in low scores (<14) for all the studies. The main areas of weakness were a clear description of the participants, of the methods used to access posture, of the principal confounders and lack of power analysis. External and internal validity were also threatened by the lack of a representative sample and blinding of the participants and assessors, respectively. The review provides low evidence that mouth-breathing pattern in children between the ages 5-14 years is associated with postural deviations. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Evaluation of a new method for the collection and measurement of 8-isoprostane in exhaled breath for future application in nanoparticle exposure biomonitoring.

PubMed

Marie-Desvergne, Caroline; Dubosson, Muriel; Mossuz, Véronique Chamel

2018-05-14

In the field of nanoparticle exposure biomonitoring, oxidative stress biomarkers measured in exhaled breath condensate appear promising to detect early respiratory effects in workers handling nanomaterials. However, condensation is known for its poor efficiency in collecting non-volatiles in exhaled breath, leading to the low sensitivity of such measurements. Moreover, to be easily used in field studies on large groups of workers, the collection device must be disposable and convenient. In this study, we have tested a totally disposable commercial device that allows for the easy dry collection of exhaled air after filtration on a patented filter. The suitability and efficiency of the SensAbues (SB) device for collecting 8-isoprostane were evaluated and compared to the RTube (RT). Seven healthy volunteers performed two 15 min collections of exhaled breath, one with the SB and one with the RT. Blank devices were used to determine the background levels induced by each device. 8-isoprostane was measured in all samples using an EIA technique. The levels of 8-isoprostane in the exhaled breath of volunteers after collection with the SB were significantly higher than those after collection with the RT. Moreover, the levels obtained in volunteers with the SB were significantly higher than background levels obtained in blank devices, which was not the case for the RT. This is the first study to report the ability of the SB device to collect and measure 8-isoprostane in exhaled breath. The proposed method offers better sensitivity than a classical collection with the RT device and should be further explored before future application in biomonitoring studies.

Computerized method to compensate for breathing body motion in dynamic chest radiographs

NASA Astrophysics Data System (ADS)

Matsuda, H.; Tanaka, R.; Sanada, S.

2017-03-01

Dynamic chest radiography combined with computer analysis allows quantitative analyses on pulmonary function and rib motion. The accuracy of kinematic analysis is directly linked to diagnostic accuracy, and thus body motion compensation is a major concern. Our purpose in this study was to develop a computerized method to reduce a breathing body motion in dynamic chest radiographs. Dynamic chest radiographs of 56 patients were obtained using a dynamic flat-panel detector. The images were divided into a 1 cm-square and the squares on body counter were used to detect the body motion. Velocity vector was measured using cross-correlation method on the body counter and the body motion was then determined on the basis of the summation of motion vector. The body motion was then compensated by shifting the images based on the measured vector. By using our method, the body motion was accurately detected by the order of a few pixels in clinical cases, mean 82.5% in right and left directions. In addition, our method detected slight body motion which was not able to be identified by human observations. We confirmed our method effectively worked in kinetic analysis of rib motion. The present method would be useful for the reduction of a breathing body motion in dynamic chest radiography.

Chiral pathways in DNA dinucleotides using gradient optimized refinement along metastable borders

NASA Astrophysics Data System (ADS)

Romano, Pablo; Guenza, Marina

We present a study of DNA breathing fluctuations using Markov state models (MSM) with our novel refinement procedure. MSM have become a favored method of building kinetic models, however their accuracy has always depended on using a significant number of microstates, making the method costly. We present a method which optimizes macrostates by refining borders with respect to the gradient along the free energy surface. As the separation between macrostates contains highest discretization errors, this method corrects for any errors produced by limited microstate sampling. Using our refined MSM methods, we investigate DNA breathing fluctuations, thermally induced conformational changes in native B-form DNA. Running several microsecond MD simulations of DNA dinucleotides of varying sequences, to include sequence and polarity effects, we've analyzed using our refined MSM to investigate conformational pathways inherent in the unstacking of DNA bases. Our kinetic analysis has shown preferential chirality in unstacking pathways that may be critical in how proteins interact with single stranded regions of DNA. These breathing dynamics can help elucidate the connection between conformational changes and key mechanisms within protein-DNA recognition. NSF Chemistry Division (Theoretical Chemistry), the Division of Physics (Condensed Matter: Material Theory), XSEDE.

Reduction in membrane component of diffusing capacity is associated with the extent of acute pulmonary embolism

PubMed Central

Piirilä, Päivi; Laiho, Mia; Mustonen, Pirjo; Graner, Marit; Piilonen, Anneli; Raade, Merja; Sarna, Seppo; Harjola, Veli-Pekka; Sovijärvi, Anssi

2011-01-01

Acute pulmonary embolism (PE) often decreases pulmonary diffusing capacity for carbon monoxide (DL,CO), but data on the mechanisms involved are inconsistent. We wanted to investigate whether reduction in diffusing capacity of alveolo-capillary membrane (DM) and pulmonary capillary blood volume (Vc) is associated with the extent of PE or the presence and severity of right ventricular dysfunction (RVD) induced by PE and how the possible changes are corrected after 7-month follow-up. Forty-seven patients with acute non-massive PE in spiral computed tomography (CT) were included. The extent of PE was assessed by scoring mass of embolism. DL,CO, Vc, DM and alveolar volume (VA) were measured by using a single breath method with carbon monoxide and oxygen both at the acute phase and 7 months later. RVD was evaluated with transthoracic echocardiography and electrocardiogram. Fifteen healthy subjects were included as controls. DL,CO, DL, CO/VA, DM, vital capacity (VC) and VA were significantly lower in the patients with acute PE than in healthy controls (P<0·001). DM/Vc relation was significantly lower in patients with RVD than in healthy controls (P = 0·004). DM correlated inversely with central mass of embolism (r = −0·312; P = 0·047) whereas Vc did not. DM, DL,CO, VC and VA improved significantly within 7 months. In all patients (P = 0·001, P = 0·001) and persistent RVD (P = 0·020, P = 0·012), DM and DL,CO remained significantly lower than in healthy controls in the follow-up. DM was inversely related to central mass of embolism. Reduction in DM mainly explains the sustained decrease in DL,CO in PE after 7 months despite modern treatment of PE. PMID:21143754

Breath-hold imaging of the coronary arteries using Quiescent-Interval Slice-Selective (QISS) magnetic resonance angiography: pilot study at 1.5 Tesla and 3 Tesla.

PubMed

Edelman, Robert R; Giri, S; Pursnani, A; Botelho, M P F; Li, W; Koktzoglou, I

2015-11-23

Coronary magnetic resonance angiography (MRA) is usually obtained with a free-breathing navigator-gated 3D acquisition. Our aim was to develop an alternative breath-hold approach that would allow the coronary arteries to be evaluated in a much shorter time and without risk of degradation by respiratory motion artifacts. For this purpose, we implemented a breath-hold, non-contrast-enhanced, quiescent-interval slice-selective (QISS) 2D technique. Sequence performance was compared at 1.5 and 3 Tesla using both radial and Cartesian k-space trajectories. The left coronary circulation was imaged in six healthy subjects and two patients with coronary artery disease. Breath-hold QISS was compared with T2-prepared 2D balanced steady-state free-precession (bSSFP) and free-breathing, navigator-gated 3D bSSFP. Approximately 10 2.1-mm thick slices were acquired in a single ~20-s breath-hold using two-shot QISS. QISS contrast-to-noise ratio (CNR) was 1.5-fold higher at 3 Tesla than at 1.5 Tesla. Cartesian QISS provided the best coronary-to-myocardium CNR, whereas radial QISS provided the sharpest coronary images. QISS image quality exceeded that of free-breathing 3D coronary MRA with few artifacts at either field strength. Compared with T2-prepared 2D bSSFP, multi-slice capability was not restricted by the specific absorption rate at 3 Tesla and pericardial fluid signal was better suppressed. In addition to depicting the coronary arteries, QISS could image intra-cardiac structures, pericardium, and the aortic root in arbitrary slice orientations. Breath-hold QISS is a simple, versatile, and time-efficient method for coronary MRA that provides excellent image quality at both 1.5 and 3 Tesla. Image quality exceeded that of free-breathing, navigator-gated 3D MRA in a much shorter scan time. QISS also allowed rapid multi-slice bright-blood, diastolic phase imaging of the heart, which may have complementary value to multi-phase cine imaging. We conclude that, with further clinical validation, QISS might provide an efficient alternative to commonly used free-breathing coronary MRA techniques.

Blinded Validation of Breath Biomarkers of Lung Cancer, a Potential Ancillary to Chest CT Screening

PubMed Central

Phillips, Michael; Bauer, Thomas L.; Cataneo, Renee N.; Lebauer, Cassie; Mundada, Mayur; Pass, Harvey I.; Ramakrishna, Naren; Rom, William N.; Vallières, Eric

2015-01-01

Background Breath volatile organic compounds (VOCs) have been reported as biomarkers of lung cancer, but it is not known if biomarkers identified in one group can identify disease in a separate independent cohort. Also, it is not known if combining breath biomarkers with chest CT has the potential to improve the sensitivity and specificity of lung cancer screening. Methods Model-building phase (unblinded): Breath VOCs were analyzed with gas chromatography mass spectrometry in 82 asymptomatic smokers having screening chest CT, 84 symptomatic high-risk subjects with a tissue diagnosis, 100 without a tissue diagnosis, and 35 healthy subjects. Multiple Monte Carlo simulations identified breath VOC mass ions with greater than random diagnostic accuracy for lung cancer, and these were combined in a multivariate predictive algorithm. Model-testing phase (blinded validation): We analyzed breath VOCs in an independent cohort of similar subjects (n = 70, 51, 75 and 19 respectively). The algorithm predicted discriminant function (DF) values in blinded replicate breath VOC samples analyzed independently at two laboratories (A and B). Outcome modeling: We modeled the expected effects of combining breath biomarkers with chest CT on the sensitivity and specificity of lung cancer screening. Results Unblinded model-building phase. The algorithm identified lung cancer with sensitivity 74.0%, specificity 70.7% and C-statistic 0.78. Blinded model-testing phase: The algorithm identified lung cancer at Laboratory A with sensitivity 68.0%, specificity 68.4%, C-statistic 0.71; and at Laboratory B with sensitivity 70.1%, specificity 68.0%, C-statistic 0.70, with linear correlation between replicates (r = 0.88). In a projected outcome model, breath biomarkers increased the sensitivity, specificity, and positive and negative predictive values of chest CT for lung cancer when the tests were combined in series or parallel. Conclusions Breath VOC mass ion biomarkers identified lung cancer in a separate independent cohort, in a blinded replicated study. Combining breath biomarkers with chest CT could potentially improve the sensitivity and specificity of lung cancer screening. Trial Registration ClinicalTrials.gov NCT00639067 PMID:26698306

Sleep-Disordered Breathing and Mortality: A Prospective Cohort Study

PubMed Central

Punjabi, Naresh M.; Caffo, Brian S.; Goodwin, James L.; Gottlieb, Daniel J.; Newman, Anne B.; O'Connor, George T.; Rapoport, David M.; Redline, Susan; Resnick, Helaine E.; Robbins, John A.; Shahar, Eyal; Unruh, Mark L.; Samet, Jonathan M.

2009-01-01

Background Sleep-disordered breathing is a common condition associated with adverse health outcomes including hypertension and cardiovascular disease. The overall objective of this study was to determine whether sleep-disordered breathing and its sequelae of intermittent hypoxemia and recurrent arousals are associated with mortality in a community sample of adults aged 40 years or older. Methods and Findings We prospectively examined whether sleep-disordered breathing was associated with an increased risk of death from any cause in 6,441 men and women participating in the Sleep Heart Health Study. Sleep-disordered breathing was assessed with the apnea–hypopnea index (AHI) based on an in-home polysomnogram. Survival analysis and proportional hazards regression models were used to calculate hazard ratios for mortality after adjusting for age, sex, race, smoking status, body mass index, and prevalent medical conditions. The average follow-up period for the cohort was 8.2 y during which 1,047 participants (587 men and 460 women) died. Compared to those without sleep-disordered breathing (AHI: <5 events/h), the fully adjusted hazard ratios for all-cause mortality in those with mild (AHI: 5.0–14.9 events/h), moderate (AHI: 15.0–29.9 events/h), and severe (AHI: ≥30.0 events/h) sleep-disordered breathing were 0.93 (95% CI: 0.80–1.08), 1.17 (95% CI: 0.97–1.42), and 1.46 (95% CI: 1.14–1.86), respectively. Stratified analyses by sex and age showed that the increased risk of death associated with severe sleep-disordered breathing was statistically significant in men aged 40–70 y (hazard ratio: 2.09; 95% CI: 1.31–3.33). Measures of sleep-related intermittent hypoxemia, but not sleep fragmentation, were independently associated with all-cause mortality. Coronary artery disease–related mortality associated with sleep-disordered breathing showed a pattern of association similar to all-cause mortality. Conclusions Sleep-disordered breathing is associated with all-cause mortality and specifically that due to coronary artery disease, particularly in men aged 40–70 y with severe sleep-disordered breathing. Please see later in the article for the Editors' Summary PMID:19688045

Clinical evaluation of Krimidanta Pratishedha (anti-caries) activity of Triphaladi Gandusha in high risk dental caries patients.

PubMed

Atara, Achyuta G; Manjusha, R; Shukla, Vinay J; Vaghela, Dharmendra B; Rooparalia, Brijesh

2014-01-01

Dental caries is the most common complaint encountered in clinical practice. Virtually every adult in the world has experience of dental caries. It affects almost 80% of the population. It is now being viewed in dual perspective- "caries as a disease" and "caries as a lesion". To evaluate the efficacy of Triphaladi Gandusha for its anti-caries activity and improvement in Oral Hygiene Index in high risk patients of dental caries and to compare the efficacy of prevalent method of mouth rinsing and classical method of Gandusha. The study was conducted in 40 patients, 20 in each Group-1 and 2. Group -1 was given prepared Triphaladi mouthwash (mouth rinse) while Group-2 was given Triphaladi Kwath for Gandusha (retention). The effect of treatment was assessed by subjective and objective parameters (like salivary pH, buffering capacity and microbial count). Triphaladi Gandusha (retention) in Group - 2 provided better results in the improvement of Ruja (toothache), Dantaharsha (tooth sensitivity), Sarambha (inflammation), pH of saliva, microbial count in salivary sample. And Triphaladi Mouthwash in Group - 1 provided better results in Srava (discharge), bad breath, pH of saliva and buffering capacity of salivary sample. There was no improvement in Chidrata (cavity formation), Krishnata (discoloration) and Chaladanta (mobility) with Triphaladi Gandusha and mouthwash. Study concluded that although both groups were effective, but Gandusha group patients' got better relief in subjective symptoms compared to mouthwash group.

Adults with ADHD and Sleep Complaints: A Pilot Study Identifying Sleep-Disordered Breathing Using Polysomnography and Sleep Quality Assessment

ERIC Educational Resources Information Center

Surman, Craig B. H.; Thomas, Robert J.; Aleardi, Megan; Pagano, Christine; Biederman, Joseph

2006-01-01

Objective: ADHD and sleep-disordered breathing are both prevalent in adulthood. Because both conditions may be responsible for similar symptoms of cognitive impairment, the authors investigate whether their presentation may overlap in adults diagnosed with ADHD. Method: Data are collected from six adults with sleep complaints who were diagnosed…

Nasal and Oral Inspiration During Natural Speech Breathing

PubMed Central

Lester, Rosemary A.; Hoit, Jeannette D.

2015-01-01

Purpose The purpose of this study was to determine the typical pattern for inspiration during speech breathing in healthy adults, as well as the factors that might influence it. Method Ten healthy adults, 18–45 years of age, performed a variety of speaking tasks while nasal ram pressure, audio, and video recordings were obtained. Inspirations were categorized as a nasal only, oral only, simultaneous nasal and oral, or alternating nasal and oral inspiration. The method was validated using nasal airflow, oral airflow, audio, and video recordings for two participants. Results The predominant pattern was simultaneous nasal and oral inspirations for all speaking tasks. This pattern was not affected by the nature of the speaking task or by the phonetic context surrounding the inspiration. The validation procedure confirmed that nearly all inspirations during counting and paragraph reading were simultaneous nasal and oral inspirations; whereas for sentence reading, the predominant pattern was alternating nasal and oral inspirations across the three phonetic contexts. Conclusions Healthy adults inspire through both the nose and mouth during natural speech breathing. This pattern of inspiration is likely beneficial in reducing pathway resistance while preserving some of the benefits of nasal breathing. PMID:24129013

Update on diagnostic value of breath test in gastrointestinal and liver diseases

PubMed Central

Siddiqui, Imran; Ahmed, Sibtain; Abid, Shahab

2016-01-01

In the field of gastroenterology, breath tests (BTs) are used intermittently as diagnostic tools that allow indirect, non-invasive and relatively less cumbersome evaluation of several disorders by simply quantifying the appearance in exhaled breath of a metabolite of a specific substrate administered. The aim of this review is to have an insight into the principles, methods of analysis and performance parameters of various hydrogen, methane and carbon BTs which are available for diagnosing gastrointestinal disorders such as Helicobacter pylori infection, small intestinal bacterial overgrowth, and carbohydrate malabsorption. Evaluation of gastric emptying is routinely performed by scintigraphy which is however, difficult to perform and not suitable for children and pregnant women, this review has abridged the 13C-octanoic acid test in comparison to scintigraphy and has emphasized on its working protocol and challenges. A new development such as electronic nose test is also highlighted. Moreover we have also explored the limitations and constraints restraining the wide use of these BT. We conclude that breath testing has an enormous potential to be used as a diagnostic modality. In addition it offers distinct advantages over the traditional invasive methods commonly employed. PMID:27574563

DOE Office of Scientific and Technical Information (OSTI.GOV)

Latty, Drew, E-mail: drew.latty@health.nsw.gov.au; Stuart, Kirsty E; Westmead Breast Cancer Institute, Sydney, New South Wales

Radiation treatment to the left breast is associated with increased cardiac morbidity and mortality. The deep inspiration breath-hold technique (DIBH) can decrease radiation dose delivered to the heart and this may facilitate the treatment of the internal mammary chain nodes. The aim of this review is to critically analyse the literature available in relation to breath-hold methods, implementation, utilisation, patient compliance, planning methods and treatment verification of the DIBH technique. Despite variation in the literature regarding the DIBH delivery method, patient coaching, visual feedback mechanisms and treatment verification, all methods of DIBH delivery reduce radiation dose to the heart. Furthermore » research is required to determine optimum protocols for patient training and treatment verification to ensure the technique is delivered successfully.« less

TH-CD-202-06: A Method for Characterizing and Validating Dynamic Lung Density Change During Quiet Respiration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dou, T; Ruan, D; Heinrich, M

2016-06-15

Purpose: To obtain a functional relationship that calibrates the lung tissue density change under free breathing conditions through correlating Jacobian values to the Hounsfield units. Methods: Free-breathing lung computed tomography images were acquired using a fast helical CT protocol, where 25 scans were acquired per patient. Using a state-of-the-art deformable registration algorithm, a set of the deformation vector fields (DVF) was generated to provide spatial mapping from the reference image geometry to the other free-breathing scans. These DVFs were used to generate Jacobian maps, which estimate voxelwise volume change. Subsequently, the set of 25 corresponding Jacobian and voxel intensity inmore » Hounsfield units (HU) were collected and linear regression was performed based on the mass conservation relationship to correlate the volume change to density change. Based on the resulting fitting coefficients, the tissues were classified into parenchymal (Type I), vascular (Type II), and soft tissue (Type III) types. These coefficients modeled the voxelwise density variation during quiet breathing. The accuracy of the proposed method was assessed using mean absolute difference in HU between the CT scan intensities and the model predicted values. In addition, validation experiments employing a leave-five-out method were performed to evaluate the model accuracy. Results: The computed mean model errors were 23.30±9.54 HU, 29.31±10.67 HU, and 35.56±20.56 HU, respectively, for regions I, II, and III, respectively. The cross validation experiments averaged over 100 trials had mean errors of 30.02 ± 1.67 HU over the entire lung. These mean values were comparable with the estimated CT image background noise. Conclusion: The reported validation experiment statistics confirmed the lung density modeling during free breathing. The proposed technique was general and could be applied to a wide range of problem scenarios where accurate dynamic lung density information is needed. This work was supported in part by NIH R01 CA0096679.« less

Determination of volatile organic compounds for a systematic evaluation of third-hand smoking.

PubMed

Ueta, Ikuo; Saito, Yoshihiro; Teraoka, Kenta; Miura, Tomoya; Jinno, Kiyokatsu

2010-01-01

Third-hand smoking was quantitatively evaluated with a polymer-packed sample preparation needle and subsequent gas chromatography-mass spectroscopy analysis. The extraction needle was prepared with polymeric particles as the extraction medium, and successful extraction of typical gaseous volatile organic compounds (VOCs) was accomplished with the extraction needle. For an evaluation of this new cigarette hazard, several types of clothing fabrics were exposed to sidestream smoke, and the smoking-related VOCs evaporated from the fabrics to the environmental air were preconcentrated with the extraction needle. Smoking-related VOCs in smokers' breath were also measured using the extraction needle, and the effect of the breath VOCs on third-hand smoking pollution was evaluated. The results demonstrated that a trace amount of smoking-related VOCs was successfully determined by the proposed method. The adsorption and desorption behaviors of smoking-related VOCs were clearly different for each fabric material, and the time variations of these VOCs concentrations were quantitatively evaluated. The VOCs in the smokers' breath were clearly higher than that of nonsmokers'; however, the results suggested that no significant effect of the smokers' breath on the potential pollution occurred in the typical life space. The method was further applied to the determination of the actual third-hand smoking pollution in an automobile, and a future possibility of the proposed method to the analysis of trace amounts of VOCs in environmental air samples was suggested.

Transpulmonary pressures and lung mechanics with glossopharyngeal insufflation and exsufflation beyond normal lung volumes in competitive breath-hold divers.

PubMed

Loring, Stephen H; O'Donnell, Carl R; Butler, James P; Lindholm, Peter; Jacobson, Francine; Ferrigno, Massimo

2007-03-01

Throughout life, most mammals breathe between maximal and minimal lung volumes determined by respiratory mechanics and muscle strength. In contrast, competitive breath-hold divers exceed these limits when they employ glossopharyngeal insufflation (GI) before a dive to increase lung gas volume (providing additional oxygen and intrapulmonary gas to prevent dangerous chest compression at depths recently greater than 100 m) and glossopharyngeal exsufflation (GE) during descent to draw air from compressed lungs into the pharynx for middle ear pressure equalization. To explore the mechanical effects of these maneuvers on the respiratory system, we measured lung volumes by helium dilution with spirometry and computed tomography and estimated transpulmonary pressures using an esophageal balloon after GI and GE in four competitive breath-hold divers. Maximal lung volume was increased after GI by 0.13-2.84 liters, resulting in volumes 1.5-7.9 SD above predicted values. The amount of gas in the lungs after GI increased by 0.59-4.16 liters, largely due to elevated intrapulmonary pressures of 52-109 cmH(2)O. The transpulmonary pressures increased after GI to values ranging from 43 to 80 cmH(2)O, 1.6-2.9 times the expected values at total lung capacity. After GE, lung volumes were reduced by 0.09-0.44 liters, and the corresponding transpulmonary pressures decreased to -15 to -31 cmH(2)O, suggesting closure of intrapulmonary airways. We conclude that the lungs of some healthy individuals are able to withstand repeated inflation to transpulmonary pressures far greater than those to which they would normally be exposed.

Breath-holding ability of offshore workers inadequate to ensure escape from ditched helicopters.

PubMed

Cheung, S S; D'Eon, N J; Brooks, C J

2001-10-01

Following a helicopter ditching in water, the survival rate of individuals not mortally injured by the impact ranges from 50-85%. One possible cause for this low survival rate is that the crew and passengers cannot hold their breath underwater long enough to make the often difficult escape from an inverted and submerged helicopter. We investigated pulmonary function, breath-holding times in air (BHTa) and water (BHTw) of 228 students enrolled in offshore survival courses required to work in either the offshore petroleum industry or in military marine aviation. Comparisons were performed based on occupation, SCUBA experience, and smoking. In 25 degrees C pool water, the overall BHTw ranged from 5.4 to 120 s with a median of 37 s. Of the 228 subjects, 34% had a BHTw less than the 28 s required for the complete evacuation of a Super Puma helicopter under ideal conditions. No significant differences in BHTw were observed based on either smoking history (Non-Smoker, 41.5 +/- 21.6 s; Smoker, 37.2 +/- 20.2 s) or occupation (Novice, 37.5 +/- 21.1 s; Offshore, 40.5 +/- 21.1 s; Military, 45.2 +/- 20.9 s). However, SCUBA-trained individuals had a significantly longer BHT, (47.4 +/- 21.6 s) than non-SCUBA (37.6 +/- 20.6 s), as well as a greater force vital capacity (FVC), BHTa, and subjective comfort in water. It is concluded that the inability to breath-hold in emergency situations is a major contributor to the low survival rates of marine helicopter ditchings. Therefore, efforts must be made to both decrease escape times and to increase survival time underwater.

Ontogeny and morphometrics of the gills and swim bladder of air-breathing striped catfish Pangasianodon hypophthalmus.

PubMed

Phuong, Le My; Huong, Do Thi Thanh; Malte, Hans; Nyengaard, Jens Randel; Bayley, Mark

2018-02-01

The air-breathing fish Pangasianodon hypophthalmus has been shown to have highly plastic branchial surfaces whose area (SA) increases with temperature and aquatic hypoxia. This modulation occurs through development of inter-lamellar cell mass (ILCM). Paradoxically, in conditions where this fish has been shown capable of covering its entire aerobic scope from the water phase, it has been shown to have a very small branchial SA. To address this paradox, we measured the SA, harmonic mean diffusion distance (τ h ) and calculated the anatomic diffusion factor (ADF) of the branchial and swim bladder surfaces in fish ranging from 3 to 1900 g at 27°C in normoxia. Since the lamellae were distinguishable from the ILCM, we measured the actual SA as well as the potential SA if ILCM were lost. As a result of low τ h , P. hypophthalmus has a high capacity for branchial oxygen uptake with or without ILCM. Actual and potential gill ADF were 361 and 1002 cm 2  µm -1  kg -1 , respectively, for a 100 g fish and the ADF of the swim bladder was found to be 308 cm 2  µm -1  kg -1 By swimming fish to exhaustion at different temperatures, we show that modulation of this SA is rapid, indicating that the apparent paradox between previous studies is eliminated. Regression analysis of log-log plots of respiratory SA in relation to body mass shows that the gill scales with mass similarly to the SA in active water-breathing fish, whereas the swim bladder scales with mass more like the mammalian lung does. This fish presents a combination of respiratory surfaces not previously seen in air-breathing fish. © 2018. Published by The Company of Biologists Ltd.

Pressure Dependence of the Radial Breathing Mode of Carbon Nanotubes: The Effect of Fluid Adsorption

NASA Astrophysics Data System (ADS)

Longhurst, M. J.; Quirke, N.

2007-04-01

The pressure dependence of shifts in the vibrational modes of individual carbon nanotubes is strongly affected by the nature of the pressure transmitting medium as a result of adsorption at the nanotube surface. The adsorbate is treated as an elastic shell which couples with the radial breathing mode (RBM) of the nanotube via van der Waal interactions. Using analytical methods as well as molecular simulation, we observe a low frequency breathing mode for the adsorbed fluid at ˜50cm-1, as well as diameter dependent upshifts in the RBM frequency with pressure, suggesting metallic nanotubes may wet more than semiconducting ones.

Micro gas analyzer measurement of nitric oxide in breath by direct wet scrubbing and fluorescence detection.

PubMed

Toda, Kei; Koga, Takahiro; Kosuge, Junichi; Kashiwagi, Mieko; Oguchi, Hiroshi; Arimoto, Takemi

2009-08-15

A novel method is proposed to measure NO in breath. Breath NO is a useful diagnostic measure for asthma patients. Due to the low water solubility of NO, existing wet chemical NO measurements are conducted on NO(2) after removal of pre-existing NO(2) and conversion of NO to NO(2). In contrast, this study utilizes direct measurement of NO by wet chemistry. Gaseous NO was collected into an aqueous phase by a honeycomb-patterned microchannel scrubber and reacted with diaminofluorescein-2 (DAF-2). Fluorescence of the product was measured using a miniature detector, comprising a blue light-emitting diode (LED) and a photodiode. The response intensity was found to dramatically increase following addition of NO(2) into the absorbing solution or air sample. By optimizing the conditions, the sensitivity obtained was sufficient to measure parts per billion by volume levels of NO continuously. The system was applied to real analysis of NO in breath, and the effect of coexisting compounds was investigated. The proposed system could successfully measure breath NO.

The potential offered by real-time, high-sensitivity monitoring of ethane in breath and some pilot studies using optical spectroscopy

NASA Astrophysics Data System (ADS)

Skeldon, Kenneth D.; Patterson, Claire; Wyse, Cathy A.; Gibson, Graham M.; Padgett, Miles J.; Longbottom, Chris; McMillan, Lesley C.

2005-06-01

Breath analysis applied to biomedical applications has gained much momentum is recent years due to the growing research demonstrating that breath gas can provide clinically useful data. Particularly exciting is the area of real-time breath analysis which, when coupled with appropriately chosen target species, can offer a novel method for non-invasive patient monitoring. Here we describe the role of ethane, a breath gas of universal appeal in assessing in vivo oxidative stress (cell damage). We first present a review of emerging applications where real-time ethane monitoring could yield original new results for healthcare. We then report on results from a portable ethane spectroscopy system (accuracy better then 100 parts per trillion (1 part in 1010) over a 1 s time response) that we have developed to exploit some of these applications. By presenting some initial results from pilot studies in the life sciences, we comment on the requirements that the next stage of optical spectroscopy technology has to meet in order to benefit clinical end-users.

Electronic response to nuclear breathing mode

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ludwig, Hendrik; Ruffini, Remo; ICRANet, University of Nice-Sophia Antipolis, 28 Av. de Valrose, 06103 Nice Cedex 2

2015-12-17

Based on our previous work on stationary oscillation modes of electrons around giant nuclei, we show how to treat a general driving force on the electron gas, such as the one generated by the breathing mode of the nucleus, by means of the spectral method. As an example we demonstrate this method for a system with Z = 10{sup 4} in β-equilibrium with the electrons compressed up to the nuclear radius. In this case the stationary modes can be obtained analytically, which allows for a very speedy numerical calculation of the final result.

Respiratory muscle activity and patient–ventilator asynchrony during different settings of noninvasive ventilation in stable hypercapnic COPD: does high inspiratory pressure lead to respiratory muscle unloading?

PubMed Central

Duiverman, Marieke L; Huberts, Anouk S; van Eykern, Leo A; Bladder, Gerrie; Wijkstra, Peter J

2017-01-01

Introduction High-intensity noninvasive ventilation (NIV) has been shown to improve outcomes in stable chronic obstructive pulmonary disease patients. However, there is insufficient knowledge about whether with this more controlled ventilatory mode optimal respiratory muscle unloading is provided without an increase in patient–ventilator asynchrony (PVA). Patients and methods Ten chronic obstructive pulmonary disease patients on home mechanical ventilation were included. Four different ventilatory settings were investigated in each patient in random order, each for 15 min, varying the inspiratory positive airway pressure and backup breathing frequency. With surface electromyography (EMG), activities of the intercostal muscles, diaphragm, and scalene muscles were determined. Furthermore, pressure tracings were derived simultaneously in order to assess PVA. Results Compared to spontaneous breathing, the most pronounced decrease in EMG activity was achieved with the high-pressure settings. Adding a high breathing frequency did reduce EMG activity per breath, while the decrease in EMG activity over 1 min was comparable with the high-pressure, low-frequency setting. With high backup breathing frequencies less breaths were pressure supported (25% vs 97%). PVAs occurred more frequently with the low-frequency settings (P=0.017). Conclusion High-intensity NIV might provide optimal unloading of respiratory muscles, without undue increases in PVA. PMID:28138234

Important influence of respiration on human R-R interval power spectra is largely ignored

NASA Technical Reports Server (NTRS)

Brown, T. E.; Beightol, L. A.; Koh, J.; Eckberg, D. L.

1993-01-01

Frequency-domain analyses of R-R intervals are used widely to estimate levels of autonomic neural traffic to the human heart. Because respiration modulates autonomic activity, we determined for nine healthy subjects the influence of breathing frequency and tidal volume on R-R interval power spectra (fast-Fourier transform method). We also surveyed published literature to determine current practices in this burgeoning field of scientific inquiry. Supine subjects breathed at rates of 6, 7.5, 10, 15, 17.1, 20, and 24 breaths/min and with nominal tidal volumes of 1,000 and 1,500 ml. R-R interval power at respiratory and low (0.06-0.14 Hz) frequencies declined significantly as breathing frequency increased. R-R interval power at respiratory frequencies was significantly greater at a tidal volume of 1,500 than 1,000 ml. Neither breathing frequency nor tidal volume influenced average R-R intervals significantly. Our review of studies reporting human R-R interval power spectra showed that 51% of the studies controlled respiratory rate, 11% controlled tidal volume, and 11% controlled both respiratory rate and tidal volume. The major implications of our analyses are that breathing parameters strongly influence low-frequency as well as respiratory frequency R-R interval power spectra and that this influence is largely ignored in published research.

Computational Fluid Dynamics Investigation of Human Aspiration in Low Velocity Air: Orientation Effects on Nose-Breathing Simulations

PubMed Central

Anderson, Kimberly R.; Anthony, T. Renée

2014-01-01

An understanding of how particles are inhaled into the human nose is important for developing samplers that measure biologically relevant estimates of exposure in the workplace. While previous computational mouth-breathing investigations of particle aspiration have been conducted in slow moving air, nose breathing still required exploration. Computational fluid dynamics was used to estimate nasal aspiration efficiency for an inhaling humanoid form in low velocity wind speeds (0.1–0.4 m s−1). Breathing was simplified as continuous inhalation through the nose. Fluid flow and particle trajectories were simulated over seven discrete orientations relative to the oncoming wind (0, 15, 30, 60, 90, 135, 180°). Sensitivities of the model simplification and methods were assessed, particularly the placement of the recessed nostril surface and the size of the nose. Simulations identified higher aspiration (13% on average) when compared to published experimental wind tunnel data. Significant differences in aspiration were identified between nose geometry, with the smaller nose aspirating an average of 8.6% more than the larger nose. Differences in fluid flow solution methods accounted for 2% average differences, on the order of methodological uncertainty. Similar trends to mouth-breathing simulations were observed including increasing aspiration efficiency with decreasing freestream velocity and decreasing aspiration with increasing rotation away from the oncoming wind. These models indicate nasal aspiration in slow moving air occurs only for particles <100 µm. PMID:24665111

Identification of breathing cracks in a beam structure with entropy

NASA Astrophysics Data System (ADS)

Wimarshana, Buddhi; Wu, Nan; Wu, Christine

2016-04-01

A cantilever beam with a breathing crack is studied to detect and evaluate the crack using entropy measures. Closed cracks in engineering structures lead to proportional complexities to their vibration responses due to weak bi-linearity imposed by the crack breathing phenomenon. Entropy is a measure of system complexity and has the potential in quantifying the complexity. The weak bi-linearity in vibration signals can be amplified using wavelet transformation to increase the sensitivity of the measurements. A mathematical model of harmonically excited unit length steel cantilever beam with a breathing crack located near the fixed end is established, and an iterative numerical method is applied to generate accurate time domain dynamic responses. The bi-linearity in time domain signals due to the crack breathing are amplified by wavelet transformation first, and then the complexities due to bi-linearity is quantified using sample entropy to detect the possible crack and estimate the crack depth. It is observed that the method is capable of identifying crack depths even at very early stages of 3% with the increase in the entropy values more than 10% compared with the healthy beam. The current study extends the entropy based damage detection of rotary machines to structural analysis and takes a step further in high-sensitivity structural health monitoring by combining wavelet transformation with entropy calculations. The proposed technique can also be applied to other types of structures, such as plates and shells.

Incorporating the gas analyzer response time in gas exchange computations.

PubMed

Mitchell, R R

1979-11-01

A simple method for including the gas analyzer response time in the breath-by-breath computation of gas exchange rates is described. The method uses a difference equation form of a model for the gas analyzer in the computation of oxygen uptake and carbon dioxide production and avoids a numerical differentiation required to correct the gas fraction wave forms. The effect of not accounting for analyzer response time is shown to be a 20% underestimation in gas exchange rate. The present method accurately measures gas exchange rate, is relatively insensitive to measurement errors in the analyzer time constant, and does not significantly increase the computation time.

Effect of Breathing Technique of Blowing on the Extent of Damage to the Perineum at the Moment of Delivery: A Randomized Clinical Trial

PubMed Central

Ahmadi, Zohre; Torkzahrani, Shahnaz; Roosta, Firouze; Shakeri, Nezhat; Mhmoodi, Zohre

2017-01-01

Introduction: One of the important tasks in managing labor is the protection of perineum. An important variable affecting this outcome is maternal pushing during the second stage of labor. This study was done to investigate the effect of breathing technique on perineal damage extention in laboring Iranian women. Materials and Methods: This randomized clinical trial was performed on 166 nulliparous pregnant women who had reached full-term pregnancy, had low risk pregnancy, and were candidates for vaginal delivery in two following groups: using breathing techniques (case group) and valsalva maneuver (control group). In the control group, pushing was done with holding the breath. In the case group, the women were asked to take 2 deep abdominal breaths at the onset of pain, then take another deep breath, and push 4–5 seconds with the open mouth while controlling exhalation. From the crowning stage onward, the women were directed to control their pushing, and do the blowing technique. Results: According to the results, intact perineum was more observed in the case group (P = 0.002). Posterior tears (Grade 1, 2, and 3) was considerably higher in the control group (P = 0.003). Anterior tears (labias) and episiotomy were not significantly different in the two groups. Conclusions: It was concluded that breathing technique of blowing can be a good alternative to Valsalva maneuver in order to reduce perineal damage in laboring women. PMID:28382061

How to deal with morning bad breath: A randomized, crossover clinical trial.

PubMed

Oliveira-Neto, Jeronimo M; Sato, Sandra; Pedrazzi, Vinícius

2013-11-01

The absence of a protocol for the treatment of halitosis has led us to compare mouthrinses with mechanical oral hygiene procedures for treating morning breath by employing a hand-held sulfide monitor. To compare the efficacy of five modalities of treatment for controlling morning halitosis in subjects with no dental or periodontal disease. This is a five-period, randomized, crossover clinical trial. Twenty volunteers were randomly assigned to the trial. Testing involved the use of a conventional tongue scraper, a tongue scraper joined to the back of a toothbrush's head, two mouthrinses (0.05% cetylpyridinium chloride and 0.12% chlorhexidine digluconate) and a soft-bristled toothbrush and fluoride toothpaste for practicing oral hygiene. Data analysis was performed using SPSS version 17 for Windows and NCSS 2007 software (P < 0.05). The products and the periods were compared with each other using the Friedman's test. When significant differences (P < 0.05) were determined, the products and periods were compared in pairs by using the Wilcoxon's test and by adjusting the original significance level (0.05) for multiple comparisons by using the Bonferroni's method. The toothbrush's tongue scraper was able to significantly reduce bad breath for up to 2 h. Chlorhexidine reduced bad breath only at the end of the second hour, an effect that lasted for 3 h. Mechanical tongue cleaning was able to immediately reduce bad breath for a short period, whereas chlorhexidine and mechanical oral hygiene reduced bad breath for longer periods, achieving the best results against morning breath.

Breath analysis using external cavity diode lasers: a review

NASA Astrophysics Data System (ADS)

Bayrakli, Ismail

2017-04-01

Most techniques that are used for diagnosis and therapy of diseases are invasive. Reliable noninvasive methods are always needed for the comfort of patients. Owing to its noninvasiveness, ease of use, and easy repeatability, exhaled breath analysis is a very good candidate for this purpose. Breath analysis can be performed using different techniques, such as gas chromatography mass spectrometry (MS), proton transfer reaction-MS, and selected ion flow tube-MS. However, these devices are bulky and require complicated procedures for sample collection and preconcentration. Therefore, these are not practical for routine applications in hospitals. Laser-based techniques with small size, robustness, low cost, low response time, accuracy, precision, high sensitivity, selectivity, low detection limit, real-time, and point-of-care detection have a great potential for routine use in hospitals. In this review paper, the recent advances in the fields of external cavity lasers and breath analysis for detection of diseases are presented.

Nonlinear dynamics and health monitoring of 6-DOF breathing cracked Jeffcott rotor

NASA Astrophysics Data System (ADS)

Zhao, Jie; DeSmidt, Hans; Yao, Wei

2015-04-01

Jeffcott rotor is employed to study the nonlinear vibration characteristics of breathing cracked rotor system and explore the possibility of further damage identification. This paper is an extension work of prior study based on 4 degree-of-freedom Jeffcott rotor system. With consideration of disk tilting and gyroscopic effect, 6-dof EOM is derived and the crack model is established using SERR (strain energy release rate) in facture mechanics. Same as the prior work, the damaged stiffness matrix is updated by computing the instant crack closure line through Zero Stress Intensity Factor method. The breathing crack area is taken as a variable to analyze the breathing behavior in terms of eccentricity phase and shaft speed. Furthermore, the coupled vibration among lateral, torsional and longitudinal d.o.f is studied under torsional/axial excitation. The final part demonstrates the possibility of using vibration signal of damaged system for the crack diagnosis and health monitoring.

Information flow to assess cardiorespiratory interactions in patients on weaning trials.

PubMed

Vallverdú, M; Tibaduisa, O; Clariá, F; Hoyer, D; Giraldo, B; Benito, S; Caminal, P

2006-01-01

Nonlinear processes of the autonomic nervous system (ANS) can produce breath-to-breath variability in the pattern of breathing. In order to provide assess to these nonlinear processes, nonlinear statistical dependencies between heart rate variability and respiratory pattern variability are analyzed. In this way, auto-mutual information and cross-mutual information concepts are applied. This information flow analysis is presented as a short-term non linear analysis method to investigate the information flow interactions in patients on weaning trials. 78 patients from mechanical ventilation were studied: Group A of 28 patients that failed to maintain spontaneous breathing and were reconnected; Group B of 50 patients with successful trials. The results show lower complexity with an increase of information flow in group A than in group B. Furthermore, a more (weakly) coupled nonlinear oscillator behavior is observed in the series of group A than in B.

Does rhinoplasty improve nasal breathing?

PubMed

Xavier, Rui

2010-08-01

Rhinoplasty is a surgical procedure that aims to improve nasal aesthetics and nasal breathing. The aesthetic improvement of the nose is usually judged subjectively by the patient and the surgeon, but the degree of improvement of nasal obstruction is difficult to assess by clinical examination only. The measurement of peak nasal inspiratory flow (PNIF) is a reliable tool that has been shown to correlate with other objective methods of assessing nasal breathing and with patients' symptoms of nasal obstruction. Twenty-three consecutive patients undergoing rhinoplasty have been evaluated by measurement of PNIF before and after surgery. All but three patients had an increase in PNIF after surgery. The mean preoperative PNIF was 86.5 L/min and the mean postoperative PNIF was 123.0 L/min ( P < 0.001). Not surprisingly, the greatest improvement in PNIF was achieved when bilateral spreader grafts were used. This study suggests that rhinoplasty does improve nasal breathing. (c) Thieme Medical Publishers

Carbon monoxide in breath in relation to smoking and carboxyhaemoglobin levels.

PubMed Central

Wald, N J; Idle, M; Boreham, J; Bailey, A

1981-01-01

Carboxyhaemoglobin (COHb) levels were studied in 11 249 men. The distribution among the 2613 men who smoked cigarettes was well separated from that in 6641 non-smokers (including ex-smokers). The distribution for 2005 cigar and pipe smokers was intermediate, though some of the highest COHb levels occurred in cigar smokers. Using a COHb cut-off level of 2%, 81% of cigarette smokers, 35% of cigar and pipe smokers, and 1.0% of non-smokers had raised COHb levels. In a subsidiary experiment alveolar air samples were collected from 162 smokers and 25 non-smokers using a simple breath sampling technique. Carbon monoxide concentrations in alveolar breath were highly correlated with COHb levels (r = 0.97) indicating that COHb levels can be estimated reliably by measuring the concentration of carbon monoxide in breath. Alveolar carbon monoxide measurement is thus a simple method of estimating whether a person is likely to be a smoker. PMID:7314006

Heart rate variability and aerobic fitness.

PubMed

De Meersman, R E

1993-03-01

Heart rate variability, a noninvasive marker of parasympathetic activity, diminishes with aging and is augmented after exercise training. Whether habitual exercise over time can attenuate this loss is unknown. This cross-sectional investigation compared 72 male runners, aged 15 to 83 to 72 age- and weight-matched sedentary control subjects for the amplitude of their heart rate variability. Heart rate variability was assessed during rest while subjects were breathing at a rate of 6 breaths per minute and at an augmented tidal volume (tidal volume = 30% of vital capacity). Fitness levels were assessed with on-line, open-circuit spirometry while subjects were performing an incremental stress test. Overall results between the two groups showed that the physically active group had significantly higher fitness levels (p < 0.001), which were associated with significantly higher levels of heart rate variability, when compared with their sedentary counterparts (p < 0.001). These findings provide suggestive evidence for habitual aerobic exercise as a beneficial modulator of heart rate variability in an aging population.

Rapid Point-Of-Care Breath Test for Biomarkers of Breast Cancer and Abnormal Mammograms

PubMed Central

Phillips, Michael; Beatty, J. David; Cataneo, Renee N.; Huston, Jan; Kaplan, Peter D.; Lalisang, Roy I.; Lambin, Philippe; Lobbes, Marc B. I.; Mundada, Mayur; Pappas, Nadine; Patel, Urvish

2014-01-01

Background Previous studies have reported volatile organic compounds (VOCs) in breath as biomarkers of breast cancer and abnormal mammograms, apparently resulting from increased oxidative stress and cytochrome p450 induction. We evaluated a six-minute point-of-care breath test for VOC biomarkers in women screened for breast cancer at centers in the USA and the Netherlands. Methods 244 women had a screening mammogram (93/37 normal/abnormal) or a breast biopsy (cancer/no cancer 35/79). A mobile point-of-care system collected and concentrated breath and air VOCs for analysis with gas chromatography and surface acoustic wave detection. Chromatograms were segmented into a time series of alveolar gradients (breath minus room air). Segmental alveolar gradients were ranked as candidate biomarkers by C-statistic value (area under curve [AUC] of receiver operating characteristic [ROC] curve). Multivariate predictive algorithms were constructed employing significant biomarkers identified with multiple Monte Carlo simulations and cross validated with a leave-one-out (LOO) procedure. Results Performance of breath biomarker algorithms was determined in three groups: breast cancer on biopsy versus normal screening mammograms (81.8% sensitivity, 70.0% specificity, accuracy 79% (73% on LOO) [C-statistic value], negative predictive value 99.9%); normal versus abnormal screening mammograms (86.5% sensitivity, 66.7% specificity, accuracy 83%, 62% on LOO); and cancer versus no cancer on breast biopsy (75.8% sensitivity, 74.0% specificity, accuracy 78%, 67% on LOO). Conclusions A pilot study of a six-minute point-of-care breath test for volatile biomarkers accurately identified women with breast cancer and with abnormal mammograms. Breath testing could potentially reduce the number of needless mammograms without loss of diagnostic sensitivity. PMID:24599224

All APAPs Are Not Equivalent for the Treatment of Sleep Disordered Breathing: A Bench Evaluation of Eleven Commercially Available Devices

PubMed Central

Zhu, Kaixian; Roisman, Gabriel; Aouf, Sami; Escourrou, Pierre

2015-01-01

Study Objectives: This study challenged on a bench-test the efficacy of auto-titrating positive airway pressure (APAP) devices for obstructive sleep disordered breathing treatment and evaluated the accuracy of the device reports. Methods: Our bench consisted of an active lung simulator and a Starling resistor. Eleven commercially available APAP devices were evaluated on their reactions to single-type SDB sequences (obstructive apnea and hypopnea, central apnea, and snoring), and to a long general breathing scenario (5.75 h) simulating various SDB during four sleep cycles and to a short scenario (95 min) simulating one sleep cycle. Results: In the single-type sequence of 30-minute repetitive obstructive apneas, only 5 devices normalized the airflow (> 70% of baseline breathing amplitude). Similarly, normalized breathing was recorded with 8 devices only for a 20-min obstructive hypopnea sequence. Five devices increased the pressure in response to snoring. Only 4 devices maintained a constant minimum pressure when subjected to repeated central apneas with an open upper airway. In the long general breathing scenario, the pressure responses and the treatment efficacy differed among devices: only 5 devices obtained a residual obstructive AHI < 5/h. During the short general breathing scenario, only 2 devices reached the same treatment efficacy (p < 0.001), and 3 devices underestimated the AHI by > 10% (p < 0.001). The long scenario led to more consistent device reports. Conclusion: Large differences between APAP devices in the treatment efficacy and the accuracy of report were evidenced in the current study. Citation: Zhu K, Roisman G, Aouf S, Escourrou P. All APAPs are not equivalent for the treatment of sleep disordered breathing: a bench evaluation of eleven commercially available devices. J Clin Sleep Med 2015;11(7):725–734. PMID:25766708

Adenosine A1 Receptors in Mouse Pontine Reticular Formation Depress Breathing, Increase Anesthesia Recovery Time, and Decrease Acetylcholine Release

PubMed Central

Gettys, George C.; Liu, Fang; Kimlin, Ed; Baghdoyan, Helen A.; Lydic, Ralph

2012-01-01

Background Clinical and preclinical data demonstrate the analgesic actions of adenosine. Central administration of adenosine agonists, however, suppresses arousal and breathing by poorly understood mechanisms. This study tested the two-tailed hypothesis that adenosine A1 receptors in the pontine reticular formation (PRF) of C57BL/6J mice modulate breathing, behavioral arousal, and PRF acetylcholine release. Methods Three sets of experiments used 51 mice. First, breathing was measured by plethysmography after PRF microinjection of the adenosine A1 receptor agonist N6-sulfophenyl adenosine (SPA) or saline. Second, mice were anesthetized with isoflurane and time to recovery of righting response (RoRR) was quantified after PRF microinjection of SPA or saline. Third, acetylcholine release in the PRF was measured before and during microdialysis delivery of SPA, the adenosine A1 receptor antagonist 1,3-dipropyl-8-cyclopentylxanthine (DPCPX), or SPA and DPCPX. Results First, SPA significantly decreased respiratory rate (−18%), tidal volume (−12%) and minute ventilation (−16%). Second, SPA concentration accounted for 76% of the variance in RoRR. Third, SPA concentration accounted for a significant amount of the variance in acetylcholine release (52%), RoRR (98%), and breathing rate (86%). DPCPX alone caused a concentration-dependent increase in acetylcholine, decrease in RoRR, and decrease in breathing rate. Coadministration of SPA and DPCPX blocked the SPA-induced decrease in acetylcholine and increase in RoRR. Conclusions Endogenous adenosine acting at adenosine A1 receptors in the PRF modulates breathing, behavioral arousal, and acetylcholine release. The results support the interpretation that an adenosinergic-cholinergic interaction within the PRF comprises one neurochemical mechanism underlying the wakefulness stimulus for breathing. PMID:23263018

Effects of Cold Therapy on Pain and Breathing Exercises Among Median Sternotomy Patients.

PubMed

Zencir, Gülbanu; Eser, Ismet

2016-12-01

The most painful activities during the days following cardiac surgery are coughing and deep breathing exercises. Cold therapy is an effective nonpharmacological method that decreases the pain during coughing and mobilization. In this study, the effects of cold therapy on pain and breathing exercises among patients with median sternotomy following cardiac surgery were investigated in a randomized crossover clinical trial. Data were collected from patients with median sternotomy (N = 34) in the first two postoperative days. Because of the crossover design of the study, each patient was taken as a simultaneous control. Gel pack application was used as the cold therapy. Patients underwent four episodes of deep breathing and coughing exercises using an incentive spirometer (volumetric). Patients were evaluated according to the visual analogue scale for pain intensity before and after deep breathing and coughing exercise sessions. The pain score was 3.44 ± 2.45 at baseline for deep breathing and coughing exercises on the first day. The reported postoperative pain in the gel-pack group was not significantly different before and after the deep breathing and coughing exercises, but it significantly increased in the no-gel-pack group (p < .001). Although the interaction between the treatment and time was significant (partial eta-squared: .09), the gel-pack group had a lower change in average pain levels. This interaction was not significant in terms of spirometric values. In conclusion, cold therapy had a positive effect on pain management in the early period of post-cardiac surgery but was not effective for the pain associated with breathing exercises. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Validation of a new mixing chamber system for breath-by-breath indirect calorimetry.

PubMed

Kim, Do-Yeon; Robergs, Robert Andrew

2012-02-01

Limited validation research exists for applications of breath-by-breath systems of expired gas analysis indirect calorimetry (EGAIC) during exercise. We developed improved hardware and software for breath-by-breath indirect calorimetry (NEW) and validated this system as well as a commercial system (COM) against 2 methods: (i) mechanical ventilation with known calibration gas, and (ii) human subjects testing for 5 min each at rest and cycle ergometer exercise at 100 and 175 W. Mechanical calibration consisted of medical grade and certified calibration gas ((4.95% CO(2), 12.01% O(2), balance N(2)), room air (20.95% O(2), 0.03% CO(2), balance N(2)), and 100% nitrogen), and an air flow turbine calibrated with a 3-L calibration syringe. Ventilation was mimicked manually using complete 3-L calibration syringe manouvers at a rate of 10·min(-1) from a Douglas bag reservoir of calibration gas. The testing of human subjects was completed in a counterbalanced sequence based on 5 repeated tests of all conditions for a single subject. Rest periods of 5 and 10 min followed the 100 and 175 W conditions, respectively. COM and NEW had similar accuracy when tested with known ventilation and gas fractions. However, during human subjects testing COM significantly under-measured carbon dioxide gas fractions, over-measured oxygen gas fractions and minute ventilation, and resulted in errors to each of oxygen uptake, carbon dioxide output, and respiratory exchange ratio. These discrepant findings reveal that controlled ventilation and gas fractions are insufficient to validate breath-by-breath, and perhaps even time-averaged, systems of EGAIC. The errors of the COM system reveal the need for concern over the validity of commercial systems of EGAIC.

Double blind randomised controlled trial of two different breathing techniques in the management of asthma

PubMed Central

Slader, C A; Reddel, H K; Spencer, L M; Belousova, E G; Armour, C L; Bosnic‐Anticevich, S Z; Thien, F C K; Jenkins, C R

2006-01-01

Background Previous studies have shown that breathing techniques reduce short acting β2 agonist use and improve quality of life (QoL) in asthma. The primary aim of this double blind study was to compare the effects of breathing exercises focusing on shallow nasal breathing with those of non‐specific upper body exercises on asthma symptoms, QoL, other measures of disease control, and inhaled corticosteroid (ICS) dose. This study also assessed the effect of peak flow monitoring on outcomes in patients using breathing techniques. Methods After a 2 week run in period, 57 subjects were randomised to one of two breathing techniques learned from instructional videos. During the following 30 weeks subjects practised their exercises twice daily and as needed for relief of symptoms. After week 16, two successive ICS downtitration steps were attempted. The primary outcome variables were QoL score and daily symptom score at week 12. Results Overall there were no clinically important differences between the groups in primary or secondary outcomes at weeks 12 or 28. The QoL score remained unchanged (0.7 at baseline v 0.5 at week 28, p = 0.11 both groups combined), as did lung function and airway responsiveness. However, across both groups, reliever use decreased by 86% (p<0.0001) and ICS dose was reduced by 50% (p<0.0001; p>0.10 between groups). Peak flow monitoring did not have a detrimental effect on asthma outcomes. Conclusion Breathing techniques may be useful in the management of patients with mild asthma symptoms who use a reliever frequently, but there is no evidence to favour shallow nasal breathing over non‐specific upper body exercises. PMID:16517572

Quantification of the thorax-to-abdomen breathing ratio for breathing motion modeling.

PubMed

White, Benjamin M; Zhao, Tianyu; Lamb, James; Bradley, Jeffrey D; Low, Daniel A

2013-06-01

The purpose of this study was to develop a methodology to quantitatively measure the thorax-to-abdomen breathing ratio from a 4DCT dataset for breathing motion modeling and breathing motion studies. The thorax-to-abdomen breathing ratio was quantified by measuring the rate of cross-sectional volume increase throughout the thorax and abdomen as a function of tidal volume. Twenty-six 16-slice 4DCT patient datasets were acquired during quiet respiration using a protocol that acquired 25 ciné scans at each couch position. Fifteen datasets included data from the neck through the pelvis. Tidal volume, measured using a spirometer and abdominal pneumatic bellows, was used as breathing-cycle surrogates. The cross-sectional volume encompassed by the skin contour when compared for each CT slice against the tidal volume exhibited a nearly linear relationship. A robust iteratively reweighted least squares regression analysis was used to determine η(i), defined as the amount of cross-sectional volume expansion at each slice i per unit tidal volume. The sum Ση(i) throughout all slices was predicted to be the ratio of the geometric expansion of the lung and the tidal volume; 1.11. The Xiphoid process was selected as the boundary between the thorax and abdomen. The Xiphoid process slice was identified in a scan acquired at mid-inhalation. The imaging protocol had not originally been designed for purposes of measuring the thorax-to-abdomen breathing ratio so the scans did not extend to the anatomy with η(i) = 0. Extrapolation of η(i)-η(i) = 0 was used to include the entire breathing volume. The thorax and abdomen regions were individually analyzed to determine the thorax-to-abdomen breathing ratios. There were 11 image datasets that had been scanned only through the thorax. For these cases, the abdomen breathing component was equal to 1.11 - Ση(i) where the sum was taken throughout the thorax. The average Ση(i) for thorax and abdomen image datasets was found to be 1.20 ± 0.17, close to the expected value of 1.11. The thorax-to-abdomen breathing ratio was 0.32 ± 0.24. The average Ση(i) was 0.26 ± 0.14 in the thorax and 0.93 ± 0.22 in the abdomen. In the scan datasets that encompassed only the thorax, the average Ση(i) was 0.21 ± 0.11. A method to quantify the relationship between abdomen and thoracic breathing was developed and characterized.

Application of ion chemistry and the SIFT technique to the quantitative analysis of trace gases in air and on breath

NASA Astrophysics Data System (ADS)

Smith, David; Španěl, Patrik

Our major objective in this paper is to describe a new method we have developed for the analysis of trace gases at partial pressures down to the ppb level in atmospheric air, with special emphasis on the detection and quantification of trace gases on human breath. It involves the use of our selected ion flow tube (Sift) technique which we previously developed and used extensively for the study of gas phase ionic reactions occurring in ionized media such as the terrestrial atmosphere and interstellar gas clouds. Before discussing this analytical technique we describe the results of our very recent Sift and flowing afterglow (FA) studies of the reactions of the H3O+ and OH- ions, of their hydrates H3O+(H2O)1,2,3 and OH- (H2O)1,2, and of NO+ and O2+, with several hydrocarbons and oxygen-bearing organic molecules, studies that are very relevant to our trace gas analytical studies. Then follows a detailed discussion of the application of our Sift technique to trace gas analysis, after which we present some results obtained for the analyses of laboratory air, the breath of a healthy non-smoking person, the breath of a person who regularly smokes cigarettes, the complex vapours emitted by banana and onion, and the molecules present in a butane/air flame. We show how the quantitative analysis of breath can be achieved from only a single exhalation and in real time (the time response of the instrument is only about 20 ms). We also show how the time variation of breath gases over long time periods can be followed, using the decay of ethanol on the breath after the ingestion of distilled liquor as an example, yet simultaneously following several other trace gases including acetone and isoprene which are very easily detected on the breath of all individuals because of their relatively high partial pressures (typically 100 to 1000 ppb). The breath of a smoker is richer in complex molecules, some nitrogen containing organics apparently being very evident at the 5 to 50 ppb level. These results and those for banana and onion vapours and butane/air flame forcibly demonstrate the value and the scope of our Sift ion chemistry approach to the analysis of very complex gas mixtures, and that this method is accurately quantitative if the appropriate ion chemistry is properly understood.

Effect of inhaled corticosteroid treatment on exhaled breath condensate leukotriene E(4) in children with mild asthma.

PubMed

Steiss, Jens-Oliver; Rudloff, Silvia; Landmann, Eva; Rückes-Nilges, Claudia; Zimmer, Klaus-Peter; Lindemann, Herrmann

2008-01-01

Chronic airway inflammation in children with asthma might be present even in the absence of pathological lung function tests and is known to increase the risk of permanent pulmonary damage. Thus, we aimed at investigating to what extent inflammatory markers such as leukotrienes (LTs) in exhaled breath condensate (EBC) or fractional exhaled nitric oxide (FE(NO)) reflect therapeutic effects in these patients. Fifty steroid-naive patients (aged 8.8 +/- 2.7 years) were included in the study. EBC was collected before and 6 months after therapy with inhaled corticosteroids. LTs were determined by using commercially available ELISA. In addition, FE(NO) was measured by means of a chemiluminescence analyzer. Conventional lung function testing was performed revealing vital capacity, forced expiratory volume, maximum expiratory flow, and specific resistance. In EBC, LTE(4) but not LTB(4) levels significantly decreased after steroid therapy from 45.3 +/- 36.0 pg/mL to 17.2 +/- 11.4 pg/mL (p < 0.0001) concomitant with a slight, but significant improvement of lung function parameters. Mean FE(NO) also indicated therapeutic success; however, in 20 of 50 patients, exhaled NO concentrations were higher after therapy. These findings suggest that LTE(4) in breath condensate may be helpful in latent inflammatory activity in the bronchial mucosa in children with asthma.

Comparison between deep breathing exercises and incentive spirometry after CABG surgery.

PubMed

Renault, Julia Alencar; Costa-Val, Ricardo; Rosseti, Márcia Braz; Houri Neto, Miguel

2009-01-01

To compare the effects of deep breathing exercises (DBE) and the flow-oriented incentive spirometry (IS) in patients undergone coronary artery bypass grafting (CABG) through the following variables: forced vital capacity - FVC, forced expiratory volume in 1 second - FEV(1), maximal respiratory pressures and oxygen saturation. Thirty six patients in CABG postoperative period underwent thirty minutes of non-invasive ventilation during the first 24 hours after extubation and were randomly shared into two groups as following: DBE (n=18) and IS (n=18). The spirometric variables were assessed on the preoperative period and seventh postoperative day (POD). The respiratory muscle strength and oxygen saturation were assessed on the preoperative period, first, second and seventh POD. The groups were considered homogeneous in relation to the demographic and surgical variables. It has been noted fall in the values of FVC and FEV(1) between the preoperative period and the seventh POD, but without significant differences between groups. The maximal respiratory pressures showed drop in the first POD but with and partial recovery until the seventh POD, also without significant differences between groups. The oxygen saturation was the only variable that was completely recovered on the seventh POD, also without significant differences between groups. There were not observed significant differences in maximal respiratory pressures, spirometric variables and oxygen saturation in patients undergone deep breathing exercises and flow-oriented incentive spirometry after coronary artery bypass grafting.

A fractionation of the physiological burden of the personal protective equipment worn by firefighters.

PubMed

Taylor, Nigel A S; Lewis, Michael C; Notley, Sean R; Peoples, Gregory E

2012-08-01

Load carriage increases physiological strain, reduces work capacity and elevates the risk of work-related injury. In this project, the separate and combined physiological consequences of wearing the personal protective equipment used by firefighters were evaluated. The overall impact upon performance was first measured in 20 subjects during a maximal, job-related obstacle course trial and an incremental treadmill test to exhaustion (with and without protective equipment). The fractional contributions of the thermal protective clothing, helmet, breathing apparatus and boots were then separately determined during steady-state walking (4.8 km h(-1), 0% gradient) and bench stepping (20 cm at 40 steps min(-1)). The protective equipment reduced exercise tolerance by 56% on a treadmill, with the ambulatory oxygen consumption reserve (peak minus steady-state walking) being 31% lower. For the obstacle course, performance declined by 27%. Under steady-state conditions, the footwear exerted the greatest relative metabolic impact during walking and bench stepping, being 8.7 and 6.4 times greater per unit mass than the breathing apparatus. Indeed, the relative influence of the clothing on oxygen cost was at least three times that of the breathing apparatus. Therefore, the most efficient way to reduce the physiological burden of firefighters' protective equipment, and thereby increase safety, would be to reduce the mass of the boots and thermal protective clothing.